Have you ever been told “don’t lift your kids” because of Prolapse or other Pelvic Health Issues? Rachel Prince, founder of re|Born Active explains how you can get back to lifting and functional movement again.
Language matters; the way information, or a diagnosis, is delivered to us makes a difference. Let’s take the example of “Don’t Lift Your Kids” because of common pelvic health outcomes from pregnancy – in particular prolapse but I’ve also heard women being told the same with diastasis recti and higher levels of incontinence.
Yes of course we have to clear the red flags, tissue damage and so forth, but once cleared, remember the above are NOT a contraindication to exercise or movement. You are moving day to day! You get yourself from A to B, you get up from a chair, you’re picking up toys from the floor, not to mention carrying your baby.
SO, think about what you NEED to do in life. Lifting your kids, even if they are a bit older IS something you HAVE to do. Otherwise you’ll be pushing them with your feet along the floor or dragging them by the arms…. not really an option right?!
The first thing is dialling down the fear-avoidance beliefs that may have been imposed upon you. You’ve done this before, you are safe. For example, you might choose not to heavy squat or deadlift with a barbell in the gym just yet, but you have to pick up your child from the floor to put them in their high chair or lower into a cot… same but different? One is structured and guided (if with a trainer), the other is typically done without thinking and more ‘uncontrolled’. So why not get stronger to make the uncontrolled easier?
There is no need to go from 0 to 100, exposing yourself to graded levels of functional movement will help increase your capacity to carry out said movements and stimulate adaptation e.g. muscle strength and growth (hypertrophy) including pelvic floor!
So how to start? Here are some tips:
Strengthen the deep core muscles
Start with the strengthening the deep core with the breath and pelvic floor muscle training in a variety of positions, while also gaining an understanding of what it feels like to bear down (and therefore how you are managing rises in intra-abdominal pressure). I do believe knowledge is power (and sometimes a curse) but if you become more aware of your body, it makes it easier to adapt.
Give yourself scaling options to manage what you feel comfortable with and ready for e.g. if you want to avoid symptoms, discomfort or certain sensations or work to just shy of them, then you have multiple variables you can play around with. All of which will elicit changes in intra-abdominal pressure. For example, you can change:
- Breath strategy– inhale down, exhale up, exhale down and up, exhale down pause for an inhale and exhale up, and so forth.
- Posture– in particular the trunk and position of the ribcage and pelvis in relation to each other, pelvic positioning (anterior, posterior tilt etc.), but even down to the foot (such as dropped arches) and up to the head (is the head more forward or back in line with body).
- Position– all exercises can be altered to a position of less pressure including supine, side lying, kneeling, half kneeling, seated, standing, prone and consider how you manage transitions between them.
- Driver– how we drive the body to move in space; what body part, as this will create the reaction e.g. our foot or hand as examples. A driver can also be a cue rather than a body part either verbal or physical touch.
- Direction– which way are you moving; front/back (sagittal), side to side (frontal), rotational (transverse) or anywhere 360 degrees! If one pattern or plane of movement is bothersome, try another!
- Height– are you reaching or lifting from the ground to overhead or from knee / hip height to chest level and so forth. What level do you feel successful in vs. too challenging, work your way up to it.
- Distance– you can alter different ranges e.g. closer to the body vs. further away and consider how that will change how you carry out a task with load. You could work initial range first to be cautiously confident and work up to your end range.
- Load– how light or heavy can you lift or, more importantly, do you need to lift? You might want to master bodyweight first at speeds that are important for you to carry out daily tasks and then add load, but also think about how much your kids weigh as a benchmark.
- Rate– the speed at which you are moving! Slow and controlled vs. fast and higher intensity. Again, think about what speed you NEED to operate at in life chasing after kids!
- Duration– including how long (time) how many sets, reps, time under tension etc. Start with what you are already doing and then increase in increments.
- Environment – your surroundings. Are you at home with the kids vs. outdoors or at the gym by yourself. Remember the environment you are working out in also has the ability to keep you calm vs. stressed!
Progressively expose yourself to discomfort
You may choose to expose yourself to symptoms, sensations or work into the discomfort you are experiencing (with progressive overload) particularly if they are not changing and are present in your day to day anyway i.e. start with functional movements that are KEY to your everyday life and see if sensitivity decreases. And you can still work with the variables above to manage.
Plan for scaling back if needed
Always have a scale back plan. As soon as something doesn’t feel right, symptoms worsen to a point beyond where you feel comfortable, you experience pain, then you have that scaling option to revert back to.
Consider the impact of other factors
Think about the other factors in your life that might be impacting progress; managing stressors, diet/nutrition (and therefore levels of bloating, toilet habits etc.), sleep (well rested vs. fatigue or exhaustion), illness as well as times of the month where sensitivity might vary (menstrual cycle around ovulation and before your period as examples)
Track what makes your symptoms worse
Keep a diary or track what exacerbates symptoms, sensations, discomfort etc. so that you can be prepared for the days when things might not go to plan and realise that one or more bad days might not be limiting progress – it could literally just be a bad day! We all have them and our level of performance to carry out tasks, activities, training or sport changes regularly with or without pelvic floor concerns.
This last point 6. will be good for some but too much for others i.e. if you are someone who can get obsessed with the detail then it might be too much and lead to overthinking everything. You want to get on with life, remove fear and an enjoy the experience of getting stronger and improving your health, fitness and wellbeing.
You might not be ready physically and mentally to pick up a barbell yet and that is fine! At the very least train your body and pelvic floor an appropriate level and intensity to make your body stronger, life easier AND enjoyable!
And lastly don’t forget to relax. Unclench that butt and jaw! It can be easy to hold on tight to everything as a way to ‘protect’ the body e.g. overly engaging/activating your abdominals and pelvic floor, but too much tension is troublesome! Be sure to fit in activities that require you NOT to think about it all the time and help you unwind whether that be with the family, friends or even on your own including meditation & mindfulness.
If you do need further support, seek out a qualified health professional that can show a positive pathway to where you want to be and empowers you, not frightens you out of movement.