Category: Blog Posts

by Ashley Newton, PT, DPT

Pelvic pain, a topic that when I started my career as a physical therapist was not well-talked about, is now enmeshed in conversations over platforms such as TikTok and Instagram. As someone who is passionate about health equity, literacy, and informed care, I am over the moon that more and more people are talking about this topic! But when we say pelvic pain, to what exactly are we referring?

The term pelvis technically refers to the basin-like area between the hip bones below the abdomen and contains the bladder, rectum, and reproductive organs. Thus, pelvic pain refers to the experience of pain in the lower abdomen and pelvis and is often intertwined with the urinary, digestive, and reproductive systems in addition to the muscles that ultimately support those systems. The experience of pelvic pain is not one that is limited to a specific character, meaning pain can be dull, sharp, aching, throbbing, chronic, acute, cyclical – the list goes on and on. Pelvic pain can also cause pain in other areas including the low back, buttocks, and inner thighs. Some people may notice their pain all the time, while others may only notice it during certain activities such as defecation, sexual activity, tampon use, sitting on a hard surface, etc. There is so much that is individual about the experience of pelvic pain, and it is often distressing for folks as it is not only uncomfortable to physically experience, but for many, uncomfortable to talk about. Hence, my elation for the exposure pelvic pain is getting on social media is unparalleled. People should be able to feel safe to talk about their health and ultimately get access to the help they need!

So, apart from the solutions to decrease pain, why is getting help for pelvic pain so important? When the body is in pain or anticipating pain, it guards in response to that stimulus. The pelvic floor musculature, the muscles that occupy the pelvis, are intimately connected with our nervous system. This makes sense – they have an important job of guarding and supporting our organs! When the nervous system enters fight or flight and we start to brace ourselves in response to pain, the pelvic floor contracts. However, the pelvic floor can get stuck in this contracted phase especially if we continue to brace/the stress that caused us to brace is not relieved. As a result, the pelvic floor has difficulty doing its jobs of supporting, stabilizing, facilitating blood and lymph flow, and relaxing/contracting for urination/defecation/sexual activity. It will become weak in this contracted position which will likely lead to other muscles trying very hard to stabilize to compensate for the pelvic floor. Truly, the list goes on and on when it comes to the effects of pelvic floor dysfunction on the rest of the body. It is the base of our core, and we know in life that a stable base or foundation is essential to just about everything. 

Ultimately, pain and muscle dysfunction go hand in hand and I encourage anyone who experiences pelvic pain to start a conversation with a trusted healthcare professional regarding options for solutions. Maybe you have a ‘high pain tolerance’, but honestly a body in pain is one that isn’t working properly in some way, and it is always better to address things early so that maladaptive habits do not have the time to build and cement themselves in routine. 

One thing that I think is especially important to note, however, is that people with pelvic pain can and should exercise. Now, it absolutely depends on the type of exercise (aka if it causes pain, don’t do it!), but motion is lotion! Movement helps facilitate blood flow while the cardiovascular component of exercise helps our body switch gears and go into the rest and relax phase of our nervous system. Don’t think that pelvic pain means that people can only do stretching exercises. Quite the contrary! Folks should be focusing on breathing mechanics, posture, and self mobilization of tissues as needed to help their core canister be more adaptive! In pelvic health physical therapy, my goal for clients is to be empowered to take charge of their health and feel like powerful, bada** as they move throughout their day. It’s all about getting the right tools so that the body has what it needs to succeed which truly looks different for every single person. If we meet the body where it is at and give it the love and respect it deserves, both the brain and physical body are able to heal in harmony. <3

by Sarah Apple Kingsley, pt, dpt

High blood pressure or hypertension is a serious health condition that often shows no symptoms. However, it puts you at a greater risk of developing heart disease, stroke, and even cancer. The increased pressure buildup in your arteries and throughout your cardiovascular system puts an increased strain on your heart, nervous system, and entire immune system making you more susceptible to many chronic and autoimmune diseases. Many factors contribute to increased blood pressure including but not limited to poor diet, sedentary lifestyle, stress, smoking, and family history. Working to control some of these risk factors is an important way to help reduce your blood pressure numbers. 

We learn in PT school and hospital settings “pale raise the tail, red raise the head.” This means when the blood pressure is too low, we want to elevate the legs or sacrum/tailbone to increase blood pressure and elevate the head in order to decrease blood pressure. These are usually extremes for more of an immediate response and blood pressure reaction. For long-term management, yoga is a great way to regulate your blood pressure by incorporating breath practices into movements and poses to regulate your central nervous system. Some poses I’d recommend to help lower blood pressure and why include the following:

• CORPSE POSE/SAVASANA is the final resting posture where one lies flat on their back with arms and legs splayed out focusing on breathing and truly letting all the tension go. This pose is great because the arms and legs are extended as they often are not in our usual day-to-day. This resting posture can decrease stress, which is often linked to high blood pressure.

