Tag Archives: flagstaff

Flagstaff Sports Massage Update

We have been busy!  Back in October I started to put together a team of massage therapists, Flagstaff Sports Massage, to help me out with some of the bigger camps that come to Flagstaff to train at altitude.  We also took on a few contracts with race series directors down in the Phoenix valley area, XTERRA Trail Running and Mountain Bike Association of Arizona, and one race in Tucson, Epic Rides Kona 24 Hours in the Old Pueblo.  We are hoping to work the remainder of the Epic Rides races this year too!

Yep, that’s a lot of links, as I say, we have been busy, and keeping other therapists busy too.  On top of that we are currently working with NAU Swimming and Diving, and completing putting together a massage therapy program with NAU Track and Field, and Cross Country.

Recent dates also include:

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The Value of Remedial Exercises in Treatment_ Guy Fisk

‎”Physicians have neglected the use of exercises as curative procedures, with the result that many quacks, cultists, trainers and others have used them as an entering wedge to obtain a medical practice” ~Guy H. Fisk, 1941

Remedial Exercises in Treatment

Click above for text.

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Anterior Hip Capsule Release

Free the Hips (fig. 1)

Prolonged sitting, hip flexor tightness, overuse and misuse can all cause hip problems.  Often when the “soft tissue” i.e., muscle, becomes tight the deeper layers of the connective tissue surrounding a joint will become short, stuck and glued down.  The hip capsule is unique in that it has a sort of rotatory arrangement of its fibers.

One commonly seen pathology, is the head of the femur (ball) becoming fixated into the posterior portion of the acetabulum (socket).  A pain generator to be sure, as the bone grinds on the inside of the joint space.    This may occur as a result of a dropped arch, internally rotated leg, and rotation of the femur.

One way to address the issue at the hip, is to position yourself or client/patient as shown in (fig.1).  This external rotation of the femur causes the head of the femur to migrate into external rotation, stretching the iliofemoral lig., which attaches the hip to the thigh and visa versa.    (The one that gets all glued up during bouts of great hip flexion and approximation of muscular origin-insertion.)  If you are a therapist using this technique position hands just inferior to greater trochanter.  Gravity will help those who help themselves.  To add an enhancer to this position, you may try pelvic tilts…tuck the tail bone under and back out.  Some people may feel a bit strange about this enhancer so I recommend pushing the knee into the floor for a count of 6-8 seconds, release and repeat 3-5 times.   You may also feel a bit of increase in ROM in adductors, sometimes that feels great.  DO NOT use this technique if you have to great a range of motion already.  In my opinion loose joints are more dangerous than tight joints.  Enjoy!

For more info or to book a session with Geoffrey Bishop, LMT in Flagstaff, AZ…call 928-699-1999.  e mail at staytunedaz@gmail.com

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Benefits of Steam Offered at Stay Tuned

Steamy Wonder Canopy available at Stay Tuned Therapeutics

Steamy Wonder Canopy available at Stay Tuned Therapeutics

Why steam is better than wrapping

Dr. John Welbes, Director the college of Massage Therapy in Omaha, Nebraska recommends steam baths in the treatment of cellulite, finding it superior to body wraps in raising tissue temperature. “Body wraps are very slow,” says Dr. Welbes, “it may take an hour to achieve the same temperature increase that you can get in about 10 minutes in a steam bath.” According to Dr. Welbes, the heat helps loosen the fatty tissue so that it is less solid and can more easily be broken down.

Potential Dangers to Wrapping:

The wraps and electric blankets that are commonly used to heat clients during a body wrap are often made of plastic. Plastic releases toxins when heated, which can then absorbed by the body, creating more toxicity. The blankets also create an electrical field effect which many people believe is not healthy.

Weight and Cellulite Loss Benefits and Steamy Wonder™

A moderately conditioned person can easily sweat off 500 grams of sweat in a sauna-the equivalent of running three to four miles or 475 to 600 calories. While the weight of the water loss is regained by re-hydration, the calories burned are not.

