Tag: core

Are You Breathing The Right Way? (How breath impacts our body)

Are You Breathing The Right Way? (How breath impacts our body)

Posted on by Monica

Did you know we use our muscles to breathe? I mean we don’t really have to think about using them, but our muscles are working to pull air into our lungs and push air out. Several muscle groups surrounding our chest and core are all contracting and relaxing in beautiful synchrony to allow breath in and out of our lungs. Pretty cool stuff. But sometimes we are not breathing the “right” way. We might hold our breath or take small shallow breaths without even noticing we are doing it. And these little breath changes can have big impact on our body.

Why Breathing The Right Way Matters

breathing the right way

The main muscle we use for breath is our diaphragm. The diaphragm is a dome shaped muscle that lies just below the lungs. It contracts and relaxes rhythmically, and normally subconsciously. But often, due to physical changes (such as pregnancy), posture, stress, or other factors we stop breathing deep into our diaphragm. Instead we might start chest breathing using the accessory respiratory muscles of our chest and neck. No bueno.

Breathing deep into the diaphragm helps with proper physical function, especially core stability and health. The diaphragm is one of the deep core muscles contracts and relaxes in harmony with the pelvic floor, the transverse abdominis (core), and multifidi muscles. Read my Pop Can Core post to learn how the diaphragm is connected to our other deep core muscles.

How To Breath the Right Way

how to breath the right way

Ok, so how do you make sure you are breathing the “right way”? First let’s visualize the diaphragm. Like I mentioned earlier, the diaphragm is a muscle that sits just under the lungs at the bottom of the rib cage. When we inhale the diaphragm contracts downward creating a vacuum that allows air to be pulled into the lungs. We we exhale the diaphragm relaxes and rises back up to force air out of lungs.

Unfortunately due to any of the aforementioned reasons, sometimes we stop breathing deeply into our diaphragm. Instead our breath stays “shallow” and we no longer allow the diaphragm to contract all the way down. Just like with any muscle when it’s not contracting and relaxing appropriately problems tend to arise. So let’s make sure we are fully activating our diaphragm by following this exercise below.

Diaphragmatic Breathing Exercise (belly breath):

Step 1: Lie on your back with your knees flexed and your hands on your stomach near lower ribs.

Step 2: Take a deep breath in through your nose. Feel your belly and lower ribs expand out into your hands. The diaphragm is contracting downwards.

Step 3: Slowly let the breath out through pursued lips (like you are blowing out a candle). As you blow out feel your a deep abdominal muscles (your TA) activate and your belly contracts inward. The diaphragm relaxes upward.

Repeat for 5-10 breaths.

diaphragmatic breathing

Laying down is the best way to stay relaxed and really tune into your breath and muscle activation but this can be done in any position including sitting or standing.

Benefits of Proper Breathing

There are numerous benefits to breathing the right way. Some of the main benefits include:

  1. Improves core muscle stability
  2. Improves exercise tolerance
  3. Promotes relaxation/reduces stress
  4. Lowers heart rate/blood pressure
  5. Less work of breathing
  6. Improved oxygenation to the body

Practicing Your Diaphragmatic Breathing

exercises for diaphragmatic breathing

There are several other parts of the body that dictate how you breath. Your rib mobility, posture, chest wall flexibility, and core strength can all play a roll. And when you are not breathing properly one or more of these elements may be negatively affected. Improper breathing patterns can be related to neck pain, shoulder pain, low back and incontinence.

So once you nail down the diaphragmatic breathing exercise described above try working on your belly breath during other daily activities or exercise. Some other ways to work on your breathing include:

  • Try belly breathing while sitting at your desk. Assume an upright posture and practice breathing deep into your belly. As you slowly exhale, activate your abdominal muscles.
  • Work on deep diaphragmatic breathing during core stability exercises. Blowing out is a great way to activate your deep transverse abdominis muscle.
  • Practice diaphragmatic breathing and pelvic floor contractions. As the diaphragm contracts downward on an inhale the pelvic floor also lengthens downward. During the exhale the diaphragm relaxes upwards and the pelvic floor muscles should also contract or stretch back upwards.
  • Try diaphragmatic breathing while on your hands and knees, sitting on an exercise ball, or while laying on your side. Every position will work the muscles in a slightly different way so it’s good to mix it up.

What’s Next?

Proper breath technique is one of the main building blocks for proper body function. But besides helping with your deep core activation good diaphragmatic breathing can be calming and relaxing. Personally I love some good belly breathing after a hectic day with my kids. Keep following along for more helpful hints for taking care of your body. Follow me on Instagram @movinglikeamother for quick tips and tricks.

Keep calm and breath on.

