Response to NPR's article "Flattening the 'Mummy Tummy' With 1 Exercise 10 Minutes A Day"

The latest NPR article about “Flattening the Mummy Tummy” came into my world from 5 different directions today. I read (initially between clients) and then re-read and then re-re-read this article. I desperately wanted to agree however it has my radar up, to say the least. In all fairness, I am not familiar with this specific technique, I have never been to a class and I can only speak about the method within the context of how it was written in the article. I do have some concerns (read: major opinions) and would like to open up more dialogue around this and all exercise techniques in the postpartum period.

  1. Mummy Tummy.  We need to change the culture around the ‘flat is fit’ mentality. Let’s just focus on being functionally strong and well supported in our day to day lives!

  2. 10 min of exercise will cure DR. First of all, just no. No, no, no.  It is a major disservice to tell women that one exercise for only a few minutes a day will fix Diastasis Recti (DR). What about how we are using our bodies the other 23 hours and 50 min? I think it is way more important to consider how we sit, stand, carry babies, lift weights, bend, squat, and carry car seats! It isn’t about ‘exercising’ the core but rather about ‘re-training’ the core. I have worked with many clients with DR and I am certain it isn’t a simple or quick fix.

  3. The ‘sucking in’ idea has to go. Far, far away. Sucking in the tummy muscles can do more harm than help. Think about squeezing the center of a balloon. If we create excess tension in the center, where does the pressure in the balloon go? Up and down. Either direction is problematic, but especially concerning is down due to pressure and stress on the pelvic organs and pelvic floor.

  4. Reflexive core. I do think these instructors are focusing on the involuntary contraction of the lower abdominals by utilizing an exhaling breath. This exhale is attempting to activate the reflexive core but really it is the combined function of the diaphragm, abdominals AND pelvic muscles.  This is what should kick in for us naturally as we move and I use an exhale technique to help my clients retrain the reflexive core. But I don’t cue ‘tighter, tighter, tighter’ at the abdominals. I cue a coordinated contraction among the muscles. And cue the ability to generate only the appropriate force necessary for the demand of the task. A simple roll over in bed has a different contraction and demand than when we are running or jumping.

  5. DR doesn’t have to completely close to have a strong, functional core. Not much else needs to be said here. My goals for a client are never to decrease DR by X amount. My goal is for the client to stop peeing when they sneeze or to decrease low back pain when carrying baby.

  6. This type of exercise isn’t functional! This is already somewhat tied into my other points. But sitting cross-legged, on your hands and knees or performing this while standing doesn’t exactly replicate life. What about holding a 30 lb toddler while reaching down to pick up a heavy bag? THIS is life. And often times, the postpartum reflexive core needs to be re-trained to know how and when to kick in with variable demand situations. A suck in and hold is just not how the core system works.

  7. A piece of me feels this preys on the desperation of women. Fix DR in 10 min over 12 weeks? Lose inches off my waist without doing anything else? I will have a completely flat tummy again? And finally....Let’s all measure and compare ourselves during class? Yikes.

  8. I am biased. I believe all women should have access to a Pelvic Health Physical Therapist in the postpartum period for solid guidance and support. For BIG PICTURE pelvic health and body wellness over the long term (because postpartum bodies are more complex than DR and belly fat). I am also a strong proponent of home systems such as Restore Your Core and One Strong Mama because we all provide so much more than just ‘quick fixes’. I also want to mention the phenomenal Julie Wiebe, PT as I have learned a TON from her educational series!

All women’s bodies are unique. If you would like to talk about how the above relates to your specific condition, feel free to contact me on FB. If you'd like to read more, you can visit our other blogs here.

Why Kegels might not eliminate urinary incontinence

As a Pelvic Health PT, I’ve been at odds with the over-prescription of Kegels as a silver bullet ‘cure’ for all things wrong in the pelvis, specifically urinary incontinence (UI). This could be a much longer blog post, but I stuck to the top 3 reasons why I think Kegels are generally ineffective.

