Pelvic pain impacting your relationship and family role?

Is pain in your pelvis holding you back from being your whole self with your family and relationships?

 

 

Pelvic dysfunction affects both women and men. Here is some recent research that presents how pelvic pain can affect our lives and how we can help heal and be the man or woman we want to be for ourselves and the others in our lives.

The latest this month from The Journal Physical Therapy describes that after childbirth the study by Wuytack et. al brings to light that mothers describe 3 main themes of mothers with pelvic pain: 1. The more they do after giving birth, the more pain there is 2. New Mothers tend to push through this pain to get their work done and take care of their baby, and 3. How mothers describe their role and self-image as different, in part because of this pain. in almost 20% of women, this pain does not subside on its own. Seeking help from a physical therapist for pelvic pain can help in determining which structures may be involved in contributing to this pelvic pain and building a plan to work back to function that will help the new mother meet her new life demands with improved strength, posture control, and tolerance of different functional postures like lifting heavy babies and reaching with carseats.

How can a physical therapist help?

We first create a professional and caring relationship where you can describe what is painful and we help verbalize what important things you are having difficulty with being able to do. As pain can affect us in many ways understanding why rehabilitation is important is an important first step in having open communication before we jump into the treatments. Then we keep the converstation going by testing basic function in functional tasks like squatting, bending, lifting, the strength the the major movements and range of motion of aspects of the body that connect to the pain you are experiencing. Additionally we look at posture and how the body stabilizes under progressive challenges in a safe and controlled environment that determines the whole picture of where the function is now. Then we build a plan to where you want to go with exercises that incorporate basic functional exercise that mirror your real life demands and specific training on how to use the pelvic muscles, breathing, posture, and coordinate these aspects to work together.

 

 

 

Men likewise suffer from issues related to dysfunction of the pelvic muscles that impact their role to participate fully in relationships from pain with basic motions and postures that prevents them from working and fulfilling their duty in the home as well as diminishing a healthy normal sexual function that is a vital part of intimacy and relationships. Lavoisier et al describes in his paper from 2014 that pelvic muscle rehabilitation is one important and overlooked aspect in men that suffer from erectile dysfunction and premature ejaculation. That’s right, instead of a little blue pill, we need to work on muscle control, relaxation, and control to optimize sexual performance and overcome these common and oft swept under the carpet issues that come down to posture, mobility, breathing, ability to relax and contract. The Lavoisier study shows that 20 sessions of pelvic muscle rehabilitation increased blood flow 87% in men with erectile dysfunction and premature ejaculation. If you or someone you know is suffering from these issues, I hope this can be an encouragement that these issues can be resolved and through understanding how to use our pelvic muscles and how to use our bodies to optimize the function of our pelvis. Anytime we can solve a scary problem with a little guidance from a PT and learning how to control and appreciate our own bodies, it can be powerful in helping us reconnect with our own ability to heal ourselves and rely on the signals our body is giving us. It takes some work and attention to change ingrained habits no doubt, but we can solve this. If you are in the Portland area call me at Bridgetown Physical Therapy & Training Studio @ 503-222-1485

If you are looking for help where you are, search out a PT who specializes in men’s & women’s health.

 

I have been through pelvic pain myself. It is difficult to find help and understand where to begin to heal. I feel that patience is key, it may be a long process but keep seeking the answers and the teachers available to you to integrate awareness of the pelvis into your everyday movements.

 

Links to articles:

http://www.ncbi.nlm.nih.gov/pubmed/25929535


http://www.ncbi.nlm.nih.gov/pubmed/25082919

Am I Breathing Wrong?

My friend asked me last night as we were waiting in line for tacos at Porque No to correct her body issues and if I had noticed anything horribly wrong about her body that I havn’t been telling her. Surely many people assume that as a PT after spending time with someone I should be able to find something “wrong” with someone at least in the way they hold their body. Even if I did, should I say something about it?

