Back Pain, Pelvic Health, Pregnancy, Whole Body

The One Where I am Pregnant

This is the one and only post written during my pregnancy. (I’m full term now, just waiting on baby to arrive.) Writing a blog or engaging in social media just hasn’t been a priority the last nine months. I’ve been spending less time online. I wanted to experience this pregnancy with less technology, fewer distractions and time wasters. For a variety of reasons, we made a conscious decision to keep our news off social media.  Now I’m heading into my maternity leave, and I wanted to write a quick post. Short and sweet, just a few things I’ve learned about alignment and natural movement during the last nine months. These are all things that I knew on an intellectual level, but being pregnant has caused me to understand and appreciate them in a new way.

1) Keep moving, so that you can keep moving. This is probably the most important thing I did during this pregnancy. JUST KEEP MOVING.  I’ve made this recommendation to my clients, but now I really understand how important it is.  You are gaining weight gradually and your body is going through major changes over the course of almost a year. If you keep walking, squatting, going up and down the stairs, getting up and down off the floor, you will gradually gain the strength as your weight gradually increases, and you will be able to continue doing those things.  Two of my goals for this pregnancy were to reach the end and still be able to get up and down off the floor and be able to hike at least 2 miles. I’m nearing the end, and let me tell you, I feel truly enormous, but it’s manageable. I can’t imagine how difficult it would be to get around if I hadn’t been moving all along. Last week we went for a hike– uphill, downhill, up and over boulders, through a partially dried up creek.  At this stage of the game, I’m tired, I’m slowing down, and I stop for lots of pee breaks (good thing I’ve been practicing my squatting!).  We went slow, about 3 miles in 2 hours, BUT I did it. Not only did I do it,  I enjoyed it. I share this not to brag (my endurance certainly isn’t what I had hoped it would be!), but to encourage you that it’s possible to never reach the point where you are too big to move. Just keep moving.

img_5271  img_5273

2) Do what you can, then rest.  There were days that I could walk about 10 minutes before I needed to have a snack and take a nap.  You’re tired. I hear you, mamas.  Sometimes it is a victory just to get out of bed and walk to the mailbox. When you can only muster the energy for a little movement, DO IT, then rest. Other days I felt up for a long walk, going to prenatal yoga class, and teaching a class.  When you feel good, and you can challenge yourself, DO IT, then rest.  Give yourself grace. Growing a baby is hard work. Release yourself from expectations. Your body is doing an amazing thing.

3) Don’t underestimate the importance of pelvis back, ribs down & feet straight.  Seriously, this one small thing saved me from so much potential pain. I didn’t have any back pain during this pregnancy, and this is part of the reason why. I knew this was important before, but experiencing it while pregnant took it to a whole new level. In my classes, I demonstrate leaning your pelvis forward and thrusting your ribs (what NOT to do).  It’s really common to assume this position in pregnancy because the extra weight in front tends to pull you forward, unless you know to stand differently. As I got bigger, demonstrating this became more and more uncomfortable. Even just being in this position for a few seconds feels awful. I actually had a hard time demonstrating for the pictures below because it feels that bad.  You can learn more about this (and see better pictures of these various positions) in these posts about pelvis positionrib position, and how to stand when you are pregnant.

(Left to right: Ribs lifted, pelvis forward & feet turned out, pelvis back & ribs down.)

img_3849  img_3851  img_3850

4) This stuff really works, AND ALSO sometimes you need additional support. By “this stuff” I mean practicing good alignment, moving more (and moving better), sitting less, the corrective exercises, and moving towards more natural movement.  Don’t get me wrong– I’m tired, I wake up stiff and achey, and my fingers and toes are starting to get a little sausage-y.  This pregnancy hasn’t been without it’s discomforts, but I’m nine months pregnant and I’m not totally miserable. For starters, I haven’t peed myself once.  Yes, the baby head pressing on my bladder is causing unspeakable pressure. Yes, I pee more frequently than I did before.  But I’ve never felt like I couldn’t control my bladder. I haven’t had any back pain, sciatica, pubic symphysis pain or hemorrhoids.  One thing I did experience early on was SI joint instability and a tweaky feeling in my hip. Before I got pregnant, I knew that my right side was weaker and less stable, so it was no surprise when it started giving me trouble after gaining my first 10 lbs.  I knew the exercises I needed to do to improve my pelvic stability, but it wasn’t getting better. Getting additional support from a PT was really helpful.  She could manipulate the bones of my pelvis to help correct a rotation and tape my sacrum to give a little extra support until my muscles were strong enough to keep my pelvis stable and aligned on their own. Here’s the thing with the common pregnancy aches and pains: most of them come from issues that were there before you were pregnant (like mine did). Add the extra weight, the shift in hormones, and all the other changes that occur, and the “weakest link” presents itself. These issues aren’t “just part of pregnancy” that you have to live with; often there is something you can do to make it better.  Seek out help!  Try the things in this blog or find a Restorative Exercise Specialist near you.  If you need additional support, see a chiropractor, PT, massage therapist, or another professional who can help.

