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If you are currently pregnant or recently postnatal, taking a moment to think about nutrition and how to make sure you are best equipped with as much energy as possible to cope with the delivery, the initial recovery post delivery and then looking after a little new one should be one of your top priorities. Doing this will really help with your recovery, it will help a diastasis recti and c-section recovery and ensure your moods are more levelled when you are sleep deprived.

Here are some ideas to help you make better decisions when out and about, and of course being prepared is the best way to avoid grabbing the first thing that you can to satisfy your sugar craving.

  1. Plan ahead your week if possible and buy your food online. Firstly this will make it less stressful when taking baby to the shops plus stop you buying unwanted foods that you are trying to avoid that may stare at your from the shelf! If you don’t have them at home you won’t want to snack on them!
  2. Start your day with a high protein breakfast or smoothie (very easy to do and make the night before if you are time pressured in the mornings) or eggs and smoked salmon on rye bread. If you want to omit the bread you can always add half an avocado and a few oat cakes.
  3. Swap fruit juices for water or try and mix half fruit juice with half water to reduce the sugar content.
  4. Dried fruits and nuts are a great protein source that together will reduce your need for a chocolate bar. Very easy to keep a stash in your handbag.
  5. Try making foods in advance and freeze them such as flapjacks and raw date balls. Then you have a snack to grab and go or keep in your bag when you are out and about.
  6. Plan a week of meals in advance, snacks desserts and drinks included.
  7. Indulge every so often – When you do go and meet your mummy friends in a café, try avoid sugar loaded foods but if you are planning it into your week maybe have it as a treat day and indulge yourself. You are allowed to! As long as it’s not every day if your goal is to get your body back to pre-baby state and feel good about yourself!
  8. Drink herbal teas as often as you can as this does not get an association with having a piece of cake (in general), whereas a coffee and cake go quite nicely together, so changing your drink choice can help to reduce the need and want for unwanted sugar and calories.
  9. Having snacks prepared for you in your bag when you are out and about can also reduce the quick fix of buying the first chocolate or cake you see and eating it whilst walking. You won’t even remember you ate it when eating on the move.
  10. Eat regularly – during the early months your body will be using every ounce of energy to help you recover from delivery, create milk, provide for your baby and just survive, eating regularly will help to keep your emotions and mood level, and keep energy levels balanced.

FEEL GOOD ABOUT YOURSELF!!

I am sure my father in law would not mind me using him as a reference but a few years ago now, he had a hip operation to help repair his hip joint after falling from his road bike on a closed circuit cycling event. Since his operation he has had multiple follow up appointments with his surgeon, physiotherapist and hydrotherapy to help his recovery with plenty of ‘homework’ to be done at home in between appointments. He has worked very hard to recover and rehab his hip and he has had to retrain his body to return to his ‘normal’ pre-injured activity level and he is still not quite there yet.

Since the arrival of my baby boy via a C-section it got me thinking about all the women who return to exercise post a C-section and how little information women are given about the process. After my boy was born, I was told the following

  • 1. Dont lift anything (heavier than your newborn baby)
  • 2. Dont drive for 6 weeks
  • 3. Dont go up and down stairs if you can help it

WAIT A MINUTE! WHAT?! How am I supposed to cope? I have just had MAJOR ABDOMINAL SURGERY!!!

Luckily for me I had 2 of the most amazing women in my life come and save the day, my mom and mother in law! Phew! Without them I am not sure how I would have gotten through it! They came and did the washing, cooking, cleaning, school pick up and drop off and walking the dog. I could not have done it without them! Oh! and not to forget my fabulous childminder who came to collect and drop off my daughter so she had some fun and other kiddies to play with whilst I could rest and recuperate. Plus, my brilliant husband who took the bull by the horns, and did so much more than I could have asked him to do so that I could just rest and recover.  So, it took a team to help me within the first 6 weeks, but thats not even mentioning my active steps to recovery!

WHAT!!! A women who has had MAJOR (and I say MAJOR) abdominal surgery should wait 6 weeks before they are signed off by their GP to get going and start exercising again! STOP! NO! PLEASE WAIT!!

Where is your physiotherapy referral?

What about how to move during those first 6 weeks?

What exercises are safe for me to do and what should I avoid?

