Improve Bladder Health After Childbirth

After giving birth, many women face challenges with bladder control that can be both frustrating and inconvenient. Post-childbirth bladder issues, while common, can have a significant impact on a new mother’s daily life, affecting everything from routine activities to emotional well-being. Understanding the causes of these issues and recognizing the symptoms are crucial first steps in managing and improving bladder health.

Bladder issues postpartum are often due to the stress and strain placed on the pelvic floor muscles during pregnancy and childbirth. These muscles support the bladder and help control urine flow, so any weakening or damage can lead to bladder leaks, urgency, and other symptoms. The good news is that with the right approach, you can strengthen these muscles and regain control. In this article, we will explore effective exercises, lifestyle adjustments, and holistic methods to improve bladder function and enhance your quality of life as a new mother.

Understanding Post-Childbirth Bladder Issues

Causes of Post-Childbirth Bladder Issues

Bladder issues after childbirth are primarily due to the stress and strain on the pelvic floor muscles, which support the bladder and other organs in the pelvis. During pregnancy, the weight of the growing baby can weaken these muscles. The process of giving birth, especially vaginal delivery, can also stretch and sometimes tear the pelvic floor muscles, making them less effective at controlling the bladder.

Hormonal changes after childbirth further contribute to bladder problems. These hormones, which helped your body to carry and deliver a baby, can make the muscles and tissues in the pelvic area more relaxed. This relaxation can reduce support for the bladder, leading to leaks and urgency issues.

Common Symptoms and How They Affect Daily Life

Post-childbirth, many women experience various bladder issues that can significantly impact their daily routines. One common symptom is urinary stress incontinence, which is the involuntary leakage of urine. This can occur when you laugh, cough, sneeze, or engage in physical activities. Such unexpected leaks can cause embarrassment and inconvenience, affecting social interactions and physical activities.

Another common symptom is urinary urgency, where you feel a sudden and strong need to urinate. This can make it difficult to control your bladder, leading to frequent trips to the bathroom, which can disrupt daily activities and sleep. Some women also experience frequent urination, finding that they need to empty their bladder more often than usual, which can be especially bothersome when you’re busy caring for a newborn.

Effective Exercises to Strengthen Your Bladder

Pelvic Floor Exercises: Kegels and Beyond

Pelvic floor exercises, especially Kegels, are highly effective in strengthening the muscles that control the bladder. To perform Kegels:

– Sit or lie down in a comfortable position.

– Exhale and tighten the muscles you use to stop urine flow, holding the contraction for 5 seconds.

– Inhale and relax these muscles for another 5 seconds.

– Repeat this exercise 10-15 times, 3 times a day.

Other exercises, such as pelvic tilts and bridges, can also help. Pelvic tilts involve lying on your back with your knees bent, then tightening your abdominal muscles to tilt your pelvis upward, holding for a few seconds before relaxing. Bridges involve lying on your back with your knees bent and lifting your hips toward the ceiling, squeezing your buttocks and pelvic floor muscles, then lowering slowly.

Incorporating Bladder Control Exercises into Your Routine

Incorporating these exercises into your daily routine can make a big difference in strengthening your bladder. You can start by scheduling specific times to do your Kegels, such as during your morning routine, after meals, and before bed. Setting reminders on your phone can also help you stay consistent.

Another tip is to integrate pelvic floor exercises into other activities. For example, you can do them while brushing your teeth, watching TV, or even while feeding your baby. Consistency is key, so find moments throughout your day when you can perform these exercises without disrupting your schedule. Remember, patience and persistence are essential for seeing improvements.

Next, we’ll discuss lifestyle adjustments and holistic approaches that can further support bladder health postpartum.

Lifestyle Adjustments to Support Bladder Health

Importance of Hydration and Balanced Diet

Proper hydration and a balanced diet play a crucial role in maintaining bladder health post-childbirth. Drinking enough water flushes toxins from your body and prevents dehydration. Dehydration can cause the bladder to become irritated, which can worsen bladder control problems. Aim to drink approximately eight glasses of water a day, but adjust based on your needs and activities. Adding electrolytes to your water is another way to combat dehydration.