How steam and treatment packages help you lose weight and reduce cellulite

As you relax in the Steamy Wonder™, your body is actually working hard to eliminate toxins and burn fat. Weight loss becomes possible because body fat becomes water soluble at 110 degrees and the body can sweat out fats, toxins, and heavy metals. During a heat treatment your heart works harder pumping blood at a greater rate to boost circulation, supplying the conditioning benefits of continuous exercise. Heart rate, cardiac output and metabolic rate increase. Because the metabolism rate increases during the Steamy Wonder™ treatment you are burning calories, not just water!

Scientific Research

As the body works to cool itself, there is a substantial increase in heart rate, cardiac output and metabolic rate. Blood flow during whole-body hyperthermia is reported to rise from a normal 5 to 7 quarts per minute to as much as 13 quarts per minute.

This benefit was recognized in the prestigious Journal of the American Medical Association as long ago as August 1981: “Many of us who run do so to place a demand on our cardiovascular system, not to build big leg muscles. Regular use of a sauna imparts a similar stress on the cardiovascular system, and its regular use may be as effective, a means of cardiovascular conditioning and burning of calories as regular exercise.”

“Clients come for stress reduction treatments weekly and the side benefit is that their clothing size is reducing as well as their stress level. They haven’t changed anything in their routine for weight loss beside regular Steamy Wonder™ treatments.”
B. Carol, Lic. Esthetician, LMT & Ayurvedic Practitioner, Fairfield, Iowa

According to a study published in The American Journal of Medicine, sauna bathing is well tolerated, safe and has therapeutic value for most healthy people, as well as for most patients with stable coronary heart disease.

Researchers examined the benefits and risks of sauna bathing for healthy adults and children, as well as for patients with coronary heart disease, hypertension, and congestive heart failure. This comprehensive review of the world’s biomedical literature (1966 to the present) was carried out by investigators from the Department of Internal Medicine and University of Oulu, Finland, and the Division of Cardiology, Washington Hospital Center, Washington D.C.

Relief from Joint Pain

Steam therapy has been used for hundreds of years by many cultures in the treatment of arthritis, rheumatism, joint stiffness and muscle spasms.

How does it work?

The deep heat of the Steamy Wonder™ helps to relieve pain by causing the blood vessels to dilate. This causes increased blood circulation and allows more oxygen to get to soft tissue injuries and sore muscles. This helps to reduce pain and speeds up the healing process. Increased blood circulation carries of metabolic waste products and delivers oxygen rich blood to oxygen-depleted muscles, so they recover faster. Muscles relax most readily when tissues are warm.

Scientific Research:

Sauna bathing has been used as a thermal therapy to treat pain and other symptoms of rheumatic disease. In studies based on interviews of 0ver 200 patients, 40% to 70% of participants reported that sauna bathing alleviated pain and improved joint mobility.
(Source: The American Journal of Medicine February 1, 2001, Volume 110)

Muscle Pain Relief

Steam therapy using the Steamy Wonder™ has been found to significantly reduce muscular pain and spasms. Pain is found to be alleviated in just one session and the benefit can last for several days after the treatment. Regular steam treatments 2 to 3 times per weeks have shown to have profound relief for those having muscle pain due to injury, menstruation pain, headaches, fibromyalgia and low back pain.

How steam works

As heat penetrates the muscles, capillaries dilate and there is an increased flow of oxygen to sore muscles. Muscles and tissues become more pliable and relaxed helping to increase mobility and reduce stiffness.

Scientific Research:

Sauna bathing has been used as a thermal therapy to treat pain and other symptoms of rheumatic disease. In studies based on interviews of over 200 patients, 40 to 70 percent of the participants reported that sauna bathing alleviated pain and improved joint mobility. (Source: The American Journal of Medicine, February 1, 2001, Volume 110.)

In addition, a New Jersey Medical School Researcher found that heat therapy was more effective than analgesics for low back pain. Several different types of pain including the lower and upper back and menstrual pain can be treated with low-level heat therapies.

The results showed that the low level heat therapy provided significantly more pain relief beginning on the first day of treatment than the oral analgesics and the effects lasted more than 28 hours after the treatment was completed.

