Many of us have a PCP and perhaps a chiropractor and favorite massage therapist. Some of us have just a PCP we see for check ups or for when something goes wrong. Optimally, our healthcare team should be fluid and change somewhat as our emotional and physical needs change. NO matter what, we should feel like the members of our team are TRULY listening to our words and working their best to help us navigate the path to attain or maintain optimal health. We should NEVER keep a team member when it just doesn't feel like they truly hear you. The world is still working to hear and value our intuition with respect to knowing what our body needs. We have become so disconnected from our body's that it can be difficulty to value what we innately know we need. But, you should value your intuition. It may be that a healthcare practitioner steers you in a different direction, but, they should explain their reasoning.
Our teams may all be comprised of different people. The massage therapist that is best for you may not be best for your best friend. That is ok. Keep your ears open to the options and share that information with your friends and family when they need to add a new clinician to their team. Your own healthcare team may and should evolve as your health changes. Remember that every healthcare team member should be giving you homework and/or educating you about your body. Are you gaining knowledge and insight on how to improve and maintain your own health. Are you being shown the path necessary to take charge of your health? You are the strength in your healthcare web. The clinicians are just the support system. They are there to support you and guide you not to do the work for you.
At Newburyport Wellness, LLC, it is my goal to hear you clearly and work to teach you how to be a stronger, have less pain and achieve your fitness goals. Using manual therapy, exercise and education my number 1 hope is that you complete your therapy knowing your body better- knowing how to care for the imbalances (Yes, we all have them!) and to lead your best physical life. While physical therapy is my background, my goal is to help people avoid frank injuries and remain healthy and happy!
Just like a spider web, you are unique, resilient and strong. The branches you see supporting the web can come and go, but the true strength is in the web you weave.
Fall Is A Time To Nurture Ourselves and Our Children
I love fall for the bountiful garden crops, fresh food and crisp fall air. It seems so natural to nourish our bodies with good food throughout the summer and fall. It is also a time to take stock of where your body is physically. Most of us have small aches and pains that we ignore or push off, thinking it will go away. Every time the season’s change it can serve as a reminder to ourselves to reassess our body and think about what is working well and what maybe needs to be addressed.
As we begin this fall, take the time to ask yourself a few questions about your own health.
While every ache and pain or mini injury isn’t a reason for huge concern, if you find yourself making excuses for recurrent aches, pains or alterations in your body habits, it is time to listen.
If You Think You Don’t Have Time For Self Care, Here Is Why Your Should Make The Time
Let’s face it… The American Way is to work and give…. Never ask for help unless it is an emergency. Take care of everyone else first… This is not a healthy habit and it is surely one we don’t wish for our children. Be the model of change for your lovely children! I think we would all agree there are only a small percentage of people who are connected with their body well and listen to it’s signals for rest, proper nutrition, exercise and medical intervention. We should want all of these things for our children. We have to lead by example. If you are a new mom, take it from a veteran mom, ask for help when you need it. No one can do it all well alone!
How To Teach Our Kids To Be Good Guardians Of Their Body
Ok, I have hit my limit of frustration, aggravation and down right anger!! So for those of you who know me you know that is so not my normal state! I was visiting my mother on Memorial Day. She has a coupon obsession, where my sister and I have to go through a pile of coupons whether or not we will actually ever remember to use them. I was flipping through these endless pages and came across an add for incontinence underwear (I won’t mention the name of the company). There were four women leaning on each other, holding hands and smiling as if t he world was perfect. All had on shirts, all were different sizes and even different ethnicities. So far so good, right? They were all beautiful and literally aged 20’s-30’s. Well, here’s where things go South (literally)!!!! They were all wearing beige incontinence briefs!
