Field Guide: Pelvic floor muscle biofeedback gadgets and devices

Field Guide: pelvic floor biofeedback gadgets

There has been a recent explosion in “fem-tech” options, particularly pelvic floor biofeedback devices. On the one hand this is empowering women to improve their exercising in the privacy of their own homes, on the other hand resulting in a more than a little confusion about what they do.  With most devices over £100 it is important to spend your money wisely.

Pelvic floor Biofeedback devices

Generally, we advise that if you can already contract your pelvic floor muscles then you don’t need to do passive pelvic floor muscle stimulation. Your muscles will develop quicker by doing ‘active’ exercises where the brain initiates the activity rather than a machine. Check out the videos on our Pelvic Floor School.

However, if you WANT to work with a gadget to do active exercises, a biofeedback device can enhance your practice. Particularly, if you need to work on your brain skills (co-ordination, multi-tasking, downtraining) as much as your isolated muscle strength & endurance (which they can be helpful for too).

How to they work?

  • The action of your muscles contracting is relayed to a machine which “shows” you what you are doing.  There are several different ways this can be done.  
    • Some machines pick up the electrical signal from your muscles while some respond to pressure.  
    • Some give you a visual picture of what you are doing,
    • others beep or vibrate in response to your contraction.
  • Biofeedback devices are great to correctly identify your pelvic floor muscles in different positions. They also ensure you are contracting correctly and also help you focus on relaxing fully between contractions
  • These gadgests let you see how well your muscles contract and relax.
  • They give targets to aim for to improve strength, endurance and co-ordination.
  • Practice more complicated tasks. Skills you need for real life or your sport.
  • Make exercising a bit more fun (!) and interesting. This will help you to keep up long-term practice (rather like a piece of gym-kit for your pelvic floor!)

Examples of pelvic floor biofeedback devices:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision. Specialist physiotherapists, like myself, have units in clinic for you to try before you buy.

Electrical biofeedback devices: with connecting wires

Peritone EMG biofeedback unit and Simplex EMG biofeedback unit are  the ones we have used in our clinic for many years (same device in different packaging).  Many physiotherapy departments have these for you to use at your visit and/or to borrow. Just like French women train in their postnatal rehabiliation sessions.

They are effectively two parts.  You place a small internal electrode (called a Periform, which is single person use,  into the vagina. Then put your clothes back on!. Then link your internal device by a cable to the handheld Pelvitone or Simplex unit (we can loan one of these to you).  

When you contract your pelvic floor muscles their electrical activity registers on the screen. This makes the  lights change from orange to green and gives an audible beep.  

You can practice your quick maximum power squeezes seeing how high you can make the lights go. Also, practice keeping the lights green while you cough or try moving your arms or legs. There is also a work/rest function which ‘counts’ the endurance holds for you and tells you your average squeeze score at the end.

These devices are widely available from lots of online sellers +/- £160 (including the Periform).

Pelvic floor training devices: which connect via bluetooth to a phone app

Elvie Trainer

Elvie for pelvic floor biofeedback

Elvie  £169

The Elvie updates the design of the traditional units above. It is popular as it has modern smart phone visuals, easy charting & a sense of community amongst users.  

I have one I can show you in clinic but the internal device (the pebble) is the expensive part, and understandably single use only, so I’m afraid you can’t try before you buy.

It is a discreet, attractive, wireless bluetooth pebble-shaped device. This goes inside the vagina. Use an app to turn your phone into the biofeedback monitor/exercise tracker.  No cables between you and the phone but you can’t put knickers back on or the bluetooth can’t connect. It is beautifully packaged and well designed by women. It can be used in the second trimester of pregnancy but is not recommended for the 1st and 3rd trimesters.

Elvie is officially available “on prescription” but sadly, I don’t know anyone whose managed to get one this way.

Pericoach System

Pericoach System for pelvic floor biofeedback with a phone app which can also connect to your physiotherapist

Pericoach System £145

Pericoach System shows your pelvic floor contractions as clear graphs on your phone. Pre-set programmes guide you to practice exercises twice daily and, like the Elvie, uses algorythms to automatically progress you as you improve your skills. You can give you physiotherapist access to your data so that she can guide you virtually.

