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Using My Heritage to Teach About the Importance of Functional Squatting

My family is originally from Gujarat, India. My parents migrated to the US in 1972. Me and my four older brothers were very young when we moved here to the US. I was only 2 years old.  When I was in middle school my father decided to take me and one of my brothers to India to visit my grandmother. This was my first time ever traveling to our home country. I spent all summer there with my grandmother who was widowed. She lived in a very small village with a very small home. We had very little running water. Most of our water came from a well, which I remember having to go get for her in big barrels. No central air and an outhouse with no westernized toilet seat.

My most memorable memory of this trip was when my father took me to the toilet at the airport.  When I walked in, I looked for the toilet seats and everything looked very different.  I was very scared and then a women next to me kindly showed me the toilets.  She took my hand and showed me the holes in the ground that had a water basin next to them. She showed me how to squat down to use the bathroom and use the water to wash. I was so embarrassed and but did what she showed me. That summer I learned so much. Squatting was something that was normal for every function of daily life.  Not only did we have to squat to use the bathroom, we had to squat to bathe our bodies, squat to help wash our clothes in the creek, squat to cook, and squat and bow down to pray. I learned such a great deal about life during that summer and many more summers that I had the privilege to go visit my grandmother. 

It is amazing to me how God has brought me full circle. I use those things I learned that summer and my past experiences as a pelvic floor therapists today on a daily basis. Functional squatting and the importance of keeping our neutral spine for ADLs is a crucial part of my teaching. I reflect back to my days in India as I try to educate my patients on squatting and pelvic floor training and am so thankful that I have my past to be able to do this with.

Pelvic Floor Dysfunction

The pelvic floor consists of several layers of muscles that cover the bottom of the pelvic cavity. These muscles have 3 distinct roles:

1) To support the pelvic organs, the bladder, uterus and colon within the pelvis
2) To assist in stopping and starting the flow of urine or passage of gas or stool
3) To aid in sexual appreciation.

When performing a proper contraction of the pelvic floor muscles, you should feel a sensation of pulling up and in. A functional stop test can be done to know if you are contracting the right muscles. This is done by trying to stop the flow of urine during flow. Attempt to completely stop the flow of urine by contracting these muscles. You should not hold your breath or contract the abdominals or other hip and leg musculature while contracting the pelvic floor. Take note of whether you can completely stop the flow of urine stream.

What can make the pelvic floor muscles weak:

*Childbirth
*Constipation
*Sustained coughing or sneezing
*Heavy incorrect lifting
*Obesity
*Hormones associated with menopause

Types of Dysfunction:
* Stress or Urge Urinary Incontinence
* Constipation or Bowel leakage
* Prolapse
* Painful intercourse or penetration
* Pelvic Pain
* Coccydynia

Pelvic floor therapy can help to provide conservative treatment options for both men and women who are experiencing any type of pelvic floor dysfunction and laxity. Appropriate exercise, muscle awareness, electrical stimulation, biofeedback and massage can reduce the symptoms that may occur with pelvic floor dysfunction.

For more information please contact His Therapy at 864-534-1780 or email at sabina@histherapy.net

What Does a PT Do for Urinary Incontinence

As many of you may know that a physical therapists can help people to exercises with weights to help with strengthening or they can teach someone how to use crutches after surgery to help them walk. But how can physical therapists help with bladder or bowel problems like incontinence?

The pelvic floor muscle is a skeletal muscle just like other muscles in our body and they respond to

the same training techniques. Some physical therapists have developed special skills in

training the pelvic floor muscles. These therapists are called pelvic floor therapists.

If someone wants to strengthen their biceps arm muscle they have to learn the correct

exercises. Then they perform the exercises with the correct difficulty (not too hard, not too

easy) for the correct duration of time (it takes 4 to 6 months to increase the size of a

muscle). Pelvic floor muscle training is the same. First you have to learn the correct

exercise. This is challenging as it is an inside muscle and sometimes hard to find. In

fact, 40% of people are doing the exercise wrong. The best way to tell if you are doing

the exercise correctly is by palpating inside the vagina or rectum. A trained physical

therapist can measure the muscle by palpating just inside the vagina or rectum and asking

you to squeeze. This usually not painful but gives a lot of information about the muscle

How big is the muscle?

 Can you feel the muscle?

 Is the muscle painful and tense? – it is very important to relax and this may be the primary reason exercises do not work.

 Can the muscle elevate and support the organs – especially important when the organs are sagging?

 Can the muscle squeeze tight – to stop urine leakage?

 Can you hold the contract – long enough to get to the bathroom?

 Does the belly muscle work with (or against) the pelvic muscle?

 Does the breathing work with the pelvic floor muscle?


All these things are helpful in developing the correct exercise program. In many cases

the exercises are difficult to learn and additional information is needed. EMG

biofeedback can help. This device allows you to see the muscle contraction just like the

EKG allows you to see the heart contraction. To monitor the pelvic floor muscle a sensor

is placed inside the rectum / vagina or stuck to the outside of the rectum. If the

contraction is strong the line goes up (and stays up). If the contraction is weak the line

does not go up very high and fall quickly. Seeing this can help you to activate the correct
muscles and keep them activated increasing the effect of the exercises.

