How much should you hold your pelvic floor muscles?

How much should you hold your pelvic floor muscles during the day?

How much should you hold your pelvic floor muscles during everyday activitites?

Are you supposed to think about them?

Or should you just let them do their own thing?

First it depends if you are a naturally tense or relaxed person? Then to consider whether they have fully recovered after childbirth? They should work on ‘automatic pilot’ going up and down through a variety of gears. But you might need to re-train that skill.

MIght your pelvic floor muscles be just wafting about?

Do your pelvic floor and tummy abdominal muscles support your internal organs and your back as you go about your day?  Or might they have a tendency to droop when you aren’t paying them attention?  Might you have a pelvic floor with a tendency to “waft about”??

Its probably the most common thing I point out to mums in clinic. Even if you have been religious about using Squeezy App and doing your daily pelvic floor targeted exercises. You may have one more step to go. Making sure that your pelvic floor joins in more when you do more and knows how to relax when you relax.

Should you hold your pelvic floor muscles up ALL DAY ?!?!

Yes…. and ….No.    Just like your abdominals and all the other muscles of your body your pelvic floor is not a  one gear, one trick pony. 

We have moved on from the concept of “on” or “off”. 

We realise now that your brain needs to decide at any given moment how much muscle activity is “enough” for the task you want to do. A well trained and exercised pelvic floor can automatically choose to be completely relaxed, fully sharp and contracted, with plenty of medium level options in between.

What is Your Resting Tone?

This is the amount of activity your muscles have at rest.  Where they sit naturally when you are not thinking about them. 

Untrained muscles, or muscles after childbirth or an episode of injury, can have terribly low resting tone.   

leopard too little pelvic floor muscle activity

To be fair – I think this mama is asleep – but how many of us look like this when sat on the sofa (#GBBO)??

Too Little Tone: 

…leaves us “hanging” off our ligaments with a tendency to overstretch joints and muscles into saggy patterns. This has obvious cosmetic fallout.  Also you will have difficult stabilising movement (getting weird joint clicks and clunks), or be vulnerable to injury. Untoned muscles are responsible for issues like incontinence, bladder urgency, difficulty emptying bowels and pelvic organ prolapse.

squirrel too much pelvic floor muscle activity

Or do you relate more to this Mum – fired up & alert, all the time ??

Too High Tone:

…has you perched on the edge of your seat, tense glutes, shoulders up, neck muscles tight like guitar strings – leading to neck pain, shoulder aches and pelvic pain.  Sometimes also responsibe for incontinence, urgency and difficulty emptying bowels too.  I know seems weird!  But too MUCH pelvic floor tone can be a problem as well as too little!

Video: grading pelvic floor control in standing, carrying, reaching and JUMPING!

Today’s video was made last year, in collaboration with Tena.  This is part of a series teaching pelvic floor from basics to more advanced. A Pelvic Floor Exercises 101!

Find the whole Pelvic Floor 101 sequence here.

In this video, experiment with me and the lovely models as we explore finding our pelvic floors and controlling how much they work –  even as we move handweights and try a bit of stretching & leaping too.  It takes practice to improve your “automatic pilot” function for every day life. 

https://youtu.be/kPdIILv_7fg

So Mama’s. Pelvic Floor Muscles for Real Life.  No pelvic floors just wafting about! Practice standing up. Add some hand weights. Stretching.

And if you want to get back to running or that trampoline you gotta practice JUMPING too!!

Author: Amanda Savage, MCSP MSt (Cantab). Specialist Pelvic, Obstetric & Gynaecological Physiotherapist

© Amanda Savage, All Rights Reserved, 2021

Content Disclaimer:

The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents if you are not a face to face client of mine. Professional advice should be obtained before taking, or refraining from taking, any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article or video.

Why Pelvic Floor Stretches Help Most Mums & How to Do Them

Bladder or Bowel issues after your baby?

Why stretching around the pelvis could help the pelvic floor work better….

Pelvic floor STRETCHES? Are you puzzled?  Were you thinking that my advice would be to work on tightening up and strengthening your pelvic floor?

Did you know that taking time to stretch and align the muscles all around the pelvis might help the pelvic floor work better? YES!  Just once a day for about 6 minutes can make Mums so much more comfortable – and find their pelvic floor muscles really perk up. FAST.   It’s not crazy.    If your pelvis is wonky or your back is stiff – just tightening up the pelvic floor muscles won’t improve bladder control.   Because the muscles can’t work properly together if they are at funny angles!

Today we are exploring  WHO might need to do that (and WHY)  and HOW to do the right stretches really well (and quickly).

VIDEO: Pelvic Stretches for Mums

Why we need to do pelvic floor stretches before we strengthen

The muscles must work together to control and move the pelvis.

You could picture your pelvis muscles working together just like the guy-ropes on a tent.  If there is a good balance through every part of the rope network the tent sits upright, symmetrical, self-supporting  – it holds strong but can sway in the wind as needed, able to adjust to change in the environment with ease.   You can easily open the door and push your way in with no effort or move bags of kit back out.  The tent has full height, the groundsheet is stretched perfectly corner to corner without wrinkles or twists.

Magic, when all is well…

In a similar way when the muscles around the pelvis have good length to allow the pelvic bones to sit symmetrically, at the right angles, you can sit comfortably on a chair, or move efficiently transferring your weight seamlessly and effortlessly from one leg to the other as you walk or climb stairs. Your back feels comfortable, hamstrings don’t get injured, bowels empty easily, bladders fill and empty without trouble, pelvic organs stay securely inside, sex is comfortable.

But problematic if out of kilter

However, there are problems if one or more guy-ropes is overtightened..

Changing the tension in some of the guy-ropes on one side of the tent will cause distortions to the tent  not only on the side of the ropes that have been tightened but also on the opposite and/or diagonally opposite side. In the video (above) see how this distorts my ability to whistle – even though there is nothing wrong at all with my mouth muscles?

Symptoms can seem logical: soreness right where the scar is making sex painful or tampons uncomfortable, or making wearing tight clothing irritating. Or more distant issues can develop like sciatica, persistant pelvic girdle pain, bladder irritability or constipation.

Are you out of kilter? A hidden consequence of childbirth?

  • Did you have a difficult pregnancy with pelvic girdle pain or back pain, or just a very heavy baby (!).  Were you limping around a bit towards the end? 
  • Did you have to work your pelvic support muscles very hard during your labour?  Lots of squatting, using your legs to support you? Or maybe your legs had to be up and held at a funny angle for a while? That would be something that would make your inside thigh and abdominal muscles work very hard.
  • And of course the common scenario that causes this type of guy-rope problem is an episiotomy or perineal tear during childbirth.  The scar that forms can be more rigid than the original tissue – creating a pucker or pull on one side of the pelvic floor. 
  • If after your baby you were really sore you might have found yourself sitting sideways in your chair, or sitting awkwardly on the edge?  Or you might have limped around trying to stop everything hurting? Unfortunately, very quickly it can become a habit to have tension in the pelvis.

