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“LOW PRESSURE FITNESS LITERALLY SAVED MY LIFE“

And for that reason we have a Low Pressure Fitness trainer in Norway!

 

“I felt completely broken and devastated that my life had been ruined by childbirth. My doctors were no help.”

 

Sadie is now paving the way for a more developed post natal approach of health care in Norway.

 

We leave Sadie’s testimonial to you.

sadie-low-pressure-fitness

A year after my daughter was born I was in a very bad place. I had suffered grade 3 pelvic organ prolapses post partum (bladder, uterus and rectum), also had anal prolapse, and diastasis recti. I was in so much pain and discomfort on a daily basis that all I could do was get through the day and try and take care of my daughter. I had never envisioned that something like that could happen after birth. I had never thought my life as I knew it could be over. I was so lost and desperate, and extremely depressed.

 

Every doctor I had been to had told me it was no big deal. They had ignored all my pain and issues voiding my bladder and bowels. They brushed off my symptoms, like the fact that I tore every time I had a bowel movement. Or the fact that I could not stand for more than 5 minutes without severe back pain. None of them examined me standing, even though I begged, and said the damage wasn’t that bad. When standing my organs were literally falling out. But nobody cared. I wasn’t interested in surgery (why would I want the people who were ignoring me to cut me open?) and so they didn’t have anything to offer.

 

I had been going to physical therapy and all I was given was kegels. I became so hypertonic that my pain got much worse. I couldn’t even sit without discomfort. I was told there was nothing else I could do. I was so tired, so exhausted (my baby didn’t sleep) and in so much pain I didn’t think to question anyone. I assumed since everyone said it was so common (even though nobody talks about it!) that they knew what they were talking about. One day I had a follow up with my doctor, and when I told her how desperate I was she actually said “well, you chose to have children so you must have known something like this could happen”. And that was the slap across the face that I needed to wake up.

 

I went home and did what I have always done but had forgotten to do this time (due to hormones, lack of sleep, and an assumption that those caring for me actually cared), which was to take my health into my own hands. It didn’t take me long to find hypopressives and read more about Low Pressure Fitness – luckily I was born and raised in Spain so it was easy for me to find information. I couldn’t believe something so widespread hadn’t even been heard of here. I immediately contacted trainers to train via skype (there were no trainers anywhere in Scandinavia, I live in Oslo). The first to reply was Trista Zinn in Canada, and I got started.

 

After just a few days (after a year of thinking my life was over!!!!) my symptoms were so much better I could go for a walk with the stroller pain-free for the first time. I couldn’t believe it! Why is not everyone teaching this to new mothers everywhere? Why hadn’t anyone cared enough to learn about other techniques than useless kegels? How could this not be the norm for post-partum care? I trained religiously, and as I got better my conviction grew stronger, Low Pressure Fitness needed to be available to everyone who needed it!

 

I incorporated other techniques (osteopathy, myofascial release) and kept training, and am now asymptomatic from injuries so bad that the medical community meant surgery was the only way to go. But now I can carry my daughter as much as she’ll let me, and she’s 12kg. When she was 3kg I could hardly hold her, I was in so much pain. I even jumped on a trampoline recently. The future is bright!

 

Even though I had started a business before having my baby, I felt it was wrong for me to find a way to heal and just go on with my life, while other women who were in my same situation might never get the help they needed. I felt like the only way I could deal with everything that had happened to me was to try and make something good of it. So I decided to go back to my hometown of Barcelona and become a certified trainer for Low Pressure Fitness, and help others learn how to get their cores and pelvic floors functional again, reduce their diastasis and back issues, and feel stronger and more stable in their bodies than they thought possible.

 

As I have built up my practice here in Oslo, my story has spread, and I also train clients via skype, both in Norway and around the world. It’s so amazing to be able to build something so positive out of such an awful personal experience. I am so happy to be able to give hope to others and help them get their bodies back to feeling well. If nothing else, I would like to prevent others living in fear that their lives are over for as long as I did. Because there is always something you can do. I collaborate with other therapists and find that in many cases, a holistic approach really accelerates healing. I am working hard to spread information about the effectiveness of Low Pressure Fitness and am happy to see more and more professionals, not just patients, opening their minds to a new approach. If nothing else, I feel we should all want to have as many tools in our toolbox as possible, so we can help people as much as possible. That is what I wished had been true for those helping me. And I am working hard for it to be the norm in the future. I still meet some skepticism from time to time, and if people aren’t convinced by mine or others’ results, I like to remind them, that if they open their minds, they won’t fall out.

