Office Location: 1817 S Main Street, Suite 10 SLC, UT 84115 | Phone 801 . 859 . 4142
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Getting Out Of Back Pain

11/18/2022

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Tension in the back is all too common! A high percentage of my clients are coming to see me because of it.

Many people who also see me for pelvic issues such as urinary leakage, pelvic organ prolapse, pelvic pain or healing abdominal separation postpartum say that they have a history of back pain that comes and goes, or experiences persistent chronic back pain.

Understanding some of the contributing factors to excessive tension in the muscles of the back can be key to decreasing or eliminating  pain, and improving function.
  • Breathing Patterns
  • Postural Patterns
  • Movement Patterns
  • Stress, Nervous System Regulation & Lifestyle Habits

Breathing Patterns

Because breathing is automatic, we don't always notice HOW we breathe.  Becoming a better breather is key to oxygen delivery, nervous system regulation, core movement and stability.  If the diaphragm is not moving well neither is the ribcage or the core canister.  You have got to move it to use it!​
  • Core Breathing
  • Oxygen Advantage
  • Buteyko Breathing

Postural Patterns

Our posture is created by our emotional states and how we move and present ourselves in the world.  Become more aware of unnecessary tensions that are affecting our postural state.
  • ​Feldenkrais Lessons: Posture for Life
  • Alexander Technique: 5 tips for standing posture
  • Katy Bowman of Nutritious Movement: Lower your risk of injury with proper alignment

Movement Patterns

I am sharing a home program circuit of some of my favorite moves to decrease tension in the back.  The emphasis here is to release the back extensors through breath, positioning and recriprocal inhibition (contracting  the abdominal flexors to relax the back extensors).

Stress Patterns

We live our lives in automatic.  How can we bring more presence to our lives in order to optimize nervous system signaling and therefore appropriate cues for the health of each system of the body.  
  • Understand and tend to the nervous system: Predictive Processing -Why expectation matters for movement and pain, Befriending your nervous system (50% off right now!),  Learn to repair your nervous system.
  • Mindfulness and Stress Reduction: Online programs with Tara Brach, Mindfulness Based Stress Reduction
  • Lifestyle Habits: Be True- Discover your core values and live your life on purpose (if you go to SoulSalt's IG page you can find the Black Friday/Cyber Monday code for 50% off),  Hire a Wellness Coach
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Healing Your Abs Postpartum

5/16/2022

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Healing the Abdominal Wall Postpartum
Postpartum Body
Of course, I am biased, but I believe that every person that gets pregnant and gestates a baby for 9 months and then goes through the intense experience of delivery, should go see a Pelvic Health Physical Therapist (or Occupational Therapist) in the postpartum period (even if it has been many years since the last delivery).

At the Postpartum evaluation I can assess the integrity of the pelvic floor and the abdominal wall.  When I assess the abdominal wall, besides checking for diastasis recti,  I like to observe posture, breathing patterns and recruitment patterns of the core with different loads:
  • standing:  resisting the arms to movement in flexion, extension and rotation, forced expiration
  • lying on the back: lifting a straight leg, lifting both straight legs, resistance to the arms, forced expiration

A Common Core Pattern: Overactive upper abs and rib gripping

In a previous post I addressed how increased internal pressure contributes to prolapse and urinary incontinence.  Increased internal pressure can effect the healing of DR and the abdominal wall as well.  In the post mentioned above, I discuss and provide an example of what a non postpartum body looks like with overactive abs.  The tension created by the over activation of the upper abs and gripping with the diaphragm and muscles of the ribcage creates downward pressure into the lower abdomen and the pelvic bowl.  People who have this pattern also tend to over activate their neck, rib, diaphragm, and spinal extensor muscles.  In order to heal the DR and abdominal wall there needs to be better balance with all the muscles of the core.  In this post, I will share some moves to help you connect to your lower abs without recruiting your upper abs first.  

Are you an overactive upper ab and rib gripper?  How can you tell?
  • Your lower abs stick out compared to upper abs or despite working out, your lower abs still don't get toned.
  • When you engage your core you can see a crease across your ab above your belly button.  You can see a demonstration of this in the blog mentioned above.
  • Blow out really hard on your exhale like you are going to blow out 50 candle.  Do your lower abs push out?
  • When you lie on your back and lift both straight legs does your back arch, your neck tense, your ribs grip and your abs push out?

Even if you don't grip your upper abs, these moves can still be helpful for you!

