Keep Hydrated 

Dehydration can happen due to the dry air on planes, reduced water intake due to the busyness of travel, or increase in alcohol consumption at your holiday gatherings. Water in our gut and colon keeps things moving through the system, which keeps you regular. Hydration also keeps stool softer so that you don’t have to strain when you go. 

Keep Moving 

Physical activity is great for your whole body, but it also helps keep your gut moving. Our normal exercise routines often fall by the wayside when we travel or have time off from work, but maintaining some exercise will keep your gut from slowing down. Give your digestion a jump start by taking regular walks and getting in any other workouts you can. It doesn’t need to be strenuous, just get out and move! 

Balance Your Meals 

We all love to have a big celebratory meal, but starving yourself until dinner and then overeating is hard on your digestive system. Even if you’re having a big meal later, try to have some regular healthy snacks or small meals throughout the day to keep your system moving. Eating and drinking generates movement of food through the gut, so having something every few hours spurs more gut motility and helps prevent a backup. 

DIY a Squatty Potty 

The best position to poop in resembles a squat, with knees a little higher than your hips. At home you may have a Squatty Potty, or any small stool that you can place under your feet while sitting on the toilet. When you travel, you can get creative on how to make your own. A small trash can, step stool, or small box could all work as something to put your feet up on. Getting into this position to poop will help relax your pelvic floor and ease any straining. For more information on how positioning matters for pooping, see our previous post on the topic: https://motipt.com/constipation/. 

Have a happy (and regular) holiday season! 

The post <strong>Managing Constipation Over The Holidays – Tips From a Pelvic Floor PT</strong>  appeared first on MOTI Physiotherapy.

1) Normalizing Sensation 

When we have any surgical incision that heals into a scar, the nerves surrounding that tissue get temporarily disrupted.  This can result in numbness or heightened sensitivity at the healing incision and eventual scar. Frequent touch and movement to the scar and surrounding skin will help recalibrate the sensations that these nerves feel, so that both numbness and increased sensitivity start to move back towards normal.  

2) Improving Scar Tissue Mobility 

When an incision heals, scar formation is a normal part of the process. However, sometimes when scar tissue forms it adheres to the surrounding fascia and muscles. This can result in uncomfortable pulling as anything around the scar moves. Scar tissue is naturally less flexible than our normal skin and connective tissues, so we also want to make sure that it can move as well as possible. Directly moving a scar can reduce the chance that it develops uncomfortable adhesions and is able to move well with you. 

You can think of scar mobilization as having two phases. The first phase is while the incision is not yet closed or fully healed. The second phase is after the incision is fully closed and healed. 

Phase One: The emphasis in this phase is on normalizing sensation and gently moving the skin around the healing incision. This includes lightly running your fingers over the incision and surrounding tissue and gently pulling the skin around the incision in different directions. At this stage there should be no direct pulling or movement of the incision to ensure that it is able to close and heal properly. 

Phase Two: Once the incision is fully closed and there is no scabbing left, more direct scar mobilization can begin. Using a neutral lotion or oil, you can apply direct pressure to the scar and move your fingers in multiple directions. This can be circles, up/down, and side to side movements. The more directions the scar is moved in, the more flexible it will be. When that feels comfortable you can progress to lifting the scar by lightly pinching it between your fingers and pulling it away from your abdomen. This helps make sure it is not adhering to any of the tissues below it. 

We encourage you to seek out a pelvic health physical therapist for further assistance and guidance in recovery post C section! 

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Postural Changes 

All that weight in front can pull you into a more arched position in your low back, which adds to compression of the joints and overactivity of the lower back muscles. To help counterbalance this, try tucking your tailbone underneath you periodically to unload your back and let it stretch. Perform the below exercise to work on your posture. 

Posterior Pelvic Tilt 

In standing or sitting, feel your tailbone tuck underneath you, as if you were a dog putting their tail between their legs. Hold this position for a few seconds and then release, repeating 10 times. Putting your hands on your hips can help you feel the movement of your pelvis. 

