A Pregnant Physical Therapist’s Top Tips for Your Healthy Pregnancy

Navigating the pregnancy literature on proper posture, exercise and sleeping alignment can be overwhelming and the guidelines presented are often not a “one size fits all”. Afterall, everyone’s pregnancy is unique. Below you will find some quick and easy tips that I utilized and found helpful throughout my pregnancy that kept me fit, aligned and pain free throughout my work day as a physical therapist at EMH.

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“Rewire Me” The Source for Your Healing Journey

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I am fascinated by how the body and mind work together to heal from pain and injury.  To learn more about healing and how physical therapists can help patients be committed to their healing process, I interviewed my good friend Rose Caiola, founder of Rewire Me, a company with a wealth of resources, writings and teachers in fields of physical, spiritual and emotional health, all thoroughly researched and curated by Rose and her team at Rewire Me.

Here are some of the gems I gleaned from our interview:

Evelyn: Why did you start Rewire Me?

Rose: Rewire Me evolved from life lessons I’ve learned from age 13 onward, meeting various teachers and mentors who helped me on my life’s healing journey. Connecting with these teachers proved more beneficial than trying to “fix things on my own.”

Many people feel alone when dealing with life’s challenges and don’t know how to ask for help or even where to look for guidance. One method or teacher may not resonate for every person, so I thought “Wouldn’t it be wonderful to have a site with a range of authentic experts, teachers, and healers?” People can seek and access these teachers’ wisdom through writings, books and classes to help them on their healing journey”.

Rewire Me’s website includes a range of experts on topics such as relationships, parenting, physical health, spiritual growth,  dealing with illness and loss –  incorporating all aspects of life.

E: How can people with physical pain start their healing process?

R: The first step is to acknowledge that there is something wrong. Many people don’t want to acknowledge that they are feeling pain, so they bury it or pretend it is not there. Once you acknowledge there is a problem, then you can reach out to a friend, call a medical professional, research on professional medical websites like WebMD and go on to Rewire Me to find teachers who may inspire them.
People may reject acknowledging pain or injury due to fear of the unknown.  Others may feel that asking for help is a sign of weakness, especially if they are used to being in charge or control.  Pain can make a person feel out of control. In essence what this really translates into is, ‘I don’t feel worthy enough to have somebody help me. I don’t love myself enough to get the help I need.’

E: How can one rewire fear-based thinking that stumps taking positive action?

R: Set a little time in the morning before you have to start your day. Sit up, feet on the floor to ground yourself and spend 5 minutes focusing on your breath, feeling and focusing your attention to the breath moving in and out, at whatever pace. This centers you to the present.

After the 5 minutes of quiet breath, ask “What do I want to happen today so I can achieve good health, or be successful as a parent or attain a work goal”

Envision your hero, or person of history who inspires you, for example, Amelia Earhart. What would it feel to be like her? Envision and embody the emotion of Amelia‘s courage, risk taking, forward thinking. How do you think she felt when she was flying solo in the starry night sky?

E: How can we help patients stay motivated and the course of treatment; to understand that their home program as physical therapy is not a “quick fix?”

R: Well, one I think is to have faith in the healing process. So that might become their mantra. ‘Today I’m going to do what I can to heal myself.’ ‘Today I’m going to take that first step.’ ‘Today I’m going to do my physical therapy exercises.’ Not worrying about tomorrow, not thinking about anything else, but having faith that they can overcome. When and if they come up to a crossroad or a flare up, don’t give up. Tell yourself “It’s okay.” Acknowledge that it’s painful and that you’ve hit a rock or a wall. Figure out how you can go around the wall instead of letting yourself get stuck. Avoid the “Oh poor me.’ ‘This always happens to me.’ ‘This is my life.’ If you keep repeating that story, you’re never going to get anywhere. Replace them with positive statements. The brain and body are listening!

The second thing to do is Practice. Practice your home exercises, self care techniques, say your positive affirmations out loud.  With practice different parts of our brain light up and those neural networks become bonded over time, overriding faulty pain patterns. If you play a sport you have to practice to compete well.  But, if you don’t practice, you won’t play as well. My kids are on sports teams and if they don’t practice, they get benched. They’ll say: “Why did the coach do that? I’m so angry…the coach hasn’t put me in play for the last 3 games!” Well, if you don’t practice, why would that coach put you in the game? It’s the same with committing and doing your home program, practice allows your body to change for the better.

Third, Schedule the 2-3 times a day in your calendar where you know you can do your physical therapy exercises. They don’t take long, right?

E: No. People wouldn’t do them otherwise, so we keep them short and manageable.

