This is the one and only post written during my pregnancy. (I’m full term now, just waiting on baby to arrive.) Writing a blog or engaging in social media just hasn’t been a priority the last nine months. I’ve been spending less time online. I wanted to experience this pregnancy with less technology, fewer distractions and time wasters. For a variety of reasons, we made a conscious decision to keep our news off social media. Now I’m heading into my maternity leave, and I wanted to write a quick post. Short and sweet, just a few things I’ve learned about alignment and natural movement during the last nine months. These are all things that I knew on an intellectual level, but being pregnant has caused me to understand and appreciate them in a new way.
1) Keep moving, so that you can keep moving. This is probably the most important thing I did during this pregnancy. JUST KEEP MOVING. I’ve made this recommendation to my clients, but now I really understand how important it is. You are gaining weight gradually and your body is going through major changes over the course of almost a year. If you keep walking, squatting, going up and down the stairs, getting up and down off the floor, you will gradually gain the strength as your weight gradually increases, and you will be able to continue doing those things. Two of my goals for this pregnancy were to reach the end and still be able to get up and down off the floor and be able to hike at least 2 miles. I’m nearing the end, and let me tell you, I feel truly enormous, but it’s manageable. I can’t imagine how difficult it would be to get around if I hadn’t been moving all along. Last week we went for a hike– uphill, downhill, up and over boulders, through a partially dried up creek. At this stage of the game, I’m tired, I’m slowing down, and I stop for lots of pee breaks (good thing I’ve been practicing my squatting!). We went slow, about 3 miles in 2 hours, BUT I did it. Not only did I do it, I enjoyed it. I share this not to brag (my endurance certainly isn’t what I had hoped it would be!), but to encourage you that it’s possible to never reach the point where you are too big to move. Just keep moving.
2) Do what you can, then rest. There were days that I could walk about 10 minutes before I needed to have a snack and take a nap. You’re tired. I hear you, mamas. Sometimes it is a victory just to get out of bed and walk to the mailbox. When you can only muster the energy for a little movement, DO IT, then rest. Other days I felt up for a long walk, going to prenatal yoga class, and teaching a class. When you feel good, and you can challenge yourself, DO IT, then rest. Give yourself grace. Growing a baby is hard work. Release yourself from expectations. Your body is doing an amazing thing.
3) Don’t underestimate the importance of pelvis back, ribs down & feet straight. Seriously, this one small thing saved me from so much potential pain. I didn’t have any back pain during this pregnancy, and this is part of the reason why. I knew this was important before, but experiencing it while pregnant took it to a whole new level. In my classes, I demonstrate leaning your pelvis forward and thrusting your ribs (what NOT to do). It’s really common to assume this position in pregnancy because the extra weight in front tends to pull you forward, unless you know to stand differently. As I got bigger, demonstrating this became more and more uncomfortable. Even just being in this position for a few seconds feels awful. I actually had a hard time demonstrating for the pictures below because it feels that bad. You can learn more about this (and see better pictures of these various positions) in these posts about pelvis position, rib position, and how to stand when you are pregnant.
(Left to right: Ribs lifted, pelvis forward & feet turned out, pelvis back & ribs down.)
4) This stuff really works, AND ALSO sometimes you need additional support. By “this stuff” I mean practicing good alignment, moving more (and moving better), sitting less, the corrective exercises, and moving towards more natural movement. Don’t get me wrong– I’m tired, I wake up stiff and achey, and my fingers and toes are starting to get a little sausage-y. This pregnancy hasn’t been without it’s discomforts, but I’m nine months pregnant and I’m not totally miserable. For starters, I haven’t peed myself once. Yes, the baby head pressing on my bladder is causing unspeakable pressure. Yes, I pee more frequently than I did before. But I’ve never felt like I couldn’t control my bladder. I haven’t had any back pain, sciatica, pubic symphysis pain or hemorrhoids. One thing I did experience early on was SI joint instability and a tweaky feeling in my hip. Before I got pregnant, I knew that my right side was weaker and less stable, so it was no surprise when it started giving me trouble after gaining my first 10 lbs. I knew the exercises I needed to do to improve my pelvic stability, but it wasn’t getting better. Getting additional support from a PT was really helpful. She could manipulate the bones of my pelvis to help correct a rotation and tape my sacrum to give a little extra support until my muscles were strong enough to keep my pelvis stable and aligned on their own. Here’s the thing with the common pregnancy aches and pains: most of them come from issues that were there before you were pregnant (like mine did). Add the extra weight, the shift in hormones, and all the other changes that occur, and the “weakest link” presents itself. These issues aren’t “just part of pregnancy” that you have to live with; often there is something you can do to make it better. Seek out help! Try the things in this blog or find a Restorative Exercise Specialist near you. If you need additional support, see a chiropractor, PT, massage therapist, or another professional who can help.
Sneeze pee. If we are honest, most of us will admit that this has happened once or twice….you laugh, sneeze, cough, jump, or some other high pressure activity….and you pee yourself. Just a little. (Or a lot.) It’s VERY common, which has led many of us to believe that it’s NORMAL. We accept it as an inevitable part of aging or something that happens once we’ve had children. Incontinence is prevalent among women who have never given birth and in men as well. I experienced sneeze pee in my early twenties before I found Restorative Exercise™. (I’m happy to report that it’s now resolved.) I’ve been talking about urinary incontinence, but you can have fecal incontinence too. I came across this ad in a magazine last week.
The message I have for you today is this: incontinence is not a natural part of human function, and you have the power to change it.