Pelvifly/K-Goal

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative  pelvic floor biofeedback with sophisticated integration to a remote physiotherapist if required

Pelvifly £189 with basic plan. Subscription for full integration with a physiotherapy coach.

Pelvifly is a package connecting the K Goal pressure sensor to a phone app for sensitive imaginative biofeedback games with sophisticated integration to a remote physiotherapist if required

The largest of the internal probes, which will suit those who find more petite devices fall out too easily. It responds to the pressure of your pelvic floor squeezes. This is particularly useful for those who need to learn to relax the pelvic floor (called downtraining). Pelvifly offers the greatest variety of challenges with innovative vibrant visuals – including butterflies visiting flowers, rockets flying through tunnels, basketballs into hoops and an engaging octopus!

The BASIC plan (no further cost after purchase) sends you a muscle test once a month and daily challenges. With a SMART subscription (£24/month) you will have more programs to follow to suit your chosen goals. Pelvifly are rapidly expanding their telehealth services. With a CARE package (£96/month) you will be connected, virtually, to a Pelvicoach (a specialist physiotherapist) who can interact remotely to set up bespoke assessment and training programmes, support your progress, exchange messages and save and print your progress reports.

Pressure Biofeedback devices

kegel8 trainer for pelvic floor biofeedback uses a pressure system

Kegel 8 Biofeedback Pelvic Trainer £94.99

Kegel8’s biofeedback pelvic trainer uses a pressure system where you squeeze on a larger tube (NB latex covering) which moves a dial on the hand held unit.   Unsophisticated but effective for checking what you are doing and therefore a relatively inexpensive option

Epi-no Delphine Plus birth trainer can also be used for  pressure pelvic floor biofeedback can be used in pregnancy

Epi-No Delphine Plus £99.99

Eip-No’s primary purpose is a tool to stretch the perineum in preparation for vaginal delivery. It can also be used as a biofeedback tool before & after birth. The dial lets you visualise the amount of squeeze pressure you are creating with your muscle contraction.

Epi-No (like the Kegel8 Trainer) is less sensitive than the electrical biofeedback or bluetooth devices. However, the advantage of the Epi-No is that it is  certified for use through your whole pregnancy. It can also be used in the latter part of pregnancy (after 37 weeks) to help to stretch the vaginal opening. A recent study * did not show evidence of a protective effect of the Epi-No device on birth trauma, however, anecdotally many women feel it has helped with their confidence to relax the vaginal opening in preparation for birth.

*Kamisan Atan I, et al. BJOG 2016  Does the Epi_No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial.

Other trainers

Vibrance Pelvic Trainer

The Vibrance Pelvic Trainer    is a petite internal device which vibrates when you correctly contract your pelvic floor muscles.  The device is  easy to insert but you may need to hold it in position. There are no wires, or external unit, the vibration is felt in the device itself.

This device could also be useful as a ‘bridge’ back to penetrative sex, if you don’t want to use a traditional vibrator. You could practice inserting the trainer at your own pace. You might find the vibration element helpful to re-sensitise your tissues.   They are available directly from www.vibrancepelvictrainer.co.uk  £140.83 with VAT exemption.

This links to a digitally annotated instructional video for Vibrance PFT on youtube:https://www.youtube.com/watch?v=n8IoqefRzTU

Note about VAT exemption

If you have had a problem for more than 3 months, you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly). If you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. If you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Try before you buy

Many physio clinics can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. (NB you still have your own internal probe – no sharing of those!).

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Physios can also teach you active exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Field Guide: pelvic floor muscle stimulation machines

Field Guide: Pelvic floor muscle stimulation machines

Pelvic floor Muscle Stimulation Units

These units are designed to be used at home to artificially stimulate the pelvic floor muscles to work. Electrical impulses are sent from the machine directly to the pelvic floor to mimic the messages that your brain is supposed to send.

These units are ideal for people who really don’t know where their muscles are. Or what they are supposed to do! They are also good for very weak muscles that can only contract a few times before they fatigue. Or muscles that can only muster a very tiny amount of strength.

  • the sensations (a sort of tingly feeling) created by the electrical impulses help your brain to correctly identify the location of your pelvic floor muscles.
  • the machine will stimulate the muscles to work (contract). It is possible to change the settings to favour different parts of the muscle.
  • you can practice joining in with the machine to learn how to contract your muscles without help
  • the machine can help you to ‘hold’ a muscle contraction while you concentrate on learning to breathe and/or move at the same time
  • we usually recommend that you wait until 3 months postnatally before using a stimulation machine.

