Work that Pelvic Floor (week 28)

Crunches don't really seem to be happening for me any more. I'm at the seven-month mark, and my belly is  big enough now that it gets in the way. I have a hard enough time getting off the couch once I sit down. I have quickly learned that either I sit down on the edge, or I sit in a firm chair.

On top of which, I've realized that my inability to lift the weights I used to lift before I was pregnant is a direct result of the loss of strength in my core. One of the principles I learned early on as a personal trainer was that a strong core helps you lift heavier weights, which in turn makes for stronger arms and legs.  In some cases it takes the scenario "you don't know what you got until you lose it" to make you realize how true that really is.

The loss of strength in my core is directly a result of the stretching of my rectus abdominus over my uterus. In its stretched-out state, it simply can't contract with the same strength it had before. So, how do you strengthen a core that just doesn't work the same way it used to? You need change your focus to the deeper muscles in your core and pelvis. And you can forget about looking for that familiar "burn" when you do an intense ab routine; instead, you need to visualize the muscles that are working and focus on contracting them to their maximum ability.

What to Work On

Pelvic Floor: This includes the group of muscles that support and help control the action of the vagina, the uterus, the bladder, the urethra, and the rectum. Contracting the pelvic floor muscles prevents the flow of urine when you are peeing, and causes the vagina to tighten. Giving birth puts a lot of stress on these muscles, and can weaken and damage them. This can result in stress incontinence (a.k.a. "mommy bladder") and decreased satisfaction during intercourse. Stress incontinence means that you might leak small amounts of urine while coughing, sneezing, laughing or exercising. 

Strong pelvic floor muscles can support the extra weight of pregnancy and help you push during the second stage of labour. When done regularly, these exercises can help to prevent stress incontinence and improve your healing time after birth. Another bonus of the exercises is that women with strengthened pelvic floor muscles are more likely to be orgasmic and have a more satisfying sex life.

Transverse abdominus: it's a muscle I've talked about in my earlier blog entitled How to Train Your Abs During Pregnancy. For those of you who don't know, your transverse abdominus is a muscle that runs underneath the more visible rectus abdominus (the muscle that shows when people have 6-pack abs), and acts as your stomach girdle.

How to Work on Your Pelvic Floor
I'm sure you've heard of the term "kegels", but you may not be aware of how to do them. First of all, they're the easiest exercise to do because you can do them pretty much any time, anywhere. You can be lying down, sitting in the car driving, or standing in line at the bank.

Finding them: First of all, you need to figure out how to contract your pelvic floor muscles. The easiest way to do this is to try and stop the flow of urine while you're peeing. If you succeed, you've got the basic move.

Perfecting your technique: Once you've identified your pelvic floor muscles, empty your bladder and sit or lie down. Contract your pelvic floor muscles, hold the contraction for five seconds, then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.

Repeat 3 times a day: Aim for 3 sets of 10 per day.

How to Work Your Core
Pelvic Tilts: They can be done lying on the floor or standing with the back to a wall. The standing version is a bit more difficult, but it is a good option for women who are not comfortable on their backs.


1. Lie on your back with the knees bent and the soles of the feet on the floor (or you can stand with your back against a wall). This is your neutral position, with the natural curve of the lumbar spine causing the low back to be slightly elevated.

2. On an exhale, gently squeeze your glutes (butt muscles) and pull your hip bone towards your lower ribs. Your butt will not actually leave the floor, but you will feel your low back press into the floor (or wall).  You are essentially taking the curve out of the low back.

3. After a few seconds, inhale and return to your neutral position.

4. Repeat this movement 5 to 10 times.

Click here for an animated version of this exercise.


Tail Wagging

Starting Position: Kneel on a mat and assume the "all-four's" position. Keep your head in a neutral position by looking down at the floor.

Action: Keeping your shoulders still, move your right hip toward your right shoulder as far as you can. Slowly return to the starting position then move your left hip toward your left shoulder as far as you can

Bird Dog
There's no sense in re-inventing the wheel. Here's a great link on how to do the bird dog exercise.

Mental Health and Pregnancy (Week 26)

I've been feeling great during these past few weeks of my pregnancy. My belly is ever expanding, and I've gained a total of 20lbs so far. Even though my thighs slightly rub together now when I walk (gack!), the doctor says I'm right where I need to be in terms of weight gain.

My baby is healthy and active (he kicked my Obstetrician's Doppler microphone 3 times during my last visit), which I guess isn't a surprise given how active mommy tries to be. I've been keeping active with a combination of swimming twice a week, walking twice a week, and doing various 20-minute exercise videos to work on muscle maintenance.

My mood has also been pretty good. Although I alternate days between feeling tired and energetic, overall my spirits are pretty high. I'm very glad for that. Not everyone is so lucky. It is just as easy to feel depressed and anxious as it is to feel happy and joyous when you're pregnant. I am ever aware of the possibility that I may get depressive symptoms during and/or after my pregnancy.

