Sunday, January 26, 2014

Pelvic Floor Pain

I'm a clincher.  I am not sure when this all got started, but throughout the years my body established a pattern of tensing my butt cheeks whenever I was stressed or exerting myself physically.  Over time this clinching produced a multitude of problems throughout my body.  I had chronic low back pain, hip pain, urinary incontinence, menstrual problems, irritable bowel syndrome, and painful intercourse.  I sought relief from multiple healthcare professionals, numerous medications, yoga, Kegel exercises, massage, chiropractic adjustments, and surgical procedures but pain relief was only temporary.  Then I discovered internal pelvic therapy (IPT) and my journey to fixing myself began.

Wondering what internal pelvic therapy is?  Simply put, it is massage therapy that is performed in the vagina and/or rectum when external massage cannot effectively reach or treat areas of tightness.  Sounds like a really uncomfortable massage, huh?  I was skeptical at first, but after just one session I felt positive results.  After the second session I was a believer.  Weeks later, here I am sharing my discovery in effort to help others who might be suffering needlessly.

Not sure about what conditions might benefit from IPT? This is a partial list:
  • Pelvic floor pain and dysfunction
  • Endometriosis
  • Painful intercourse
  • Urinary incontinence, urgency and/or frequency
  • Irritable bowel syndrome
  • Scar tissue from abdominal and/or vaginal surgical procedures
  • Hip, low back, coccygeal (tailbone) pain
  • Pudendal neuralgia  
  • Spinal misalignment
  • Infertility

You might be wondering how my body got to the point of needing IPT.  The short answer is that  I have hypermobile, or super flexible/double jointed hips that can stretch beyond the normal range.  My body had to compensate for this condition by over-working some of the muscles that aided in my core stability.  The long answer outlines how day to day activities, combined with my unstable core,  led to my chronic pain.

Childbirth and surgical procedures brought trauma and scar tissue into my abdomen and pelvis.  The scar tissue pulled my body out of alignment and put further stress on my already unstable core.  The traumatized core muscles shortened and pressed down on my organs.  My first  surgery for urinary problems happened when I was 3 years old, my last was two years ago. I delivered two children, had a tubal ligation, a surgery for cervical cancer, and a hysterectomy.  The scar tissue in my pelvis and abdomen wrapped even tighter around my soft tissue and organs.  I developed stress incontinence and my body dealt with this issue by clinching the muscles in my pelvis so I would not leak urine.  As the incontinence grew worse, my body clinched more and more.  My muscles soon recognized clinching as the norm.  My hip pain increased and my left knee started popping when I stood for long periods of time. I had bladder repair surgery and the incontinence problem was solved, but immediately after my surgery I began having intense pain in my pelvic floor and left hip.

As a massage therapist I pride myself in continually striving to educate myself about massage theories and  modalities. So in my determination to fix myself I read articles and books. I massaged my abdomen, hips, and quads.   I rolled on a tennis ball for my hamstrings, gluts, IT Band, and piriformis.  I stretched.  Nothing worked, but for some reason I just knew that the right kind of massage would relieve my pain.  Then quite by accident, as I was rolling my gluts on the tennis ball, I lost my balance and my life was forever changed.  The tennis ball rolled under my coccyx (tailbone) and I instantly felt the good hurt. After I sat poised atop a tennis ball for several minutes, the muscles in my pelvic floor softened and I began to have hope.

