pelvic pain

How To Manage Pelvic Pain Over The Holidays

Hi friend. I’m gonna get straight up personal with you and if you don’t know me yet, allow me to introduce myself. I am Amanda Fisher, pelvic floor physical therapist with a history of pelvic floor issues from peeing my pants to pelvic organ prolapse to pelvic pain to postpartum issues from 3 cesarean deliveries.

Yes, I have experienced my fair share of pelvic floor dysfunction. Now I know it was God’s Plan for me to go through those times to help people like you.

Pelvic pain is a real thing and I can tell you first hand, I have HAD it and still HAVE IT from time to time.

After 10 years of having pelvic pain, I know what to start doing when I feel it creep back in (because let’s face it, we all get busy and fall off the bandwagon of habits we SHOULD continue because it is good for us…but I'm human too) and this time of year is the perfect time for it to come a knockin’. Who isn’t a tad bit stressed around the holidays?! Um…I think we are all raising our hands here.

So, how do I get a handle on my pelvic pain over the holidays?

First thing to do is find a pelvic floor physical therapist in person or virtually. Having a coach or a professional to chat with about your symptoms and give you support/ advice when you need it most is a MUST!! This also creates accountability for me to stay on top of my exercise regimen to kick pelvic floor symptoms.

Second, I schedule or plan out my week and month. I tend to do this on Sundays. I look at my week and plan out what days I can go to the gym (with or without my kiddos), what mornings/ evenings I can walk, and when I can do my pelvic stretches/exercises (I try daily). Writing it down in a notebook or planner makes my brain think that this is happening today and I almost never miss it IF I write it down.

Third, I get a journal and spend a few minutes EACH morning while sipping my coffee (before my kids wake up) writing five things I’m grateful for and 1-2 things I can do today for someone in my family/ friend circle and for a complete stranger. This helps re-wire the brain for positive thoughts. And we could all use a little more of this in our lives, am I right?!

Fourth, motion is lotion. The days I sit on the couch and binge watch Netflix are the days I feel worse. This could be because I am not staying hydrated, or eating more junk food, BUT mostly, it’s because I am sitting in one posture (bad) and not getting blood flow to the tissue. I have to move to feel better and you have to move to create energy and get the blood flowing. I feel so much better after working out, walking etc and then following it up with 1-3 quick pelvic floor stretches to lengthen tissue. So bundle up and get out! OR set a timer in your home and don’t stop moving until it goes off. Follow up with a happy baby stretch or a deep squat to stretch out the pelvic floor muscles.

Fifth, don’t cancel on myself!! This time of year is hectic with all the holiday parties and childhood gatherings, BUT I still make time for myself so I can continue to feel better. And you should too! It is easier to continue a habit I am doing consistently because if I stop it one day, it is much harder for me to get back on the horse and start again.

If you want more information on this or what else I am doing for pelvic floor issues, please email me amanda@empoweryourpelvis.com.

What You Eat MAY Affect Your Hormones

The talk of how crazy women can be has been going on for centuries.  Did you know a hysterectomy was thought to cure women of "hysteria"? Crazy right?!  The thought was women were going crazy (mood swings) because their uterus was searching for children.  So they must be cured if you remove it. 

I am thankful to be living in times of modern medicine.  We know so much more now days about what can affect our hormones.  There are lots of options out there, but I will be focusing this blog on more food related items. 

So how can our hormones get "imbalanced"?  The most common causes are: 

  • excess stress
  • lifestyle choices
  • aging
  • genetics
  • lack of nutrients
  • pregnancy, miscarriages and abortions 
  • environmental exposure to toxins

We have quite a bit of control over the above, especially our genetics.  New studies have shown that we can turn on and off genes in our DNA with external factors (such as diet, sleep and stress). How cool is that?!  The DNA is still passed down to your children and grandchildren, but the choices you make today, can affect your great grandchildren.  Pretty amazing.  

So what choices can we make to make a positive change?

  • Start adding dark, leafy greens: most nutrient dense food, yet lacking in a lot of people's diets
    • dark greens clean you blood, improve circulation and improve your immune system by restoring strength and reducing inflammation
    • Start by adding in a 1/2 cup of cooked (lightly sauteed or steamed is best) greens to your day.  Slowly work your way to 3-4 cups of raw and cooked greens
  • Add more healthy fats (Fats! Handout)
    • Women's bodies are made up of about 60% fat.  That's almost 50% more than males and it is important for our fertility (that's hormones ladies!). 
    • When we eat a low fat diet, our bodies have a harder time digesting fat-soluble vitamins (Vitamins A, D, E and K) which play an important role in hormone regulation. 
    • Add more Omega 3s to support brain function (deficiencies have been linked to ADD, ADHD etc) 
    • Examples of my faves: coconut butter and avocados
20171008_082306.jpg

How much fat do I need?  It depends.  Start by keeping a journal and see how you feel after eating good fats. I feel better when eating meals with more healthy fats and I find I am eating more fats now than ever before, somewhere between 30-50% of my daily food, especially while pregnant. Eating more healthy fats has been shown to help some women regulate their hormones to getting their periods/ cycles back on track (while reducing their carbs, not eliminating them).