Examples of stimulation units:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision.  Many specialist physiotherapists, like myself , have units in clinic for you to try out before you buy.

Traditionally the stimulation is delivered by a battery-operated handheld unit with wires to a internal electrode. The price points vary depending on the number of programmes available & the style of the electrode supplied. A new design on the market is Pelviva, which are wireless foam single-use electrodes.

kegel8 tight & tone

The kegel 8 Tight & Tone Electronic Pelvic Toner £98.99 is a simple classic pelvic floor stimulation unit which we  have used in our clinic for many years.  The buttons are large and few! You may prefer to use it with a periform electrode

Neen Pericalm is discreet and easy to use

Neen Pericalm £69 + buy a probe

is often brought in by customers (availabe on amazon). I also find this one easy to follow the instructions and set the programmes.  It is also very small and discreet. You will need to buy a vaginal or anal probe to go with it.

Kegel8 Mother Nuture is also a TENS machine

Kegel 8 Mother Nuture £79.99

Even though it is the cheapest one that Kegel8 offer it has all the programmes you will need, plus doubles up as a TENS machine if you anticipate another delivery. A periform probe is a more slender option than the one provided with it.

Nu-tek levator mini

Nu-tek Levator mini continence stimulator.  

 Win-health  supplies our practice.  It is a good stimulator though the buttons and set up are a little fiddly until you understand how it works. I recommend you select the Periform probe (which has a hole in the middle rather than solid) most clients find it more comfortable.

kegel8 Ultra20

Kegel8 Ultra 20 £134

has more programmes & is supplied with the shapely Glide Gold Vaginal Probe. The customer instructions are good. My videos with Kegel8 use this machine as the demo

pelviva foam internal electrode

Pelviva £44.95 for starter pack of 3/£214 for 1 month pack x15

Pelviva is a unique product that does not require a handheld unit like those above. It is a disposable single use foam electrode which is activated just before use then delivers 30-min internal stimulation. video here

How to use a stimulation machine: video series

I have created a series of videos to show how a machine works, what the cables and probes look like and explain in a not-too-tech way how to use them to help problems with bladder leakage, prolapse or recovery after a baby.

These videos will help you understand your condition, as well as how the machines work. Then, you will be able to decide whether a machine would benefit you and which programmes you would choose.

You will see that these videos were created as a project for Kegel8. However, you will find most of the information applies to stimulation machines in general.

Note about VAT exemption

If you have had a problem for more than 3 months you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is also essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. However, if you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

.

Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Try before you buy

We can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40

What's the difference between a pelvic floor biofeedback gadget and a muscle stimulation machine

What’s the difference between a pelvic floor biofeedback device and a stimulation machine?

Help! So many different pelvic floor gadgets – which one for me?

You have probably heard of “gadgets” to help exercise your pelvic floor muscles.   If you have been thinking about buying one you may already have looked around online.  My complete sympathy if you are feeling overwhelmed and confused!  Not only  about which one to get but also the difference between them.  They range in price enormously.  The language can be confusing.  There are so many different suppliers..… 

This post aims to help you understand:

  • the braod difference between a stimulation unit, a biofeedback device and weights/resistance devices and reminder devices/apps

I hope this overview will start to clear the confusion for you.  Once you have a fair idea which category gadget or device interests you most do read the Supported Mums Field Guides (with regularly updated product links)  to each: 

There are broadly four types of pelvic floor gadget

  • Stimulation units
  • Biofeedback devices
  • weights/resistance devices
  • Trackers/Memory Aids

# Stimulation units

send electrical impulses TO your muscles to help them to contract/exercise  (they wholly or partially do it for you)

examples:  Kegel8 Mother Nuture, Kegel8 Ultra20, Neurotrac Continence, NuTek-Levator, Neen Pericalm, Pelviva Muscle Trainer, Innovo Shorts

whereas

# Biofeedback devices

show you what you are doing with your muscles when you contract/exercise them using your own brain.  Some do this by sending an electrical impulse from you to the machine but there are others that do this using a pressure signal or another type of sensor.  

