Legacy Physical Therapy 2961 Dougherty Ferry Road Saint Louis, MO 63122
Call: 636-225-3649 Fax: 888-494-7074 Email: info@legacytherapystl.com

Do You Have a Diastasis Recti?

Wow! We had an amazing response to our last blog post about rehabbing the mummy tummy. If you missed it, please check out our take on the importance of considering many factors when rehabilitating the postpartum core and/or diastasis recti, before reading on.

Diastasis recti is a separation of the abdominal muscles that commonly happens with pregnancy. For some women this separation heals back up without much effort after delivery. However, many women still have a diastasis recti months or years after delivery.

“How do I know if I have a diastasis recti?” This is a question that we get asked all the time. There is a simple test that you can perform yourself to determine if you have a separation of your abdominal muscles? Check out our quick how-to video.

How to Test for a Diastasis Recti?

So, did you perform the test? Do you have a separation of the abdominal muscles? If you had trouble telling if you had a diastasis recti, please contact us at Legacy Physical Therapy for a free discovery session to help you.

Or maybe you performed the test and you realized that you do have a diastasis recti. Now what? There are things that you can do to rehab your core whether you are 6 weeks, 6 months, or 6 years postpartum. Call us to discuss your findings with one of our experienced women’s health physical therapists. We are here to help.

 

Rehabbing the Mummy Tummy/ Diastasis Recti

Yesterday my Facebook feed was inundated with multiple shares of this NPR article titled, “Flattening The ‘Mummy Tummy’ With 1 Exercise, 10 Minutes A Day.” After all, with a title like that who wouldn’t want to click on the article and and learn what seems to be such a simple fix for diastasis recti. The trouble is that the “Fix” is never this simple.

While I appreciate the awareness this article is bringing to the topic of diastasis recti and recovery of the partpartum core, Diastasis recti is far more complex than any one single exercise for one single muscle. Diastasis recti is not just about the abs, but moreover is about full body alignment and optimal intra-abdominal pressure regulation. One of the things that I talk to my patients about all the time is that I can give them the world’s best abdominal exercise program to perform 10-20 minutes a day, but what they are doing the other 23 hours and 40-50 minutes makes a bigger difference to their diastasis recti.

Core Muscles

Core muscle function is so much more than static recruitment of a single abdominal muscle. Your transverse abdominal muscles, pelvic floor muscles, diaphragm, and deep back muscles form your deep core canister. They all work together to provide anticipatory stability. So few women realize that their breathing pattern is connected to their abdominal wall performance and their pelvic floor muscle function. My colleague, Julie Wiebe PT has a wonderful video about how all these muscles coordinate together on her webpage. Check it out. If we do not consider breathing pattern when rehabbing a diastasis recti, we are missing a big part of the picture. Chronic drawing in of the abdominal wall is not the answer! If we squeeze in the middle all the time, what are we doing to our pelvic floor down below… setting it up for issues down the road.

The research on diastasis recti is emerging and evolving. There is no way to prevent it during pregnancy by doing an exercise. It is a normal part of many women’s pregnancies. Don’t get me wrong, there are definitely things that you can do before and during your pregnancy to reduce your risk of a large diastasis recti and improve overall core function and support. However there other factors such as one’s genetics, overall tissue laxity, number and proximity in time of pregnancies, and singleton versus multiple pregnancy to name a few.

What’s a Woman to Do?

While this article is good to raise awareness, it barely scratches the surface of what is really needed to address the postpartum core rehabilitation. My best advice is to seek the care of a women’s health physical therapist to do a full assessment of core support system. At Legacy Physical Therapy, we see women all the time who think they are doing the right thing to rehab their core, but find that despite performing the exercises their symptoms are getting worse. If you cannot get to see a women’s health physical therapist, then please do your research when searching for solutions online. Below is a list of some of my favorite go to sites.

If you think that you are dealing with a diastasis recti or postpartum core weakness, we can help. Give us a call at 636-225-3649 to chat with one of our women’s health physical therapist to see how we can help. If you are not sure if you have a diastasis recti and want to be checked by a professional, call us to set up a free screening appointment. We are happy to help.

I think I have Pelvic Floor Dysfunction- Now What?

Pelvic Floor Dysfunction

In our last blog post we discussed the 10 sign that you may have pelvic floor dysfunction.

If you missed that post, CLICK HERE to read it.