• CHILD’S POSE/BALASANA is the other resting pose which can be extremely calming and which helps to open many joint structures and fascial lines that get restricted and cause high blood pressure. Staying more lifted in a child’s pose with a block underneath the forehead is even better because it not only decreases the stress and strain on the hips and low back, but also helps to stick with our theme of having the head above the tail to aid in decreasing blood pressure. Reach your arms out in front of you as you sit back toward your heels from a kneeling position with a block underneath the forehead.

• BRIDGE pose engages your gluteals, which have fascial and musculature connections to our deep abdominal and spinal stabilizing muscles. Activating your deeper core postural stabilizing muscles has been shown to tap into your parasympathetic nervous system, which is responsible for BP regulation and especially helping to decrease BP. While most poses aim to relax or hang into joint structures to “calm” the body, working your core, finding your deep abdominals, and connecting to the proximal muscles of the body may actually help more. Make sure to engage your glutes and contract your lower abs with an exhale upon lifting your bottom from the floor.

• COBRA pose, where you are on your stomach with your hands underneath your shoulders. Engage your glutes and abdominals to protect your low back as you pull back with your hands, peeling the head of your arm bones away and drawing the shoulder blades together, slightly down, and almost as if they could pull through your chest wall. This pose, as discussed earlier, facilitates the head above the tail positioning that aids in lowering blood pressure.

• THREAD THE NEEDLE helps activate the multifidus and rotatores muscles, deep spinal stabilizers responsible for rotating the spine. This rotation decompresses the spine and can have beneficial effects on the nervous system. Begin in all 4’s quadruped with your hands under your shoulders and knees under your hips. Breathe in as you press into your left hand and reach your right arm out to the side and up towards the ceiling, breathe out as you bring the right arm underneath and across to the left. Perform a few repetitions before coming to rest on your right shoulder to feel a stretch in the back of your arm as you energetically pull back with the back of your hand against the floor. Once again, stay higher up in the hips and keep some tension on your abdominal muscles to protect your back and stay in a parasympathetic state. Repeat on the other side.

• RECLINED SPINAL TWIST with similar reasoning involving the decompression that rotation can have on the nervous system. Begin lying on your back. This can be taught in two ways. For the greatest amount of protection to your lower back, you would want to bend BOTH knees keeping them close to your chest as you roll onto the RIGHT side, keeping your LEFT arm out to the side in a T or goal post position trying to keep the left shoulder blade in contact with the floor. Alternatively, you can just bend your LEFT knee keeping the right leg straight or slightly bent as you roll onto your RIGHT side, again keeping the left shoulder blade on the floor. Hold for 5-10 breaths, with each exhale feel the twist creating more space in your body. Repeat on the other side. 

You can find these poses and more in our LYT yoga classes. We work to engage the core to activate our parasympathetic nervous system and some classes also include a cardiovascular component to promote long-term blood pressure management as well! You will be surprised how small but specific movements can be challenging yet stimulating to the body for not only blood pressure benefits, but overall health, wellness, fitness, posture, and VITALITY!

by Dr. Ashley Newton, PT, DPT

The winter holidays are a special time of year for many. They are filled with family get-togethers, delicious treats, and heart-warming traditions. For as sweet and jolly as this time of year can be, it can also be a sneaky pelvic floor saboteur! Watch out for the following things around the holidays so you can be prepared to keep your pelvic floor happy:

Bladder Irritants: Different foods and drinks can irritate the bladder lining. Two of the most common bladder irritants are caffeine and alcohol. As we tend to migrate inside in the winter months and the holidays roll around, we become more inclined to reach for a hot cup of coffee or a drink with friends from out of town. Instead of coffee, it can be helpful to opt for a cup of non-caffeinated tea or cider so as to not wreak havoc on your bladder. Bladder irritants can increase the urgency to urinate. We want to spend the holidays with friends and family, not constantly running to the bathroom!

Foods and Travel that Constipate: It is no doubt that when we travel, we eat and drink things outside the norm of our day-to-day eating habits. We also tend to be on planes, trains, and in automobiles and spend our days on holiday outings and family visits. Unfortunately, travel constipation is a real thing! We overall tend to drink less water and eat foods with which our body is unfamiliar! Make sure you hydrate, hydrate, hydrate this holiday season and ensure that, even when you travel, you get some fruits and vegetables in your diet to keep the colon happy!

Nervous System Dysregulation: We all know that as much as the holidays are fun, they can often be filled with stress. Deadlines approach, holiday lists abound, and we visit family and often have dreaded conversations and sometimes debates. The nervous system can get fried around the holidays and we can wind up holding tension in our pelvic floor and abdomen. Remember that the pelvic floor and abdomen are intimately connected with our nervous system and when the body senses stress, these can be areas that tighten in response. This tightness has the potential to lead to pain and dysfunction in the core and pelvic floor. So, how do you combat the stress that will inevitably occur??

1. Try deep breathing: Stimulate the rest and relax part of your nervous system by slowly inhaling for 2 seconds and exhaling for 4 seconds.
2. Dance it out! Get your heart pumping and move your body!
3. Self-massage: Give your body and skin some TLC in this cold weather!
4. Stand firm in your boundaries: This is the hardest one, but know when you need a break to care for yourself. Be kind and firm in what you need, you deserve it!
5. Splash cold water on your face: Simple but this helps to stimulate the vagus nerve and calm the nervous system!

