The English are typically known to love a queue, have a stiff upper lip and can’t stop moaning about the National Health Service.

Whilst I think the NHS is an amazing resource to have with amazingly hard working people who work within it, there is an area where I believe much could be improved.

And as you may have guessed, it’s post-natal treatment and after-care. It seems to me that most new mums get assigned to the conveyor belt of one-in, one-out.

I remember as a child, visiting my Aunty and watching her being taught how to bathe her new-born baby, spending five days in hospital before being discharged.

I am not suggesting it was perfect in those days but it does seem it was much less hurried than by modern standards. Nowadays you can be discharged hours after birth with little more than a wave and a goodbye.

Home you go with your baby, instructions not included.

Once at home you are at the beck and call of your newborn and quite rightly so but who is looking out for mummy and her recovery?

This is the part where the cynical would say to this, “we coped ok in my day” and “My mum never made such a song and dance, why all the fuss now?”

I am pretty sure though that if you are reading this thinking something similar then you have never taken the time out to ask your Mother how it was for her after delivery.

I had that very conversation with my Aunty on Mothers’ Day. And despite my work in the post-natal period it still shocked me to find out that she had suffered with stress incontinence for 18 years after the birth of her first baby.

I asked her why she hadn’t done anything? Her answer: “until now no one has asked me about it, so I just got on with it”

And there you have it, the reason no one made a song and dance or made a fuss. Because nobody asked the right questions.

Incontinence is a topic even media portrays as something you just put up with. You all know the advert with the lady and the lift.

And so why would anyone talk about it?

It is therefore no surprise that incontinence is not a screening question on the membership form for a gym when you join up looking to shift your baby weight and get your fitness back to levels you once knew.

So why should your local gym be responsible for our incontinence issues? The reason I believe is because nobody else is dealing with this.

So I come back full circle to what is lacking in the NHS. Perhaps they don’t have the resources to deal with this or maybe it’s just they have blinkers on to anything embarrassing and it seems certainly with regards to difficult labour, pregnancy or even menopause.

It is simply not good enough to fob off women with pads and kegals, let us not just treat the symptom and leave the cause.

In France women are given 8-10 specific health appointments as part of their national health service (either free or heavily subsidised). It is during these appointments that women are given what I like to call a Mummy MOT.<

No stone is left unturned – from the internal condition of your pelvis, nutritional support to aid recovery and breast feeding. And probably the most valuable gift given is a program to restore the natural working order of the pelvis, from bladder to clitoris. Now that’s what I call post-natal after-care.

Our situation on this side of The Channel isn’t going to change anytime soon. Maybe it is our English stiff upper lip that stops us addressing real post-natal issues.

This brings me to a chance meeting I had with an inspirational woman, Jenny Burrell, who after 13 years in the pre/post natal field has developed her own class using functional movement and pelvic care into a perfectly shaped class, designed to get our bits working and talking to each other again.

The class addresses re-connection, restoration and re-education. This is called the Foo Foo Fun Club. All the muscles, joints and ligaments that take a hit during pregnancy get an overhaul. But the biggest change you’re bound to see is your mood and confidence.

I didn’t want to pass up getting involved with this initiative and I am one of the first health and fitness professionals to qualify to run Foo Foo classes in the East London area.

If you are finding yourself at your wit’s end with the NHS with regards to post-natal care, then your local Foo Foo ambassador is your best bet at a great recovery.

I begin teaching my first Foo Foo class on 14th April 2013 with four awesome mummies at CrossFit London. The classes run in 6 week courses.

For East London-based course details or further information email me at sally@crossfitlondonuk.com

Sally Dixey is a Personal Trainer and foo foo ambassador in Bethnal Green.

The title if these posts is starting to resemble a bad bunch of sequels lol.

Overall I pretty impressed with this sports bra

. I will conclude this series with a full summery.

For now the next test.

Box Jumps and a fast moving WOD.

The WOD in question is the second in the Crossfit Games Open 13.2.

Task:

10 minute Amrap

5 Shoulder to Overhead 35Kg/52Kg

10 Deadlifts 35Kg/52Kg

15 Box Jumps 20″/24″

This wod is geting back to the old skool roots of Crossfit. A simple unassuming looking WOD that has a big old sting at the end of it’s tail.

