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10 Books For An Awesome Mindset!

2 May

 By Jenny Burrell BSc (Hons), Founder of Burrell Education, Specialist For Pregnancy and Post Natal Fitness & Therapy, London, UK.

www.burrelleducation.com

1.  Gary Zukav – The Seat of the Soul – Deep, deep, deep – like a spiritual punch in the head.  Mr. Zukav will rock your tiny world.  Tough spirtual love but on the money every time.

2.  Steering by Starlight – Martha Beck – stuck in a rut? Get quiet! Simple!  :-)) Then get busy doing what the hell you came here to do!!!!!!!!  Martha holds no punches.  The book is full of gems that will guide you to a kick ass life if you are prepared to go through the ‘ring of fire’.

3.  Age of Miracles – Marianne Williamson – Unashamedly women’s business!!!!!!! Especially if you’re over 40!  You know who you are :-)

4.  Broken Open – Elizabeth Lesser – ooooooooh this will make you cry, cause that’s what you do when you’re broken down and lose the ‘game face’.

5.  Practicing the Power Of Now – Eckhart Tolle – Anything by this man is gold. DEEP and profound.  A real life changer.

6.  The 7 Habits of Highly Effective People – Stephen R. Covey – foundation text by the father of ‘get your ass in gear’…with love.

7.  Think and Grow Rich – Napoleon Hill – always think ‘shame about the title’ – gives a false impression.  Written in the 1920’s and still as relevant as ever.  The truth never changes.

8.  10 Spiritual Principles of Successful Women – Victoria Lowe – found this in an airport bookshop in Chicago when I was en route to the home of Oprah, how apt.  Honest and inspiring text.

9.   Life with Full Attention- Maitreyabandhu – a Bhuddism inspired text that just stops you in your tracks and insists you create PEACE AND STILLNESS in your life DAILY!!!!! Amen.

10.  A Thousand Names for Joy – Byron Katie – Ms Katie is peace personified – her quote ‘Happiness is a quiet mind’ is a personal mantra.  De-junk your life on every level  -PEOPLE, PLACES AND THINGS and keep it simple, simple, simple.

www.burrelleducation.com – Passionate About Pregnancy & Post Natal Health & Fitness Education FOREVER! 

Visit the SITE and FACEBOOK PAGE for lots of FREE STUFF, COURSES & ‘THE CRUNCHLESS CORE DVD’.

Nutrient Content of Coconut Water Versus Gatorade

6 Apr

By Jenny Burrell BSc (Hons), Founder of Burrell Education, Specialist For Pregnancy and Post Natal Fitness & Therapy, London, UK.

Nutrient Content of Coconut Water Versus Gatorade

As a huge fan of Bikram Yoga, I first came across avid consumption of coconut water after attending the extremely dehyrating classes and of course I needed to know why it was considered such an exlir ;-).  I am a self-confessed science nerd!  In his awesome book, Superfoods, David Wolf (did you see him on the viral documentary about food & nutrition recently?) gives an amusing demonstration of the power of keeping it natural when considering your hyration and recovery drinks after strenuous exercise.  I think the case for making the ‘natural choice’ is made pretty clear here!  Anyway, I NEVER trusted those blue energy drinks!!!!!!!!!!!!!!!!!!!!!!!

Nutrient

Units/100g

Gatorade

Coconut Water

Sugar g 5.33 3.71
Dietary Fibre g 0 1.1
Calcium mg 1 24
Iron mg 0.20 0.29
Magnesium mg 1 25
Phosphorus mg 9 20
Potassium mg 14 250
Sodium mg 39 105
Zinc mg 0.26 0.10
Copper mg 0.25 0.04
Manganese mg 0.05 0.142
Selenium mcg 0.0 1
Fluoride mcg 34 Trace
Vitamin C mg 0.4 2.4
Thiamin mg 0.011 0.030
Niacin mg 0.22 0.08
Pantothenic Acid mg 0.055 0.043
Vitamin B6 mg 0.022 0.032
Folate mcg 0.0 3
Amino Acids (Building Blocks of Protein) mg 0.0 785

Adapted from: Superfoods by David Wolf – North Atlantic Books 2009.

www.burrelleducation.com – Passionate About Pregnancy & Post Natal Health & Fitness Education FOREVER! 

Visit the SITE and FACEBOOK PAGE for lots of BRILLIANTNESS!!!

My Top 2 EASY Social Media Books and More

4 Apr

By Jenny Burrell BSc (Hons), Founder of Burrell Education, Specialist For Pregnancy and Post Natal Fitness & Therapy, London, UK. http://www.burrelleducation.com

PS., I’m reblogging this post as I am fairly pleased with myself :-) My intention at the beginning of the year was to blog and read more…I’ve published 40 blogs so far so feel like I’ve been successful at establishing a habit.  Actually it does get easier once you get into a groove.  I remember listening to some good advice on an audio book while walking the dog and the author said – YOU’VE GOT TO BE ADDING SOMETHING VALUABLE TO THE CONVERSATION…..I hope I am !

PPS., If you use WordPress like me, I hope you know that you can schedule a whole week of blogs at once or on a Sunday night like I did this week and take the strain out of staying connected!

Happy New Year to you all!!!  Super stoked to start 2012!  In great health at last and with a head and heart full of energy for our brilliant profession and all the plans that I have for this brand new year.  So without further ado, I’ll tick off two daily jobs on my NEW YEARS RESOLUTION LIST…..READ DAILY & BLOG MORE! Voila!