So tbh there are not many mums who wouldn’t benefit from doing some pelvic floor stretching!

Quick Guide: Technique

Which style of stretches & when?

Use static stretches (the ones you ‘hold’ for 10-30s).  No bouncing!

Start with once a day to learn and enjoy the stretches.  Then you are looking for 2-3 opportunities through your day to stop and deliberately release tension and stretch the different muscle groups.  Pick stretches to suit the environment you are in.  Once your problem has settled then drop to a once a day holistic sequence to keep the muscles stretched for ever.

They are best done when the muscles and soft tissues are a warmer temperature:

  • when you get back from a trip to the park,
  • after an exercise class, or dance-a-long with the kids
  • warmed up by a bath or shower,
  • after a TV snuggle under a blanket before climbing into bed….

How many & how long?

  • Hold each position for a comfortable stretch for 30 seconds, repeated 3 times.
  • Research shows that you do not achieve anything extra by doing more reps or increasing the time.
  • If you have a lot of pain start with fewer shorter stretches eg 2 repetitions of 15 seconds each.

Quick Guide: 3 Favorite Pelvic Floor Stretches for Pelvic Flexibility

#1 Hip Flexion with opposite leg extension

Hip flexion:  gently draw one knee to your chest then let the other leg slide out straight.  30 seconds letting gravity do the stretching work.  3 x each side.

#2 Butterfly Stretch

Adductors: 20-30 seconds gently easing out the inner thighs with gravity. 3 x

#3 Happy Baby Stretch

upper hamstrings: ease the “sit bones” wider. 20-30 seconds. 3 x

Let me know if this helps you?

Try the three stretches (or 15 mins guided video sequence) every day for a week and see what you notice changing? Improved posture, easier squatting to the floor, better bowel opening, more pelvic floor awareness? Do let me know?

electrical stimulation programme for new mums

Which is the best electrical stimulation programme for new mums?

Which is the best electrical stimulation programme for new mums wanting to rehab their pelvic floor muscles? This is one of the topics Kegel8 founder, Stephanie Taylor, asked me about in some video Q & A sessions about the Kegel8 Ultra 20 machine. She is passionate about helping their customers get value and success from a purchase.

In this video:

  • What to do to help your muscles from the very early days before you can use an electrical stimulation machine.
  • When you can start using a electrical stimulation machine safely after birth
  • Why it is important to test the sensation in the nerves, have a longer rest time between contractions and how to avoid muscle fatigue.

Watch here (or read the adapted transcript below). In this video we are discussing the electrical stimulation programmes for new mums on a machine called a Kegel8 Ultra 20 V2 Electronic Pelvic Floor Toner. Other models in the Kegel8 range are very similar. The principles are the same for all electrical stimulation machines. Even if you don’t have a Kegel8 you might find this helpful to understand how your own-brand of machine works too.

https://youtu.be/EHrAtWd0Z0U

Q: Stephanie asked me: “We’ve got lots of programmes on the Kegel8. I’m a new mum.  Which programme is going to be best for me – if I’m looking to get back in shape – what’s your recommendation?”

The first few weeks: simply connect your brain and pelvic floor naturally

Let’s start by thinking about a very new mum.  You’ve had a baby and you are starting out with your exercising.  In the first 12 weeks the body is very fragile and very vulnerable.  We do want you to start exercising but we don’t encourage the use of electrical equipment in this early phase.  Why? Partly because you will still have some bleeding, you might also have some hidden raw wounds but also because it is a fragile vulnerable time. 

What you do need to be doing in those early days is using your muscles as best as you can. Using your own brain to to activate them.  Even if all you are doing is pulsing your muscles a tiny bit and you think “Is it worth it?”. It IS.  Because that pulsing action will bring blood flow close to the area. Blood flow helps healing.  And helps to get healthy tissues again.  In your head it will feel like little tiny pulses, not very exciting. Everything might feel swollen and engorged. But those tiny exercises are a really important thing to do. Little and often through the day. To keep your brain and your pelvic floor connected together and encourage these muscles to start working again.

From 6-8 weeks: feeling proper contractions

About 4-6 weeks you should be feeling that you have some proper pelvic floor contractions. They should feel useful to you. For example, when you want to cough and sneeze and pick up your baby.  It’s all a bit mad that nature delivers through the muscles that you need and then hands you a heavy baby to look after. Not quite how you or I would have designed it.  But that is the reality.  So we’ve got to get these muscles working.

From 12 weeks: why you might choose to use an electrical stimulation programme?

After 12 weeks there are other options to consider.

  • If you are not getting enough sense of being able to exercise your muscles yourself
  • Or you don’t feel that you are getting a pelvic floor muscle contraction.
  • Or you don’t feel that you are progressing.

Then you might like to use a machine to help you.

What is special about the electrical stimulation programmes for new mums?

Some programmes on the Kegel8 V2 Ultra 20 are designed specially for postnatal mums. For example programmes 14 & 15. What makes them different?

A sensory phase

The first phase of these programmes is actually a circulation phase, a very low frequency current, to create just a tingling sensation for about 10-15 mins.  This allows you to test whether you can actually feel anything.  A problem that can affect new mums is finding that the nerves aren’t working properly at all and you can’t feel things properly.  It wouldn’t be safe to use a machine if you couldn’t feel properly as you would have no way of knowing how high to turn it up which could be sore.  So the first phase allows you to test for what you can feel. This phase is also really good for circulation. It brings blood flow to the area and oxygen to the tissues. 

A muscle strengthening phase

Later in the programme it moves to a muscle strengthening phase. It actually makes the muscles tighten and release.  But different to the one that is listed for stress incontinence, this phase has a longer rest time between the contractions.  When we make muscles contract they do need to be able to relax completely between contractions before we ask them to contract again. 

A longer rest time

When your muscles are very weak it is important to have almost twice as long resting to working.  As you get stronger you can choose a programme where there are shorter rest times but when you are very new post delivery it is really important to have a rest phase. 

An overall shorter programme

The overall working in this programme is 15-20 mins maximum, because your muscles will fatigue easily. Tired muscles can’t do anything. Yet you’ve got to look after the baby! So it’s really important that the machine doesn’t made you so tired that you can’t look after your baby and hold your body up!

So that is the idea behind this programme being called a postnatal programme

Q: How often would you recommend using an electrical stimulation programme for new mums?

