Self-massage with balls during & after pregnancy

Low back, hip & pelvic pain during & after pregnancy can restrict mobility and limit moms in their daily activities. Having some self-management techniques to alleviate the pain can be a life saver for a better sleep, improved mobility & remaining active.

How about using massage balls for self-treatment? You can do it anywhere, anytime, for as long as you want! Isn’t it the best?

WHO IS THIS FOR?

  • Pregnant or post partum women who experience low back, hip, sacrum or pelvic pain (**an assessment by a pelvic health PT is highly recommended prior to do these techniques, to make sure they are appropriate for you**)
  • Pregnant women who are closer to labour (>36 weeks) and want to improve their pelvic mobility in order to ease labour and birth
  • Pregnant women in labour who want to reduce pain during the contractions

First watch the warm-up video to help your tissues get in the mood and ease into the release. Then, move on to the next video for more in depth massage techniques.

**The Yoga Tune up massage balls are available at my clinic for purchase, or online :)**

2 self-release techniques for your guts!

If you have abdominal discomfort from bloating or constipation,
this video for you!

Or if you came to see me and I mentioned that you had tension around your intestines, this video is for you too! 

Here below is a video with two techniques you can do at home to release your small intestine and colon.
This is a quite powerful health tool that you can use for yourself or your kids to help with digestion!

Why do we have tensions in our guts? 
Stress, intense core workouts, habit of clenching the belly to “look flat”, poor diet, and trauma (ex: car accident, falls) can all lead to tensions in the fascias and connective tissues around our guts.

Why is it bad to have tensions in our intestines? 
It can lead to many problems, including:
– Decreased flow and mobility in the digestive system, leading to bloating/constipation and discomfort along the digestive track in some cases

– Increasing pressure on the pelvic organs such as the bladder, uterine and rectum, and can lead to urine leakage, urinary urgency, painful menses

How to prevent tensions to build up in my guts? 
By…
– Decreasing your stress level as much as possible
– Having a healthy diet that includes adequate fibre & water intake
– Avoiding to clench your core to look like you have a “flat belly” through your daily activities- let it go instead, let it breath 🙂
– Once in awhile, massaging your intestine with the techniques demonstrated in my video to keep things moving!

Top 3 tips for hemorrhoids & anal fissures

(If you rather watch my video summarizing these things, click link above!)

Hemorrhoids and anal fissures are a real pain in the butt to deal with. And when you just gave birth and you have a newborn to take care of, the last thing you want is to cry out of pain on the toilet every time you have a bowel movement. So let’s make things easier for you mammas.

First, you may have hemorrhoids or anal fissures, or the whole package deal (both).

What is the difference between hemorrhoids and anal fissures?

Hemorrhoids are basically swollen veins that are bulging out of the rectum lining. They can be located internally (inside the rectum) and/or externally (outside of the anus). Some people have them and are not symptomatic (inactive hemorrhoids). A flared-up or active hemorrhoid is normally caused by recent increased of pressure in the pelvic area. For example, childbirth, pregnancy and severe constipation are common causes.

An anal fissure is a small cut in the lining of the anus. It can be caused by childbirth, constipation, straining, passing large stool, and anal sex.

What are the symptoms? 

Both hemorrhoids and anal fissures can present the following symptoms:

  • Pain with bowel movement often describes as if “you were passing sharp glass through your rectum”
  • Blood on the toilet paper after bowel movement

If you do not have these symptoms but you have had them in the past, that means that your condition is under control (hemorrhoids are not active, or fissure is healed). That’s awesome!!! Keep it that way by following tips #1 et #3 below 🙂

What to do? 

#1 Keep your stool soft! 

The first thing to look at is the quality of your stool. Keep it as soft as you can – you do not want a hard stool to go through these painful spots, believe me! Target a #4 type stool on the Bristol Stool chart, like a snake or a soft sausage. Drink plenty of water and check your fibre intake – if you need more info, read my blog post about bowel health.

