How to find time in a normal day to do pelvic floor exercises?
Everyone knows that pregnant and postnatal mums are supposed to do pelvic floor exercises (also often known as Kegels). How do you fit them into a busy day???
You need an exercise habit
Muscles develop best from being made to perform regularly to build neural connections and to move their function from something you have to conciously ‘think about’ to something you do spontaneously without needing to apply mental effort. Think of something as simple as wearing your seat belt – you learned to put in on initially but now you automatically reach for it and plug it in before you set off – that’s a learned habit. We need the pelvic floor to learn to automatically get involved as a support system when we sneeze, cough, and more importantly lift and carry. Anyone noticed how much lifting and carrying mums do???!!?!
How to build a habit
There are many gurus who write about the power and value of habits and how to form them. Relevant to us with pelvic floor training are:
Find a trigger. A really specific one. Not just ‘today’ or even ‘this morning’ rather ‘when I clearn my teeth’, …… ‘when I am waiting outside pre-school’….. ‘whenever I put pasta on to boil’……’sit down to watch……..’
Be short & specific. If it takes too long your brain will find a way to sabotage your intentions. So though the pelvic floor booklets traditionally suggest you first do the longer holding type pelvic floor squeezes followed by the quick ones – in practice I actually tend to start beginners off with the shorter ‘quick’ squeezes, done on their own as This only takes about 35 seconds (see My favorite Standing Pelvic Floor exercise ever for the detail). Get this habit going first then later once you have a routine established add the longer task of doing the slow holding ones.
repetition…repetition…repetition…… you will probably have heard of the 10,000 hours of practice needed to take you from good to outstanding piano player, tennis player, tiddly wink champion. Fortunately, the pelvic floor doesn’t do that many different things (fast contractions, endurance (slow) holds, and relaxation). You just need to DO them.
Practice Deeply. Researchers into ‘talent’ have identified what makes best practice. One key thing is being mindful and noticing what you are doing. Doing less but with more sincerity and awareness. Try to block out everything (and everyone) when you practice so that you can really tune in and feel what you are doing for better results.
REAL examples: for real busy mums
# 1 Teeth cleaning: Multi-task your morning rituals
Even busy new mothers, who might not have brushed their hair or had a shower, remember to clean their teeth!
First stand still (no actual teeth cleaning yet) and focus on the pelvic floor muscles. These are the soft muscular tissues around the opening of the bladder, bowel and vagina.A pelvic floor squeeze is when you pull up around the back passage (like stopping wind) as well as the vaginal/bladder opening (like stopping a wee). Concentrate on 10 really good strong squeezes of the pelvic floor muscles in a row, focusing on making every squeeze a good one. Remember to RELAX the pelvic floor properly between each contraction. It is possible to overwork the muscles causing tension and tightness in the pelvic floor. Some people experience pain and discomfort during sex because they find it difficult to relax their muscles. Make sure you notice what both a contraction and a relaxation feel like.
Then try to sustain a medium hold of your pelvic floor muscles while you are cleaning your teeth Perfect mum-multitasking!You will find you can only hold the pelvic floor contraction for a few seconds to start but with practice you might manage to clean the whole top row of teeth before you fatigue!
# 2 A private moment (possibly): when you have a wee
Everyone has to wee……eventually. No matter how busy you are. Mostly you are by yourself (even if the door is open). Finish your wee. Clothes up, hands washed etc but just before you are about to return to the fray, STOP, stand still. Do My Favorite Standing Up Pelvic Floor Exercise Ever. 35 secs start to finish. Done. Go. You will forget all about them in between……but then you will have to wee again sometime…..Repeat………see ….roughly every 2-3 hours…..which is 5-6 x a day……..so Getting Them Done.
If you work – make this one a priority on work days. There is a satisfaction in getting paid to do your pelvic floor exercises and one less thing to think about when you get home.
# 3 Tap into tech on your phone
If you are a gadget kind of girl, you might enjoy working with a reminder app on your phone, or a pelvic floor exerciser or tracker device.
The Squeezy app is a simple reminder device with lovely visuals to help you focus when you practice.
You can set the app to remind you at 3 personalised times of day. Think about when that might work best for you? You want the app to send you the reminder text at a time when you WILL be able to follow through. So when does the morning actually, truly get a bit of a lull in it? As you get home from school/pre-school run? Does the baby have a morning nap routine? Then think through the rest of the day for true windows of opportunity. They don’t have to be evenly spaced. You just need 3 times in a day. Lunch time? Just before your partner gets home (or is that max-chaos??!), roughly just before you have supper?
Or follow the Tweets of the hilarious Elaine Miller of GussetGrippers.
# 4 Little Ones TV time. Follow a video yourself.
If you are better with supervision – join me for an exercise session straight from your computer. I will keep reminding you to focus on your pelvic floor throughout! You can follow the “Pilates for your pelvic floor” sequence through online exercise host pactster.com Use the code PhysioPostnatal to access all their videos free for a month (try HIIT workouts from the team at & Breathe Postnatal too) .
Little ones? If they are having their TV time…..good time to have yours. Set up your device nearby and follow a video – you will only need very low sound once you are familiar with the exercises.
# 5 Anytime they are awake.
Yes AWAKE. Not asleep. Truly. My sister (mother of 4) mantra – never do anything when the baby is asleep that you could have done when they were awake. All a baby needs is entertainment. What is more entertaining than you doing pelvic floor exercises!? You can count out loud – that’s educational (in French if you feel the need to be really educational). They could hold the phone (see Squeezy App above) or join in the video (see above). If they enjoy the whole thing they will also remind you to do it again.