Did you answer YES to any of the 10 signs in our last post? Are you wondering what you can do about it? Read on…

5 things you can do today to help pelvic floor dysfunction

  1. Learn to kegel. A “kegel” is a contraction or squeezing of the pelvic floor muscles. Try to contract your pelvic floor muscles as if you are trying to stop the flow of urine or hold back gas. If you can feel a squeezing sensation or successfully stop a flow of urine, then you are likely able to kegel. If you cannot kegel or aren’t sure if you are doing a kegel correctly, a pelvic physical therapist can help assess your kegel and then teach you how to properly contract your pelvic floor muscles. It is worth saying that it’s not all about squeezing your pelvic floor muscles or kegeling! The pelvic floor muscles need to be able to relax too.
  2. Avoid bladder irritants such as caffeine, alcohol, fried foods, citrus fruits and fruit juices, spicy foods, tomatoes and tomato based products, and/or artificial sweeteners. Once you have eliminated the potential irritants for a couple weeks, you can try to add them back in one by one to tease out which substance seems to have the most effect on your symptoms.
  3. Avoid constipation and straining. Keeping your stools soft through a diet rich in fiber and plenty of fluids (ideally water) will reduce the strain and stress placed on the pelvic floor. Tools such as the “squatty potty” can position you properly to further reduce the strain on the pelvic floor making bowel movements easier. Pelvic physical therapy can also be helpful in teaching you how to properly relax your pelvic floor muscles to reduce constipation or straining with bowel movement.
  4. Breathe! A few repetitions of deep belly or diaphragmatic breathing throughout the day can help pelvic floor dysfunction. When you breathe diaphragmatically, as you inhale your diaphragm moves down and your belly expands, and as you exhale your belly retracts and your diaphragm goes back up. Deep breathing helps calm the nervous system and reduce urgency and pain symptoms. Not sure how to belly breathe? Pelvic physical therapists can teach you the proper technique.
  5. If you think you have a pelvic floor dysfunction, the best thing you can do is to have an evaluation done by a trained pelvic floor physical therapist. In your evaluation, you and the pelvic physical therapist will discuss what your symptoms and goals are; the therapist will perform an evaluation to determine the source of your problem; and you will decide together what the best treatment plan for you will be.

It is our mission at Legacy Physical Therapy to help people overcome pelvic floor dysfunction. We would be honored to partner with you in your care. If you are wondering if you are dealing with pelvic floor dysfunction and you would like to talk with one of our talented pelvic physical therapists, you can email or call us at 636-225-3649 to set up a free discovery session.

10 Signs You Have Pelvic Floor Dysfunction

Woman Wondering about Pelvic Floor Dysfunction

“Pelvic floor dysfunction, what’s that? I have never heard of pelvic floor dysfunction. Sure I have had a few kids, but I doubt that I have any pelvic issues. Pelvic issues only happen to little old ladies, not me”

Does this sound like what is running through your head right now?  You are not alone. Many women suffer from pelvic floor dysfunction, but are unaware that the symptoms they are experiencing are related to their pelvic floor.

Have you ever experienced any of the follow?

  1. Bladder Leakage– Whether it be a small drop with a sneeze or a complete loss of urine while on the way to the restroom, bladder leakage is NOT NORMAL. However it is common. One in three women will experience bladder leakage in their lifetime.
  2. Urgency and Frequency– Do you know where all the bathrooms are in town? Do you urinate more than 7 times a day? Do you constantly feel like you need to pee? Are you getting up at night to pee? If you answered YES to any of these then you are probably dealing with urgency, frequency, and pelvic floor dysfunction.
  3. Fecal Incontinence– This can come in many forms: inability to control gas, staining or smearing on the underwear, fecal urgency, or complete loss of stool.
  4. Bladder pain or Burning with Urination– Many women think that they are dealing with frequent recurrent UTIs and subject themselves to countless rounds of anti-biotics only to have the symptoms not go away. The missing factor may be pelvic floor dysfunction.
  5. Constipation and/or Straining to Have Bowel Movement– We are designed to push to have a bowel movement, but not to strain. Our pelvic floor needs to relax appropriately to let the bowel movement pass We should be having regular bowel movements that are the consistency of soft log.
  6. Pain with Sex, Tampon Use, or Gynecological Examination– These things are not supposed to be painful. Too many women, “grin and bear it” thinking that pain with sex is just part of it. I am here to tell you that it is NOT!
  7. Vaginal Heaviness, Bulging, or Feeling of Falling Out– These symptoms are common signs of a pelvic organ prolapse, where one or more of the pelvic organs starts to push into the vaginal canal and cause these symptoms. TOO MANY WOMEN are told that these symptoms are normal after having children and they just need to live with it until the symptoms are bothersome enough that surgery is needed. This is NOT THE CASE for many women. By identifying and working to rehabilitate their pelvic floor dysfunction, many women can alleviate these symptoms.
  8. Low Back Pain, Abdominal Pain, or Pelvic Pain– Many women are surprised to learn that their low back pain may be caused by pelvic floor dysfunction. The pelvic floor is part of our core support system, so if it is not working appropriately then we can get extra stress and strain on our low back, abdominals, or hips.
  9. Difficulty Starting Urine Stream or a Hesitant Urine Stream– We were not designed to push to pee, but many women feel like they need to push to get the urine to come out.
  10. Inability to ‘Kegel’– A kegel exercise is the generic name for a pelvic floor muscle contraction. Contracting the pelvic floor prevents urine or feces from escaping. Research has shown that over 40% of women think they are doing a Kegel exercise correctly, but they are not.