 


Sadie Lawler
LPF-CT

Sadie Lawler is a personal trainer and LPF-CT living in Oslo, Norway. She grew up in Barcelona and spent some years in New York and London as well, her professional life has included everything from directing TV shows to starting one of Oslo’s first organic local groceries. After having her daughter and experiencing first hand how limited the post-partum care is in Norway, she is now on a mission to spread the word of Low Pressure Fitness, in the hopes that no other women will have to experience what she did. She is an advocate for women’s health and believes that caring for new mothers is crucial in a society that is constantly pushing for effectivity in all areas of life.

TREATMENT OF URINARY INCONTINENCE WITH HYPOPRESSIVE EXERCISE

The Spanish Scientific Nursing Society journal (SCELE) has just published an original research article titled Hypopressive exercise for the treatment of urinary incontinence in multiparous women: clinical series.

 

The study presented the results of treating a clinical series of multiparous women who suffered from urinary incontinence. Based on the hypopressive exercise guide described by the founders of Low Pressure Fitness (Rial and Pinsach, 2014), a novel protocol was proposed with the objective of improving urine leakages.

 

Urinary incontinence is very common after delivery. The type and number of deliveries are considered major risk factors. In many cases, women do not seek appropriate treatment since urinary incontinence has become socially normalized after a certain age or as a consequence of delivery. However, supervised treatment with specific exercises can be helpful and at the same time healthy.

 

In recent years, hypopressive exercise has started to be applied in the treatment of pelvic floor dysfunctions such as prolapse and incontinence. Although it is very popular, there is a limited body of evidence regarding it’s benefits. Additionally, there are very few references available regarding the best protocol for treating urinary incontinence with hypopressives. In this study, the authors suggested a new protocol which consisted of ten minutes of Level 1 LPF exercises practiced once a week over three weeks. After that, the session duration increased to fifteen minutes and was carried out twice a week. Lastly, in the last two weeks practice time was increased to twenty minutes twice a week.

 

After a seven-week intervention protocol based exclusively on hypopressives, urinary incontinence was again assessed. All cases showed improvements in both, the severity and quantity of the leakages. Two cases showed complete remission of urine leakages and all the women expressed great satisfaction with the program.

 

urinary-incontinence

 

The results of this study:

  1. Provide more data on the potential effectiveness of hypopressives for the conservative treatment of urinary incontinence.
  2. Lay the ground work for new experimental studies involving larger groups.

 

The fact that the sessions were short, supervised and progressively introduced to the patient could influence the desirable findings. The results of this study show us that a short protocol (10 to 20 minutes of hypopressives performed once to twice a week) can also be effective in reducing urinary incontinence in a case of multiparous women.

 

All the certified professionals of Low Pressure Fitness, experts in hypopressive exercise can be found in this link.

LOW PRESSURE FITNESS AT RIMINIWELLNESS 2018

RiminiWellness is the largest fitness and wellness trade show in Italy and one of the largest in Europe. With participation in 2017 at 268.120, this year’s event promises even greater numbers. Low Pressure Fitness was present this year with 4 workshops and 8 mini masterclasses to present, inform, instruct and demonstrate the pressureless training system to the Italian fitness community. While participants in the masterclasses were predominantly Italian, there were also many participants from Slovenia, Czech Republic, Poland, Ireland and many other European countries.

 

LPF-RiminiWellness-2018

 

The workshops presented included: “What nobody has ever told you about Core Training, myths and new perspectives”, “The core’s missing link: diaphragm and pelvic floor”, “Myofascial relaxation and Postural Re-Education with LPF” and finally, “Low Pressure Fitness: much more than hypopressives”. Each workshop was attended by fitness professionals as well as physical therapists and other medical professionals, that all expressed interest in this innovative and exciting training method for both men and women.

