Emily Field

My top 5 early post partum tips.

5. Hydration, hydration, hydration
Breastfeeding mums require an additional 1-2 litres of water per day to keep up with milk production. Being well hydrated also helps keep bowel motions soft, reduces bladder wall irritants and aids tissue recovery.

- Fill multiple bottles to place in convenient locations around the house ie. next to feeding chair, lounge, bed
- Have a glass with each meal and each coffee/tea
- Set reminders on your phone
- Sip your water don't skull it

My top 4 early post partum tips.

4. Keep bowels soft and don't strain
The dreaded first bowel motion post partum can be a source of stress for new mums. Look at your diet, hydration and use laxatives if required to keep bowel motions soft. Only attempt to open bowels when you feel the urge, support the perineum, use a foot rest so your knees are above hips and avoid breath holding. These are key to making it as smooth as possible.

My top 5 early post partum recovery tips.

3. Compression garments as tolerated
Post delivery our abdomen and pelvis will often feel more comfortable with some support. This also provides support to the healing tissues of the perineum or caesarean scar and can help to reduce stretching and swelling. Often garments with high compression like SRC shorts aren't well tolerated until a few days post delivery. You could try a pair or your pre pregnancy high waisted tights in the first few days.

My top 5 early post partum recovery tips.

2. Gentle pelvic floor squeezes
Initially post partum our goal with pelvic floor recovery is to reestablish the mind to muscle connection and encourage the tissues to heal. Gentle pelvic floor squeezes at about 30-40% strength for 1-2 seconds can help to encourage blood flow to the healing tissue, flush out some of the swelling and wake up those connections. It's important to wait until the catheter is removed to start.

My top 5 early post partum recovery tips

1. Horizontal rest
As new mums we have to be up holding, changing, and carrying our new little human for much of the day. Post delivery, whether va**nal or cesarean, swelling and bruising will be present and will increase with upright positions. As much as able, try to prioritise a few times throughout the day where you are lying down. This allows the swelling to come away from these areas, takes pressure off your healing tissues and takes the pressure off your pelvic floor.

Happy International Women's day. Here's to strong women. May we know them, may we be them, may we raise them. We do not have to be strong alone. Sometimes the strength to ask for help is far greater.

My favourite part of being a pelvic health physio is empowering women to understand their bodies, when and where to seek help, know their options and give them the knowledge to make informed decisions about their health. What a privilege!

Endometriosis is a chronic, systemic inflammatory disease characterised by the growth of endometrium-like tissue outside of the uterine cavity. "It associated with severe, life-impacting pain during periods, sexual in*******se, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility." (The world health organisation.)

As can be seen by the symptoms, endometriosis had a huge impact on the pelvic floor and surrounding structures. It is complex and the whole body impact is different in each individual.

Pelvic floor physio interventions can assist in optimising bladder and bowel habits, improving pelvic floor tone, coordination and strength, assisting in pain management, and managing associated musculoskeletal concerns.

Quality over quantity

Most of the time when the pelvic floor is weak we compensate with other muscles such as inner thighs and glutes. So when trying to strengthen our pelvic floor we want to make sure these muscles stay relaxed. This helps the brain recognise which muscle to use.

This might mean that instead of 10x10 second holds, you might only be able to do 5x5 second good quality holds. When the pelvic floor is fatigued, the other muscles will likely take over so we know it’s time to stop and rest.

Why does my tummy bulge when doing ab exercises?

This is referred to as coning and happens when your deep abdominals aren’t strong enough to match the pressure within your abdomen when doing an exercise.

This is something to be aware of during and post pregnancy and is a sign that the exercise you are doing is probably too difficult at the moment. Try to engage and hold your pelvic floor and deep abdominal muscles while doing the exercise and see if the coning is still present.

If it is, try to reduce the difficulty of the exercise to a point where there is no coning and slowly build back up from there. When in doubt, chat with your pelvic floor physio.

How do I know if I’m doing it right?

You should be able to feel that gentle drawing up and in along the T and be able to move your spine and breathe. If you are bracing your abdominals, it will feel difficult to move your spine and you will likely be holding your breath.

If you’re still unsure, book in to see a pelvic floor physio to be assessed.

When you “engage your core”, you ideally are using the deep core muscles to create a stable cylinder.

I like to cue this by getting people to imagine the letter T with the horizontal line between the front of the hip bones and the vertical line up from the p***c bone. Think about squeezing and lifting your pelvic floor up the vertical line like a zipper. Then imagine you’re drawing the points of your hips together along the horizontal line. You should feel a gentle drawing in of your lower tummy at the intersection of the T.

I don’t like to use cues such as “squeeze your abs”, and “brace your tummy” as most of the time people will just squeeze their abdominal muscles instead.

Have you tried reformer Pilates?

It’s perfect to strengthen and lengthen muscles. There are plenty of modification options for pregnancy, post partum and injuries and it’s great to help focus on pelvic floor control.