Scores are worked out on total reps.

So how did the bra measure up.

As I expected not a problem.

I have to make mention of the coverage it gives you. I am not usually one for training with my top off but for the first open last week (13.1) Mid WOD I had to tear my vest off, Hulk stylee.

The nice thing about this Shock Absorber is that it covers well so that even with a top off you don’t feel over exposed.

Box Jumps and Shock Absorber gets a huge thumbs up!

Sally Dixey is a Crossfit London Coach in Bethnal Green

Skip test time.

I have just acquired a new speed rope from Wolverson.

Getting happy with my speed rope

I love it best 20 quid spend this month. It makes such a huge difference to your double unders!

How did my Shock Absorber find the skips?

No problem at all.

I know I have a small bust and your probably thinking that would still be the case if I had a few more cup sizes but honestly this new ultimate sports bra is not just comfortable but the design gives you maximum compression that your boobs aren’t going anywhere.

Sally Dixey is a Personal Trainer in Bethnal Green @ Crossfit London

This is the first of many pictures I will use as I test how well Shock Absorber’s new ultimate sports bra lives up to it’s name.

Continuing from my previous post Handstands made the short list of movements that needed a test run.

How well did it keep everything in?

Was it comfortable?

I decided to test this out under wod conditions and as my handstand push up strength needs improving I decided on a scaled JT.

JT is usually 21-15-9 Handstand push ups, ring dips and push ups.

My version 9-6-3 Still tough enough.

Did everything stay in place? Check

Comfort? Sure.

How about a bit of hip snap with a kipping handstand push up? No problem.

Sally Dixey is a Personal Trainer @ Crossfit London in Bethnal Green

Not being very blessed with much, I can get away with something cheap and simple. I can imagine but not relate to the difficulty some of my friends face

It seems that comfort, support and of course colour are seen rarely as a set. So finding the perfect bra to accompany your training sessions has now become as much a drama as finding the perfect jeans.

You are wondering where I am going with this?

Well a few weeks ago I received an email from House of Fraser asking me to review the latest Shocker Absorber.

They wanted to know what I found of the fit, style and performance.

Obviously they were not aware of the ease I have finding a sports bra.

If they did they would have asked someone else.

Anyway I agreed. A few weeks later and it arrived. This is probably the most expensive sports bra I have ever worn so I had high expectations.

Would I notice the difference from my cheap sports direct bra? If I am honest not a lot.

I hate having small boobs but I guess this is the pay off -easy to find and cheap sports bras.

If I was to have a more constructive review of this bra I would  need to reach out. So turning to Facebook I posted for feedback and not before long I had a long list of criteria to run through. Brilliant.

Now the work begins.

While I test out the fit and performance why not give me your thoughts on how it looks.

Check out the straps!I had to keep the top catch fastened and take over my head.

It has a small clip attached for your ear phones.

Sally Dixey is a Persoanl Trainer @ Crossfit London, Bethnal Green

Sacro-iliac joint pain.

Having just covered all matters relating to pelvic girdle pain (PGP) it seems like a perfect time to discuss the sacro-iliac  joint.

This can be another source of pain and discomfort during pregnancy, but thankful like PGP it is manageable and usually subsides after childbirth.

If at any time you have fallen funny and landed on your butt that was probably your first introduction to the Sacro-iliac joint.

(The science bit)
The Sacro-iliac joint is one of the largest joints of the skeleton, where the pelvis and spine join. The bone is smooth and slides together and with large ligaments strengthening their connection.

So the question is: how does pregnancy upset this joint and cause us pain? It’s all down to those pesky hormones that relax all our joints and ligaments. We couldn’t give birth without them but boy do they give us a rough time!

Normally our bodies have the ability to compensate for these changes.
But when hormone levels are higher than normal or there is already an underlying instability of the pelvis, the sacro-iliac joint can begin to slide out of place.

This is when pain is felt.

You could think of pain as the signalling telling our bodies:”It’s time to slow down and adapt your movements”

You will feel this commonly in the lumber (lower) region of the back, possibly radiating into the butt and down one or both thighs. Referred pain may be felt at the symphysis pubis .