I re-read the pertinent chapters of a terrific book on trigger point therapy and luckily for me I found information about internal massage.  From there I did an on-line search for internal massage and found a great guide to internal pelvic floor self- massage (www.beyondbasicsphysicaltherapy.com).  I began doing internal massage on myself and felt relief almost immediately.   (The hard to reach areas were worked with my husband's assistance).  Still not completely satisfied,  I found a great article written by Dr. Chaitow, an osteopath in the United Kingdom.  For years he treated patients with the assumption that  weak core muscles was the root of their problems and pain.  After structural evaluation, Chaitow found that some of his female patients who had pelvic pain, painful intercourse, and stress incontinence had excessively toned musculature and that Kegel-type exercises exacerbated their problems. He also found evidence that internal vaginal massage could improve symptoms of interstitial cystitis.  But my favorite part of his article, The Pelvic Floor Paradox, was "the tennis ball trick".  I began doing the tennis ball trick and I checked in with myself  regularly to see whether I was clinching or not.  Soon after I began rolling and trying to be more self-aware,  my hip and back pain were reduced considerably.  I alternated between rocking and IPT daily, all the while monitoring my clinching.  I began feeling more open and relaxed in my pelvis and after rocking and performing self-massage  for a week and a half, my pelvis drastically shifted on the left side and my hip pain disappeared.

What followed next was a thing of comedic beauty.  I stood up and marveled at my pain-free hip.  With a big smile on my face I took one step forward and immediately went three steps to my left.  My core muscles had been so jacked up that compensation had changed my gait.  The reason I walked crooked was due to muscle memory.  My muscles were in a new position--their original, optimal performing position, but the muscles moved as if my pelvis was still misaligned.....which made me look like a drunk failing a sobriety test.  I walked wonky for a few days and even bonded with some folks coming out of Rupp Arena that were staggering as well.... but I am happy to report I am now walking upright without any sidestepping.

So back to that clinching thing.....recognizing the problem was half the battle and I can thank Hubby for first pointing out my clinching.  I am trying to retrain my core muscles by checking in with myself many times per day, and if I catch myself clinching, I focus on relaxing my body.  Nowadays, whenever I feel low back, hip, or pelvic tension, I break out the tennis ball,  do a bit of self-massage, and ask my body to just chill the heck out.

I realize this is not an easy thing to talk about for many people and I respect your privacy.  But those of you who are suffering pain like I was and would like more information on how to possibly get pain relief with IPT, please send your questions to:  KimBlackwell1964@gmail.com

8 Ways To Beat The Winter Blues

I found this terrific article on Huff Post 50 and wanted to share.  The way I see it is........ if you come to my office you can knock out several of these at once!





After the holiday high of family time and festivities, you may find the January melancholy setting in. If you're one of 90-some percent of people, you've fallen off the New Year's resolution bandwagon, your bank balance is running low from costly Christmas gifts, and there's no work holiday in sight for a few months.
It's no wonder an estimated one in five Americans suffer from SAD or seasonal affective disorder, often referred to as the winter blues. You may be sleepier than normal, not have the energy to socialize, and be craving carb-laden comfort foods.
Sound familiar? The bad news is we're still a ways away from basking in the warm glow of the summer months. The good news is life doesn't have to stop just because it's colder out than in Antarctica.
While you should talk to your doctor if you feel depressed for several days and have lost interest in things you normally enjoy, there are plenty of do-it-yourself remedies for the occasional case of the seasonal blues. We've rounded up some of the best things you can do to get yourself out of your funk.
Sayonara, doldrums.
  • 1
    Take your vitamins
     
    With fewer hours of sunlight, our vitamin D levels drop during the winter months. While there's nothing like getting some actual rays, a study from NYU found people with SAD saw improvements in their mood with supplementing with the vitamin. Dr. Andrew Weil recommends taking 2,000 IU of Vitamin D daily. Another supplement which has been shown to help with seasonal depression is melatonin. The hormone helps regulate your sleep cycle, which can be thrown off by the shorter winter days. There's a different optimal time for everyone to take melatonin, so discuss with your doctor to find out what time of day is best to supplement. 
  • 2
    Get moving
     
    Yes, we know. Who wants to brave the blistering cold (and unforgiving workout gear) to go to the gym when you could just as easily stay curled up on your couch with a warm drink and cozy blanket. But exercise can boost your feelings of well-being, help you stay positive, and and even boost your drained energy back up by upping your brains feel-good chemicals. So why not make the most of it and embrace what winter weather has to offer! Get your workout, your sunshine, and even a little fun with activities like skiing, ice skating, or even taking the little ones sledding. Did you know an hour on the rink can burn around 500 calories? Another bonus of getting off the oh-so-comfy couch. 
  • 3
    Keep your resolutions
     
