We would like you to think about your breathing, specifically the connection and impact it has to your core and pelvic floor.
Throughout pregnancy and after baby, the core or deep abdominals, which helps stabilize the body is compromised. One of the most important muscles of our core is the diaphragm, responsible for providing core stability through pressure created in the abdomen as we inhale and exhale.
During pregnancy our diaphragm is pushed upwards while our ribs are pushed out to make space for the baby. This physiological change makes it difficult to take full deep breaths. Notice how pregnant women often breath heavily from their chest? Noticed an increase in bra band size during pregnancy? Have you returned back to your pre pregnancy band size? Postnatally, it is important to retrain the diaphragm muscles and to regain your rib mobility through 360 breathing (see mechanism of breathing in practice). This is the first step in your recovery, not just physically but emotionally as well.
A shallow breathing pattern ie that chesty breath we mentioned above releases cortisol, also known as the flight or fight hormone. On the other hand, a deep 360 breath engages your diaphragm contracting it down to stimulate your vagus nerve thereby signaling to the brain that everything is safe and that the body can let its guard down. In short it activates the Parasympathetic Nervous System (PNS). As a relaxed body performs better, you will notice an improvement in sleep, digestion ect.
Your breath is further connected to and works in coordination with your core and pelvic floor. In fact the pelvic floor and diaphragm should move in unison for your core to function optimally, whether during exercise or while performing everyday tasks. It is when this coordination is out of sync that you may experience pelvic floor disorders such as leaking, develop a prolapse, or increased abdominal separation. All three systems require each other to function correctly so that you can not only exercise but perform your daily tasks.
The image below helps to visualize where the muscles sit and how they are interconnected, the diaphragm on top, transverse abdominals (TVA) wrapping around the front, the pelvic floor at the bottom and the multifidus in the back.
MECHANISM OF BREATHING IN PRACTICE
Stand in front of the mirror and take a deep breath in, do you notice your shoulders moving up towards your ears? This is often a sign of shallow breathing. Try to focus on breathing without them moving.
Place your hands around your rib cage right underneath your bra line and take in a big breath of air. Your ribs should move out in the front, sides and back. Did they move a lot? Did one side or part move more than the other? Did the ribs on the back left under your thumb not move as much as the right? No? This can be a source of neck or midback tightness you may have been feeling. Do you only expand in the front? That lengthens the rectus and fascial connections, maybe the reason why your abdominal separation has not healed yet.
Next, bring awareness to your belly by placing one hand above your belly button and keeping the other on the front of your ribcage. As you inhale and your ribcage expands, your belly also expands. Don’t force it, your ribs are meant to expand more than your belly. As you exhale, think of your belly knitting together and lifting towards your ribcage rather than just pulling your belly button towards the spine. To get that great 360 rib expansion, you may need to regain TVA and oblique strength. Your core should be capable of maintaining tension while letting your ribs expand. We love pelvic tilts and heel slides to work the TVA in isolation.
Lastly, bring awareness to your back body. Lay down on your back or sit on a chair with your feet on the floor. Place one hand on your low back keeping the other on your ribcage. As you inhale, you should feel your back push towards your hand. Do you feel any back expansion? If not Bird dogs and rows are some of our favorite exercises to work the multifidus and regain back mobility.
INCORPORATING YOUR PELVIC FLOOR WITH 360 BREATHING
Time to squeeze & release!
The pelvic floor is the hammock that supports the body’s internal organs and provide control, sexual function and stability to the pelvis and spine. One in three women will experience some form of pelvic floor weakness. Learning how and when to properly engage and release those muscles can help avoid any unnecessary discomfort such as leaking, bulging or pain when lifting heavy objects (or your baby), coughing or laughing. For example, you want to exhale and lift your pelvic floor when picking up baby, coughing or laughing.
On average a pelvic floor is made up of 30% slow twitch and 70% fast twitch muscles. Therefore, we encourage our clients not to purely focus on those quick Kegels at the traffic lights but to set time for a proper contraction and release, without these you are potentially not exercising 70% of your pelvic floor. You should aim A long strong Kegel exercise you should be able to contract for a 10 seconds and release for another 10 seconds. You will not be able to achieve is straight away however this should be your goal before you try any high impact exercises.
How to coordinate your Kegels with your breath:
When you inhale and the diaphragm contracts down toward the pelvis, the pelvic floor must elongate or relax to accommodate for the change in abdominal pressure. In other words, you want to relax both passages as if enabling urination and the passing of wind. This should be a gentle release, you are not forcing your pelvic floor down.
As you exhale, the pelvic floor and lower abs gently contract and lift towards the ribcage as the diaphragm also lifts up. As mentioned previously be conscious of not sucking your stomach in towards your spine. Your stomach should appear flat without a dip appearing at the belly button.
Other factors to watch out for is the squeezing of your legs together, tightening your buttocks or hip flexors, or holding your breath! Each one of these is a sign that another part of your body is trying to kick in and help your pelvic floor as it is weak, thereby reducing the efficiency of the exercise.
A visual aid we like to use is the toy crane, the ones you find in carnivals or kids play areas. Hopefully you have won a soft toy from one of these machines and the analogy does not cause you to tense up!
The inhale is when the crane descends opening and relaxing the claw. The exhale is when the crane closes in grabbing the soft toy and bring it up.
WHEN TO PRACTICE 360 BREATHING & KEGELS
Health care professional and physiotherapists would advise you to practice 10 reps of short and long Kegels 3 times a day. This can seem daunting however we have a few notes that help:
· A fun way to work the faster twitch muscle of the pelvic floor is by bouncing a ball and lifting the muscles as soon as the ball comes up to your hand and releasing as it goes towards the floor.
· Before your workout to help you prepare and incorporate it into your exercises
· While you perform squats, you exhale on the way up and inhale on the way down
· While feeding the baby
· As part of your bedtime routine, it relaxes the body and helps you prepare for sleep
· Change it up! Try this lying supine, on all fours or in child’s pose.
· The squeezy app by the NHS is a wonderful tool as it provides a timer, visual aid and reminder to do your Kegels.