So we can’t affect the release of the joint-relaxing hormone, this is a given.

What you can do is work on balancing out tight and/or weak muscles connected to the pelvis. The piriformis is a common culprit. It connects from your pelvis to the top of your leg. Try using a form roller or a tennis ball will also do the trick.

I  keep  mentioning stability and I can’t push this point enough. A stable pelvis will support your growing bump and counter the effect of the hormones by giving you a strong base to work from.

Never neglect your pelvic floor work. Use you abdominals to hold your bump in. And don’t be afraid of squats!
This all helps give the sacro-iliac joint the support it needs, to help reduce or eliminate any discomfort.

Next week I will be putting together a short video showing some simply ways to engage your pelvic floor .

(Sacro-iliac pain can sometimes be mis-diagnosed as sciatica. If you do feel pain and discomfort in this area please consult your doctor first. Seeking professional help with exercise is advisable)

For London based consultations you can reach me at sally@crossfitlondonuk.com)

Sally Dixey is a Personal Trainer in Bethnal Green @ Crossfit London

Symphysis Pubis Dysfunction or Pelvic Girdle Pain as detailed in a past post is the separation of the symphysis pubis.

One of two things will happen if you experience this. You will want to stay in bed for the remainder of your pregnancy, everyday activities seeming too painful or you will want to carry on with some sort of activities least of all your day to day tasks.

First things first though make sure you see your doctor. In severe cases you will need to see a physiotherapist.

Either way management of the pain and knowledge of what will worsen or help the situation is always useful.

Exercises for someone with Symphysis Pubis Dysfunction (PGP).

I wish I could give a straight forward answer but I can’t. I can generally state that movements that would worsen the condition would include movements that mean the hips, legs are separated ie a wide squat, lunges. Or simply putting one foot in front of the other ie walking.

Saying that though this will vary from woman to woman. Ranges of movement and particular exercises will differ across the board.

Prescription needs to be specific to each woman. How do certain moves and ranges feel? If pain is experienced quite simply STOP

I have seen a client who struggles with wide squats but found regular squats with a shortened range fine. Or couldn’t do lateral lunges but reverse lunges and regular lunges are fine.

If you want to continue to train you need to be realistic that something like Crossfit at this point is probably going to be extremely scaled and or stopped altogether for a more gentler approach.

Remember ladies this is fine!

Your symphysis pubis will return to normal after your baby is born.

It is Ok during pregnancy to take the tempo down. It is a small amount of time in the grand scheme of life.

Believe me you won’t have time to slow down when your baby arrives!!

In all cases focus on the core stabilising muscles of the pelvis is vital.

Working on transverse abdominal activation, pelvic floor recruitment will all make this condition far more manageable. And would be prescribed for any degree of PGP.

(Please note -Always seek help and advise from a trained professional)

Approaching day to day tasks you will need to think about how you move.

Here is an everyday example to help get in and out of bed.

Keeping your legs together. Hips and knees square, rolling onto your side and pushing yourself up to seated using your arms. Swing your legs gently, allowing your legs to dangle off bed/sofa, keeping them firmly together throughout the movement.

Remember the golden rule – if it hurts or gives you pain STOP

(A small minority will experience extreme pain, during pregnancy you are not able to use pain relief in the same way as before. Please consult your doctor or midwife for advice on pain relief and ways to deal with it.)

I hope this gives you a good starting point for PGP management. You can reach me through email for further advice on specific areas and questions. -sally@crossfitlondonuk.com

Sally Dixey is a Crossfit London Coach at Bethnal Green

An article idea was given to me by a Facebook friend -The Changing Face of Pregnancy and Exercise.

Great idea, I thought what might make this even more interesting is a look back over history at what shaped the way we looked at pregnancy.

Ancient Times sounds like a very idyllic time to have a baby.

People were spiritual believing birth and death were like the sun and moon. Cycles of life.

Faith was put in women to carry and deliver children without male interference and almost entirely delivered in an upright position. Women continued with their day to day tasks until the baby was born. (The only exception to this rule is Greek and Romans, who had a distrust for women)

Labour pains were considered as a reaction to the baby fighting his way out of the womb. Death rate in delivery was very low.