A balanced diet rich in fiber helps prevent constipation, which can further stress your pelvic floor muscles. Include fruits, vegetables, and lean proteins in your meals. Foods high in fiber, such as beans and oatmeal, support healthy digestion and reduce pelvic floor strain. Avoid excessive consumption of spicy foods and caffeine, as they can irritate the bladder and worsen symptoms.

Avoiding Bladder Irritants

Certain foods and beverages can act as bladder irritants, exacerbating post-childbirth bladder issues. Common irritants include caffeine, alcohol, artificial sweeteners, and acidic foods like citrus fruits and tomatoes. Limiting or avoiding these items can help reduce bladder irritation and improve your overall bladder control.

Instead, opt for bladder-friendly alternatives such as water, herbal teas, and non-acidic fruits like bananas and melons. Keeping a bladder diary can help identify specific irritants in your diet. Track your food and beverage intake alongside your bladder symptoms to determine which items you should limit or avoid.

Tips for Managing Urinary Urgency

Managing urinary urgency involves a combination of behavioral techniques and lifestyle adjustments. One effective technique is bladder training, which involves gradually increasing the time between bathroom visits. Start by holding your urine for a few extra minutes and slowly extend the time as your bladder strength improves.

Double voiding can also help manage urgency. After urinating, wait a few moments and try to go again to ensure your bladder is completely empty. Additionally, practice good bathroom habits, such as sitting comfortably and taking your time during each visit.

Holistic Approaches to Improve Bladder Function

Calming the Nervous System and Relaxation Techniques

Calming the nervous system and relaxation techniques can significantly improve bladder function by reducing stress and promoting muscle relaxation. High stress levels can worsen bladder issues, so incorporating stress-reducing practices into your daily routine is beneficial. Techniques like deep breathing, prayer, and progressive muscle relaxation help calm the mind and body.

Utilizing Herbal Remedies and Natural Supplements

Certain herbal remedies and natural supplements are known to support bladder health. Supplements like magnesium can help relax bladder muscles, while herbs such as pumpkin seed extract and cranberry are believed to improve urinary tract health. Always consult with a healthcare provider before adding new supplements to ensure they are safe and appropriate for your needs.

Herbal teas, such as chamomile and peppermint, can have a soothing effect on the bladder, reducing irritation and discomfort. Incorporating these natural remedies into your daily regimen can serve as a gentle, supportive measure for bladder function.

The Role of Physical Therapy in Bladder Management

Physical therapy plays a vital role in managing bladder issues post-childbirth. A trained physical therapist can guide you through targeted exercises and treatments that strengthen the pelvic floor muscles, enhancing bladder control. Techniques may include biofeedback, manual therapy, and specialized exercises tailored to your specific needs.

Regular sessions with a physical therapist ensure you learn the correct techniques and perform exercises effectively. They can also offer personalized advice and modifications based on your progress and symptoms.

Conclusion

Recovering and improving bladder function after childbirth is achievable through a combination of exercises, lifestyle adjustments, and holistic approaches. By understanding the causes and symptoms of post-childbirth bladder issues, incorporating effective bladder control exercises, and making mindful lifestyle changes, you can manage and potentially alleviate these challenges. As emphasized, hydration, dietary adjustments, relaxation, and physical therapy all play essential roles in this recovery journey.

Taking proactive steps towards improving bladder health can enhance your overall quality of life and restore confidence in your daily activities. If you find yourself needing more guidance and support, consider scheduling a consultation with us at Mamas & Misses. We are here to help you achieve optimal wellness and regain control of your body with holistic education and tools tailored to your needs. Learn more about pelvic floor physical therapy for women.

Discover How Holistic Care Can Improve Pelvic Health

Holistic care focuses on treating the whole person, not just specific symptoms or conditions. When it comes to pelvic health, this approach can be especially beneficial. Your pelvic floor plays a crucial role in supporting various bodily functions, including bladder and bowel control, sexual health, and even posture. By addressing the body as a whole, holistic care can offer comprehensive solutions that improve both physical and mental well-being.

Holistic care for pelvic health includes a variety of practices and techniques, from physical therapy and specialized exercises to dietary changes and stress management. By combining these elements, you can create a balanced and effective plan to enhance your pelvic wellness. This approach can help reduce pain, improve function, and increase your overall quality of life.