R: That’s great, so patients start to feel better, get stronger and over time they’ll see the many benefits of committing to their treatment.

E: Yes!  You’ve used the term “healing journey.” What does that means to you?

R: A healing journey means learning to love myself. Learning to forgive myself, including what happened in my past.  Incorporating growth and love from others and building this Rewire Me community is all about healing. Healing your heart. Healing your physical, emotional and spiritual well-being

Check out Rewireme.com to be inspired and continue on your healing journey!

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PelviCorFit™ by EMH Physical Therapy Grand Opening

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Have you been working out for years, but neglecting a crucial muscle group??

At EMH Physical Therapy we recently launched our brand new PelviCoreFit™ program designed to whip your pelvic floor muscles into shape. Proper firing of pelvic floor muscles is not only essential for pelvic health but is also a key factor in overall core strength and fitness.

Visualize this:

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The pelvic floor muscles form a sling that transmit forces from the ground up and from your head down. If pelvic floor muscles are weak and unaccustomed to firing during exercise, you could be promoting a faulty movement pattern in the chain. Neglecting the Pelvic floor muscles can potentially lead to more serious conditions such as chronic hip, back or pelvic pain, urinary or fecal incontinence, GI and bowel disorders, and erectile or sexual dysfunction. At EMH Physical Therapy we will help you identify and strengthen the pelvic muscles during your general workouts to help prevent future dysfunction!

Additionally, did you know that the pelvic floor muscles play a fundamental role in breathing through connections to the diaphragm?  Think about doing cardio, executing a heavy lift, or performing a Vinyasa flow with a sub optimal breathing pattern. Strengthening the pelvic floor muscles can improve breathing which will help to optimize your workout efficiency.

Come try out our discounted  PelviCoreFit™ program, learn about proper activation of the pelvic floor muscles and bring your workouts to the next level!

We offer 2 options:

“PelviCorFit™ #1” – One fifty minute session with a DPT + Fitness Guru that includes 15 minute pelvic floor/core education followed by a 30 minute PelviCorFit™ workout, then Q&A. Regular price is $200. New Client price is $50

“PelviCorFit™ Pack” – Three (3) fifty minute sessions with your DPT + Fitness Guru. The first session is similar to the description above. The 2 follow up sessions include 45 minute PelviCorFit™ workouts plus instruction on how to implement pelvic floor awareness into your fitness program. Regular price is $500 for 3 sessions. New Client price is $130

To register call 212-288-2242

or

email info@emhphysicaltherapy.com

For more information click here

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“Cupping”: not just for Olympians

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Were you watching the Olympics this summer wondering about those red circles on Michael Phelps’ shoulders? Those marks, called “sha,” are from an ancient Chinese healing technique known as “cupping.

Cupping has been around for over 5,000 years. It’s practitioners stated it released toxins and helped correct imbalances in the flow of energy.

There were two cupping types: dry and wet. Dry cupping is performed when a glass bulb with a smooth rounded lip is suctioned onto the skin via heat. Either a cotton ball is lit on fire and used to generate heat inside the cup, or alcohol is rubbed around the rim and lit on fire before being placed on the skin.

The heat inside the bulb generates a vacuum like effect, producing a negative pressure on the connective tissue or fascia under the skin pulling the skin upwards (1).

The resulting  “sha” are painless broken skin blood vessels which heal in 3-7 days.

Wet cupping was administered in the same way, except the skin is slit prior to application to allow blood to escape (2).

This method is rarely used today.

Myofascial Decompression – cupping in the 21st century

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The modern application of cupping by physical therapists is known as “myofascial decompression.”

The purpose of myofascial decompression is to:
  • reduce adhesions, scar tissue of skin and connective tissues
  • restore normal mobility
  • improve efficiency of movement.

Instead of glass bulbs, hard plastic cups are used and instead of heat generating a vacuum, a hand pump suctions the skin. This allows for a more precise application of pressure.

The application of cupping is done with the “cup” device left in place for 5 – 10 minutes or slowly moved back and forth over the restricted area.

How can we – non super-human species – benefit?

While more studies are needed the literature thus far shows some positive effects from myofascial decompression (3), including decreased neck (4) and low back pain (5).

Empirically, we at EMH Physical Therapy observe that the cupping technique combined with functional movements reduces pain and releases tight tissues quicker for patients with painful cesarean scars, plantar fasciitis, scoliosis and other conditions.

Keep in mind that cupping is an adjunct treatment, used alongside other types of manual therapy, therapeutic exercise and neuromuscular re-education at the discretion of your physical therapist.