The manufacturers say that you can use these devices up to twice a day every day.  I think a lot of women feel that is an unrealistic goal.  We tend to start women out in clinic using their device once every other day.  As a starting place.  You don’t want to put yourself off.  These are plastic gadgets in in very delicate places!  If you do too much too quick you end up not wanting to do anything. 

So I tend to aim to underachieve at first. Use it for 20 minutes every other day. Then if that is going well, and you are liking it and you feel it is beneficial, you could go to every day.  And if you were blessed with time to do twice a day that would be a bonus. I am not sure that is very many mums?!  We find people get good results on every other day or once every day.

Feeling more confident how to choose an electrical stimulation programme as a new mum?

I hope this post has given you more confidence to get started with a Kegel8 Ultra 20 stimulation machine or something similar? We have made several other videos about using stimulation machines. For other conditions, for example for a prolapse, for an overactive bladder or for stress incontinence. We also do a Q&A to show the different types of probes available.

Another series is all about the pelvic floor and how to do exercises without a machine too!

Please don’t hesitate to email if you have questions and I will do my best to help. Please do comment below or on YouTube if you found these helpful.

You must not rely on any information or guidance we provide you with as an alternative to medical advice from your doctor or healthcare provide and we expressly disclaim all responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered by you or any third party as a result of your reliance on any information or guidance we provide you with.

If you have any specific questions or concerns about any medical matter, you should consult your doctor or healthcare provider as soon as possible.

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your healthcare provider. Do not delay seeking medical advice, disregard medical advice or discontinue medical treatment because of information or guidance we provide you with.

Nothing in this disclaimer will limit or exclude any liability that may not be limited or excluded by applicable law. 

Field Guide: incontinence pads and pants and knickers

Field Guide: incontinence pads and pants

Trying to stay dry with bladder leakage? Not sure what will work best for you – incontinence pads or pants?  Overwhelmed by the choices in the shops and online? This detailed post & video discusses all the options and explains the difference between them. Don’t waste money buying the wrong thing. Tips and tricks to feel safe and dry without irritating your skin.

This is a practial, unbiased, useful overview of incontinence protection products, to help you decide what might suit you best. 

https://youtu.be/PjoAj9xNHxs

Even a few drips or spurts when you cough or sneeze (stress incontinence) can quickly make your knickers feel wet and uncomfortable. It’s natural to worry that it has gone through onto your clothes and be anxious that everyone can see what has happened.  Irritable bladders can catch you short before you make it to the toilet, or even unexpectedly empty without much warning (urge incontinence). Those leaks can be very big. 

 Fear makes you avoid doing things.  Feeling anxious takes the edge off life and motherhood.  Let’s start by making you feel safe.  #No More Miserable Mums.

full disclosure: this article contains some affiliate links marked*. As an amazon associate I earn from qualifying purchases. If you make a purchase by clicking through from an affiliate link I receive a small commission  at no further cost to you. Thank you, this helps to support this blog.

#1.  Disposable incontinence pads

Sanitary pads and incontinence pads are not made of the same thing.  It is important to use a pad designed for bladder leakage not menstruation.

The products designed to be used for menstruation are great for that purpose. However, they do not to cope well with liquid.  This is because they are predominantly cottonwool based. So if they get wet, they just go soggy and misshapen. If you are moving about they can get scrunched up, rub,  and leave your skin in contact with urine causing chafing and soreness.

The right pads for the task are worth the little bit of extra cost.   With the advent of new technology you will be amazed how slim a proper bladder leakage pad can be to hold a large amount of liquid, keep damp away from your skin and control smell.  

WHAT TO LOOK FOR IN THE SHOPS (or online )

Products for incontinence are usually in the same ‘feminine hygiene’ aisle (or website section of an online store) separated into one column of shelves for products for periods and one for bladder leakage.

Most brands will send you free samples from their websites.  Collect them up and see which suit you best!

disposable incontinence pads

Some of the main UK brands are Tena, Always, Attends, Poise, as well as supermarket own-brands and Boots’ StayDry range

How much urine leakage do incontinence pads hold?

The most common indicator of absorbency is a row of filled ‘drip’ or circle symbols to indicate the level of leakage they will contain.

In general, pads for ‘lighter’ bladder leakage look and feel like pantyliners. They come in boxes to keep them flat and compact.   This makes a good starting point if you are looking for something to keep you confident and safe against a small leak (up to 6 teaspoons = 30ml). These would work for or a few drips or spurts if you move awkwardly, or cough unexpectedly with a full bladder.  

If you suffer with more severe leakage, you will be worrying about getting wet clothes. Look at the pads in bags which will be more absorbent or disposable absorbent pants (see below).

A bad cough, hayfever, trying anything bouncy for a prolonged period could leak a small yogurt pot worth (= 100ml). Of if you have an irritable bladder (officially called overactive bladder) which can trigger a sudden urge and empty at the front door, or if you wait too long, you have the risk of potentially emptying most or all of your bladder (which could be 200ml – 400ml),

If you are getting wet when you do sport or play with your kids your priority should be to solve the bladder problem further.  Talk to your physio about organising a full assessment. 

TOP TIPS for using pads

  • Shape them – to create a gully (see video)
  • Put them a bit further forward in your knickers, as the bladder tube (urethra) is just below your pubic bone
  • Change them regularly to avoid irritating your skin
  • Wear knickers that hold them snug

#2   MODERN DISPOSABLE PANTS

If you need complete confidence that no matter which way you bend, stretch, move or lie you will have full protection in all directions these are better than a substantial pad that only protects the gusset.   

  • ideal for night time leakage
  • exercise classes with lots of matwork or changes of position
  • crazy play with the kids
  • a bladder that struggles to make it to the toilet first thing in the morning
  • long car journeys or travel when toilets and timing are so uncertain.

The modern absorbent waterproof disposable knicker is technically sophisticated.  Still a way to go on style (they are trying).  Unfortunately, thye need to be big to be absorbent and need a deep waistband to hold them snug & safe. Available in standard white, cream and black.  Some with dodgy flowers.

I don’t believe these could ever feel “normal” (as marketed). However, they do give mums freedom to move without worrying. Put a big pair of “PE” pants (aka Bridget Jones) over the top to make them a tad more “out of sight out of mind” (- and organise a physio appointment to solve this problem).

If you are often using disposable incontinence pads or pants definitely look at the next option, washable knickers.  You will be amazed to see that you can get the same absorbency in a much more “normal” looking knicker.  Worth the upfront costs and kinder to your skin as well as the environment.

#3  WASHABLE KNICKERS WITH INBUILT PROTECTION

We are so lucky to be in the era of textile research and design. I am delighted to see this being applied to continence underwear. 