Contact Missy or Geoffrey today for a consultation or to book your session!

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Tegenkamp, Yoder Begley Win USA 5K Titles at CVS Caremark Downtown

By: Jim Estes, USATF

PROVIDENCE, R.I. – (September 20, 2009) – Matt Tegenkamp (Portland, Ore.) and Amy Yoder Begley (Portland, Ore.) won the respective men’s and women’s titles Sunday at the USA 5K Championship in Providence. Tegenkamp, 27, the reigning U.S. champion at 5000 meters on the track won his first U.S. road title in 13 minutes, 57 seconds, while Yoder Begley, 31, the 2009 USA 10,000 meter champion on the track and USA 15K champion, ran 15:27 to add the 5K road title to her collection of 2009 crowns.

As a field of more than 10,000 runners toured downtown Providence for the 20th CVS Caremark Downtown 5K, the lead men’s pack passed the first mile in 4:30 with Ben Bruce (Eugene, Ore.) leading defending national champion Anthony Famiglietti (Knoxville, Tenn.), Tegenkamp, Bolota Asmerom (Oakland, Calif.), Jordan Horn (Flagstaff, Ariz.) and Ian Burrell (Flagstaff).

By two miles, the lead group had thinned to about ten men with Asmerom assuming the lead ahead of Famiglietti and Tegenkamp.

Making the final turn off Canal Street and up the only major hill on the course, Tegenkamp made his move around Famiglietti and Asmerom to kick to a one-second win over Asmerom. Famiglietti was timed in 13:59 for third as Horn and Burrell captured fourth and fifth (U.S.) in 13:59 and 14:01, respectively.

In the women’s race, three-time Olympian Jen Rhines (Mammoth Lakes, Calif.) led a deep field of women through the first mile in 4:54. As the lead women passed two miles in 9:50, the contenders were narrowed down to Yoder Begley, Rhines, Rebecca Donaghue (State College, Pa.) and Sara Hall (Mammoth Lakes).

With about 800 meters to go, Yoder Begley made her move, but Donaghue and Rhines held on until Yoder Begley had last push at three miles to pull clear for the title. Donaghue held off Rhines by one second for the national runner-up position, running 15:30. Hall took fourth in 15:33 and Katie McGregor (St. Louis Park, Minn.) finished fifth U.S. in 15:50.

The USA 5K Championship was the eighth stop on the 2009 USA Running Circuit (USARC) and paid $30,000 in U.S. prize money with Tegenkamp and Yoder Begley taking home $5000 each as national champions plus $3000 as overall race winners.

The 2009 USARC, a USA Track & Field road series featuring USA Championships from one mile to the marathon, attracts the best U.S. distance runners. The 2009 USARC has ten events each for men and women. Magdalena Lewy Boulet (Oakland, Calif.) currently leads the women’s standings with 59 points, while Famiglietti tops the men with 49 points. For more USARC information, go to: USATF.org

20th CVS Caremark Downtown 5K: USA Championship
Providence, RI, Sunday, September 20, 2009

MEN
1) Matt Tegenkamp (OR), 13:57, $8000
2) Bolota Asmerom (CA), 13:58, $5000
3) Anthony Famiglietti (TN), 13:59, $3000
4) Jordan Horn (AZ), 13:59, $1500
5) Andrew Lemoncello (GBR), 14:00
6) Ian Burrell (AZ), 14:01, $1000
7) Bado Worku Merdessa (ETH), 14:05
8) Stu Eagon (WI), 14:07, $900
9) Aucencio Martinez (CO), 14:09, $700
10) Phillip Reid (CA), 14:10, $500
11) Ben Bruce (OR), 14:12, $300
12) Mohamed Trafeh (CA), 14:14, $100

WOMEN
1) Amy Yoder Begley (OR), 15:27, $8000
2) Rebecca Donaghue (PA), 15:30, $5000
3) Jen Rhines (CA), 15:31, $3000
4) Sara Hall (CA), 15:33, $1500
5) Mary Cullen (IRL), 15:48
6) Katie McGregor (MN), 15:50, $1000
7) Molly Huddle (RI), 15:52, $900
8) Renee Metivier-Baillie (CO), 16:02, $700
9) Amy Mortimer (RI), 16:05, $500
10) Salome Kosgei (KEN), 16:10
11) Amy Hastings (CA), 16:11, $300
12) Lindsay Allen (AZ), 16:23, $100

Full race results at: www.cvsdowntown5k.com

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No Pain, No Gain?