 

Low Pressure Fitness: much more than hypopressives

 

The participants in the mini master classes over the four days included exercise professionals, health professionals as well as exercisers. All were enthusiastic about the new technique and especially the sensations experienced during the workouts that were all geared at teaching the basic fundamental postures and breathing and, where possible, having them try the expiratory apnea, our “signature exercise”.

 

LPF-RiminiWellness-2018

Low Pressure Fitness staff at Riminiwellness

 

The staff of Low Pressure Fitness instructors was on-hand to assist the participants during the mini masterclasses and give information and distribute material on LPF in Italy.  They were also invaluable in sharing their own personal experiences and results of their work with many of their own clients to show the participants that the LPF method is both instructor and user-friendly with benefits that can be attained when the exercises are performed with precision. RiminiWellness has proven to be an excellent event to showcase this innovative, multidisciplinary training method. To learn more about Low Pressure Fitness and courses in Italy for health and exercise professionals write us to: [email protected]

 

Author:
Mimi Adami
Low Pressure Fitness Italy Director & LPF-Coach

Facebook:
Low Pressure Fitness Italy

SHOULD I DO HYPOPRESSIVES DURING THE IMMEDIATE POSTPARTUM PERIOD?

Hypopressive exercise has been suggested as an alternative rehabilitation tool for abdominal and pelvic floor postnatal recovery. Nowadays, hypopressives are widely prescribed by health and fitness professionals during the postpartum period in many European countries. However, there is a lack of scientific literature about the optimal time to start a hypopressive program after delivery. Therefore, the purpose of this article is to address some of the common questions we receive at Low Pressure Fitness regarding this topic. Among the most frequent questions about postpartum and hypopressive training we highlight the following:

 

  • How soon after giving birth can I start my hypopressive training?
  • Can I do hypopressives if I am breastfeeding?
  • Can I do hypopressives if I had a c-section?hypopressives-postpartum

At present, there are no randomized controlled trials on the long-term effects of hypopressives during the postpartum period. Additionally, there are different opinions regarding the best time to start these exercises. Opinions vary from beginning immediately after delivery to waiting until the late postpartum period. Here we summarize opinions from different experts on this important topic.

 

What do professional associations say?

The puerperium corresponds to the period right after delivery. That is, the first week after giving birth. It extends from the first day to the tenth day after the baby is born. The late puerperium period includes day 11 through day 42. While the remote puerperium makes reference to day 43 onwards. The following period, generally called late postpartum, starts in week six or 40 days following birth (the famous quarantine). Of note, the postpartum period can last up to six to twelve months after giving birth.

 

The guidelines from the Spanish Association for Physical Therapy for the late postpartum period recommend starting hypopressive training six weeks after delivery. They state “abdominal exercising should always be hypopressive”. Regarding the puerperium (first 48 hours-first week), this association suggests that women should avoid traditional abdominal exercises and perform hypopressives.

hypopressives-postpartum

On the other hand, the Professional Guide for Mothers’ and Fathers’ Education in Pregnancy and Childbirth, coordinated by the Service for Assistance Coordination and Care, recommends hypopressive exercise only during the late postpartum period (from the sixth week onwards). The Ministry shares a similar view for Health and Social Services of the regional government of Cantabria (Spain). They state in their guidelines that women should perform hypopressive exercise during the postpartum period, specifically 30 to 45 days after delivery (the quarantine).

 

During the postpartum period, it is advisable to seek guidance and instruction from an exercise professional

 

Our Delivery emphasizes that once the quarantine is over, it is important to practice kegel exercises and hypopressives with the supervision of a physical therapist who can explain how to perform the exercises properly. Our Delivery also recommends Kegel and hypopressive exercise to women who had a cesarean section.

 

Tamara Rial, PhD, Director of Low Pressure Fitness, suggests that when there is no medical contraindication to exercise, hypopressive training can start after the quarantine (six weeks postpartum). However, in the case of surgical procedures such as a caesarean section, it is advisable to wait three months. It is also important to visit a health care provider after delivery and to check the pelvic floor prior to commencing a postnatal fitness program.

hypopressives-postpartum

During the postpartum period, it is advisable to seek guidance and instruction from an exercise professional who can adapt the program and address individual needs. To find a certified Low Pressure Fitness specialist visit our online directory.