Understanding Holistic Care for Pelvic Health

Holistic care means looking at the whole person when treating health issues. For pelvic health, this means focusing on more than just the symptoms. We consider physical, emotional, and even lifestyle factors. The pelvic floor is a group of muscles that support your bladder, bowel, and reproductive organs. When something goes wrong with these muscles, it can cause pain, leaks, and other problems.

Holistic care involves different therapies like physical therapy, diet changes, and stress management. Physical therapy can help you learn exercises to strengthen your pelvic floor. Nutrition plays a role too. Eating the right foods can reduce inflammation and improve how your muscles work. Stress affects your muscles and overall health, so managing it is crucial.

By focusing on the whole person, holistic care helps you find and fix the root causes of your pelvic issues. This approach can improve your quality of life and help you get back to everyday activities without pain or discomfort.

Benefits of Holistic Approaches to Pelvic Health

Holistic approaches to pelvic health offer numerous benefits. First, they can provide long-term solutions rather than just temporary relief. By addressing the root causes of your symptoms, you’re less likely to experience recurring issues. This can make a big difference in your overall well-being.

Another benefit is reduced pain and discomfort. Techniques like physical therapy can help you strengthen your pelvic floor, which can ease pain and make everyday tasks easier. Nutrition and stress management also play a role in reducing inflammation and muscle tension.

Holistic care also helps improve your emotional health. When you feel better physically, your mood and outlook improve too. Reducing stress and managing pain can make you feel more in control and happier overall. By using a variety of treatments, holistic care offers a well-rounded approach to better health, making it easier to achieve and maintain pelvic wellness.

Holistic Practices and Techniques for Pelvic Wellness

There are several holistic practices and techniques that can improve pelvic wellness. Here are some effective ones to consider:

1. Pelvic Floor Exercises: Also known as Kegels, these exercises (when done correctly) help strengthen and lengthen the muscles of your pelvic floor. Regular practice can improve bladder control and reduce pelvic pain.

2. Yoga and Pilates: These activities focus on core strength, flexibility, and balance, which are essential for pelvic health. Specific poses and exercises can target the pelvic floor muscles.

3. Nutrition: A diet rich in fruits, vegetables, lean proteins, and fiber can reduce inflammation and support muscle health. Staying hydrated is also key.

4.Stress Management: Practices like prayer and deep breathing can reduce stress, which affects muscle tension and overall health. Calming the nervous system will help you manage stress more effectively, improving your general well-being.

5. Manual Therapy: This includes techniques like massage or myofascial release performed by a trained therapist, which can relieve tension and pain in the pelvic area.

Integrating Holistic Care into Your Daily Routine

Integrating holistic care into your daily routine doesn’t have to be complicated. Here are some simple steps you can start with:

1. Daily Exercises: Set aside a few minutes each day for pelvic floor exercises or a short yoga session. Consistency is key to seeing benefits.

2. Healthy Eating: Focus on eating a balanced diet with plenty of fruits, vegetables, and lean proteins. Drinking enough water is also crucial.

3. Manage Stress: Spend a few minutes each day in prayer, gratitude, reflection or deep breathing exercises. This can help you manage stress and feel more centered.

4. Regular Check-ins: Pay attention to your body. If you notice any pain or discomfort, don’t ignore it. Sometimes a slight change in your daily routine can make a big difference.

5. Seek Professional Help: Schedule regular appointments with a pelvic floor physical therapist who specializes in pelvic health. We can offer personalized advice and treatments tailored to your needs.

By making these small changes, you can incorporate holistic care into your routine and see significant improvements in your pelvic health.

Conclusion

Pelvic health is an essential part of overall well-being, and adopting a holistic approach can bring transformative benefits. By understanding the importance of holistic care, you can address various aspects of your physical and emotional health, leading to a more balanced and pain-free life. Incorporating practices like pelvic floor exercises, mindful eating, and stress management techniques can greatly improve your pelvic health.

Taking small, consistent steps can make a big difference over time. Whether it’s setting aside a few minutes for daily exercises or focusing on a balanced diet, every effort counts. Your body will thank you, and you will feel more empowered and in control of your health.

For personalized support on your journey to better pelvic health, visit Mamas & Misses. Our team specializes in holistic care, pelvic therapy, and more to help you achieve optimal well-being. Take the first step today and improve your pelvic health with our expert guidance.

