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!

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.

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.

​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. 

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.  

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!

• 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.

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  "multiple 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?

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.

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