    Whether you've been meaning to quit smoking or get to the gym more, staying on track with your resolutions will give you a sense of accomplishment and a goal to keep you motivated. Plus, some studies show a correlation between depression and healthy behaviors. A CDC study found that women with healthy behaviors like exercising and not smoking, experienced fewer depressed day than those with less-healthy behaviors. 
  • 4
    Don't be a hermit
     
    After the holiday high of family gatherings and days off from work, in the new year you might feel yourself feeling more isolated with a less packed social calendar. Being socially isolated can make you more vulnerable to mental health problems and just plain lonely. Some researchers believe that one in five people feel sad solely due to social isolation. If you're feeling blue, the last thing you might feel like doing is having to put on your social mask. But doctors say, the more you withdraw, the worse you will feel. So take this time to try something you've always wanted to do, like volunteering or taking a cooking class. 
  • 5
    Try light therapy
     
    No, this doesn't mean you need to be stuck under a sun lamp. Just getting outside and taking a walk in early morning sunlight could do you some good, according to WebMD. Morning light exposure is especially effective in treating symptoms of seasonal depression, according to some research. You can also get light boxes, which simulate sunlight and help regulate the brain chemicals that affect your mood. As little as a half hour to a full hour each day can help lift your spirits. Just a few weeks of treatment have been proven to help around 70 percent of patients. 
  • 6
    Treat yourself
     
    The start of the year can be stressful with freezing temperatures, new year's resolutions, and several months to go before the next holiday. Though you might be worried about money after the big holiday spending splurge (another cause of stress), it might be helpful to ease up and treat yourself to a little something. To keep yourself active, treat yourself to an outing, whether it's a sporting event, a mini-trip, or even a spa day. Massages have even been shown to lower depression by over 50 percent, by reducing stress hormones and the increasing depression-fighting chemicals, serotonin and dopamine. 
  • 7
    Consider aromatherapy
     
    Smells can be a big source of comfort and evoke memories of happier times. If you're a big believer in alternative medicine, or even if you're a skeptic, it's worth giving aromatherapy a shot to lift your spirits. An NIH study found aromatherapy can be an effective supplementary treatment for people with depressive symptoms. Lavender in particular has shown to help with symptoms of depression and insomnia. For seasonal depression, aromatherapy experts recommend oils like bergamot, jasmine, and neroli among others. Try adding a couple of drops of these essential oils to your bath water, in a diffuser, or aroma lamp to help you relax. 
  • 8
    Indulge a little
     
    Is there anything a little chocolate can't fix? Some research suggests that dark chocolate (we're talking 70 percent cocoa or more) helps boost dopamine levels in your brain. Good news, just in time for Valentine's Day.



Monday, January 20, 2014

Release The Kraken

This article really resonates with me.  I do a LOT of massage on women that have fascial holding around their breasts due to bra constriction.  Abdominal tension can contribute to low back pain, IBS, pelvic floor dysfunction, infertility, bladder control issues, and a whole host of other problems.  If you have suffered any of these maladies caused by the "body vice grip" aka shapewear, massage therapy on your abdomen can help.





"I hate Spanx because even though they look so good under your clothes, sometimes mid-wedding I'll be like, 'I feel so nauseous,'" actress Jennifer Coolidge once said. "They're so tight, who knows what you're cutting off?"
Turns out, that star was on to something. While we can all relate to the aforementioned pain and suffering, most of us have no idea about the health ramifications of shapewear. Are we hurting our bodies in the name of smooth garment lines? We spoke to gastroenterologist Dr. John Kuemmerle, dermatologist Dr. Maryann Mikhail and chiropractor Dr. Karen Erickson to find out.