I copied this article to my blog because it raises some interesting points about pain. Not all are entirely agreeable to me, but it is thought provoking.

‘Pain is inevitable, but suffering is optional.’ So goes a well-known but anonymous quote. For many athletes, pain is a normal everyday experience and success is often achieved in spite of pain. But what’s the best strategy for coping with and overcoming pain and how can athletes distinguish between benign and potentially damaging pain? Matt Lancaster looks at the latest evidence

Pain is synonymous with sport. Endurance athletes relish the challenge of ‘pushing through pain’ while boxers expect to fight on regardless of a jarring blow to the chin. Adulation is reserved not just for the star rugby player, but anyone who can play through pain and contribute to the team. Winners and heroes overcome pain. Losers don’t.

But the price of pain can be high. Pain both demands attention and creates fear(1). It can restrict the ability to concentrate on performance and take away the opportunity to compete. Pain can even end sporting careers. The relationship between pain and sport is filled with challenges for sportsmen and women as well as those who support them. However, although pain of some description is no stranger to most athletes, it’s still a curious phenomenon in many ways. For example, consider the following questions:

* How are some people able to shrug off a painful injury?
* How can two athletes with the same injury experience different pain?
* Why do some pains seem to last ‘forever’?
* Why can some people compete, seemingly regardless of pain, while others struggle to overcome even a minor niggle?

This article will explore these questions, offering practical advice about when it is appropriate to perform in the presence of pain, when you should consult a professional, and how to best approach pain in a sporting environment.

The diagnostic dilemma

If you tear your hamstring muscle or sprain an ankle it hurts – obviously. Since the 17th century, the medical and scientific world has sought to diagnose pain by identifying the particular tissue that has been injured. For example, the philosopher René Descartes proposed that a pure pain sensation is transmitted from the damaged body to an entirely separate organ, the mind, just as… pulling on one end of a rope…makes to strike at the same instant a bell which hangs at the end(2,3). Descartes separated the body from the brain, and even today it is usual for people to make a distinction between physical pain and mental pain(3,4).This is especially the case in sport.

However, there are some problems with this classical view of diagnosis. For instance, an extensive network of nerves supplies the various tissues in your back, making them potential sources of pain when injured(5). It follows that if you can identify the damaged spinal tissue, for instance using magnetic resonance imaging (MRI), it should be possible to explain the pain.

The problem is that while MRI findings of severe damage to the discs or nerves is associated with the experience of pain, studies have failed to demonstrate a clear relationship between the majority of tissue damage observed on MRI and the patient’s pain(6). What’s more, almost 40% of people who have no history of back pain have abnormal, damaged spines at more than one spinal level when scanned using MRI(7)! Likewise, the damage shown by ultrasound investigations of athletes with painful patella tendons (jumper’s knee) does not necessarily correspond directly to the degree of pain experienced by the athlete(8).

This doesn’t mean that identifying the injured structure is not important or that it isn’t crucially involved in your pain. But looking to tissue damage alone (which is both frequent and often quite subtle in sporting injuries) to explain the relationship between pain and sporting performance is probably not sufficient.

A painful process

Another theory, first proposed in 1965, suggested that far from acting like an old-fashioned telephone exchange, your brain and spinal cord can actually increase or inhibit the transmission of pain signals(9). Gate control theory was revolutionary because it proposed a mechanism for the brain to have a modulating influence on the generation of all pains, and not just mental pain(10). While the original theory has been modified and expanded, it has essentially stood the test of time and been supported by 40 years of scientific research(11).