How can requiring a full pull up by the age of 20-35 be accepted as the norm? Now, my own father had a birth defect that impacted his ability to know when he had to go to the bathroom, so by all means I am sensitive to the reality that there are many that have trauma and birth defects that necessitate this protection. However, this is clearly not the only market that this company is targeting. It is just another example of how the problems women face are marginalized and normalized by adds like this. NO! It is not sexy and cool to pee down to your shoes when you sneeze or run just because you had 2 kids. Many women have dysfunction WITHOUT having the trauma of birthing children. This is not ok! Women need to know that the first line of defense is NOT a sanitary product or full on incontinence pad/underwear! Dearest women of the world! Stand up and take charge! Own your body and BE PROACTIVE! We don’t wait for cavities, we brush our teeth and try to floss. Don’t wait for incontinence or assume that your sporadic leaking will always stay as such. Learn what you need to do for your body today. Everyone is a bit different. And, studies show that just having your MD say, “Do your Kegels” is not sufficient. Early intervention can do nothing but improve the odds that you won’t be the one of the over 15 million women to experience stress incontinence in the US. Studies show that women wait over 6 years to seek help once they start experiencing episodes of incontinence. Why wait? The one thing I can assure you is that nothing stays the same. What is a little incontinence now, will be more sooner or later. It negatively impacts quality of life. Don’t let the adds fool you! Incontinence is common but not a normal consequence of having kids or aging!
The American College of Obstetrics and Gynecology just announced guidelines to expand the time frame in which women will receive medical oversight during the post partum months. They also gave heed to the value in the tradition of caring for women for 30-40 days post partum. There is an overall recognition that the mental and physical demand of pregnancy, giving birth and caring for newborns requires this added support.
The medical field is beginning to recognize that women undergo tremendous emotional, physical and mental fatigue growing, delivering and caring for a child. This is fantastic! Now, we as women need to reframe our own expectations when it comes to recovering from childbirth. We have been taught for years that we should be as independent as possible. And, for so many years, women have been marginalized in healthcare. Not only are studies for medicine based on men, but, women’s complaints are often discounted by our medical professionals (PS- this is the framework in which we were taught and I often think it is absolutely un-intentional). This has taught many of us to keep our concerns to ourselves and march forward regardless of what our body is telling us. Social Media tells us we should look perfect during pregnancy and right after giving birth. We are supposed to be all smiles and health. How do we reframe our expectations given this systemic dysfunction in the state of Women’s Health?
I have treated so many women who were frustrated and depressed that their body had “failed” them when they were not fully healed at 6 weeks post partum. I myself was one. The truth s we have a long way to go. We need new systems in place to educate and support moms to be and new moms. For now, I hope that if you are reading this you share it with a young woman you love.
Pregnancy is a physically demanding job that lasts 9 months. The changes in your body begin before you can see them. Your pelvic floor, back and abdominals are under strain for months. Tearing or C section scars are wounds that go beyond the external stitches you see. It requires time and appropriate care to heal optimally. And even if you don’t have scars as a visual reminder, the act of childbirth is intense and exhausting. Your entire body is under strain. This is just the physical change. Emotionally, we are now overwhelmed with the responsibility of caring for a new life. The life shift is something no one can prepare you for. This is said to help you realize the magnitude of work your body has done, not to scare you. It is said with the wisdom of hindsight and scientific analysis. Because we come to this earth with a unique body, our path to recovery will be unique too.
The future of postpartum care will be defined by individual assessment and support that is mom-specific. Yes, we will share many commonalities, but, it is my view that physical recovery can not be tracked to medical pathways. We each deserve no less than a full assessment to determine where our body compensated for the demand of pregnancy and where our body needs the most support to begin the process of recovery. Remember that problems can arise long after an injury (think that old ankle sprain that still bugs you once in a while). We are raising future moms and dads. We need to teach them that self care is critical to a long and happy life. Take the time even if it feels like you don’t have it to at least breathe. If you can reach out to a healthcare professional with questions. Those of us in this profession are here to help. I always take calls and questions to help guide women. If you feel like you are not being heard, move on to someone who will listen and guide you.
To move towards more complete healthcare for women, we ourselves need to value it and demand more complete care. We need to value the notion of true recovery versus looking good and we must learn to be gracious with our bodies during this time.
With love and gratitude for all you do everyday!
Why You Might Need a Tune Up?
Nobody skates through life without injury. Injuries typically heal but often leave us with altered movement patterns that leave us at risk of injury. Do you ever wonder why it is that friends and family say they made it to 40 or 50 and then they started to fall apart? That is because all of those injuries that “healed” without incident, really left the body weakened. The human body compensates well for injuries. In the process of making up for a weakened area, other muscles strain to pick up the slack. This leaves the body at risk of new injuries.
The Fit Guy Who Had No Inner Core....
