postnatalpilates — Blog — Kirsti Pilates to You

So I never really thought I would be writing about products or recommending products on my IG feed. However, this one is a doozy. If you have ever had a baby, are thinking about having a baby, are pregnant or have had any sort of pelvic floor weakness/disfunction, then you’ll wanna keep reading. Below is a breakdown of my experience with the Perifit device that reads pelvic floor strength and stamina directly from your lady bits via bluetooth games on your mobile phone! Intrigued? Yep, I was too.

It all started with this blog I wrote a while back. It was about my experience of Pilates and pregnancy and birth and the after affects of birth on my pelvic floor and how Pilates helped me recover.

Recently a company, Perifit, contacted me to say they had read my blog and thought I might be interested in their product. Having no idea who Perifit was, I was totally dubious about this so called company wanting to give me free stuff to try. After a Google search and a brief read of the excellent reviews this company was getting, I was more inclined to respond positively to their request for trialling their product. So, what is Perifit? Well this is straight from their website: ‘Perifit is a Kegel exerciser that lets you control video games with your pelvic floor. When you contract your pelvic floor the bird goes up. When you relax it, the bird goes down. These games were designed by doctors to help properly strengthen the pelvic floor. It works so well that more than 1000 doctors already recommend Perifit to combat incontinence and prolapse and other pelvic floor disorders.’

Once it arrived, it sat on my bedside table for weeks. Partly because the unknown is a bit terrifying and that’s always a good excuse to procrastinate, party because I thought it might take ages to set up, read the instructions and just generally figure out. But I was wrong. Well, the unknown is always a little terrifying, but it was straightforward to read about and set up. First tick!

When I decided to give it a go, opening the box and noticing it’s uncanny resemblance for a vibrator, I all of a sudden felt like I needed to excuse myself from the living room couch, ha! ‘It’s for work’, I was telling myself.. and my partner wink, wink.

Once you have downloaded the Perifit app, turned on the device and activated bluetooth on your mobile, you’re all set for insertion. It’s only mildly uncomfortable initially, if I had to compare it to a pap-smear, where a pap-smear is an 8 or 9 on the discomfort scale, this is about a 1 or 2. Totally manageable.

You can target your pelvic floor training based on your needs, simply take a short test and it will calculate which training program is best for you eg postpartum, incontinence or intimate wellbeing. Once you have your program, your games will be targeted to getting the best outcome from your program.

So the game itself… well, think of a rudimentary Mario Cart meets Angry Birds type scenario. Where you (or your pelvic floor to be more specific) are the object that has to fly (by contracting your pelvic floor) to capture the floating items in the sky. And then brought back down (again, with the controlled release of of your pelvic floor) along a specific pathway of floating objects to capture either in a linear angled line or something a bit more adhoc. The point being that you want your pelvic floor to be able to do both, steady increasing contraction with steady decreasing release as well as short sharp contract and release muscular control.

After the game you receive your results on an intricate biofeedback screen, this helps to break down the difference between your deep vs superficial muscles. It tells you how you rate in terms of Force, Frequency, Stamina, Release and Accuracy. The stats you get are so interesting and really help to target the specific areas of improvement.

There’s a manual mode, which I love! Its designed to record the muscular behaviour of your pelvic floor in its functionality. So, pop it in while your vacuuming or carrying the baby and see how your pelvic floor naturally reacts in these situations. Fascinating!

Why is this relevant to Pilates and my work?

Some would argue that historically, Joseph Pilates would not have cued pelvic floor engagement. His writings indicate that he believed his exercises would activate the neuromuscular system in its natural “correct” patterns, like those of the "newborn babe" or animal. We also know that he believed in the importance of breath…"Before any real benefit can be derived from physical exercises, one must first learn how to breathe properly." Joseph Pilates.