examples: Neen Educator, Kegel8 Pelvic Floor trainer, EpiNo, Simplex,  Pelvitone, Nu-Tek Levator Mini,  Elvie, Pericoach, KGoal (Pelvifly), Vibrance Trainer

Then there are gadgets for pelvic floors that are already working well:

# Gadgets that add resistance and/or weight

to your ‘ordinary’ pelvic floor exercises – to make the muscles work harder – just like you push or pull weights in the gym or pull against a resistance band or  work with a Pilates circle

examples:   Educator,, Pelvic Toner, Pel, Aquaflex Cones, Kegel Weights, Secret Whispers 

# Gadgets and apps that help you remember

to do your pelvic floor exercises, keep track of your progress, or prompt you to follow a sequence to make sure you regular perform a full range of tasks

examples:  Squeezy App, Intimina,  Tena’s PPX app

Note:  Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions but these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them

Keen to learn more? Check out our Field Guides

  • which piece of kit might be useful to you depending on your circumstances
  • the detail of how they work, subtle differences and where to get them
  • when a gadget is not suitable or contraindicated

Supported Mums Field Guides: 


Not sure what YOU need?

Make the most of your local specialist physiotherapist

Most electrical devices cost over £100.  An hours appointment 1:1 with a specialist physiotherapist would  cost £70-90 (depending on area).  If you are hesitating what to buy, or even if you need a device at all,  why not first have a full assessment of your situation first?

Get clarity first

Remember that a specialist physiotherapist like myself, will do a proper examination of your pelvic floor, to give you complete clarity on what your personal pelvic floor strength, endurance and function.  Then together you can decide and plan the most appropriate and effective strategy for you to develop your muscles and skills further.

It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

Try before you buy

Most clinics will have a drawer full of gadgets and devices for you to see, touch  and discuss – and many, like our clinic, have units for you to borrow if you prefer to try before you buy.  

Or if you have already bought a unit or gadget and don’t feel that you are getting the most from it do book an appointment with a physiotherapist who will be able to help you to:

Or you might not need a gadget at all!

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions. Readers would love to know your experiences if you would be happy to share?

Savage, A.M (2019). Neuromuscular electrical stimulation devices. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 125, 16-25

Savage, A.M (2021). Handheld biofeedback devices to enhance pelvic floor muscle training. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 128, 54-57

Savage, A.M (2018). Continence products and medication devices: issues that pelvic health physiotherapists need to consider. Journal of Pelvic, Obstetric & Gynaecological Physiotherapy, 122, 30-40

a glass how much should you drink in a day

How much should you drink in a day? & When should you have a wee?

question mark
How much water should you drink? When should you wee?

Two tricky questions…

Other health and hygiene questions are easy.  How often should you clean your teeth?   Wash your hair?  Change your pants? But these two bladder questions – How much should you drink? and When should you wee? are full of issues, myths & legends. This article helps you understand the UK guidelines, understand why how much you drink influences when you will wee – and offers tips & tricks to for a happy bladder!

Bladders & drinks FAQs

  • Does how much you drink cover just water or all your drinks? 
  • Are tea and coffee drinks? 
  • What about the milk in your cereal? 
  • Is it different if you are taller/smaller, fatter/thinner or breastfeeding? 
  • Is it better  to have a few big drinks or sip from a bottle all day? 
  • Should we wee when we first feel it or when we are busting? 
  • Is it ok to hang on……..but how long is hanging on for too long? 
  • Am I normal if I wee in the night?   
  • Is it ok to have just a tiny wee before you go out the door?   ………

Phew….see what I mean about a tricky subject?!

How much water should you drink: official guidelines

Your body needs water or other fluids to work properly and to avoid dehydration. That’s why it’s important to drink enough fluids. In climates such as the UK’s, we should drink about 1.2 litres (six to eight glasses) of fluid every day to stop us getting dehyrated. In hotter climates, the body needs more than this. We also get some fluid from the food we eat.

NHS Choices

Extra (practical & useful) tips & info:

Normal fluid intake should be 1.2 to MAX 2 litres in a 24 hour period.