I’m lucky enough to have this one at home to help with my post partum recovery. And maybe to come up with some fun programs for when I return to work…

GO2 Health

You’ve probably all heard the phrase “engage your core” but what does this even mean? How do I do it? And how do I know if I’m doing it right?

To understand this we need to have a quick think about the anatomy. The deep “core” is made up of 4 groups of muscles that work together to manage the pressure in the abdomen.

I like to think of these muscles creating a cylinder:
- Transverse abdominus which acts like a corset around the abdomen
- Pelvic floor at the bottom
- Diaphragm at the top
- Multifidus at the back right next to the spine

When you “engage your core”, you ideally are using these muscles to create a stable cylinder.

Exciting news!

I’m returning to clinic in November. Call GO2 Health to book in (3355 5540).

Muscles of the pelvic floor

The pelvic floor is often described as a sling or hammock. However, it is actually made up of 3 layers of muscle. These muscles work together to “squeeze” (closing around the urethra, va**na and a**s) and “lift” (drawing up to support the pelvic organs).

To function correctly they must be able to:
- Maintain a sustained resting tone for support
- Contract quickly and strongly to maintain continence
- Relax fully to empty bladder and bowel
And be coordinated enough to do all this at the appropriate time.

This week is Women’s Heath week. Let’s support the women in our lives who are suffering and shine some light on these conditions.

This week is World Breastfeeding Week. It’s aim it to educate on the benefits for breastfeeding and to support mums on their breastfeeding journey.

I’ve been lucky enough to have a wonderful breastfeeding journey so far. For this I am so grateful as I know it’s not always easy or even possible.

What does a post partum physio check up involve?

Regardless of how you deliver your baby, I highly recommend that every new mum has a pelvic floor physio check up post birth. This is usually done at 6 weeks post partum, just like the obstetric check up.

Your post partum physio check up usually involves a thorough history of:
- Pelvic floor concerns including bladder and bowel, prolapse symptoms, continence, pain, sexual concerns
- Any musculoskeletal concerns such as pelvic or back pain
- Details of pregnancy/s and delivery
- General health
- Exercise and activity goals
- Work/life requirements

Your appointment will usually include a pelvic floor and abdominal examination. This involves an external and internal va**nal examination to check pelvic floor strength and relaxation, prolapse, scar tissue healing, sensation as well as some measurements to help guide return to exercise. An abdominal assessment is also done to check for muscle separation and caesarean scar healing.

It’s understandable that you might be nervous about the internal exam. But don’t let that stop you from booking in. We can still gather plenty of other valuable information without doing an internal exam. Any assessment is better than none.

https://www.instagram.com/p/CRh-FSuN_B0/?utm_medium=copy_link

Return to exercise post partum (weeks 6-12)

At 6 weeks post partum most mums will have their obstetric checkup. This is to check on mums recovery and make sure healing is well underway. Usually at this appointment you will be told whether you can resume exercise.

Also at 6 weeks it is recommended to have a women’s health physio check up. This is assess your pelvic floor (and any other factors) and guide you with appropriate return to exercise plan.

There are many factors to take into account for returning to exercise so an individual approach is always recommended. Exercise options weeks 6-12 post delivery might include:
1. Pelvic floor exercises - continuing with progressions
2. Functional pelvic floor exercises - continue as previous
3. Walking - if you’re feeling ready you could start to incorporate some small hills
4. Low level Pilates based exercises - starting to introduce abdominal focused exercises if appropriate for you
5. Body weight exercises such as squats, lunges, step ups and light weighted upper body exercises such as rows - progressing to using a light band or weights

Please note: Running and plyometric exercises are NOT recommended until at least 12 weeks post partum to allow for tissue healing of the nerves in particular.

Watch for signs and symptoms telling you to slow down (see previous post).

Return to exercise post partum (weeks 2-6)

By week 2 post partum most mums will be able to feel their pelvic floor contract and relax. It’s likely you will note a difference in strength and endurance compared to pre-pregnancy and during pregnancy. Your body might also be feeling tight and stiff from the long hours of feeding and cuddling your baby.

Exercise options weeks 2-6 post delivery:
1. Pelvic floor exercises - progressively increase your hold length and number of reps. Don’t forget the quick flicks
2. Functional pelvic floor exercises - if you’re not already, start to think about engaging your pelvic floor as you stand up from a chair or bend down to pick up your baby
3. Gentle walking - also a great excuse to get outside in the sunshine
4. Gentle core/pelvic mobility exercises - starting to incorporate exercises such as bridging and clams if these feel good
5. General stretching - a good rule of thumb is trying to reverse the position you find yourself in most frequently. This will likely be chest, neck and shoulder stretches

Watch for signs and symptoms telling you to slow down (see previous post).

1 in 4 Australian adults experience incontinence. Approximately 80% of these in the community are women.

70% of those that suffer from incontinence do not seek help.

Let’s break the stigma! Incontinence is not normal. You don’t have to suffer in silence. Pelvic health physios can help.