Advantages:  

  • good for the environment. 
  • great if you are usually fine but like to know you have back up. 
  • more discreet if you need a thicker pad. 
  • look much more like real knickers.
  • most are machine washable
  • available in a range of colours and styles
  • Natural products and airflow around your vulva, less irritation

Disadvantages:

  • once you are wet you need to change the whole knicker
  • some are not machine washable

Brands: washable incontinence knickers UK

Brand will hold same as… Laundry
ProTech Dry High Waist Briefs
(also called Maxi Pant)
30-60ml 2-3 tablespoons Up to 60 degrees
Speax. Hi-Waist, Hiphugger,
French Cut, Bikini
40ml 8 tsps Cold wash, tumble or line dry
Speax Thong 15ml 3 tsps Cold wash
Love Luna (Sainsburys),
Lady Leaks No VPL, Lady Leaks Maternity Knickers, Lady Leaks Midi Knickers
30ml 6 tsps cold machine wash, do not tumble
GiggleKnickers 30ml 6 tsps 40 degree, tumble or line dry
Hush Hush
Seamless Panty or Lace waist panty
100ml small yogurt pot  
Wearever Underwear
regular absrobancy
Maximum absorbancy
175ml
650ml
half a cup or a full bladder machine wash warm, tumble dry (cotton style only)
Pro-tech black knickers absorbent for incontinence

PROTECH DRY High Waist Brief (also called Maxi Pant)

made from sturdy cotton, 3 layer mesh-style gusset, surprisingly flat: an absorbant layer (40ml = 8 tsps), odour retention layer & wick away surface, smoothly sealed seams.

www.stressnomore.co.uk

* use SUPPORTEDMUMS at checkout for a 15% discount

Speax washable incontinence pants

SPEAX

From the manufacturers of Thinx period pants. Five different styles: from Hip Hugger, through classic bikini to thong.  Varying prices depending on style £16 – £24 . 

The main knicker is a quality silky material (not cotton), gusset is subtle. Fun colours!

Speax incontinence pads are silky & colourful

NB: they  are  cold wash only (no bleach or fabric softener) with low tumble dry which you might miss in the instructions (and then be very cross about!).  Answers to other FAQs here:

shethinx.com

Giggle Knickers cotton washable incontinence pants

Giggle Knickers

A fresh feeling, environmentally aware, small company with a quality range of machine washable cotton pants designed to replace a liner.

Brief or high waisted £12.99-£14.99

www.giggleknickers.co.uk

GK are zero rated for VAT as long as you are an individual and you don’t buy more than 9 at a time. Compostable mailing bags.

Love Luna (Sainsburys)

Good budget choice. Silky material 91% nylon, gusset is 100% polyester with cotton padding, quite a wide stiff gusset, so a little more ‘aware’ that you are wearing them, than more expensive brands.

3 styles: full knickers, no VPL workout knickers, maternity knickers

£12 per pair.

www.tuclothing.sainsburys.co.uk

Wearever washable incontinence pants knickers

Wearever

A ‘sturdier’ look but this range can cope with more leakage than the more fashion based ranges. Variety of styles, colours and absorbancies (regular or maximum).

pair shown here are silky panel at front with lace panel at back

available from iMedicare at www.mypelvichealth.co.uk

You are eligible for VAT relief on your order if you are an individual purchasing Wearever for the treatment of incontinence.

What will suit you best?

Probably a mixture of different things! Life is sweet with all it’s variety, messy moments, strategic plays and aspirational hopes. No one product will solve a typical situation or day. Be open minded, treat yourself. Mums matter.

And don’t forget – you can CURE this!

80% of women can improve or completely cure their incontinence through the simplest strategy of sticking to a 3 month programme of pelvic floor exercises. Best success comes from a 1:1 assessment of your situation and a bit of supervision by a specialist physiotherapist. You can self refer to an NHS physio or many private clinics all over the UK.

Look after yourself, share your troubles with a friend, encourage other women to seek help. #No More Miserable Mums

Please let us know which products you like best in the comments below or join our conversations @propelvic. Have you changed your life through the right knickers or exercises?

Content Disclaimer:

The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents of if you are not a face to face client of mine. Professional and/or medical advice should be obtained before taking or refraining from taking any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article, blog or video.

EVB capris may help support your pelvic floor when running

EVB Sports Shorts: an active mum’s best friend?

Is running making you feel leaky, heavy or vulnerable? EVB Sports Shorts could be your new BF.

What are EVB Sports Shorts?

EVBs (as they are affectionately called) are sports kit – shorts, capris or leggings. Specially designed for women who feel vulnerable when they run or take part in higher impact activities.  Women’s health physiotherapists recommend them for those who need to find discreet ways to manage a bladder or prolapse problem. They add an extra layer of support to your body from the outside. Special panels lift and protect your bladder and pelvic organs.

Affiliate + Discount code: this post is not sponsored but I received a free pair of shorts to trial. If you find this article helpful and decide that you would like to buy a pair, UK supplier Win-Health offer 5% discount to readers using my affliliate code Amanda Savage on a telephone order: 01835 864866 or Free call 08081685522.

Would you benefit?

Do you find your bladder leaks a few kms in? Or get a feeling that your entire lower half moves about too much as you pick up your pace?  Or that you beloved run is counterproductive at the moment – straining and fatiguing your core muscles? Do you finish feeling leaky, achey and with vaginal or anal heaviness, spoiling the rest of your day?

Sound familiar? These EVB specialised sports shorts/leggings have helped mums with these symptoms.

EVB sports shorts in 4 styles

How do they work? More support everywhere that matters…

EVB Sports Shorts are made of a specialist high quality stretch material. This is designed to create more lift and support for the perineum and abdominal wall.  They aim to BE your essential support muscles while you work on recovering yours (with your pelvic floor exercises).https://supportedmums.com/pelvic-floor-school/

They are not just guess work or cosmetic.  Their inventor, Yvonne Brady, is a chartered engineer (as well as mum of 3 and regular marathon runner).  Her company have invested over a million in R & D, including projects with physios, to design-in specialised support panels. These are in the gusset, to support the pelvic floor and in the front panel to support the abdominal wall.

If your bladder leaks when you run EVB shorts give extra support to your abdominals and pelvic floor

 Ultrasound studies have shown they mimic the role of the pelvic floor muscles. They lift the bladder neck and prevent the anterior vaginal wall from moving down.  Also it may be that better positioned muscles and tissues will themselves function better. Or the better positioning will train them to do what they should be doing when you run.

Reality Check – I tried them out..

I had seen and heard physios rave about these. But I like to try things out for myself before highlighting them here.  I asked Yvonne to send me a pair to try and to show my mums in clinic.    