Take my good friend, a personal trainer. He works out with weights, does cardio and looks super fit. And yet, about every 6 months, he throws out his back. One day he made his way to my office and it was easy to tell that his big, MOVER MUSCLES were strong, but, his inner core of stabilizer muscles were not working well together to stabilize his spine. I watched as he lifted his leg and his entire spine contorted under the strain of lifting his leg against gravity. We in the fitness industry are great at training Mover Muscles, but, we really fall behind when it comes to training inner core. Activating your inner core appropriately takes more than activating your Transverse Abs. It means training your system to work efficiently and synergistically.
A Tune Up identifies your areas of strength and weakness. It gives you a step by step plan to attack those areas of weakness. A Tune Up gives you insight to your most important asset.. YOU!
TIPS FOR WHEN YOU NEED A TUNE UP:
1. HAVE YOU HAD A SIGNIFICANT INJURY IN THE PAST?
2. HAVE YOU SPRAINED AN ANKLE? (A SPRAINED ANKLE CAN IMPACT YOUR PELVIS AND CORE, BUT THAT IS RARELY ADDRESSED IN THERAPY.)
3. DO YOU HAVE INTERMITTENT OR CHRONIC PAIN IN ONE OR MORE AREAS OF YOUR BODY?
4. HAVE YOU RECENTLY HAD AN ACHE OR PAIN THAT CAME AND WENT A WAY BUT WITHIN A MONTH OR TWO, ANOTHER STARTED?
5. DO YOU SIT FOR LONG PERIODS DURING THE DAY?
6. ARE YOU A WEEKEND WARRIOR?
TIPS TO MAINTAIN HEALTH IN 2018
1. THE OBVIOUS: DRINK PLENTY OF WATER (THE HARDEST FOR ME!). BREAK IT UP THROUGHOUT THE DAY. ESPECIALLY FOR THOSE WITH INCONTINENCE, IT CAN BE DISASTROUS TO DRINK ALL OF YOUR FLUIDS AT NIGHT.
2. BREATHE: FOCUSING ON A PROPER BREATH HELPS TO TURN ON YOUR INNER CORE CONTROL ACTIVATION SYSTEM PROPERLY.
3. DON’T GIVE UP ON POSTURE! PROPER POSTURE ENABLES YOUR INNER CORE TO ACTIVATE OPTIMALLY. IT ALLOWS FOR OPTIMAL DISTRIBUTION OF THE PRESSURE OF GRAVITY THROUGHOUT YOUR BODY AND SETS YOU UP FOR A BETTER BREATH.
4. GET TO KNOW YOUR PELVIC FLOOR. CAN YOU DO A PELVIC FLOOR LIFT (KEGEL)? DO YOU FEEL THE FRONT MUSCLES OR BACK MUSCLES OF YOUR PELVIC FLOOR MUSCLES ACTIVATE? IF YOU FEEL THE BACK OF YOUR PELVIC FLOOR MUSCLES ACTIVATE YOU NEED TO WORK ON POSTURE FOR SURE!
5. SLEEP. MOST OF US HAVE HEARD THAT WE NEED TO SLEEP MORE AND MANY OF US, (INCLUDING MY SELF) MAINTAIN THAT THERE IS NO WAY TO FIT IN MORE SLEEP. BARRING THOSE OF YOU WITH TINY ONES WHO ARE SUPER UNPREDICTABLE IN THEIR SLEEP PATTERN, I OFFER THE FOLLOWING CHALLENGE… IF YOU ARE NOT SLEEPING THE RECOMMENDED 7-8 HOURS, TRY JUST ADDING 30 MINUTES TO YOUR SLEEP TIME. A SLIGHT INCREASE IN SLEEP TIME IS BETTER THAN NONE!
6. SET ASIDE TIME FOR YOURSELF. WE ARE CONDITIONED TO GIVE AND OFTEN FEEL BADLY ABOUT TAKING TIME FOR OURSELVES. WE NEED TO TEACH OUR KIDS THAT SELF CARE IS IMPORTANT. TAKE THE TIME TO MEDITATE, EXERCISE OR WHATEVER FILLS YOUR SOUL!
WISHING YOU ALL A GREAT END TO THE HOLIDAY SEASON AND A GREAT START TO 2018!