References

1. Kravetz, R.E., 2004. Cupping glass. The American Journal of Gastroenterology 99, 1418.
2. Xue, C.C., O’Brien, K.A., 2003. Modalities of Chinese medicine. In: Leung, P.-C., Xue, C.C., Cheng, Y.-C. (Eds.), A Comprehensive Guide to Chinese Medicine. World Scientific, Singapore, pp. 19–46.
3. Cao H, Han M, Li X, Dong S, Shang Y, Wang Q, et al. Clinical research evidence of cupping therapy in China: a systematic literature review. BMC Complementary & Alternative Medicine 2010;10:70.
4. R. Lauche, H. Cramer, K. -E. Choi et al., “The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain—a randomised controlled pilot study,” BMC Complementary and Alternative Medicine, vol. 11, article 63, 2011.
5. Y. D. Kwon and H. J. Cho, “Systematic review of cupping including bloodletting therapy for musculoskeletal diseases in Korea,” Korean Journal of Oriental Physiology & Pathology, vol. 21, pp. 789–793, 2007.

 

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How to Foam Roll Most Major Muscle Groups in 5-10 Minutes

Don’t you wish you could get a deep tissue massage every day? If you said “yes!” then I highly recommend you make a small investment in your own foam roller.

I foam roll every time I go to the gym because it’s the easiest way to self-release all of the major muscle groups. Foam rollers act on the fascia, or connective tissue, that lies above all muscles and organs of your body. When you use a foam roller, you’re making the fascia mobile, which ensures all structures underneath will function without restrictions.

When ordering remember: darker colors usually mean a firmer roller. If you are a beginner try white or a light color. If you want a deeper, firmer tissue massage go with dark grey or black.

Check out my quick video that hits most major muscle groups in just a few minutes. Happy rolling!

Having trouble losing the “Mom Belly” Post Baby?

Why diastasis recti may be your problem and how you may be making it worse…

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If you’re doing a million crunches to get your abs back post baby but can’t seem to lose that last little “pooch,” STOP!! You may be experiencing a very common postpartum complaint: diastasis recti.

 

What is diastasis recti?
It’s a separation of your rectus abdominis (6-pack muscles). As your belly expands during pregnancy, the connective tissue between the right and left sides of the muscle (called the linea alba) stretches to accommodate your growing baby. This separation may persist postpartum and in some women does not naturally reduce. This gap leaves your abdominals less functional, weaker and allows the other soft tissues to hang out. This causes that little belly that most new moms learn to hate.

Do I have diastasis recti?
Lay on your back with your knees bent and feet flat on the floor. Place 2 fingers at your belly button. Now lift your head like you’re trying to look at your belly while keeping your abs relaxed. Do you feel a gap along the midline of your abs at your belly botton, how about above or below the belly button? If you can fit more than 2 fingers in this “gap” you have a moderate-severe case of diastasis recti.test

What can I do about it?
Don’t freak out! You can learn a simple exercise to “brace” your abdominals that will begin to close this gap. Begin on your back with knees bent, feet flat and try to engage your deep abdominals by inhaling and bringing the navel to the spine as you exhale. See the exercise program below (“Other Resources” at the bottom of this blog) for a beginner plan geared towards closing the gap of your diastasis recti. If your goal is to get back to running, yoga, barre classes, spin classes etc., it’s recommended that you attend a few (anywhere from 2-12) PT sessions in order to strengthen your abdominals and avoid stressors that you’re not ready for. For example, planks and crunches are too challenging for abdominals weakened by diastasis recti and can worsen the separation if done improperly or too soon.

Bracing Steps (standing & lying down)

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Other Resources:

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Home exercise program for beginners: View at www.my-exercise-code.com using code: TGQQAGV

http://mumafit.com.au/  A site created by an aussie mom of 3, Maternal Wellbeing Specialist, and International Holistic Life and Wellness Coach. She also has a very popular app that has quick and easy exercise programs for during and after pregnancy.

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Leaking is More Common Than You Think

Hmmm…. How to put this delicatelyWoman jogging on a track

Do you often find yourself leaking urine while exercising?  Squat… leak a little, overhead press… leak a little more, jump… forget about it, pants are soaked!

If this describes YOU, know that you are not alone. You likely fall into the 25% of women between the ages of 18-44, or the 44% of seniors, or the 33% of female athletes who experience varying levels of incontinence. These astounding statistics represent only those who have come forward to report symptoms. If you are skeptical, just take a look at YouTube (search “girl peeing while lifting weights”). You will find solidarity; everything from women admitting to leaking during exercise, to videos of complete loss of bladder control while executing a heavy lift. Today, there are even T-shirts glorifying urinary leakage during workouts in order to empower women and banish feelings of shame.

