Getting to the Core of Postpartum Fitness: Regain Bladder Control at Home

For many women, childbirth is a beautiful and exciting experience. However, it can also bring about certain challenges, one of which is bladder incontinence, especially postpartum. This can be the cause of some very embarrassing situations, be quite disruptive in your daily life, and can even be a contributor to postpartum depression due to the isolation that often occurs when you don’t trust your bladder to go leave the house. However, the good news is that there are effective ways to regain control of your bladder.

In this blog post, we will explore how you can address bladder incontinence through posture, breathing, pelvic floor muscle training, and habit changes, all from the comfort of your own home. Let's get started on the journey to better pelvic floor health and postpartum fitness with a core exercise program that truly gets to the core of the issue.

Posture Matters

Proper posture is the foundation of good pelvic health. When you maintain correct posture, you reduce unnecessary pressure on your pelvic floor muscles, which can help prevent incontinence issues. Here are some tips to improve your posture:

• Stand tall through your neck - bring your chin in slightly. Not so much that you create a double chin, but just the opposite of a jutting chin.

• Gently pull your shoulders away from your ears. Feel your shoulder blades glide down your back

• Stack your rib cage over your pelvis. Make sure your ribs are not flared. Use your core muscles to connect and align your ribs and pelvis.

• Check in on the pelvis. Is it rolled forward or backward? Play with both ways to try to find a comfortable neutral.

• Soft knees line up under your pelvis; don't lock them. By the time you have made the above corrections, they will likely not be locked out (rigid)

• Check in on your feet. Do you have a slight arch? Shift side to side, do you feel like you are standing with your whole foot or leaning to one side, into your toes, or into your heel? To correct any of these, try to feel the four corners of your feet making contact with the floor. Spread your toes slightly apart. How does that feel?

Breathing Techniques

Your breath can play a significant role in controlling bladder incontinence. Not only does deep, whole-body breathing help to calm your entire nervous system the pressurization through your abdomen and pelvic floor are controlled by your breathing. Learning h0w to teach your diaphragm, core and pelvic floor muscles work in concert during breathing can help strengthen your core and reduce the risk of leaks.

Here's how to do it:

• Relax your tongue off the top of your mouth. Feel your jaw fully relax. You will find your tongue pushed into the top of your mouth often, and that's OK, it is supposed to be there to help with neck posture and lymph drainage! Just relax it when you are taking deep breaths for relaxation, and especially when working with relaxing your pelvic floor.

• Inhale - Feel your abdominals expand into your lower belly - Feel your pelvic floor gently expand. Feel your ribs fully expand on both sides and all the way through your back.

• Exhale - Begin to feel your exhale at your pelvic floor. This is not a full Kegel, just a gentle contraction. Be aware that your exhale begins deep in the body; feel the pelvic floor gently push your exhale up and out of your body. Scoop the muscles of the belly from the pubic symphysis bone in front, up the lower abs, and behind the navel.

• Lastly, feel your ribs contract down to get the final bit of air out. (If you feel pressure against the pelvic floor with the rib contraction, then take this out just for now. Work on the belly/back/pelvic floor breathing, and then add in the rib contraction when you can.)

Pelvic Floor Muscle Training

Pelvic floor muscle training is a crucial part of regaining bladder control. These exercises help to strengthen the muscles that support your bladder and control urination. Here's how to perform Kegels:

• First we work to relax the muscles of the pelvic floor, whether the muscles are weak or overly tight. The relaxing helps with awareness of muscle movement on the inhale and the exhale. Try deep breathing in a yoga squat, child’s pose or on an exercise ball, feel for the feedback of the muscles expanded and lengthening on the inhale. Become aware of this feeling before moving on.

• After you are able to feel the muscles expand on the inhale, then feel for the opposite on the exhale. You can engage a bit more of a muscle contraction to feel the engagement here. Just remember that the muscles should be able to expand and contract in equal measure. It is not better to be able to engage a strong contraction if you are not able to fully relax the muscles, as well.

• When you have been successful with full contraction and full relaxation of the pelvic floor it’s time to take it to your workout or any other lifting (you know, lifting those kiddos!) We generally say that you want to contract the pelvic floor muscles on the exertion, or the lift, as you exhale. This is a great rule of thumb. Although know that there are some very good reasons why we may have you brace through your core and create the intra-abdominal pressure prior to heavy lifting, but that is for another blog post. Working with a pelvic floor specialist can help you to differentiate when you may need to brace. Again, though, the general rule of thumb of contracting your muscles, exhaling and lifting on the exertion is a great place for most people to start.

Habit Changes

In addition to posture, breathing, and pelvic floor exercises, making lifestyle changes can significantly improve your bladder control. Here are some habits to consider:

• Stay hydrated but avoid excessive consumption of caffeine and alcohol, as they can irritate the bladder. There are some foods that can also affect the bladder negatively such as tomatoes and chocolate (so sad, I know!) Sometimes we abstain from drinking water thinking that we will help with incontinence however the opposite is actually true. When you are dehydrated your muscles communicate less efficiently and may even spasm or twitch, leading to incontinence.

• Include dietary fiber to prevent constipation, as straining during bowel movements can negatively affect your pelvic floor.

• Focus on one habit every week to check through your posture and breathing. Is it brushing your teeth this week? Standing in front of a mirror can be very useful for checking in on your posture. Turn sideways, too, notice how you can see big differences from making some small changes through your posture.

• Practice deep, whole-body breathing at night, before bed, and after the kids have gone to sleep. Either for 10 breaths or 10 minutes. Do you feel like you can coordinate the relaxation and contraction of your core and pelvic floor muscles?

Conclusion

Bladder incontinence is a common postpartum issue, but it's not something you have to live with forever. By paying attention to your posture, practicing proper breathing techniques, engaging in pelvic floor muscle training, and making positive habit changes, you can regain control of your bladder and improve your pelvic floor health. Combine these strategies with a well-designed core exercise program, and you'll be well on your way to getting to the core of postpartum fitness. Remember, patience and consistency are key. Even if you don’t feel or notice immediate changes, long-term bladder incontinence doesn’t go away on its own. Keep working at it and you will see and feel improvement before long! And don't hesitate to consult with a healthcare professional for personalized guidance on your journey to better pelvic health.