How do I care for other siblings whilst I have a newborn?

I am here to tell you how you can start to do things within the first 6 weeks to help with your healing process; so take a deep breathe and lets begin…..

  • 1. Rest and relax as much as you possibly can
  • 2. Rolling over every time you aim to sit up or lie down, aim to lie on your side first. This will avoid any crunching or sit up type position which will put a lot of pressure on the scar and abdominals.
  • 3. Restore your breathing. Start re-connecting with your breathe. Super easy and simple to do when lying in bed resting. Breathe in to feel ribcage and belly gently expand and relax and breathe out to feel ribcage soften in and down, naval draw gently towards spine and engage your pelvic floor gently. Before you do any lifting, rolling or sit to stand movements try practicing your breathe and breathe out to perform the movement or lift.
  • 4. Walking  – increase your walking slowly depending on your energy levels. Some days you will feel great and other days you might feel like you have taken a step backwards. That’s quite normal. Go with your body, and if you feel great do some more walking and if not, rest more. Eventually you will feel up for doing more even if at the time you don’t feel like that will ever happen!
  • 5. See a women’s wellness physiotherapist in your area. Even if you don’t have pain or discomfort it would be a good idea just to have an overall clearance with a professional who understands what you have gone through and can really tell you how your body is healing.
  • 6. Start some gentle exercises. (guided my a fitness professional who specializes in women’s health and fitness)  This very much depends on each person, some feel ready to go within 2 weeks of a C-section and others take much longer.
  • 7. Don’t be hard on yourself and this is not a time to push yourself to test your limits, go with your body and if it says yes I am ready to try and do more, then do, and if you feel exhausted the next day it’s a sign your body is still recovering and building its strength so do less. Eventually your body will just do what you are asking.

Happy Healing! 

Go slow and build a strong foundation!

Fitness post delivery (whether recent or a few year later) can be a totally different experience to when you were pregnant, as now you need to firstly have the extra energy to expend on doing some exercise plus having some spare time.

Well, I have some exciting news for you all. We can all find 10min I am sure at some time during our day.  Have a think and if you struggling to find this then perhaps its time to evaluate what’s important in your life, and what’s just ‘getting in your way.’ Once you can do this then you can conquer that challenge and free up some ‘YOU TIME.’ Its important to value yourself and if you do and want to exercise then its time to STOP THE EXCUSES and find the time.

Here are my top tips to help you find the time and what you will need to get started….!

1.FIND 10-20min within your day. Look at your diary/week and find the time to dedicate to yourself!

2. BUY THE RIGHT HOME EQUIPMENT

Gym membership can be expensive so why not keep some kit under your bed or sofa for the quick ‘go to’ when you have your ’10min YOU TIME’

What to buy? 2 x 4-8kg Dumbbells, a resistance band, 8kg Kettlebell, exercise mat.

Although an out lay initially it will be worth it long term and much cheaper than a gym membership.

(This is only a guide if you know you can lift heavier then adjust what you buy according to your strength.)

3. WALKING IS A GREAT WAY TO STAY FIT AND HEALTHY

just 10mins a day will help to maintain your fitness levels and keep your heart strong and healthy

4. FREE PT/CLASS ONLINE– join the physically-fit online video membership to have access to a variety of classes to suit your needs. Choose one you like and follow along. Baby can even watch you whilst you workout.

5. INVITE A FRIEND – instead of meeting for a coffee and cake why not walk and talk. With Covid, you could always meet online and do a workout together for extra motivation!

6. ADD MUSIC TO YOUR WORKOUT – if you enjoy music put together your favourite music into a playlist and head out on your brisk walk or run. Or perhaps listen to a podcast that you have been wanting to do for a while. A great way to kill two birds with one stone.

7. SET YOUR DAYS AND TIMES – if you pencil the day and time during the week you will aim to exercise into your diary, this can help to keep you on track and dedicated to your ‘YOU TIME’ give it a go!

Hope this helps you to find a way to get some movement/exercise into your day. It does not need to be hours long, a little goes a long way but more importantly is trying to do it regularly.

