Thursday, 16 November 2017

Pelvic Health Series: Our journey to regaining strength, alignment, & function Kellie - part 3

This has been a humbling journey for me. Not only seeing a physiotherapist for assessment and treatment, but also journaling about my journey through this blog series. Writing about my experience has allowed me to reflect and dig deeper into learning about my own body.

My last blog post explained my initial assessment with Bounce Back Physical Therapy and diagnoses. If you didn’t read it yet you can find it here! I want to now take you on my journey through my “homework”, three follow-up visits, and what being “discharged” means to me.

Homework

At each appointment – the initial and follow-ups – Jillian gave me a series of stretches, exercises, and tips to implement into my daily routine. As the list grew, I would often feel overwhelmed with how to sneak it all in. What made it feel more manageable was when I remembered our discussion about how it’s okay to be imperfect and really that our goal is to have perfect alignment and engagement available to us. I actually came to enjoy incorporating the stretches into my post-workout routine or while I played on the floor with our girls. I would complete the prescribed core exercises at the end of my workout or sprinkled in throughout the day. I never put it upon myself to get it all done in one shot and definitely did not pressure myself to complete each exercise and stretch every single day. This made it attainable and decreased the stress of adding tasks to my daily routine!

Each of our bodies are so different and what was prescribed to me might be completely different than what is prescribed to you, but I still want to give you an idea of my homework list. After three appointments (one assessment and two treatments), my to-do list entailed:
  • standing oblique stretch
  • seated quadratus lumborum (side low back) stretch
  • actively relaxing my pelvic floor with the use of a soft ball
  • actively relaxing my core and practicing “tension to task” technique
  • mindfully shifting my weight into my heels while standing and walking throughout the day
  • continue with self c-section scar massage, as well as adding in abdominal massage for the deeper adhesions
  • once a day to check-in with my rib alignment on the wall
  • laying pec stretch, which then progressed to a standing doorway chest opener
  • core breaths – belly breaths with multifidus engagement
  • glute squats – super challenging squats where you really force your weight over the heels!
  • core exercises – kneeling lean backs (I call these Matrix), bridge lifts, and single leg heel touches – with the focus on full core and pelvic floor engagement and release with breath

Yes, the list in lengthy, but remember that this was over the course of a month and a half. As I began noticing small changes in my alignment and posture, I also started to notice that this movement was becoming my new normal. I would automatically engage slightly while squatting to pick up Mikah and exhale as I came to standing with the weight in my heels. I would naturally allow my upper back to curve the way it is meant to rather than try to sit as straight and tall as possible, which also allowed my core to relax. It is truly amazing that once we become more mindful of our body position during movement and stillness that we can really sense when we are at our most functional.

Follow-up visits / “treatments”

Now that you know what I walked away from each visit with, you might also be curious about what actually happened during those visits. Well, other than Jillian and I going way over time because we get busy discussing all things pregnancy, birth, postpartum, fitness, mom life, balancing it all, and wine… I continued to learn so much about my own body. I have always maintained very straight posture. For as long as I can remember people have commented on how I sit and I take pride in this, but what I didn’t realize I was doing was actually forcing out the natural curve of my thoracic (or mid) spine. Who knew? Each visit we would check in with my glute squat form and really emphasized keeping my bum untucked. I have started to incorporate these small changes into moves in my classes and the light bulb moments I’ve seen in my client’s eyes is priceless!!

My first two appointments were only two weeks apart and in that time, with really only postural changes and bringing awareness to certain movements or body positions, we had already begun to close my abdominal separation. Small changes really do have a big impact! The tension in my linea alba, which is the connective tissue between the rectus abdominis, was strong even from our first assessment which likely helped the quick shifts in the musculature.  Some manual work helped to break down some of the scar tissue around my caesarean section incision, which has made movement through my core a lot more comfortable. Upon my final visit, where I graduated from therapy (more below!), we even found that one of my ribs might be in fact keeping my rectus abdominis slightly open. The body is truly interconnected and amazing!

Discharge planning

As a nurse, we learn about discharge teaching and how this actually begins before the patient is even admitted. I found this also true with my pelvic health physiotherapy journey. Jillian set me up for success from our very first meeting and continued to build on that knowledge at each appointment. At my fourth appointment, when we discussed that it could be my final visit, I had mixed emotions! Most of me was excited and proud that I had taken my rehabilitation seriously and committed to making small changes that had turned into healthier habits. A smaller bit of me was sad because I had enjoyed learning from someone who cared equally, if not more, about women’s pregnancy and postpartum bodies as I do.

I thoroughly enjoyed our discussion on how the goal moving forward will be that I no longer am required to do the prescribed exercises and stretches daily. With improved habits and a strong core base, I should be able to move with function and freedom!

If you are reading this, but hesitant to book an appointment because you are afraid that you will be told you need to avoid certain exercises or are no longer allowed to complete certain movements – please do not let that hold you back! A Pelvic Health Physiotherapist is on your team! Their goal is to have you moving in ways that make you feel strong! Sure, depending on your situation (pregnancy, diagnoses, breath connection, etc) they might suggest changes or pulling back from certain movements for a short time. If this is the case for you, I promise that it will be worth it! After your alignment and core function are improved, you will be amazed at your increased strength through those same movements!

I am so thankful that I hopped on this journey of self-improvement and found answers to questions that I didn’t even know I had. I continue to feel empowered by my strong and capable body!

A few final thoughts…

Would I have been completely fine if I never made the initial appointment? Definitely. I had great core connection and body awareness. However, the knowledge and strength I have gained through someone else’s assessment and treatment plan have been empowering.
Do I wish I had seen a pelvic health physical therapist sooner? YES! I am really just so excited about how much I learned about my own body and some of the things I can now bring to my clients in class.
Would I encourage you – pregnant, postnatal, neither – to be assessed? YES! We all have “little” things we can work on with our alignment and core function. Just as Jillian said to me at my first appointment – “If we can make you stronger and more efficient, why wouldn’t we?!”
What is one thing I wish I could demonstrate to everyone reading? How much stronger I am because of my increased connection to engaging my core in the most efficient way!

“The human body is the most complex system ever created. The more we learn about it, the more appreciation we have about what a rich system it is.” – Bill Gates

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