Picture from Pinterest courtesy of Dani Menesis at Studio Pilates

These two points give us an insight into what makes Pilates so effective. When we breathe as we should, physiologically, we can distribute our intra-abdominal pressure in a balanced way throughout the thoracic, abdominal, and pelvic cavities. When we can balance intra-abdominal pressure (IAP) distribution, we are creating muscle balance in our “core muscles". Our core muscles include the diaphragm, all the abdominals, the deep intersegmental spinal muscles, and the pelvic floor. To facilitate ideal distribution of IAP, the diaphragm has to be able to move up and down freely, which requires that ALL core muscles, including those in the pelvic floor and abdominal wall, can work in both concentric (shortening) and eccentric (elongated) contraction. When we breathe correctly, we are using these muscles in a balanced way, and our spine can stabilise due to the correct distribution of IAP.

Picture from Pinterest courtesy of Healthwise, Incorporated

So this is why I rate this device. Although Pilates works the body as a whole, understanding how and where we need to build stability and that our muscles need to be trained in both eccentric and concentric function (pelvic floor being one of those critical areas), is an essential tool to building overall strength and mobility.

I would describe childbirth like a semi-trailer has rail-roaded you from the inside out, so it’s not hard to imagine the imbalances and dysfunctions that women can experience after such an event. We are often told to do our ‘Kegels’ before and after childbirth to prepare and rebuild the pelvic floor muscles, this is often interpreted as just focusing on the concentric contraction in an isolated activity. As already mentioned we don’t just want the shortening of the muscle, we want the eccentric or elongation of the muscle as well. So thank you Perifit for making a device that helps with the both, and therefore setting the groundwork for successful, whole body Pilates conditioning!

Me in action! Getting my clients to switch on their core, with the help of the Magic Circle.

My experience with birthing big babies and how Pilates helped my pelvic floor ‘come back’

Ah, the ‘P’ word. Prolapse. More specifically, vaginal prolapse. A word that expectant Mothers fear, and new Mothers don’t want to hear. When the pelvic floor is strong, it supports the pelvic organs to prevent problems such as prolapse. If you’re not familiar with what a prolapse is, emedicinehealth.com define it as ‘a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel or the vagina itself -may begin to prolapse, or fall out of their normal positions’. Yikes. No one wants to imagine their bits hanging between their legs, unless you’re male, in which case, the more hang the better, right?! So, you can imagine my state of disbelief when the Pelvic Floor Women Physio examined me 6 weeks after the birth of my second child and told me I had stage 1 prolapse. Now I knew things were a bit dicey down there, but I didn’t know things were that bad?!

Image courtesy of womenshealthadvice.com

So how does a vaginal prolapse happen?

Damage to the pelvic floor occurs particularly:

1) when there is a long second stage labour (tick- both of my boys),

2) during instrumental deliveries – vacuum extraction or forceps (tick- both of my boys), and

3) in the delivery of large infants (tick- second baby 4.1kilos; Womhealth.org.au).

I guess looking at the history of both births I had a fair chance of a prolapse.

After birth, I distinctly remember having a feeling of detachment - not to my baby, but to my body. It was like my organs and insides were just floating around aimlessly inside my skin, not quite sure what to do, where to be or how to behave, especially my bladder. I was wetting myself for a good week after baby number 2. Highly annoying! Don’t even get me going on having to sneeze or having a laugh at this time. I really had to tune into my bladder, the moment I needed to go to the toilet, there was no waiting, I had to go right then!

I don’t blame you if you’re thinking, ‘but she’s a Pilates teacher, she must do her pelvic floor exercise ALL the time?’ Well yes, and no.

When I was pregnant (and subsequently immediately after birth for the next little while), I would specifically carve out some time in my day to activate my pelvic floor. Usually I was doing a routine, mundane task like, waiting for the kettle to boil in the kitchen or having a shower- anything that happened daily and more than once a day where I would get in the habit of doing them while I waited (more on those specific exercises later).

When I’m not pregnant I don’t really think about my pelvic floor all that much. Sure, I do Pilates and part of doing Pilates is having an awareness of how to engage those muscles in order to stabilise them while another body part is mobilised. But this ‘internal stabilsing’ is something that has become second nature. So, when I do my everyday tasks (e.g., bending down to pick up the many things sprawled across the floor- clothing, toys, mess, towels, animals, children) I first stabilise internally through my pelvic floor, and low abdominals before I mobilise my torso in the direction of the ‘thing’ I’m picking up. Pilates in this way has been a savior. When you can use your pelvic floor and deep abdominals, you are less likely to have low back pain, and I know how inconvenient and restricting back pain is when you have small children who want to be hugged and chased and comforted.

