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Hello,
Thank you for your website and the DVD, both of which are full of so much information. It is great to have somewhere to get advice and answers.
I am writing from the UK with two questions!
Background info: I had a vaginal birth 18 months ago – forceps and a third degree tear. I saw a women’s health physio every couple of months for the first year. I had the ‘falling out’ feeling, visible bulge, discomfort at the end of a day when I had been on my feet a lot / carrying heavy loads etc. She said I had a rectocele and cystocele and then at the last appointment described it as a weakening in both the front and back of the vaginal wall – she wouldn’t give it a name or a grade as said it wasn’t helping to worry about that, it was better to focus on how it felt and impacted daily life.
Programme with physio: With the physio I built up kegels so that by the end I was doing 10 long (20 second holds) and 20 short (1 second holds), three times a day. When I was discharged from physio she said that I only needed to continue doing then once a day now that my pelvic floor was back in better shape.
Now: 90% of the time I have no problems. However, I know that if I stop doing kegels the symptoms come back. Also if I am tired / spend too long on my feet / carry too much etc I feel it. I am also keen to keep my pelvic floor in good shape. I am currently doing your DVD workouts and also kegel exercises as directed by physio.
Questions:
1. In your DVD notes it says not to perform more than 8 or 10 kegels a day. So I wanted to ask: Is continuing to do the 10 long (20 second) ones and 20 short (1 second) ones a bad idea? I feel better when I am doing this programme three times a day, but I do not want to cause any further problems. Is overworking the pelvic floor really a bad idea, or would I know from how my pelvic floor felt if I was doing too much?
2. With all the exercises in all the workouts on the DVD, do I need to contract my pelvic floor for every one, even if it doesn’t say to? Eg when doing the stomach one in workout 1, should I contract the pelvic floor (if it doesn’t already contract automatically)?
3. I generally contract my pelvic floor before an action that I know is going to stress it (for example if I were to jump of a wall I would contract it before landing). Is this right or wrong?
4. I read that cycling standing up stresses the pelvic floor – however I also know I have lost all glute strength since being pregnant and this is a good way to rebuild it! Is there a way that I can adjust cycling standing up to reduce pressure on the pelvic floor? Currently I try and just listen to my body, so don’t do it for too long, stop if discomfort etc.
Apologies for the long post. Many thanks for all the information that you provide – so accessible and helpful! I really have found it great both in terms of physical advice and also positive encouragement.
Elizabeth
Hi Elizabeth,
1. I don’t recommend more than 8 two step Kegels/day – significantly less than yours – I would much rather see you performing 4 sets of planks each day than such a huge number of Kegels. lets focus on getting your TA strong.2. Yes, our goal through the dvd (not so much in Workouts 1 and 2) but as you get to workouts 3 and 4, our goal is that you are beginning to feel your pelvic basket muscles co-contract. So, yes, is the answer. On your seated adductor squeeze – you should feel your tail bone lifted in correct sitting position activating your multifidi, your pelvic floor will lift, your TA contract (which lifts the pressure up in your rib cage, lifting your chest) while your adductors work to squeeze the ball between your knees.
3. That is right! Thats called a firing pattern – with time that will happen automatically instead of being a voluntary act or squeeze.
4. Listening to your body is always a great first step. Most of the difficulty in standing on your pedals is that your breathing intensity and volume goes up. If you keep your chest up and tail bone lifted you will be fine.
5. The water is a good form of exercise, but your posture remains important. If I start doing rotations in the water and my back flexes and my tailbone tucks under, I will activate my rectus abdominus instead of my TA – so be aware of body positioning. Also be aware of small breath holds – also a rectus abdominus recruiter and forces pressure down on our pelvic floor. Breathe out with all exertion.
6. Thank you for the apology on the long post 🙂
Tasha
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