-Monica

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Bouncing Back After Baby (Why All New Moms Should Have Physical Therapy After Pregnancy)

Bouncing Back After Baby (Why All New Moms Should Have Physical Therapy After Pregnancy)

Posted on by Monica

Hi ya’ll. Some of you may know that I recently began seeking further education in the area of women’s health. I especially have a strong interest in the pregnancy and postpartum population. Since having my two babies I have realized how much change women undergo physically. It’s actually quite amazing what our bodies are capable of. But unfortunately, our postpartum bodies are not perfect. Muscle weaknesses, posture changes, and healing tissues can lead to aches, pains, and impaired function. Luckily physical therapy is available to help women after pregnancy with many of these new and unanticipated challenges.

The need for physical therapy after pregnancy

physical therapy after pregnancy

In my recent postpartum course I discovered some staggering statistics on the number of women struggling with postpartum pain or issues who are not receiving any treatment. Some of the particularly noteworthy statistics include:

Pregnancy related lumbopelvic pain persists in 25-50% of women at 3 months postpartum. And if the pain is there at 3 months postpartum, then it will most likely still be there at one year postpartum. 

Sometimes this back pain can become chronic. So what exactly does this mean? This tells us that postpartum women suffering from low back pain need therapeutic intervention. Unfortunately the pain will not just magically go away. 

What’s more, only 32% of women who have PLBP (pregnancy low back pain)  or PGP (pelvic girdle pain)  report it to their care providers. And then of those who report pain to their providers only 25% of these women get a treatment recommendation. This means a huge number of women are not getting any treatment or professional help for their physical problems after having a baby.  

Postpartum Care in Other Countries

physical therapy postpartum

So why aren’t more women in the U.S. getting physical therapy after pregnancy? I mean their body just went through a huge change, they potentially had surgery, and their physical demands just grew exponentially with a new tiny human on the scene. 

Many other countries are leaps and bounds ahead of us in their postpartum care of mothers. In France, the Netherlands, and Australia every woman is automatically given several visits with a pelvic floor physical therapist to address healing issues,  muscle imbalances, or any other concerns.  Fox News published an article addressing the vast difference between France and the U.S in their care of the postpartum women. In fact, U.S. women are the least likely to get physical therapy treatment after pregnancy (only 24%) compared to Europeans.  

Yet, of these women who do get treatment in the U.S. up to 87% reported positive effect, meaning that therapy works. Obviously. Therapy can help your body heal effectively in order to prevent chronic pain symptoms, incontinence, pain with future pregnancies, and safe return to exercise and regular activities. 

postpartum care

Common Problems Postpartum 

Below are some of the common problems women might experience postpartum.

Abdominal Separation/ Diastasis Recti 

When we are pregnant our uterus and stomachs grow as the baby grows. This new growth can place extra pressure on the linea alba which is the tissue that runs down the middle of your 6 pack abs (also known as your rectus abdominis). The added pressure on your linea alba can lead to a separation of your abdominal muscles known as a diastasis recti. A diastasis recti is diagnosed postpartum if the distance between the abs is 2 finger widths or more when measured slightly above and below the belly button, or there is insufficient muscle tension.  Around 4 weeks postpartum this separation naturally starts to come back together.

However, about 60% of women still have a diastasis recti 6 weeks after childbirth. In fact, if a diastasis recti is present at 8 weeks postpartum it will likely still be present at 1 year (Coldron, 2008) An untreated diastasis recti can contribute to low back pain, pelvic pain, urinary incontinence, and other pressure system issues in our body. 

A physical therapist would be able to assess and provide proper treatment to help heal a diastasis recti. We do not have any specific exercise program supported in the scientific literature to heal a diastasis. What matters is the quality of your exercises and movement which would be assessed by a specially trained PT.

Incontinence

For many women pregnancy and postpartum is the starting point for urinary leakage and other bladder problems. There is no “normal” amount of leakage or pee with activity. A systematic review shows that 33% of women have urinary incontinence at 3 months postpartum. At 4 years postpartum about 29% women reported incontinence. Postpartum incontinence could be from weakness, poor coordination, pelvic floor muscle endurance or from overactivity and muscle trigger points. Again a pelvic floor therapist would be able to evaluate and determine to the best specific and individualized treatment for you. 

Therapy after having a baby

Cesarean Section Scar Healing  

One in three women have a cesarean section according to an article written by The Bump in 2017. A cesarean section is a major surgery in which several layers of the abdomen are cut open. Caesarean sections vary in the layers sutured or not suture as well as the depth and amount of scarring. There are several techniques for scar mobility and massage to help the healing process. A physical therapist can perform and educate a woman on these techniques to aid in optimal recovery. 

Perineal Tearing 

Tearing is the tissue damage that happens during labor and delivery. Greater than 85% of women have perineal trauma with vaginal birth (about 50% of women have episiotomy). Tissue healing of the pelvic floor is important for proper function and remaining pain free.