Feet, Hip/Leg Pain, Pictures of Exercises, Shoes

5 Steps to Safely Transition to Minimal Shoes

Minimal or barefoot shoes have become increasingly popular in the last few years because of their health benefits.  Vibram claims their shoes will strengthen muscles in the feet and lower legs, improve range of motion, stimulate neural function, eliminate heel lift to align the spine, and allow the body to move naturally.  Under the right conditions, minimal shoes can absolutely facilitate these changes; however, most of us don’t have feet that are healthy enough for these shoes without some training. 

Being barefoot is natural, but our feet don’t function naturally anymore.  Two main factors in our modern environment have led to feet that are severely lacking in muscle strength, joint mobility and neurological connection:

  1. Shoes that have stiff, supportive soles and positive heels
  2. The lack of natural surfaces in our environment.

The lawsuit against Vibram Five Fingers has been all over the news and social media the last few days. I’m not going to get into it, but you can read the details and an analysis by Katy Bowman here if you are interested.  The problem is not that Vibrams (or any minimal/barefoot shoe) are dangerous; the problem is that our feet are deconditioned, and we fail to properly train them before jumping into a minimal shoe. Wearing a “supportive” shoe your whole life and then one day putting on Vibrams to go for a hike is like wearing a full body cast your whole life and then trying to do a cross fit workout.  You the lack strength, mobility and neurological connections necessary, and you are going to get hurt.  A principle of any good exercise program is a gradual, appropriate increase in the demand you place on the tissues.

My friend and fellow Restorative Exercise™ Specialist, Jennifer Gleeson Blue, put it this way, “You know how you don’t take someone on the brink of death-by-hypothermia and submerge them in a hot bath? It’s the same with minimal shoes. Your feet are on the brink of death-by-stability-shoe. But step one isn’t a five finger shoe.”  

5 Steps to Transition to a Minimal Shoe:

1) Stop wearing positive heeled shoes.  Switch to flat shoes and make sure they are wide enough for your toes to wiggle and spread.  If you can tolerate it, try a shoe that has a more flexible sole. Even some athletic shoes have a heel that is slightly higher than the toes, so look closely!

2) Stretch your calves.  Wearing positive heeled shoes causes the calves to become short and tight.  We need to restore length to the calves to allow us to safely transition to a flat or minimal shoe.

20140513-212717.jpg
CALF STRETCH: Place the ball of one foot on a rolled up towel/yoga mat or a half foam roller. The heel should remain on the floor. Hold at least 1 min, then switch feet.

3) Work on toe and foot mobility. Do these stretches to release muscle tension, improve circulation and neurological connection, and decrease pain.

TOFst
Stand on one foot, reach the other foot behind you, tucking the toes under. Hold for 1 min, then switch feet. If you get foot cramps, take a break and try again.
toelift
TOE LIFTS: Work on lifting each toe individually. This is a motor skill we should have! Keep practicing until the neurological connection has been restored.
toespread
TOE SPREADING: Stick your fingers between your toes to stretch the little muscles between the toes. You can also buy Foot Alignment Socks that do the same thing.
tennisball
TENNIS BALL MASSAGE: Stand with a tennis ball under the ball or your foot. Hold for 1 min. Try to relax and let the foot drape over the ball. Roll the ball back towards the arch, finding a sore spot. Hold for 1 min. Continue down the length of the foot until you reach the heel.

4) Spend time barefoot around the house and backyard.  Try out a variety of surfaces.  This allows your feet to start getting reacquainted with FEELING things when you walk around.

NOTE: This transition may take weeks, months, or even years depending on the current health of your feet.  Steps 1-4 are important for EVERYONE regardless of whether you intend to wear minimal shoes or not.  If your foot has undergone significant damage from a lifetime of ill-use, surgery, or injury, minimal shoes may not be appropriate for you. That’s ok. You can still receive huge benefits from the above steps.

5) Start with short distances and natural surfaces in your minimal/barefoot shoes.  Once you are ready to start wearing your new shoes, start with small distances.  Slowly increase your walking mileage before you even think about running. (Although I don’t really I recommend running in minimal shoes.) Start with natural surfaces such as grass, mulch, or dirt to start training your feet.   Concrete and asphalt are unnaturally hard surfaces and may cause you pain and injury.  (I can wear my vibrams all day on natural surfaces, but I can only last about a mile on concrete.) As you increase strength and mobility, you can increase your mileage and try a greater variety of surfaces.