Oooh it comes to us all!!!  Nevermind just being on Facebook and Twitter, I really needed to understand how they worked and how to maximise social media prescence without wasting time staring at various screens for the best part of the day so I did a little research and found the first two  books, both are awesome as explaining the ‘HOW TO DO’ and the ‘WHY’ and how to knit it all together time-efficiently.


Then stumbled across this little gem and literally ready it in one sitting then started again!!!  Perfect for these fiscally conscious time, I’m loving austerity, being creative and seeing how far a little brain power combined with elbow grease gets me ;-).

Lastly, fresh back from South America and having drunk Acai slush puppies in Brazil and felt crazy gooooood and smuggled home fresh Maca powder from Cusco. I’m re-reading this little gem and I’ve gotten busy making my OWN GREEN DRINK POWDER with great results.  I’ll blog my recipe shortly.  (I did, it’s in the archive)

Keep it passionate and remember, mediocrity is a sin!  Go BOLD or GO HOME!

Jenny X

Train Women? Read These Books!

4 Apr

By Jenny Burrell BSc (Hons), Founder of Burrell Education, Specialist For Pregnancy and Post Natal Fitness & Therapy Education, London, UK.

www.burrelleducation.com

1. Fat Around the Middle – Marilyn Glenville – easy to read and understand. Great for clients who really need to get the message that STRESS is making and keeping them fat!

2.  The Female Body Breakthrough – Rachel Cosgrove – a kick ass text, she tells it how it is and shows you how to get blinding results from pretty easy to do changes in nutrition and beefing up your workouts (not so easy:-) – a personal favourite.

3.  From Belly Fat to Belly Flat – Dr CW Randolph – great if you have clients who are pre or currently menopausal and just can’t seem to shift the fat, especially from around their mid-section.  Some tough love here but I guess the mantra is ‘want something different, got to DO SOMETHING DIFFERENT!  I personally, followed this book to help me with my Oestrogen dominance issues.

4.  Women’s Bodies, Women’s Wisdom – Dr. Christianne Northrup – my ‘women’s business’ bible!  Even Oprah has a copy permanently by her bedside.  If you train women, get this!!!!!

5.  Pregnancy & Childbirth – A Holistic Approach to Massage and Bodywork – Suzanne Yates – I studies with Suzanne and was massively inspired.  A beautiful, sentient book, my bodywork bible.

6.  Anatomy and Physiology for Midwives – Coad with Dunstall – one of the major texts on the reading list for student midwives in the UK.  Heavy on the science but what did you expect? ;-)

7.  Optimum Nutrition, Before, During and After Pregnancy – Patrick Holford – Does what it says on the tin from the ever-on-it Mr. Holford.

8.  Fitness for the Pelvic Floor – Beate Carriere – Foundation text.  Period! (Pardon the pun!)

9.  The Metabolic Effect Diet – Jade & Keoni Teta – BIG, BIG SCIENCE MADE SIMPLE!  The Teta brothers rock!  Got stubborn fat all of a sudden?  They’ll help you understand what’s going on and fix it, dramatically!

10.  Balancing Hormones Naturally – Kate Neil & Patrick Holford – Again, does what it says on the tin.  Great advcie and strategies for regaining endocrine balance.

www.burrelleducation.com

Passionate Pregnancy & Post Natal Health, Fitness & Therapy Education – FOREVER!

Why Fat Loss May Be Harder For Your Breastfeeding Clients

2 Apr

By Jenny Burrell BSc (Hons), Founder of Burrell Education, Specialist REPs Endorsed Pregnancy and Post Natal Fitness& Therapy Education, London, UK. http://www.burrelleducation.com



What do women want on their return to exercise after having their babies?

  • Fatloss?
  • Energy?
  • A better looking  & functioning belly?
  • A non-leaky pelvic floor?
  • Rest?

With over a decade of experience working with this client population, the tools and strategies to tackle all of these areas have never been more effective, plentiful and easy to implement.

1.  Let’s start with post baby fat loss.  A bit of a tricky subject if you’re not able to get with the science.  There are a few key factors why post baby clients hold fat:

  • The heightened Cortisol during pregnancy, remains high after birth and this situation is not helped by the added stressors of the early post birth period, poor sleep patterns and for some, the hormonal influence on fat stores perpetuated by on-going breast feeding.  It’s a complexed subject but here Jade Teta of the Metabolic effect succinctly explains one of the mysteries of why many women DO NOT lose fat when they breastfeed unless perhaps you are Victoria Beckham or Abbey Clancey :-)!
  • The next key area of the post baby fat loss conundrum is EXERCISE INTENSITY.  I could write forever on this but basically, the magic bullet for blitzing fat stores is INTENSITY NOT TIME!  Unfortunately, most people don’t like to get uncomfortable (literally and metaphorically) so rarely go there!  Unfortunately, discomfort is a vital key to effective exercising in shorter sessions that have huge fat burning/hormonal shifting potential for HOURS AFTER YOUR ACTUAL EXERCISE SESSION!   Here are the generally accepted key elements of a metabolism boosting, fat busting session:

a)       It’s short 20-30 mins maximum

b)      Contains compound, integrated, functional movement – no individual ‘body-part’ exercising here! OK, may just bi’s and tri’s ;-) firm arms mean the world to us girls!