# 6 Bath Time: theirs
You have to be there to prevent drowning and flooding but otherwise once they are safe sitting and floating about independently this can be a bit of a dead time for you. There is only so much bathroom cleaning and laundry sorting to be done. Pelvic floor exercises can be done in any position. Standing, sitting on the toilet, kneeling beside them. If you are really tired lying on the bath mat can be nice……..
# 6 Bath Time: Yours
Private, quiet, contemplative. Also a good time for pelvic floor massage if you feel that your muscles can get tight or tense through the day. It is important to relax pelvic floor muscles as an exercise too. This helps to empty the bowel and bladder well and makes sex more comfortable.
# 6 Kids bedtime:
Story time. Hold your pelvic floor muscles and read one page, relax completely and read the next. Repeat for whole book! The challenge is not to hear your voice change, or forget half way through the story. Very good exercise for not holding your breath.
And pelvic floor exercises can be done in the dark…. when you are on ‘corridor watch’ (as we used to call it for our hopper-upper), or up in the night with a teether, or winding after a feed, or kneeling beside their bed patting their back…………….
#7 Your bedtime
Rather like your childhood prayers, the rhythm of pelvic floor contractions might lull you to sleep..zzzz
Or actually 2-3 minutes of pelvic floor squeezes will bring lots of blood flow to the area and might just put you in the mood for something a little more romantic……
Pelvic floor exercises not working for you?
If you feel that you are not making progress with your pelvic floor exercises by yourself, do ask your GP to refer you for a full assessment, examination and guidance with a specialist pelvic floor physiotherapist. She will help you establish whether pelvic floor weakness or tightness is your main concern, as well as explore other factors like pelvic alignment and joint issues which could be making your efforts on your own ineffective. Read more about how to find a specialist physiotherapist on our resources page.
Can I run yet?is a popular request from postnatal mums inphysio clinic. Before you dash out that door, use this postnatal checklist to make sure that your body is primed and ready for a successful, rewarding and injury free run. Download a printable of the 10 checks here.
We all love running
Running is a fabulous free, effective, fun way to exercise which appeals to many new mums .It’s heart, lungs, legs, bum.It burns calories quickly.You don’t need anyone else to do it with (but can if you want to).It is magic time ALONE.You can listen to music, your music. You can go at any time of day for 15 mins or 50, depending how lucky you get with your childcare. It lends itself to an erratic life, no class commitment required .You can even run in the rain.
Where will you start? Plan to avoid injury and disappointment
As a specialist physiotherapist I tend to pick up the problems that have developed or show up from mums running too soon, or without realising that their body wasn’t ready.These are things like sciatica, back or groin pain, recurrence of their antenatal pelvic girdle pain, incontinence and vaginal prolapse.
Run before? Often I worry that those who ran pre-baby are most at risk of injury as it can be difficult to work out where to re-start .You always remember what you were doing at your peak (!) but it can be tricky to find that “sweet spot” distance/time/pace to start back from.
Before you had your baby(ies) were you an erratic jogger, more into 5k fun runs or a half marathon junkie?What was your peak?Can you remember how you started out and built up from couch to that first 5k? You are going to need to take yourself back closer to the beginning to allow your body time to build the skill-sets of running in the right order – but don’t worry – it will all come together much quicker than the first time you took up running.
Or never at all? Or are you a complete newbie?Perhaps running is the only exercise option you are going to have with your post-baby lifestyle and its all new to you? You can take up running from any level of fitness but it is important to learn more about the process and tried and tested techniques of getting from couch to 5K+ so that you have fun, enjoy the process and don’t get disheartened. Follow all these steps and you will be out their running with the pros before you know it.
Can I run yet? a Mum’s Pre-run CHECKLIST
#1 Good Shoes
Will your shoes absorb 80% of the impact?
Your shoes are your first line of defence against the high impact of running.
Each step sends a jolt of high pressure, 4 times your body weight, through your ankles, knees, pelvis and spine. When running that can be 800+ steps per mile! If your foot moves to much on landing this can affect the biomechanics throughout the body and leads to common conditions such as plantarfascitis, ankle/knee strains, sciatica and hip pain.
The softening effect of the pregnancy hormones takes a while to return to normal, taking longer if you are breastfeeding.
TASK 1:Check your trainers
Look at the soles.If the tread pattern has worn away it is a sign of degrading and loss of cushioning.The sole should feel squishy not wrinkled and tough!
Try them on:with sports socks and make sure there is a gap of around half a centimetre between your longest toe and the end of the shoe as your feet will expand as you exercise.Many women’s feet flatten and change shape during pregnancy and rather like your bust you can need to be re-fitted for shoes.
Re-lace: Don’t try to secure a gaping shoe by tying the laces too tightly. Laces need to be tied firmly but not so tight that circulation is restricted during exercise. There are lots of different ways to lace shoes for your indivdual foot type.
review your orthotics:if you needed orthotics before, now with the changes of pregnancy you may need them reviewed or refitted – book an appointment with your podiatrist or physio and let them know you want to run.
go shopping with professional advice:Take your old shoes down to the nearest reputable sports shop for more advice.Many now have either a treadmill (often with video) or a force plate to create a picture of the pressure points in your foot which may provide useful information.A trained assistant will watch you run, give advice and help you try different styles.In Cambridge we have Up and Running & the sports shop at David Lloyd.
#2 Flexible back & pelvic symmetry
Can your pelvis transfer your weight from leg to leg?
Running is a sequence of standing on one leg then the other, just speeded up so you don’t see it.
