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by Dr. Cathy Malloy & Dr. Rachel Miller
It's summer! Many of you are likely busy in your yards gardening or performing other lawn maintenance including weeding. Repetitive bending and lifting can lead to back pain or stiffness. Here are a few tips to keep you feeling good so you can enjoy your time outside. When it comes to gardening we want to remember good body mechanics. The closer you are to what you are pulling, the less strain it will be on your back. Instead of standing and leaning over something closer to the ground, try kneeling (either on both knees or one and then switch sides) on pads. Instead of repetitively bending forward (spinal flexion), perform a hip hinge. To hip hinge, pretend you are holding a light stick against your back. Your head, mid-back, and bottom would all be touching the stick with a little space behind your low back and neck due to the natural curve of the spine. This is called a neutral spine position. When you bend forward, the three points of contact should remain touching the stick. If the bottom part lifts away it is because you are flexing your lumbar spine/low back. If the middle part lifts away, it is because you are overarching your mid-back. Both of these can contribute to tightness in your back muscles which may contribute to stiffness in the spine and possibly back pain when performing this motion repetitively, especially when performing strenuous tasks like pulling and lifting. Hip hinging will optimize your core and glute activation so those muscles can do the work instead of your back. If you are a visual learner, watch this video of a standing hip hinge or this video of a kneeling hip hinge. Lastly, work smarter not harder. Invest in a hand weeder so it is easier to get the roots, which will also decrease the probability of the weed returning. Also try to pull weeds on days that the soil is soft. If it hasn't rained in a while try watering the soil first to make pulling the weeds easier on your body. Happy gardening!
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by Rachel Miller, PT, DPT
Pilates was originally called Contrology Developed by Joseph Pilates, he named his exercise method after one of the most important Pilates principles, control. You truly have to think about what you are doing. We all use our easiest to find, strongest muscles by default and the only way to change that pattern is to consciously do something different. This will create better balance in your body. The Pilates equipment is meant to be the starting place It can look intimidating, but the reformer and other Pilates equipment is actually designed to ASSIST you. For example, think about double leg lower, which is a core exercise where you lay on your back with legs straight up in the air and lower them down and lift them back up. This is a hard exercise, and often is not done correctly. On the Pilates equipment, the legs are supported by putting the feet in straps which are connected to springs. This makes it easier to hold the legs up and also provides resistance as you lower the legs. This provides eccentric strengthening (which means strengthening into a position of stretch) which will help with flexibility. The mat exercises are often more challenging and are meant to supplement the equipment. Pilates is for a wide variety of ages and ability levels Our clients range from 12-90 years old in the studio. The equipment is extremely adaptable - we can change support, resistance, and range of motion. What I love most about the equipment is that there is always a choice. For example, footwork on reformer. This exercise is usually performed lying on your back. But it can also be modified to sitting on the arc or sidelying. Choosing a heavier spring tension will make the focus leg/lower body strength. But a lighter spring will focus on deep core and hamstrings. In Pilates, heavier is not always harder- it depends on your body. Most of the exercises have modifications to make it easier and progressions to make it harder. This is why it is a perfect fit when used as part of Physical Therapy. It is also great for ongoing fitness and is a fabulous addition for cross training, which is why many professional athletes practice Pilates regularly. To experience the benefits of Pilates- increased strength, flexibility, body awareness, posture and so much more, you need to try it for yourself. The Pilates PT offers private and semi-private training and small group equipment classes, specialty classes and a weekly live virtual mat class- plus we have a Pilates PT on demand video library. The best place to start if it is new to you? Our Pilates intro package! As Joseph Pilates says, “In 10 sessions, you’ll feel the difference. In 20 sessions, you’ll see the difference. And in 30 sessions, you’ll have a whole new body.” by Rachel Miller, PT, DPT