 

In the past I would learn something really exciting from a body work guru or physio and want to share it with everyone going around telling everyone to unlock their knees, scoop their pelvis, tuck their chin, breathe with the diaphragm going on up the chair to every joint correcting everyone. By the time I would be done they looked like a perfect statue except the trembling and grimacing on their face trying to keep their body that way.

 

As a young clinician, enthusiasm to help can sometimes harm if we forget the fact that the body changes slowly and that each person has their own unique circumstances. This podcast with Greg Lehman and Jack Chews is one that brings a nice counterbalance https://youtu.be/1geNiokT3DI to what for me coming at people with a right and wrong mentality and armed with systems of biomechanics based on normative values and my own understanding of Dr. Kelly Starrett’s system, I would size people up and help them become aware of how their body parts fell outside of these norms.

 

I think there can be well-meaning in pointing out how people can do better. There is also a lot of harm in pointing out people’s flaws or assuming that certain ways people move or posture are right or wrong.

 

Being honest with people is important but just to assume the information you have is absolutely correct, in order to effect change in someone it is counterproductive to teach in a way that increases anxiety by drawing negative attention and judgement to a person’s body scheme or habits. Do you change your behavior long term if you feel that you have been force fed the “right” way or if you take the time to find your own truth and incorporate it in your life in your own way, does this change the way you behave?

 

As a person and a PT I feel a lot more positive about what I learn about my body and how I teach people when I guide others from a position of helping people find their own answer.

 

When it comes to breathing:

 

First notice your body as it is-- appreciate it

 

  1. Start by noticing your exhale; what body parts move, what feels tight

  2. What part initiates your inhale.

  3. Take inventory of your joints in relation to each other

 

Now try this-- Try adding these things

  1. Bend your knees

  2. Inititate the breath from the belly

  3. breathe Down

 

There are so many effective cues for breathing “properly”, I do not even like that term because it makes me come off as above the person I am trying to help and make the person feel bad about not being able to do something instinctual correctly.

 

If you are reading this as a person who wants to work on your breath, start by being positive about what you are doing in terms of breathing, you are alive, you have gotten this far doing it your own way, even if you are a “chest breather” you are still using your diaphragm, its just not given the chance to be the primary driver because it may be acting as a stabilizer because of your posture stress levels, the way you are comfortable stabilizing.

 

Most courses I have been to and what I find in my own practice is to start on your back with your knees bent

    Try these:

    Breathe down

    initiate the breath in the pelvis

    try to make the belly rise before the chest

 

Then incorporate these cues while you are walking, or in yoga poses while you hold the pose or syncing the breath with the movement: its simplistic not a bad start to inhale while you extend or reach, and exhale while you flex in or return to the starting position.

 

If you want to focus on changing your breathing I think trying it in these fundamental or what I call pejoratively “baby” exercises. These are problematic because they are so much slower and more minute and esoteric than daily life tasks so yes a lot of work needs to be done to incorporate these into how you actually live. But this comes first. It is not to say you have to stop doing your weight lifting of cycling or lifting your kids. As you learn these baby breathing exercises try to incorporate them into your major movements.

 

Breathing as a major part of the daily routine trains ourselves to live in a way that does not build more tension that we then have to experience when we have down time. Breathing transforms exercise into a whole body stimulator that leaves you more relaxed after and more mobile. Hold your breath and you are increasing the stiffness of your tissues. Do you feel like after everything you do you need a $100 massage and an hour of yoga just to get your body back to normal?

 

What if you could feel more relaxed and be more compelling during that work presentation? less nervous the night before an exam? Feel that deep runner’s high after that 10K run? What if you needed to do less to feel better?

 

Breathing is a powerful way to positively benefit every physiological system of the body. You are already doing it. It starts with appreciating it. If you need help getting started email me

Grant Headley PT, DPT at gmheadley@gmail.com

If you are in Portland, OR call 503-222-1955 and we can do work in person.