If you listen to the language people use to describe their pain, it soon becomes apparent that pain is quite simply pain, and is not separated into physical or mental compartments. All pain invokes not just a pure sensory response, but a range of thoughts and emotions also(3,12) and pain emerges from the integrated, combined action of the pain system(2,3). Simplistically, this system can be viewed as three separate parts of the nervous system, all of which modulate pain.

How do some people shrug off a painful injury?

Remember that following an acute injury, such as an ankle sprain, pain receptors are first stimulated by the mechanical stress and strain placed upon the tissue. ‘Inflammatory soup’ soon floods the tissue leading to peripheral sensitisation. Several hours later, similar chemicals will also lead to spinal modulation(19). Pain and sensitivity to movement and pressure increase over a period of a few hours; the time between the transition from the original mechanical pain (which may pass) to the maximum sensitised state may provide athletes with a ‘window of opportunity’ to shrug off their pain and continue competing.

However, this mechanism is probably only the tip of the iceberg. When you are totally focused on your opponent, or consumed by the contest, supraspinal and spinal modulation may act to inhibit the transmission or limit the awareness of the pain signal(18). We’ve all heard stories of sportsmen and women who have continued despite an injury which (theoretically) should have caused them to stop: a boxer with a broken hand, rugby players with torn ligaments, a long jumper with a strained hamstring etc. In the cut and thrust of competition, the pain system can ‘shut the gate’, and athletes are able to continue in spite of injured tissue(18). However, once your attention is drawn back to the acute pain (particularly following competition), awareness of the pain becomes strong again, especially if this also coincides with an increase in peripheral and spinal modulation.

So, should you ignore pain and try to shrug off an injury? Acute sensitisation is a normal, helpful process to encourage you to stop using the injured tissue and avoid further damage(20). It might be helpful to ask yourself the three questions in the box below.

There are a few other questions, which are perhaps even more important. We’ll get to these later. But remember, acute pain usually occurs for a good reason. It makes sense to seek professional advice as soon as you can. Sometimes people can overcome acute pain and continue to compete, but that doesn’t necessarily make it a wise decision!

How can two athletes with the same injury experience different pain?

Studies have confirmed that people respond differently to similar levels of painful stimulation(19). Differences exist not just in our individual sensitivity to a painful stimulus, but also in our perception of pain and how we display it. Pain is individual, even when the stimulus is not, but while we cannot know exactly what someone else is experiencing, our brains undergo quite similar activity when confronted with someone else’s pain(21). This is the basis for empathy and acknowledging someone’s pain is normal and important.

Our individual sensitivity to pain is in part explained by our genetic makeup (22-24), while studies involving twins have shown that learned behaviours are also important (25). Again, the division of pain into real and mental is unhelpful and the variation in pain between two athletes with the same injury lies at all levels of the pain system. Even for the same athlete, pain sensitivity varies under different circumstances, and perhaps not surprisingly, can become significantly less during competition(26).

It’s also worth noting that different groups in society may have significantly different pain responses, and this applies within sport. A study performed 40 years ago demonstrated that contact sport athletes could tolerate experimental acute pain for longer than non-contact athletes, while both groups could tolerate more acute pain than non-athletes(26).

Pain sensitivity may also be different in different people at different times; the way athletes display that they are in pain can vary, both between individuals and also between groups of athletes from different sports. It might be an extreme example, but imagine a footballer who could potentially be rewarded with a penalty responding to the pain from a kick in the shin. Now, assuming the tissue damage is equivalent, think about the same incident involving a Thai kick boxer who is in the middle of a title fight. Get the idea?!

Why do some pains seem to last forever?

During ongoing or chronic pain, adaptive changes at all levels of the pain system often outlast their usefulness in helping us protect injured tissues. Movements and pressures that would otherwise be normal continue to cause pain long after the risk of further injury has passed and often even once the tissue has essentially healed.

Examining possible tissue damage remains important when considering ongoing or recurrent pains, but a broader approach is required to address an athlete’s fear and anxiety about their ongoing pain and help them return to their sport. Focusing too much attention on pain can actually increase pain(18). It is probably more helpful to concentrate on working hard to strengthen the tissues at a sensible rate, regain normal fitness and aim to return to training.