Happy Exercising x

A Diastasis Recti or DR is the widening of the gap between the 2 sections of the Rectus Abdominus or (6 pack muscles)

The split occurs at the Linea Alba, the mid line collagen structures of connective tissue at the front of the abdomen. (see image)

100% of women have some level of diastasis of the rectus abdominis in the third trimester (Diane Lee, 2013)

66% of women with a DR have some level of pelvic floor dysfunction

What is a Diastasis Recti? How do i know if i have it and how do i fix it?/post natal pilates classes exercises diastasis recti

The Linea Alba no longer provides tension and stability. All the muscles of the abdomen, which includes the Transverse Abdominus or TVA, internal and external obliques and Rec Abdominus meet at the center of the midline. When this gets stretched the Linea Alba is no longer able to provide tension and stability for the body. Therefore your whole body is affected by this weakness.

WHAT CAUSES DR?

DR is a result of excessive intra-abdominal pressure or loading. It is common in later stages of pregnancy but can occur earlier and in multiple pregnancies. When the Linea Alba is stretched due to a growing bump, the connective tissue is weakened and this affects the surrounding muscles and fascia. This then leaves the front of the abdominals very weak and unsupported. This connective tissue down the mid line is meant to be taut and at full length and aligned from breastbone to pubic bone, when it is pulled wide due to a growing bump then it is not at full strength and cannot work optimally, therefore we need to address this line and get it ‘in line’ to restore full strength of the abdominals and repair the diastasis.

Diastasis is a symptom of excessive and unsupported intra-abdominal pressure and therefore should be treated as part of an integrated programme to re-align, re-connect and re-store strength to your whole core structure not just ‘closing the gap’.

HOW TO TEST FOR DIASTASIS RECTI?

Lie on your back with your knees bent and your feet flat on the floor. Relax your head and shoulders and place your fingers just above your belly button.

Lift your head and neck very slightly off the floor and press down with your fingertips. If you feel a gap that’s the diastasis. You will feel the muscles close around your fingers as you lift your head. Relax your head down and move fingers to below belly button and repeat the movement and then repeat this movement with fingers on your belly button.

The gap is measured in finger width’s.

EXERCISES TO AVOID IF YOU HAVE A DIASTASIS

Crunches

Sit ups

Oblique twists

Scissor legs (both legs at the same time)

Roll up

Roll over

WHAT EXERCISES CAN I DO TO HELP CLOSE A DIASTASIS?

BREATHE

If I just highlight what I mentioned earlier that a DR is about too much excess and un-supported intra-abdominal pressure, therefore we need to FIND and connect with your deep core muscles first. So, lets breathe to find it. Take a big breath in through nose and expand ribcage and belly, as you breathe out gently draw pelvic floor upwards and feel a light connection in your stomach. You are not ‘sucking’ it in, holding it flat or forcing a movement to occur. Let your breath do it for you! You should feel your breath expand the ribs and belly and avoid lifting shoulders as you breathe. As you breathe out you should feel your ribs soften in and down and your belly flatten towards spine gently!

POSTURE

You need to correct your posture and address your alignment. The cause of the excessive pressure and loading was due to the bump expanding. We need to teach our bodies where we are again in space without a bump and if we can align our pelvis and ribs this can help correct our diastasis. A correct alignment can also address any pelvic floor issues as it is more likely to function more effectively if your pelvis is in neutral.

CONNECT

Then you can learn to engage and ‘switch on’ your TVA and Pelvic floor muscles not only when you doing exercises but also when you performing your day to day tasks. You wont always have to do this but whilst there is an imbalance through the body we need to teach these muscles to engage when you doing movements in order to support our body.

STRENGTHEN

Once your pelvic floor and TVA are connecting then you learn to strengthen and load your core to pull the midline back together and ensuring that your stomach can take load again with a flatter and stronger stomach because of all of the above steps!

What is a Diastasis Recti? How do i know if i have it and how do i fix it?/post natal pilates classes exercises diastasis recti

WHAT I SAY……

It’s a journey that won’t last forever. It’s a process. Follow the steps, get some support from a women’s physiotherapist or a local personal trainer who specializes in pre and post-natal wellbeing and start with your foundations. Once this is connected and strong you can do all the things you so want to do, but get strong and connected first! Don’t rush it, healing will happen if you practice and give it time. But more importantly practice it correctly!