TASK 2: wobble test
Try standing on one leg for a few seconds, then the other.Did they feel the same or different?Were you markedly more ‘wobbly’ one way, or have to jut your hip out to balance.Any pain triggered?Was it easier to move from right to left than left to right (or vice versa).Did one way just require more ‘thinking’?
If this simple test from one leg to the other makes you suspicious that you have a problem shifting your weight evenly, once you hit 3000 running steps this could lead to a back or pelvis problem becoming unmasked.
Check your technique: With an expert. If you already have a suspicion that your back or pelvis is not ‘right’ DON’T run yet because it is likely only to get worse.
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 new back or hip problem ask your GP to refer you for a physiotherapy assessment.
Are you a list kind of girl?– To Download a free printable check list CLICK here:
#3 Glavanised gluts
Have you got one bottom better than the other?
The other big load bearing muscles are the gluteals.As you stride forward each buttock needs to help take your weight and create forward propulsion.Weak bottom muscles and you will overuse your hamstrings and calves causing cramp or muscle strains.
TASK 3: the pilates bridge with knee fold test
This task mimics the job the gluts have to do when you run. Check your gluts are working equally well right and left with this task – you should feel your buttocks not your hamstrings take your weight and your foot should feel that it can just ‘float’ off the floor.
Lie on your back with your knees bent, feet flat.Draw yourself up into a bridge position.Are you hips level?Can you feel both gluteals (bottom muscles) working evenly or is one side doing all the work?Now focus on supporting your body weight with your right leg and let your left knee fold in over your hip.Feel the work in your right bottom.Then put your foot down and repeat folding your right knee in. You should feel your buttocks not your hamstrings take your weight and your foot should feel that it can just ‘float’ off the floor. You should be able to move smoothly from one side to the other without dipping hips, cramp in feet or hamstrings or rapid fatigue.
Focus your training: before you go out running and risk an injury, build up your muscle strength and co-ordination by doing a few sessions of my postnatal pilates sequence specifically designed to Galvanise your Gluts.
A traditional head lift/crunch style abdominal exercise doesn’t reflect the role the abdominals have to play when you move. In a sit-up/crunch you are keeping your legs still and moving your upper body – but when you run you need to keep your body still and move your legs!At full sprint both your feet will be off the floor at the same time.
TASK 4: The Pilates double table top position reflects this action well.
Can you do 10 leg extensions from table top postion, maintaining neutral spine, a lightly engaged core and while breathing naturally??? Your abdominals should not bulge or dome. NB: Start with your arms by your side (arms back, seen in the picture, is the more advanced version).
Check your technique: If you find your abdominals bulging you are not strong/co-ordinated enough to run yet. It may be that you need to improve your technique: see this video 3 Tips to Control Abdominal doming in Tabletop position
Focus your training: Follow my postnatal Pilates sequences Mind the Gap I progressing to Mind the Gap II for a few days – you will see a great improvement of your ability to control the abdominal wall which will mean you have back and pelvic support when you are running.
Postnatal pelvic floors can be slow to react and need waking up before you run.No good getting half way down the road before you start to think – ooh all a bit floppy and leaky….. where’s my undercarriage support….???
TASK 5: 35 second pelvic floor pre-run priming routine:
Turn your toes out, like a ballet dancer.Tighten your pelvic floor and notice how this position favours the back passage (the anal sphincter) just like you are stopping wind.Pretend you are having tea with the queen and made the mistake of baked beans for lunch.You need to effectively close the anus opening without clenching your buttocks more than a smidgen and without it showing on your face.Do 5 on and off squeezes, not trying to hold, just good squeeze, let go completely.
Then turn your toes in, like a pigeon. Now when you tighten up underneath it should feel different.Less going on at the back and more focus at the front, around the bladder tube and vagina area.Let the area be soft, almost a bit saggy,then lift and tuck the vagina up inside.Let go – completely.Then repeat 5 on – off contractions.Best lift you can do and relax.
Finally turn your toes into your normal standing posture.Now try to do both the previous actions at the same time.Most people start with the back tightening and then like a big zip come forward to lift and tuck the front.When you let go each time now it should feel like there was a bigger ‘up’ and a bigger ‘drop’.Repeat.If you are feeling clever add in some side to side tension too!
When you have done 5 squeezes with your toes turned out, 5 with your toes turned in and 5 with everything together you will have done 15 really good pelvic floor muscle contractions.NOW your muscles will awake and far more ready to cope with the impact as you run.
Check your technique: If you need to refresh your knowledge of pelvic floor anatomy do watch the videos in our Pelvic Floor School.
Focus your training: Pelvic floor need more attention?Check out my Pilates for your Pelvic Floor routine.20 mins everyday for a week and you should already feel an improvement. If you don’t then organise a proper vaginal assessment of your pelvic floor muscles with a specialist physiotherapist.
Have you warmed up your brain connection to your core?
Runners can be a little guilty about using running to warm up (yes you know you do). The purpose of the ‘warm up’ is literally to bring your muscles and tissues to a warmer temperature to make them less likely to injure (like bringing eggs to room temp before you bake!).A brisk walking pace before you break out into a jog is recommended.Or…because I am a multi-tasking kind of person – you could do some household chores while at home – hoover, mop a floor, hang out the washing – anything that makes you feel that you want to remove a layer.
TASK 6: pre-run prep
But I also recommend that you warm up your brain. 5 simple tasks (you will recognise them from the checks above) to focus your neural connections on the muscle actions that you need to run well. Have your kit on (including shoes), do this right in the hallway before you dash out the door.