It is wonderful that women are finally coming forward to bring this previously taboo topic out into the open.  Just last week, Kate Winslet explained that she no longer jumps on trampolines for this very reason.  Leaking when exercising, sneezing, or coughing is so normal that Winslet’s admission was received with more “it’s nice to know she’s normal” reactions than surprised ones.  Yet, shockingly, statistics show that women will wait, on average, 6.5 years before reporting incontinence, because as normal is it may be, women rarely speak of it, even to their medical providers.  It’s no wonder urinary (and fecal) leakage has generated a $28 Billion dollar industry in the US alone.

If you are leaking while exercising, it is likely that your pelvic floor muscles are just not firing properly in order to withstand the load. We call this Stress Urinary Incontinence (SUI) which describes urinary leakage that occurs particularly with physical activity or exertion. While this issue is extremely common, it is not something you want to leave untreated. Whether you are losing a few drops or outright “peeing your pants”, help is out there, in some cases, right around the corner.

First you must understand that the pelvic floor muscles are just that: muscles. Therefore, you can strengthen them like any other muscle. We spend hours in the gym attempting to perfect every muscle in the body, but somehow forget the pelvic floor, a keystone to our overall health and fitness.

The tricky part is that you can’t easily see these muscles. As a matter of fact, you may not even be able to feel them. That is where Pelvic floor rehabilitation comes to the rescue. At EMH, we teach you how to identify, isolate and strengthen the pelvic floor muscles to restore normal function. We then help you integrate pelvic floor techniques back into your exercise routine so that you can squat, overhead press, and jump “leak free”.

So at your next holiday party, just think to yourself — 1 in 4 of the women in this room are currently peeing in their pants. Luckily, you don’t have to be one of them.

Strong Abs during Pregnancy and for New Mom’s

The staff Doctors of Physical Therapy at EMH specialize in pre and postpartum physical therapy for a healthy pregnancy and a fast recovery after delivery. Preventing Diastasis Recti is one aspect of our expertise.
Please forward to all your pregnant/new mom friends and family!

Diastasis Recti Abdominis (DRA) can occur in up to 66% of pregnant women due to hormones that allow ligaments and joints to relax, the increasing baby size in utero, improper weight lifting (ie heavy food bags, other children, furniture etc), a history of prior C-section or abdominal surgery and repetitive poor mechanics during daily activities and lack of regular exercise.

Men can also develop DRA due to faulty weight lifting mechanics, obesity and chronic medical conditions that result in frequent coughing such as bronchitis.

What is a DRA?

DRA is defined as the separation and thinning of the rectus abdominus muscles (see diagram in green) and stretching of the linea alba (see diagram in blue). The linea alba runs from the xiphoid process (base of sternum) to the symphysis pubis (center of pelvic bone). Both the rectus abdominus muscle and linea alba are the main support for the front of the abdomen, keeping the visceral organs in place and functioning well. They also maintain pelvis stability during walking, lifting, bending and squatting.

What are the symptoms of DRA?

Symptoms may include:

  • Noticeable small or large bulge in the center abdomen
  • Sharp or burning abdominal pain during bending, lifting, standing and walking
  • Lower back pain
  • Feeling like the intestines or stomach may fall out
  • Poor posture
  • Longer term problems of prolonged DRA may include Stress Urinary Incontinence, Fecal Incontinence and Pelvic Organ Prolapse.

How To Measure for a DRA?

The best way to measure is a finger width measurement. Lie on your back, knees bent, head resting on floor/pillow. Place tips of 4 fingers across the body at naval or just above/below the naval per your comfort. Now raise your head and shoulders slightly upward. If your fingers descend inbetween the parallel rectus abdominus muscles on either side of your naval, measure how many fingers move downward. If there is a true split of the linea alba, your finger will fall into a space that feels squishy (your intestines live here!). A positive DRA is one where there more than 2 fingertips (1 inch or 2.5cm width) that lower. We have measured women with 3 to 4 inches ( 8cm) wide and have helped them narrow back to 1 inch (2.5cm) wide.

 

What to Do if you have a DRA?

