women's health

Squats and Pregnancy (Part 2): Squats to take you from "Pregnancy Butt" to Peaches

The Many Faces of Squats during Pregnancy and Postpartum

Did you know there’s a million and one different ways to squat? And guess what, there is not a “best” squat for everyone, find the best squat variation for YOU that works with your goals! Squats are one way to help turn "pregnancy butt" into peaches.

Body Weight Squats during Pregnancy

The first set of squats are great because as parents we frequently get up and down from the ground, chair or couch and it’s great to replicate these movements. Being able to do these squats can help so we don’t get stranded on the ground or trapped under a sleeping baby unable to move. 

  1. Body weight transition from Bear to Squat and Tripod to Squat —> for when you sit on the ground and need to stand
  2. Body Weight Air Squats—>squatting is one of the most basic functional movements we have and it is great to train for everything from sitting on a chair to picking things up off the ground
  3. Box Squats, both Conventional Stance Box Squats and Sumo Stance Box Squats—> If you ever go from sitting in a chair to standing then you already do box squats, so let’s focus on doing them correctly and utilizing the glutes to our advantage.

Weighted Squats during Pregnancy

Weighted squats are a great addition to a workout routine. As parents, we must be able to move with weight for everyday function. This includes picking kids up, carrying carseats, putting kids into beds/cribs and even bending down to pick something up from the bottom shelf of the grocery store. It’s important to add weight as it is nearly impossible to go through life without it…as much as we train for birth it is equally important to train for life.

  1. Goblet Squat—> If you are new to lifting weights or need a confidence boost, goblet squats are a great exercise as it moves the load closer to your center of gravity, helping you get into a better position. Better yet, if you can’t squat low, this is a great exercise because the weight helps act as a counterbalance making it a little bit easier so you can train for progress
  2. Front Squat—> This is a great squat variation for those looking to improve flexibility while strengthening the upper back and quads
  3. Back Squats—> A back squat can help improve overall glute, low back and hip strength
  4. Bulgarian Split Squat—> This squat help you get both deep and low into your squat, allowing for the pelvic outlet to fully open. Added bonus in the fact it helps prevent muscle imbalances, challenges mobility, all while recruiting the glutes and improving core strength and stability

Improving Squat Mobility while Pregnant

Needing a little TLC to get into the squat position? Try some squat therapy to help mobilize the hips and upper back to get you to a better squat today! Also, did you know that not being able to do a squat could be caused by anything from foot mobility to a tight upper back? If you are looking to improve your squat, give us a call at (331) 307-7110 to schedule an appointment today and start building those peaches. 

Urinary Incontinence & Your Period

Lately I have heard more and more women ask about incontinence that only occurs at certain times of their cycle. For some it is the week before their period starts and for others it is only during their period that they notice increased incontinence. Unfortunately, the research on incontinence and a woman’s monthly cycle is seriously lacking. Luckily, we do have one study that gives a little insight into cyclical incontinence. The study showed 41% of women notice their incontinence is cyclical and of those women 42% notice symptoms just before their period and 36% of women notice increased symptoms during their period.3

 

Leaking Before & During your Period

While we need more research on cyclical incontinence, it can be helpful to look at the research we do have—specifically increased incontinence during menopause.  Menopause, like the premenstrual time frame, is when the natural production of estrogen declines. In fact, estrogen levels are lowest right before, during and immediately after the period. These low estrogen levels can decrease ligament laxity and increase ligament stiffness.4 What this means is that approximately a week before menses occurs there is a drop in estrogen which is believed to decrease the strength of the urethra, the tube that connects that bladder to the urinary meatus (how we get urine from the bladder to the outside).

The human body is an amazing thing - it changes and adapts to the hormones that our body naturally releases and the pelvic floor is no different. In fact, the pelvic organs as well as the surrounding connective tissues are all estrogen-responsive, meaning the tissues respond and adapt to fluctuations in estrogen.2 We commonly see this effect in women with stress incontinence who are pre-menopausal due to lower levels of estradiol being produced.1  With the decrease in estrogen, the  pelvic floor and surrounding ligaments are unable to appropriately adapt to changes in intra-abdominal pressure, causing increased incontinence due to the decreased strength, increased stiffness and decreased ligament laxity.

These natural fluctuations in estrogen may also affect the orientation of the cervix. The change in orientation can affect the sphincter of the urethra, or the ability to start/stop the flow of urine efficiently and effectively. This helps us better understand that increased incontinence before and during our periods may be due to the decrease in estrogen which changes the pressure around the urethra causing it to lose elasticity and not being able to fully close and stop the flow of urine.

Leaking When Using a Tampon or Menstrual Cup

By inserting a tampon or a menstrual cup we are naturally altering intra-abdominal pressure (IAP). Altering our ability to appropriately create and maintain IAP, we alter our body’s ability to properly adapt to the environment. This is done through either hypertonic (tight) muscles that are unable to properly relax and therefore unable to create a strong contraction because it is always contracting or hypotonic (reduced tone) and are not able to create a strong contraction.

Leaking only when using a tampon or menstrual cup may also be a sign of a cystocele (bladder prolapse) masking stress urinary incontinence. A cystocele can cause the urethra to kink and actually block the flow of urine. By using a tampon, it acts as a pessary to reduce the cystocele and unkink the urethra allowing for the proper flow of urine. Unfortunately, in some cases, this proper flow of urine reveals incontinence that was previously hidden by the cystocele.

What can we do about it?

As there are structural changes taking place, it may be a good idea to re-frame your workout based on your cycle. If you are one of those that notices increased incontinence prior to your period or during, it may be a good idea to transition to lower impact exercises or focus more on the rest and recovery phase of health. Now that is not to say that you can’t exercise, it may just be a good idea to swap out double unders or box jumps for BIRTHFIT functional progressions or unilateral farmers carry or even Russian kettlebell swings.

As with any leaking or incontinence issue, it is important to be evaluated by someone with extra training in pelvic floor health. That way a care plan can be created based on your specific needs. To find one in your area reach out to your BIRTHFIT Regional Director for local resources or check the Herman & Wallace Certified Pelvic Rehabilitation Practitioners or the list of APTA’s Women's Health PT.

 

Resources

1.    Lu Y1, Lang JH, Zhu L. Estrogen receptors in pelvic floor for female stress urinary incontinence. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Jun;29(3):402-6.

2.    Tzur T1, Yohai D1, Weintraub AY1. The role of local estrogen therapy in the management of pelvic floor disorders. Climacteric. 2016 Apr;19(2):162-71. doi: 10.3109/13697137.2015.1132199. Epub 2016 Feb 2.

3.     Bidmead J, Cardozo L, Hooper R. The impact of the menstrual cycle on urinary symptoms and the results of urodynamic investigation.BJOG. 2001 Nov;108(11):1193-6.

4.     Reese M, Casey E. Hormonal Influence on the Neuromusculoskeletal System in Pregnancy. Musculoskeletal Health in Pregnancy and Postpartum: An Evidence-Based Guide for Clinicians. January 2015. (pp.19-39).