  • Chewing starts your digestion and most of us aren't chewing our food enough.
    • Chewing less makes it harder for food digestion to occur and can cause bloating, gas, abdominal pains, constipation/ diarrhea etc 
    • TRY chewing your bites 20-30 times and see if you notice a difference in how you feel!

So again...

  • Take longer to chew your bites (20- 30 times)
  • Add 1/2 cup of leafy greens to 1 meal a day, working up to each meal 
  • Add good fats to one meal.  It might be avocado slices to your eggs in the morning or to a salad at lunch.  

Pelvic Organ Prolapse: 50% of Women Who Have Had Children May Have This

Pelvic Organ Prolapse (POP) is a diagnosis women can get postpartum and after childbirth.  Statistically, 50% of women are at risk for POP after pregnancy, but you can develop POP prior to pregnancy.  I ended up having a little pelvic organ prolapse during my "training for half marathon" days, which then worsened postpartum (with each of my pregnancies).  Know this though, having prolapse does not mean you have to stop exercising. I certainly have not and I am pregnant with my third! :)    

Picture from Google Images

Picture from Google Images

Prolapse can tend to be a scary word, so let's go over what it is.  Pelvic Organ Prolapse (we will discuss female anatomy) is when the pelvic organs are pushing against weakened pelvic floor muscles that are not functioning to support the organs within the pelvis (bladder, uterus, rectum, urethra) and women can begin to feel pressure in vagina (sometimes women feel like an old tampon is coming out) from the organs starting to come down into the vagina.   

3 Most Common Types of POP:

Picture from Google Images

Picture from Google Images

1: Cystocele: bladder prolapse.  Women may complain of feeling pressure in vaginal canal.  Sometimes the pressure is felt when the rectum is filling with stool and pushing in on cystocele.  Other times it is felt after lifting or carrying weight (same with all 3 types), such as babywearing.

2. Uterine: The uterus can lower post pregnancy and delivery.  Sometimes it is difficult to keep a tampon in due to a lower uterus or some women find intercourse uncomfortable because their partner may be hitting their cervix during deep penetration.  Do keep in mind, the uterus does move during our cycles (higher and lower) and this is why some women may feel this during their days 14-21 of their cycle (different for everyone). 

Picture from Google Images

Picture from Google Images

3. Rectocele: Rectum prolapse:  Some women may complain of feeling a bulge in vagina when the rectum is full of stool.  Some women have to "splint" or insert their fingers vaginally to push back on the rectum to void during a bowel movement. 

Prolapses are measured by grades of 0-4.  "0" meaning no degree of prolapse and "4" meaning the prolapse is bulging outside of the vaginal opening.  Your doctor can give you your grade of pelvic organ prolapse in their office.  I like to look at my patients' prolapase in the clinic in a few different positions and let the patients see what they are feeling in their vaginal canal. Remember, 50% or more of women can have some kind of degree of POP after baby and some can be asymptomatic and manageable. Some POPs cause more issues so it's important to seek proper postpartum exercises and the help of a pelvic floor physical therapist to assess what exercises would benefit you and help you get back to certain exercises that interest you.  

With being early postpartum, and/ or if you are experiencing "feeling of pressure in your pelvis" or "pressure down there", it is important to avoid certain activities and exercises:

  • Avoid standing for prolonged periods of time: this could be household work, baby wearing through the grocery store,  carrying toddler, lifting heavy weight (moving furniture) etc 
  • Avoid wide leg squats and lifting from a deep squat, especially while holding your breath may increase your prolapse
  • Avoid abdominal exercises: such as crunches, sit ups, planks and push ups (not saying avoid forever)
  • Avoid running, jumping, HITT workouts, plyometrics and burpees etc ( I like to avoid these until 4-6 months postpartum AT LEAST to help the pelvic floor muscles heal properly after delivery). 

What you can do while exercising in early postpartum:

  • Pay attention to what you are feeling in your vagina while exercising and afterwards.  Increased bulging and pressure are bad.  If you feel this, you may have increased your exercise time or intensity too soon. 
  • Focus on your posture and alignment while exercising.  Remember to keep ribs stacked over pelvis.
  • Watch your breathing with exercises.  EXHALE during exertion and avoid holding your breath with exercises.
  • Focus on core and pelvic floor strengthening and retraining to get the muscles on the right tract to support you and your organs again
  • Do exercises in different positions: lying on your back, back and hips elevated, sidelying, sitting, standing (avoid too much of this one due to gravity)

I like to suggest to new moms to seek the help and guidance of a pelvic floor physical therapist before getting back into running or plyometric exercises to avoid POP and other pelvic floor dysfunctions in the future (especially if they are having signs of pelvic floor dysfunction: urinary incontinence, pelvic pain, feeling of pressure, diastasis recti, low back pain, hip pain etc).   . 