World continence week 2021

https://www.instagram.com/p/CQZ0jctNYFx/?utm_medium=copy_link

Return to exercise post partum (weeks 1-2)

Why do we dedicate 6-12 weeks of structured rehab to recover from most surgeries but often jump straight back in to pre pregnancy exercise after the 6 week obstetric check up?

Pregnancy and giving birth, regardless of type of delivery, has a huge impact on our body. We need to give it time to recover and slowly build the strength back up.

So where do I start? Exercise options weeks 1-2 post delivery:
1. Pelvic floor exercises - slowly building up with long holds, quick flicks and the knack
2. Gentle walking - ideally on a flat surface and not pushing the pram or carrying bub. Start with 10 mins and build from there
3. Gentle core/pelvic mobility exercises - pelvic tilts and gentle stretching are ideal

Watch for signs and symptoms telling you to slow down (see previous post).

https://www.instagram.com/p/CQN5bztNoak/?utm_medium=copy_link

When to slow down with post partum exercise

One size doesn’t fit all when it comes to most things in life. Returning to exercise post partum is no different. There are so many factors to consider. Previous activity level, pregnancy and complications, delivery etc.

When returning to exercise it’s important to watch for signs that you might be progressing too quickly.
1. Pain anywhere, especially around your pelvis and stitches
2. Discharge or changes in bleeding (please see your doctor ASAP)
3. Dizziness or feeling lightheaded
4. Dragging or heavy feeling in your va**na
5. Leaking of urine or faeces and/or difficulty controlling wind
6. Abdominal doming/coning

Slow down and seek support from your doctor or pelvic floor physio. Remember it’s not a race to get back to exercise. Be kind to yourself. You’re not a failure if it takes a bit longer than you expect.

https://www.instagram.com/p/CQH7G2at-X-/?utm_medium=copy_link

Exercise in pregnancy is a topic that keeps popping up. There is so many negative and hurtful comments posted on many pregnant mumma’s social media.

We need to change the perception.

Exercise in pregnancy is recommended for ALL women without contraindications. Guidance from obstetricians and physios can help to navigate the fear and give women the confidence to take control of their physical activity during pregnancy.
https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Exercise-during-pregnancy-(C-Obs-62).pdf?ext=.pdf

2020 has been a challenging year to say the least. So much fear and worry. So many changes to our day to day lives, our livelihoods and our community.

With uncertainty around every corner, IT’S OK to feel overwhelmed. IT’S OK to feel anxious and down. IT’S OK to ask for help.

YOU ARE NOT ALONE💕

Check in on your friends and family. Please ask for help because IT’S OK to need it.

Happy Women’s Health Week!

This is the week to put yourself and your health first. Book that health check you’ve been putting off. Take some time out of your busy week to do something for you!

“I don’t have time” is not a good enough excuse.
You can’t take care of everyone else if you neglect yourself.

Yes ladies I’m talking to each and every one of you 💕

APA | Federal funding for physiotherapy assessment for pregnant and post-partum women will improve lives, increase productivity and save money To mark the start of Women’s Health Week the Australian Physiotherapy Association (APA) is reiterating its call for Medicare subsidies for physiotherapy assessment and management for all Australian wo

“The Knack”

An important component of stress urinary incontinence management. I think of it as functional pelvic floor training.

The knack refers to active contraction of the pelvic floor muscles prior to activities which cause incontinence such as coughing, sneezing and jumping. Leaking often can occur with these activities as the pelvic floor may not be strong or coordinated enough to counter the sharp, sudden increase in intra-abdominal pressure.

Best to check with a pelvic health physio if you’re experiencing any of these symptoms.

What is a pelvic health physio?

Do you think of pelvic floor, continence, pregnancy, pelvic pain? Do you think it’s just for women?

I’ve been thinking a lot about this question and how to explain it to patients.

We certainly can help with pelvic floor concerns, pain, continence and pregnancy related conditions. But we also look at you as a whole person and how your pelvis and pelvic floor connects to the rest of your body. We look at how your symptoms impact on your life and work with you to help manage them. We definitely treat men as well as women because after all they have a pelvic floor too (even if they don’t know).

Pelvic floor conditions are often more complex than just the structural issue.

Ready to get back to the gym post-iso? Be sure to follow these tips from physios around Australia to make your return without injury as smooth as possible.

✅ Warm-up and cool-down properly using stretching, foam-rolling and icing techniques to aid in your recovery.
✅ Drop your pre-iso weight by 20-30% and gradually increase the weight over four-eight weeks depending on your age and fitness level.
✅ Get your form checked by a professional and ensure you are controlled and slow in your repetitions.
✅Don't go too hard, too early! Build up to your pre-iso levels as your muscles and tendons will have likely shrunk, making you more susceptible to injury.
✅Check in with your local physio to avoid injury and manage your return to full capacity.

For more recommendations from APA Sports and Exercise Physiotherapist Julie Campbell, MACP, and Brooke Patterson, APAM, on returning to the gym, head to https://ab.co/2XPA3Z6