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Solving Tight Hip Flexors Postpartum.. Beyond A Stretch

6/12/2020

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A Bit About The Hip Flexor
The hip flexor muscle complex extends from your diaphragm (breathing muscle that sits under your ribs) all the way down to your thigh bone (femur).  This long and vital muscle group is strained during pregnancy as you begin to "over arch" your back to balance out a growing belly.  This posture has several ramifications for the hip flexor and may leave you with back pain or the feeling that you need to stretch your hip flexors post baby. But, there are a few things to consider before you start your hip flexor stretches! I invite you to consider how your breath, posture and movement might be a better solution to alleviating hip flexor "tightness."
Posture To Reduce Hip Flexor Pain
When we stand in a typical upright posture the hip flexor runs straight down from the diaphragm, attaching to several vertebra of the lower back. Studies indicate that the top portions of the psoas act as stabilizers of the core.  With the spine in an over arched (extended position) for a prolonged period during pregnancy or even when holding babies, we are taking the muscle and inhibiting its ability to work in an optimal position. The upper portions of the psoas are elongated and can't work effectively as a stabilizer. In addition, it is possible that there is an increase in shear force (rubbing) on these tissues as they now have to course over the vertebra at a new angle. Of course the muscles feel tight! They are on stretch! They do not need more stretching.  The lower fibers of the hip flexor may indeed be a bit tight as they shorten slightly with back extension. This can be addressed with postural correction much more efficiently than a stretch. Its not what you do for 30" but how you move and hold yourself throughout the day that matters more!  Working on posture to avoid over arching of the spine is a critical step to reducing hip flexor tightness and back pain. 
Breathing And It's Effect On The Hip Flexors
 The diaphragm and psoas major are connectd. During pregnancy the diaphragm cannot descend it's full excursion during the last months of pregnancy. Under proper conditions the diaphragm and upper portion of the psoas move synergistically with breathing to provide support to the core. During pregnancy (or when standing with your butt clenched and back overarched), this nourishing ebb and flow of the diaphragm and it's effect on the psoas is interrupted. Focusing on reconnection of a full breath to the pelvic floor when in a variety of positions will help to re-engage this dynamic duo, restore function  and reduce pain. 
Movement To Restore Hip Flexor Activation And Reduce Back Pain
 Lastly, engaging your breath in a variety of positions to retrain the connection of the hip flexor to breath is the first step to restoring core stability to reduce back pain. Remember that you need to be strong and stable in a variety of positions and in that the psoas can be retrained to function as part of a team not as a stabilizer on its own .

Want to learn more? Check out my breathing video as step 1.  Call or email me with any questions!
Get your breathing video here!
Schedule a 20 minute complimentary discovery call here!
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Why Working From Home Might Be Exacerbating Your Urinary Urgency and Stress Incontinence

5/26/2020

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I can just imagine the joking conversations amongst friends now. How the best part of Coronavirus quarantine is that no one has to worry about getting up frequently to go to the bathroom at work. I am sure there are many extra trips being made to empty bladders "just in case!"  Leaking is also less of a worry when we are home instead of out and about. But, are you aiding and abetting a faulty pattern? What happens when we slowly return to life and need to manage away from a bathroom for more than an hour?
Signs of Bathroom Overuse...
  • Are you heading to the bathroom more than 6-8 x/day? 
  • Is your strong urine flow less than 10 seconds consistently?
  • Do you run to the bathroom just because you are heading outside to take a walk or play with your kids? 
Who Cares If You Are Overusing The Bathroom During Social Distancing?
Training your bladder to empty all of the time can be counter productive to what you are trying to avoid... Accidentally peeing. Compensating for dysfunction may be inadvertently promoting more dysfunction. By emptying your bladder when it is not full, you are training it to think it is full. This means, that when it is time to return to out of the house living, you will likely be more likely to need the bathroom on a regular basis... This is exactly what you don't want when you are out and about during a pandemic!
How Does Fluid Intake Impact Bladder Health Anyways?
We all know we are supposed to drink water, but, when you leak or experience urinary urgency, it is easy to cut down on water intake in an effort to compensate for the frequent desire to urinate. This can lead to bladder irritation  and an increased desire to pee. It can also lead to constipation. When your bowels are backed up, your belly feels full and you may misread this fullness and think your bladder is full when it is not.  Dehydration can also lead to UTI's.  Lastly, muscles need water to function well. If you have a tendency towards pelvic pain, a chronic state of dehydration may only be making things worse.
TIP 1: Drink water slowly! The tendency is to be so busy that we forget to drink. When we think of it we guzzle water your body is less able to  absorb water and we tend to expel it more rapidly. 

