Tuesday, 9 February 2016

An interview with Dr Joanna Helcke

You may remember reading my post about Pregnancy Fitness with Dr Joanna Helcke. She is an award winning pregnancy and post natal fitness instructor. She has her own online fitness programme which you can find out more about on my previous blog review or through her website here, Online Programme

I was lucky enough to interview her and here are the questions I asked. As you know I am trying to get back into exercise but I had a caesarean so I have to take it slowly. I couldn't wait to ask her some questions based on that.

1)      What exercises would you recommend for strengthening and toning your core after pregnancy?The first thing I always recommend is to check your abdominals carefully for an abdominal separation (diastasis recti) and if you have one then you need to assess how wide it is (measured in fingers) above, below and at the belly button. You then need to check what the gap feels like: soft and spongy, taut and springy or perhaps somewhere in between? 
Once you have got answers to these questions you will have a clearer idea of how best to strengthen your deep abdominals and importantly, what exercises to avoid doing so as not to exacerbate the separation, if you have one.
In terms of getting the abdominals working properly again after pregnancy, there is more to it than a simple set of exercises that can be done daily. Posture is key, getting the pelvic floor muscles strong again is equally important and eating food that helps the body heal is vital. Before embarking on post-pregnancy abdominal exercises please do pop over and take a look at this piece I wrote which takes you through the dos and donts of dealing with the postnatal mummy tummy. It’s so important to get things right and avoid doing yourself any damage.    

2)      What are the best exercises to undertake after a caesarean?
Without a doubt I’d advise anyone who has had a caesarean to start off in the very early days by doing pelvic floor exercises, as this will help increase the flow of blood to the pelvic region which, in turn, will encourage the wound to heal. Over the first few weeks, these pelvic floor exercises can be done in different positions such as standing, sitting, lying on your right- and then left-hand side or on your back. 

Formal exercise is not to be resumed until at least 8 to 9 weeks after having a C section but before then I would definitely encourage you to start regular walking to rebuild strength and fitness- just be sure to maintain good posture if pushing a buggy so as to protect the lower back. Anything water-based can be started up once everything has fully healed. Many (although not all) new mums find that as long as the section has healed well, they will feel well enough to start up specialist, mother-and-baby postnatal exercise at around 9-10 weeks postpartum.  A combination of postnatal deep abdominal work alongside working on rebuilding strength and stamina is ideal. 

3)      How can you suggest ways to motivate women to exercise during pregnancy and after?

I find that falling pregnancy is, in itself, enough to motivate many women who have never previously been interested in exercise. It’s that sudden realisation that you are not only looking after yourself but also the wellbeing of your unborn child. This is an incredibly powerful motivator. 

As for after pregnancy, do you want the standard fitpro response or do you want to know what I really think as a mum of three boys? The standard fitpro response is going to be the usual “lose the baby weight, lose the mummy tummy blah blah…” (all true by the way). As a mother of three boys I’ll tell you that the true motivation to get exercising postnatally is that it keeps you SANE! Exercise is incredibly powerful when it comes to keeping emotions on an even keel. Motherhood is indeed very lovely but it’s also pretty hard work and fitness is the best tool I know of for keeping truly happy! 
If you can find a form of postnatal exercise that you do with other postnatal women, so that the exercise also becomes a weekly social event, then this can be very motivating, highly effective and will give you a huge boost to emotional wellbeing. 

4)      Do you suggest any diets for promoting a healthy lifestyle to compliment your workouts?
I’m very keen on the “don’t beat yourself up about what you are eating” diet! Ok, so I am being flippant but you get the gist! I genuinely believe that telling people to go on this or that diet is unhelpful as it immediately puts people into what I would refer to as a “depravation mind set”. So in general I turn things round the other way and ask people to ADD things into their days: ADD lots and lots of leafy greens, ADD protein into breakfasts, ADD hydrating herbal infusions into the day etc. I also say to people to ask themselves a simple question when choosing what next to eat: “is this going to nourish me and my baby?” This can really help you make good choices, an example being chocolate! I am an absolute chocolate addict but I only eat chocolate which I know is actually doing me good: very dark, often raw, frequently homemade. If I were to pick up a piece of white or milk chocolate and ask myself “Is this going to nourish me?” then the answer is a clear “no” but swap to my yummy koko Crunches and the answer is “yes” which means that I get my daily fix!

5)      What exercises do you recommend for tightening your pelvic floor after pregnancy?
Pelvic floor exercises have changed considerably over the last 5 years or so. Until relatively recently we were told to pull up on the pelvic floor muscles (PFMs) for 10 seconds, repeat 10 times and then do a series of short, sharp PF squeezes. And that was it! In fact, I am pretty sure that many mums and mums-to-be are still being given this largely outdated information. 