c)       The exercise makes you sweat

d)      The exercise makes your muscles burn

e)      You get out of breath

f)       You get hot

g)      You push yourself ie., get a little uncomfortable

h)      You don’t over-rest within the training period

The third component of successful post baby fat loss is Optimum Re-Nutrition.  Pregnancy, birthing through to the early post birth period is a time of depletion for the mother.  When the dust has settled, a key consideration is to re-nourish the body, replenishing depleted stores of essential vitamins and minerals that ensure her system regains balance and functions optimally.  Many clients have no idea of the positive nutritional potency of many everyday foodstuffs and conversely how harmful to health many  foods in their current diet are too – mainly those that come in packets!  These days it really seems that we’ve finally nailed it!  We have a long-term formula that actually works in terms of health, wellbeing, offsetting later life disease and helping us to consistently shed and keep fat off.  Basically it boils down to:  Get rid of, or at the very least CONSISTENTLY LIMIT the C.R.A.P  in our diets– starchy carbohydrates and grains,  refined foods and to be honest any sugar, alcohol and processed/packaged foods.  Following these protocols will have a transformational effect on your clients’ energy, wellbeing and fat loss potential.  Insulin is the master hormone for fat loss and once you get out of the sugar-trap, the results are amazing but for a lot of people a diet consisting mainly of restricted quantities of carbohydrates, protein, vegetables and selected fruit is challenging….that is, until they see the fat falling away.  Based on my own personal and client experience, I created a cut and paste Post Baby Fat Loss manual that you can plug into your business almost automatically to establish your own system for POST BABY FAT LOSS THROUGH OPTIMUM NUTRTION.

  Check out the contents here:

http://www.burrelleducation.com/

2.  Energy – Short, energising exercise session, a great diet, some key supplementation (high quality multivit, essential fats), good hydration and a dedicated strategy for resting as much as possible and not trying to be superwoman during this challenging life phase will go a long way to ensuring that your mommy has hugely improved energy levels.  Top tip:  If funds permit, suggest to clients that they find someone to help with the big cleaning jobs a few hours a week can be transformational and probably not far off the price of the 2 bottles of wine they won’t be consuming per week anymore.

3.  A better looking and functioning belly & core.  OK, second only to Pelvic Floor issues ‘OMG, look at my belly!’ is the sentence that I hear uttered the most often.  Indeed,  after  at least 6 months of skin, fascia and muscles being stretched and the curious and annoying development of cellulite on the deflated tummy not to mention the dreaded stretch marks, the return journey back to a flat or at least half decent tummy isn’t always as smooth and rapid as most moms hoped it would be.  Also for many, Diastasis (the separation of the two bellies of the rectus abdominis alongside a flaccid and weakened mid-line tissue) adds an extra dimension to a difficult restorative period.  The final annoyance comes in the form of C-Section recovery which, I REALLY GET NOW!  (I managed to have 2 C-Sections  – only 12 months apart!).  Not only is C-Section blooming painful in the early days – you are left challenged to perform the simplest of tasks (bending over to put knickers and socks on!!!!) but then when you start to feel stronger after a few months and lift a heavy object , wear high heels or stay on your feet all day, the gift of an achy scar pointedly reminds you that the healing process still has a way to go.  Below are 3 core-restore exercises that I used on myself, and in my programmes with clients that I’ve found to be extremely effective and with clients with their core strength assessed to be at Level 2 or above ( Level 2 = 2 finger or under distension with still weakened midline unable to withstand significant intra-abdominal pressure continuously).


 Kneeling Scapular Retraction & Abdominal Scooping

Looks simple but there’s a lot’s going on here.  This exercise is great for activating the lumbar and thoracic musculature/fascia.  Holding the kneeling hip flexion position ‘turns’ on this musculature and fascia from lumbar to the thoracic back, whilst simultaneously performing scapular retraction by pulling the band wide further activates deconditioned thoracic musculature.  TVA/PF activation occurs as the client aims to withstand the pull of gravity on her abdominals by activating TVA and its synergist PF. Suitable for Levels 2, 3 & 4 clients.  If the client is unable to activate TVA she works, and experiences a bulging of her abdominals, this position is too advanced for her.  You can regress this exercise by performing it in a standing position (still with knees bent and in hip flexion) to reduce the effect of gravity on still weakened abdominal muscles and midline.  Here this exercise is shown being performed on a Power Plate.  The principles of Whole Body Vibration accelerate this brilliant exercise, taking it to another level but is still highly effective when performed on the ground.  The settings are 30-30-Low.  (Please seek advice from a certified experienced Power Plate Trainer if you are not certified to use this equipment with Post Natal clients).

Assisted Heel Drops and Heel Slides

One for the Pilates massive! – I teach this in the ‘flat back’ or ‘imprint’ lumbar position for the PN client to off-set and de-train her anterior tilted pelvis and to assist in lengthening shortened lumbar musculature and fascia.  The flat back also ensures that the lengthened abdominals are being re-strengthened in a shortened position (the anterior tilted pelvis and Pregnancy has lengthened the muscles and tissues).   Client gently holds her knees as she works, ensuring the at TVA activation and the lumbar position is maintained throughout.  As the client progresses, the hands can be placed on the floor as she works.  NB: You might find that early returning C-Section clients might first need to start with HEEL SLIDES before progressing onto this ASSISTED HEEL DROP as lifting the legs into the start position might be too challenging for them.


  

Heel Slides (With Glider) With Arm Extensions

 Kneeling Straight Arm Press Downs with NEUTRAL PELVIS!