#2 Decrease inflammation 

My number one to achieve this is a very natural way to decrease swelling: good ol’ ice! But how do you ice your butt hole? Using this wonderful device called the ANUREX which you keep in your freezer. It literally saves lives (according to my clients…!) – the best investment you will ever make to sooth the area. It comes with a little bottle of lube that you can put around it to make insertion easier. You basically insert the anurex in your rectum for a few minutes to help decreasing pain and swelling. I recommend using it 2-3x/day when things are flared-up.

There are other ways to decrease inflammation such as using topical prescription drugs. Some of my clients found lots of relief in Proctofoam which is a numbing foam with cortisone. It is used with an applicator that you gently insert in the anus. Ask your doctor 🙂

The other thing you should consider to decrease inflammation and pressure is to sit on a donut cushion (a cushion with a hole in the middle). This way, your anus will be free of pressure and it will be better for the healing process. You can find those cushions pretty much anywhere in health care stores or even Walmart.

#3 Squat to poo!

I cannot put more emphasis on the importance of the squat position during bowel movement!! I told you about it in my post about bowel health, and this was more as a preventative recommendation. But here my friends, I am telling you: you don’t have the choice anymore!! You need to get a Squatty Potty!!! Squatting during bowel movement relaxes the tension from your pelvic floor muscles around the rectum, and makes it easier to release stool without straining. Since avoiding to strain is huge in healing hemorrhoids and anal fissures, you really want to put all the chances on your side. The Squatty Potty is available at Canadian Tire (in the bathroom items aisle) or you can also purchase it online. Or else you use whatever you have at home to elevate your feet while you poop – however make sure it is high enough so your knees are higher than your hips!

 

I followed all these tips but I am still struggling….

OK – do not panic. You are not a lost cause, there are still a few things you could consider. First, go see a Pelvic Health PT to see if there is any tension in your pelvic floor that could make your stool more difficult to pass, thus restricting the healing of your condition. I learned a super powerful technique at the Institute for Birth Healing called the “anal sphincter release” and it has been working like a charm to reduce tensions around the anus and make more space for the stool to go through. It is a super gentle technique to relax the anal sphincter.

The last resort option is to consult your doctor and see if you would be a candidate for surgery. I would not recommend this option if your symptoms are still recent (<3 months), and you have not tried all of the above. Hemorrhoids can be removed through different procedures. But they are only removed if they are causing extreme pain and difficulty with bowel movement (that means – they won’t remove them for aesthetic reasons just because you don’t “like how they look” – anyway I swear you do not want to go through this surgery if you do not have symptoms, because the recovery is quite painful!)

 

I hope this gives you a few tools to manage your symptoms.

Sophie

Tips for a peaceful bladder during the holiday travels

The holiday travels can be a source of anxiety for folks who experience bladder control issues. Long travels, flights, airports, being in places where you don’t know the location of the bathrooms, can indeed make things stressful. 

Here are a few tips to go through the holiday travels with a bladder at peace!

#1 – Avoid bladder irritants before and during your travel time

Coffee, tea, alcohol, carbonated drinks, acidic, spicy & sugary food can all be triggers for those who experience bladder urgency & incontinence. Avoiding them the day before and during your travel time may just be what you need to keep yourself out of trouble.

#2 – Keep the bowels moving

I know this can be a challenge when you are away from home and you eat things that you don’t normally eat, drink more alcohol than usual, perhaps eat less fruits and veggies than what you are used to. But remind yourself that constipation is one of the #1 causes of pelvic disorders. When your rectum is full, it can press on your bladder and cause urinary urgency and incontinence. Straining on the toilet can also worsen a prolapse, so you really want to keep things moving while you are away and don’t let it go too long.

One good way to manage it is to carry dried fruits with you so you get your fibre intake, as well as a water bottle to keep those fibres wet & moving along the intestinal track. Fibre supplement caps such as Metamucil can also be a good way to get your fibre intake without carrying too much food on you. However, be aware that increasing your fibre intake without increasing your water intake at the same time can actually make your constipation worse by bulking your stool too much! So make sure that both water & fibre intake go hand in hand! 

If you have not had a bowel movement for more than 2 days, try my intestinal massage to get things started.