 

Author:
Dr. Tamara Rial

HOW CAN LOW PRESSURE FITNESS BENEFIT PILATES?

In his first Law of Thermodynamics Antoine Lavoisier (1743-1794) said that matter can’t be created nor destroyed, it is only transformed. When a general law is properly stated, it will also apply to the specific. In our case, we are talking about physical exercise and recovery, where this rule certainly holds. After all, every new approach springs from the what our forebearers have said before, and in today’s fast paced world, fusion is the buzzword for any discipline.

 

In the following article we will understand how Low Pressure Fitness connects to Yoga and Pilates, emphasising the benefits of Low Pressure Fitness training. Many people practice the three or just two of them in a training combo, or else they practice them in succession, depending on their mood or the class timetables available. The three disciplines share common ground and differences in approach, focus and style.

 

Centuries after it was first developed, Yoga is still a relevant holistic training method, and after its advent in the fifties the same can be said for Pilates. More recently created, Low Pressure Fitness is a great new approach to exercise and wellness, with particular aims and features.

 

Yoga, Pilates and Low Pressure Fitness share a common goal, which can be broadly stated as regaining control of the body through awareness. They prioritise body alignment, breathing and postural fitness. Stacking the spine, engaging the core, inhaling and exhaling with control are classic cues we will find in the three disciplines. Low Pressure Fitness is a training program with an ecclectic outlook, stemming partly from Yoga and which was developed some decades after Pilates.

 

Neither of them require complex machinery or a specific place, but they might make use of simple accessories. Low Pressure Fitness includes certain props such as massage balls and wood-rollers, Pilates uses the well-known swiss ball and Yoga, elastic bands and blocks.

 

The main difference between Yoga and Pilates and Low Pressure Fitness is the spiritual component of Yoga, which the other two do not have. Yoga is generally more static than Pilates and Low Pressure Fitness. Yoga poses or assanas are held for as long as possible, excepting the continuous movement of vinyasa, a continuous flowing sequence which connects several poses, like the sun salutation (surianamaskara).

 

Pilates exercises are usually done in a specific order, one after another, and like Yoga, have colourful names to identify them, like the swan, the jack-knife or the criss-cross. They appear to be simple, but they require precision and strength. Strong emphasis is put on technique.

 

The connection between Low Pressure Fitness and Pilates is obvious, since both aim for a better management of intra-abdominal pressure. Scientific research also shows that one of the common benefits of Low Pressure Fitness and Pilates is the increase flexibility.

 

Both Pilates and Low Pressure Fitness consider local body awareness. Pilates will focus on specific areas of the body, especially the voluntary contraction of core muscles. Low Pressure Fitness will also provide the added value of another type of concentration and centralisation, which is the apnea, that activates the involuntary muscles in the pelvic floor.

 

Like Yoga and Pilates, Low Pressure Fitness belongs in the category of useful exercises to balance myofascial tensions, realign posture and improve breathing. Exercises are also sequenced from the simple to the complex, with a focus on the core muscles, the pelvic floor and breathing. Low Pressure Fitness exercises include the same patient and focused attitude as in Yoga and Pilates, but with one distinctive feature: permanent focus on decreasing pressure on pelvic area.

 

What is specific to Low Pressure Fitness is the breath-holding which allows for a wider range of motion. Exercise will often focus on working on the sagittal plane (right or left sides) of the body. As we can see in the pictures, these are probably the exercises which provide more improvements, but we also find more advanced postures targeting coronal plan and the three planes at the same time, with complete torsions of the upper body.

 

Unlike the traditional approaches to abdominal and pelvic floor exercise, which will focus on one segment of the core at a time, the Low Pressure Fitness program addresses the core to perform synergistically and as a whole.  

 

What are the benefits of Low Pressure Fitness?

 

Among its many benefits, Low Pressure Fitness is used by physiotherapists and trainers for:

  • pelvic floor restoration
  • trimming the waist-line
  • preventing and reducing back pain
  • enhancing breathing
  • posture and balance.

It is specifically focused for:

Myofascial release of the abdominal wall and diaphragm, resulting from Low Pressure Fitness are also well-acknowledged benefits of Low Pressure Fitness. The constant movement of the diaphragm in a Low Pressure Fitness session, promoted both by breathing and by the apneas produces a cooperation between the need for a longer range of motion and the abdominal response. Connective tissue loosens up and so does the abdomen.