We just got back from a week in the Great Smoky Mountains.  It was BEAUTIFUL!  I was inspired by “Screen Free Week” to take a tech break while we were there.  I used my iPhone only as a phone, camera and map/GPS, and I stayed off Facebook, email, Instagram, etc.  It was a great decision for the health of my body and mind.  I highly recommend it!

GSMcabin

These are pictures from a 5 mile hike up and over a ridge, down into a valley with a waterfall, and back.  You can see (in the first picture) how rocky and uneven the ground was.  The trail was covered in pebbles, rocks, tree roots, mud, moss…. and my feet, legs, and hips felt great (tired, but great) the whole way and even better the next day!  Had I done this hike  in Vibrams 2 years ago, I probably wouldn’t have made it all the way, and I definitely would have been in serious pain.  I’ve been “training” my feet for 4 years now, so they could handle the workout.  Wearing minimal shoes can be a very healthy and enjoyable experience, but you have to do the prep work!

vibrams           bridgem&tabramsfalls

PS- In case you’re looking for a new pair, here is a GREAT list of minimal shoes.  Click here for winter weather options.

 

Health

Silence is Golden

IMG_1076

I just got back from an advanced teacher training in Hawaii led by my teacher and mentor, Katy Bowman.  It was an amazing week in a beautiful place with some of my favorite, like minded people.  Why did Katy pick Hawaii and this particular retreat center for our training?  Well, besides the fact that Hawaii is awesome and a tropical jungle provides a lot of outdoor movement opportunities, I think part of the draw was this: no technology.  The retreat center we went to had no cell service (for me anyway), no TV’s, no traffic, no loud music, no air conditioning, and no cloud of 3G internet. We had the opportunity to practice our own alignment and natural movement at a deeper level without the distractions that technology can bring.

Honestly, it wasn’t a zero technology week for me.  There were a couple locations with spotty wifi, which I will admit, I used a couple times to message my husband. (Who I left in Tennessee, alone with our high maintenance dog, friendless, and up to his eye balls in Civil War research.  He deserves a big THANK YOU for letting me go.  Also, I should clarify that he isn’t friendless because he is a loser, but because we just moved to TN and haven’t made friends yet.)  The lack of technology became very freeing.  It was SO therapeutic to live a week without constantly checking my email, thinking about whose phone call I need to return, and reading the endless stream of Facebook posts.  I became very aware of how much “noise” these cause once they were gone. If a week without your phone and computer sounds like hell, a technology free week is probably just what you need.  Trust me, it’s worth it.

We started each morning with a silent class at 5:45am, before the sun came up.  I didn’t realize before this experience how often I am distracted (during an exercise class) by others talking around me or by my own words.  It was 1 hour 15 minutes every day with nothing requesting my attention other than what was happening in my body in that moment.  There was no multitasking going on here.  No stretching in front of the TV.  No going for a walk while talking on the phone.  I noticed things about my body that I hadn’t noticed before.   I think this is one reason why people find yoga so relaxing. It’s a 1 hour break from the constant noise both outside your body and inside your head.

IMG_1067

windowview

Whether it is technological “silence” or verbal silence, I can’t recommend it enough.  Maybe you can’t get away for a week, but how about an afternoon? Or an hour?  Even on a smaller scale, these things have huge benefits.

Try this:

Turn off the TV, the computer, the iPod, and the cell phone.  (Don’t turn it on silent because, if you’re like me, you’ll still be distracted when it vibrates and lights up.)  Put the kids down for a nap.  Put the dog outside.  Lay or sit down on the floor, close your eyes, and take a few deep breaths. Then go through a few of your favorite stretches, trying to focus your mind on what is happening in your body.  Notice where you feel tension and try to let it go. When you start thinking about the grocery list, or that irritating person at work, or that project you need to complete, bring your mind back to what is happening in your body. Do this for 10 -15 minutes (or longer!), and notice the effect it has on your mental and physical state.

Balance, Habits, Knee Pain, Standing

Paddle Boarding Part 2: Take a Stand for Your Knees!

In Paddle Boarding Part 1 we looked at my sister’s default position when on an unstable surface.  Another common response when on an stable surface is to lower our center of mass (in the pelvis) to feel more steady. Your center of mass is closer to the ground when you are kneeling, making it easier to balance. Here my mom and I are trying to get up from our knees to our feet.

kneeling

bent knees

Once we got to our feet, we had our knees bent, again slightly lowering our center of mass. Bending the knees is instinctual when you feel wobbly, as is turning your feet out and widening your stance. If you’ve ever played sports, this is the common “ready position”.