#3 Select an aisle seat if possible

There is no point in stressing yourself out while travelling on the plane by having a window seat and not being able to access the bathroom on time if you need to. Sometimes, paying the extra few bucks and buy some peace of mind is the way to go, this way you don’t end up having to wake your neighbours up every time you have to use the washroom. One less thing to worry about!

#4 Exception to “no just in case” rule

I know I have told you in the past that going to the bathroom “just in case” is not a good strategy to work on your bladder capacity. However, when it comes to air travel where you may have to wait in line for security or other things, you can make exception to the rule. This is not the time to work on bladder capacity that day, you can work on it while you are in a more familiar environment. Emptying your bladder before security & boarding could be a good solution to avoid distress associated with bladder urgency while you are waiting in line and cannot use the washroom.

#5 Wear protection in case

There is nothing worse than feeling uncomfortable from urine leakage in your underwear and pants, especially in public when you can’t change right away. Wearing a liner or incontinence pad during your travels can be a good way to keep your mind at peace, knowing that you have protection just in case, and that you can change it if you have an accident. I highly discourage you from using menstrual pads for that purpose, as they do not breath well and may create some irritation around the vulva. Go for pads that are specifically made for incontinence (ex: Poise) and will be much more comfortable for you. Carry a few in your purse in case you need to change them over the course of the day, and maybe a change of underwear as well.

#6 Urgency: stop, breath, distract, kegels

If you are on the plane and have sudden bladder urgency but there is a line up to the bathroom, use the “stop and breath” technique. As you are waiting, try to distract yourself from your bladder by bringing your attention to your breath, and count up to 10 nice breaths in & out, feeling the air coming in through the nose, out through the mouth.

You can also use mental distraction: counting backward from 1000, mentally listing the American states, find the names of all the people you know whose names start with an “A”, or whichever silly task you may find. You can download games on your phone before taking off which you can use for distraction during the bathroom line up. The less you think of your bladder, the more control you will regain over the urgency. Your bladder literally feeds on your thoughts, it WANTS YOU to think of it. Do not let your bladder control your mind!

You can also do a few kegels (pelvic floor contraction / release) to distract yourself from the sensation of your bladder. Squeeze for a few seconds, release, squeeze, release… Do this 5-10 times. Normally, the urgency will decrease as you do this.

#7 Trust yourself

In a new environment, this is so easy to lose your confidence in your bladder control, as you may not know where the bathrooms are. Reminding yourself that there is a huge psychological component to bladder control, and the more thoughts you put into your bladder or are worried about it, the more you are giving material for your bladder to feed on and take control over your mind.

Finding a positive and empowering mantra that you can repeat mentally when you feel about to lose control may be a great way to work around this. Something around the lines of:

“I am calm, in control, and I know I can do this.”

Close your eyes and try to picture yourself in an environment that is familiar to you where you would be in control (ex: in your own house). Or picture yourself on the beach, on the top of a mountain, or any environment that brings calm & quiet into your mind. Take 10 breaths here.

 

Alright – that’s it for my little tips!!! I know you can do this!! 

Happy holidays everyone and see you back in January 🙂 

Sophie

Vaginal scar tissue: 3 techniques to release it

Vaginal tears from childbirth can heal in different ways, and many people are not aware that sometimes they need a little help in the healing process. In fact, vaginal scar tissue can often heal “tight” and not super flexible, and can cause pain with sex.

If this is your case, these techniques can help with releasing the scar tissue and make it softer. I recommend doing them every day or other day until there is no discomfort anymore with any of the techniques and that sex feels comfortable.

Painful sex: how to use vaginal dilators to stretch your vagina

There is this myth going around in our society that it is “good to have a tight vagina” – but good for who exactly?! I’m asking you.

What if I was telling you that most of my clients consulting for painful sex issues present, in fact, a tight vagina, and it sure makes their sex life not pleasurable at all! Is that good? It sure ain’t.

There is a difference between having a healthy muscle tone in your vagina so you can have good sensation during sex, versus having a high tone and tight pelvic floor. Hypertonic pelvic floors are NEVER good and healthy – they can cause pain, incontinence, overactive bladders and so on. We want those tissues to breath, to allow stretch, to be dynamic, to move!