5 spine curls (loosen the connection back to pelvis)
TIP: or if you only get your run in the evening when your partner comes in from work – do your warm up while the kids are in the bath – even half an hour before you actually go will still be effective – you will be warm and all the right connections switched on – then as soon as you have the requisite childcare …you can be gone!
Focus your training: If you are better disciplined with a voice to keep you attentive and help with breath and timing the 10 minute Pre-run Prep in my postnatal pilates sequence has it all covered. Follow the links for free access to these professionally made videos.
Everyone pays attention to a good bra fitting postnatally.You may need your sports bra re-fitted too.
Especially if you now have a bigger bust.Protecting and caring for your delicate breast tissue isimportant after the stretching through pregnancy and breast feeding. An ill fitting bra will press on your trapezius muscles (running along the neck and back) which can cause pain and discomfort.
TASK 7:put your old sports bra on
Wear it for about five minutes to assess comfort and fit. Lift your arms up, bend down and jump to see if the bra and breasts stay in place. If you find spillage over, under or at the sides, reassess!
There are two types of sports bras. For small to medium busts compression bras press the breast against the chest wall to minimise bounce and enhance support as you move but if you are bigger than a 36B you will find you need an encapsulation bra (who thought that name up?), so that there is support for each breast in a proper cup.
Are you a list kind of girl?- To Download a free printable check list CLICK here:
#8 Support Pants
Extra layers in all the right places.
Again, its all about support.The best pair to reduce joggle.Of the belly, of the pelvic floor, of your back.Maybe even wear two pairs?
JoJo Maman have a good pair of postnatal ones that are made of thick lycra. You can wear the tummy panel high up to under the ribs to help hold your tummy, or roll back (like yoga pants) to reinforce the pelvis. They also have a vest that comes down to give tummy support if you prefer support top down rather than bottom up.
Or tight cycling shorts under your running ones to come up higher over your tummy.
Are EVB shorts a new mum’s best friend? If you plan to do a lot of sport invest in the clever design of the EVBsport.com * range of leggings, shorts and capris. They have special extra support stitching for the abdominals and pelvic floor areas. Designed from the ground up by a running mum.
* this is an affiliate link, if you make a purchase by clicking through from here I receive a small commission at no further cost to you. Thank you, this helps to support this blog.
#9 Bladder and bowel check
Be prepared for unexpected events
Your Bladder:Running is going to make the bladder jig up and down.You could get bladder leaks on running, even if you have been fine for normal activities till now. Running is a higher impact activity than most other things and could unmask a pelvic floor problem. If it happens, you are not going to panic as on this website we have all the information you need to sort it out.At the same time it could happen and we don’t want it to spoil your first run because you didn’t expect it. For that first run have a good quality panty liner in place so that anything unexpected doesn’t embarrass you. Any signs of bladder trouble default to brisk walking, which can be just as effective for fitness and calorie burning, for now.
If you are already experiencing bladder leaks please don’t run yet –sort it out with advice from us here at Supported Mums or by getting in touch with your local specialist physiotherapist. And meanwile there are lots of other ways to get fit which are more pelvic floor friendly.
Your Bowel:The pelvis is a compact space. If the bowel is full it will feel uncomfortable when you run and could put pressure on the bladder causing unexpected leakage.
TASK 9 wees and poos before you go!
Leave time in your routine to have the option to empty your bladder & bowel before you go out.You need privacy and TIME for a good poo.Take a book to read – it helps switch off your thinking brain and let you relax.
Check your technqiue: Watch3 Ps for a Perfect Poo Then enlighten family and friends!
Focus your training: The bowel is controlled by the Pelvic floor too?Check out my Pilates for your Pelvic Floor routine.20 mins everyday for a week and you will already feel an improvement.
Humans have a tendency to try to over achieve and then feel disappointed and demotivated when we fail to reach our goals.You can’t start back running where you left off months ago.You will just feel unfit and disappointed.The best advice I ever read for getting back into running was aim to underachieve.You want to get home thinking – “that was great, I feel fabulous, I could easily have done more, I can’t wait to go again “.
TASK 10: download a pacing app
There are lots of great couch to 5km programmes that will help you pace your run and lead you safely and effectively from nothing back to your 5 km and beyond.
I highly recommend the much loved “Laura” the voice of the Podcast “Couch to 5km” downloadable from the NHS choices website, and now also as a free app. It got me from barely able to run for 1 minute (I know, for a physiotherapist frankly quite shocking!) to a comfortable 20 min just like it said it would. There are also extension podcasts for C25K graduates. If you want to be able to listen to your own playlists there are many paid for options you could try.
Run to enjoy the headspace
Half the week I ‘run’ rather than walk my dog. My runs are my treat to listen to my favorite podcasts. Now I’ve done the NHS couch to 5km app enough times I can set my phone timer for suitable walk/run intervals in the background to keep to a plan that challenges me but doesn’t over do it.
There are lots of books about Running and Mindfulness, or running as mindfulness (quick Amazon search will give you more than 5 recent ones). Authors explain the benefits on mood, anxiety and sleep patterns.
Or run with friends for motivation and company:
if you ran before with a group ask your partner or family to help you with childcare specifically for that time-slot so that you can rejoin the group you used to belong to.
Buggyfit classes and/or baby boot camps have lots of cardiovascular elements and you can take your baby in their pram. This would be a good place to learn warm up and cool down sequences and find like minded local mums to get out running with.