Simple Steps for Returning to Running after Having a Baby

Returning to running after having a baby can feel like a daunting task. Your body has gone through so many changes, and it’s important to approach this journey with care and patience. Running is a wonderful way to regain your fitness and find a sense of normalcy, but knowing where to start can make all the difference.

First and foremost, understanding your body’s readiness to resume running is crucial. Jumping back into high-impact activities too soon can lead to injuries and setbacks. It’s essential to listen to your body and get the go-ahead from your healthcare provider. Once you have the green light, creating a tailored running plan will help you ease back into the sport safely and effectively.

Assessing Your Readiness for Running Post-Baby

Before lacing up your running shoes, it’s important to assess your body’s readiness. Your body has gone through significant changes during pregnancy and childbirth, so rushing into running can lead to injuries. Here are some key steps to determine if you are ready:

1. Consult Your Healthcare Provider: Your doctor or midwife needs to give you the all-clear before you start running. They will assess your overall health and advice you on any post-birth complications you may have had.

2. Check Your Pelvic Floor: Your pelvic floor muscles play a crucial role in supporting your organs and maintaining bladder control. Weak pelvic floor muscles can lead to discomfort and even injuries when running. Having an assessment done by a pelvic floor physical therapist is the best way to find out how your pelvic floor is doing postpartum. 

3. Perform a Self-Assessment: Start with simple activities like walking, bodyweight squats, and light stretching. Pay attention to any pain or discomfort, especially in your lower abdomen, pelvic area, or lower back. If you feel strong and pain-free, you may be ready to progress to running.

4. Evaluate Your Energy Levels: New motherhood can be exhausting. Ensure you have enough energy to take on a running routine. If you find yourself overly tired or lacking sleep, it might be best to focus on replenishing nutrients and prioritizing rest before you begin running again.

Taking these steps will help ensure that your body is ready and that you can return to running safely and comfortably.

Building a Safe and Effective Postpartum Running Plan

Once you’ve determined that your body is ready, it’s time to develop a postpartum running plan. Having a structured plan will help you gradually build your strength and endurance while minimizing the risk of injury.

Start Slow: Begin with brisk walking before transitioning to running. Walking helps condition your body and prepares your joints and muscles for the impact of running. Aim for 20-30 minutes of walking, a few times a week.

Build Hip Strength: Rebuilding strength in your hips and buttock muscles will keep your pelvis stable while you’re running. Rushing back into running without first addressing strength deficits can lead to injuries. 

Interval Training: When you start running, use intervals to ease into it. Alternate between walking and running. For example, run for one minute, then walk for two minutes. Gradually increase the running intervals as you build stamina.

Listen to Your Body: Your body will tell you if you’re doing too much. Pay attention to any discomfort or pain, and don’t push through it. It’s okay to slow down or rest as needed.

Set Realistic Goals: Set achievable goals to keep yourself motivated. Whether it’s running for a certain number of minutes or completing your first mile, celebrating small milestones can keep you on track.

Schedule Rest Days: Your body needs time to recover, especially after childbirth. Incorporate rest days into your plan to allow your muscles to heal and rebuild.

Stay Consistent: Consistency is key to building your running endurance. Stick to your plan as closely as you can, but be flexible and adjust as necessary based on how you feel.

With a safe and well-thought-out plan, you’ll be on your way to enjoying the benefits of running again.

Strengthening Exercises to Support Your Running Routine

Strengthening exercises play a vital role in supporting your running routine, especially post-baby. These exercises help build muscle, improve stability, and prevent injuries. Here are some effective exercises:

1. Pelvic Floor Exercises: Strengthening your pelvic floor is crucial. Practice Kegels by tightening your pelvic muscles as if you’re stopping urine flow. Hold for a few seconds, then relax. Repeat several times a day.

2. Core Strengthening: Your core helps support your entire body during running. Exercises like planks, bridges, and gentle abdominal crunches can strengthen your core without putting too much pressure on your abdomen. Start with short durations and gradually increase as you get stronger.

3. Glute Bridges: Lie on your back with your knees bent and feet flat on the floor. Lift your hips towards the ceiling, squeeze your glutes, and hold for a few seconds before lowering down. This exercise strengthens your glutes and lower back.

4. Leg Strengthening: Incorporate squats and lunges into your routine to build leg muscles. These exercises help with stability and power during running. Make sure to keep proper form and avoid overextending your knees.

