It had happened once before. Finsbury Park, June 23, 1996, to be precise. The Sex Pistols had briefly re-formed for the Filthy Lucre tour and a bunch of us, sad thirtysomethings, had gone along to drink beer and relive our misspent youth. Looking back I don’t know which bit I find more embarrassing, the fact that a mother of three tried to pogo or the fact that my pelvic floor failed me, but all I can say is thank God I was wearing PVC jeans.
Eleven years and another baby later, I find myself jumping up and down yet again. With a rope. I’m following my personal trainer Lucy Sinclair’s exercise programme in a desperate attempt to part company with my oversized bum and, according to Lucy, skipping is also a great “cardio booster”. Fitspeak. I hate it. But, although it’s my first attempt at the programme, I am already feeling quite pleased with myself. I’ve started the day with my saintly WeightWatchers breakfast of two coffees and two half-point yoghurts with fruit. And the baby has conveniently gone down for her morning nap, which gives me just long enough to complete the entire routine.
So I’m skipping, or at least trying to skip because I’m not very good at it at first. Jump, trip, jump, jump, trip. But then I start getting better. Within a few minutes I am up to 20 skips. And then I feel it. The warm wet sensation sliding down my inside leg. And this time I am not wearing plastic trousers.
To be honest, I am not that shocked, or even embarrassed. Stress urinary incontinence (SUI) is a common problem; it occurs when the strain of an exercise, a sudden sneeze or cough, a laughing fit or even lifting something heavy like a toddler puts extra pressure on your bladders causing an accidental leak, especially in women. In fact, the top three risk factors for SUI are 1) being female; 2) getting older; and 3) having babies. This makes me about as high risk as it is humanly possible to be.
It could be worse, though. I had an elective Caesarean section with my fourth baby, now 12 months old, which, in terms of my pelvic floor, is probably a good thing because new research from the School of Medicine in Cardiff University confirms something that many women have suspected for years. The school assessed 208 women for two years after giving birth and found a significant increase in the prevalence of SUI in women who underwent vaginal delivery as opposed to elective Caesarean.
As a medical condition, female incontinence is hugely under-reported. Women either hope it will go away or hate the idea of talking about it to a doctor. However, in 1999 a British study of about 1,000 48-year-old women found that more than 50 per cent had experienced symptoms of SUI in the previous year. Though one of those women in ten suffered from moderate or severe incontinence, only about half had sought professional help. Why? Embarrassment has to be a factor but maybe they feel personally responsible, too. I do. If I had done my pelvicfloor exercises during pregnancy I’d still be tight as a gnat’s chuff, but I was too preoccupied with blood tests, ultrasounds and avoiding soft cheeses to remember that I was supposed to lift and squeeze my pelvic-floor muscles 30 times a day. I felt so bombarded by instructions about what I should and shouldn’t do if I wanted to deliver a healthy baby that the prospect of being able to skip or shoot ping-pong balls at some point in the future seemed irrelevant.
In the same way that telling people that “exercise is good for you” rarely persuades anyone to go to the gym, standard pregnancy advice can be technically correct but, if it fails to convince a woman that it will provide tangible benefits, tends to get ignored. Which is a shame because the evidence to support pelvic-floor exercises exists. An extensive review of adjunctive therapies for the treatment of SUI carried out at the University of South Australia last year indicates that pelvic-floor management training is by far the most effective way of curing the problem.
Women who do the exercises at a slow speed, sustaining near maximum contractions for six to eight seconds at a time, with three sets of eight to 12 contractions performed two to four days a week and continuing for up to five months can expect rates of cure for SUI of up to 73 per cent — 97 per cent of people experience improvement if not total cure. Skip, skip, lift, clench, hold . . .
STARTING WEIGHT: 11st (70kg)
GOAL WEIGHT: 9st 13lb
WEIGHT LOSS OVER 6 WEEKS: 9lb
Three things I have learnt . . .
- Getting back in shape after a baby is an internal as well as an external process
- I need to be dressed and have all my equipment ready before I put the baby down so that I can get straight into the programme the minute she goes to sleep.
- I shouldn’t drink anything before I exercise.
Pelvic-floor exercises
Personal trainer Lucy Sinclair, of Newborn Fitness, suggests the best pelvic routines
Your pelvic-floor muscles act as a cradle for the bladder, uterus, bowels and other pelvic organs, so it is essential to keep then strong. These muscles become more relaxed during pregnancy and during the delivery they undergo a tremendous amount of stretching. Most mothers will be aware of what happens when the muscles are weak as it leads to leaks also referred to as stress incontinence. However, there are exercises to whip those muscles into shape.
It is best to start them in the first trimester of pregnancy as that will prevent the pelvic floor from sagging too much later on. Strong pelvic floor muscles also help you to have an easier delivery.
The more you train a muscle, the stronger it gets and these muscles should be trained every day. You should contract the muscles until the pelvic floor becomes tired. At this stage take a break and have another go later.
Before you train the pelvic floor muscles you need to know how to contract them. The easiest way to locate this contraction is to squeeze in the muscles you would use if you were desperately trying to stop yourself from peeing. Now try these:
The drawbridge Contract the pelvic floor muscles to create the feeling of lifting a drawbridge. Hold this position for a count of ten, then slowly release. At first aim to do five sets of ten repetitions a day, then work up to ten sets a day.
Quickies Lift the whole pelvic floor in one contraction. Hold it for one second and then release with control. Do this five to six times, then rest and repeat.
The Wave (quite difficult) Begin the contraction at the back of the pelvic floor near the coccyx and move it forwards towards the pubic bone. Hold the contraction for a few seconds, then slowly release from front to back. Aim for five repetitions.
The full benefits of these exercises won’t be felt for six weeks. The best thing about training the pelvic floor is that it can be done anywhere at any time, so get started now.
To contact Lucy Sinclair, call 07875 467931 or e-mail lucy.sinclair@yahoo.co.uk. To find a personal trainer, visit newbornfitness.co.uk
Next month: Walking. Suzi’s weight-loss diary returns in two weeks.
If you’re a new mother and can’t shift your baby tummy — or you simply want to get in shape — you can look at Suzi’s exercise plan at timesonline.co.uk/dietandfitness