TIP 2: If your one of those gals who does ok all day and at bedtime, suddenly feel a frequent urge to head to the bathroom, try the above mentioned sipping of water for 2-3 hours before bed. Also, try some relaxation breathing to relax your pelvic floor muscles before heading to bed. 

Want to learn more and see if you might be a good fit for virtual PT and coaching to reduce your symptoms of urgency and leaking don't wait! Call today to set up your complimentary Discovery Call! Mention this blog for 20% off your first session!
GET MY BREATHING FOR PELVIC HEALTH VIDEO HERE!
Call Now!
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3 Foods To Boost Bone Health In The                                Postpartum Period

5/21/2020

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Bone density takes a dip during pregnancy and during nursing. However, it is rarely mentioned as an issue because studies show that by and large it returns to baseline when you are done nursing. But, because so many women eventually suffer from osteoperosis, I'd like to present the case that we should consider the importance of optimizing bone nutrition and health during this stage of life. 

WHY BONE NUTRITION AND HEALTH MATTERS POSTPARTUM
1. Women are having babies later in life. That means less time to come back to baseline and regroup with regards to your health prior to the onset of perimenopause and menopause. 

2. Women stop building more bone density by their early 20's at the latest.  

3. Women often take hormonal birth control in their younger years and this may negatively impact bone health during the prime of their lives!

4. By 50 years of age, bone breakdown can begin to exceed bone repair.

5. The older you are when you get your period the more likely you are to get osteoperosis

SOME BASIC STATS
16% of women in their 40's have osteopenia (the stage before the diagnosis of                          osteoperosis)         
14% of women 50-59 years old suffer from osteoperosis
22% of women 60-69 years old suffer from osteoperosis
39% of women 70-79  years old suffer from osteoperosis
70% of women 80 + years old suffer from osteoperosis. 
SO WHAT CAN YOU EAT TO SUPPORT BONE HEALTH DURING THE POSTPARTUM PERIOD?
SALMON-  570 IU's of  vitamin D (super necessary for bone health!)
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CHIA SEEDS- 1 serving has 4 grams of protien and 18% of Calcium RDI in one serving!
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 White Beans 1 cup contains 13% of your calcium RDI! 
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Want some recipes? 
If you are not a fish eater due to consistency, try grilling your salmon to get a more firm consistency.  Not sure of a chia seed recipe or don't like the consistency? Email me for 3 ways to add chia seeds to your diet. If you don't like the consistency, try blending it first to make it less like tapioca. Personally I love ginger pear chia seed pudding for a snack (chopped ginger to taste, 1/2 diced pear, 3 TBS chia seeds and 1/2 cup vegetarian milk, cinnamon to taste and a dash of maple syrup if you want some extra sweetness)!  White bean soup is just one option for beans! My kids like turning white beans into a dip like hummus and even a "cookie dough" dip!  Get creative and try something new! If cooking and exploring food is not your forte and you really want to shift your health and wellness in the postpartum period, start thinking about a coach! Call today and we can talk about what you are looking for! 
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Mother's Day During Covid-19

5/8/2020

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Happy Mother's Day to all of the caretakers of the world.  Whether mother by birth or mother by your role as leader, mentor or caretaker, my gratitude and great love goes to you all. Right now during Covid-19, women all over the world are holding up so many. We hold up our children, parents, in-laws, neighbors and more.  We have worried for our loved ones and for those we don't know. Covid-19 has called upon us all to stretch in ways we never imagined. But who is holding you up? Who holds up the one who holds up so many? Is a workout enough to check the box of selfcare? I would like to propose that we move beyond the response of "as good as can be expected."

I want you all to know that I am thinking of you and energetically stand here in my home holding up and sending energy of replenishment and gratitude to all of you.  When so many define self care as hair care, massages, and brunch with extended family on Mother's Day, I can only imagine that it will be a challenge for many to redefine a successful Mother's Day. I invite you to consider the gift of giving yourself some time to quietly listen to your body. Covid-19 has presented as difficult for many who stay so busy that there is no time for quiet introspection. For many, sitting quietly and truly listening to our innermost goals, body signals and dreams can be daunting. My beloved caretakers of the world, the gift of Covid-19 can be that we finally take the time to reconnect with the purity and simplicity of what is important. Health, happiness, connectedness to family. 

