Aligned PT Pelvic Health and Wellness

Did you know September is Interstitial Cystitis (IC) month? Physical Therapy can play a integral part in helping to manage symptoms. IC is not just a bladder disease and often coexists with tight pelvic floor muscles that require physical therapy.
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March is Endometriosis Awareness Month

"Endometriosis is a condition in which tissue similar to the lining inside the uterus is found outside the uterus, where it induces a chronic inflammatory reaction that may result in scar tissue" (From the world endometriosis society). It is estimated that endometriosis affects 1 in 10 women during their reproductive years.

Symptoms may include painful periods, pain with in*******se, fatigue, chronic pelvic pain, infertility, and heavy bleeding.

Pelvic Health PT's are part of a team approach to treating Endometriosis.

Pelvic floor dysfunction is a common condition in women with Endometriosis. Chronic inflammation of the endometrial tissue can cause severe abdominal and pelvic pain. The pelvic floor muscles may become very guarded and tight in response to the pain. Pelvic health PT's treat trigger points in the pelvic floor muscles to help reduce tension and work to ensure proper contract/relax of the pelvic floor muscles.

PT's can also help to down train the central nervous system which can become highly reactive due to chronic pain. This is achieved with techniques such as breathing techniques, massage, and mindfulness meditation.

Abdominal massage and a type of massage specifically termed visceral mobilization may help with the pelvic organs such as the bladder to reduce scar tissue and adhesions.

"The endometriosis association is working hard to make real changes in the medical world so that women and girls with endometriosis can have the best care and treatment options available to them." The endometriosis association

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It can be difficult to facilitate a pelvic floor contraction if you are newly postpartum, have had recent pelvic surgery, or if you have a pelvic organ prolapse. Choosing a position that eliminates gravity can make it easier to find the pelvic floor muscles and successfully strengthen them.

Elevating your pelvis on a yoga block placed horizontal under your sacrum or using a foam wedge/couch cushion can be helpful to decompress your pelvic organs and eliminate gravity. In this position you may have an easier time finding your pelvic floor.

You may also find that this position relieves pressure from a pelvic organ prolapse.

Once it is easy to find your pelvic floor muscles in an anti gravity position then you can progress to laying on your back and eventually to sitting and standing positions.

Remember to try and fully relax your pelvic floor between contractions and avoid gripping with your buttocks or abdominal muscles. Stop exercises if you are experiencing pelvic pain as the pelvic floor muscles can also be over tight. Seek consult from a pelvic health PT should you have any questions regarding your pelvic floor.

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If one of your New Years Goals is to begin taking control of your pelvic floor health then join me for an introduction class on pelvic floor strengthening. The great part about this class is that you can take this class from the comfort of your own home via zoom. I am offering three classes this month to choose from. I look forward to working with you! See the events section of my page for details on how to sign up.

Pelvic floor strengthening before and after a Hysterectomy, why is it important?

Your pelvic floor creates a muscular sling of support for your pelvic organs. In females, this includes the bladder, uterus, and re**um. The uterus sits in the pelvis behind the p***c bone and is nestled in between the bladder and the re**um.

After a hysterectomy the bladder and re**um may shift to fill in the space from the uterus. Sometimes this shift can lead to incontinence or other times it can lead to the bladder or re**um slipping downward in your pelvis. This is termed a pelvic organ prolapse and can create the feeling of pelvic pressure. Prolapse after a hysterectomy is more common in women who have had multiple pregnancies and who already have weakened pelvic floor muscles.

The good news is that pelvic floor exercises can help reduce this risk by increasing the support of the bladder and re**um from the sling of muscles under the pelvic organs, aka your PELVIC FLOOR. Pelvic floor muscles can also be strengthened pre hysterectomy as a preventative way to avoid pelvic organ prolapse. It can take 4-8 weeks to strengthen your pelvic floor.

You may find it helpful to have a consultation with a Pelvic Health PT as many women don’t perform pelvic floor exercises correctly. Substitution with the upper abdominal wall or gluteal musculature for pelvic floor contraction can be very common. A Pelvic Health PT can help you to find the correct muscles to increase the sling of support for your pelvic organs helping to prevent pelvic organ prolapse following a hysterectomy.

Reducing downward pressure and straining caused by constipation can also greatly reduce your risk for pelvic organ prolapse.

Pelvic floor exercises following a hysterectomy should always feel comfortable and pain free.

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Many women experience low back pain during pregnancy. I always tell my patients there are things you can do to support and prepare your body for the changes that occur during pregnancy. The softening of ligaments, increased mobility of joints, and muscle guarding can lead to pain.