Low Back or Pelvic Pain

Pregnancy related low back pain or pelvic girdle pain is common during and after pregnancy. Due to changes in the body’s composition and posture during pregnancy many muscles and ligaments can become stressed out and irritable. And as previously mentioned, the core muscles are often quiet weak so there is a lack of stability which can further contribute to pain in the back and pelvis.

Upper Back and Neck Pain

Similarly upper back and neck pain is often present postpartum. Upper back pain is reported in about 43% of postpartum women. This again is due to muscle imbalances and forward posture preferences when holding baby, feeding baby, and more.

There are numerous other things a physical therapist can assist a new mom with after having a baby. Other impairments that often need to be addressed are posture, gait, breathing patterns, body mechanics, and potentially nerve pain. 

How Can Physical Therapy Help New Moms After Pregnancy

Physical Therapy after having a baby

No two women, pregnancies, or birth stories are the exact same so there is no one size fits all treatment for new moms. An individualized treatment session with a PT would allow a therapist to look at your specific impairments. There are numerous ways physical therapy could help a woman after pregnancy.

Examples include:

  • Help aid appropriate healing of perineal or C-section scars/incisions
  • Education on body mechanics and positioning techniques to improve function and prevent pain
  • Provide specific techniques and exercises to heal and strengthen the abdominal muscles (often through use of biofeedback, palpation, observation). They can help postpartum moms retrain the deep core muscles to work effectively and appropriately 
  • Provide specific exercises to heal and strengthen the pelvic floor muscles
  • Assess posture, breathing patterns, and gait mechanics for correctness and efficiency
  • Evaluate and treat low back pain and pelvic pain. Possible techniques include massage, taping, manipulations, and appropriate exercises.
  • Provide an individualized treatment plan for safe return to exercise

physical therapy after pregnancy

What’s Next?

Ok, ok I’ll get off my soap box now. I just recently realized how little education is available to American women regarding their postpartum bodies. To be honest with you there is so much I have learned already that I was not aware of when I had my children. Luckily, I was able to use some of my prior knowledge of the human body to heal and get rid of the little pain and discomfort I did experience after having my babies. But most women do not have a background or education base on body biomechanics and exercise science.

So what can you do? I would love love love if you could share this info with all the mamas or mamas to be out there. I do believe there is a movement happening in the U.S. for postpartum care to be more common place. Do not be afraid to ask your doctor for a referral to a pelvic floor therapist or woman’s health specialist. I think there is a bit of a stigma around woman needing therapy after pregnancy. But you wouldn’t be embarrassed if someone told you your leg muscles were weak. Weakness of the core and pelvic floor shouldn’t be any different.

Keep following along as I embark on this journey of education regarding health and wellness for the pregnancy and postpartum woman. And I do believe the saying, once postpartum, always postpartum. Our bodies are fricken amazing. Let’s give them the love and respect they deserve.

–Monica

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The "Pop Can" Core (understanding core function)

The “Pop Can” Core (understanding core function)

Posted on by Monica

The core is arguably the most important part of our body. It plays such a huge role in our bodies function that when it is working improperly small movements can be difficult and painful. But how do you know if your core is functioning properly? The core is fairly complex and for those who haven’t spent endless hours studying the musculoskeletal system and knowing where over 600 muscles attach and how they contract (thanks PT school) it can be difficult to imagine how the core works.

The “pop can” core analogy

Luckily, there is a common analogy that can make the core a little more easier to understand. The “Pop Can” analogy is a great way to picture and imagine how all the muscles of your core need to work together properly.

And by all means, if you are offended by the the word “pop” you can call it the “Soda Can” analogy. Calm down Californians. And personally, I’m more of a seltzer water kinda gal, hence my “pop can” images. But I digress.

Incontinence, back pain, and even breathing problems can be due to a poor functioning core. So lets dive into the pop can analogy and learn how all the parts need to work together.

The components of the “pop can” core

pop can core

So we all can picture a pop can right? A perfectly pressurized cylinder with an aligned top and bottom that run perpendicular to each other. A pop can is incredibly stable due to it’s perfect cylindrical shape. And our core is also very strong and stable when it’s in good alignment and functioning properly. So what makes up our “pop can” core.

The Top: The top of the pop can is our diaphragm. This is a muscle that contracts and relaxes rhythmically as we breath.

The Bottom: The bottom is our pelvic floor. The pelvic floor is a “sling” or “hammock” of muscles that holds our bladder and rectum.

The Sides: The sides of the “pop can” are composed of the abdominal muscles and the back muscles. The transverse abdominis muscle is one of the important core muscles that make up the sides of “can”. You can read more about the importance of this muscle and exercises to appropriately activate it in some of my older posts.