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Best of Utah Body & Mind 2022

5/16/2022

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I am blown away by the continued support of my clients, friends and colleagues who have taken the time to vote in City Weekly's Best of Body & Mind edition.  This year, I was again awarded Best Physical Therapist!!!

I am honored and grateful for the people in our community who support local, private practices and businesses.  Thank you, thank you, thank you for your vote!

​You can access the online version here.
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Making Rest a Habit

11/23/2021

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This fall as my partner and I prepared our garden beds to rest for the season, it made me think about tending to the body.  I thought about the idea of rest and how vital it is to intentionally rest our bodies in order to allow our nervous system to regulate and maintain the health of our tissues and organs.  

We live in a GO & DO culture.
How often do we pause in quiet rest during the day?
How often are we truly present to the here and now of everyday tasks and activities?
​

A few years ago I read the book, "Breaking the Habit of Being Yourself" by Joe Dispenza. Honestly, I didn't put into practice what he shared in his book, but I do remember he said that 95% of our day is on automatic.  I was blown away how high the percentage was!  
As many of you know from working with me, I am a big fan of bringing mindful pauses and resets in the day to pattern interrupt the habitual circuitry that can propagate a pain cycle or an organ to muscle loop.

Restful Practices

This holiday season don't get trapped in the buzz of over scheduling, prepping, and parties. Find your rest with some of my favorite strategies and wellness professionals: 

1. Yoga Nidra or Sleep Hypnosis. Dr. Andrew Huberman talks about Yoga Nidra and Sleep Hypnosis and their benefits in this video.

2.  Mindful Breathing.  The idea is simply to focus your attention on your breathing—to its natural rhythm and flow and the way it feels on each inhale and exhale.  Allow your breathing to move down into your core as well as the ribcage.

3.  Spend time daily with connective tissue release.  Our fascia is fluid and assists our body in metabolic functions and relays sensory info to our nervous system.  Just like brushing teeth, our fascial tissue needs daily maintenance. Some of my favorites for fascial release: MELT METHOD, Tune Up Fitness.

4.  Mindful Movement.  Mindful movement allows us to check in with our bodies and get moving in a way that can help to rewire habituated pathways, thereby reducing tension and stress that has been built up in the system.  Some of my favorites: Feldenkrais Method, Qigong, Z-Health, Anatomy in Motion, Yoga, Nutritious Movement.

May rest be with you!

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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What can you do for knee pain?

4/26/2021

 
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I spent the last 2 weekends digging out weeds and prepping the ground for our new garden space. I used my right leg a lot to push on the shovel when I worked with the weeds and soil.

By the end of these heavy duty, all day gardening sessions, my right knee felt so stiff and painful I needed to address the tension around the knee.

I felt so good after my "knee rehab" session that I thought that I would share what I did.  I am not pain free yet, but I know that if I keep this routine up through the week, I will be good to go in no time!


How to get rid of a painful & stiff knee

  • Decompress knee with a band
  • Release with balls: quadriceps, hamstrings, calves
  • Work the tissues surrounding the knee with Gua Sha tools (or a butter knife)

Decompress

Release Around Knee Joint

Gua Sha Tool to Tissues Around Knee Joint

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.

My Favorite Words: Flow & Fascia

12/14/2020

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There are 2 words that I use in almost every session with a client: fascia and flow.  We want our fascial system to be fluid: mobile, hydrated, elastic, adaptable.  Beyond its most common function of providing our body's structural support, new research has shown the many roles of fascia:
  • supports our sensory nerves and proprioception
  • assists our body in metabolic functions
  • defends our body against bacteria and other organisms
  • helps cells transport nutrients to other cells
  • houses cells that assist in tissue repair
There are different categories of fascia that I will not dive into, but you can read more about them in this blog about Understanding Fascia.  Holding patterns and tensions in the fascial system can be a major contributor to pain and health.

Improving FLOW to Fascia: A Demonstration

Let's Get Moving!!!
​2 Ways to Enhance Flow to Fascia: Myofascial Release with a Ball & Sensory Input

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Movement Practices to Settle Your Body

9/29/2020

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I have been reading the book, My Grandmother's Hands by Resmaa Menakem.  This book "is a call to action for Americans to recognize that racism is not only about the head, but also about the body.  Menakem introduces an alternative view of what we can do to grow beyond our entrenched racialized divide and takes readers through a step-by-step healing process based on the latest neuroscience and somatic healing methods." Quote from the back cover of the book.