Another important aspect of pelvic floor activation is pelvic floor release. Especially for me, as a Pilates teacher, I’m constantly thinking of drawing ‘in and up’. I do it along with my clients, so, when I’m telling them to do it, I’m unconsciously doing it along with them! If the pelvic floor becomes difficult to relax, it’s constantly in a state of being semi-flexed. Imagine flexing your bicep constantly and never fully letting go, after a while this would cause your arm to lose flexibility, strength and the ability to relax. That is similar to what happens to the pelvic floor (goop.com).

After birth, the body naturally starts to restore and repair. After a week of wetting myself, I could start to hold my bladder slightly longer, after a few weeks, sneezing wasn’t so scary. Still, after the confirmation of stage 1 prolapse at 6 weeks postpartum, I knew there was some further work to do. When I went back to the Pelvic Floor Women Physio at 12 weeks postpartum, I had another internal and was relieved to hear everything was back to ‘normal’.

So what are the actual exercises I did while pregnant and post pregnancy for strengthening and releasing the pelvic floor? Here are 2 simple things that I did:

1. Sitting down with a pillow or folded up towel between the bottom of your inside thighs, sit yourself towards the edge of the couch or chair (no kickin’ back in a slump!). Feet flat on the ground, lift up tall out of your pelvis up to the top of your head. Take an inhale breath to prepare, then on the exhale breath, gently squeeze the pillow or towel while thinking about stopping a wee mid-stream as well as holding in a fart. This will lift the hammock of muscles at the base of the pelvic floor from your front passage to the back passage in and upwards. Try and hold for 5 seconds (you can build up to 10, 15, 20, 30 secs etc.). Make sure that when you let go, you feel a proper distinction between the contraction and the release. If you feel like you couldn’t distinguish between holding the pelvic floor up and letting it go, try reducing the amount of time you hold on for. I was starting at about 3 sets and worked up to around 8-10.

2. Standing up, slightly bent over (kitchen bench is usually a good option), with your legs hip width apart (it’s harder to squeeze your glutes together in this position so you have a better chance of isolating the pelvic floor muscles), draw up and in through the pelvic floor when you exhale (remember, this should feel like you are holding a wee and fart). I often put my hand on my low tummy when doing this. You want to feel that your low tummy is pulling away from your hand towards your spine. Repetitions and durations are the same as the sitting variation.

A couple of pointers to be aware of:

· Don’t hold your breath. Breathe normally over the contraction of the pelvic floor muscles,

· Don’t squeeze your bum cheeks together (can be tricky to isolate pelvic floor and the surrounding muscles- if you find it hard to switch off the glutes try the version standing up), and

· Tune in to your shoulders- make sure they don’t creep up to your ears and start overworking.

Image courtesy of @neetaphotography on location at Authentic Pilates Melbourne, Hampton, Melbourne.

Upon reflection, I think the odds were always going to be against me given my birth scenarios, regardless of my job and pelvic floor abilities! However, I’d hate to think what state my insides might be in without the exercises I did during and after pregnancy… who knows?!

I credit Pilates as setting the baseline of my fitness and strength before I fell pregnant. Being attune to my body allowed me to work safely through exercise to maintain my strength and flexibility while I was pregnant, making the road back from the birth of my boys not as daunting as I initially expected.

I recently made this little video demonstrating the sitting down pelvic floor exercises. In the video I’m using a Pilates Magic Circle, however, a rolled-up towel or cushion would be fine.

For those of you interested in starting Pilates prior to, during or after your pregnancy in the comfort of your own home check out my website for more information and contact details.

Please note: This is not intended to be specific advice; pelvic floor muscle training is not necessarily one-size fits all. I recommend being evaluated by a pelvic floor specialist if you are experiencing difficulties.

You should also be sure to gain clearance from your Obstetrician/GP after the birth of your baby before you undertake/begin any exercise.