 

How does Low Pressure Fitness work?

 

Low Pressure Fitness optimises the body posture by adjusting the neuromuscular connections between the autonomous nervous system and portions of the body lacking in alignment and relief. It prevents urinary incontinence by restoring muscular tone in the abdomen and the pelvic floor. It improves breathing patterns by enhancing movement in the torso and the diaphragm and it relieves back pain by promoting flexibility and a wider range of movement.

 

Low Pressure Fitness promotes axial lengthening and restoring the strength of the abdominal oblique and transverse muscles.

 

Since there is so much in common between the Low Pressure Fitness, Yoga and Pilates, it is also frequent to find contentious attitudes, with people trying to argue which of the three is better. We feel that it is not necessary to choose between either. An all-inclusive stance will allow us to reap the benefits of all of them. Just workout, enjoy be ecumenical and enjoy!

 

Hugo Loureiro
Low Pressure Fitness Portugal Coach and Pilates Personal Trainer (PT Studio)
Dr. Tamara Rial
Founder & Developer of Low Pressure Fitness

“MY PELVIC FLOOR SYMPTOMS ESSENTIALLY VANISHED”

I came to learn about hypopressives after the birth of my third daughter. Always a very active person prior to kids, I felt frustrated by the limitations placed on my physical recovery by the development of an anterior prolapse. Not only was I looking for something to improve my pelvic floor health, but I was desperate to find a focus that could rebuild my core again. Hypopressives changed everything for me. The shape of my body quickly returned to what I used to look like, my pelvic floor symptoms essentially vanished, but most of all I felt a renewed sense of energy. My posture improved dramatically as well. I continue to use hypopressives as my core training to supplement other more cardio-based activities. For me, hypopressives have been just as effective (and much more enjoyable) than any other exercise I have tried in the past to target the core. I don’t miss planks or sit ups in the least! I feel taller, more centered and more energized after a session. I have Trista to thank for helping me to perfect my technique, to focus my practice and to keep me motivated. It was a life changer for me!

 

H.H.
Trista Zinn´s Client

 

WHAT’S HIDDEN BEHIND ATHLETIC INCONTINENCE?

Let´s get real and take out of the closet the topic of urine leakage in women’s sport. Recently, wikipedia has introduce a new term to describe exercise-induced urinary incontinence, called Athletic Incontinence. It´s the specific form of stress urinary incontinence  stress urinary incontinence that results from engaging in high-impact or strenuous activities. Generally, it is thought to be the consequence of a decreased support system of the pelvic floor due to increased intra-abdominal pressure during high-impact exercise. It has become a condition too common in female athletes. It represents a huge problem related to the  quality of life of sufferers, but at the same time it´s socially invisible. Meanwhile, different types of incontinence effect a large proportion of american women and the prevalence is much higher for female exercisers of all ages!

 

If statistics state the problem, why we don´t talk about it?

 

There is a huge taboo around the topic so it´s still under-reported. One of the most common problems that female athletes face, during and after their sport career, is stress urinary incontinence. Unfortunaltely, the topic is rarely discussed by an athlete’s healthcare provider. Behind exercise-induced urinary leakage are hidden several consequences such as cultural taboos, embarrasment, lower self-steem, early sport drop or other related lumbo-pelvic issues. Is a threat to an athletes health and well-being since it may limit their participation in athletic activities. Enterprises, concious about the problem , sell the solution  in the form of “female exercise pads”. Sounds like a bad joke, but at the same time, they may be the only people aware of this secret.

Why athletic incontinence is so common?

 

A literature review about this topic (Goldstick & Constantini, 2014) states that the prevalance  ranges from 28 to 80%, with the highest prevalence in high-impact sportswomen such as trampolinists, gymnasts, aerobic gymnasts, hockey players and ballet dancers. Leakage is due to a failure of the pelvic floor system that is unable to overcome the increase of intra-abdominal pressure which occurs regularly during high-impact activities such as jumping, landing, running. Strenuous exercise may overload and weaken the pelvic floor muscles. There are several risk factors associated with this condition, notably pregnancy and childbirth. However, studies have shown about 25-30% of stress urinary incontinence occurs in young athletes with no obstetric past. These numbers are even higher in activities and sports that significantly increase intra-abdominal pressure such as the trampoline whereby athletes have the highest incidence (80%) of urinary loss (Eliasson, Larsson & Mattsson, 2002).