Best to first consult a pelvic physical therapist for a tailored postural, stabilization and home exercise program targeting the Tranversus Abdominus (deepest and lowest muscle of our abdomen), the pelvic floor muscles and the multifidi muscles (lower back stabilizers). Here are some tips to help you immediately:

  • Avoid positions that may further separate the recti muscles, like doing sit ups, crunches, strong stretches of the abdomen, quick trunk rotation movements
  • Stand and sit symmetrically (not to weight bear more on one side vs the other)
  • During standing, gently unlock your knees and gently pull your stomach inward while breathing normally
  • Self bracing of your stomach with your hands pushing the rectus together when sneezing, coughing or laughing
  • Wear a pelvic and abdominal support product to help maintain erect trunk posture and decrease pain until your muscles are aligned and strong

 

 

Sitting is Detrimental To Your Health

“In the interest of keeping our  current and prior patients healthy (and happy) I am pleased to introduce “EMH Physical Therapy Better Health & Movement Blog”

Today ‘s article is about posture. The key to a healthy spine, pain free neck and lower back is to maintain a neutral spine throughout the day, work or play.

EMH Physical Therapy offers manual therapy to release restrictions,  low level laser therapy to stimulate healing and tailored exercise programs. Yes, we still offer individual 45 minute treatment sessions by one licensed Doctor of Physical Therapist.

The-health-hazards-of-sittingWritten By: Lauren Calado, DPT, PT 

Our bodies have 650 muscles and their function is to contract, stretch, fire up… MOVE.

Did you know that more than 80% of us sit for over 10 hours a day? As technology in the work-place and at home increases, physical activity is rapidly declining.

A New York Times article reported, “Jobs requiring moderate physical activity, which accounted for 50 percent of the labor market in 1960, have plummeted to just 20 percent” (2011). Add on more time dining, watching television and more than 75% of your day could be spent sitting. This is a functional contradiction to human anatomy and physiology and has a negative impact on your health.

The health risks of prolonged sitting include low back pain, muscle weakness, impaired posture, neck/shoulder pain, nerve impingements, decreased flexibility and pelvic floor dysfunction. Other disorders that may develop as a result of long periods of sitting are decreased cardiovascular endurance, obesity, poor circulation and decreased life span. Yikes!

Tips to decrease the health risks of sitting:

• Take one flight of stairs up/down instead of taking an elevator to your floor destination
• Walk to a co-worker to talk instead of calling/texting/emailing
• Stand up during TV commercials
• Perform a few different core/strength exercises such as standing squat, push up, or an abdominal exercise 10 reps twice a day.
• Wear one of the new fit bracelets to track your walking or cardio results
• Park your car further away from the office or your house
• Enter/Leave the subway station that is one stop away versus the closest station to home/work

Research shows that your brain needs a movement break after 50 minutes of working, thinking, sitting. Get up for the last 10 minutes of each hour to take a walk, pet the dog, do a quick errand. Your brain will be refreshed and creative thinking will be enhanced.

If you are experiencing sitting related problems, consult a physical therapist. Physical therapists have 7 years of education in advanced anatomy and physiology, movement science and interventional healing therapies. The Direct Access law allows you to consult a PT first, so you don’t have to see a doctor, get a prescription and be referred to physical therapy. We can help you heal from sitting related dysfunction.

 

Pelvic Pain App developed by Evelyn Hecht, PT

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“She inspires us to not accept the status quo, to strive for wonderful things and not just acceptable things. There’s a lot of good nuggets of wisdom and interesting ways of looking at the profession. Some Apps are fun but the best are more about life”-  Dr Joe Simon

 

I felt this quote was the best to describe my thoughts about this interview. Dr Evelyn Hecht has been treating patients with Pelvic Floor Dysfunction (PFD) longer than there has been a doctorate program at my alma mater. But innovation is not the key to riches. Evelyn saw a need in the marketplace and decided unlike many in our industry not to wait for someone else to do it .

Lately i have consulted with more and more physicians and surgeons on their legacy or exit strategy. Evelyn is no where near the end , matter of fact , she is on the cusp of a new road in healthcare. Apps are a highway of free traffic from possible clients from around the world. Evelyn has just made it easier for the vast population to accept her as the expert in the field.

Pelvic floor therapy is a growth factor for practices across the country. This new specialization is growing with a medical network from physicians, physios & psychologists.

INTRODUCING, PELVIC TRACK a new app to help PATIENTS and practitioners to work together. The challenges associated with communication with the therapist dealing with pelvic floor therapy. Again , it was not looking for a better mousetrap but to create one that doesn’t exist from the need of her patients and her therapists.

The motivation for our new grad and younger (not age but career wise)  listeners. Evelyn has made strides and conquered the niche market. Marketing pelvic floor therapy through facebook, through her blog and now through her App is something i would ask all my listeners to take a deeper look at.

I hope you find the takeaways that I did.

For more info or to read the article directly click  HERE

To purchase or for more info on Pelvic Track App click HERE