If you are in Bath, Bristol or London you are lucky to have This Mum Runs networks near you. This Mum Runs is a community encouraging and supporting real mums into or back into running. For beginners they run (paid for) courses to take you from new to running for 30 minutes. You join a once a week group (at a mum friendly time), led by a TMR trained coach called a “Runmaker” who helps with learning to pace and running technique. Then you aim to do 2 independent runs on your own or with friends in between. Graduates or those who can already run comfortably for 30 mins can join in a local, free running group, led my a Run Angel, thoughtfully on an evening or Sunday morning 8am. Read more on their inspiring website.
Can I run yet? If you can tick all 10 then Go run girl!
Missing a few? We can support you
Specialist Physiotherapists help postnatal women build up their bodies to run again. We work to pre-empt the most common problems that can arise if you run on an under prepared postnatal body. I hope this guide is a useful focus on the essential ground work to make your running the fun, useful, effective and safe activity that it should be. Please don’t hesitate to ask questions in the comments below.
Please let me and other readers know how you have got on and which tips resonated with you? We can all inspire each other.
Are you a list kind of girl?– To Download a free printable check list CLICK here:
I was glad to speak with several mums individually through the afternoon, but later felt saddened to realise how many mums were still suffering with their bodies; not feeling reconnected to their abdominals and pelvic floor; feeling their sex lives were disappointing and, most worrying of all, not sure where to turn to for help and advice.
After last year’s &Breathe workshop Getting your Mojo back! I wrote this blog post for their site and now have adapted it for readers here at SupportedMums.
Let’s talk about sex
Through my work as a physiotherapist who specialises in coaching women, and men, on how to find and work their pelvic floor I have had lots of conversations about our bodies and how they cope with sex after a baby.
Sadly, nobody seems to be expecting postnatal sex to be any good. Popular press seems to be limiting our expectations. Why shouldn’t postnatal sex be as good as pre-baby?? I know many women who have found that childbirth improves their experience. Once the vaginal canal has been stretched it is more comfortable and accommodating, and they often enjoy having a more filled out body, feel sexier, and also enjoy seeing their partner in a new role as parent.
WHAT IS ‘GOOD’ SEX?
I hasten to remind you that I am a physiotherapist, not a sex therapist, so I am not even going to go down the road of what constitutes ‘hot’ sex – that’s different for everyone and another topic entirely. My expertise is the exploration of your body and what might classify as good sex.
First you should definitely be able to actually have sex. It sounds simple, but it’s not always the case.
All your parts and your partners’ should be able to fit together successfully without feeling there is a block.
Then it should be without pain.
And most importantly with pleasure for you.
Personally, I think of it as the type of sex that keeps your relationship with your partner connected, bonded and fun. It keeps you feeling like a woman and lover, not just a mother. It keeps you feeling valued and loved and allows you to value and love in return.
WHEN THINGS ARE REALLY NOT RIGHT
If you are not having sex because there is a deep problem with yours or your partners’ libido (totally not ever in the mood), or physically something is stopping you even trying (this could be a physical block, some bad healing, an infection, discharge, scarring) then you need to get to the root of why this is mentally and how to heal physically and mentally. If you are ready to have sex and you feel you just CAN’T then now is the time to take action. Book an appointment to see your GP for a proper examination, and don’t be afraid to discuss the issues so you can start to get the bottom of the situation.
WHEN IT IS JUST A BIT FLAT
However, even if you are having sex, sometimes it’s not quite the same as before. Perhaps you’re feeling is that there’s no real medical reason why it shouldn’t be ok, but its just not really ‘doing’ it for you. Then, I have three things for you to look into. These three things could help you shift from things being a bit boring or uncomfortable, or not very satisfying, back to a place of ‘ok I can get more sexy and heat up a bit from here by myself’. And that’s a good starting point. Over the next series of posts, # GET YOUR MOJO BACK we’ll be covering:
Are you flexible enough?
Do you have enough lubrication?
Do your pelvic floor muscles squeeze in the right way?
How to exercise your pelvic floor the right way.
1. ARE YOU FLEXIBLE ENOUGH?
As I also treat antenatal and postnatal pelvic girdle pain as part of my work I am convinced that you have got to have really good movement at the base of your spine, where it meets your pelvis, and in your hips in order to really get comfortable for sex. The Karma Sutra looking like advanced yoga may be no co-incidence!
The problem is that you can go stiff in your back and hip joints very quietly, experiencing no pain at all, no apparent loss of ability to walk, sit, or carry things or babies. With our bodies it is easy to not notice what you are missing.
In everyday life, clues that your back/hips might be stiff are:
You wake in the morning feeling like a granny 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 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 or your legs feel really heavy, like you are walking through thick treacle;
on reflection you can’t really stand up properly straight anymore!
With sex itself stiffness might present 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.
This last manifests as not getting enough external stimulation on the clitoris, which makes reaching an orgasm dependent on penetration alone – which can be pretty tricky for most of us!
If you think stiffness might be a problem for you:
spend a week or two focusing on stretches for your lower back, inner thighs and hips;
if you had pelvic girdle pain during pregnancy and it is still niggling, go back to your physiotherapy team 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;
If it was a ‘traumatic birth’ (was your baby’s head very big, did you have to get into some awkward positions, did you have to have your legs put into stirrups, did you struggle to walk properly for a few days?) you’re quite likely to need to see a physiotherapist in case, even if no-one’s told you that’s on offer. And if you had a Caesarian, there can still be quiet trauma that’s impacting your movement and mojo, caused by being unable to feel your lower half properly or then sleeping on a hospital bed for a night or two.