If you answered YES to any of the above then you may have pelvic floor dysfunction. The National Institutes of Health found that pelvic floor disorders affect 10% of women ages 20-39; 27% of women ages 40-59, 37% of women ages 60-79 and nearly 50% of women over 80.

If you have experienced any of the 10 signs listed above you are a perfect candidate to explore the possibility of your pelvic floor being the cause or a contributing factor.

Remember there are treatment options for you! Don’t suffer and compromise your quality of life when the treatment is so easy! If you believe you or someone you know may be dealing with
pelvic floor dysfunction, call our office at 636-225-3649 and
we will help you determine your best treatment options.

Fibromyalgia and Physical Therapy

Fibromyalgia is a clinical condition of unknown etiology characterized by chronic generalized body pain associated with fatigue and psychological distress. It typically presents in young to middle aged women and can result in sleep disturbance and significant impairment in activities of daily living.

Fibromyalgia trigger points

Fibromyalgia trigger points

While medical therapy for fibromyalgia exists and may to a limited extent be beneficial in managing pain, physical therapy plays a major role in treatment and rehabilitation. The aim of physical therapy is aimed at deconditioning and muscle weakness. There are different modalities of physical therapy aimed at treating different aspects of fibromyalgia.

1. Cadiovascular Fitness Training

Patients suffering from fibromyalgia are generally inactive and often become physically inactive over time. Exercise has shown benefits in long term management of fibromyalgia, with studies even showing an improvement in pain. In recent years, exercise remains one of the  most commonly recommended treatments.

Exercises are ideally low impact and could include Tai Chi, water exercise, and Qi Gong. Water based exercises seem to offer a small degree of advantage over exercises performed on land, but sometimes are not as convenient to perform. Based on patient function prior to initiating therapy, exercise programs can be tailored to the patient specifically.

2. Physical Therapy

Treatment is aimed at increasing overall muscle strength, and is aimed at reducing muscle weakness. Common advice and treatment may include:

  • Avoid muscle overloading- ie lifting heavy weights
  • Correcting body alignment
  • Muscle conditioning and stretching
  • Encouraging general activity

3. Muscle Massage

While this provides both psychological and physical relief to some extent, there is no strong evidence that it is useful as an individual treatment modality; rather it is better used in combination with other therapies.

4. Acupuncture

Randomized controlled trials have shown that acupuncture can provide significant improvement in pain reduction and a reduced perception of pain. However its long term benefits have not been adequately studied, and there is no clear guidance on how often treatment should be administered. It may be more beneficial as an adjunct therapy.

5. Transcutaneous Electrical Nerve Stimulation (TENS)

TENS is an electrical based pain reliever. It is more useful for localized pain, and hence its use for fibromyalgia may be limited. However it is an easy therapy that the patient can self administer at home.

Exercise and physical therapy are mainstay treatment options for fibromyalgia. Treatment options need to be tailored to the individual. With optimal therapy, patients can experience a significant improvement in symptoms.

Check Out Our Changes

If you have not already noticed, we wanted to point out that we have made some updates to our website to make it more user friendly. Now no matter what device you are using to view our website you should have an easier time viewing the content.

Key changes include:

  • Mobile friendly viewing
  • Easy sign-up for our newsletter
  • Easy access to our articles on our blog accessible off the home page
    • We will continue to have the Newsletter archive on our website for our newsletters from 2008-2015, but moving forward you can access the articles easily from our blog.
  • You can see any upcoming classes that we will be hosting on the right side of the screen.

We would love to hear from you on what you think of our changes. We want our website to be as helpful as possible for you, so if you want to see something different, let us know.

Curious About Essential Oils?

We are excited to start offering classes again at Legacy Physical Therapy. It has been a little while and we are glad to be back. Our first class back will be an introduction to essential oils.