5. Single Leg Strengthening: Focus on exercises that require you to maintain your balance on one leg at a time. Some examples of exercises that are single leg strengthening are lunges, split squats, and staggered deadlifts. 

6. Stretching: Don’t forget to stretch! Stretching your hamstrings, quadriceps, and calves will keep your muscles flexible and reduce the risk of injury. Focus on slow, gentle stretches that feel comfortable.

Integrating these exercises into your routine will enhance your running performance and help you return to running safely and effectively.

Common Challenges and Tips for Overcoming Them

Returning to running postpartum comes with its own set of challenges. However, knowing what to expect and how to address these challenges can make the process smoother.

1. Lack of Time: Balancing motherhood and personal fitness can be tricky. Try to incorporate running into your daily routine, even if it means shorter runs. Running with a jogging stroller can also be a great way to exercise while spending time with your baby.

2. Fatigue: Postpartum fatigue is common. Listen to your body and rest when needed. Ensure you’re getting enough sleep and nourishing your body with healthy food to fuel your runs.

3. Bladder Control Issues: Some women experience bladder leaks while running. Strengthening your pelvic floor with exercises before you begin running can help prevent this from happening. 

4. Finding Motivation: Staying motivated can be a challenge. Set small, achievable goals and celebrate your progress. Joining a postpartum running group can provide support and encouragement from other moms.

5. Physical Discomfort: If you experience any pain or discomfort while running, slow down or take a break. Pain is a signal from your body that something might be wrong. Consulting with a physical therapist can help address any underlying issues.

6. Regaining Strength and Endurance: It takes time to rebuild strength and endurance. Be patient with yourself and focus on gradual progress. Consistency is key, and over time, you’ll notice improvements.

Facing these challenges with determination and the right strategies will help you successfully return to running.

Conclusion

Returning to running post-baby is a journey that requires patience, preparation, and self-care. Assessing your readiness ensures you don’t rush into the activity prematurely, while a structured running plan helps you ease back into it safely. Strengthening exercises support your running routine and help prevent injuries. Overcoming common challenges with practical tips keeps you motivated and on track.

Remember, every woman’s postpartum journey is unique, so it’s important to listen to your body and adjust your routine as needed. For more guidance and support on postpartum care plans, contact Mamas & Misses Physical Therapy. We offer specialized programs to help you return to running and build a healthier, stronger you.

Holistic Ways to Boost Pelvic Health

Pelvic health is an important aspect of overall well-being that often goes overlooked. Your pelvic floor muscles support organs like the bladder, uterus, and rectum. Taking care of these muscles can improve your quality of life, from enhancing bladder control to easing childbirth and recovery.

Understanding the significance of pelvic health is key to recognizing how it affects various aspects of daily life. Weak pelvic muscles can lead to discomfort, pain, and even issues like incontinence. Boosting pelvic health isn’t just about avoiding problems; it’s about building a strong foundation for physical wellness.

In this guide, we’ll explore holistic approaches to boosting your pelvic health. From diet and nutrition tips to effective exercises and lifestyle changes, you’ll find practical advice to strengthen your pelvic area. These holistic methods can be easily integrated into your daily routine, helping you achieve better pelvic health and overall well-being.

Understanding Pelvic Health: Why It Matters

Pelvic health is essential for many aspects of a woman’s life. The pelvic floor is a group of muscles that support your bladder, uterus, and rectum. These muscles help control when you go to the bathroom and even play a role in sexual function. When strong and healthy, your pelvic floor can prevent problems like incontinence and pelvic organ prolapse.

A weak pelvic floor can lead to various issues, making daily activities uncomfortable and sometimes painful. Many women experience these problems after childbirth due to the strain on the pelvic muscles. Poor pelvic health can also affect your posture and lower back, as the muscles support the spine and abdomen.

Maintaining strong pelvic floor muscles improves your overall well-being. It can make physical activities like running and lifting easier and prevent injuries. Knowing the importance of pelvic health helps you understand why it’s worth taking steps to strengthen these crucial muscles.

Diet and Nutrition Tips for a Stronger Pelvic Floor

Eating the right foods can significantly impact your pelvic health. Diet plays a vital role in keeping your pelvic floor muscles strong and avoiding issues like constipation, which can strain these muscles.