This lovely recipe was brought to you by a lovely colleague of mine who specialises in Nutrition for pregnancy and post natal recovery. She has shared with me a few recipes. Try and plan your week of food so you avoid the sugar highs and lows, starting with a breakfast of soaked oats overnight is a great way to start the day and beat the tiredness of feeding and being up through the night! Get organised and put these onto your next shopping list.

find after having a baby that using a slow cooker is a great way to make healthy, nutritious and tasty meals quickly and easily. The beauty of a slow cooker, is that you can make the food at any time during the morning even up until the early afternoon and have it ready in time for dinner. I often find it easier to find time to cook in the morning than in the evening when everyone is tired and babies are often unsettled. The following are two of my favourite slow cooker recipes. Both are full of protein and antioxidants which are crucial in the healing process post birth. The chili con carne and the beef Thai green curry are also an excellent source of iron, a nutrient which new mothers can often be low in after birth. 

Slow cooked Thai green curry with salmon/ chicken/ beef/ tofu (whatever takes your fancy)

Simply add the following ingredients to your slow cooker, stir, turn your slow cooker on to high and leave for 4-5 hours. 

Ingredients
1 x tin coconut milk

1 x sachet /3 tablespoons of thai green curry paste (the jar/ sachet will give directions for how much to use). I find the best curry pastes are those where water is not the first ingredient.

3 x skinless, boneless salmon fillets cut into bitesize pieces (or 3 x chicken breasts/ beef steaks/ a packet of tofu)

1 x sweet potato chopped into bitesize pieces

1 x tin of chickpeas (drained)

1 x fresh pineapple (chopped) (tinned pineapple also works well and saves time)

1 x green bell pepper (chopped)

2 x cloves of garlic (minced)

1 x onion

½ tsp crushed chili pieces

Serve with rice

By Katharina Howard, Health Focus Nutrition.

This lovely recipe was brought to you by a lovely colleague of mine who specialises in Nutrition for pregnancy and post natal recovery. She has shared with me a few recipes. Try and plan your week of food so you avoid the sugar highs and lows, starting with a breakfast of soaked oats overnight is a great way to start the day and beat the tiredness of feeding and being up through the night! Get organised and put these onto your next shopping list.

Chili-con-carne

Simply add the following ingredients to your slow cooker, stir, turn your slow cooker on to high and leave for 4-5 hours. 

Ingredients

1 x packet of beef mince

2 x onions (chopped)

4 x cloves of garlic (minced)

2 x teaspoon ground cumin 

2 x teaspoons all-spice

1 x teaspoon cayenne pepper

1 x teaspoon dried chili flakes (add more or less as needed to suit taste)

2 x 400g tins of chopped tomatoes

2 x tablespoons of tomato ketchup

3 x tablespoons balsamic vinegar

1 x tablespoon sugar (any kind)

1 x 400g tin of red kidney beans (drained and rinsed)

1 x teaspoon of cocoa powder 

Serve with rice, sour cream and grated cheese

It is also easy to make a vegetarian version of this chili by adding your choice of tinned beans in place of the mince. 

Thank you to Katharina Howard from Health Focus for providing the nutritional support for my clients.

This lovely recipe was brought to you by a lovely colleague of mine who specialises in Nutrition for pregnancy and post natal recovery. She has shared with me a few recipes. Try and plan your week of food so you avoid the sugar highs and lows, starting with a breakfast of soaked oats overnight is a great way to start the day and beat the tiredness of feeding and being up through the night! Get organised and put these onto your next shopping list.

Breakfasts

Overnight oats: 

40g porridge oats

200g natural yogurt

Mixed blueberries, strawberries and raspberries

Method:

You can use a jar (a Kilner jar is great, mug or bowl)

Make layers of porridge oats, natural yogurt and berries

Cover and place in the fridge overnight

The oats will absorb the yogurt and some juice from the berries.

In the morning take out of fridge, stir and enjoy!

This is such a versatile recipe as you can add any fruit you like. Grated apple/ pear and a sprinkle of cinnamon make a great alternative to berries. 

The protein in the yogurt and oats and the vitamins, minerals and antioxidants in the fruit are great for helping with the healing process, the calcium in the yogurt is great for keeping your calcium levels up if you are breastfeeding and the fibre in the oats helps keep everything regular in the bowl department. 

I am sure there are many methods that can be applied to performing the C- section massage, but here is how I do it and has worked for me and my past clients.