A proper exercise program includes the answers these questions:

 How long to hold the contraction?

 How long to rest between? – rest is as important as hold

 How many to do at a time and how many times to do them in a day? – studies tell us that you must do more than 45 per day to get results

 What position should the exercises be done in?

 How do you breathe during the exercises?


If you want more information about this or any of our services please call us at 864-534-1780.

Pelvic Floor Therapy and Prostate Cancer

Men who have been diagnosed with prostate cancer or have other medical problems related to their prostate may have some symptoms that a pelvic floor therapists can help them with. Many men suffer from urinary incontinence, urgency and retention issues and many more things that affect their way of life and every day function. Both pre and post therapy is very beneficial to these patients. Treatment may include:

1) Education on the anatomy of the pelvic floor and physiology of micturition process

2) Bladder retraining including assisting patients with proper bladder voiding schedules and avoiding bladder irritants

3) Education on proper posture and body mechanics

4) Manual cueing and biofeedback training on proper pelvic floor contractions

5) Biofeedback for pelvic floor training

6) Core stabilization exercises

Outcomes are fantastic! Patients gain the control they need of their bladder. Many men decrease the amount of pads they have to use secondary to leakage, wake up less at night to void, have less urgency and overall feel better with a more active daily lifestyle!

Please call His Therapy for more information. 864-534-1780 or visit our website for more information     www.histherapy.net

Bed Wetting

We got the opportunity to do a segment on Mommy Matters on Fox News this weekend on bed-wetting. We wanted to share the tips that we discussed on the segment with you! 

Bed-wetting: What do you do to help children get through this?
•    Education- anatomy and physiology
•    Counseling parents and the child regarding voiding and drinking habits
•    Toilet posturing 
•    Positive motivation of the child and parents
•    BIOFEEDBACK – method of allowing the child to see the EMG tracing of the pelvic floor muscle contraction and relaxation in a fun manner tailored specifically for children
Food or physical changes you recommend-
•    Typical America diet lacks fiber
•    Children often don’t drink enough water to maintain a healthy bladder
•    Bladder irritants- caffeine and sugar
•    Sedentary lifestyles and obesity are huge contributing factors to urinary dysfunction and bedwetting
Advice for parents who are struggling with this issue
•    You are not alone in this- research shows 5 million children in the US wet their bed
•    Every child is different and may need a different treatment plan- seek advice, research and ask questions. 
•    Go with your gut instinct- no one knows your child better than you
•    Research shows pelvic floor therapy is an effective treatment option. If you’ve not tried it, consider it!

Can Diet and Lack of Rest Cause Pelvic Pain

YES your diet and lack of rest can cause your pelvic pain!

Found a great website with a lot of great information. www.Pelvicguru.com. Tracy Sher is an amazing PT and has a ton of information about pelvic floor health. She has an article about nutrition and how what we eat will effect your pain. Please take a look at it.

https://pelvicguru.com/2012/08/26/is-your-pelvic-pain-related-to-what-youre-eating/

Three things she mentions in this blog I totally agree with: 

“Consider an elimination diet to see if you are sensitive to or allergic to any of the most common food allergens.”                            I have my patient’s go through a 1 to 2 week detox period to try to find out what they may be sensitive to which is similar to what she describes on this blog. We all have certain foods and drinks that we are sensitive to and the only way we can truly know what these are is by getting rid of possible irritants then slowly bringing them back into our diet to see how we react to them.
“Once you figure out if you are sensitive to any foods, then you can eliminate them from your diet and begin to heal your digestive system.  Your digestive system is key to your overall health.”                                       Very true! I also believe this to be true. Probiotics and natural foods and herbs are very important to put into our diets. I am from India and growing with a very traditional Indian diet I realize how those herbs and ingredients were and are so important. For example garlic, turmeric, onions, flax seeds, chia seeds, and cloves were used in almost all the meals. These ingredients plus many more are essential for our bodies to decrease the toxins and help with healing. Normal American diets just do not have these ingredients and more processed the meals are in this country the more unhealthy they are for us.
“Heal your hormone system.”                               In this step she discusses how sleeping and naturally healing our hormone imbalances is so important. She recommends going to sleep at 10pm and getting adequate rest every night is crucial for us to help no only digest our foods but heal our bodies. I do so agree with this as well. SLEEP and REST are so important for all of us. It can and will reduce pelvic pain!

Thank you Tracy for your information!

If you have any questions or comments on this blog, please feel free to contact me at Sabina@histherapy.net or to 864-534-1780.    www.histherapy.net

Diastasis Recti

Diastasis Recti refers to the unnatural separation of the abdominal muscles via stretching or thinning of the connective tissue in the midline (Linea Alba). While this is very normal to occur during pregnancy to allow for a growing baby (100% of women will have some separation at 37 weeks gestation), it is when the muscles remain apart after baby is born that this can become a concern. A distance of 1-1.5 finger widths between the muscle bellies is considered “normal” and greater than this would be considered a diastasis, however the prognosis of healing will be affected not just by the distance of separation, but also the amount of tension remaining in the linea alba. 