1. Fiber-Rich Foods: Adding more fiber to your diet helps you avoid constipation. Foods like fruits, vegetables, whole grains, and legumes are great sources of fiber. Aim to include a variety of these foods daily.

2. Hydration: Drinking enough water keeps your digestive system moving smoothly. Staying hydrated prevents hard stools and reduces the strain during bowel movements. Aim to drink at least 8 glasses of water a day.

3. Proteins: Proteins are the building blocks of muscle. Include proteins in your diet, such as chicken, fish, beans, venison, grass-fed beef and nuts, to support muscle repair and growth.

4. Healthy Fats: Omega-3 fatty acids, found in fish, flaxseed, and walnuts, help reduce inflammation and support muscle function. Try to incorporate these healthy fats into your meals.

5. Avoiding Irritants: Some foods and drinks can irritate the bladder, making pelvic health issues worse. Limit your intake of caffeine, spicy foods, and alcohol to keep your pelvic floor muscles functioning well.

By focusing on a balanced diet rich in fiber, lean proteins, and healthy fats while staying well-hydrated, you can nourish your pelvic floor muscles and keep them strong and healthy.

Exercises and Practices for Pelvic Wellness

Regular exercise is essential for a strong pelvic floor. Incorporating specific exercises into your daily routine can help you build and maintain healthy pelvic muscles.

1. Kegels: These are the most well-known exercises for the pelvic floor. To do Kegels, tighten your pelvic muscles as if you’re stopping the flow of urine. Hold for a few seconds, then fully release and lengthen your muscles. Repeat this exercise several times a day to build strength.

2. Squats: Squats are excellent for pelvic health. Stand with your feet shoulder-width apart, lower your body as if sitting back into a chair, then slowly rise back up. This strengthens your glutes and pelvic muscles.

3. Bridge Pose: Lie on your back with your knees bent and feet flat on the floor. Lift your hips towards the ceiling as you contract your pelvic floor muscles and hold for a few seconds before lowering down. This exercise strengthens the pelvic floor and lower back.

4. Yoga and Pilates: These practices focus on core strength and flexibility, which can benefit your pelvic floor. Poses and movements that involve pelvic tilts and core strengthening are particularly helpful.

Making exercises a regular part of your routine will promote pelvic wellness and prevent issues related to weak pelvic muscles. Consistency is key to seeing results and maintaining muscle strength.

Lifestyle Changes to Support Pelvic Health

Certain lifestyle changes can go a long way in supporting and maintaining good pelvic health. These changes are easy to incorporate and make a big difference.

1. Maintain a Healthy Weight: Excess weight puts pressure on your pelvic floor muscles. Aim to maintain a healthy weight through balanced eating and regular exercise to reduce this strain.

2. Avoid Heavy Lifting: Lifting heavy objects can strain your pelvic muscles. If lifting is necessary, use proper techniques, like bending your knees and keeping your back straight, to minimize the risk of injury.

3. Quit Smoking: Smoking can cause chronic coughing, which strains your pelvic muscles. Quitting smoking improves your overall health, including your pelvic health.

4. Manage Constipation: Avoiding constipation reduces the strain on your pelvic floor during bowel movements. Incorporate high-fiber foods into your diet and stay hydrated to keep your digestive system moving smoothly.

5. Stay Active: Regular physical activity helps maintain muscle tone and overall health. Choose activities that you enjoy and can stick with, like walking, swimming, or cycling.

Making these lifestyle changes will help you support your pelvic health and prevent issues that can arise from weak pelvic muscles.

Conclusion

Taking care of your pelvic health is important for your overall well-being. Understanding why pelvic health matters helps you recognize the need for a strong pelvic floor. A balanced diet rich in fiber, lean proteins, and healthy fats supports your pelvic muscles. Regular exercises like Kegels, squats, and bridge poses strengthen these muscles. Making lifestyle changes such as maintaining a healthy weight, avoiding heavy lifting, and staying active can further enhance your pelvic health.

By incorporating these holistic approaches into your daily life, you can promote and maintain a healthy pelvic floor. Strong pelvic muscles benefit many aspects of your health, from bladder control to physical activities and even childbirth recovery.

If you need more guidance and support on your journey to better pelvic health, get in touch with our pelvic floor physical therapists at Mamas & Misses. Our holistic education and tools can help you decrease pelvic floor pain, optimize bowel and bladder function, and improve overall wellness.