Start by using any oil/cream you may have. I personally liked using Rosehip oil, it is said to be great for nourishing the skin, improving texture and tone, plus its supposed to help stretch marks! Tropic, Tamanu Healing Balm is also great on any scars.

WHOLE TUMMY MASSAGE

Start by massaging your entire stomach in a clockwise direction. This will get you feeling comfortable with touching your skin and bringing connection to your brain. Moving in a clockwise direction can help improve digestion and often this is quite slow post surgery due to not moving as much. Once you feel comfortable with this try and move closer and closer to the scar until you feel comfortable touching the scar. Sometimes I have ladies just hold their whole palm of hand over their scar and breathe. The massage is meant to be healing, restful and relaxing. If at any point you become stressed or emotional, please stop and visit it another day to give it another try.

SIDE TO SIDE - LEFT TO RIGHT AND RIGHT TO LEFT

you may or may not be ready to touch your scar but you can do this as close to your scar as possible and for those who are comfortable, you can perform this on the scar. Starting from the left side of your scar, press lightly down into your skin and drag your finger all the way to the right side of the scar. Repeat this movement 5-10 times. Then reverse this movement and do it from right to left 5-10 times.

**notice how the scar feels, all of it lumpy, parts of it lumpy, the ends feel restricted etc. As you progress your massage and touch do you feel this improving**

PRESS AND PULL

Starting just above the scar moving from left to right again, press lightly down and drag your fingers towards your belly button. Lift off and move a little to the right along the scar, press down and pull upwards towards your belly button. Keep repeating this until you reach the end of your scar on one side and then do it all the way back to the starting side.

DIAGONAL PRESS AND PULL

Similar to the above but starting on the scar press lightly down and on a diagonal pull upwards, using your other hand to anchor below the scar and pull slightly downwards. Repeat along the scar from left to right and then back from right to left.

CIRCLES

Performing mini circles with your index and middle finger, moving from left to right and right to left again. Press firmly without causing pain. If you don't feel comfortable doing this on the scar do it above and below the scar until you find it easier to do it on the scar.

COMPRESS AND TWIST

In order to do this you do need a smooth lacrosse type massage ball. Like a spikey massage ball but smooth. Press it down onto the scar and gently twist, move along the scar (or as close to it as possible) from left to right and right to left. I also like doing this in a clockwise direction around my whole stomach as can aid digestion and reduce stiffness and tightness in other areas that may be affected by the surgery indirectly.

EXTRA TIPS

  1. Don't force a movement
  2. Work where you feel tighter
  3. If there is pain, stop immediately
  4. Work as close to the scar as you can until you feel ready to massage on the scar
  5. There is no rush, go at your own pace
  6. If you don't like using your fingers, look to invest in the smooth lacrosse massage ball its great for doing all of the above without touching the tummy and scar.
  7. Hydrate and move gently within your comfort level
  8. Try and do your massage at the same time daily until you achieve a sense of suppleness in the skin and tissues. Once you have achieved this then you can do it once a week and move to once a month
  9. Scar tissue remains active for up to 2 years so keeping this going will be really helpful as it slowly heals over time with a good foundation.

I CANT TOUCH MY SCAR OR TUMMY!

Often a C section can be a very traumatic experience if it was not planned. This causes us to disconnect from this area due to the event being too overwhelming. This is out body's way of coping with a stressful and traumatic time. It's a very natural part of coping with trauma. Being unable to touch or look at your scar may mean your body is dealing with some trauma from the event and you may need to seek professional support and help to unlock and let go of the trauma so that you can focus on self healing and self care.

I found this amazing visual video on you tube by Naturally Nurtured Birth Services and found this to be so great in understanding the depth of the incision. It really shows that it's not just the outside layer (skin) that has been cut. Watching this, I hope will give you a deeper understanding of why taking your time to recovery properly is important and how the holistic approach to c section recovery is vital to greater healing in the long term.

Here is an outline of the layers that a Cesarean Section cuts through.

Initial cuts (and the visible scar) are horizontal through:

  • Skin
  • Fat
  • Fascia

Then the incisions are made vertically through:

  • Abdominal muscle
  • Peritonium (the fascial membrane which wraps around the internal organs)
  • Uterus (Bladder is moved down)
  • Amniotic Sac

Until you reach the baby.