2. DO YOU HAVE ENOUGH LUBRICATION?
Painful sex can be caused by a lack of vaginal lubrication. All the hormone changes of pregnancy, delivery and breastfeeding can change our natural production of essential body fluids in the vagina area. Couple this with lower libido and rushed foreplay and then sex feels sore as body parts struggle to slide and glide past each other.
Forget KY Jelly. There are now some beautifully packaged, organic, pH balanced personal lubricants which can enhance your love life and help keep you moisturised and comfortable.
YES is the first organic (yes, organic!) lubricant on the market and it’s certified by the Soil Association, no less.
3. DOING THE RIGHT SQUEEZE…
Do your pelvic floor muscles just ‘squeeze’ or actually create some grip and tone?
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 of the penis 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 but nothing happens
You feel there is too much room inside (you might also notice this with using tampons)
If you think this might be a problem for you:
make pelvic floor muscle training a focus for few weeks trying to make some impact on your muscle tone;
concentrate on getting a good technique
and perhaps MOST importantly! Then you have to do ENOUGH exercises to make the muscle change and grow.
This is absolutely my favourite standing pelvic floor exercise. I love that it anchors you to the spot with a quick little routine to stop you getting distracted part way through.
Honestly takes 35 seconds but pings your pelvic floor muscles awake.Little and often improves muscle memory, reaction times, and encourages quick muscle growth.
Turn your toes out, like a ballet dancer, 5 squeezes of the back passage
Turn your toes out, like a ballet dancer.Tighten your pelvic floor and notice how this position favours the back passage (the anal sphincter) just like you are stopping wind.Pretend you are having tea with the queen and made the mistake of baked beans for lunch.You need to effectively close the anus opening, without clenching your buttocks more than a smidgen and without it showing on your face!Do 5 on and off squeezes, not trying to hold, just a good squeeze, then let go completely.
2. Turn your toes in, like a pigeon, 5 lift and tucks of the vagina/bladder tube area
Then turn your toes in, like a pigeon. Now when you tighten up underneath it should feel different.Less going on at the back and more focus at the front, around the bladder tube and vagina area.Let the area be soft, almost a bit saggy,then lift and tuck the vagina up inside.Let go – completely.Then repeat 5 on – off contractions.Best lift you can do ….and relax. Don’t worry if your abdominal muscles join in a little bit but keep the focus on your pelvic floor.
3. Turn your toes normal, both areas together as a unit
Finally turn your toes into your normal standing posture.Now try to do both the previous actions at the same time.Most people start with the back tightening and then like a big zip come forward to lift and tuck the front.When you let go each time now it should feel like there was a bigger ‘up’ and a bigger ‘drop’.Repeat.If you are feeling clever add in some side to side tension too (yes, the pelvic floor is bowl shaped, see this in my video showing a model pelvis in the pelvic floor school)
When you have done 5 squeezes with your toes turned out, 5 with your toes turned in and 5 with everything together you will have done 15 really good pelvic floor muscle contractions.NOW your muscles will be thinking – hey she doesn’t normally work us like this – we are going to need to grow!
In this video I go through the exercise with Stephanie from Kegel8 and The Knack too.
When to do it?
Perfect exercise to do little and often through an ordinary day.It tags on really well to cleaning your teeth – or after a wee.At home, use that quiet moment in the toilet to focus on yourself.If you are working, linger in the cubicle for an extra 40 seconds – you are getting paid to exercise!
Important note
If you think this exercise is mad and you couldn’t feel a thing when you tried to do it – try it lying down, not so much the feet positions but focusing first on the back passage and then on the front. This positon takes the weight of your organs off the pelvic floor and gives you more chance to ‘feel’ the muscles working.If that still leaves you cold – then I would recommend you have a chat to your GP and ask for a referral to a specialist pelvic floor physiotherapist for a full assessment and examination.There are lots of things we can teach you in clinic 1:1 to help you find and improve your muscle function.
When you are busy with a newborn baby, sex can drop quite low on your ‘to do’ list. If it isn’t even comfortable when you do find the moment, it is all too easy to lose the intimacy in your adult relationship. There are some simple but effective things you can do yourself, straight away, to improve your comfort and enjoyment.
#1 .Pelvic floor exercises improve sexual health too
Commit to a couple of weeks of daily pelvic floor exercises to bring about proper change in these muscles. The pelvic floor muscles play an important role in giving you a sense of closure around your partner as well as support and friction to create your own pleasurable sensations.
Taking time out to deliberately exercise the pelvic floor muscles will bring blood flow to the area, tone and tighten the muscles and improve your ability to feel the walls of the vagina during sex. Many women report they are able to reach orgasm more easily, and that their orgasms are more powerful, after focusing on pelvic floor muscle exercises
#2 Keep a personal lubricant in your bedside table drawer
The hormone changes of pregnancy and breastfeeding can leave your body surprisingly dry at the vaginal opening and deeper inside. When you are trying to grab a quick sexy moment, with maybe less time than usual to get in the mood, your body may not produce enough natural lubrication. This can make penetration painful or the movement of your partner inside you can feel like a friction burn.
Using a personal lubricant during your foreplay (it works best if you put it on both of you) can make a magical transformation to your comfort and enjoyment.
If you are still experiencing discomfort after boosting your pelvic floor muscles, trying a personal lubricant and the other tips in this series, then don’t hesitate to talk to your GP.
They will be sympathetic and impressed that you have already tried these first steps. Your GP can organise referral to a specialist physiotherapist to give you personal 1:1 assessment and guidance, and they will be able to move on to other investigations of the possible causes of your pain.