What happens when the pop can doesn’t work?

pop can core analogy

Muscle Pain: So, just like a pop can the top, bottom, and sides of the core all need to be strong and intact to maintain pressure and a nice cylindrical form. But when one part of the “can” is not being activated properly (such as the abdominals) another portion will take on too much of the work. This can lead to problems. Repeatedly using the wrong muscles, such as our low back muscles, can lead to pain and stiffness.

Alignment Issues: Another common problem that can cause difficulty with core muscle function is poor alignment. The top and and the bottom of the “can” need to be parallel and in neutral alignment for proper muscle activation and stability. Things like improper posture, and poor pelvic alignment can make it difficult to activate the spinal stabilizers and maintain proper core pressure.

pop can analogy- incontinence

Low Pressure: Speaking of pressure, this is the third way core stability, incontinence, and back pain can be related to the “pop can” core. A closed pop can with good internal pressure is very hard to crush. So our trunk (or “pop can” core) needs to be strong and appropriately pressurized to keep strength and stability in our body. For example if the bottom (the pelvic floor) is weak it will make maintaining core stability difficult.

pop can analogy

Excessive Pressure: Similarly, when excessive pressure is placed on the “pop can” (such as during pregnancy) this can also cause problems. Just like when a pop can bursts in the freezer an over pressurized core can cause one area to become weakened causing issues such as incontinence, back pain, or difficulty breathing.

What’s next?

Hopefully, this pop can analogy can be helpful in understanding how core function relates to things like back pain and incontinence. A strong and stable core is crucial for all movement. So when addressing body problems we like to start from the core and work our way outwards. If you are looking to start strengthening your core I’d recommend starting with your transverse abdominis muscle. Or check out more effective core strengthening exercises on some of my older posts. And coming up I’ll be talking about the bottom of the pop can…the pelvic floor!  So be sure to subscribe to the blog and check back in the coming weeks.

–Monica

 

Pop can core explained

5 core exercises for a better belly (without a single crunch)

5 core exercises for a better belly (without a single crunch)

Posted on by Monica

Why is it that when we think about core exercises a sit-up or crunch is the first thing that comes to mind? Maybe because they are the most common? I’m not sure. But a crunch is definitely NOT the most effective core exercise. As you have seen in my other posts about getting rid of the mommy pooch, stabilizing your pelvis, and the importance of the TA muscle there are manyyyyy other better and more effective core exercises out there. Doing crunches is a great way to fatigue your rectus abdominis muscle or “6 pack” muscles and make you feel like you’re just burning belly fat. However, for a better looking belly you are much better off trying out these 5 core stabilizing exercises. And guess what? There ain’t a single crunch.

5 no-equipment, at home core exercises

Exercise #1: Dead Bugs

Lie on your back. Contract and brace your abdominal muscles. Lift your legs to a 90 degree position and raise your arms overhead. Slowly extend one arm back while straightening your opposite leg just above the floor. Return to starting position and repeat on the opposite side. Perform slowly and with control while keeping your core engaged. (Say hi to Artie…my cat)

Perform for 5-10 reps each side.

Exercise #2: Plank

core exercise plank

Assume a position on toes and elbows with shoulders, back and buttocks in a straight line. Activate your deep core muscles by pulling your belly button in towards your spine. Avoid letting your low back sway down or hiking hips up.

Hold for 30-60 seconds.

Exercise #3: Elbow to Knee

Start in a hands and knees position. Extend one arm and the opposite leg to hip level. Bring that elbow towards the extended knee so they meet near your belly button.

Repeat 10 reps on each side

Exercise #4: Leg Lifts

Start by laying flat on your back. Place your hands under your hips or buttocks. Raise your head and shoulders up off support surface. Brace your core. Slowly raise your legs together upwards and then lower so they are hovering just over the floor.

Repeat 10 reps

Exercise #5: Bear Crawl Step Ups

Start in a hands and knees position. Raise your knees up off the ground so they are hovering parallel to the support surface. Slowly step each leg back to assume a plank position. Step feet back to return knees to just under hips without letting your knees touch the floor. Keep your core tight and braced throughout the exercise.

Repeat for 16-20 reps total.

Repeat these exercises for 3 – 4 sets. Ensure that your core is tight and braced throughout each exercise. For tips to ensure that you are appropriately bracing your deep core muscles check out how to activate your transverse abdominis muscle.

What’s next for core?

If you’re looking to improve your posture, decrease back pain, improve your athletic performance or just your overall physical well-being you need to start with the core. And yup…you can bet your bottom dollar I’ll be talking more about core in future posts. Luckily I’ve got loads more great core exercises up my sleeve. My recommendation would be to start with basic abdominal bracing exercises, progress to the exercises in this post, and then be sure to subscribe to the blog for future higher level core exercises.

Happy strengthening!

–Monica