Category: Pelvic Organ Prolapse

exercises for busy women

7 secret exercises for busy women

1 Comment

New Mum, Grandma or simply a busy life? It’s not always easy to fit formal exercise in. Here’s a list of 7 secret exercises for busy women. Anywhere, anytime gems that don’t look or feel like exercises – but will help maintain YOU!

Try these #7 secret exercises for busy women!

#1 Stand well: when talking

Can we DO posture?  Does that really count as exercise?  Absolutely.

In Kenya, the Maasai Warrior are taught from an early age to stand for hours at a time, still and upright.  To find this amazing posture they are told to focus on their feet. 

Try this:

  • feet a little apart, pointing straight forward
  • press the inside edges of the heels towards each other (they don’t actually have to touch)

That’s it.  But as you make that small adjustment at your feet, notice the cascade of muscle activity through the rest of your legs and bottom muscles?  Feel the gluts and legs come ‘alive’, feel the stretch on the front of the thighs as your pelvis draws back into neutral, notice your lower abdominals activate and the spine straighten?  By the time you even get to your head and shoulders you will feel that by getting the feet ‘right’ everything else has drawn into place? 

Posture requires effort

You may find that today you can only ‘hold’ this posture 5-10 seconds before feeling tired and fatigued by the effort involved, both physical and mental.  That’s ok.  That feeling is your muscles working in an endurance hold that they are not used to.  But if every time you stand to talk to someone, cuddle a baby, answer the phone, stand in a queue, you practice this posture….just 10 seconds at a time… within a week it will feel far more natural and you will be able to stand, still and grounded, for many minutes at a time.

#2. Sit well: watching TV

Notice your ” tail bone” and  “sitting bones” underneath you. 

Bring your weight forward to get off your tailbone and on to your sitting bones.  Can you feel your weight evenly left and right?  Stretch up through every bone of your spine, drop your shoulders back and down, let the top of your head lift towards the ceiling. 

Let the seat support you  – but if you have a large gap around your waist tuck a small rolled up towel or thin jumper into the gap to hold your spine in it’s natural curve if you are settling in for something epic (current fav in our house is Elementary….see you in 5 seasons….)
 

#3 Core: in the car

Notice the seat belt where it crosses your lap.  It lies exactly over your lower abdominals (transversus abdominis).  In a class we often facilitate our awareness of our abs by touching with our finger tips – in the car use the pressure of the seat belt as a natural guide.

Let your abdominals sag against the seat belt on purpose.  Now, breathe in fully, let the abdomen swell a little, then as you breathe out, gently draw the lower abdominals towards you.  Then hold them gently (just less than 50% of what you could do).  And Breathe.  Finally, release, letting them sag back onto the belt. 

Do this cycle again – draw in as you exhale…but now keep breathing naturally and watch one lamp post go by…watch another go by…let a third go by…then let go.  Start a “how-many-can-I-hold-for-lamp-post-challenge”?

#4 Walk: everywhere: fast

Walk fast and you burn a LOT of calories.  It’s almost as good as jogging.  Try to walk so that you could “speak” but not “chat”.

Head up, lower abs in 20%.  Aim for you heel to strike the floor first (so that people can here you coming). This activates your gluts (bottom muscles) for a more intense leg work out.  No casual strolling about – make even the shortest walk count.

#5 Pelvic Floor: in a queue

Here’s an exercise to ping your pelvic floor muscles awake in less than 35 seconds.  Little and often improves muscle memory, reaction times, and encourages quick muscle growth.

  1. TURN YOUR TOES OUT, LIKE A BALLET DANCER, 5 squeezes of the back passage area
  2. THEN TURN YOUR TOES IN, LIKE A PIGEON, 5 ‘lift and squeeze’ of the bladder tube area
  3. TURN YOUR TOES NORMAL, both areas together

#6 Balance practice: cleaning your teeth

Balance is a skill you have to train seperately to being “fit”.

Stand on one leg, pull up out of your waist, feel the bottom muscles working to hold you.  Notice the strength and stability in  your ankle.  Progess by closing your eyes!

#7 Be Mindful: with friends and family

Mindfulness is quite simply the practice of being in the now.  You formally practice it in yoga and pilates classes. Did you know you can also be mindful in any situation, even complex ones, out on a walk, driving, even cooking. Or to  mentally  “step back” in the middle of a social event. 

Let yourself be completely present so that your mind is in a physiological state of rest but not asleep.  Allow your thoughts come and go but you are not remembering, not planning, not analysing or deciding. Rather, sensing, noticing, appreciating…. 

Yes, even with visiting family….

Author: Amanda Savage MCSP, MSt (Cantab), Specialist Pelvic, Obstetric and 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 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.

How much should you hold your pelvic floor muscles?

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

Leave a comment

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.

how to improve pelvic floor control by simply breathing

How to improve pelvic floor control by simply breathing

1 Comment

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?

why do tampons go sideways picture

Why do tampons go sideways?

16 Comments

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.

the vagina is like a squashed tube

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.