Many of us have considered ourselves healthy and partaking in self care if we exercise and eat relatively well.  We often ignore or truly do not even notice some areas of dysfunction that may not yet impact our daily life. We might stay on the treadmill of overworking and overextending because it is what we all do. It is so hard for most of us to live in alignment with our innermost passion and sense of connectedness with self.  Maybe in today's world it isn't even totally possible. 

But FOR THIS MOTHER'S DAY, I invite you to take a moment and ground yourself in the idea that you have received an invitation to find happiness, connectedness and health in a simpler, more authentic journey. Slow down and listen to your body. Connect with your intuition and draw strength from the infinite energy of earth. This connectedness with yourself and with Earth can fill you when you need to draw on extra energy while supporting others. It will allow you to connect with your own body to truly hear the messages of what it needs. True self care is in listening to the messages of your body and responding to them to achieve long term health.  At Newburyport Wellness we support this shift to inner wisdom and self action towards complete health.  Mention this blog to receive 50% off a 12 session coaching package or a Complimentary Telehealth physical therapy consultation to begin the journey of self empowered healing!  Happy Mother's Day!  Offer expires 5.15.20. Email and your spot will be reserved. Only 10 spaces for 50% off available.
darcie@nbptwellness.com
Link to Mother's Day meditation: youtu.be/Akhhw9hd8gQ
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Pregnancy During The Time Of Coronavirus

4/30/2020

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Pregnancy is a time of unprecedented body change requiring new physical demands and nutritional needs.  There are emotional fluctuations and more! Quite often during pregnancy we meet other expectant women in classes and when out and about. Women often rely on acupuncture, massage, physical therapy, chiropractic care and more to manage discomfort and optimize the health of their body during this time.  Many women are torn between taking their doula or partner to the hospital and worried about negotiating everchanging hospital guidelines due to Covid 19.  Often we plan on family coming to stay with us when we first come home. Now during the time of Coronavirus the pregnant woman is forced to rethink our entire web of support. 

For many of us, the experience of living during the pandemic has been a roller coaster inciting a variety of evolving emotions and responses. Now, instead of being a sprint we have transitioned to a marathon and instead of trying to persevere this alone, we need to redefine the plan. Did you know that there are many practitioners who have successfully transitioned to telehealth sessions? I am so excited to say that as a hands on physical therapist, I have found the transition to telehealth to be amazingly transformative and empowering for my clients.  For as long as I have had my practice, I have pushed to empower women to listen to their body and now more than ever my clients and I work together to remap patterns of muscle activation in order to achieve their goals.  But, how do you redefine your web of wellness when social distancing is a must?
Redefining Your Web Of Support During Coronavirus
1. Start by contacting one trusted professional and ask them if they know of any other health professionals who are offering telehealth services. The professional you are reaching out to knows you and can recommend someone that matches your needs better than a blind recommendation. You may not need their services now, but keep their info handy!
2. If you ask friends or post on social media be sure to ask people what they like about the recommended professional. Who is great for your friend may not be the best match for you!
3. If you are not sure you need the service or if they can even help you with telehealth, call them! Ask questions and get to know them a bit over the phone! 
4. If you are planning social distancing from extended family when your baby is born, don't forget that family CAN help from afar.... They can read books, do a virtual art project, or have a virtual dance party with older children to give you some breathing room with your new baby. Maybe they can still make you food and drop it off or set up a delivery from your favorite nourishing restaurant.   
5. Most importantly, don't forget that you are NOT alone. Asking for help feels strange to many of us, but it is so important to ask because there are many people in your life looking for ways to help!
6.  JOIN THE THRIVING THROUGHOUT PREGNANCY AND BEYOND PROGRAM STARTING MAY 5TH! 
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Symphysis Pubis Dysfunction