Most of us are told we can return to abdominal exercise at 6 weeks post partum. That is the common rule of thumb in the US. However, as a physical therapist and mom of 2, I get a twitch in my brain when I think about this. Let’s pretend you had ACL surgery. Are you allowed to return to Olympic lifts and tennis at 6 weeks? Rotator cuff surgery? Do you get to bench press the minute you have healed 6 weeks? NO! Why then do we get cleared to exercise our abdominals and pelvic floor without limitation at 6 weeks post partum? Recovery from childbirth is NOT the same for all of us. The injuries vary and, therefore, so does the recovery.
Here are the facts:
So What Does This Mean?
The reality is that we don’t have all of the answers proven in science yet. But, I will break it down from a science based perspective:
A vaginal delivery does not impose a frank tear to the abdominal musculature but it may result in a frank tear of the perineal tissue. The pelvic floor is an integral part of the inner core (transverse abdominals, multifidous back muscles, diaphragm, and pelvic floor muscles). The inner core must function well for optimal long term physical health. Nevertheless, our abdominal muscles have been stretched out past their optimal length for contraction throughout much of pregnancy. A
C-section results in a frank breach of the abdominal wall.
When we partake in traditional abdominal exercises like crunches, we are bearing down on the abdominal organs and asking your abdominals to lift your upper body. When we are jumping, we are asking the pelvic floor to absorb shock and support our organs. Asking your abs to contract at a high level exercise like a crunch or a burpee is asking a lot of your muscles. In 17 years of doing orthopedic PT, I have never treated someone post operatively that was allowed to do any strength exercise they wanted at 6 weeks post operatively. Injured tissue repairs best with guided and progressive increases in load. Why then are women cleared to one of the most demanding abdominal wall exercises at 6 weeks post partum?
Not all women will experience negative effects if they return to a high level of exercise once cleared. It depends on previous level of fitness, birth trauma and collagen make up. Many women do, however,experience back pain, hip pain, knee pain or incontinence. This may very well be the caused by dysfunctional activation of the inner core and weakness of outer abdominal muscles resulting in poor form and muscle activation patterns with activity. If you have symptoms (even if you had your kids years ago), I implore you to reach out and explore the possibility of inner core dysfunction. If you are a new mom, I urge you to resume workouts thoughtfully!
So I have been missing my runs lately. Kids are crazy busy with sports and squeezing in a run is hard. I am missingthe days when I could throw my daughter in the jogging stroller and go. As I watch moms run with their jogging strollers I am filled with jealousy. The feeling of a super hard workout pushing my kid, her 50 pounds of snacks and the stroller.The subsequent freedom of running when I could run without a stroller. I felt faster and a bit stronger. And then….
I suddenly see the list of side effects that jogging with a stroller can create. When you walk, jog or run a lot with a jogging stroller, you are drastically changing the mechanics of how you move. Normally when you walk or run, yourtorso rotates to help balance the rotation of your pelvis with each stride. Rotation of the torso allows for your abdominal wall to freely expand on inhalation and recoil on exhalation. A slight pitch forward of your body helps with propulsion. When you use a jogging stroller you eliminate the slight pitch forward, torso rotation and a true freedom of breath. I watch people either hunched forward pushing the beast of an object in front of them or almost overly upright. Whether you hold the stroller with one arm (or two), you are eliminating the normal trunk and pelvic rotation that occurs with running. Because you are pushing, your abdominal muscles are likely to be actively stabilizing the entire time. Well at least that is a plus, right? Well, not so much. When your abdominal muscles are on overdrive during a run, it is changing the way the body is creating and distributing internal pressure. Hello back pain or pelvic floor dysfunction! Hello altered mechanics when you walk or run without a stroller. And to really fast forward, a lack of trunk rotation is correlated with an increased risk of falls as we age!
So now what?! This is how our generation has and continues to survive the early years of our children’s lives. Clearly giving up running or the jogger is a no go. However, how great would it be if you could really learn how your body should move so that when you aren’t pushing a stroller, you can revert to the pre-jogging stroller way of moving? How great would it be if you had all of the information necessary to make the best choice for your body?
As I write this I want to assure you that you don’t need to give up running with your jogging stroller. Please, if you need the stroller to get out and move, do so. Many of us need it for sanity's sake as much as physical wellness. I write this to educate about the plusses and minuses of the jogging stroller. I write this to educate. Knowing how your body works and why dysfunction occurs is powerful information.