A great way to strengthen the abdominals without creating the usual intra-abdominal pressure associated with crunches against a weakened core.  Emphasize NEUTRAL PELVIS and TVA activation at all times to ensure the abdominals are not strengthened in a lengthened position and the Pelvic Floor muscles are in the perfect position to be activated.  Start and finish positions are shown.  Suitable for Levels, 2,3 and 4 clients.  Remember to coach: EXHALE ON EXERTION (ie., when the band is being pulled down).

4.  A Non-Leaky Pelvic Floor – Pelvic Floor exercise has come a long, long way since Mr. Kegel and his great revelations BUT there is still a way to go beyond the walls of research and academia.  In plain terms….women are still leaking and those sales of Tena Lady are increasing year on year (yes I actually checked!!!).  So, a bit controversial here,  can I posit the notion that if Kegels are the sole answer to urinary and faecal incontinence (ie., they were easily taught, people understood them and compliance was easy) why does just one half of my local supermarket shelf look like this?

Right now, there is a huge, well researched and vociferous movement towards emphasising the importance of including MOVEMENT to re-train the Pelvic Floor once the client is out of the acute tissue trauma phase post birth.  That said, movement won’t necessarily solve the problems of more complicated and critical cases such as prolapse, but in the case of those simply seeking a restorative programme post birth,  the principles, practices and rationale of MOVEMENT BASED PELVIC FLOOR EXERCISE really has to be in the kit-bag of any medical and fitness professional who specializes in rehab in this area.

So what does the PF love?  Squatting, lunging, lifting, pulling, tilting, multiplanar movement, hopping, and balancing – do these moves sound famililar?  THESE ARE ALL FUNCTIONAL MOVEMENTS THAT WE’RE ALREADY PRESCRIBING FOR OUR CLIENTS!  All give superior unconscious stimulation to the PF muscles without the aid of performing or cueing Kegels and fit beautifully with modern exercise prescription and preparing the client for her REAL LIFE!  Combined with an optimal breathing strategy, basically (exhale on exertion – this puts a ‘lock’ on the Core Cannister and offsets increased intra-abdominal pressure against weakened abdominal tissue) PELVIC FLOOR EXERCISE BECOMES FUNCTIONAL.   I’ve summarized the ‘turn-ons and turn-offs’ for the Pelvic Floor in the table below:

Pelvic Floor ‘Turn On’s’/Strengtheners

Pelvic Floor ‘Turn Offs’ / Weakeners

Integrated Whole Body Movement!  Think of the effect of immobility on the continence of sedentary elders. Immobility
Vibration – whole body vibration also involves Pelvic Floor muscles too! Combative sports or those that involve body blows (consider a parallel bar gymnast).
Instability – the whole core is activated included TVA which is a synergist of PF. Anterior tilted pelvis (the usual pelvic position of the Pre & Post Natal client).
Adduction –due muscular & fascial links between adductors of the Femur and PF. Over-active Piriformis – seen by some as part of the Posterior PF.  The rear PF gets strong, the front PF gets weak!
Abduction – due muscular & fascial links between the deep lateral rotators of the Femur and the PF. Pregnancy (stretching of the PF muscles by the weight of a growing baby).
Multi-Planar Movement –a combination of stimulation of adductors and the stretch reflex occurring in the PF muscles. Vaginal birthing especially when assisted (ventous/forceps/episiotomy) – produces varying degrees of soft tissue and nerve trauma that can have a direct impact on the function and connection to the PF muscles post birth.
C-Section –crucial synergistic core ligaments, nerves, skin, blood vessels and fascia are severed and take many, many months  and in some cases, years to repair/reconnect
Working against gravity, especially with progressed speed and power.
TVA Activation & Diaphragmatic Breathing – TVA, Diaphragm and PF muscles are synergists. Persistent coughing without mindful control of the increased intra-abdominal pressure.
Co-Activation of PF through activation of the Muscular Sling and fascial systems ie., full body integrated/compound movements. Obesity  – causes chronic increase intra-abdominal pressure.
Menopause – causes a fall in Oestrogen production which affects connective tissue formation and strength.
Ageing – an ongoing decrease in Collagen and Elastin formation affects connective tissue tension and less resistance to gravity and pressure.

5.  Finally, last but most definitely not least –  Rest – For too long, meditation and those with a consistent practice have been seen as some sort of secret society but thanks to advances in modern technology the rest of us mortal souls can now enter the loop.  The power of meditation is HUGE and it’s a massive asset to health and well-being  and FAT LOSS even if you have just a few minutes a day to dedicate to it.   Even when night-time sleep is hard to come by using strategies such as ASSISTED MEDITATION wearing a set of headphones listening to an audio recording is a huge asset to redressing the imbalances caused by sleep deprivation.  Check out http://www.centerpointe.com and www.blissitations.com.  Both of these sites have products that you can purchase and or download that literally give your brain the equivalent of the best massage you’ve EVER had!  Utterly blissful and even 10 minutes does you the power of good!  Perfect for the time pressed mommy.  For more on this, check out my previous blog on Stress, Sleep Deprivation and Fat Loss.

So, in conclusion, fat loss is tricky at the best of times, never mind after the endocrine turbulence associated with pregnancy, birthing and breastfeeding.  Helping your clients to understand the facts will help to temper her anxiety that her body has gone to pot FOREVER.  Simply helping her to detoxify/clean up her diet and teaching her new ways to rest can be a great way to start on the journey to losing her baby weight in the early days but ultimately, this is one time in most women’s life when they are forced to learn the art of patience, self-acceptance regardless of what size they are wearing and a time for redefining what success means in terms of their diet and fitness.  It’s always a little dark before the light :-).  With our help, great guidance and empathy they will make it back and be better, stronger and wiser for their ‘down-time!