4/7/2020

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With all of the beautiful pics that flood our minds when we think of pregnant women, not once do I imagine the face of excruciating pain getting up from a chair or the ever so painful attempt to roll over in bed.  However, 31% of pregnant women report symptoms associated with Symphysis Pubis Dysfunction (SPD).  Reports indicate those numbers could be even higher due to lack of reporting. 
Signs of SPD:
  • “shooting” pain in the symphysis pubis;
  • radiating pain into the lower abdomen, back, groin, perineum, thigh, and/or leg;
  • pain on movement, especially walking, unilateral weight bearing or hip abduction
  • pain with activities of daily living, including bending forward, standing on one leg, rising from a chair, go up or down stairs, turning in bed
  • pain relieved by rest
  • clicking, snapping or grinding heard or felt within the symphysis pubis;
  • dyspareunia (painful intercourse)
  • occasional difficulty voiding;
  • unmotivated fatigue.
Could My Pain Be Something Else?
Yes,  pain in this area can be caused by round ligament pain (stretching of the uterine ligaments that occurs during pregnancy), urinary tract infection, nerve impingement and more. 
What Causes and Exacerbates SPD?
  • Biomechanical strain to the pelvis (ie growing baby!)
  • Weakness in the core and hips (staying strong during pregnancy is key!)
  • Inadequate pressure management (Ie you are straining during daily movement and you may not even be aware!)
  • If you were "loose ligamented" prior to pregnancy, you are more at risk during pregnancy
  • Previous back or hip injury
  • Prolonged sitting or standing asymmetrically
What Can I Do To Manage My Pain
  • Proper posture, movement, breathing and lifting is the #1 best strategy for managing your symptoms. (PS- this is critical for ALL pregnant  and postpartum moms for optimal pregnancy and recovery!)9782386276
  • Avoid sleeping without a pillow between your knees
  • Don't stay in one position for too long. 
  • S-I joint stability belts can be helpful. I have found that they can be very helpful if you have a lot of walking to do. They can be uncomfortable if you are sitting and getting up frequently.
  • SI joint taping can provide support and stability and has the benefit of lasting up to 3 days! 
  • Performing some targeted exercises will help keep the right muscles working to support your pelvis
  • Of course there are chiropractors and other supportive healthcare options.  However, during this time of social distancing due to the Coronavirus I am even more amped up to promote self awareness and management.  I have been surprised by how great my Telehealth sessions have been going! Call today for a complimentary phone consult to determine if this is a good option for you!    9782386276
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Step Into Your Power

3/18/2020

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NOW IS THE TIME
Now is the time to allow your inner strength and power to shine. In a time when it can feel like we are in control of nothing, remember that you have control over the most important thing of all, YOU.  What can you do to harness your strongest inner self? 

1. Add as many herbs, onions, mushrooms, garlic, ginger and tumeric to your meals as possible!  Antimicrobial and anti-inflammatory foods will boost your immunity! 

2. Walk away from stress eating. Fuel yourself from the inside with good food! Think brain-body connection. If you are feeling IBS symptoms from stress, you need to double down on the commitment to eating well to promote digestive health.

3. Breathe! Sit outside, lay on your floor, sit comfortably in a chair and breathe deep! NOT a belly breath. A full torso breath. Not sure if you've got it? Email me and I will send you a link to my breathing video.  darcie@nbptwellness.com

4. Move. If you don't have time without kids. Have a dance party with them, play Silly Simon Says. If you can get out for a walk- Do it! 

5. If you are a list person like me, ONLY put 2-3 reasonable and measurable things on your "must accomplish list" and if you don't get to the rest, take true joy in getting those 2-3 things done. 

6. Don't give up on your health goals! Stay focused on your goals. If you were on the fence about whether you had the time or energy, recognize that the time IS now.  If we are individually strong, we are all stronger. If we are home with our little ones lead by example. This is a great time to teach healthy choices and self care.  
Call today to set up a complimentary consultation for Telehealth Physical Therapy or Coaching For Chronic Pelvic or Back Pain! 9782386276
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Winter Self Wellness Check- How Is Your   Body Moving and What Can You Do To Help                         It Stay Injury Free?

11/3/2019

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If you could increase your ability to ward off future injury and maintain health by doing 3-5 exercises per week would you? If you could minimize your risk of giving up activities that you love in the future would you? ​
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To most of us wellness means trying to eat well and exercise when we can. Many of us put our own health on hold to care for kids, work and tend to others in our lives.  To be honest, there are times when our own self care needs must take a back seat for other priorities. However, it should not be the norm.  All too often, if we have an ache or pain we wait for it to disappear. We hope that it goes away. If we have old injuries or have always had one leg that was much stronger than the other, we write them off as battle wounds or just the way we were born without giving thought to how these injuries and asymmetries may impact our future health.