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I have been taking time with the second part of Menakem's book, which is titled "Remembering Ourselves".  He says, "The place to begin the all-important healing of trauma is with the body.  Your body.  Each of our bodies."  He provides body and breathing practices to get to know, experience and understand the body.  I have been enjoying these practices and have incorporated some of the ways to settle into a movement practice.  The movement sequences shared below bring in novel ways to move the spinal chain and mobilize the joints.  "Sometimes trauma energy can get stuck in the joints," Manakem states.  The momentum and rotations can help to release the energy and reduce the tension along the kinetic chain. 
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
​
Disclosure: I only recommend programs and products that I would use myself.  If you use these links to purchase something, I may earn a small commission at no additional cost to you.
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Breathing for a Healthy Core

7/29/2020

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Exhalation activates the parasympathetic system and increases vagal tone
Exhalation stimulates the parasympathetic nervous system and increases vagal tone.
We take breathing for granted: I am alive, therefore I am breathing well.  Unfortunately, this is just not true.  Almost everyone could benefit from breathing better.  When it comes to getting out of pain, or healing the core from abdominal wall separation to leaking urine, the first step to improved function is to learn how to breathe better.  Breathing better doesn't mean taking big breaths, in fact, breathing better means breathing slow, low & less.  If you want to dive into the depths of why its important to breathe slow and less check out these books:
  • Oxygen Advantage
  • Breath: The New Science of a Lost Art

In my practice, I like to work with the body wholistically.  From this wholistic lens, how we move and use our body in the day to day affects the health of our tissues and systems. Habits that are repeated day in and day out can become a "tax" on the tissues and systems.  A VERY common habit that I see in our bodies is breath holding.  Chronic breath holding increases internal pressure and stresses the nervous, hormonal and immune systems.  Over time, this can impair physical and psychological (our brains consume 20 % of the body's oxygen supply) function.  

Break the habit of breath holding

Observe yourself over the next few days to notice if you breath hold.  If you do, when does it happen?  Typically people breath hold with transitions such as getting out of bed/chair, bending, lifting & reaching.  People also tend to hold with multi-tasking such as cooking, gardening, house cleaning.  Breath holds happen when thinking, or concentrating such as writing a letter, putting on make up, or learning a new skill.  We want to be able to experience every moment of our daily life with our breath steady and paced to meet the task at hand.  Breath holding is a sign of stress and living life on automatic!
Being in the present moment is the way out of breath holding!

Suggestions for breaking the habit of breath holding 

  • You can't talk and hold your breath at the same time (really, you can't) so sing or hum while cooking dinner or cleaning, etc.
  •  To prevent the tendency to breath hold with transitions such as getting out of bed/chair, bending, lifting & reaching: count out loud to 10 throughout the task, or you could just exhale on the effort phase of the movement.
  • Pair a task that you do often throughout the day with breathing "low, slow and less": while you wash your hands, paused at a stop light, picking up the kids toys from the floor, etc.
  • Simply just notice.  When you are  _______  can you find your breath and let that be your anchor to whatever you are doing.
Below I share 2 drills to connect you to your core.  The silent breathing is great to find the slow, low and less.  The Exhalation drill is a great way to bring in the expansion and contraction of your abdomino-thoracic cylinder!
​Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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The Role of Adverse Life Experiences in Chronic Pain

6/18/2020

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Adverse Childhood Experience and the role in chronic pain
The Adverse Childhood Experiences study was the first longitudinal study of its kind to demonstrate the impact between early trauma and the onset of adult chronic illness, both mental and physical.
​

The researchers, Dr Felitti and Dr Anda recruited over 17,000 people in the Kaiser Permanente Health Care System from 1995-97 with longterm follow up for tracking health outcomes.  The results of the study were initially published in the Journal of the American Medical Association in December 2001. (1)

The participants were surveyed  on trauma oriented questions based on 8 types of trauma and (later they added physical and emotional neglect for a total of 10).


Early trauma types or Adverse Childhood Experiences (ACE):
  • Emotional, Physical and Sexual abuse
  • Physical and Emotional neglect
  • Mother treated violently
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member​
Upon completion of the study, the outcomes were very clear:
  • There was a definite connection between childhood trauma and adult onset of chronic disease.
  • 2/3 of the adults in the study experienced 1 or more of the adverse childhood experience.
  • The more ACES a person had, the greater chance of medical, mental and social issues as an adult.  With an ACE score of 4 or higher they found an increased risk for hepatitis, chronic lung disease, sexually transmitted infections, heart disease, cancer, diabetes, autoimmune diseases, depression, mental illness, suicide, alcohol, drug & tobacco addictions.  People with high ACE scores were more prone to violence, divorce, broken bones,  and more medical prescriptions. (2)
Without question, the ACES study is evidence to the impact that early chronic toxic stress has on the brain, the body and behaviors.  Since the initial publication of the ACES study, there have been numerous studies that have validated Anda and Felitti's outcomes. 