 It is NOT 1.2 litres of water on top of all your other drinks

  • This is ALL fluids added up together (tea, coffee, water, juices, alcohol).
  • 1.5-2 litres equates to 6-8 standard 250ml mugs a day, or 4 x 500ml water bottles.
  • Don’t count the milk in your cereal. But if you have soup for lunch, jelly to follow and smoothies to drink you might want to be aware of their impact on the total volume.   
  • If you are breastfeeding or doing sweaty exercise you may need an extra glass here & there to replace lost fluid. But unless you sweat profusely or produce gallons of breast milk – this is not nearly as much as you think. 
  • Drinks should be evenly spaced at approx 2 hour intervals. With the last proper drink 2 hours before bedtime (ideally non-caffeine), just sips thereafter. 

How to be nice to your bladder: filling tips

Let’s talk through the look of a ‘normal’ day, in an untroubled happy bladder world. It will help your brain understand how it should all work. 

If you have been suffering with mad dashes to the loo, uncomfortable and inconvenient urges and bladder accidents, these habits will really help. 

# 1 . Take an ‘organised approach’ to when to fill & empty the bladder

A standard mug or glass (of tea, coffee, water etc) is 250ml. Many people are often surprised to realise that you therefore need no more than 6-8 mugs/glasses in 24 hours.

a mug to show size
A standard mug is 250ml

The bladder prefers regular and spaced filling intervals rather than droughts or floods. Though the bottled­ water companies would like to persuade us differently, it is not normal to be constantly sipping water.  A drink every couple of hours should rather nicely lead to needing a wee every couple of hours. 

  • If you look at your wee when it comes out it should be pale yellow.  If it looks like water you are drinking too much, if it is dark yellow you are not drinking enough.
  • Drink every half an hour ? Guess what…you are going to need to wee every half an hour…
  • If 1.2 litres IN gives you 5-6 wees out. Then if you are drinking 3 litres a day, simple maths says that’s about 12 standard wees. Or 6 very very full bursting ones. Those bursting wees are highly likely to be accompanied by some unpleasant sensations or not quite making it!  Cut back on the volume (to 1.2 litres a day) and you could get an instantly happier bladder
  • Monitor your fluid intake carefully for a few days. Your ‘bladder’ problem could be merely operator error at the filling end.

# 2 Not all drinks are equal

It can seem strange that we say 1.2 litres of FLUID and don’t distinguish water from other drinks.  Tea and coffee are, however, just water with flavoring.  Think how you pour the water out of the kettle?

glass of water
Water is the best choice

So they will hydrate you but…you might want to think how the ‘flavoring’ could affect you:

  • Caffeine is a known bladder irritant. Some people notice that they react worse to ‘real’ coffee than instant (or vice versa).  Adding fat (milk or cream or on trend is butter!) slows the absorbtion of caffeine.
  • Tea can be ‘light’ by design (eg Earl or Lady Grey). Or light in the making; a few leaves gently steeped is very different from squashing the teabag to death in a mug.  The ‘builders’ tea’ version has extra caffeine and tannins – that’s what stains the mug.
a cup of tea
How do you ‘take’ your tea?
  • Alcohol is a diuretic (for every glass in, you will get one and half out…think hangover…dry mouth, dehydration, headache…).   
  • You may notice your bladder reacts to certain types of alcohol (spirits, wine, fizz) differently.  Find your tipple of choice and note what to avoid when there isn’t a handy toilet!
  • Fizzy water and de-caf coffee can also be irritating for some people. It is thought that it is something about the manufacturing process.
  • Watch out for ‘sneaky’ ingredients.  Fruit teas are high in sugar. Green tea has caffeine (and is also a diruetic – hence drunk on ‘diets’). Many hot chocolates are high in sugar & can contain caffeine.

#3 Take more notice of how drinks affect you

Start to notice how long it takes for different drinks to pass through you and make your bladder uncomfortable. 

Squeezy App (which reminds you to do your pelvic floor exercises) has a bladder diary you can use to monitor your fluid intake and trips to the loo or download a chart here.

  • You may find you are not as ‘tolerant’ of your favorite drink as you used to be. 
  • Don’t feel you have to go cold turkey. Just cut down a bit on the likely culprits. Then increase the balance of plain water. You will likely see a quick reduction in bladder urgency and increased capacity to hold. 
  • Pick your moments. It doesn’t mean you can’t drink your favorite double strength cappaccino…but maybe not just before a long car journey or the cinema?