There are some aches and pains that just are minor glitches in the system. Some are warning signs that something needs attention. This is particularly true with aches and pains that make a repeat appearance every so often.  It is also the same for a chronic discomfort that isn’t quite bad enough to disrupt your day to day function. You may even avoid things because you know it causes pain. Doctors will even say it- “If it hurts, don’t do it.” But, where is the question, “Why?” Why should you give up something you love? And, if you can’t do one thing now, will it lead to being unable to do more things in the future? 
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Many of these injuries that lay far off in the future can be predicted by careful assessment. At Newburyport Wellness, LLC it is my mission to help individuals fully realize the power of understanding how their body works in order to harness the best of it for life. The goal is to understand your body’s strengths and weaknesses and to learn to listen to the signals it is giving you in order to optimize long term health! This fall I invite everyone to look at health and fitness in a new light.

Self Body Scan-
  • When you squat is the weight equal between both legs? (if not, the question is why?)
  • Can you balance 30” on each leg? Does one leg work much harder to keep your balance?
  • Can you lay on the floor with legs out straight and raise your arms overhead without your ribs lifting off of the floor? (If not you are likely missing some shoulder range of motion
  • In standing, can you raise your arms overhead without your shoulders rising up?
  • Can you sneeze or do 25 jumping jacks without fear of leaking?
  • If you sit in a firm chair and sit tall, can you rotate your torso (don't move hips) equally to the left and right? 
What to Do? 
If you notice any asymmetries from the above list or you have a history of injuries, it would be great to make a call to Newburyport Wellness and talk things over.  Immediately start to consider the following: how does your finding affect your day to day function? Do you always stand with you weight on one side?  Try to become more aware of how your body is working around any of the issues you found. Now, you have to decide if these movement choices are out of habit or necessity?  Does changing your posture change your pain?  Can you change anything so that you are moving more symmetrically?  The bottom line is awareness is key! If you take a moment to really think about how your body is moving and really tune in to how it feels you will be better able to identify when you need to seek help, before the symptoms are raging and function limiting.  You are worth the few minutes of your day to tune into your body in a new way!
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Long And Short Term Potential Effects Of           Early Return To Moderate- Vigorous                          Exercise Postpartum Part 1

9/19/2019

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​There is no shortage of messages that pushes women to rush back to high level workouts ASAP postpartum. The question is, what are the risks and benefits of choosing to do so? It seems as if the story is different depending on with whom you speak and with what website you find. Finding answers about what to do and when can be exhausting. Let's talk about the Risks and Benefits of High Intensity Exercise during the early postpartum months. This blog will outline the Risks and Benefits. Part 2 will go over some tips and guidelines.