Medieval Times to 17th Century is where things start to get a bit ugly.

Attitudes were starting to change as conflict erupted between the church and ancient traditions.

Labour pains became punishment for Eve’s sins.

There was little to no sanitation. Rooms were made dark and warm with straw scattered on the floor to absorb any fluids.

C Sections were performed during this time but on dead mothers.

Women were encouraged to spend the last few weeks of pregnancy in bed resting.

During these times it seems that a little more intervention started to take place and delivery became far less serene.   Death rate were still relatively low but certainly creeping up.

The next era to make there mark was the 18th century and the beginning of science.

The forceps were introduced in 1740! No antiseptic though!

Intervention was far more aggressive and common place and is when delivery started to make it’s way into hospitals (though upper classes thought this was very common and continued to have home births)

Living conditions were poor at this time, hygiene was still a long way off.

The nutrition of expectant mothers was dreadful which all led to increasing rates of death in labour. It didn’t seem to occur to the doctors how external factors impacted the death rate and chalked it up to the ‘danger of child birth’ this only seemed to make matters worse as intervention at this time was not as sophisticated as it is now.

Times started to change in Georgian to Regency Times.

Moving back to nature was starting to produce more normal births and a trend begun. Just as progress was picking up speed, the death of Princess Charlotte after 50 hour of labour, plunge England into mourning probably only ever seen again on that scale when Princess Diana died.

Shops closed for 2 weeks. People from every class wore black arm bands. People looked for a scapegoat. Dr Croft who attended to Princess Charlotte fitted the bill and after weeks of fingers pointed at him, he committed suicide.

Child birth from here on took a much more aggressive tone. Birth was seen as hard and very difficult process. Hygiene and better living did help but death rates were still very high. Activity during pregnancy was frowned upon, many women disappearing from society until after birth.

Victorian Era – A time when women were to be seen and not heard. Where women were seen as fragile frail creatures who were entirely to blame for miscarriage. Citing over exertion as the probable cause. You can imagine what this did for activity levels during pregnancy.

Yuck!! Pregnancy and a Corset!!

Pain relief became common place. Even Queen Victoria used chloroform. And the first successful cesarean was carried out in 1882.

Great strides were being made in the medical field during this time but a women’s natural ability to deliver, something she had been doing for thousands of years was wildly underestimated.

It is not until present day that we are now moving back to the idea that a women can deliver without medical intervention or drugs. Birthing centres were first introduced in America during the 1970′s.

Delivery reverting back to standing and squatting positions. Death rate over the last 50 years have plummeted

This marked the beginning of a new wave of women who wanted to give birth the way nature intended. Intervention is only used in emergencies and drugs offered in birthing centres are limited to be gas and air. Birthing pools and hypnotherapy becoming far more popular.

The advise to stay active during pregnancy is now picking up pace, with special classes being programmed and courses to educate fitness professionals increasing in popularity.

Slowly and I mean slowly people are starting to view pregnancy in a new light. Women is seen as a powerful force who is not only looking out for her own health by staying active but also giving her unborn child a great start too.

Still there are a lot of negative views of exercise, particularly something like Crossfit.

I love the photo’s of my friend Rachel Steadman during her pregnancy. The irony between the two different shots.

Accaptable – Holding her daughter overhead.

Unacceptable – A kettelbell Swing

Both of equal weight, it’s probably less awkward in fact to swing the bell.

Why such a view??

Because we have lost sight and forgotten that pregnancy is as old as time.

Looking at the history things only got worse the more we interfered, the less active women were and as cities and villages became crowed and unclean.

I am not suggesting we revert back to ancient times and bang clubs but we could learn a lot from how our ancestors view life, birth and death.

If a women has always done an activity,  carry water buckets on her head or swing a kettlebell why does she have to stop?

Please lets be sensible about how we look at a training pregnant women. I bet she is more in tune with her own body and more clued up about her limitations then you think.

(If you are pregnant and want to continue training I would always advise to seek out some professional guidance first and consult your doctor)

Sally Dixey is a Personal Trainer with Crossfit London in Bethnal Green