#4 Sweating? Breastfeeding?  When you might need extra fluid

people at a yoga class
sweating or just a glow?

Hot days & exercise:   We don’t just lose fluid from our bodies when we wee.  It also escapes from our body in our breath (think how you can steam up a mirror). Also when we sweat.  If it is a hot day, we need extra fluid.  If you are doing an extra sweaty activity, drink a little extra before and be sure to re-hydrate after.  “Guesstimate” the amount that you might have glowed away. As well as the drink you were probably due about then anyway. But don’t over do it.

baby breastfeeding
drink extra to replace the volume given to the baby

BreastfeedingIt is important to have some extra fluid each time you feed…but again don’t over do the drinking or you will just be weeing more. To estimate the amount you need to re-hydrate – think about the milk volume that you produce when you express? Probably about  200-400ml?  So an extra glass/mug of fluid is all you need back again. You don’t need to down a pint of water – your poor bladder will just fill to bursting really quickly and not love you for it.

When should you have a wee?

A quick summary of the daily OUT routine. IF you are drinking 1.2 litres fluids in 24 hours (which is one 250ml mug roughly every 2 hours)

  • One wee in the middle of the night is considered normal 
  • On waking up expect a BIG wee  (400-600ml) – you could possibly fill a pint glass
  • Then through the day expect 5-6 average wees (200-400ml) – each one could fill a big mug
  • You do not need to wait until you are bursting to empty your bladder.
  • Aim to empty when your bladder holds a good mug-full. Little ‘yogurt pot’ wees should be avoided.

How to be nice to your bladder: emptying tips

# 1 The first sensation is usually too early

 After 45 minutes to an hour your bladder would normally hold about 120ml (a yogurt pot) of urine. Then you would get a ‘I might need a wee‘ sensation. This happens as the walls of the bladder (it’s a muscle) stretch for the first time.  

pot of yogurt
120ml “a yogurt pot wee” is a bit early

Our brains should know to recognise this as an ‘irritating-stretching-message’ not a ‘need-a-wee-now’ message.  Subconsciously we should

  • clock the time,
  • do the maths (only an hour since I last had  a wee)
  • tighten our pelvic floor muscles in a slow steady way,
  • distract ourselves with the job in hand

and within 2-3 minutes the feeling of wanting a wee completely disappears – like we never needed one in the first place – we go on with our activities, almost forgetting that we have a bladder.

This is the bladder’s normal first response.

That first annoying signal isn’t particularly useful. It’s just a very early warning signal. Like your petrol gauge alerting you when you still have 60 miles in the tank.   You don’t need a wee when there is only a yogurt pot worth in the bladder, even if the bladder feels a bit scratchy about it.  Just ignore it and it will go away.

mini-van
safety or just-in-case wees are for long car journeys – ONLY

 If circumstances are justified,  it’s ok to have a “just-in-case” or “safety wee“.  Say you’re  about to go on a a long car journey. Or about to have a swim or a shower. Or go to bed.  Then it makes sense to get rid of even the 120ml so that you have a long run ahead of you.  But you need to justify to yourself why you didn’t just ignore the feeling.   Otherwise it can quickly become a habit to have a wee every time you get a bit of sensation. That can be very disabling.

#2 . Ignore the first message and wait for the next one

Normally, that first message quickly disappears. We forget all about the bladder. We can fill it for a second hour (or so) till there is more like 300ml. Think a large ‘Cath Kidston’ mug-worth. Then you should get a dullish, polite “you need a wee” sensation that sends us off for a comfortable-but-not-urgent wee. 

big mug
A nice big mugfull – 200-400ml – is a perfect comfortable wee

This is when you should go.  There is still a bit of room in the bladder. If you have to stand in a queue, find your front door keys, answer the phone.  There is a bit of give and it is not too heavy if you need a cough or a sneeze.

# 3. But do not leave it for a third or fourth message…

But do we go when we should go??  Of course not……Many people (and especially busy, distracted mums)  leave it TOO LATE.  