                         Photo by Charlotte Karlsen on Unsplash
 When I had my first child 10 years ago it was standard to wait 6 weeks whether you had a c section or uncomplicated vaginal delivery, and you would be magically cleared to return to your previous workouts. Recently, I have read some articles that say you can return to exercise within a few days of delivery and others that recommend the 6 week waiting period or more! It is impossible to not be confused.  The Continence Foundation of Australia recommends a slow progression of activity and full resumption of prior level of activity at 16 weeks postpartum. The ACOG (American College of Obstetricians and Gynecologists) notes that there is a variance in what is an appropriate return to exercise based on the pregnancy and delivery, but does note that some can begin exercise within days of giving birth. It recommends exercises such as lifting weights, sit ups, push ups, yoga and pilates. It also recommends Kegels. The ACOG recommends women start with simple postpartum exercises (but doesn’t list a single one or any references) and suggests a progression to moderate and vigorous exercise.  This makes it very difficult for women to make smart choices with regards to their postpartum return to exercise. The terminology- return to light exercise is vague and open to interpretation. How long should one take to progress to vigorous exercise? The timeline is variable based on several factors.
The Variables That Impact Return To Exercise Include:
  • Complications during pregnancy
  • What number birth is this for a given mom
  • What are prior injuries of mom
  • What is genetic make up of mom (ie did she have lax ligaments prior to pregnancy?)
  • Complications during labor- ie. How long did she push? Did she have a C-Section?
  • What was prior fitness level of mom
The Short & Long Term Benefits of Exercise Postpartum
There are 6 guidelines worldwide that discuss the benefits of postpartum exercise. Some benefits include:
  • Help strengthen and tone abdominal muscles (but doesn’t mention that the exercises must be done properly)
  • boost energy
  • may be useful in preventing postpartum depression
  • promote better sleep.
  • relieve stress.
  • Returning to high level exercise may load a pelvic floor for improved function (provided there is no dysfunction prior to initiating exercise
  • High Intensity exercise may increase total body strength for overall health
The Short Term Risks of Early Return to High Impact Exercise
  • Prolonged healing of injured tissue
  • Overstrain to pelvic floor, abdominal wall or back
  • Continuation of incontinence if experienced during pregnancy (50% of women experience some incontinence post baby. Don’t allow your body to potentially develop a faulty compensation pattern.)
The Long Term Risks of Early Return to High Impact Exercise
  • Pelvic floor dysfunction (painful sex, stress urinary incontinence, fecal incontinence, etc).  This can begin soon after during pregnancy, months or even years after delivery. 
  • Over stressing loose ligaments causing foot malformation, pelvic/back instability/injury, other orthopedic injury. ​
Take Home Message
There are short and long term consequences for everything and you cannot prepare for them all. We each need to take into account the long and short term benefits and risks of each choice. There is no dispute that in most cases return to light exercise (walking, proper breathing technique) is beneficial postpartum. But, when and how to progress to moderate-vigorous exercise is more complicated.
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The Impact of C-Sections on Postpartum                                   Recovery

8/1/2019

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​A c-section is major abdominal surgery.  There are protocols of rehabilitation for many major surgeries. Most orthopedic surgeries require physical therapy afterwards. 
No one would have an ACL reconstruction and wing it after surgery. Why aren’t women encouraged to seek out physical therapy post baby? 

A look at C-sections from the outside in
Scar tissue healing is a process and to heal optimally, it is imperative to address it properly. When scar tissue forms it lays down in a haphazard fashion that is mechanically inefficient in distributing forces. Massage helps to organize the tissue to heal stronger. Post ACL surgery, patients are taught how to massage the scar tissue to promote healing and prevent the scar tissue from binding down to the tissue below. Often knee and ankle surgeries get the most attention for scar tissue management as they can bind to the bone below easily. But, what about abdominal scar tissue healing or binding to lower musccular levels and/or organs? For optimal healing the scar not only needs to heal externally, but also needs to organize properly internally to help transmit forces placed on the abdomen properly. All women post c-sections should be educated on scar tissue massage.

The breach of the abdominal wall can impact breathing, and disrupt the muscle patterns of activation that support and stabilize the body during movement. If a person post ACL surgery is not out running at 6 weeks, why can a woman post c section be lead to believe she can/should run and do sit ups at 6 weeks without a conversation and evaluation by a specialist? The abdominal musculature of all  pregnant women becomes stretched and mechanically inefficient during pregnancy. Adding a c-section surgery can further the dysfunction of the abdominal wall. The inner core musculature is pain regulated, meaning the muscles can shut down with pain. While our body's are very resilient, not all abdominal muscles return to a totally optimal state of activation post pregnancy and c-section. 

Women who have had a c-section often are glad for the lack of trauma to their pelvic floor. However, if you had bowel or bladder leaking during pregnancy, pelvic pain during pregnancy or you pushed for an extensive time during labor prior to your c section it can be assumed you are at increased risk of pelvic floor dysfunction post baby. 

What Should Moms Post C Section do?

Minimally, moms should be shown how to massage the scar tissue to optimally heal the tissue superficially and reduce the risk of internal adhesions (which can continue to develop well past the scar healing externally).

Women should see a women's health PT to assess their inner core pressure management strategy post baby to ensure proper abdominal activation.

Core exercises should be started with your spine in a neutral position and be progressed according to your individual ability to activate your core muscles during exercise once medically cleared. 
​
Moms should be taught proper lifting strategies for baby right away.
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    Darcie
    Is a mom of two, life long exercise enthusiast and women's health coach & physical therapist. 

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Darcie Pervier
p. 978-238-6276
e. darcie@nbptwellness.com


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