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If I could write a letter to my younger self...

acl injury pelvic floor Sep 20, 2019

If I could write a letter to me...

And send it back in time to myself at seventeen...

Know the song?

When my knee starts bothering me, this song almost instantly pops in my head. I thought of it just this morning. 

I had a non contact acl injury when I was 17. This was initially a very dark window of my life. Thankfully it was short. But it ultimately was one of the best things that happened to me because it introduced me to the physical therapy world. And it was until I successfully rehabbed my knee that I knew what mental toughness was.

I didn’t really know what an ACL injury was until it happened to me, other than it’s an indefinite season ending injury. That’s the only way my dad could get me from jumping out of trees and off high walls.

As I got older, I would get recurrent “runners knee” or “IT band syndrome” almost always accompanied by peeing myself when I ran distance.

Then I developed a fascination and passion for pelvic...

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Rehab For Pelvic Organ Prolapse...More Than Just Kegels

[When will other healthcare pros jump on board?]

Cough cough... not going to call any specific group out...yet.

I have heard one too many times that pelvic floor rehab for people with varying degrees (grade 3 and 4) of prolapse "isn't effective." Which isn't entirely false... but it's under the false notion that the crux of rehab is developing better pelvic organ support with a stronger, supportive levator ani... by doing some kegel-based program.

Now... rehab will not fix an advanced prolapse... Just like rehab doesn't remove osteoarthritis nor does it fix a torn rotator cuff tendon or ligament tear. Just want to make that clear. Rehab, more often than not, can help successfully manage a pelvic organ prolapse. 

Let me step back for a moment and ask you to consider this...

...Think of it like rehab for a partial anterior cruciate ligament tear… or substantial elongation of the posterior knee capsule -- which… the latter is SO prevalent by the...

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A Cinderella Story - Princess Pee Pants

[A Cinderella Story ]

Once upon a time there was a little girl. This little girl was very close to her mom. Let’s call her Molly. Her mom instilled in her that she was in control of her own destiny... Life would be hard and there would be times when she would need help from others. She learned that some people would lead her down a path of short cuts, quick fixes. She learned that some people would lead her down the path of grit, grind, and struggle, and fulfilling glory. She learned from a very young age that most things in life require hard work day in and day out. 

This little girl’s mom suddenly passed away, and she would go on to live with her aunt.Her life quickly changed. She used to have to work for everything. Now she was given everything without having to work for it. How nice right?

 Several years down the road, she found the man of her dreams through Tinder.  She and her husband became pregnant. She gave birth to a...

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Three Ways to Test Your Core Strength

Hello everyone! 

I hope you all had a great weekend. Today's blog post should be called a VLOG because I want to share with you a video I recently posted to Youtube.  Check it out!

Click Here To Watch The Video!

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CrossFit Comeback: Bracing and Breathing Balance

TVA breathing/bracing balance: When to use which?

 When getting back to exercise, I encourage my postpartum athletes to scale intensity so that they are in the aerobic predominant energy system. Meaning, you should be able to breathe with whatever you are doing. Then after this, I ensure my athletes understand the goal of the work out and where breathing comes in.

When you are in the aerobic zone, you should be able to utilize just enough of your deep core brace for what you need to do AND breathe. If you can't, you're diaphragm/accessory breathing muscles may not be conditioned enough to what intensity you are bringing to the workout or your core isn't strong enough to not need support of the diaphragm. If this is you, scale back intensity - this is either how fast you are cycling through reps, slow your pace, cut back on the weight, and/or decrease reps or overall volume. You may also need to modify the movement if your core isn't strong enough.

Here is one example of how I...

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CrossFit Comeback: Roadmap to Kipping

I recently did an Instagram Live interview with Jeanice, @mypelvicfloormuscles on how to avoid being strong on the outside but weak on the inside. First, let me say how amazing Jeanice is - she provides amazing content in such a fun way. If you aren't following her, you need to!! 