Sizing – do it properly – no guessing

You size yourself by measuring your waist and hip size.  NB: Not guessing!! It’s really important that you have the right size for NOW. Not who you would like to be! They need to be really tight to work well. However, if they are too tight they will they be horribly uncomfortable. And I worry that you would risk the waist band pushing down into your tummy.  There is a useful video guide to sizing on their website

Styles:

The shorts, capris and leggings are intended as outerwear (knickers on underneath) – available in black

The “Boxer Brief” is available black or nude to wear underneath other clothing.

Getting them on:

They come beautifully packaged with clear instructions.

They warn that fitting into them first time can take a few minutes due to the technology they supply.  Everything reassures you that you can pull them hard. “they will not rip”, it says, but I had to read that twice to have confidence!  It really is a wiggle process to get them over your hips and pulled right up to give gusset support. Once you get there (!) they do fit like a second skin (with benefits) and were entirely comfortable.  

Initially I wasn’t sure about the “look” for going out out. I am not normally a tight tight shorts person and a more fairweather jogger. But you will see on the website pictures & happy testimonials of proper mum runners! They are meant to be worn as your outerwear, shorts or capri style, with normal underwear underneath.  However, the bottom-conscious could easily fit another pair of leggings/looser clothes over the top.

Returns & Exchanges

Yvonne is passionate about her EVBs and wants women to feel confident to make an investment in themselves.  UK supplier Win-Health customer support is quick and responsive with generous & fair exchange & returns policies.

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I firmly believe that self-care is not self-indulgence. Looking after our bodies after birth is essential. Exercise is fundamental to both physical & mental wellbeing. Fit mums enrich their own and their kids’ lives.

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The information contained above is provided for information purposes only. The contents of my blogposts, articles and my videos are not intended to amount to advice and you should not rely on any of the contents of if you are not a face to face client of mine. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this article. Amanda Savage disclaims all liability and responsibility arising from any reliance placed on any of the contents of this article, blog or video.

trampolining to illustrate the Knack

The Knack: No 1 pelvic floor trick for mums

What is “The Knack”

Need a Quick Win with improving your bladder leakage?

The Knack is the magical art of drawing up your pelvic floor muscles just before you cough, sneeze, laugh or pick up something heavy.  Research has confirmed it works to stop urine leakage *

So simple – yet not everyone knows about it

There can be Quick Wins with pelvic floor exercises.  I still clearly remember  when I helped a client stop leaking in just one week by teaching her the Knack – and she was FURIOUS to have waited that long!  Sarah came to physio with the problem of urinary stress incontinence, leaking urine when she coughed and sneezed. It had been happening since her second son was born……….17 years before.

She had diligently practiced pelvic floor muscle exercises as everyone had told her to. When we checked them, properly, with a vaginal examination, her muscles were firm, with an excellent strong contraction.  But, no one had ever explained the connection between practising strong muscle squeezes and WHEN TO USE THE SKILL IN REAL LIFE

I taught her about the Knack.  The next time she came back she was CROSS!  It worked – no leaks when she coughed – and quite rightly she was angry that no one had taught her something so easy, so simple and so effective sooner. It was humbling. 

And my priority ever since to make sure I spread the word about this technique.  I don’t want today’s new mums to wait even 17 hours to figure this one out.

Your pelvic floor is like a trampette

You probably didn’t have to do this pre-contraction of the pelvic floor before you were pregnant, because a pre-pregnancy pelvic floor has a lot of the Knack: your healthy pelvic floor bounces pressure away like a new trampette natural tone and tension in it.  Like a trampette, straight out of the box from Argos, you can bounce up and down on it and your body weight barely makes a dent in the springy surface. 

Pre-pregnancy, most of the down pressure when you cough or jump is deflected straight back up towards your head by the pelvic floor muscles.  Your bladder barely feels a bump.

However, you don’t need me to tell you that pregnancy and delivery have a notable affect on our soft tissues. 

The abdominal wall is a clear indicator of what happens when you stretch  elastic slowly and steadily for 9 months!

 Some are more lucky than others in the natural ‘spring back’ department.  Most women know that they are going to have to work the Knack: after a pregnancy the pelvic floor is stretched like a used trampetteto restore abdominal muscle tone and strength.   The pelvic floor has carried the same baby-burden and if you had a vaginal delivery (or pushed a long time before eventually needing a caesarean) there will have also been some micro tears to the muscle fibres and their connective tissue attachments. 

Now, at least temporarily, the pelvic floor behaves like the well-used trampette – a sense that if you jump too hard your feet might touch the floor!

The Knack creates supportive tension

the knack: what your friends and your pelvic floor are forIf you tighten your pelvic floor muscles, in the exact moment before you cough, it is like two friends pulling your trampette tight for you just for that moment that you want to jump. 

Yes, I admit its not ‘natural’, it’s not ideal, it requires thinking, you didn’t have to do it before……but it can make the difference between a bladder leak or not. 

Practice makes perfect

Practice  the Knack with a ‘pretend’ cough after you have had a wee. Your bladder is empty so you are unlikely to come unstuck.

Then, challenge the system, gently.  Hold your pelvic floor muscles firmly – cough lightly.  After a few days of practice, when that is feeling safe and secure, challenge the skill by coughing a bit harder.  Then increase your confidence by allowing an hour to pass so that your bladder is fuller when you cough (but start with the lighter coughs again!). 

With practice you will train a “learned-reflex”, a habit.  Your brain gets so used to the sequence of prepare, protect, cough that you do it on auto-pilot.

Sneezes are harder (and coughing fits, choking, vomiting….)

Sneezes are harder to resist with your pelvic floor than coughs, because you have less warning that they are coming and generally they create more downward abdominal pressure. Especially if you are one of those people who make everyone in the room jump out of their skin when you sneeze or are prone to 6 in a row?   A hacking cough with a head cold, or an allergy induced coughing fit are jolly tricky too. 

Work on getting the anticipated, lighter coughs sorted first and then the rest can follow as your muscles strengthen.

Allow yourself some slack

Beware multi-tasking – I remember having a full bladder, baby in one hand, the folded Maclaren in the other, one foot on the escalator, and I sneezed – NOPE – the Knack did not work!!!  But hey, I could live with that – it seemed fair – it was a lot to ask of my pelvic floor system. 

If you can successfully use the Knack 9/10 times and only the occasional leak gets through that is excellent. 

Know when to ask for help

The Knack alone might not be enough for you.   Your pelvic floor muscles can be so weak that you need help to get them working again.  And it is possible to have muscles that have repaired too tight or are constantly overworking and becoming easily fatigued or sore.   

Remember there are specialist physiotherapists attached to every UK maternity department who can give you an individual assessment, training and support.   Don’t hesitate to ask your GP to refer you to a specialist physiotherapist  

Does the Knack work for you? Any questions?  Please do ask, I am very happy to help.