 

What other problems are related?

 

Recent studies confirm a relationship between low back pain and urinary incontinence. The highest prevalence of athletic incontinence, as mentioned before, has been shown  in high-impact sports like gymnastics. This sport includes activities such as jumping, landing, and running which  can also cause compression to the lumbar spine and result in nerve inflammation.

Eating disorders were also associated with higher prevalence of stress urinary incontinence. The lack of proper nutrition, hormonal changes, muscle weakness, and vomiting are possible causes that influence negatively the structural pelvic system.

 

How to prevent or treat it?

 

Just doing simple pelvic floor prevention exercises can help women stay dry. Pelvic floor muscle exercises should be the first-line of treatment and incorporated regularly into exercise and sport training programs.

Joinning a regular exercise program based on Low Pressure Fitness is the preferred method for pelvic and abdominal training for thousands of women around the world. In additon, this method has no side-effects and doesn´t need equipment. Low Pressure Fitness has demostrated to be an effective tool to decrease leakage symptoms in a randomized controlled trial done by Rial (2015). The satisfaction of practitioners is complete as shown in the following testimony of a female Spanish marathoner who experienced exercise urinary leakage:

 

“As an athlete I must say that Low Pressure Fitness for me has been a great benefit to my health, both in terms of improving my quality of life, sport and emotional.
I am 37 years old and love my job, as a physical trainer …. and in my free time I am a marathon runner. I run half marathons and races that goes from 40miles to 62miles. I have spent almost seven years running, and the small losses of urine will appeared in the fourth year. The loss starts in the first miles, where I feel like 4 drops fall and it´s very uncomfortable. Since I started doing Low Pressure Fitness every morning these small daily losses have disappeared. The Low Pressure Fitness for me have been my best medicine, I practice them every morning and then I repeat in the afternoon.
Thank you to all the people who are researching low pressure fitness!”

Anna
Madrid, Spain

PAINFUL SEX? DYSPAREUNIA? CAN LOW PRESSURE FITNESS HELP?

A common sexual disorder among women is  dyspareunia which is pain that occurs before, during or after coitus. It involves sexual dysfunction with observable effects on a women´s quality of life. It is recurring or persistence pain that is experienced in the genitals or the pelvic structure. On average, its prevalence can reach 10%-15% of menopausal women, increasing in post-menopausal women. The causes of sexual pain are numerous. Nowadays, the mechanisms that trigger this disorder remain various and unknown. Among the primary causes, emotional factors such as sexual abuse, unsatisfactory sexual encounters, stress or psychological problems stand out; physical factors such as insufficient lubrication, other sexual disorders, vaginism, irritations, pelvic surgery, are important to consider too.

 

The treatment of sexuality and its disorders must be approached from a multidisciplinary perspective which includes treatment from a physiotherapist who specializes in pelvic floor dysfunction and sexuality.

 

Can physical therapy exercise like Low Pressure Fitness help?

Unfortunately, dyspareunia is a subject that often remains in the dark. So sometimes both physical therapists and patient remain silent. Currently, attending a specialist in sexual disorders and an expert Low Pressure Fitness teacher is an excellent way of support. Education, appropriate verbal instruction and application of physical techniques can help.

 

It has been found that 30% of women with some kind of pelvic dysfunction are incapable to contract their pelvic floor muscles. Physical feedback, awareness and body control are essential. Therefore, one of the primary goals of Low Pressure Fitness is to acquire awareness of the pelvic floor musculature. It is important to know anatomical structures and physical feeling of the perineum in any sexual disorder treatment. Other objectives of Low Pressure Fitness are to increase elasticity of the vaginal tissue and normalize the pelvic floor tone. In general, women who suffer from pain during sexual intercourse have a tendency towards hypertone and high pelvic stiffness. In this sense, keep balance between the fascial connective tissue and muscular components will help prevent pelvic floor hypertonicity. Myofascial stretching that Low Pressure Fitness produces facilitates muscular relaxation as well as blood circulation. It will bring mobility to the pelvic area and a body readjustment.