BUT HEY – that was not the point of my post actually. I wanted to tell you that if you feel like your vagina is so tight that penetration feels like sandpaper in your lady bits or like trying to fit a banana in a toothpaste tube, this video is for you.

This is for you, post partum mom who had vaginal tearing or episiotomy, or simply a challenging healing time, and now feels like sex is no longer the same and that there is not enough space down there.

This is for you, menopausal women who had no sex for years and just met a new partner, and discovers the sad reality of “use it or lose it”. Indeed, after a certain age, if we do not have sex very often, the vagina can actually shrink…! But hey, you can get it back!

This is for you, young woman in your 20s who has never been able to insert a tampon without pain, or never been able to have painfree sex ever since you became sexually active. You are actually starting to think that this may be how sex is supposed to be, and may start wondering why people even have sex.

PLEASE DO NOT ACCEPT PAINFUL SEX AS YOUR REALITY!

Return to running after birth: do you make the cut?

When should you return to running after delivery? There is so much controversy about this topic, and I thought I would share the updated 2019 guidelines to enlighten your decision making. Remember that these tests are only one part of the puzzle, and that a Pelvic Health PT assessment should also be part of it to make sure that you core and pelvic floor are ready for it too.

What’s the risk of going back to running without meeting those criterias?

You may put yourself at risk for permanent damage/injuries such as vaginal prolapse (when your bladder is descending into the vagina), or even pelvic/low back pain. Or you may get lucky and nothing will happen. But do you want to take that chance?

I have had clients who regretted not having been informed about holding off on high impact after birth, as they dealt with low back pain or vaginal heaviness for years after the fact… until they finally consulted with a pelvic health PT to address it. Believe me ladies, it is not worth the risk, especially if a few weeks of adequate exercises prescribed by a Pelvic Health PT can prevent those injuries.

Watch my 10-min video below to test where you’re at 🙂 

Also, if after going through these tests you feel like you make the cut, please ensure to go back to running very progressively – starting with some walk/run, flat course, short distances, slower speed, etc.  A pelvic health PT can guide you in the progression. You can find the updated guidelines at p.5 here for more details 🙂

Leaking urine: weak or tight pelvic floor?

Many people think that if they are leaking urine, they must necessarily have a weak pelvic floor. Starting from this assumption, they start doing Kegel exercises, and sometimes make their problems worse! Why is that?

In this video, I am drawing the distinction between a weak and a tight pelvic floor, and why Kegels can be harmful in some cases!

What to expect after your vaginal delivery?

One of the things I hear the most from my post partum moms is “No one told me this could happen..!”

Indeed, not many women are informed about what to expect in the pelvic area after baby is born. We spend soooo much time preparing for labour, birth and baby’s care. But once these adorable little humans are out of the uterus, it can be comforting to know what is normal and what’s not. No one needs an additional source of anxiety when trying to take care of a newborn, am I right..?

So here’s a list of the most common pelvic symptoms you may face after delivery:

1- Pain and soreness in the perineum

The perineum refers to the area between your vagina and anus. After all it’s been through, normal that it may feel sore and painful for a few days.

Your best friends will be: ice packs, sitz baths with witch hazel or calendula infusion, witch hazel pads, peri bottle to clean after urination & bowel movement, pain medication if needed. 

2- Painful bowel movement, hemorrhoids, blood in stool, constipation

Again, depending on how your birth went (pushing time, baby’s position, baby’s size, use of forceps or vacuum, tearing, etc…), your rectum area may have taken a hit in the process. Totally normal to have some of these symptoms for the first few weeks.

Your best friends will be: anurex (cooling device for the rectum – available to purchase at my clinic), stool softeners, squatty potty (to have a more optimal position on the toilet), ointment (ask your doctor), donut cushion. For constipation: water, fibre & magnesium supplements. For more detailed info about this topic, read my post about bowel health!

