We are excited to announce that Mark Bengtson, MPT is now taking select cases after taking the last year to mentor and build the team at North Idaho’s top-rated physical therapy clinic, Pinnacle Physical Therapy.
Twyla was challenged with neck pain and headaches following neck surgery and wasn't able to enjoy the outdoor activities she loved such as biking and running. After speaking with her doctor, she was recommended to see Pinnacle Physical Therapy in Post Falls, ID, voted Best Physical Therapist of 2019. After completing therapy with the team at Pinnacle, she now is free of headaches and neck pain. She's back to doing what she loves. This is her story.
I'm lying facedown on an exam table at a state-of-the-art running clinic in New York City, about to perform a basic exercise for professional analysis. "Okay, Katie, I'd like you to lift your right leg in the air, using your glutes," says Colleen Brough, P.T., M.S., the physical therapist who's there to check my strength and form. No problem, I think. She places her hand on my right hamstring--my achy, troublesome one--as I lift and then lower my leg back down to the table with minimal effort and an attitude of That's all? "You contracted your hamstring as well as your back," Brough says gently. "Try again, but this time, power the move with your glutes by squeezing your butt before and while doing the lift." Okay, got it. Simple enough. But it isn't. Impossible, actually. I lie there motionless, slowly coming to the realization that clenching your face doesn't help you clench your butt cheeks. Forget lifting the leg. I am entirely unable to activate my glutes, a fact Brough describes with one cruel but apt word: "Astonishing."
We are frequently asked by postpartum women, “when can I start exercising again?” Many women don’t feel confident enough to get back to exercising so they can feel like themselves again. On the other hand, we’ve noticed that some women are trying to jump back into physical activity as soon as possible. Your OB-GYN will usually give you the green light to return to exercise 6-8 weeks postpartum. Some questions to consider are: What constitutes appropriate and safe exercise? What should be your primary focus as you start back into restoring your pre-pregnancy body? What are the risks that come with returning to exercise too quickly?
Pregnancy: Typical Pelvic Posture
No matter the type of birth, pregnancy leads to a specific posture in the female body. Picture a very pregnant woman walking down the street. She is probably walking with her feet a little wider than normal, slightly toed out, and waddling with an increased sway in her back to account for the fact that she is carrying 10+ lbs directly in her abdomen. This posture will inevitably lead to increased pressure in the low back and front of hips, as well as create over lengthened inner thighs and abs.
During the postpartum period, it is important to get those muscles that were over lengthened and underused during pregnancy back on board. Your body has an increased risk of injury as you have elevated levels of relaxin hormone in your system during pregnancy and while nursing. Therefore, it is essential that you restore all the abdominal oblique and transversus abdominis muscle and and pelvis muscular support you can get! Relaxin is a hormone that helps our ligaments and tissues stretch during pregnancy and delivery. Postpartum, your body is still adapting and may be a little more hyper-flexible and loose than usual. It is important to key in on the all-important internal and external obliques and get the pelvic floor ascension muscles working effectively once again to protect your body from injury.
Beginning with the birth
The birth process is unique to every woman, so it is important to find out what exactly happened during your delivery. Some questions you should ask your doctor, nurse or doula : “Did I have an episiotomy? C-section? Did I experience tearing? How many stitches do I have?” All of this information is critical to know in order to have a full understanding of the ideal timing to get back into activity.
Where did my abs go?
Your oblique and transversus abdominis muscles were just stretched out for multiple months! In addition to that, your skin has been stretching to accommodate the growing baby. The baby pushes your internal organs back and up, which can create increased connective tissue tension through your back. You may find that re-finding and feeling your abs turn on is harder or than it was before. Yep, that is totally normal! You need to learn to find them again through re-positioning your pelvis through proper breathing and pelvic stabilization exercises. When you do, you’ll experience massive improvement in mobility and enhanced security for your pelvis, back and trunk.