You can and will enjoy comfortable sex again – but you must be brave to let them know that you are suffering.
Imagine the state of your ankle if you fell on an uneven pavement, gave it a nasty twist and then still had to run home – you wouldn’t be at all surprised to be looking at a hot, red, swollen, bruised and very tender foot and ankle? Add a cut and some stitches and you would feel very sorry for it.
Because everyone can see the damage you would be lavished with care and attention: crutches to keep the weight off; leg up when you sit down to reduce swelling; tubigrip; icepacks; exercises to keep it stiffening up and plenty of willing helpers to let you take it easy for a good few days.
Everyone knows that you have to nurse and care for an injury to help healing to take place successfully, to avoid complications and to get back to normal walking again as quickly as possible.
WE NEED TO CARE FOR BRUISED SORE VAGINAS TOO
During birth the perineum (the skin and tissues surrounding the opening of the vagina) experiences a traumatic stretch and strain. Clinically this is termed a soft tissue injury. It would be great to care for the perineum in the first weeks of motherhood with a similar respect for the healing process.
Unfortunately, things are stacked against the love and attention needed, apart from the obvious distraction of a beautiful, demanding newborn:
you are high on the birth experience so your own bottom is low on your agenda
nobody can see your sore bits and you don’t limp so there is no outside sign that you are injured
you can’t (wouldn’t?!) exactly discuss your sore bits with many people
most of the time you are sitting on the sore part to feed which makes it go numb
mothers are incredibly stoic people and don’t complain
it’s hard to know what’s ‘normal’ so there is a tendency to just battle on
In these posts I have pulled together tips and tricks to guide you how to care for your perineum from day one until it is all feeling better again. Don’t hesitate to ask if you want clarification or think of something that I have left out that would be useful for other new mums to know?
In the early days of a newborn baby there is an awful lot to think about for the newly hatched egg. However, don’t forget, every day, to stop and think about the chicken. Who is going to look after the egg properly if the chicken is tired, weak, undernourished and sore?
For a truly happy family, new mothers, and especially their recently wonderfully used bodies need some love and attention too.
CHICKEN-CARE #1
Take the baby out in the pram for a pacy 20 minute walk. Breathe deeply, stand tall and hold your tummy in. Walk so that you hear your heels clicking (this makes your bottom muscles pert), and go fast enough that you couldn’t talk. Baby exposed to sunlight to help regulate their sleep cycles – tick. Posture and core muscles woken up – tick. Cardio-vascular exercise – tick!
Do you respect your body and your own needs? What did you do today for yourself? What could you do to feel stronger and fitter?
If you are nursing a tender bruised perineum after your childbirth heroics that doesn’t seem the kindest option does it? But actually soft cushions or the sofa may press up against the sore area more than you would think, as they mould in around you. This can restrict the blood and lymphatic flow to the tissues. It will all feel a bit numb after a while as you sit there but can feel very sore and achey when you stand up again. Definitely NOT a ring cushion – an old fashioned solution – as they pull all your weight and pressure down into the centre just where you hurt the most.
My midwife was insistent that I sat on a kitchen chair to breastfeed to improve my posture. I was still spectacularly unsuccessful at breastfeeding but the positive outcome was that I noticed I didn’t ache so much in my undercarriage when my marathon feeding stint finished.
A harder surface and more upright chair works because you take more weight through your feet and ‘sitting bones’ keeping pressure off the perineum and coccyx. This stops the soft tissues and their blood supply from being squashed and lets air flow under.
When I worked in the hospital there were these fabulous “valley” cushions but they don’t seem to be available anymore (unless you want to splash £199 on amazon!). Luckily I would suggest a cheaper alternative which we used to use if we ran out of the real deal: for an immediate DIY, or a subtle ‘out and about’ solution fold two matching hand towels into square blocks. Put one under each bottom cheek leaving the perineum a few centimetres blissfully airborne in the middle. Try it and smile as you find pressure relief!
If you have a long slow feeder or suffered with a good deal of stitches to the vagina or anal area, or are coping with piles, you will be grateful for improved comfort for several weeks ahead. Mother hens, be kind to your body.
How did you cope with a sore bottom and feeding? If you have any tips to help other mums, please comment below.
Have you ever had the experience of an uncomfortable tampon or one that looks as though only the side half of it has absorbed anything?
Why do tampons go sideways? There are few reasons:
1. There’s more space inside than you might think
The vagina is surprisingly wide and stretchy. Essential for babies heads to come out but leaving plenty of room for things to move about – especially for tampons to go sideways.
I think we mentally picture the vagina as a narrow tube – rather like a hosepipe. However, though you can’t see much at the opening, inside the vagina there is quite a decent space. The vagina is a tube, but not an evenly shaped one – more like a squashed tube, wider side to side than top to bottom.
This clever shape helps to let a babies head out without damage to the vagina itself.
The pelvic floor muscles should support the tube from below and from the sides. However, pregnancy, childbirth, straining for constipation, pressure from chronic coughing or lots of lifting can all stretch and weaken the pelvic floor muscles. As a result the vagina tube can feel more “gapey” or spacey – and it’s easier for tampons to drift off centre or tilt to one side.
2. the cervix deflects the tampon sideways
If the end of the tampon comes up against the cervix it can tilt off sideways into the ‘cheek’ area giving you inadequate protection and that ‘half used’ look when you remove it.
The cervix is the opening to the uterus (womb). It sits right at the back of the vagina tube, dangling down from the top of the tube (similar to the way your epiglottis sits right at the back of your mouth). The cervix is the size and shape of a nose. You can put your finger inside and find it.