When you can, run without the stroller and be aware of how your body is moving. Pumping your arms is not the same as rotating your torso. When you are using the stroller, be sure to try and allow your belly to expand when you inhale. Be aware of back pain, incontinence or hip pain. Don’t wait to address it! The longer a problem exists, the longer it can take to remedy the situation!
As we finally embark on some good weather, go out and enjoy your runs. Keep your mechanics in mind and breathe!
Until we can run with this form , we will do the best we can!
We have all been there…. Do you remember buying your first car? The excitement, pride, and pure desire to keep it in perfect condition. I remember obsessing over the maintenance book that stated when I would need to get my car serviced. I was never late getting these ever so important tune ups!
Fast forward 10 years into my career. Endless accounts of disbelief from my clients as to why their back is “suddenly” in extreme pain instead of the occasional ache. Anger and frustration that they can no longer push through that pain to get in their usual workouts. The list is endless. From a personal stand point, I did what many moms do. I got lost in my kids and my daily 1 hour workouts diminished to biweekly or triweekly 30-45 minute events….. if I was lucky.
I get it! It is hard to carve out time for yourself and when you do, you want it to count! For many of us that means some pampering (massage, pedicure, etc) or a great workout where you REALLY sweat! However, behind those small aches and pains or subtle postural changes are a message. The message is this: “Your body is changing. It is time for a tune up.” Equate this to the squeak of a car when it is time for a new belt or new brakes. “Pushing through it” means compensating and setting up faulty patterns. “Pushing through it” means you are setting yourself up for the potential of future breakdown. Nothing stays the same forever, so that small amount of pee that you leak when you sneeze will likely become a bigger problem if left unattended. The same is true for the chronic aches and pains and postural changes.
Know anyone with forward shoulders? A rounded lower spine?
There are many ways to think about a tune up. Energy rebalancing, massage or a chiropractic adjustment are two ways that people often choose to align their bodies. My approach is entirely from a functional point of view. Reset the motor plan for your body and keep that plan active with a few specific exercises. Learn the short cuts that your body wants to take to avoid areas of weakness and create a plan to keep your body strong in all the ways it needs to be to do the things you love. The truth is, our bodies are just intricate machines. Nevertheless, we expect our body to go on forever without a real tune up. Unfortunately, it just doesn’t work that way. 17 years of practice has shown me that the path to long term health means looking at the small details and creating a personalized plan of action. Think of it like this: not every tune up is the same. Sometimes you need an air filter, brakes and new tires and sometimes you just need your tires rotated. I encourage you all to think about your bodies in a new way. Don’t put things off for another day. The time to optimize your wellness is now!
Ok. So we all have heard it before. "Just do your Kegels." Well, the truth is that it's not quite that simple. Studies show that a verbal cue alone is not enough to get the right action. Let's face it, when you work out, do you think, "Ok, now let's do an exercise for my pelvic floor." Did you give your pelvic floor one half of a second of thought before injury or giving birth? We get visual feedback for most of the other muscles we use in our body; especially when exercising. (ie. Bicep curl: I watch my hand pick up the weight, and bend my elbow. I feel the weight and see my arm move. I can even see my bicep contract!) But, most of us have not watched our pelvic floor in action! There is no feedback loop to help you know that something is off because you never knew what it looked like or felt like when it was working right. So, for many of us, finding a good standing posture and actively doing a Kegel is not the magical key to incontinence prevention and pelvic floor recovery. Thinking you know where the muscles are and knowing where they are will make all the difference. Furthermore, if you don't get personalized feedback about how your body is working, how do you really know what you need? Now, there is so much more awareness about pelvic health. That is great! Some exercise classes include pelvic awareness into their regime. I have taught those classes myself! But, I have learned despite all of my efforts to describe the goal of the exercise, the feeling of contraction and even with promoting good posture first, women and girls still have a hard time achieving a great PF contraction. I have learned that more often than not, a PF contraction performed during a class or during a one on one session prior to appropriate training, quite often targets the posterior muscles of the vagina and anus. Most of us want to target the front muscles around the urethra (where you pee from)! It takes just a few minutes to identify and activate each of the ever so important components of the pelvic floor. Once you get the training you have achieve that magical connection with your pelvic floor! And the good news is, there is no internal exam needed to get started!
Is a mom of two, life long exercise enthusiast and physical therapist. She combines her two passions to promote female health and fitness.