*Just to be clear, even though DR is often referred to as a ‘separation’, this does not mean that there is an opening in the abdominal wall, rather that the muscle bellies are sitting a bit further apart. There is still intact connective tissue between the muscles, however it may be thinner than before – unlike an hernia which refers to an actual tear or hole in the connective tissue.*
 
The most common symptoms of Diastasis Recti are the appearance of a belly bulge, a feeling of core ‘weakness’, and compromised function of the deep core and pelvic floor muscles (which stabilize the pelvis and the spine) leading to hip, pelvic, and back pain or pelvic floor issues. 
 
However, Diastasis Recti is not always visible or symptomatic. For example, I have known some women with 4cm separations postpartum to have a ‘flat’ stomach (as defined by societal expectations), be pain-free and still be able to perform very physically strong feats. Therefore, I don’t believe the end goal of healing is just about the width of separation, but how all of the muscles in the body function as a whole.
 
Some causes of this can be:

Over-corrected sitting and standing posture – a habit of thrusting the ribs with chest out, shoulders back. Although we are often taught is a good posture – this actually creates excessive tension on the linea alba – pulling it apart – AND generates more IAP!
 
Very tight abdominal musculature – which can increase IAP and also pull away (think tight oblique muscles pulling on a diagonal away from the midline)
Shortened psoas major – this will often appear as rib thrusting when lying down on your back with the legs out straight (this was the most noticeable factor amongst the three aforementioned men with DR) and means that even just lying flat on your back, doing nothing(!) can actually contribute to a diastasis

 Do your ribs do this when you lie down?

Tight shoulders and chest muscles which will lift the ribcage and create a lateral pull on the LA every time you reach overhead
Constantly increased intra-abdominal due to chronic digestive upsets and bloating
Repetitive increased intra-abdominal pressure via habitual movement and exercises (think repetitive sit ups, straining on the toilet, breath holding, or ALWAYS sucking in your stomach)

For more information please contact us today at 864-534-1780 or sabina@histherapy.net

Why Would You Need to Have Pelvic Floor Therapy

Have you ever wondered if pelvic floor therapy is for you? Here are a couple questions you can ask yourself to determine whether you could benefit from seeing our specialist.

1) Do you leak urine when you cough or sneeze?
2) Do you strain with bowel movements and often find yourself constipated?
3) Do you wake up during the night to use the bathroom?
4) Do you have pain during sexual intercourse?

If you answered “yes” to any of these, pelvic floor therapy IS for you! With as little as 2-3 sessions, you will see improvements in your pelvic floor which will improve your confidence and help you live the happy and healthy life we all desire!

Call  today for  more information: 864-534-1780
www.histherapy.net

Make 2017 a Great Year Start by Thinking About Having Good Pelvic Floor Health

Having strong pelvic floor muscles gives us control over the bladder and bowel. Weakened pelvic floor muscles mean the internal organs are not fully supported and you may have difficulty controlling the release of urine, feces (poo) or flatus (wind).

Common causes of a weakened pelvic floor include childbirth, obesity and the associated straining of chronic constipation. Pelvic floor exercises are designed to improve muscle tone and prevent the need for corrective surgery.

What are pelvic floor muscles?

Pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women. The diagram below shows the pelvic organs and pelvic floor muscles in women (right) and men (left).

The pelvic floor muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick.

Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor is able to move down and up. The bladder, uterus (for women) and bowel lie on the pelvic floor muscle layer.

The pelvic floor muscle layer has hole for passages to pass through.There are two passages in men (the urethra and anus) and three passages in women (the urethra, vagina and anus). The pelvic floor muscles normally wrap quite firmly around these holes to help keep the passages shut. There is also an extra circular muscle around the anus (the anal sphincter) and around the urethra (the urethral sphincter).

Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles.

What do pelvic floor muscles do?

Pelvic floor muscles provide support to the organs that lie on it. The sphincters give us conscious control over the bladder and bowel so that we can control the release of urine, feces (poo) and flatus (wind) and allow us to delay emptying until it is convenient. When the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine and feces.

Pelvic floor muscles are also important for sexual function in both men and women. In men, it is important for erectile function and ejaculation. In women, voluntary contractions (squeezing) of the pelvic floor contribute to sexual sensation and arousal.

The pelvic floor muscles in women also provide support for the baby during pregnancy and assist in the birthing process.

The muscles of the pelvic floor work with the abdominal and back muscles to stabilize and support the spine.

What can make these muscles loose?
Pregnancy and childbirth for women
Straining on the toilet
Chronic coughing
Heavy lifting
High impact exercise
Age
Obesity

Please call us at His Therapy to get more information and schedule your first session! It is an important part of your body that you need to learn how to control and work! We look forward to being able to serve you this coming new year! 864-534-1780

Pelvic Floor Awareness

The pelvic floor muscles are such an important part of our body for both men and women! Don’t forget about them!

If you don’t know much about them feel free to look us www.histherapy.net or give us a call to learn more 864-534-1780!

We would love to help you discover the world of pelvic floor wellness!