Gentle Movement 

One reason your low back can get achey is stiffness. Giving your back some gentle, rhythmic movement can help ease stiffness and move more comfortably. Perform the below exercise to practice some gentle back and pelvic movement. 

Pelvic Circles 

If you have a birth ball, sit on it with legs wide. If not, you can sit in a regular chair or stand. With your hands on your hips, slowly begin making small circles with your pelvis. Make them larger as you get more comfortable. Perform about 10 circles in one direction, and then 10 circles in the other direction. 

Unload and Stretch 

Sometimes you just need to give your back more of a break to allow the muscles to fully relax and take some pressure off of your spine. Sitting can still create some compression in your back, but using a supported stretching pose can help stretch and unload it. Perform the below exercise to give your back a break. 

Supported Child’s Pose 

Begin in a kneeling position, placing a pillow between your bottom and your heels if needed. Place a bolster or stack of pillows in front of you, with knees wide. Straddling the pillows, lay your chest down onto the bolster or stack of pillows. Leave room for your belly, placing a supportive pillow underneath it if needed. Let yourself relax into the pillows while your back elongates and stretches. 

Strengthen and Support 

The best way to alleviate back pain is preventing or minimizing it ahead of time. The more you can use the right support muscles, the less excessive strain will go into your back during pregnancy. Your abdominals will certainly stretch in pregnancy, but they can still be helpful support muscles, along with the deep muscular stabilizers in your back and your butt muscles. Keeping these muscles strong and active in pregnancy can help reduce back pain overall because you will be giving yourself better support. Perform the below exercise to work on strength and support for your back. 

Bird Dog 

Start on your hands and knees. Feel your lower belly tighten to support the weight of your belly. Slowly lift one leg and the opposite arm so that they are in line with your torso, and imagine reaching the arm and leg long. Make sure nothing moves but the arm and leg, no back arching or hips twisting. Come back to the start position and switch to the other side. If this feels too difficult, try only moving the legs, alternating between sides. This can be modified further by sliding each leg out straight behind you without lifting it. 

If persistent back pain continues in pregnancy, seek out a Women’s Health physical therapist to get an assessment and personalized plan! 

– Dr. Lindsay Brunner, PT, DPT, OCS

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Let’s start with the basics. What is your pelvic floor? The pelvic floor is a sling of muscles at the bottom of your pelvis. Their primary functions are to help you control urination/defecation and to aide in supporting your pelvis and torso. Both men and women have pelvic floor muscles to perform these functions. However, women will have a more complex use of the pelvic floor muscles if they choose to have a baby. 

Which brings us to: What does the pelvic floor need to do in childbirth? The answer may surprise you. Those of us that are aware of the pelvic floor mostly know that it is something that needs to be contracted in order to hold back urine. Many people have heard of Kegels, or pelvic floor contractions, at some point. Contraction of the pelvic floor can be helpful during pregnancy to provide additional pelvic support and help control urination in the face of increased pressure on the bladder. However, when it comes to childbirth, the pelvic floor muscles actually need to be able to relax and lengthen. Once we think about what needs to happen during birth, this starts to make a lot of sense. As the baby descends into the birth canal and begins to exit the pelvis, they must pass through the sling of pelvic floor muscles. If those muscles are tight and short or are holding on strongly, the baby will encounter an elastic wall that impedes their descent. The same holds true once the baby is beginning to exit the vaginal canal. If the pelvic floor muscles are too tight and are keeping the vaginal opening more closed and taught, then it will be harder to push the baby out and the risk of tearing at the perineum is increased. You can think of the pelvic floor as a gate at a driveway. The gate needs to be open for anything to pass through! 

So what can you do to get your pelvic floor relax in the months and weeks before birth? Below are 4 positions/exercises that can help promote pelvic floor relaxation and lengthening. 

1. Wide Leg Squat

Coming into a wide leg squat position helps open the pelvis, and gravity will naturally promote lengthening in the pelvic floor. This is best performed as a repetitive exercise instead of a position that is held. Step your feet wider then your hips, with your feet angled out slightly. Slowly lower into a squat, thinking of pushing your knees out and letting the muscles around your groin relax. Try performing 5-10 of these in a row. 