Doterra Complete Offering

We hope that you can join us for this great basic essential oils class that will help explain what an essential oil is, what determines the quality of an essential oil, how they are used and some basic essential oil protocols for health and wellness. Class is Wednesday April 6th from 6:30pm-8pm at  Legacy Physical Therapy 2961 Dougherty Ferry Road Suite 105 63122. Register for this FREE event at 636-225-3649 or e-mail info@legacytherapystl.com

Do you have an idea for a class you would like us to host? Please let us know!

The Healthy Games

Healthy Games Logo

Do you want to improve your health in 2015? We at Legacy Physical Therapy want to help!
Read below for a super exciting challenge that starts SOON!!!

On January 12th, we will be launching
“The Healthy Games” 6-week Health challenge!
Whether you are wanting to lose weight, moving into your new healthy lifestyle, or maybe you’ve gotten a little off track with the holidays… this is a great way to get engaged, have a bunch of fun, and win a little money too!

Here is a link to give you a little information about the challenge.
http://www.thehealthygameschallenge.com/

Here’s the best part…. you can utilize your own or any meal/nutrition or exercise plan you want plus you get to have Dr. Brooke Kalisiak, owner of Legacy Physical Therapy, as your FREE health coach during the challenge!  So grab a few friends, work colleagues or family members and lets get going on a healthier you!

How do you get started?
1)  Click on the link below and join my team!  It will only take a few minutes to get registered.  You can join NOW and start the “pre-game activities”!
http://mdcinvite.co/TheHealthyGames1-Brooke-6943

2)  Grab a few friends and inspire them to join us. You can earn points by inviting others to the party!

3)  Let’s schedule a time to talk about your health goals.  Shoot me an email (brooke@legacytherapystl.com) or call or text me (314-494-1265).  I am so excited to chat with you!

4)  Here is a link to an awesome FREE e-Book that you can download.  It will be a great resource to help you get started!
http://stopchallengechoose.com/download/#sthash.XflMH4pw.dpbs

5)  Get ready to have fun!  You can start getting involved and earning points NOW and the games officially begin on 1/12/15!
The challenge runs for 6 weeks 1/12/15-2/23/15.

Brooke Goes to Washington

On Monday September 29 and Tuesday September 30, Dr. Brooke Kalisiak PT, DPT, WCS had a wonderful opportunity to represent the Private Practice Section of the American Physical Therapy Association at our Nation’s Capitol. She was among over 75 physical therapists business owners from across the country that  convened in Washington, DC September 29 – 30,2014 to lobby members of Congress. As part of the second annual event hosted by the Private Practice Section (PPS) of the American Physical Therapy Association (APTA), Dr. Brooke Kalisiak met with the office of Senator Claire McCaskill, Senator Roy Blunt, and Representative Ann Wagner to discuss hard-hitting issues affecting the future of healthcare, patients, and physical therapy businesses.

Mo Contingency in Front of Capitol Building Brooke in Front of Capitol Building

Check out the full press release at: http://interact.stltoday.com/pr/local-news/PR100214120918820

MONDAY WORKOUTS IN MAY!!

If you are like us here at Legacy Physical Therapy, this warmer weather is inspiring you to get outside and get more active! We thought what better way to get active than to do it together!! Starting MONDAY MAY 5th join us for MONDAY WORKOUTS in MAY!! That’s right, instead of picking up the margarita for Cinco de Mayo come break a sweat at Legacy Physical Therapy instead. Every Monday in May (except Monday May 26th for Memorial Day) you can come train with the physical therapists at Legacy from 6:15-7:15pm.

Time to get your workout on!!

Time to get your workout on!!

WHAT: Workouts will vary but will involve a mix of cardiovascular and strength training. Workouts will happen rain or shine, but weather permitting we will go outside. Feel free to bring a yoga mat and your own set of small hand weights if you have them, but not necessary. All fitness levels are welcome as workouts can be tailored to the individual.

WHEN: Monday May 5th, May 12, May 19th & Tuesday May 27 (Because of Memorial Day) from 6:15-7:15pm

WHERE: Legacy Physical Therapy 2961 Dougherty Ferry Road Suite 105 63122

COST: Space is limited to 10 participants each class. To reserve a space, call us at 636-225-3649 and ask to sign up for any of the dates above. Classes are $8/person/class if you call ahead to reserve a spot. Classes are $10/person/class if you walk in without reserving a spot ahead of time (We cannot guarantee a spot). Whether you reserve a spot ahead of time or not payment is due at the time of class, CASH or CHECK only.

If this is well received we may continue the workouts throughout the summer! Please call 636-225-3649 with questions or to reserve your spot!