Here's Hanley Ramirez of the Dodgers in his ready position. (As recommended by my husband)
Here’s Hanley Ramirez of the Dodgers in his ready position. (As recommended by my husband)

This position is helpful if you are trying to get your balance during an activity or preparing to run/jump/etc into action while playing a sport. The problem comes when you are so conditioned to hold this position that you start doing it all the time. You may have learned not to lock your knees but instead to keep a slight bend in them. This can be just as damaging as standing with locked knees. There is actually another option: standing with legs that are fully extended but not locked. This position is the least damaging and most beneficial for long term health. Let’s take a look at standing positions in more detail.

Option #1: Locked Knees- Legs are fully extended and quadriceps (muscles on the front of the thigh) are contracted, pulling the patella (knee cap) up and back into the joint space.

Downside- when the quads are overused, and the  patella is pulled up/back, it starts to cause friction and irritation in the knee joint which causes inflammation, damage, pain and (eventually) cartilage degeneration.

Option #2: Bent Knees- Knees are kept slightly bent.

Downside- when the knees are chronically bent, the body adapts by shortening the muscles around that joint to keep things taught. This passive shortening  is different than an active contraction a muscle does when it is working.  When these muscles get too short and tight, they start to decrease joint space, inhibit range of motion, and compromise circulation. Eventually, it can become difficult to fully straighten the leg because of this tension. Here’s an example: Think about an arm in a sling. It is passively held in a bent position, and the muscles shorten. When the sling is removed, you can feel the tension that has accumulated. It takes time to be able to straighten the arm again.

Option #3: Fully Extended Legs with Relaxed Quadriceps– Legs are fully extended with relaxed quadriceps. To test whether your quadriceps are relaxed or not, contract and release your quads and watch your knee caps dance up and down, then leave them in the down position. If you can’t do this, make sure your knees are not bent and try backing your weight up into your heels. If you still can’t do it, try leaning forward with your backside against a wall. Often the quads are stuck in the “on” position (knee caps up), and it can take time to get them to release. Practice daily until you are able to do it standing upright. Other components of optimal stance include standing with the outside edges of your feet straight, feet the width of your pelvis, and hip/knee/ankle all in a vertical line. (I’ll have to cover these in more detail in a future blog.)

Downside- It’s really hard. There are no physiological consequences to standing this way, it’s just a lot of work. Whenever you think about it, adjust yourself to this position and eventually it will feel natural.

Hyperextended Knee Joint. Vertical Leg.
Hyperextended Knee Joint.           Vertical Leg.

(NOTE: When most people fully extend their knees, they end up with a vertical leg. If you tend to hyperextend your knee joints, “fully extended” is too far for you because when your knee is fully extended, it goes beyond the natural boundaries of the joint. A better cue would be to extend until you reach a vertical leg.)

In real life, there are times when it’s appropriate to stand with bent knees or make other adjustments to perform a particular activity; however, the more you can stand in this optimal position while doing daily activities, the healthier your knees will be. In the end, I needed to use the wide stance to keep my balance but finally got my legs straight and quads relaxed!

photo-1

Balance, Habits

Paddle Boarding Part 1: What’s Your Default?

We’re in Grand Lake, CO, aka paradise, this week spending time with family and friends before the big move.

the lake

We rented stand up paddle boards this morning and all gave it shot. Of course, like everything, this turned into an alignment education opportunity. When you get on an unstable surface, what is your default position?

This is my sister, Tarah, who is an English horseback rider and trainer, which means she spends a lot of time on a horse. She’s been riding horses for almost 20 years. She is really strong, stable and comfortable in her riding posture. This is how she looked on a paddle board.

photo-2

Which is the same posture she holds on a horse. An upright torso, bent knees, wide knees, feet turned out. Straight line from the shoulder, through the hip, to the heel.

TK on stanley

Fascinating, right? When we are on an unstable surface, we tend to go to our default position, the position in which we spend most of our time and are therefore most comfortable. She was able to get into the position that she trains in and use the same muscles, so the activity felt fairly easy. This comes in handy when you’re trying not to fall into a recently thawed lake. For other, non hypothermia inducing situations, we want to work towards being that strong and balanced in every position. When we use all our muscles and joints in a variety of positions, it keeps blood flowing to all the tissues (=oxygen/nutrients in & waste out) and keeps them healthy. Using all our muscles (rather than just the ones we always use) increases our metabolism and reduces our risk for overuse injuries.

To figure out what your default position is, just find an unstable surface to stand on and watch yourself in a mirror. The BOSU is my favorite habit revealing tool!

bosu11