We spoke for a half hour on getting back to CrossFit after having a baby. The interview will be available soon on YouTube on Jeanice's page (https://www.youtube.com/channel/UCFfloD1PWUhP_IlWbt9ZvWA).

Event though we covered a lot of info, there were many questions asked that we didn't get to answer. I am going to answer those questions in this blog series.

First question I want to answer is: When can I get back to kipping?

It depends! But in general... If I am directing the care, I am not allowing most of my athletes get back to kipping after having a baby until about 9-12 months postpartum... And sometimes longer. Why? It takes your body about 12 months to heal. If you've ever had ACL...

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Diaphragmatic Breathing

Postpartum Recovery Phase I: Diaphragmatic Breathing
Phase I postpartum rehab is about healing. You are beginning to restore tissue function from the inside out. This starts with breathing. Breathing for survival is intuitive; breathing to thrive takes work.
[Breath deeply in through your nose. Bring air into your belly, chest, and ribs so that each part rises equally. Slowly exhale through your mouth or nose. Your exhale should be equal to the length of your inhale. Progress to lengthen the time of your exhale to twice the length of your inhale. Watch for excessive airflow into your belly or upper chest. Its helpful to look in the mirror at first].
Positions: ALL.
Training your diaphragm to be the primary breathing muscle should be high priority criteria when you consider progressing yourself through phase I, II, and III. If you skip this, your body will tell you… you just have to listen/look for its subtle messages. Look/listen for the 4...
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Maximize Your Pelvic Floor Training

kegel kegels pelvic floor Jul 05, 2019
When women come to see me for issues such as urinary incontinence or heaviness associated with prolapse, or fecal urgency, I often ask if they've ever been told to do kegels.
I usually get one of the following responses (or something similar):They never did kegels and are not sure they know how to do them.
  1. They know what kegels are, they do or did them when they remember but aren't consistent or have stopped.
  2. They know what kegels are, they bought the weights but didn't use them because they didn't know what to do.
  3. They did kegels, and they didn't work.
My follow up questions to response #2-4, is
  1. Did someone formally prescribe them and if so, who?
  2. Why were you told to do so?
  3. How were you told to do them?
  4. Was there an exercise prescription?
The research, while limited in specificity and strength of the studies, clearly shows that for pelvic floor training (PFT) to work, the training has to be intentional.
What I mean by that is this: the frequency,...
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Kegel Basics

A kegel is the general term for a pelvic floor muscle contraction (PFMc) [shortening or lengthening of muscle fibers]. Your pelvic floor is a group of muscles and non-contractile tissues located deep within your pelvis that function to support optimal urinary, bowel, sexual, and movement system function. To put it simply, your pelvic floor has to be strong, endurant, fast, flexible, and adaptable. Your pelvic floor is like a single human that can lift and move something really heavy, run a marathon, sprint a 100 meter dash, and elongate/stretch like a dancer. By adaptable, I’m saying that your pelvic floor has to uphold the same qualities not only with walking and running, but with all the movements that are relevant to your life.
So how do you contract your pelvic floor?
Ladies: Imagine you have two beans: 1 in the opening of your vagina and 1 in the opening of your anus. Think about simultaneously squeezing both the beans [to prevent them from falling out] and...
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Five Habits To Shake

habits prevention Jul 05, 2019
1. Peeing in the shower.
Common responses: “But it’s so convenient!” “I don’t have to waste toilet paper when I go in the shower.” “I have been peeing in the shower since I was a kid!”
Reason: When people have problems with urinary frequency, bladder urgency, overactive bladder with or without incontinence, running water/the shower is a common trigger that 1). tells you to go to the bathroom when you really don’t have to go (based on the amount of fluid in your bladder)...this is called URGE and/or 2). Results in an involuntary contraction of the bladder muscle and maybe you leak a small or a large amount on your way to the bathroom.
Try this: Just don’t do it. Pee in the toilet.
2. Forcing urine out/”push peeing”
Common responses: “I have to go quickly because my kids are banging on the door.” “I have to get back to work.”...
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