The hip flexors are collectively termed the Iliopsoas. These muscles are ones that can commonly become tight during pregnancy. These muscles attach to the front of the lumbar spine and run all the way to the inner hip. As the pelvis tilts forward and the abdominal muscles stretch to accommodate the weight of the growing baby the hip flexors shorten and tighten. When this happens the hip flexors can pull on the pelvis increasing the lordotic curve and arching the back. This leads to back pain.

Gentle stretches for the hip flexors are one of the best things women can do for their back during pregnancy and postpartum.
*Remember to never push into pain with stretches and consult a Physical Therapist if you have questions regarding which stretches are right for you. , , , ,

Sacroiliac pain in pregnancy is one of the most common complaints of pain I see in the clinic with my pregnant patients. Did you know that during pregnancy relaxin levels are at their highest in the first trimester? This hormone relaxin, as the name suggests relaxes the ligaments in the body. This allows for increased space for the growing baby. When the ligaments start to the relax the joints that they help hold together can become loose. The area marked in red on this picture is the region of the Sacroiliac (SI) joint. This area specifically can be a source of pain during pregnancy due to the increased joint laxity.

The GOOD news is that the inner core muscles, specifically the pelvic floor and the transverse abdominals, work to help stabilize the SI joint. These deep muscles are like an internal girdle helping holding the pelvis stable during pregnancy. They give a secondary support to the ligaments. Learning to keep these muscles facilitated throughout your pregnancy can prevent the SI joint from slipping out of alignment and keep your pelvis happy!

Seek care from a PT to learn how to keep your core healthy and supportive during pregnancy and prevent or minimize pain.

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Happy Halloween Everyone! Big shout out to all the Physical Therapists out there. We’ve got your back!
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Seated spinal twists: This gentle rotation of the spine massages the digestive tract to stimulate detoxification and can help with improving circulation in your spine. I love adding in gentle spinal twists to a yoga flow to help improve and stimulate bowel movements. Constipation can be a big contributing factor with pelvic pain. This pose can be a key player in removing toxins from your body!

* Remember to always listen to your body and never push into pain. Consult a doctor and pelvic health PT if you have pelvic pain symptoms.

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Movement of body is so important for stimulating the bowels.
Specific Yoga poses are beneficial for helping the digestive system and can be used as an effective method to help treat irritable bowel syndrome and constipation.

I love poses that include spinal twists which are incredible detoxing tools! They stimulate the digestive system, promoting the breakdown of food and cleansing from all the toxins.

Triangle pose specifically produces side bending which energizes the digestive juices through stimulation of the gall bladder and the liver. The twisting motion energizes the abdominal organs.

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Did you know that bowel problems and chronic constipation can contribute to urinary urgency, incontinence, and pelvic pain?

Your pelvic floor needs to be able to relax to fully empty your bowels. Have you heard of a squatty potty or using a stool under your feel to help relax your pelvic floor? Using either a stool or a squatty potty increases hip flexion which will increase the anorectal angle. Increasing the anorectal angle can help to relax your pelvic floor and improve the ease of bowel movements.

Diaphragmatic breathing can be used while sitting on the toilet to relax the nervous system and improve ease of bowel movements.

Studies show that Yoga can be used as an effective method to help treat irritable bowl syndrome and constipation.

Look for my posts this week with specific yoga poses to help improve bowel movements!

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Taking time to fully empty your bladder can help decrease urinary urgency

Rushing when your urinate may not allow for your bladder to fully empty. If you don't fully empty your bladder you may experience the urge to go again soon after you've finished.

Try taking your time when you go to the bathroom and focus on relaxing your pelvic floor muscles.

Placing your feet flat on the floor may help you to better relax your pelvic floor muscles which is needed to fully empty your bladder.

If your pelvic floor muscles are tight it can make it difficult to fully empty your bladder.

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Does running water make you feel like you need to run to the bathroom?

This is a common trigger with Urge incontinence and in women who complain of urgency. Urgency is the sudden and powerful need to urinate.

Bladder retraining can be a helpful tool to retrain your bladder to increase time between voids.

THE KEY TO AVOIDING URINARY URGE IS NOT TO RESPOND BY RUSHING TO THE BATHROOM. RUSHING CAUSES MOVEMENT, WHICH JIGGLES YOUR BLADDER, WHICH, IN TURN INCREASES THE FEELING OF URGE.