Providing an appropriate environment for people to overcome ongoing pain is important and not always easy in sport. Coaches or team-mates who are angry at or ignore athletes with ongoing pain may contribute further to those athletes avoiding the very things that will help them return to full activity (such as a rehabilitation programme), and generate further anxiety that doesn’t help either(27). Getting this balance right and remaining positive is therefore important. People who develop an exaggerated, negative mindset towards their ongoing pain have been shown to experience both increased pain and emotional distress(28). Pain is a normal part of sport but the right mental approach can prevent it from becoming a catastrophe.

Does this mean it is OK to ignore ongoing pain? Well, it’s not quite that simple. Once again consider the three Cs. Any pain that has been present for more than a week or so, or keeps returning periodically is worth getting checked out by a professional who can not only assess for tissue damage but can also understand your pain and hopefully point you in the right direction before the maladaptive changes to your nervous system become entrenched.

Why are some people able to compete, seemingly regardless of pain, while others struggle to overcome even a minor niggle?

Although pain (especially acute pain) is related to tissue damage, this damage alone is not sufficient to explain pain fully. Pain is not just a sensation but results from the interaction between sensory inputs and brain processes, such as emotion and conscious thought. And pain is individual, not just to you as an athlete, but also to the time, circumstance and environment you find yourself in. Within the mechanics of the pain system, individual variation and modulation occur subconsciously, which helps to answer this question.

To ultimately address the relationship between pain and sport however, it is necessary to consider one further aspect of pain: your own ‘personal values’. We’ve already considered the three Cs as a guide to considering how to act in the presence of pain; however, as anyone involved with sport knows, making decisions about athletes in pain is often a judgement call. The three C questions only have meaning if we add a further, more personal line of questioning:

* Am I prepared to cope?
* How important is contributing a worthwhile performance to me?
* Am I prepared to suffer the consequences?

Having a pain killing injection two days before an Olympic final, regardless of the risks, would seem quite a reasonable thing to do for most elite athletes if it was the only way they were able to compete. Under similar circumstances, few casual joggers would agree to the same injection just days before a fun run. Entering a boxing ring, running 100 miles a week or crashing into a rugby scrum is not for everyone. Some people can continually and repeatedly overcome pain for the sake of their sport because they are prepared to. Sometimes they are rewarded with success, and sometimes, despite their desire to cope and contribute, their body succumbs to the consequences. Winners and heroes overcome pain sometimes. Losers often try and fail. Perhaps the most successful sports people are those who best understand the relationship between pain and performance: they are prepared to overcome pain, but make wise, informed decisions about when it is worthwhile trying to do so.

This post was copied from www.pponline.co.uk

References
1. Pain 2005; 113:235-240
2. J Bone Joint Surgery 2006; 88-A:58-62
3. Pain: The Science of Suffering (Columbia University) 2000; 17-31
4. Pain 2005; 113:238
5. Clinical Anatomy of the Lumbar Spine (Churchill Livingstone) 2002; 187-214
6. Phys Ther 1998; 78(7):738-753
7. N Eng J Med 1994; 331(2):69-73
8. J Ultrasound in Medicine 2000; 19(7):473-479
9. Science 1965; 150:0071-9
10. J Electromyography and Kinesilogy 2004; 14:109-120
11. B J Anaesthesia 2002; 88(6):755-757
12. Anesthesiology 2005; 103(1):199-202
13. Swiss Med Weekly 2002; 132:273-278
14. Acta Orthopaedica Belgica 1998; 64(4)
15. Acta Anaesthesiol Scand 2001; 45:1121-1127
16. Can J Anesth 2002; 49(6):R1-R5
17. Annu Rev Neurosci 2003; 26:1-30
18. Brain 2003; 126:1079-1091
19. Trends in Pharmacological Sciences 2005; 26(3):125-130
20. Topical Issues in Pain 1 (CNS Press) 1998; 45-57
21. Pain 2006; 125:5-9
22. Human Molecular Genetics 2005; 14(1):135-143
23. Proc Natl Acad Sci 1999; 96:7744-7751
24. Pain Practice 2005; 5(4):341-348
25. Arthritis & Rheumatism 2004; 51(2):160-167
26. Sport Jrnl 2003; 6(2)
27. Pain 2005; 113:155-159
28. Clinical Jrnl Pain 2001; 17:52-64

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Pain Management During Pregnancy

What happens to the abdominal muscles during pregnancy?