Til next time!  Remember…..Mediocrity is a Sin!  Go Bold or Go Home! ;-)

I‘ll be presenting at the UK Top Fitness Convention later this month, check out the amazing line-up & my sessions….

http://tinyurl.com/7uur4ld

5 Vital Steps To EXCELLENT Post Natal Fitness Programming

16 Jan

By Jenny Burrell BSc (Hons) – Founder of Burrell Education (www.burrelleducation.com) – Specialist for Modern Pregnancy and Post Natal Fitness & Therapy Education.

 

Part 1:  Application of a GREAT PARQ, Post Natal Core Strength Assessment &

Categorization the Post Natal Client

After over a decade spent restoring and training Post Natal clients, there’s one thing that’s patently clear…..bodily events during the Post Natal period are NOT an exact science.  Every woman has a unique story to tell about her pregnancy, birthing and her recovery from birth.  So when creating a programme for a PN client, your best strategy – always – is to have a system built on a)  great modern foundation education b) a thorough verbal and physical screening of your client.

If you’re just beginning to specialize in this area of fitness, you’re in luck, these are indeed exciting times in the world of Pregnancy and Post Natal exercise prescription.  The old-guard of fear-based programming is being edged out and the light of innovation and functionality is now being shone on fitness for this client population.  Over the last decade, practically, every area of the fitness education has undergone a total revolution but Pre/Post Natal education remained stale, mediocre and unyielding to many of the critical changes that could improve both it’s attractiveness and relevance to fitness professionals.  Now, thanks to innovators both here in the UK and in the USA and Canada, Pre/Post Natal fitness education has finally caught up with the rest of the fitness and rightfully take its place as a ‘happening’ subject area.

So, with no further ado, let’s get started on the key components of creating modern exercise prescription for the Post Natal client.

Key Components of Modern Post Natal Exercise Prescription

  1. Application of PARQ, Core Strength Assessment & Categorization
  2. Bespoke ‘Core & Floor’ Restore
  3. Functional Training for Fat Loss
  4. Rest & Restorative Activity
  5. Optimum Nutrition & Supplementation

 

  1. Application of a GREAT PARQ (Health Questionnaire), Core Strength Assessment & Categorization of the Client.

Quite a bit first step!  But without assessing the client all exercise prescription is not only faulty but could , at the very least hinder the progress of the client back to full health and at the worst be dangerous.  You can download my full Post Natal PARQ at www.burrelleducation.com so I won’t go too indepth here, but below is the first page:


Today’s Date:

Client Name:

Client Address:

Client Phone No:

Client Email:

 

Date of Delivery:

 

Type of Delivery (Assisted, Vaginal, C-Section):

 

6 Week Check-Up Date & Outcome:

 

Breastfeeding Status:

 

Post Natal Bleeding Status:

 

Recently Fitted IUD?

 

Post Natal Pre-Activity Health Questionnaire (PARQ)
You are advised to ALWAYS have your client complete a Post Natal Specific PARQ before the commencing any physical training and as well as ENSURING THAT YOUR CLIENT HAS BEEN GIVEN PERMISSION TO COMMENCE EXERCISING BY HER HEALTH CARE PROVIDER AT HER 6-WEEK CHECK-UP.

 

The first 5 items on the list referring to client personal details are standard,  so we’ll focus on the next 6 items on the list.

a)       Date of Delivery & Outcome of 6-Week Check-Up:  important because you need to know that your client is over 6 weeks Post Natal and has had her mandatory 6-week check-up via her Health Care Professional and been given the OK to commence exercise.  A fitness professional should NEVER take on a client who has not had this check and been given permission to exercise.

b)      Type of Birth (Vaginal, C-Section, Assisted, Complications): Important to know when considering rate of healing.  A C-Section client will generally have a slower rate of recover than a Vaginal birth client due to the nature of the surgery performed.  Also, there are generally differences in the trauma to the Pelvic Floor muscles when comparing the Vaginal birth with the C-Section.  Assisted births can involve either Forceps or Ventous and so usually require an Episiotomy.  Again, this information will have significant bearing on the healing, recovering and ability of the mother to reconnect with her whole core in the PN period.

c)       Breastfeeding Status:  Important information for a few reasons.  Firstly, if the client attends requesting a fat loss programme, breastfeeding and her increased appetite might hinder any great plans she has!  In my humble experience (unlike the celebrity scenario) most women tend to hold their baby weight until they have reduced or ceased breastfeeding.  Secondly, in order to offset possible changes to both milk supply and quality that can sometimes occur when breastfeeding mothers exercise, it’s wise to advise the mother to feed the baby before an exercise session begins as opposed to afterwards and maintain good hydration both during and after the session.  Finally, emptied breasts are much more comfortable during exercise than full ones!

d)      Post Natal Bleeding Status:  A hugely important fact to ascertain.  It’s totally normal for a woman to experience PN bleeding, but just like a menstrual period.  The flow of this bleeding lessens over the days and immediate weeks post birth.  Lochia Rubia (red flow) eventually progressing to Lochia Alba (a pale coloured flow). There are two alarm-bell ringing scenarios that every trainer needs to be aware of:  a) The client has ceased PN bleeding and after or during an exercise session, this bleeding re-commences and b)  the PN client attends for exercise and is significantly post natal ie., over 6 weeks and is still bleeding.  In both cases, the client should be referred back to her Health Care Provider and their advice sought before resuming with the client.

e)      Recently Fitted IUD:  The early PN period is when most women reconsider their contraception strategy and many choose to have an Inter Uterine Device fitted commonly known as a Coil.  Opinions vary on any strict timeframe for starting exercise after having a Coil fitted but common sense dictates that performing vigorous work within a week of fitting is probably not a great idea.  If in doubt ask your client to seek advice from her Health Care Provider during her fitting appointment.