KEY STEPS TO BLADDER RETRAINING:
1. Think about being still and calm. When you panic your body produces the hormone adrenalin which will increase bladder contractions and make urgency worse
2. Squeeze your pelvic floor muscle quickly 5 times. By contracting your pelvic floor it helps your bladder relax to stop the bladder spasm
3. As the urge peaks concentrate on suppressing the urge by taking slow deep breaths.
4. Wait until the urge subsides, urgency passes when your bladder muscle relaxes. Wait until the urge subsides before walking to the bathroom
5. Walk, don't run to the bathroom.

Using these bladder retraining techniques takes practice. But eventually the goal should be to void every 2.5 to 3 hours during the day.

*please note that the treatment method isn't appropriate for everyone. If you have tight pelvic floor muscles and quickly tightening your pelvic floor is painful then working with a Pelvic Health PT to release trigger points first may be very helpful. Talk to your Physical Therapist before beginning bladder retraining.

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Water is the best fluid for bladder health!

For urgency and frequency bladder symptoms, limiting bladder irritants can be very helpful. A bladder trigger is something that causes your bladder to contract- often without warning. Knowing your bladder triggers can help you anticipate bladder urgency.

There are a few common trigger foods and beverages that may contribute to your bladder urgency and frequency symptoms.

These include fruits, juices, caffeine, alcohol, carbonated beverages, artificial sweeteners, tomatoes, and spicy foods.

The best way to know if these are problems for you is to eliminate them for a few weeks and notice any changes in your bladder symptoms. Everyone is different and you need to identify your own trigger foods and drinks.
Take the time to notice what triggers your bladder urgency. Increase water intake to at least half of your fluid intake per day.

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What is your biggest struggle you have with your pelvic floor that holds you back from living your best life?

*Mine was leaking when laughing and with running when I was younger. My pelvic floor muscles actually didn't know how to relax all the way for me to properly void. When I laughed or ran they would relax and I would leak. Embarrassing! It held me back from laughing too hard and I was always worried I would leak when I ran. I am so happy now to have control over my muscles. It is empowering!

* I would love to hear from you and help you to feel supported with any struggles you have with your pelvic floor so that you can live your best life!

For a muscle group that is so hidden, these muscles play a vital role in the body. Not only do they support the pelvic organs but they help give us control over our bladders and bowels.

I love anatomy and I love this beautiful picture by Duvet days. It gives a great visual to how many muscles actually make up the pelvic floor!

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Garland Pose (Malasana)

This is a stretch I try and do daily and it is a great stretch to help relax a tight pelvic floor. It can also give back pain relief as it stretches and elongates the shortened muscle of the low back.

This position can help with digestive control as it allows the descending colon to fully straighten and relax to help with relief from constipation.

Did you know constipation is a big contributor to Pelvic pain?

A yoga block or two can be used to to support your pelvis as you ease into this stretch. I love holding this stretch for 5-10 minutes as I can feel my low back releasing the longer I hold the pose.

Avoid pushing into pain with your stretches and find stretches that work for you. There are so many good stretches out there to help release a tight pelvic floor and low back. Find the right ones for you!

What is your favorite stretch?

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Imagery and visualization can be helpful for helping to find and contract the muscles of the pelvic floor. Since the pelvic floor is deep within the pelvic cavity and it is not visible, imagery can be used to help engage these important muscles.

Here is one of my favorites: The Blossoming Flower
Inhale through your nose and image a flower blossoming or a rose opening as you relax your pelvic floor

Exhale through your mouth and imagine drawing the petals and leaves together as you tighten your pelvic floor.

As you are working on your pelvic floor strength it is important to find the right image that works for you!

*Pelvic floor exercises are not indicated for everyone, especially if you are experiencing pelvic pain. It is important to consult with a PT or medical doctor prior to beginning pelvic floor exercises if you have pain.

TREE POSE: I love this pose! It is a great pose for stretching your hips, knees, and shoulders and for hip stabilization on the standing leg. The hips are often a missing link with pelvic floor weakness. Hip external rotation and lateral hip strengthening can help support your pelvic floor. I call the hips the "rotator cuff" of the pelvis.

This picture was taken in August before all the smoke from the wildfires in Washington state affected our air quality. I love this location looking out at the Deception pass bridge. It is pretty difficult to exercise outdoors or even be outdoors for any length of time right now due to the smoke. That along with having my three kids starting virtual school from home this week really makes me thankful for YOGA and breathing techniques to reduce stress and put my mind in a happy place. This pose reminds us to root down and rise up!

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*The Perineum is a very important part of your pelvic floor!