Self Care. What does that phrase mean to you? There is not one right answer. I believe self care is what helps “fill your cup”, something that you are doing for yourself. Something that you do not NEED to do, but that you want to do. Self care is important for both your physical and mental health- though some activities can help both. Life for many of us is busy, even hectic at times. When our world was on pandemic pause in 2020, it was a reset. Many people had a chance to re-evaluate what was important to them and what relationships and activities they wanted to continue, and what to release. As we re-entered the world, we could choose which activities to return to, and think about how busy we wanted to be. For some of you, life probably looks similar to how it did before. For many of you, it doesn’t. And it is easy to be swept up into the hustle and bustle so do not forget to recharge. When my son was a newborn, my self care was taking a shower without worrying about a crying baby at any moment, going to the store by myself, or going to a workout class. Yes, I know most of us need to shower and go to the store- but often that was showering with a crying baby in the bouncer and going to the store without lugging the car seat in and out. Now that my kids are a little bit older, my self care has changed. It is working out. It is getting a pedicure once in a while. It is making sure to schedule a girls night out. A date night. For you, that may look different. Self care is about prioritizing YOU and doing things that bring you joy. A few other ideas to help get your mind thinking in the right direction…
 By Rachel Miller, PT, DPT
Prolapse is when one or more of the pelvic organs (bladder, uterus, rectum, intestines) move downward. Severe prolapse is when these organs come out externally, where a bulge can be seen or felt. Mild or moderate prolapse is more common. Symptomatically, prolapse can feel like pressure, heaviness or aching in the pelvic floor, or the feeling of a tampon falling out. Prevalence of prolapse has been difficult to confirm, especially given the fact that only 4-10% of women who have prolapse report symptoms. One research study discovered prolapse in 32% of women and a different study found prolapse in 98%, and other studies have shown numbers in between. While we are not sure exactly how many women it affects, it is a large percentage of middle-aged and older women. Risk factors for prolapse include increasing age, obesity, chronic constipation, vaginal delivery especially with trauma or episiotomy, smoking and giving birth to large babies. Women who have had a c-section are less likely to develop cystocele and rectocele but still are likely to develop uterine prolapse. Terms such as cystocele refer to which organ is prolapsed, in this case the bladder (see the picture for more details). There are different types of prolapse and you can have more than one at the same time. Prolapse is diagnosed with a pelvic exam (so ask your healthcare provider about it when you go next time) so you can know your body. The word prolapse can sound scary. And the statistics make you realize how many of us likely have some degree of mild prolapse without any symptoms. Don’t be afraid. I like to think of it as the organs have shifted during pregnancy, they were stretched and pushed down by baby. After delivery, our body is healing and reorganizing for up to a year postpartum. If you have prolapse right after having a baby, know that it will likely improve as you heal. If you have never had a baby or had a baby a long time ago, there is still hope. This is a wake up call to be proactive. We have control over our pelvic floor strength, and how we use our body all day long. What contributes to prolapse? Excess pressure, specifically downward pressure on the pelvic floor. Things like straining to have a bowel movement, pushing a baby out for hours. But also bearing down on your pelvic floor when you are doing strenuous activities such as lifting your kids, working out, even yelling. It is my belief that years of this excess pressure in combination with gravity and more hormone changes during peri-menopause may contribute to pelvic floor issues (such as prolapse and incontinence) later in life. While there are no studies to prove or disprove this, I believe that it is worth taking the time to work on your core and pelvic floor to help now and hopefully in the future. To be proactive, it is important to learn intra-abdominal pressure management strategies. Big words, right? What that means is learning how to use the inner core system functionally. The pelvic floor, abdominal wall, diaphragm, and deep back muscles all working together without putting excessive pressure on the abdominal wall or pelvic floor. A functional core system will not only help prolapse, but can also help with back pain and other issues as well. Unfortunately, it is not as easy as just doing one or two exercises. It is truly understanding where these deep muscles are and how to apply these concepts into your daily activities as well as other types of exercise. The goal is a functional, reflexive core system that provides support and stability. Whether you have prolapse or not, whether you have symptoms or not, right now is the best time to start. Permission to use copyright images from Pelvic Guru LLC. |
Get your free guideJust click on the picture: 7 Tips to help your back pain feel better without pain medication, injections, or surgery or Post-baby Body Basics: what every Woman needs to know about their postpartum body. 
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