You can ignore the middle message, and head into a third or even fourth hour. You can fill to nearly a pint (shift workers, teachers and nurses can often hold even more). BUT filling to your max tends to be accompanied by a sudden, very uncomfortable and urgent “need for a wee” message. The type that makes you sweat, your eyes water and comes with a strong sense of panic. Panic that you might not make it (and indeed you might not). 

pint of beer
A pint (500ml) will make your eyes water and could lead to accidents – save for first thing in the morning & emergencies ONLY

These maximum capacity wees are intended for first thing in the morning or an emergency.  BTW an emergency is being unexpectedly stuck on a motorway. NOT just putting it off for …one more paragraph, one more chore or an advert break.   And not just because you are too busy to remember to go for a wee!

#4 . Is there really something wrong with your bladder – or is it poor human judgement?

So many times the problem is really operator error. The human operator is not listening to the (rather good) system properly.  Guilty???  Which are you? Tend to go too early (friends and family tease you about always needing a wee)? Or tend to leave it too late (lots of sweaty near misses or trouble at the front door)?!

lady busy at computer
Concentrating? Distracted? or just too busy?

Or, not uncommon are you swinging between too early and too late? Do you push your limits…push your limits…leave it…leave it…just one more thing and THEN you very nearly have an accident?!  The problem is this makes your bladder very nervous. You start doing lots of little wees as soon as you feel something, just to be safe. You keep weeing early to avoid another bad experience? But then you think…this is silly… I need to train my bladder. So you start again, filling and filling, past the ‘right’ signal, on up and up …nearly bursting.. having an accident. And then you get nervous and go early again….a real viscious cycle.

What can you do to improve your bladder habits?

Homework this week. When you are heading to the toilet for a wee, try to predict the size of the wee you are going to have. Use the simple categories of:

  • yogurt pot
  • big mug
  • or pint class

( aka: small, medium and large).

I’m prepared to take a reasonably large bet that as soon as you start taking a bit more notice of what’s going in at the top and what the wees feel like at the different size points, you will quickly  tune in to the bladder sensations and interpret the messages better.

WC sign
This week monitor your fluid in and out

The hardest one to spot and get in tune with is the ‘middle’ one. It can almost be too polite to be properly useful.  A bit more interesting would mean it wasn’t so easily missed!  But we can’t change nature. Once you are familiar with the feeling of a “comfortable-size wee” you will be able to spot when to have a wee more easily. This will help stop the cycle of under or over-filling.

Exceptions – when to seek more help

If you thought you were going to have an enormous wee but only get a tiny one – or a tiny one but get far more – you may find your body is not well tuned to the sensations.  Sometimes the nerves stay confused after the pressures of pregnancy and childbirth and need retraining.   

If you do not feel that you get the ‘right’ sensations guiding you towards having a wee at that middle point and you leave it too late before the bladder suddenly decides for you, or you get unexpected leakage, then I would suggest you use the clock as a guide for a while (but all the while trying to tune in to any sensations you are getting).

looking at wrist watch
Use a watch to keep on track

Start with an hour, then have a wee, noticing how small they are at this stage. Then, once you are comfortable with this, don’t stick here too long or your bladder will get into an annoying ‘habit’ of thinking this is all you can do. Move up in 15 minute increments as feels comfortable and ‘safe’ to do.   Remember the goal is just 2-3 hours of holding  – no need for more. 

There are also medical conditions of the bladder

  • Overactive Bladder (OAB), often colloquially termed ‘irritable bladder’ is a pathology with symptoms of frequency, urgency and urge incontinence.  Commonly you feel a strong urge to wee but only a small wee comes out. Or you feel the bladder suddenly contract and leak, partially or completely (called urge incontinence).  If you have tried the tips above, but you still struggle with bladder control, keep a bladder diary to discuss the pattern with your GP.  There is medication that can help ‘calm’ a bladder. Or working with a physiotherapist on your pelvic floor muscles will also improve your control.
  • You can have a low grade bladder infection and not necessarily realise this.  Watch for cloudy urine, funny smells, feeling off colour.  The dipstix test at the GP is not that reliable – you may need to send your urine off for testing
  • You may not be making the hormones that suppress night time bladder production. If you have massive urine volumes at night, even though you are not drinking, discuss this with your GP.
  • Paradoxically – wearing a pad to prevent leakage can irritate the bladder tube and increase urge and leaks.  Try going without a pad or wearing knickers with an inbuilt pad to see if this is the case.
  • a CHANGE in bladder habits can also be an indicator of several other medical conditions.