You see, it’s really important to remember that whilst all we see as a lasting reminder of the Cesarean Section might be the most superficial incision at the skin level, it is really an elaborate corset of suturing, enabling all these layers to knit back together and heal. So it is not just the most superficial scar that needs to be included in the massage.

Why Should you Massage your Scar?

Often as a result of the C section, we can experience pain and tenderness in areas other than the scar itself. It is important to note that whilst massage can help in the manner in which scars develop and heal it will NOT prevent them from being visible. What is more important to understand are the lasting benefits that massage can help with beneath the scar.

If you experience any of the following then you need to start massaging your scar and surrounding areas;

pain during sex

clitoral and/or labial pain

feeling like you need to go to wee A LOT

numbness or tenderness around the scar

lumpy or hard spots over/around the scar

feeling of tightness or rigidity around the scar

pelvic pain, lower back pain, pain in the groin

you can’t feel your abdominals doing work!

struggling with infertility after a previous C-section

digestive troubles, IBS

When is it safe to touch/massage your scar?

It is important to remember that each mother is different therefore the healing process is very individual. The progress also depends on the degree of trauma she has suffered and the skill of the person carrying out the suturing. As a general guideline, it will take approximately 6-8 weeks for an incision to heal.

Once you have been given the all clear from your GP or midwife you can start gently massaging your stomach starting as far away from your scar as possible and working closer and closer as you begin to feel more comfortable. There is not pressure to start touching your scar immediately, go slow, take your time. Please also note, if you have had a c section a long time ago, it is never too late to start massaging your scar, breaking down those adhesion and helping your body restore its strength.

After my C section, I lost all strength in my body and I found it particularly difficult to get up from lying down and had to perform the 'log roll' technique to get up out of bed for quite a few months. This makes it particularly challenging when baby wakes crying and you need to feed, it just adds to your body aches and pains.

One of my main aims is to empower women to know more about their post natal recovering bodies so that you know how to heal from the inside out. The scar may look fine on the outside but there are many layers they have had to cut through to get the baby out. So, why not know what its all about and you might find it helps you understand how and why you need to heal properly before starting to run again or doing whatever other form of exercise you love.

So..How do Scars Form?

When we have a wound that needs to heal, our body does something amazing … it lays down new protein fibres to knit the wound together. This protein is called collagen. While these new fibers are regenerating, the uneven distribution of collagen cells is often chaotic and forms itself in a messy fashion. If left untreated, a thicker, more dense and fibrous tissue can form a scar tissue or so called adhesions. Unfortunately these can sometimes bind to nearby tissues and it can result in a pulling sensation or sometimes even a ‘trapped', restrictive feeling. Adhesions can also be a source of digestive / bowel problems, incontinence, lower back pain and sometimes even infertility. It is estimated that 93% of people develop adhesions in response to the trauma of abdominal surgery.

Once we are ‘healed’ there is a visual reminder in the form of a scar. There are four stages of wound healing: hemostasis, inflammation, proliferation and maturation. In brief:

  • Hemostatis phase
    This is when the wound begins to close by clotting (think scab forming).
  • Inflammatory phase
    This is when the blood vessels leak something called transudate which is made of water, salt and protein) and causes localised swelling, which both controls bleeding and prevents further infection. I’m pretty sure this is what we refer to as the wound ‘weeping’ or pus.
  • Proliferative phase
    This is when the wound is rebuilt with new tissue made up of collagen and extracellular matrix, it’s also when things start to feel a bit tight and pucker up a little because the wound contracts as the new tissues are built and pulls things together. Perhaps the most important aspect of this phase is the laying down of new blood vessels so that the new tissue can be healthy and receive the oxygen and nutrients required.
  • Maturation phase (aka remodeling stage)
    This is when the wound fully closes, and the ‘repair’ cells are no longer needed.

The primary aim of scar massage is to promote the alignment of collagen fibres (‘break’ the adhesions and help them to form in a ‘less messy’ way) which are laid down as part of the healing process and also the development of more supple scar tissue which will allow for movement. This benefit will not be as visibly obvious as the texture and the appearance of the actual scar, but will certainly be a ‘felt’ benefit as these adhesions are ‘tidied up’.

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