​As a physical therapist the majority of clients that I work with are in pain.  Many clients have had long standing pain in multiple areas, as well as having other symptoms such as depression/anxiety, GI disturbances, overactive bladders, hypothyroidism, migraines, etc.  I feel, that as a provider, I have the responsibility to educate and empower my clients to not only get out of pain, but to awaken their body to its full potential.  In order to fully heal, rather than putting on a temporary band aid (pharmaceuticals, cortisone injections, massages, hot/ice packs, CBD rubs) it is essential to get to the root.  The ACES study, and subsequent  "m
ultiple studies worldwide have shown a dose-response relationship between traumatic events in childhood, such as abuse, neglect, or a dysfunctional home, and later development of chronic pain." (3)  Not all people are ready or willing to dig to the root.  Healing is not comfortable, but the reality is, is that the pains of childhood are alive and well in the tissues of the body.  And it is through the body that healing can begin.  Are you ready?
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Infographic taken from the article Connecting the Dots: How Adverse Childhood Experiences Predispose to Chronic Pain. Click the pic to take you to the article.

Do you want to know your ACES score?

Go to the website www.acestoohigh.com to access the survey and discover your score.  This website is full of information and resources to begin to understand the connection between ACES and chronic illnesses.  There is hope for healing.  It is never too late.  Therapies that address both the body and mind are effective tools for the healing journey.  At ALIGN, I respect the nervous system; I am body-based and trauma informed.  I have completed my certification in the Prenatal and Perinatal Education Program, participated in online courses and have studied with Kathy Kain, the author of Nurturing Resilience: Helping Clients Move Forward from Developmental Trauma--An Integrative Somatic Approach.  "Kathy’s trainings cover various interwoven focus areas, including trauma recovery, somatic touch, self-regulation skills, and resilience. These focus areas ultimately weave together into a unified somatic approach to touch, awareness, and relationship."  If you are ready, there are many ways to begin the journey to heal.

Recommendation of body therapies that can be helpful for healing chronic illness

  • Somatic Experiencing
  • Sensorimotor Psychotherapy
  • EMDR (Eye Movement Desensitization and Reprocessing
  • Internal Family Systems
  • Biodynamic Cranial Sacral Therapy
  • Family Constellations Therapy
  • Yoga Therapy
References:
  1. JAMA. 2001;286(24):3089-3096.
  2. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. American Journal of Preventive Medicine 1998;14:245–258.
  3. W. Clay Jackson, MD, DipTH.  Connecting the Dots: How Adverse Childhood Experiences Predispose to Chronic Pain.  Practical Pain Management.  2020;2:24-28.​
Articles not referenced in this blog that are informative resources:
  • Toxic Stress: Effects, Prevention and Treatment
  • The Cost of Stress
  • The Lifelong Effects of Early Childhood Adversity and Toxic Stress
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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ALIGN will return to office visits May 18, 2020

5/13/2020

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​There has been so much change around the globe in the last couple months!  I hope you all are staying strong and healthy in these uncertain times! 
During this COVID 19 season ALIGN has been busy behind the scenes moving office locations.  The new space offers a quiet atmosphere with lots of light and more parking!!!
As I open the doors to clients I will be operating under strict guidelines for patient safety and cleanliness:
  • Please wear a mask.  I will be wearing a mask as well.  Make sure to bring your own mask.  If for some reason you can't wear a mask, contact me.
  • I have changed my schedule to allow a 15 minute buffer before the next appointment so I have time to clean in between clients.  This buffer also ensures that there is only one person in my office at a time.
  • As soon as you enter the office, please remove your shoes.  I have a shoe tray right inside the doorway. Or I have a sitting bench in the hall with cubby's to place your shoes.  If it creeps you out to have bare feet on carpet, bring socks.
  • After you remove your shoes, please head to the bathroom to wash your hands.  
  • If the door to my office isn't open, please have a seat in the waiting area.  I will come out to get you.
  • Wait in your car until a couple minutes before your session time as this will minimize time spent in the waiting area.
I want to be wise and careful as we re-enter into this new climate.  So much is changing as the world tries to get a grip on this virus.  I hope that you can be understanding and patient during this time of transition.  I look forward to seeing you in the new space!
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Contact:  Susan McLaughlin, PT 801.859.4142
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