The Link Between Mental and Physical Health
Mental health has always been a prevalent issue in my life for two reasons: a) depression and anxiety runs in my family, and b) I have a BA in Psychology, which increases my awareness and sensitivity to the topic. One of the reasons I maintain such an active lifestyle is because I'm convinced it is one of the reasons I am in such a good mood to begin with. When I don't exercise for a while, I get lethargic and generally feel "blah".

There is a large body of research on the link between mental health and exercise. Put simply, when depressed and anxious people exercise over a set period of time, many feel better. Furthermore, if they maintain an active lifestyle, they are less likely to relapse.

Other research has shown that women who exercise during pregnancy are less likely to develop Postpartum Depression. This is great news, particularly for those mothers who want to avoid taking anti-depressants during and after pregnancy.

My quick and dirty advice to those of you who are not pregnant but one day plan to be: start exercising before you become pregnant, and maintain an active lifestyle throughout your pregnancy. If you are pregnant now, it's never too late to start exercising and begin reaping the rewards.

How to Recognize Symptoms of Depression
Depression can spring up on any one of us at any point in our lives. It can be particularly distressing when you have a baby, and you feel that you should be feeling happy and motivated to take care of this new life, but you feel the opposite instead. An estimated 14 to 23 percent of moms-to-be experience clinical depression, and about 40 percent have some symptoms. That's a lot of sad pregnant women.

Symptoms of depression include: feeling sad for several weeks; loss of interest in activities you normally enjoy; feelings of guilt or hopelessness; and/or difficulty concentrating. If you recognize any of these symptoms in yourself, talk to your doctor or midwife.

How to Recognize Symptoms of Anxiety
Pregnancy is listed as a significant stressful life event. t is normal to be somewhat preoccupied with "doing all the right things" to ensure your unborn child has the best chance for a normal development. However, for some women this preoccupation can get blown out of proportion to the point that it affects how they live their lives.

Earlier this year, one of my clients was on her fourth pregnancy, and was well-aware that her anxiety levels increased during pregnancy. During our exercise sessions, she would get nervous about how high her heart rate felt to her when she did anything aerobic. Even though her doctor told her she was fine, and we used a heart rate monitor to make sure her heart rate wasn't elevated to a dangerous level, it was hard for her to not feel a sense of panic over it. The biggest thing that helped her control her anxiety was simply her awareness of what it was caused by, and that her feelings were not rational.

If you are suffering from anxiety that is persistent, intrusive or out-of-proportion; irritability; inability to sleep because of your fears; waking up with a racing heart; or have difficulty concentrating, talk to your doctor or midwife.

Pre-Natal Fitness Exercise Videos...Cheap and Cheerful Fitness! (Week 24)

I just hit my sixth month this week, and I have to say, I really have no complaints. Since my tummy now protrudes further than my chest, my hip pain is still gone, I'm sleeping well (apparently, not for long), and my energy is moderate to high (thanks to the iron supplements), I'm feeling pretty darn good. I am still training clients, walking, hiking, swimming, and now have added prenatal workout videos to my repertoire. I've also done a bit more reading on how to work on concerns about diastasis rectii (see my Sept 7th, 2010 entry on how to train your abs for pregnancy).

Why Exercise Videos Instead of the Gym?
As a personal trainer, it makes a lot of sense that I should visit the gym and train using a prenatal fitness program. So why am I not going? It's simply the psychology of it: when I go to the gym, I go there to work hard. It's what I've been doing for years. The problem is, I shouldn't be working hard now. It has taken me months to come to terms with the changes my body has undergone, and that I can't train the way I used to. Looking back, I'm pretty sure that the hip pain I had a month ago was because I pushed my body a bit too hard.

By following exercise videos, I am relinquishing control over the intensity and duration of my workouts to someone else. Frankly, it's a nice feeling. Heck, if that woman on the screen says I only need to do 15 reps of squats with no weights, then I will!

Exercise videos for pregnancy also introduced new exercises to me, and made my workouts more interesting. When you exercise for any length of time, it's important to keep things interesting so that you keep doing them.

Training Abs to Reduce Diastasis
When you are further along in your pregnancy, it becomes a good idea to use a device to support your abs while you do crunches. Whether it be a belly band, a tummy splint, or a towel, a device that wraps around your tummy while you perform a crunch will decrease the lateral force on your rectus abdominus. The least expensive tool is the towel. (see picture)

Although the woman above is clearly not pregnant, this is how you would use it to do crunches. You can increase the intensity of the crunch by lying on a stability ball. Whenever you do a crunch, make sure to pull in your belly button to engage your transverse abdominus. This will also reduce the lateral force on your tummy.