It is found between the va**na and the re**um and is termed the Central Tendon of the pelvis. Many pelvic floor structures connect with the perineum. It functions as a major support for your pelvic organs. If it is weak or lose a pelvic organ prolapse can occur.

* I always educate my pregnancy clients on the importance of having a strong yet supple perineum during pregnancy as this tissue needs to support your pelvic organs but also needs to stretch during a va**nal delivery. Tissue that is supple and has good blood supply to it will stretch better for you when you need it to.

* A muscle called the Superficial Transverse Perineum stretches across the pelvic floor from sit bone to sit bone. Tightness or trigger points in this muscle may contribute to pain with sitting. The hamstrings attach to the sit bones as well. Because of this close proximity, hamstring pain near the sitting bones may be a result of tension in the Transverse Perineum. I often work on trigger point release here with my clients to help with chronic hamstring pain and pelvic pain.

*Physical Therapy is a safe and effective treatment choice for management of perineal pain and dyspareunia (painful in*******se) and return to fitness after childbirth.

Chronic pelvic pain is pain in the pelvic area that last for 6 months or longer. I love using breathing techniques for relaxation, stretching exercises, and Yoga with my clients. These techniques have been shown to improve symptoms and quality of life with those suffering from pelvic pain.

Want to learn more about how you can start working with these techniques to minimize your pain? I offer live classes on pelvic pain reduction. Learn about the anatomy of your pelvic floor and how you can begin to relax these muscles that can become over tight and painful. See my schedule of live classes offered in September here: https://app.acuityscheduling.com/schedule.php?owner=19933467&appointmentType=15088954

alignedptpelvichealthandwellness.com/blog/the-breath-the-breath-the-breath

Diaphragmatic breathing is an important part of Pelvic Health PT

The Breath The Breath The Breath — Aligned PT Pelvic Health and Wellness Breath work is an important part of pelvic health therapy. As a pelvic health PT one of the first things I like to teach my clients is a breathing technique called Diaphragmatic breathing.

What do you do each day that brings you JOY?

After going through lumpectomy surgery and radiation therapy in 2019 for early onset breast cancer (that was caught very early by 3D mammogram) I made a pact to myself to find JOY daily! My business was created out of the idea that we should live out our own story and we ALL have gifts to share with the world. I love educating women on their pelvic floor and helping women overcome pelvic dysfunction and pain so that they can live their best lives!

I planned this hike to Thunder mountain lakes in early January with my sister and we along with a friend, were able to complete yesterday and check the box on a goal of ours! The Alpine lakes wilderness in Washington state is a beautiful place.

Did you know that jaw pain and tightness can go hand and hand with pelvic floor tightness and pelvic pain?

Being mindful of tightness in your jaw and working on relaxing your jaw when doing stretches to help you relax your pelvic floor can be very helpful. Try letting your jaw drop or place your tongue on the roof of your mouth right behind your front teeth to help relax and soften the muscles of your jaw.

Where are you holding tension in your body that you might not be aware of?

Thankful to be healthy and capable of running a half marathon in these crazy times we are in. My sis and I got drawn for the lotto for the Lululemon Seawheeze 1/2 marathon in Vancouver BC before Covid hit. Little did we know our race weekend and yoga festival that is included with the run would be virtual instead. My husband ran with me this am and my sister ran from across the state. We FaceTimed at the half way point. Thankful for a beautiful day to run. What are you all thankful for?

This is one of my favorite poses to eliminate gravity and take pressure off your pelvic organs. If you have a pelvic organ prolapse this is a great position to try to relieve pressure and heaviness in your pelvis. This position is powerful yet incredibly restorative

Place a pillow, cushion, or yoga block placed horizontally under your bum with legs positioned up the wall. This helps your pelvic floor to relax and gives the ligaments that support your pelvic organs a break by eliminating gravity!

This position can also help relax your back and gives your racing heart a rest. It can leave you feeling more relaxed with a calm mind. Spend 5 minutes or more here noticing the natural rhythm of your breath. Rest your mind on your breath which can be your calm center.

These are two great stretches that you can get started with if you are experiencing pain in the area of the pelvis and/or low back region.
Always listen to your body and never push into pain.

Hi, I'm Amy.......
I help empower women to properly discover their pelvic floor muscles to decrease pain and improve strength of the core. I provide education through virtual group classes and online individual consultation for pelvic floor health and pelvic pain.

This page will include frequent posts and tips on a strong core and pelvic floor, stretches for pelvic pain, postpartum related pain and weakness, information on ways to keep your bladder happy, and tips for a healthy pelvic floor so that you can live your best active life.