*  Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.   Miller, J.M., Sampselle, C., Ashton-Miller, J. et al. Int Urogynecol J (2008) 19: 773. doi:10.1007/s00192-007-0525-3).

Drawings copyright of A M Savage  (Proudly using stickmen since 1991)

how to improve pelvic floor control by simply breathing

How to improve pelvic floor control by simply breathing

Do you wonder what BREATHING has to do with bladder control, prolapse support or vaginal or anal pain?

Physios are not going woo-woo

It’s rather because clinical research & our understanding of the body has deepened, so pelvic floor exercises exercises are evolving. It’s no longer one size fits all.

There’s a good place for the traditional squeezes, lifts and holds, but some mums need to focus their attention more on the “let go”, relaxing and releasing of their muscles.

Pelvic floor relaxation is a thing

Previously exercises were very linear.  Squeeze ON, release/turn off.  Our focus was on what our muscles needed to be able to DO in an emergency situation – when we cough, sneeze, pick up something heavy.  This is not wrong.  If you struggle with stress incontinence (leaks when there is high pressure on the bladder) then the best thing you can learn is The Knack of getting the pelvic floor to co-ordinate with perfect timing.  

However, we now know how our muscles should be doing when we are not thinking about them.  The resting pattern of your muscles has an impact on common problems like urgency, bladder frequency, vaginal heaviness and pelvic pain. 

#1 New thing we know

Firstly, our breathing pattern and our pelvic floor muscle movement pattern are similar and interconnected.   Breathing is easier to understand, feel and control than the hidden away pelvic floor.  So if you want to better connect to your pelvic floor – start by noticing how you breathe.

#2 Weird thing to notice

However, most of the day we don’t think about our breathing AT ALL.  You wouldn’t have been thinking about yours a few minutes ago until I brought the topic up.  Your brain operates your breathing system all day, all night, 24/7 without any conscious input from you.  A gentle in and out, muscles contracting and releasing, a continuum of movement like a swinging pendulum, you are only completely full of air or completely released for a moment in time.

#3 Amazing thing we can do

Yet, you can also have incredible control over this system.  For example, you could take a deep breath right now to blow out an imaginary candle; you could whistle a little tune;  you could shout (or yodel) or pant like a dog.  With training, you could develop sophisticated breath control  as well – as a singer, long distance runner,  athlete, deep sea diver, bird impressionist. Did you know that you need enormous breath control to accurately shoot a pistol or throw a dart?

And then, when you stop panting or wolf-whistling or humming a ditty, your brain just automatically puts you back into gentle breathing mode, no questions asked.  A-MAZ-ING.

a panther demo's pelvic floor relaxation

#4  Pelvic floor muscles should be super-skilled too

We want our pelvic floor muscles to have similar super powers.  When we are NOT thinking about them we want them to gently (gently!) contract and relax, very low key, very little. Just enough to keep blood flowing through them, to nourish their feeder nerves. We want movement to keep the tissues stretchy and flexible. We want to be on standby for whatever we decide to do next. 

Then, when you decide to pick up your toddler or dash up the stairs, we need them to move up a gear or two to help carry that load from below, preventing pelvic organ descent or a sudden urge to wee. 

Similarly, if you want to push shut a heavy door, or hit a tennis serve, or do one of your room shattering sneezes, we want them to go into full tension mode to prevent leaks. And most important of all, if you want to empty your bladder or bowel, or get sexy with your partner you want them to relax and release to allow things out or in.

#5 Best thing to work on

In contrast, if your muscles are always tense they become “crampy” with painful sensations associated with a build up of lactic acid or the soreness to be touched or if stretched. Then if your muscles are always “in gear” you can’t choose to have “more” or “less” for the activity you are doing.

So take moments through the day to tune in to your breathing and from there to your pelvic floor muscles. Find time to reset your background, automatic, movement pattern to line yourself up for a day with super-powers.

Video: How to improve pelvic floor control by simply breathing 

https://youtu.be/k8V5NTkAEmM

 

  • Firstly, tune into your breathing pattern.  Feel your rib cage lift and raise as you breathe in, drop and shrink as you breathe out. Play with it.  Breathe deep, blow out an imaginary candle.  Do this a couple of times.  Then stop.  Can you feel your body revert to your base breathing pattern?
  • Then, notice how your BELLY breathes.  Yes it does!!  Drop your hands to abdomen.  Channel your inner frog.  Notice that your belly mimics your breath.  As you breathe in your belly lifts as you breathe out it falls.
  • Finally, lower your consciousness to your pelvic floor.  It is the lowest moving set of muscles.  Can you feel how these move to, in time with your breathing, ever so gently contracting & letting go. Or gathering & releasing, or lifting & lowering – whichever words work best for you.

Have you improved your pelvic floor skills by practicing breathing? Please let me know if this video and explanation was helpful and how you are getting on?

how to look after an episiotomy or tear

How to look after an episiotomy or tear after delivery

How to look after an episiotomy or tear after delivery

Did you have a vaginal delivery with stitches? If you are not sure how to look after an episiotomy or tear I have links to reliable instructions here. Not sure when you can do pelvic floor exericses (and how?). Wondering when you can massage the scar … and how to do it?

Let me guide you through the different things you need to do at each stage.

What are you dealing with?

Many mums have stitches after they deliver their baby. The area of the vulva where the cut or tear will form a scar as it heals is called the perineum. The perineum is thick tissue between the opening of the vagina and the opening of the anus. An area you normally don’t think about.

This picture from St Georges NHS scar tissue management guide shows the different areas where you might have had a line of stitches

diagram to show where episiotomy scars or tears might be

If you are squeamish it is not always good to look! On the other hand it can be helpful to know where your stitches are. You will feel more confident to avoid disturbing them, as well as caring for them to get the best possible healing.

The reason this area bleeds so much is because it has a great blood supply. This means it heals well too. Your stitches are dissolvable and usually gone by a month. However it is common to wait a full “6 weeks” to be sure that the wounds are fully healed. During these first weeks you want to encourage the healing process, and tissue stretchiness. Balancing being careful not to over exert (which will disrupt the scar as it heals), and avoid an infection in the area.