Ok, so there’s a snapshot of why it’s important to take your client through a thorough PARQ, you’ll be  a lot wiser as to your client’s current and previous health and also demonstrate your professionalism.  Don’t forget, go to www.burrelleducation.com to download my 15 page PARQ which contains 14 pages of symptoms and conditions during the Post Natal period and considerations for exercise prescription.  Enjoy!

2.     Post Natal Core Strength Assessment

Basically, there are two main issues for most women:

  • Rectus Distention (Diastasis) and
  • A Dysfunctional Pelvic Floor

My PN Core Strength Assessment has 3 main components:

a)      Questioning the client about her degree of abdominal sensation and any changes she has experienced in the post birth period.  For C-Section clients returning to exercise fairly early (ie., under 3 months)  this includes assessing the healing of  their scar (if possible) and questioning as to whether the scar is painful during or after certain activities etc.,

b)      Checking for Rectus Distension (ongoing separation of the Rectus Abdominis muscles at the midline) and Rectus Doming (a bulging of the abdominal under intra-abdominal pressure).

c)       Questioning the client about her degree of connection to and function of her Pelvic Floor muscles especially whether she experiences any incontinence – urinary or feacal.

3.   Categorising Post Natal Core Strength

After completing the above tests/questioning I’m then in a perfect place to categorize my client’s Core Strength with a view to creating a bespoke strength/restore programme for our sessions together and when she is exercising alone.  Below are the protocols that I use.

Level 1 Client (Typically Under 3 months):  Has over 2 finger wide distension (diastasis), heading towards 3 or more.  Usually very early Post Natal with a palpably weak/papery/slack midline.  Offer Remedial Advice that includes a full body stretch routine, massage therapy, Pelvic Floor work that includes Kegels, adduction and abduction work and TVA reconnection work, posture correction exercises, floor based/simple glute strengthening exercises  – if you are confident.  If you are in doubt, refer the client to a trusted Women’s Health Physio and follow their advice .  Great advice would be to focus on walking, optimal nutrition to rebuild depeleted system, Pelvic Floor and as much rest as possible.

Level 2 Client (Typically Under 6 months) :  Less than or equal to 2 finger wide distension with a low tension midline.  Basic core and functional exercise can begin but is predominated by movement in the sagittal plane to avoid directly loading the obliques.

Level 3 Client (Typically Over 6 months):  Distension has nearly or completely closed AND/OR the midline has good tension and is able to withstand intra-abdominal pressure but caution on big movements that load the obliques of build large intra-abdominal pressure is advised.  Core and functoinal work can no include selected work in the frontal and transverse planes.  Select and test exercises carefully.  Be award that even at this stage some clients can experience urinary leakage when the core is placed under swift or enduring duress  ie., a fast jump or a long jog/run.

Level 4 Client (Typically 9 months +1 Year):  Client is fully restored.  Her midline and Pelvic Floor muscles can withstand the pressure created by ‘heavy work’.  Client can be treated as ‘normal’ core and functional exercise can now include loaded work in all 3 planes to reflect REAL LIFE!

Part 2 To Follow:   Bespoke ‘Core & Pelvic Floor’ Restore for the Post Natal Client – Subscribe to be alerted instantly!

(C) Burrell Education 2012   (www.burrelleducation.com)

This information is for guidance only and created specifically for qualified fitness and aligned professionals working with the Pre/Post Client.  If you’re a mom, please seek guidance from a qualified specialist professional.

Long Term Pelvic Pain – RCOG Patient Info

24 Oct

Contents

Key points

  • Pelvic pain is any pain in the lower abdomen or pelvis. Long-term pelvic pain is pain that persists for at least six months.
  • Long-term pelvic pain is common. It affects around one in six women.
  • Long-term pelvic pain is a symptom, not a diagnosis.
  • It is often due to a combination of physical, psychological and/or social factors and should be managed or treated ‘as a whole’, rather than as a single underlying condition.
  • If a cause for long-term pelvic pain cannot be found, women may have fears that people will say it is ‘all in the mind’.
  • Whether or not a cause for long-term pelvic pain is found, doctors work in partnership with women to discuss a treatment and management plan.

About this information

This information is intended to help you if you have long-term pelvic pain. It is based on the Royal College of Obstetricians and Gynaecologists (RCOG) guideline The Initial Management of Chronic Pelvic Pain [2](published by the RCOG in April 2005).

This information tells you about:

  • the main factors that may contribute to long-term pelvic pain
  • what your doctors can do to investigate and identify the cause of your pain
  • the most effective methods recommended in the UK for managing long-term pelvic pain .

This information tells you about the recommendations the RCOG guideline makes and aims to help you and your healthcare team make the best decisions about your care. It is not meant to replace advice from a doctor or nurse about your own situation. This information does not tell you about what can be done for women whose initial treatment has not been successful. It does not tell you in detail about conditions that may be the cause of long-term pelvic pain, or about treatments for those conditions. For further information about these conditions see the section on ‘Other organisations’.