If your symptoms aren’t getting better, ask your GP to check you and if appropriate refer you to a specialist physiotherapist.

Weird stuff affects bladders

Ever have one of those  days where you seem to need to wee and wee and wee?  Not necessarily unpleasantly but  you think “where is it all coming from????”

hands writing in a notebook
Rings and ankles give clues to fluid on board

The body constantly re-adjusts our fluid balance – and sometimes does this really dramatically.  You see it best by watching how tight/loose your rings are.  Notice this week how sometimes you can slide your rings about easily but other times they are stuck on tight.  The body holds fluid when it is hot and dumps it as it gets colder.  We also have circadian rhythms that affect fluid in and out. Most people wee more in the mornings and less in the afternoon.

Stress affects bladders

When we are ‘stressed’ (anxious, worried, cross, running late) our system is releasing adrenalin.  Adrenalin triggers our Fight, Flight or Freeze response.  If a tiger walked in your door right now – your hairs would stand on end, your heart would beat faster…and you would wet yourself.  Likely bowels too.  I think it’s supposed to be so that you can run faster.

Fortunately,  you are unlikely to encounter seriously stressful moments too often but we experience mild ‘stress’  all the time.  When you are feeling anxious, worried, cross, running late , the brain ‘drips’ adrenalin into your system to help you cope.  But with that comes bladder (or bowel) irritation.  Think of standing in a queue to do an exam, or waiting to give a presentation at work…that strong need to wee…and then even to wee again.

girl with a tiger
identify your day-to-day “tigers”

So if  you are having a day needing lots of wees, ask if you are stressed? Your bladder could be used as a barometer to your stress levels?  Rather than try to ‘fix’ the bladder…can you decrease the source of the stress?

Peaceful sleep & your bladder

It is normal to get up for one wee in the night  (assuming sleeping for 6-8 hours).  Annoying…but perfectly normal. Nicer if you don’t have to but some bodies just do. 

woman sleeping
last proper drink 2 hours before bedtime
  • But don’t be hard on the grandparents. Over the age of 60 it is normal to wee once or twice in the night. Hormone changes of aging affect the way the kidneys process urine.
  • aim to have your last drink 2 hours before bedtime. Then the fluid has plenty of time to go through your system with a good wee before getting into bed. 
  • Best to avoid caffeine late. 
  • Beware, sneaky sources of caffeine like Green Tea & some hot chocolate mixes
  • alcohol is a diuretic ie more volume comes out than went in (just think hangover….dry mouth….)

if you do have a late night drink (party!)) then don’t berate your bladder for needing a 2am wee!

That first morning wee…

 If you don’t wake in the night most people wake up with a very full bladder. You will need to make getting to the toilet your priority on waking.  

====    Mums go first!   ====

I appreciate that this was a LONG blog post – but I couldn’t leave anything out. I hope it has been helpful. Do let me know if this has helped you?

Can I run yet? Advice, videos and checks by specialist physio Amanda Savage

Can I run yet? 10 things to check before you take your post-baby body for a run

 

Can I run yet?  is a popular request from postnatal mums in  physio 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

Focus your training:

 


       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.

picture of pilates bridge with knee fold to test running technique

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.

Check your technique:  To work on reducing hamstring and foot cramp see my video with 3 top tips   “How to bridge without getting cramp”

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.

#4  Abdominal control  

Can your abdominal wall hold strong at peak run?        

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).

Can I run yet? tabletop with leg extensions mimics running action

 

 

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.

#5  Primed Pelvic floor      

Is your pelvic floor ready to take high impact?      

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.

#6   Connected core      

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.

  1.  5 spine curls (loosen the connection back to pelvis)
  2. 10 leg stretches (the walking action)
  3. 10 knee folds (the  jogging action)
  4. 10 double table top legs (mimcs legs in full sprint)
  5.  10 bridge with leg changes (primes the gluts)

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.

#7   Protected Bust   

Are your post-baby assets protected ?                       

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 is  important 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. 
  • 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:  Watch 3 Ps for a Perfect Po  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.

 

#10   Motivation & Pacing?     

Aim to under-achieve!

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:

standing pelvic floor exercises

My favourite standing pelvic floor exercise, ever

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.

  1.  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.