2. Supported Deep Squat

A deep squat position will further open the pelvis, and the addition of support will let you relax more completely into the position. Start facing a chair, sofa, bed, or any other sturdy object. Using your hands to support yourself on that object, lower all the way down into a deep squat with the legs wide and then rest your forearms on the object in front of you. Your arms should be supporting at least some of your weight so that you can let your hips and your pelvic floor relax. With every inhale think of letting your groin relax more. Hold the position for 1-2 minutes, or as tolerated. 

3. Supported Child’s Pose

This more fully supported position can help the pelvic floor relax even more. Kneel in front of a stack of pillows, or a firm bolster if you have one. Widen the knees to straddle the pillows, and then let your torso lay down on the pillows so that they support you from the waist up. Turn your head to one side and let the pillows fully hold your weight. With every inhale feel the muscles in between your legs relax and descend towards the ground. Hold for up to 5 minutes, or to your tolerance. 

4. Supported Butterfly Pose

This position allows for a lot of opening in the pelvis and pelvic floor, as well as the inner thigh muscles. Position yourself in a semi-reclined position, with a bolster, wedge or pillows supporting your back. Bend your knees with your feet together and then let your knees fall open wide. Place pillows under the thighs/knees as needed to ensure your legs can relax fully without discomfort. Allow the pillows to support you and breathe deeply, feeling the entire groin area relax with every inhales. Hold for up to 5 minutes, or to your tolerance. 

All of these are good options for helping practice pelvic floor relaxation and lengthening. The best strategy is to try them out and see which ones work best for you. In what positions do you feel the most comfortable and relaxed? In what positions do you feel you can relax your pelvic floor the most? These will be the best positions for you. And when it comes time for the birth, these become good options for laboring and helping the pelvis open before delivery. For further help learning how to relax the pelvic floor and prepare for birth, consult with a Women’s health/Pelvic Floor physical therapist! 

– Dr. Lindsay Brunner, PT, DPT, OCS

The post Four Positions to Help Prepare Your Pelvic Floor For Birth appeared first on MOTI Physiotherapy.

Let’s talk anatomy. Your pelvic floor is like a sling or hammock at the bottom of your pelvis. This means that important exit paths for waste, like your urethra and your rectum, need to pass through it to get to the outside. One particular muscle, called your puborectalis, plays a very important role in your bowel function. This muscle encircles itself around the rectum like a tether. When the muscle is pulled more tightly around the rectum it cinches the passageway and helps us keep fecal matter in. This is good most of the time because we certainly don’t want to have a bowel movement at the wrong time! Conversely, when we do want or need to have a bowel movement, that muscle needs to be able to relax and lengthen so that the rectum can become an easy passageway.  

So what does this mean for how we have a bowel movement? This anatomy means that the position we’re in while having a bowel movement can impact whether the puborectalis muscle is pulled taught (constricting the rectum) or allowed to lengthen (leaving the rectal passageway more open). When we’re sitting, as we are on standard Western toilets, our positioning doesn’t help us loosen the puborectalis. But if we come into a squatting position, as many Eastern countries do, the puborectalis muscle relaxes and lengthens to allow stool to pass more easily. 

 The good news is that you don’t need to throw out your current toilet! All you need to do is place your feet on a small stool in front of you to get your knees higher than your hips. Once you’ve done this you’re essentially in a squatting position and your puborectalis will be easier to relax. If you are dealing with constipation this can make bowel movements both easier and more comfortable. Managing diet, getting regular exercise, and reducing stress are also key pillars in dealing with constipation, as well as working with your doctor and a pelvic floor physical therapist on determining the underlying cause. However, understanding the mechanics of bowel movements and changing your position is one more small way to make things easier! 

– Dr. Lindsay Brunner, PT, DPT, OCS

The post Constipation & Your Pelvic Floor: Position Matters! appeared first on MOTI Physiotherapy.