Nature will heal really well, especially with your help

There are 3 stages to think about to look after an episiotomy or tear, with different priorities to consider and different ways to help at each stage:

Early Days (0-6 weeks)

Initial wound healing and formation of a healed scar

Keep the wound clean & prevent infection

  • prevent infection getting into the area
  • quickly recognise if there is an infection and seek treatment
  • manage the bleeding (lochia) without irritating your skin

Your maternity hospital will usually have given you advice and a booklet or resource. If you didn’t get one, Oxford University NHS Hospital Trust has simple advice on how to keep your stitches clean and cared for: https://www.ouh.nhs.uk/patient-guide/leaflets/files/10929Pperineum.pdf

Leeds NHS Trust made this clear video: Physiotherapist, Jenny Watkins

https://youtu.be/e88EHQwNobY

Follow my RESCue process to reduce pain:

  • reduce the discomfort and pain so that you can enjoy being a mum
  • help haemmorrhoids, brusing and swelling to go down
  • use your pelvic floor exercises to promote blood flow and healing
  • keep pressure off your healing bottom
  • ensure you eat well and stay hydrated to have regular bowel movements. Learn how to sit on the toilet properly!
new mums need first aid

REST – ELEVATION – SOOTHE – CUE the pelvic floor muscles. Read the detail here about how to apply ice, sit comfortably, do the gentlest of pelvic floor, promote best healing.

 

Start Early days exercises to help the scar stretch naturally:

  • introduce Movement to Feel Good
  • prevent your pelvic floor or gluts muscles tightening up in a guarding pattern around the scar
  • encourage the scar to stretch naturally as it heals so that it is comfortable
  • avoid straining and excess pressure on the scar as it heals

This great booklet of specialist physio advice on moving well, emptying your bowels, & very first days exercises is free to download.


explore the Supported Mums YouTube playlist or my Pilates classes on Beam for Early Days exercises which will gently stretch the area, encourage connection to your abdominals & pelvic floor but not over-exert or put pressure on your healing body too early.


Picking up the Pace (6 weeks +)

promote formation of a flexible, comfortable scar.

After 6 weeks the scar should be fully healed, the scab is gone. Now you can look after an episiotomy or tear further by helping the body form flexible, collagen rich scar tissue. This type of tissue will comfortably move with you whatever you want to do! And you will soon be able to forget all about it!

This is when you can start scar massage

  • use scar massage to encourage the formation of a flexible, comfortable, well formed scar. This leaflet from St Georges NHS Trust is a good starting point. For more depth American Physical Therapist Amy Stein adds detail. In the video, below, my colleague, Clare Bourne explains how to massage your scar from 6 weeks.
  • you can use a natural oil like olive, almond or coconut or there are several commercial ones available with blends of essential oils included. Be sure to check for allergies & I would recommend keeping the oil only for this massage of this area.
https://youtu.be/MvDBwvTQlbU
  • return to sex. See our Getting back your Mojo series
  • seek help if you are not happy with the way you are feeling
  • do pelvic floor exercises with the intention of improving your strength, endurance and co-ordination. This will prevent leaks, support your pelvic organs. Vital preparation before you return to your hobbies and sports around 3 months. See our Pelvic Floor School for ways to progress from the basics. Including how to relax the pelvic floor & stretch it out to prevent pain. Join me for Postnatal Pilates online?

Finding your new normal (12 weeks – 12 years!)

Life and your body are not the same after a baby, and may change again with baby number two or three. What is normal? Perhaps don’t focus on getting “back” to normal as life is a forward journey? Where will your body and your family take you next?

In this phase be sure to sort out any niggly problems

  • check in on your scar 1-2 x month to make sure it is happy and to maintain it’s stretchiness
  • if you didn’t start scar massage earlier definitely give the scar some love and attention now
  • Persistent pain needs assessing further. Definitely seek help from a specialist physiotherapist. If the scar is painful or tugging as you move or during sex. Or you suspect it might be causing a problem like back pain, difficulty working your abdominals or pelvic floor.
  • give your love-life the time and attention it deserves. Check in with these suggestions if sex is painful or feels a bit flat.

If you can’t access a physiotherapist or want to learn more yourself first I highly recommend these books:

Please let me know if this post was helpful. Don’t hesitate to be in touch if you have questions.

how to look after a caesarean scar

How to look after a Caesarean scar

How to look after a Caesarean Scar

Did you have a Caesarean delivery? Wondering how to look after the Caesarean scar? How to massage the caesarean scar?

This post focuses on looking after the Caesarean scar itself. For general advice about how to get comfortable, moving well, when to start abdominal exercises and why you still need to think about your pelvic floor see this other post:

lady doing exercises after a caesarean

Let me guide you through the different things you need to do to look after your Caesarean scar at each stage.

What are you dealing with?

It is easy to take a Caesarean section scar lightly because we can only see the surface of it. Surgery and surgeons are so good at this operation, modern stitches are dissolvable, so that you will likely only see a neat 10-15cm thin line on your skin. This starts raised and red but over a few months settles to eventually be a thin silvery line.

However, underneath the surface several layers of tissues, such as fat & fascia were also cut and stitched. Fortunately, the abdominal muscles themselves are not cut – they can be pushed apart side to side to let the baby through.

Nature will heal really well, especially with your help

There are 3 stages to think about to look after a Caesarean scar with different priorities to consider and different ways for you to help at each stage:

Early Days (0-6 weeks)

Initial wound healing and formation of a healed scar

Keep the wound clean & prevent infection

  • prevent infection getting into the area by keeping the wound clean & dry
  • quickly recognise if there is an infection and seek treatment
  • avoid straining the scar which might cause it to breakdown as it is trying to heal – this is why you need to get lots of help with caring for the baby & housework and stick to the simple exercises, which make you Feel Good but don’t make the abdominal muscles pull on the scar

Your maternity hospital will usually have given you advice and a booklet or resource. If you didn’t get one, this NHS article has simple advice on how to keep your stitches clean and cared for in the first 6 weeks.

Start Early days exercises to help the scar stretch naturally:

  • introduce Movement to Feel Good
  • prevent your body tightening up in a guarding pattern
  • walk daily (start with just 10 mins then build up) to encourage your circulation, improve posture, boost your mood & move naturally
  • encourage the scar to stretch naturally as it heals so that it is comfortable with simple arm & leg movements
  • avoid straining and excess pressure on the belly as the scar heals

This great booklet of specialist physio advice on moving well, emptying your bowels, & very first days exercises is free to download.


explore the Supported Mums 0-6 weeks YouTube playlist or my Pilates classes on Beam for Early Days exercises which will gently stretch the area, encourage connection to your abdominals & pelvic floor but not over-exert or put pressure on your healing body too early.

Picking up the Pace (6 weeks +)

promote formation of a flexible, comfortable scar.

After 6 weeks the scar should be fully healed, the scab is gone. Now you can look after a Caesarean scar further by helping the body form flexible, collagen rich scar tissue. This type of tissue will comfortably move with you whatever you want to do! And you will soon be able to forget all about it!

This is when you can start Caesarean scar massage

  • use scar massage to encourage the formation of a flexible, comfortable, well formed scar. In the video, below, my colleague, Clare Bourne explains how to massage your scar from 6 weeks.
  • you can use a natural oil like olive, almond or coconut or there are several commercial ones available with blends of essential oils included. Be sure to check for allergies & I would recommend keeping the oil only for this massage of this area.