Here are 3 things you can do right now to start improving it:
1) Stop doing kegels. A too tight pelvic floor is at the root of incontinence (and other pelvic floor disorders), and kegels will make this worse. Kegels may help in a short term way, but they are a band aid and don’t address the root cause. You can read why here.
2) Instead of kegels, start squatting. Squatting uses the gluts. Strong gluts pull posterior (back) on the sacrum, which in turn pulls on the pelvic floor, stretching it out to its proper length. It’s good to note that we are often too tight and weak to squat without some preparation. Try these prep exercises to start increasing mobility as you practice squatting. You don’t have to go into a deep, full squat to reap the benefits. Keep your shins vertical (see below) to help you use the gluts and hamstrings (on the back of the thigh) instead of the quads (on the front). Hold onto a door knob or pole if you feel like you are going to fall over backwards.
3) Exercises are great, but you will see changes MUCH faster if you change your habits too. Read Fast Fixes for Pelvic Floor Disorder to learn some simple lifestyle changes you can make.
If you are dealing with incontinence or any other pelvic floor disorder (and live in Middle Tennessee), you may want to attend the Pelvic Floor Workshop at Blooma Nashville this Saturday, September 19. This class will use a combination of lecture and exercise to help women understand the mechanical causes of pain and disease and give them practical tools for change. Participants will learn corrective exercises and lifestyle modifications to heal and prevent common ailments.
This class is for any woman who has experienced (or would like to prevent):
Pelvic organ prolapse
Hip, knee, back and pelvic pain
High blood pressure
SI joint pain
A cesarean section (a pelvis that was “too small” or a baby that was stuck/breach/posterior)
Pelvic floor trauma
If you can’t make the workshop, consider a private session. We can work together to get rid these painful and embarrassing issues!
Pregnancy is another place we see the difference between posture and alignment. You all know the common pregnancy posture: pelvis and belly pushed forward with hands resting on the low back. It’s normal to see this all around us, but it’s not good alignment. Ideally, you would stand the same whether you are pregnant or not. If you haven’t read the last few posts, start by reading “Alignment, is that like posture?” and “Stand up Straight!” to bring you up to speed.
When you are pregnant, you still want all your pieces stacked perpendicular to the ground. In fact, this may be even more important when you are pregnant. If you add 30 extra pounds to a frame that is unstable, you are going to notice pain or dysfunction at the “weakest link”. For example, maybe you stand with your pelvis thrusting forward and have occasional back pain. Then you get pregnant and have excruciating back pain. Is the pain cause by the pregnancy? No, it’s the result of putting extra weight on a skeleton that was already misaligned. Pregnancy magnifies whatever misalignment you had going into the pregnancy.
This is my dear friend Leanne about 38 weeks pregnant. She is such a good sport. (Fun fact- she actually went into labor an hour after I took these photos. On the left we have the typical pregnant posture. Imagine her hands on her lower back, belly pushing forward as she waddles along. (I say “imagine”, because Leanne worked so hard on her alignment during pregnancy that she never actually waddled.) Her pelvis is leaning forward and her torso is leaning back. Her pelvis is posteriorly tilted (aka, tailbone tucked under), and her feet turned out. On the right we have a beautifully stacked skeleton. Her ear, shoulder, hip, knee, ankle are all in a vertical line. She has a neutral pelvis with her rib cage stacked right on top and her feet straight.
Picture A: Typical Pregnancy Posture (Just say no.)
Picture B: Aligned and Pregnant (Gold star!)
A pregnant woman who stands like Picture A will likely have more back pain, but alignment affects more than whether or not she is in pain. I’d like you to notice two very important things: the shape of her belly and the shape of her rear end. It’s ok, I asked her permission to have a bunch of strangers (although, let’s be honest, not that many) analyzing her very pregnant figure. Can you see that both her belly and her backside are completely different shapes in the two different pictures? In the typical pregnancy posture (Picture A) her rear end is flattened out and looks smaller. Her belly is sort of pointing upwards. In the aligned picture, you can see her gluts look bigger (in a good way) and her belly is pointing straight ahead.
Looking at the shape of Leanne’s body is a subjective assessment, but it illustrates an important underlying concept: How you stand affects your pregnancy, labor and delivery in very real ways.
1) Better baby positioning in utero. You are the container in which your baby lives. When you change your shape, you change the shape of your baby’s container, and the baby will adjust accordingly. How you stand during pregnancy can help (Picture B!) the baby to be in an optimal position for delivery. More on this here.
2) Appropriate pelvic floor tension. Standing with the pelvis in a post tilt (tucked under, like Picture A) causes excessive tension in the pelvic floor and inactive gluts. You want your pelvic floor to be relaxed enough to let a baby pass through more easily. You also want your pelvic floor to be strong enough to hold up your organs and hold in your pee. You need strong gluteal muscles to achieve this not too tight/not too loose pelvic floor muscle length. When you stand like Picture B, your gluts are being used all day long to hold you up and move you around. They will become as strong as they need to be to support your pregnant body and balance out the pelvic floor.
3) Increased birth space. The strong gluts mentioned above will pull the sacrum posterior (back), increasing the birth space (who doesn’t want that?). In addition to changing how you stand, you can also START squatting and STOP doing kegels. For more on squatting and pelvic floor health, read what the Alignment Monkey has to say.
For an extra challenge, try this online class that has a lot of one leg squatting: A Balanced Approach to Hip Strength.
If you are pregnant, and live in Middle Tennessee, contact me to start your complete prenatal alignment program!