Pregnancy Journal: 27 Weeks!

On the hayride to go find our pumpkins!

On the hayride to go find our pumpkins!

I am closer to 28 weeks than 27 weeks while posting this, but our house was hit with the stomach bug this weekend and life got away from me.  

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

So #27weekspregnant and continuing to feel great!  This is my favorite time of year.  I love the fall, Midwest weather, the clothes, the smells, the food (but really, who doesn't love food while pregnant?!), and the outside activities.  My boys and I went to a local Pumpkin Patch this weekend (prior to getting sick), and had a blast. 

I am feeling baby move more and more each day.  Especially when Jack and Landon talk to my belly.  They love telling "Baby Fred" (that's what they have named him) all about their days, what they ate and what they did.  I need to record these conversations because they are freaking adorable!  

I was low on iron so I have started taking an iron supplement and eating more iron rich foods (greens, spinach, beans etc) to help improve my levels.  My eyesight has improved with doing so.  My eyesight was getting pretty bad over the last month so I am glad my doctor caught that.  

I am continuing to eat a diet high in good fats and protein.  Lots of good research out there with having a diet high in healthy fats while pregnant and breastfeeding.  I am adding more avocado, coconut MCT oil, and Omegas to my meals and snacks throughout the day.  I definitely feel better when I do, especially when I am staying hydrated, I notice less swelling in my labia and legs.  I mentally feel better too! That's a bonus as a mom of 2 (soon to be 3!).  

Eating a diet high in healthy fats is also great for women of all ages because they help regulate our womanly hormones.  How wonderful is that!!  We could all use a little help with our hormones, am I right?!  hehe

Anyways, I'll be making a post on that soon!

Have a fabulous week!  If you want to chat about anything, remember, I do virtual consults now :)

Amanda 

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Abdominal separation (Diastasis Recti) of your mid line of six-pack muscles is all the chat right now in social media.  So...I want to give you the low down on what the hype is all about.

When I first started my training with pelvic floor physical therapy, I was under the impression that a 2 finger split was considered normal.  With time, more research and growing knowledge about this topic, we now know that not to be true.  

After you read this I hope you feel more comfortable about this topic.  

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Fact 1 :I feel like a see 3 new sponsored posts daily on this topic.  An abdominal separation can happen to the linea alba, the connective tissue within your mid line, due to the laxity that happens from growing uterus and baby.  Try not to stress out about an abdominal separation.  It is very common among pregnant and postpartum women and very possible to heal a diastasis recti (men can have Diastasis Recti too).  A study by Diane Lee, found 100% of women have abdominal separation at 35 weeks gestation (pregnancy).  Your body is smart one and knows what it is doing.  Your belly stretches to accommodate your growing uterus and baby. The study found that by 6 months postpartum, diastasis had decreased to 35-39%.  So it is important to check in with belly every now and then to see if yours has gotten stronger.  

Fact 2: Posture and alignment are important with strengthening the gap.  Pay attention to how you are standing, lifting and carrying baby. Make sure your shoulders and ribs are stacked over pelvis to keep your torso in good alignment, which decreases pressure in your abdomen (less pressure pushing on linea alba-midline of abdomen).  Try to be mindful of how you are lifting/ carrying baby, especially when in the car seat or baby wearing. This is also a great place to start seeing a pelvic floor physical therapist so they can help you with your alignment with activities and assist you on your road to recovery.

Fact 3: Another way you can decrease the pressure in your belly is by breathing out (exhaling) when you are lifting baby.  This is great to remember when lifting baby into car, crib, picking toys up from the ground, lifting holiday decorations etc.  

Fact 4: There is NOT one exercise that will heal your abdominal separation.  There is also NOT one exercise that will ruin your abdomen.  There may be exercises that you need to avoid while you are working on strengthening your separation, but you can get back to those exercises when your body is ready.  For instance, if you are seeing a pelvic floor physical therapist, they may ask you to avoid certain core strengthening exercises, like a plank, but that doesn’t mean you will have to avoid them forever.

Fact 5:  The internet gets us caught up in the separation of our abdomen.  Is it 2 fingers wide, 3 fingers wide or more.  I tend to not get caught up on the separation split width and try to not get my patients too excited on this either.  I am more interested in the tension created between the 6 pack muscles that run from the breast bone to the pubic bone. I want my patients to improve in their “bridge” between their mid line, meaning more “taut” with activities of lifting, carrying, exercise etc.  When your tension improves, you are getting stronger!