Some of the recommendations here may not apply to you. This could be because of some other illness you have, your general health, your wishes, or some or all of these things. If you think the treatment or care you get does not match what we describe here, talk about it with your doctor, nurse or another member of your healthcare team.

What is long-term pelvic pain?

Pelvic pain is any pain you feel in the lower abdomen or pelvis. Healthcare professionals consider pelvic pain to be long-term if:

  • you experience it either constantly or intermittently for at least six months
  • it happens at times other than when you have your period or sexual intercourse.

Long-term pelvic pain is common. It affects around one in six women. long-term pelvic pain is not a diagnosis in itself but a description of a symptom.

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What could long-term pelvic pain mean for me?

How we experience pain is an individual matter and may depend upon any number of factors. Long-term pain can be very difficult to live with. It may cause you emotional, social and even economic difficulties. You may experience depression, difficulties in sleeping and a disruption to your daily routine. Your may fear the worst about your pain, believing that it means you have cancer or you have a serious problem that may affect you having a baby. You may have fears that people will say your pain is ‘all in the mind’. The pain is not ‘all in your mind’.

The reasons for long-term pelvic pain are not always easy to diagnose. It is not always possible to treat. Women may need support in managing and coping with their pain.

Even if no reason can be found for the pain, many women find that the quality of their lives improves when they get a better understanding of what is involved.

What causes long-term pelvic pain?

In many cases, your healthcare professional will not be able to identify an underlying problem or give a clear diagnosis and he or she will only be able to assure you that there is no serious medical problem.

Long-term pelvic pain is often caused by a combination of physical, psychological and/or social factors, rather than a single underlying condition.

These factors may include:

  • endometriosis ( a condition where cells of the lining of the womb (the endometrium ) are found elsewhere in the body, usually in the pelvis)
  • adenomyosis (a condition where the endometrium is in pockets within the muscle wall of the womb)
  • pelvic inflammatory disease (PID) (a n infection of the womb, fallopian tubes and/or pelvis)
  • interstitial cystitis (bladder inflammation)
  • musculoskeletal pain (pain in your joints, muscles, ligaments and bones)
  • irritable bowel syndrome (IBS)
  • depression, including postnatal depression
  • previous or ongoing traumatic experiences such as sexual abuse in some women
  • adhesions (areas of scarred tissue that may be a result of a previous infection endometriosis or surgery); although these are common, they do not always cause pain
  • trapped or damaged nerves in the pelvic area.

For some women with long-term pelvic pain none of these factors may be found.

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What happens when I first see the doctor?

At your first appointment, you should have the chance to ‘tell your story’, describe the pain you have experienced and discuss your anxieties. Your doctor will take your concerns seriously and listen. By working in partnership with you, he or she will aim to identify the cause(s) of your pain. Although at times you may feel you are repeating yourself, your story is important. The way you describe your symptoms is crucial in making a diagnosis. Your doctor will probably ask you a number of questions about:

  • the pattern of your pain
  • what makes your pain better or worse (certain sorts of movement, for example)
  • whether you have noticed other problems that might be linked to the pain (intercourse, bladder, bowel or psychological symptoms, for instance).

You may be asked about aspects of your everyday life including your sleep patterns, appetite and general wellbeing. You may also be asked about how you are feeling and whether you are feeling depressed or tearful. This is because long-term pain is known to cause depression, which in turn may make your pain worse. If your healthcare professional knows how your pain is affecting you personally, this can be taken into account with your treatment.

Your doctor should explain the various factors that can lead to long-term pelvic pain (see section ‘What causes long-term pelvic pain? [7]‘).

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What types of tests might I be offered?

Tests do not always involve getting a report from a laboratory. Your own history and the way you describe the pattern of your pain can provide much more valuable information or results. Because of this, you may be asked to keep a ‘pain diary’. This involves noting down when your pain occurs, how severe it is, how long it lasts and the things that seem to affect it. A pain diary will also help you to describe your pain and to become more aware of the ways in which it affects you.

Then, depending upon your own situation, you may be offered any of the following types of tests:

  • You will probably be offered an ultrasound scan.
  • You may be offered screening tests for sexually transmitted infections.
  • If your pain is related to psychological, bladder or bowel symptoms, your consultant may refer you to a specialist or suggest you see your GP. If you have bowel symptoms, for example, you may be referred to a gastroenterologist who may offer you tests for irritable bowel syndrome (IBS).
  • If your pain occurs on a regular basis at a specific time in your menstrual cycle, then you may be offered drugs to suppress your periods for a few months. This may help your doctor in making a diagnosis.
  • You may be offered a diagnostic laparoscopy. This is a procedure carried out under general anaesthetic. It involves a small cut in the abdomen to examine your reproductive organs and look for any abnormality, problems or damage. The surgeon will insert a tiny telescope (called a laparoscope) so that your reproductive organs can be seen more clearly. A s with any surgical procedure, there are risks and benefits and these will be explained fully to you when you are offered the test.
  • If your health professional thinks that your pain is due to a particular cause, you may be offered treatment on a ‘try it and see’ basis. Such treatment could help you to avoid a diagnostic laparoscopy which carries small, but significant, risks.

What treatment may help?

Whatever your situation, you may be offered painkillers. If these do not help to control your pain, you may be referred to a pain management team or a specialist pelvic pain clinic. Depending on the type of your pain you may also be offered other treatment.

You should be offered treatment and advice if:

  • your pain is related to your menstrual cycle and you have heavy periods
  • your pain varies with movement
  • you have symptoms suggestive of irritable bowel syndrome
  • you may have symptoms suggestive of a sexually transmitted infection or PID.