3- Difficulty to hold urine, stool or gas

That is to be expected to a certain degree for the first 2 months after baby. You may feel urine coming out with laughing, sneezing or coughing, or even on the way to the bathroom, or at random times. You may feel like you cannot hold gas anymore, and that you have to rush to the bathroom to make it on time when you need to have a bowel movement. These symptoms can be quite embarrassing to deal with, but they should slowly get better over time. Starting on your pelvic floor exercises a few days after birth should speed up your recovery. After 8 weeks, it is not normal to still present these symptoms and you should definitely consult a Pelvic Health PT if that’s the case.

Your best friends will be: pads specifically made for incontinence (such as Poise) – they breath better than menstrual pads and will be less irritant for your skin

4- Vaginal heaviness / feeling that something is falling out of your vagina

For the first few weeks after birth, you may feel like your organs are falling out of your vagina if you stay on your feet too long or go for a walk. My suggestion is to:

  • Try and avoid activities that trigger heaviness, and ask your pelvic health PT about how to modify your activities to reduce pressure on your pelvis
  • Address any constipation issues – straining on the toilet is a major risk factor for prolapse
  • Avoid lifting more than your baby weight for 4-6 weeks – split your loads (ex: grocery bags, wet laundry baskets) and use your support network for domestic tasks
  • For families with toddlers: try and explain that mommy can only give hugs while sitting for now, and find creative ways to make them more independent to get into bed / vehicles so you do not have to lift them too often (ex: monkey ropes, ladders, stool to climb onto the bed). If you make it fun and interesting, they are more likely to collaborate 🙂
  •  Spend 5-10 min with your pelvis elevated when you present heaviness sensations (ex: lying on the floor with calves on the sofa or a chair, and a few cushions under your pelvis to elevate it)

Your best friends will be: anti-gravity pose (calves on a stool with pelvis elevated) or horizontal position when symptoms occur, pacing yourself to avoid triggering symptoms, squatty potty, stool softeners, support network to reduce domestic tasks

5- Intercourse may not happen @ 6 weeks postpartum

OK: first, most couples return to intercourse between 3-6 months after baby is born – those are just the statistics. The famous “6-weeks green light” from the doctor can be quite a source of anxiety for many women, actually. Indeed, some moms feel the pressure to get back to sex ASAP, when in fact they still have lots of healing to do, both physically and emotionally especially if they have experienced birth trauma.

Not to mention that moms may feel exhausted, overwhelmed, anxious or depressed. They may have a low libido, sore nipples, and vaginal dryness from breastfeeding. On top of that, they are figuring out their new role as a mother, their new routine, how to care for their baby, how to heal their body, etc. They are learning to take care of their postpartum body, but they may not feel super sexy while they are figuring it out. How are they supposed to want sex in these conditions?

Now – you have worked up the courage to try intercourse again. You were seeking that connection with your partner and you were also curious to know how it would feel like, especially that your doctor told you that your tear was healed. However, a well healed tear does not necessarily translate in a pain free tear. Some women may have no pain with sex at all after a 2nd degree tear, and some others will barely be able to tolerate penetration after a 1st degree tear. Why is that? Because no one heals the same – some people will have more scar adhesions than others, reducing the mobility of their tissues (which causes pain). Other will have tight pelvic floor muscles as a result of their birth, and this can cause pain too. 

Bottom line is: painful sex after birth is a thing! A very common thing, but it does not mean that you should accept it as your new reality. There are so many things we can do to help you, so please do not suffer through and consult 🙂

Your best friends will be: lubricant, Book “Reviving your Sex life after Childbirth” from Kathe Wallace – she shows great massage techniques to help with scars, pelvic health PT consult, Sofia Fortin from the Happy Vagina Project & her Sex After Kids masterclass

I hope I did not scare you with this post – but I just wanted to let you know that these issues are super common after birth, so don’t panic if they happen to you. But most of all, I want you to know that Pelvic Health Physiotherapists ARE YOUR BEST FRIENDS for your postpartum recovery. They will carefully listen to your birth story, let you cry if you need to cry, let you share your concerns without discrediting them. They will ask you all about your urinary, bowel, pelvic pain & sex symptoms, and they will make a plan with you. They will guide you through your recovery, so you are not alone.

You are not alone, mamma, and you deserve the best.

xx

Sophie