When you wear shapewear, you're compressing your organs.
Shapewear couldn't do its job if it wasn't tight. Unfortunately, this leaves your stomach, intestine and colon compressed, which Dr. Kuemmerle says can worsen acid reflux and heartburn. Restrictive clothing can also provoke erosive esophagitis.
Your digestive tract is also affected, explains Dr. Erickson. The intestines are supposed to contract and move food along, but when they're compressed over a long period of time, the flow of digestion is stifled. "It's like when people eat a huge meal and then unbuckle their jeans," Dr. Kuemmerle says. This damage, though not permanent, can lead to unpleasant symptoms like abdominal discomfort, bloating and gas.
Another hallmark of shapewear? Shallow breath. When you inhale, your diaphragm expands and your abdomen flares out, Dr. Erickson says, but shapewear restricts this movement and decreases the excursion in respiration.

That includes compressing your bowels.
Those with functional bowel disorders and irritable bowel syndrome should wear shapewear with caution. "In someone who has weakness down below and a tendency towards incontinence," Dr. Kuemmerle explains, "increasing intra-abdominal pressure can certainly provoke episodes of incontinence."
Dr. Erickson also notes that there can be a tendency for those wearing shapewear to not to want to go to the bathroom. "You've got all of this pressure on your bladder from the shapewear pressing down," she says. "If you postpone urinating, it can cause stress incontinence, where you leak, or it can exaggerate stress incontinence with people who already have it."

You can develop tingling, numbness and pain in your legs.
Sitting in shapewear can lead to a reversible condition called meralgia paresthetica, which is when the peripheral nerve in your thigh is compressed. This leads to tingling, numbness and pain in your legs, all of which can come and go or become constant. "It's like putting these giant rubber bands around your upper thighs and tightening them when you sit," Dr. Erickson says. (She's also seen this condition in those who wear too-tight pantyhose and pants.)
This rubber band effect can also decrease your circulation and lead to blood clots. When you sit in shapewear, Dr. Erickson explains that those genetically prone to varicosities can develop varicose veins and lymph congestion, which manifests as swollen ankles.

Your muscles will suffer if you rely on shapewear for good posture.
"Shapewear is not a substitute for having strong muscles," Dr. Erickson says. It's important to develop muscle tone, because it's those muscles that hold your posture in perfect alignment. Many people use shapewear as a crutch to avoid using those muscles, Dr. Erickson says.
And don't be fooled into thinking that shapewear works like a medical back brace. "Shapewear's a little different in that it's not therapeutically designed -- it's cosmetically designed," she explains.

Plus, shapewear can create an environment prone to infections.
Shapewear is occlusive, meaning it traps moisture and anything else under it, which predisposes shapewear wearers to both yeast and bacterial infections. Dr. Mikhail says that the most common infection she sees is folliculitis, since bacteria often gets trapped among hair follicles and causes red puss-filled bumps. "Usually folliculitis can be easily treated with topical antibiotics," she says. "But recurrent infections may develop antibiotic resistance, meaning they get harder and harder to treat."
Dr. Mikhail notes that the risks are higher in overweight individuals, diabetics and those who sweat excessively.

Like everything in life, it's important to exercise moderation: Don't wear them too often.
"Everyone I know owns shapewear -- it's kind of a miracle," Dr. Erickson admits. "But I think we want to be mindful to not wear it on a day-in and day-out basis." It's not a problem if you wear it for an evening or a special occasion, she says, but it's not a good idea to wear it daily and sit in it for hours on end.
If you're exhibiting any of the aforementioned symptoms, all three doctors recommend avoiding shapewear until the issues are completely resolved.

Lastly, choosing the right fit is key.
There are so many different types of shapewear out there. You should pick the right style, but you also need to pick the right size, Dr. Erickson says. "You really want to pick shapewear that actually fits you," she explains. "You want it to do its job, but you don't want to get something so small that it's damaging you." For example, shapewear that goes up to your bra line isn't a good idea for those with acid reflux or heartburn, as that area is particularly sensitive for people predisposed to those conditions.
A good way to tell if your shapewear fits correctly? "It's not cutting in anywhere," says Dr. Erickson, who recommends trying out different brands and materials. "All it really does is smooth out the rough edges and you can easily get in and out of it without a struggle."