Your doctor will provide you with full information about all treatment options

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Are there any risks?

Your doctor or specialist practitioner should give you full detailed information about the risks and benefits of any investigation, surgical procedure and treatment suggested. There are no risks associated with having an ultrasound scan.

Are there any alternatives?

Depending on your circumstances, you may have a range of possible options. You may be offered a combination of two or more types of treatment, such as medical treatments with tablets or injections (for example, pain relief or hormone treatment), surgery or pain management strategies. Some people find that complementary therapies can help to manage the pain.

What might happen if I don’t have treatment?

Your doctor may not be able to predict what might happen for you as an individual. For many women the pain gets better with time. Most women have no serious or life-threatening problem underlying the pain. Many women find that they can cope better with their pain after they have been given a thorough explanation of the nature of the pain, including previous test results and possible causes of the pain. They can also cope better when they feel reassured that there is no serious or life-threatening disease present.

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Is there anything else I should know?

  • You should visit your doctor if you experience any of the following:
    • bleeding from your rectum
    • a change in your bowel habits which has lasted for more than six weeks
    • new pain after you have passed the menopause
    • any unusual swelling in your abdomen
    • suicidal thoughts
    • excessive weight loss
    • irregular vaginal bleeding, such as bleeding between periods, or vaginal bleeding after the menopause or vaginal bleeding during or after sex.
  • No treatment can be guaranteed to work all the time for everyone.
  • You have the right to be fully informed about your health care and have the opportunity to share in making decisions about it. Your healthcare team should respect and take account of your wishes.
  • If you are not comfortable with the final diagnosis, you can ask for a second opinion.

Sources and acknowledgements

This information is based on the Royal College of Obstetricians and Gynaecologists (RCOG) guideline The Initial Management of Chronic Pelvic Pai [2]n (published by the RCOG in April 2005). The guideline contains a full list of the sources of evidence we have used.

Clinical guidelines are intended to improve care for patients. They are drawn up by teams of medical professionals and consumers’ representatives, who look at the best research evidence there is about care for a particular condition or treatment. The guidelines make recommendations based on this evidence.

This information has been developed by the Patient Information Subgroup of the RCOG Guidelines and Audit Committee, with input from the Consumers’ Forum and the authors of the clinical guideline. It was reviewed before we published it by women attending clinics in London, Oxford and Southampton. The final version is the responsibility of the Guidelines and Audit Committee of the RCOG.

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Other organisations

These organisations offer support:

The Gut Trust
Unit 5
53 Mowbray Street
Sheffield S3 8EN
Helpline: 0114 272 3253 (Mon-Fri, 6-8pm; Sat 10am-noon)
Email: info@thegutrust.org [18]
Web: www.thegutrust.org [19]
[20]

National Endometriosis Society
50 Westminster Palace Gardens
Artillery Row
London SW1P 1RR
Helpline: 0808 808 2227
Email: nes@endo.org.uk
[21]Web: www.endo.org.uk [22]

The RCOG consents to the reproduction of this document providing full acknowledgement is made. The text of this publication may accordingly be used for printing with the addition of local information or as the basis for audiotapes or for translations into other languages. Information relating to clinical recommendations must not be changed.

Top 10 Pregnancy, Post Natal, Female Health CentricTexts

24 Oct

My Top 10 Pregnancy, Post Natal and Female Health Centric Texts

 

1.  Fat Around the Middle – Marilyn Glenville – easy to read and understand, great for clients who really need to get the message that STRESS is making and keeping them fat!

2.  The Female Body Breakthrough – Rachel Cosgrove – a kick ass text, she tells it how it is and shows you how to get blinding results from pretty easy to do changes in nutrition and beefing up your workouts – a personal favourite.

3.  From Belly Fat to Belly Fat – Dr C W Randolph – great if you have clients who are pre-menopausal or menopausal and just can’t seem to shift the fat.  Some tough love here but I guess the mantra is ‘want something different, got to DO SOMETHING DIFFERENT!  I personally, followed this book to help me with my Oestrogen domininance issues.

4.  Women’s Bodied, Women’s Wisdom – Dr. Christianne Northrup – my bible!  Even Oprah has a copy permanently by here bedside.  If you train women, get this!!!

5.  Pregnancy & Childbirth – A Holistic Approach to Massage and Bodywork - Suzanne Yates – beautiful, sentient – my bodywork bible.

6.  Anatomy and Physiology For Midwives – Coad with Dunstall – one of the major texts on the reading list for student midwives.  Heavy on the science but what did you expect :-)

7.  Optimum Nutrition Before, During and After Pregnancy – Patrick Holford – Does what it says on the tin from the ever-on-it Mr. Holford.

8.  Fitness for the Pelvic Floor – Beate Carriere – Foundation text for the ‘Movement Based Pelvic Floor Exercise’ crew! 

9.  The Metabolic Effect Diet – Jade & Keoni Teta – BIG BIG science made simple, the Teta brothers rock!  Got stubborn fat all of a sudden?  They’ll help you understand what’s going on and fix up, dramatically!

10.  Balancing Hormones Naturally – Kate Neil & Patrick Holford – Again, does what it says on the tin.  Great advice and tips for regaining endocrine balance.

www.burrelleducation.com – Passionate About Pregnancy & Post Natal Health & Fitness Education FOREVER! 

Visit the SITE and FACEBOOK PAGE for lots of FREE STUFF, COURSES & ‘THE CRUNCHLESS CORE DVD’.

 

 

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