Finding your new normal (12 weeks – 12 years!)

Life and your body are not the same after a baby, and may change again with baby number two or three. What is normal? Perhaps don’t focus on getting “back” to normal as life is a forward journey? Where will your body and your family take you next?

In this phase be sure to sort out any niggly problems

  • check in on your scar 1-2 x month to make sure it is happy and to maintain it’s stretchiness. My colleague Clare Bourne demonstrates in the video below how to do a firmer massage from 12 weeks.
  • if you didn’t start scar massage earlier definitely give the scar some love and attention now

If you can’t access a physiotherapist or want to learn more to help yourself first I highly recommend these books:

Please do let me know if this post is helpful?

cross lady

#3 When postnatal sex is just a bit flat

Getting your Mojo back: #3 When postnatal sex is just a bit flat

What if you are having sex, confident there’s no medical issue, but its just not really ‘doing’ it for you?  I’ve heard mums say postnatal sex is flat,  “a bit boring really”, or  “sore and uncomfortable”, or “not very satisfying”.

I have 3 suggestions to help you shift from here back to a place of “OK! I’m back! & I can get more sexy and heat up a bit from here by myself”

1. Are you flexible enough?

Pelvic Health physiotherapists assess and treat antenatal and postnatal pelvic girdle pain (PGP) and back problems.  You need flexibility in the spine, pelvis, and hips for  comfortable  sex.  I’m convinced that it is no coincidence that the Karma Sutra looks like advanced yoga!

The problem is that you can go stiff in your back and hip joints quietly, with no pain at all, no apparent loss of ability to walk, sit, and carry.  However, we are not at our optimum function anymore.  With our bodies it is easy  not  to notice what you are missing.  Stiffness often doesn’t hurt.

In everyday life, clues that your back/hips might be stiff:

  • you wake in the morning feeling morelike a granny than a gazelle and have to physically ‘get going’ for a few minutes or half an hour before you feel like yourself!
  • after you have been sitting for a while your first few steps are painful or difficult
  • you seem to be living with constant back ache
  • when you try to pick up your pace to run or walk fast or do your sport, you get backache or a proper pain
  • and/or your legs feel really heavy, like you are walking through thick treacle
  • you realise that don’t really properly stand up straight anymore

With sex this manifests as:

  • a sense that you can’t let go and fully relax,
  • you can’t take your partners weight onto you,
  • you can’t get comfortable or
  • your can’t get close enough (which then means you are not getting enough external stimulation of the clitoris, making reaching an orgasm dependent on penetration alone – not enough for most women)

If you think this might be a problem for you try this:

  • spend a week or two focusing on stretches for your lower back, inner thighs & hips
  • if you had PGP during pregnancy and it is still niggling, go back to your physiotherapy team and ask for a postnatal review and assessment of your spine
  • if you think that your delivery might have triggered a back or hip problem ask your GP to refer you for a physiotherapy assessment.   We tend to focus on trauma to perineum (the soft area) but did you have to to get into some awkward positions? Did you have to put your legs into stirrups at some point? Did you struggle to walk properly for a few days? Even with a caesarean there can be hidden trauma, possibly from being unable to feel your lower half properly yet trying to move about, let alone sleeping on a hospital bed for a night or two!

2.  Do your pelvic floor muscles need some attention?

Women don’t have that many nerve endings inside the vagina.  Inside, we feel ‘pressure’ and ‘deep touch’ more than light sensations.  The sexual pleasure we feel comes from the rubbing and build up of friction against the vaginal walls.  The vaginal walls at the base and the sides are layered with the pelvic floor muscles.

Clues that lack of pelvic floor tone might be a problem for you are:

  • it just feels a bit dull and boring inside during sex
  • you want to try to grip your partner but nothing happens
  • you feel there is too much room inside (you might also notice this when using tampons)

If you think WEAK pelvic floor muscles might be a problem for you:

standing pelvic floor exercises
  • make pelvic floor muscle training a focus for few weeks trying to make some impact on your muscle tone. 
  • concentrate on good technique, especially making a difference between tensing AND releasing the muscles.  In the Pelvic Floor School there are some videos showing the muscles on my plastic mode.  Having a good visual picture of where they are really helps if their sensation is not great.
  • You can  download a free pelvic floor muscle exercise booklet here which covers the basics.  If you are ready to move on to challenge the muscles to grow further try My favorite standing Pelvic Floor exercise.  It’s  a great brain/muscle teaser to do little and often through the day and really practical to fit in to a busy life.
  • do ENOUGH exercises to make the muscle change and grow. Try our Pilates for your Pelvic Floor video for inspiration and to keep you focused.  
  • consider using a muscle stimulation or biofeedback device, or vaginal weighted cones to enhance your standard pelvic floor exercises.

If you think TIGHT pelvic floor muscles might be a problem for you: see #2 What to do when sex is painful


3.  Can you tap back into your emotions or do you need some help?

 Be open and honest with your partner, and with yourself.  You may be loving being a mother but have you have lost your love of being a woman and a sexual partner?

If you’ve tried all the obvious things like making time (!), wining and dining each other and your usual pre-baby get in the mood tricks but you know it’s still not working for you – don’t forget that YOU could be the one (of many) experiencing a genuine, real, postnatal depression, anxiety or PTSD (post-traumatic stress disorder).

Childbirth is often considered to be a painful but yet exceptionally happy and wonderful moment of a woman’s life. But postnatal depression is a very real thing and affects too many mums mildly or severely. Isobel Harper, my friend and local Cambridge counsellor, reminded me that any difficult birth, or even a birth that is just not as expected, can leave a woman with a sense of failure. This can show up as not feeling bonded to your baby, but also in other ways such as not enjoying times with friends, losing your sense of self, or lack of libido. She describes 10 overlooked symptoms of depression and more about postnatal PTSD (post-traumatic stress disorder) on her website. 

Isobel recommends seeking help from a therapist with perinatal experience

  • some hospitals have perinatal mental health teams
  • some hospitals have midwives who offer a chance to talk through your birth in more detail. At the Rosie Maternity in Cambridge this service is called “Birth Afterthoughts”
  • Petals is a national charity which supports parents who affected by trauma & loss.
  • The Birth Trauma Association, The MASIC Foundation (supporting mothers with anal sphincter injuries) and Tommy’s are all wonderful charities with extensive information on their websites.

 

Please seek help from your GP or local physiotherapy team.  We are all here to help you.


 Blog Series: Getting your Mojo back:

Please do ask questions or share your story here. Your experience will help others too. #NoMoreMiserableMums