*If you’re noticing severe difficulty or finding it impossible to feel and find your abs, you may be experiencing diastasis recti. You need your OB or PT team to identify that condition and will need specific help to address it.
How do I “find” my abdominals?
The easiest and most effective way to start to find your abdominal muscles is to breathe correctly. By that, we mean you need to figure out how to exhale fully, feel your front ribs move down, in and together and feel an abdominal contraction at the very end of the exhale. You will also start to feel your pelvic floor contract and lift with the full exhale. Next, while inhaling, try to maintain a little abdominal contraction allowing you to expand throughout the chest cavity and into the back, not just ballooning out your belly. A great tool to help achieve this is to use your hands crossed across your abdomen (hands on the opposite ribs), and feel yourself make that closure of your abdominal cavity and secure your back ribs and low back to the floor during the exhale. (we also use balloons to re-train abdominal function and appreciation in our clinic)
Once you’re able to properly use your abs and pelvic floor muscles to effectively stabilize your pelvis and spine, you next need to make sure you put them to work in everyday activity! Use em’ or lose em’ definitely applies! Whenever you roll over in bed or stand up from sitting or pick your precious new baby up, remember to exhale first, bring your rib cage down in the front and brace yourself to protect your recovering body. Your back, hips and SI joints will love the extra support and not feel strained and over-stressed.
Progressing your core stability postpartum:
Other vital muscles that stabilize the pelvis and trunk are your hamstrings, adductors, and gluteal muscles which have become over-lengthened and neuro-muscularly weakened during pregnancy.
It is imperative that you are specifically targeting and getting these muscles active again prior to returning to more aggressive weight bearing exercises like walking, running and plyometrics. Have realistic timelines and expectations related to your postpartum fitness. Respect that your pelvis, abdomen and body just went through a major musculoskeletal event that did some real damage to your structural integrity and stability. An upwards of 3 months of focused core strengthening, breathing, abdominal recruitment, and stability and endurance training is needed to restore your body back to the optimal position and strength to resume weight lifting, running and advanced cardio and strengthening activities.
Our doctors can guide you through the process of what the next best steps are for you to get on the road to recovery. Click below to schedule your free discovery consultation.
Stay tuned to a future Blog detailing Stage 2 of your partpartum journey to optimal back, pelvis and hip health!
As children, we tend to use both sides of our bodies much more easily compared to when we’re adults. As we age, we gradually start to favor one side of the body, forming muscular patterns as we repeatedly strengthen our dominant side. The result is that over time — when we do this over, and over, and over again — our learned muscle patterns wind up affecting our posture and how our body functions, especially how we breath and move.
The goal of postural restoration (or PR), according to Dr. Skip George, D.C, a Certified Chiropractic Sports Practitioner (CCSP), Certified Strength and Conditioning Specialist (CSCS) and Postural Restoration Certified (PRC) Practitioner, is to “improve bodily functions and perform at a higher level, both in our younger years and in our eighties or beyond. Postural restoration is really a treatment approach for all ages and abilities.”
In 2014, Dr. George was the first chiropractic doctor to become Postural Restoration Certified (PRC) with the Postural Restoration Institute® (PRI). He was also invited to join the PRI teaching faculty in 2015 and teaches a course for the institute called “Postural Respiration.”
In his opinion, the trick to postural restoration treatments is figuring out which dominant or overused muscles in the body need to be” turned off” or “inhibited”, and which muscles that are underused need to be “turned on” or “facilitated.” Addressing dysfunctional muscle patterns that are driven by the nervous system can allow someone to ultimately live a more balanced life.
Michael Cantrell, who holds a Masters in Physical Therapy and is also certified through PRI and a senior faculty member for PRI, teaches several primary and advanced courses for the faculty and mentors other faculty members. He explains that postural rehabilitation is really about gaining self-awareness regarding your own body, learning to become your own “realignment specialist.”
Read the full story here