At Activcore Princeton’s Pelvic Health Center, the staff and I are hosting a FREE holiday event, “Pelvic Floor Holiday De-Stress and Reset”. We will have food and a raffle, be presenting tips for holiday wellness, and doing a small exercise demo. If you are in the Princeton area, I would love to see you there! The event is Thursday, December 15th, 6:30-8pm. RSVP at the following email: princeton@activcore.com. 

I hope you all stay happy and healthy this holiday season!

<3 Ashley

by Thalia Wynne, PT, DPT, AT, RYT-200 

Welcome to part three of the three-part How to Have a Happy Low Back series! If you haven’t had a chance to check out part one or part two, I highly encourage you to start there or read them after you finish this article. From the first article, we learned that having a healthy and happy low back requires three things: stability, mobility, and adaptability. 

Stability provides support and structure. Mobility provides freedom of movement. And finally, adaptability puts it all together to allow the spine to predict, perform, and react to any scenario without giving out. This last and final need of the lumbar spine (low back) is what counts the most to allow us to do things like reach into the back seat of a car, catch ourselves from falling when we trip, or get that back corner under the couch when running the vacuum cleaner. Arguably, this is the most important piece of the pie when it comes to low back health. In physical therapy, often someone will stop coming to their sessions once their acute pain is gone not recognizing that pain relief is just the first step. The same problem that brought them to the clinic will likely reoccur without the final step of treatment – training for adaptability. 

Adaptability is where we coordinate stability and mobility to ADAPT – Assess, Determine, Act, Ponder, Turn automatic.

Assess: What is the situation calling for? At high speed, your brain is taking input from the environment to decide a course of action. After sorting through the information, the brain sends motor signals down motor nerves to command the actions you’re asking to do to complete the task. Muscles will respond accordingly. Before performing the action, the brain has considered factors from the current environment and past scenarios. For example: There’s dirt under the couch and I need to vacuum under the couch. How am I going to move to get it? The brain will begin to assess what is needed. 

Determine: After you assess the environment and have made a choice to fulfill the action, next up is determining how you are going to get there. The brain is very smart – If you have a history of low back pain and bending over is how you threw out your back before, your brain knows that you want to avoid bending over from the spine to accomplish your task. How are you going to get there? The brain and body will always take the path of least resistance and avoid pain. This is essentially why it is easy for us to develop poor movement habits. We try do it the “easy” way, without even being conscious of it. Bending at the back certainly is easy in the short-term to get under that couch but unfortunately, it puts a lot of stress on those important lumbar vertebrae and could cause breakdown and, eventually, pain. If this movement is already painful, certainly you are going to avoid it by moving a different way. The bottom line is the brain determines which coordinated movement patterns are going to be the best way to get you to the thing you want. In this case – vacuuming under the couch. 

Act: In this step, your muscles carry out the action you decided on, hopefully accomplishing the desired task successfully. Perhaps it is bending at the waist, getting down on one knee, or bending the back to get under the couch. 

Ponder: After completing the task, your brain creates a feedback loop. Was this movement successful? Did you get what you wanted without feeling any physical pain? Woohoo! Your brain loves this and will remember the success of this strategy when it comes time to get under the couch again. 

Turn Automatic: As I said before, the process of your brain talking to your nerves which are talking to your muscles which are sending feedback back up to the brain is all happening very fast. Often seemingly automaticly. How? By performing the task over and over again, your body has learned the pattern and therefore it took less effort for your brain to tell your body to perform the task that you’ve done millions of times before. This is how movement becomes effortless. For example, most of us don’t have to think about putting one foot in front of the other to walk. We just do it. 

The first key to becoming adaptable in the way you stabilize or move your spine is to make sure the patterns that your brain is learning are patterns that encourage sustainable, appropriate movement. Maintain awareness of how you carry yourself throughout the day and physically train with proper form to teach your body what proper lumbar spine mechanics are. The second key to becoming adaptable is tied to the first and here’s why. It is unrealistic that we will always have 100% biomechanically sound posture all day every day. The question becomes – are you spending more time moving in ways that support your spine, or moving in ways that stress your spine? Have you trained yourself to increase how much stress your back can handle by mobilizing in all three planes of motion and strengthening the core muscles that stabilize the spine? This is why someone who has trained appropriately can bend at the spine to get under the couch once in a while without feeling discomfort. However, someone with a weaker core and stiff back will likely experience pain with the same movement. The first person has made their spine adaptable. The second person has not. 

Congrats on making it through the last article of the How to Have a Happy Low Back three-part series! I hope you’ve learned something about what it takes to have a happy low back. The key is to train your brain and body to develop patterns of movement that will support your back, develop strength in postural stabilizers, and mobilize the spine. By training your body and developing postural awareness, you will create a low back that is stable, mobile, and adaptable. 

Check out the low back section on LYT Daily for a variety of classes focused on helping you achieve just that. https://lytyoga.uscreen.io/categories/category-low-back 

See you on the mat! 

Thalia Wynne, PT, DPT, AT, RYT-200 

IG: @thalialovee