Many women are scared to exercise during pregnancy, especially early on. However, unless you have been determined to be high risk by your doctor, it is not only safe but beneficial in many ways. In this post we’ll go through the benefits you can gain for yourself and baby by exercising through your pregnancy, based on research done by Dr. James Clapp and sourced from his book “Exercising Though Your Pregnancy”.  

Benefits for Mom: 

-Reduced weight gain in pregnancy and improved self-image 

Pregnant women who exercise from the beginning of their pregnancy tend to have reduced overall weight gain and decreased fat deposition. They also tend to report a better self-image throughout the pregnancy. 

-Reduction in musculoskeletal aches and pains   

The incidence of orthopedic problems during pregnancy and postpartum is decreased in women who exercise throughout their pregnancy, and they find it easier to return to exercise postpartum. 

-More likely to give birth by delivery date 

Women who maintain exercise during pregnancy are more likely to deliver in weeks 38 and 39, while women who did not exercise were more likely to deliver at week 40 or later. Exercising in pregnancy under normal low-risk conditions did not increase risk of premature birth. 

-Improves chance of delivery without complications 

Women who exercise throughout pregnancy are up to 30% more likely to have a spontaneous and uncomplicated delivery, and up to 75% less likely to need forceps delivery or C-section. 

-Reduce length of active labor 

-Women who exercise throughout pregnancy tend to have a about 1/3 shorter labor than women who don’t exercise, and have decreased rates of maternal exhaustion. 

-Improve overall training capacity after baby 

–All of the physical adaptations your body makes during pregnancy can actually make you able to perform at a higher level after baby. Your cardiovascular system becomes more efficient during pregnancy, and these changes can last for up to a year postpartum. 

Benefits for Baby: 

-Growth of the placenta is stimulated 

Women who exercised throughout their pregnancy had increased rates of growth for the placenta, which supports the baby with increased function. Exercise stimulates blood flow throughout the body, placenta included. 

-Increases baby’s ability to tolerate physical stress 

Baby’s heart rate learns to adapt to more various situations when the mother exercises, leading to better tolerance of labor and delivery as well as ease of transition out of the womb. 

-Reduces chance of Large for Gestational Age baby 

Exercise decreases fetal fat without decreasing baby’s healthy growth. This decreases the chance of having an overly large baby that is more prone to complications, such as birth injury or hypoglycemia after birth. 

-The stimuli of maternal exercise can help stimulate brain development 

Maternal exercise provides sound and vibratory stimuli that can spur development and stimulate the brain. 

The best way to exercise in pregnancy is actually to start BEFORE you get pregnant! The more fit you are going into pregnancy, the better you will be able to tolerate and maintain your exercise program. In non-complicated or high risk pregnancies, women are typically allowed to continue exercising at the same intensity as they were prior to pregnancy. You can certainly start exercising during pregnancy, but you will have to start slowly and you may not be able to reach the same intensity levels of those who already had an exercise program in place before becoming pregnant. Of course, always defer to the recommendations of your doctor. 

There are some types of exercise that should always be avoided in pregnancy: 

-Any exercise that involves potential impact to the abdomen 

-Exercise in extreme heat conditions 

-Exercise at high altitude conditions 

But what about miscarriage? This is the biggest fear most women have in the first trimester. The reality is that most miscarriages are caused by chromosomal abnormalities and are not preventable. Dr. Clapp’s research found no increased incidence of miscarriage or birth defects in exercising women. Unless you have been deemed high risk by your doctor, it is highly unlikely that exercise will cause a miscarriage in a healthy embryo. It’s hard to let go of the fear of miscarriage, but it shouldn’t stop you from continuing regular exercise. 

Exercising before, during, and after pregnancy is one of the many good things you can do for yourself and your baby. A balanced exercise program should contain aerobic exercise, strength training, and stretching. If you are uncertain of how to begin an exercise program, seek out a Women’s Health physical therapist or qualified trainer to help you set up a manageable exercise routine. 

-Dr. Lindsay Brunner, PT, DPT, OCS

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