The cervix is pretty solid and though it pushes up out of the way during sex, it is quite easy to accidentally knock into it by accident when inserting a tampon.
3. The tampon touches the cervix and annoys it
Have you ever put a tampon in and then barely 5 minutes later you have an overwhelming desire to pull it back out ? It is just not right, or downright uncomfortable, almost as if your body is rejecting it?
This is because the cervix is the only bit inside with decent nerve endings (if you knock it during sex it you might get a short sharp mild pain and find yourself shifting position.) If a tampon is relentlessly pressing on the cervix you get this strong urge to bear down and feel that the tampon is pushing out or that you need to take it out. Have you ever had this sensation?
A video to show the anatomy of the vagina & cervix:
Are you a visual person? I use a 3D model (and a piece of paper!) in this video to explain to Stephanie Taylor from Kegel8 how our internal organs are supported by our pelvic floor:
TIPS TO GET TAMPONS IN THE RIGHT PLACE
Don’t rush the process (mums! you know you do)
Visualise what you are doing. Keep contact with the back wall of the vagina (the bowel side) as you are putting the tampon in and it will end up underneath the cervix rather than on it. Aim for your back passage.
Not all tampons are the same. Some types expand widthways but others expand lengthways so they can effectively push themselves out as they become elongated when full. If you can’t picture what yours do, drop one in water and see what shape it becomes.
Applicator tampons give you a bit more option to position the tampon before you let go – nice to use for the beginnings and ends of periods when the vagina is a bit drier and less easy to slide tampons in
Pop a dab of lubricant (water-based) on the end of the tampon to help it slide in more easily
If you feel your cervix is sitting very low since your baby try using a menstrual cup (like a MoonCup) instead of tampons – these are designed to sit closer to the opening of the vagina rather than deep inside (more like the position of a cork in a bottle).
make time for your pelvic floor exercises with particular emphasis on the sides. Follow the videos in our Pelvic Floor School.
How have you got on with returning to having periods and using tampons and sanitary pads? Any questions? Join the conversations @supportedmums
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 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.
Truly, the inventors of personal lubricants should be honoured for services to postnatal women and their intimate relationships.
Painful sex? Might it be because of lack of lubrication? Don’t be embarrassed. We’ve all been there. You might even actually want this to be the problem because it is the easiest problem in the world to fix!
WHEN YOU HAVE A BABY YOUR BODY CHANGES IN WAYS YOU NEVER EVEN THOUGHT OF
With all the hormonal changes of pregnancy, delivery and breastfeeding, you may be surprised to find that your body may no longer make enough natural lubricating secretions for the vagina opening and the vaginal tube. Sex without enough lubrication in this area can distort and drag against your delicate female skin creating a friction burn, pain and discomfort.
You can battle through, women are so good like that, but it will be ‘grin and bear it’ kind of sex.Not much fun for you.And over time this can escalate into a bigger problem of avoiding sex because it hurts.
THANK GOODNESS FOR SCIENTISTS!
We are so lucky to live in an age where people in laboratories spend hours developing products to improve and enhance the natural functions of the body.Even better, with trends in the cosmetic and food industries to keep products natural, organic and good for us there has been a growth in the development of products which should not be harmful to the body and even put good stuff in.
NOT ALL Personal LUBRICANTS ARE THE SAME
Not all lubricants are the same.You may be alarmed to read the ingredients in some and it is important to ensure that they are pH balanced to the normal vaginal pH of between 3.8pH and 4.5pH. Lubricants with a higher pH are too alkaline and can lead to UTIs, Thrush and Bacterial Vaginosis Further, they can be water-based or oil-based. If you are not sure which is best for you do read the related post about the difference between them.
I think packaging is important too.Who wants a big tube of ‘lube’ on their beside table?Try explaining that to your 5 year old…?It is so pleasing to see the brands taking women’s sensitivities into account and producing thoughtfully packaged products that look like quality cosmetics.Thank you from all of us!
Below are links to the UK brands my clients have found helpful. They have informative websites and offer free samples too.
As usual you get what you pay for. You only need a little bit each time and your intimate relationships are invaluable.Treat yourself to something made for the purpose, in nice packaging and never run out!
Please do let our Supported Mums readers know your preferences below and share any advice?If you have come across a product that you think I should include in this list please let me know your recommendations?
The Squeezy app is a simple reminder device with lovely visuals to help you focus when you practice.
You can set the app to remind you at 3 personalised times of day. Think about when that might work best for you? You want the app to send you the reminder text at a time when you WILL be able to follow through. So when does the morning actually, truly get a bit of a lull in it? As you get home from school/pre-school run? Does the baby have a morning nap routine? Then think through the rest of the day for true windows of opportunity. They don’t have to be evenly spaced. You just need 3 times in a day. Lunch time? Just before your partner gets home (or is that max-chaos??!), roughly just before you have supper?
Or follow the Tweets of the hilarious Elaine Miller of GussetGrippers.
If you are better with supervision – join me for an exercise session straight from your computer. I will keep reminding you to focus on your pelvic floor throughout! You can follow the “Pilates for your pelvic floor” sequence through online exercise host pactster.com Use the code PhysioPostnatal to access all their videos free for a month (try HIIT workouts from the team at & Breathe Postnatal too) .
My runs are my treat to listen to my favorite podcasts. Now I’ve done the NHS couch to 5km app enough times I can set my phone timer for suitable walk/run intervals in the background to keep to a plan that challenges me but doesn’t over do it.