First the anatomy. The rectus abdominus consists of two bands of muscle fibers that are glued together by the linea alba. (See Picture). It runs from the 4th / 5th rib down to the pubic bone.  Picture 8

During pregnancy the growing baby and hormones (primarily relaxin) cause the linea alba to “unzip” in such a way that the rectus abdominus separates. (See picture). This separation, referred to as diastasis, allows the baby to come forward rather than push backwards on the spine – normal condition of pregnancy. The problem comes when the recti over separate leading to lower back discomfort, sciatica, weak abdominals, separation of the symphsis pubis and more.

“Weak abdominal muscles, like diastasis recti, contribute to poor posture which in turn cause joint misalignments, nervous system interference, and ultimately, pain and inflammation.”- Dr. Laura Brayton.

“I see this frequently in my pre and postnatal massage practice; women who have a diastitis recti have more lower back pain than women who don’t have one.” – Mollie Bollers, CMT, CIMI, Doula

Do I have the separation?

Here’s a way to find out. Lay on your back with your knees bent. Place your finger tips directly on your navel pointing toward your feet. Relax your abdominals. Slowly lift your head until you feel a ridge pulling in the midline of your body. This is diastasis. For the majority of women this separation is detectable by the 5th month.

How to prevent the separation from worsening?

First, be informed that abdominal exercises such as crunches, criss cross, jackknife, roll-up, roll over, and other exercises that involves flexion and extension of the spine ARE NOT for the pregnant mother. As a rule, during pregnancy, do not perform exercises that in the prone position require exertion of the abdominal muscles through lifting of the head and shoulders off the floor or mat and/or double leg lifts.

Exercises calling for you to lay on your back decrease your circulation and your baby’s. Also, exercises that involve rounding and “curving” of the spine (for instance when your shoulders roll forward) shift your weight back onto the spine. The shift can over stretch ligaments of the spine, tilt the uterus back increasing your chance for back labor cause, supine hypertension (decreased circulation) and more.

What to do?

There are proper exercises that avoid these complications and allow you to modify abdominal or core strengthening exercises. The key is to do it correctly by working the transverse abdominus that wraps around the abdomen like a belt.

Here is an exercise that works the tranverse abdominus.

Step 1: Sit comfortably with the legs crossed. Head, shoulders and sacrum (area between the lower back and buttocks) should be supported by a wall behind you. If you feel tight in the lower back and hips and feel as if this may inhibit your posture, place a pillow(s) underneath your buttocks that allow your legs to rest at a sloping angle to the floor.

Step 2: Place one hand at the top of your recti (where your ribs come together) and the other hand over the center of button). Elbows should be relaxed and by your side. Chest and shoulders should also be relaxed much the same way they are in a sigh of relief. The same muscles are affected.

Step 3: Breathe in through the nose â” nose in hands. Keep your chest relaxed and still. Stretch the lungs by expanding the belly. Exhale with hands drawn back to the spine.

Step 4: Tighten the abdominals. Make a slight cough to engage the tummy muscles. Repeat 3 times breathing slowly.

Step 5: On the last exhale hold the backward movement. Count out loud to regulate your breathing. Start with 30 seconds and work up to 2.5 minutes a day.

Practice this exercise 3 times a day. Try it before breakfast, lunch and dinner.

And remember that most trainers are not aware of diastisis and other prenatal and post-pregnancy healing issues. If you need help with your mummy tummy, it is in your best interests to find a fitness specialist with knowledge and experience in the special needs of prenatal and post-partum women.
Editorial provided by Anne Martens. Anne is the owner and founder of Bella Bellies Studio which is a fitness studio designed for prenatal and post pregnancy exercise.

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