Now it is understood that pelvic floor exercises work best when integrated into certain movements and there have been a number of methods developed using this underpinning concept. Pfilates is one such system and I would definitely recommend looking it up. 

It is also now known that the pelvic floor (PF) cannot necessarily be successfully exercised in isolation by simply pulling up on this group of muscles. It is connected to, and works in unison with, the abdominal cavity and diaphragm above it and the deep abdominals that wrap around the waist. These all need to be working together correctly – it’s a team effort! If, for example, breathing patterns are not quite right, this can lead to a build of pressure in the abdominal cavity. This pressure has to be dispersed somewhere and that somewhere could be through a weakened pelvic floor or through an abdominal separation. In such instances, reducing this build-up of pressure in the abdominal cavity will have the knock-on effect of strengthening the PFMs. There is a method that has long been used by physiotherapists in Spain and Latin America which is just beginning to filter through into the UK: watch out for hypopressives.  

6)      Who in the health and fitness world inspires you the most?
I could tell you about all the amazing athletes who continue to scale ever greater heights in spite of pregnancies and the constraints of motherhood. But in reality those who truly inspire me – in my life, day after day – are the many mums and mums-to-be who I see in my fitness classes: some quiet, some bubbly, some suffering from postnatal depression or anxiety, some having lived through and survived terrible loss, most putting up with sleepless nights but ALL of them there, every week, in my exercise classes. How awesome is that?

A couple of years ago, I decided that these mums are so totally amazing that I wanted to celebrate them and so I now have a monthly Mum-of-the-Month blog. Have a read of this month’s Super Mama blog and you’ll see what I mean!     

7) Do you encourage your own children to keep active?

Yes I most definitely do encourage my three boys to be physically active and to get outdoors as much as possible but what I am discovering is that this is easier said than done when it comes to teenagers… Very young children love to play in the park, go for woodland walks and explore the natural world. As they get older, organised sports work well and my youngest is incredibly keen and seems to have a sport for each day of the week (I do wonder if he will end up in the world of fitness one day, like his mum!) but as for my two teenagers…. oh dear, it’s hard work. First off, try getting a teenager out of bed. Nightmare! So I’ve had all their bikes “MOTed”, lights fitted, bike locks invested in… and they now cycle to school every day and if they want to go anywhere on weekends then they have to go by bike! On the weekends we also go for family cycle rides accompanied by an enthusiastic eleven year old and by 2 grumbling teenagers! That’s the most I can manage with them but I’m hopeful that one day they’ll grown back into the sports they used to enjoy. 





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19 comments:

  1. Such a fantastic, informative article. I completely agree about exercise keeping you sane!!

    Leah xx

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  2. Really informative - I just wish I could foster a love of exercise rather than finding it an utter chore!

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  3. Really informative interview, I wish I had heard of Joanna when I first had my son. I had no idea pelvic floor exercises had changed, my son is one and I was told to do them the old way after his birth xx

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  4. Great interview! I could have done with reading this when I had my babies, I desperately wanted to keep fit but really had no idea how and through fear of damaging myself, i waited until the kids were much older before starting to exercise again!

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  5. A fantastic read, thank you for sharing this and I will be checking out her fitness video

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  6. This was a fascinating article and so informative, especially for me as I have no children x

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  7. This is really interesting, thank you for sharing. It's so important to do exercise - I wish I found it easier than I do - but there is a very good reason for it!

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  8. a really great interview! after my cesarean my core was absolutely destroyed and I tried to go back to quickly, I definitely needed to build up my core strength and back

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  9. Really useful information. I walked after my CS down the roads near me, but never really got back to exercise apart from swimming at lunchtimes during the summer in the outdoor pool. But it's hard to fit exercise in, especially when I know my best time is first thing in the morning, but that's when I'm tiredest, most rushed, and that's also my quiet reading time.

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  10. Such a great interview, never been pregnant before but I think its important to build your core muscles first

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  11. Fantastic ideas and advice here. I am not a parent but I will keep this in mind for the future when I am!

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  12. This is a really great read, I am currently 28 weeks pregnant and would like to get back to shape as quickly as possible after the birth. This is my second and I did not achieve it the first time round so thinking second time lucky!! x

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  13. Brilliant post and interview - great advice too. I still need to start exercising following Pickles birth ;) Kaz x

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  14. Such a great interview. Really useful advice too. I wish I loved exercise but sadly I don't x

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  15. I have diastasis recti and have been working to close the muscles - it takes a lot of time though

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  16. What a great interview. I know I really should pay attention to my pelvic floor, but I'm completely rubbish at it

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  17. So pleased that you all found the information I gave here useful. It is so important to get the right messages out there as there's a good deal of mis-information bandied around. You can find all sorts of very useful info on my website www.joannahelcke.com
    Jo x

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