I've been doing a lot filming and adding to my exercise catalogue recently and it really made me thing about the continuum we use when helping the post baby client and I thought this blog might be useful to create a sense of order to the exercise prescription that we provide for our clients. This is the protocol that I follow:
1. In the early days, post birth especially if there has been birth canal trauma or C-Section, most clients are just pleased to actually 'make contact again' with their post belly-button body. Very soon after birth and only if pain isn't an issue, the client can begin using the synergyistic relationship between the breath, TVA/Abdominal Wall, Pelvic Floor and the Lumbar Muscles/Fascia to provide a foundation for an 'early days re-integration programme'. Basically, a purposeful exhale (try exhaling for a count of EIGHT) will naturally prompt 'core stiffness' - a lifting and tensioning of the pelvic floor muscles, a turning on of the lumbar muscles and fascia and a tensioning of the abdominal wall. This also has the added benefit of being extremely oxygenating (you'll need to breath in deeply too)/healing/relaxing and for moms in this early post birth period and for most client is the 'right fit' in terms of level of activity and complexity. You can also coach the client to perform quicker exhales to more stimulate the fast twitch fibres of the pelvic floor to create a more complete routine. A few minutes of each version 3 times a day is a great place to start. This is very much CONSCIOUS work for the pelvic floor and core where a definitive mental strategy is use to re-connect - the client have to 'think about it!'
2. The second stage of the continuum involves asking less indirect muscles and their continuation via fascia to also stimulate the pelvic floor. The adductors offer great stimulation mainly for the anterior portion of the pelvic floor and if the previous strategy of the purposeful exhale is combined simultaneously with adduction against the resistance of a Pilates ball. The pelvic floor contraction is further 'super-sized' and we now start on the road to UNCONSCIOUS and much more functional restorative work for the pelvic floor and core.
3. So then, the final stage of the continuum is to get the new mom back into functional movement involving the 'purposeful breath'. This involves using the LOCK, LOAD AND LOCOMOTE protocol. By this stage (post 6 week check and resuming activity) we need to teach moms how to lift loads with strength and move safely, because quite simply, that's what they do all day. A summary of this protocol is that you ask the client to (a) activate TVA FIRST, by making a short HISS)and as they (b) lift/load the baby, dumbbells or shopping bags, they then (c) exhale strongly. This creates a 'LOCK' on the core. This means that all of its components are stiffened by this action and vulnerable structures protected and the potential increase in intra-abdominal pressure created by lifting the load is reduced. This is hugely important when considering the weakened and stretched anterior abdominal wall, any Diastasis that may be present and also a weakened Pelvic Floor.
Always using this cueing system during our training sessions with clients will help to re-inforce optimal lifting strategies during their everyday life and get them stronger, fitter and faster in no time. These are positive skills for the rest of their lives not just the post birth period and combined with a bespoke exercise programme and good nutrition will reduce the incidence of backpain, incontinence and of course create a better looking belly. Try to keep it simple with clients when coaching this....my key verbal cue is always EXHALE ON EXERTION! This always does the trick. Hope that helps you out, give it a go and watch your level of core-connect for your post baby clients completely soar as you go through your next session.