  1. Urinary incontinence may come from weak pelvic muscles, but not all weak muscles need strengthened. Weakness in the pelvic muscles can be complicated. But simply put, all muscle fibers in our body need to overlap the perfect amount to generate an optimal force. So, if a muscle is too long (over lengthened) then it will be weak because the muscle fibers don’t overlap enough. A person in this scenario may benefit from increased strength training. Conversely, if the muscle fibers overlap too much (ie the muscle is tight) this will also be weak, again because the muscle will not be able to generate force. Tight does not equal strong. Tight= tight=weak! This situation would require a release of the tension prior to focusing on strength. Now hopefully you see why more Kegels (ie tightening) will be ineffective! And as a pelvic PT, I see much more of the latter situation when it comes to the pelvic muscles.

  2. Kegels don’t replicate function. Pelvic muscles never work in isolation, so why train them that way? We are taught to do them in the car while at a stop light. And repeat over and over throughout the day. One thousand bicep curls don’t help you much with a half marathon. So an isolated contraction isn’t actually what is required when you bend to lift your toddler or when you perform burpees at the gym. We need to focus on functional re-training our core system to optimize results. 

  3. Many factors can contribute to UI. It’s just a sign that something is off somewhere in the core system. Let’s also take into account standing and sitting posture (alignment matters!). How about if someone has diastasis recti? What about a prolapse? How about someone who constantly grips their tummy muscles or who truly has a weak transversus abdominus? This list goes on….

The best way to assess all the factors that contribute to UI specific to you would be to see a Pelvic Health PT. And if you are pregnant, you would absolutely would benefit from One Strong Mama, which incorporates an effective and functional way to retrain your core system and provides such an amazing support system and network!


All women’s bodies are unique. If you would like to talk about how the above relates to your specific condition, feel free to contact me on FB. If you'd like to read more, you can visit our blog here.

It's Not a Floor

We know I don't prefer Kegels (in name or function!) I also don't prefer the word pelvic floor muscles. Because it's not a floor. A floor is a hard, solid, unyielding surface.

I like to think of the pelvic muscles like a jellyfish; dome-shaped, soft and adaptable to the ocean currents.

The pelvic floor must release downward with every inhalation and recoil gently upward with every exhalation. And just like a jelly fish, when we change the pressure within our core, the pelvic muscles respond and yield to the demand. This functional system keeps our pelvic organs supported (and keeps us continent!), provides postural support and helps us maintain good sexual health. To consider it a floor doesn't relate its function.

Women's bodies are all unique.  If you'd like to talk about how this post relates to your specific situation, feel free to email at Jessica@mindfulmotionphyiscaltherapy.com or comment below.

Next blog: Your Core Is A Can of Soda which will highlight more about the reflexive core and its function

 

Thoughts on Kegels Being Useless

Want to get back in shape after baby? Do your Kegels.

Want better sex? Do your Kegels.

Want to get rid of your pelvic pain or back pain? Do your Kegels.

Want to stop losing urine when you cough or exercise? DO MORE KEGELS .

What if I told you that Kegels are not a silver bullet exercise and I am a Women's Pelvic Health Physical Therapist? Kegel advice is still being given by doctors, trainers, and magazine articles. How many of you have done what you've been told, with little or no progress? Many of us have been here.

Kegels are an isolated exercise, and may not be effective (read: even useless!) because the pelvic muscles never work in isolation. I prefer to not even use the word Kegel because of the isolating image this projects. I prefer to talk about the reflexive core. It consists of several muscles including the respiratory diaphragm, transverse abdominals and the pelvic floor muscles. These muscles all communicate and coordinate as part of a larger system of core support.

To see the progress we truly want and need, this means shifting our perspective away from isolated exercise and consider the bigger picture of total pelvic health that includes so much more than the pelvic floor. 

*Women's bodies are all unique.  If you'd like to talk about how this post relates to your specific situation, feel free to email at Jessica@mindfulmotionphyiscaltherapy.com or comment below.

Next blog: It’s Not a Floor which will highlight more of how the pelvic muscles actually function!