 

A recent study by Brazilian researchers found that Low Pressure Fitness helped in the local proprioception of the pelvic floor. In this sense, one of the main objectives to achieve with a physical therapist will be to raise awareness of the pelvic floor, and at the same time learn how to discriminate this from relaxation of the isolated muscular contractions.

 

Collectively, all of these factors will have a positive influence on a women’s physical and psychological well-being. Releasing muscular tension favors emotional balance. We must remember that the emotional and psychological factors are significant causes of sexual pain. If you suffer from any type of pain during sexual intercourse, don’t hesitate to get away from the social taboo. Talk about the subject with a professional and start an interdisciplinary treatment plan that is designed to enhance your physical and  psychological point of view.

TOO MUCH BACK PAIN DURING PREGNANCY, TOO LITTLE EXERCISE 

Unfortunately, lumbopelvic pain is too common during pregnancy. Around 45% of women experience lumbopelvic pain during pregnancy and 25% of women continue to suffer postpartum,. So…almost 50% of pregnant women experience low back pain!

Pain usually appears in the lumbar region or the front of the pelvis, due in part to changes in the stability of the pelvis as well as muscular and ligamentous tissues. Proper posture can influence the postural tension of the back muscles, known as “antigravitational muscles”.  When there is a deficiency or weakness in the back musculature, along with other risk factors such as obesity and physical inactivity, long-term postural and structural dysfunctions may appear.  Pregnancy related low back pain, also known as back pain or sciatica, is located in the lower back, sides of the sacrum, the buttocks and even down the back of the thigh extending below the knees. Pregnancy related low back pain can affect one or both sides of the back and limbs. Usually it´s aggravated by standing, walking, movements while you sleeping, tilting the trunk, or lifting objects,. So awareness and early prevention are the best solutions to fight pregnancy related low back pain.

 

Why low back pain occurs during pregnancy?

Back pain etiology is linked to the physiological, anatomical, and mechanical changes which take place during pregnancy. Normal physiological changes during pregnancy affect the spine. They may contribute to the onset of back pain during pregnancy and possibly postpartum. The most characteristic changes are the following: posture adopted by women during pregnancy; total body water content; the endocrine system and vascular alterations during pregnancy.

  • Postural Changes. There are noticeable postural changes throughout the nine months of pregnancy. These are characterized by increased lumbar lordosis. Hyperlordosis or excessive increase in the curvature of the spine is related to the contracture of the lumbar muscles which are forced to work harder, triggering pain in this area that can sometimes radiate down the legs. Most of the weight gained during pregnancy is concentrated at the bottom of the pelvis along with increased abdominal volume. Thus, a tendency to tilt your body forward would occur, which tends to compensate pregnant unconsciously with a rearward position of the upper body above the pelvis, restoring its center of gravity, but increasing the lumbar lordosis which can contribute to the development of low back pain.

  • Total body water content. The body water content increases similarly in both primiparous and multiparous, by an average of 8.5 liters. This fluid retention, particularly at the connective tissue of the spine and pelvis, increases the laxity of these joints, which could contribute to the genesis of pain.
  • Endocrinological  changes. The effects of fluid retention just mentioned is enhanced by hormonal changes during pregnancy, particularly the effect of the hormone relaxin which  increases laxity of the sacroiliac joints, symphysis pubis and cervix. This laxity, which is necessary to accommodate the growing fetus and facilitate childbirth, could also cause bloating and increased range of motion of the sacroiliac joints and symphysis, which can be a cause of lumbar pain. Also, serum levels of reproductive hormones and procollagen have been associated with the onset of pelvic pain in late pregnancy.
  • Vascular changes. Up to 67% of women report low back pain during the second half of pregnancy. It is often a consequence of the combined fluid overload with obstruction of the inferior vena cava by the enlarged uterus, which could, in turn,  result in congestion of the venous system ultimately leading to the onset of back pain, according to specialized literature hypothesis.

 

Scientific research links previous lumbar pain, stressful job or lumbopelvic pain related to previous work to a higher prevalence of low back pain during pregnancy. Even though, other important risk factors to take in account are:

 

  • Weight gain over medical recommendations, which forces the lumbar muscles to make an extra effort, increasing the risk of contractures.
  • The relaxation of the abdominal muscles: abdominal diastasis and the enlargement of the abdomen increases the physiological lumbar curve of the pregnant woman. But also the deep abdominal muscles (obliques and transversus abdominis) lose their competence and tone. To avoid this, it is essential to learn to exercise the deep abdominal muscles and implement safe core abdominal training before and during pregnancy.
  • Glute weakness. Glutes are related with pelvic floor health and spinal functionality. In the case of pregnant woman, an appropiate gluteal muscle strenght, will help stabilize lumbopelvic region, working synergistically with the lumbar spine and the pelvic floor.
  • Sedentary lifestyle: unless the pregnant woman is told by a health care provider to avoid exercise, regular physical activity is recommended for better postural control, correct biomechanical joint and a toned muscles, to suit their own changes pregnancy and childbirth reach the day in the best possible conditions.

 

Exercise better than paracetamol.

For all the above risk factors, the best preventive medicine will always be exercise. Its too extended between some health professionals recommend analgesics like paracetalmol or complete rest to recover back pain. But its well known that prolonged bed rest promotes weight gain which further deteriorates physical condition. Also, taking painkillers may not be the best solution in the short and long term.

Engaging in a regular program of exercise like Low Pressure Fitness before, during and after pregnancy to an excellent  choice to reduce the risk of low back pain.  It is recommended to tone the core muscles and for postural re-education, two principal targets for fitness pregnancy workouts. Furthermore, Low Pressure Fitness as a global program will train glutes and pelvic floor, essential musculature that provides stability to the pelvis. Specialized trainers or physiotherapists will provide the best advise and training programs before, during and after pregnancy.

BETTER POSTURE & PELVIC FLOOR THROUGH BETTER BREATHING

The core or cylinder formed by the diaphragm (at the top), the pelvic floor (bottom) abdominal muscles (front) and lumbar (back) all work synergistically to create stability to the spine. But an imbalance or excessive tone in any of these points will have observable repercussions on the other parts of the body. We have one clear example in the breathing pattern and it´s influence in posture and pelvic floor disorders.

 

At this point we should remember that the diaphragm is the most important inspiratory muscle, which sometimes can condition respiratory, postural and circulatory  function at the same time. The diaphragm works in a coordinated manner with other muscles for trunk stability and has important direct and indirect relationships through fascial chains. We cannot truly understand the breathing mechanism without understanding the involvement of the abdominal muscles as well as postural analysis. There is growing evidence for differential involvement of the abdominal wall in expiratory function. So, there is a potential role of combined pelvic floor and abdominal muscle training for the treatment of respiratory diseases. Of note, retraining and improving breathing patterns are essential for preventing injuries and for enhancing quality of life.

 

For breathing training: Low Pressure Fitness

The inspiratory muscles can be weakened due to aging, respiratory diseases, obesity, stress, smoke, and weight lifting. The diaphragm can be “overused” so it gets hypertonic, and descends from its natural position. When this happens, any effort would result more hyperpressive in the abdominal cavity.

 

For breathing training there are two different approaches: strengthening which can lead to excessive rigidity or integrating breathing patterns which can help internal and miofascial release. The second approach is the one emphasized by Low Pressure Fitness.

 

Low Pressure Fitness is an integrated and global training program which focuses on posture and breathing. It is performed via the bases of pranayama Uddiyana banda in yoga (ribs opening and expiratory apnea), in conjunction with diaphragmatic breathing.

 

During the abdominal vacuum “rib cage lift”, the inspiratory muscles contract and consequently the diaphragm rises, sucking up the pelvic viscera and fascial connections and decreasing intraabdominal pressure. This provokes a highly demanding postural training and a great help in order to raise and tone the pelvic floor muscle group and reposition the viscera.

 

In addition, retraining the action of the respiratory system leads to a decrease in mental anxiety and sometimes which, in turn, leads to gains in self-esteem. The person feels better with themselves and with greater body awareness.

 

Incorporate a global exercise program such as low pressure fitness to improve your posture as well as your  abdominal and pelvic floor muscles by retraining your breathing pattern.