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Best of Utah Body & Mind 2020

5/13/2020

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Susan McLaughlin voted Best Physical Therapist in City Weekly's The Best of Utah Body & Mind 2020

​Last week I got the text from City Weekly, "It's Official, Congratulations!"  I flipped through the edition to read:
Best Physical Therapist, Susan McLaughlin. 

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!
​
The online version of the Best of Utah Body & Mind 2020 edition can be viewed now.  As of last week they were not sure when it would get to print.
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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Telehealth Video Sessions

4/15/2020

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I know that people may wonder: 
"What good can a video session do?" or "I have my doubts about a video session."

I would like to share a little bit about what a video session would be like:
1.  Checking in and gathering information just as I would at the beginning of every session.  
2.  I will assess a few things such as movement, breathing, postural alignment, positioning, etc.
3.  Based on info gathered from the observation and assessment, we will go through a process of reeducation of your systems to allow your body to heal.  The primary systems we will be addressing and reeducating are:
-The Nervous System
-The Musculoskeletal System
-The Fascial System
-The Pressure Management System
-The Organs
-Breathing Patterns
4.  I will guide you through movements and exercises to address your individual needs.
5.  One of the keys to healing is to create an environment in which the system is optimized, even if the change is 5-10% we can move toward the path of healing.  We are creatures of habit and we have behaviors and movement patterns that we have used as strategies to make it through our lives.  Most of the time, we are not aware of the patterns that are driving our behavior or movements.  This is where I come in: in the assessment process, I can see the pattern that might be driving the pain cycle or other issue.  And I can share with you the tools that can help you break out of the cycle.
6.  You will be given a home program to work on daily.  We will follow up in a week and we will continue to build on the progress you made in that last week.
You don't have to wait out the pain or the Postpartum Recovery or the Pregnancy pain..... Let's do this!
schedule now!
Another testimonial from a video session: 
"I had the pleasure of experiencing Susan’s work via one hour video session. I stayed in my own living space at my home, and I used a specific room set up for my own quiet hours. I spent time quieting my own mind to better receive her instructions. Susan is very in tune even by video. I appreciated her patience and kind suggestions, and she was very aware of my own state even though we were not in the same city! VERY cool. Susan’s work with her hands could be literally felt even though this was via live video.... and I know it was not just my imagination, for sure. She guided my awareness and focus to areas of my body that I had not been paying attention, and through her own finely attuned skills , she verbally assisted , giving gentle guidance and feedback, helping to ease those areas of needing attention. It TOTALLY WORKS. 
Receiving that verbal guidance and feedback throughout this hour was AMAZING. Having had many injuries and surgeries, there have been dozens and dozens of people in the medical field  and in several arms of body work that have had hands on me for various reasons.  I have been able to sense the authenticity of each person. There have been only small few that have had clear intention, a purity of heart, AND a healthy amount of talent WITH mastery skills. Susan is one of those few rare people: she has great experience, generous skills and training, as well as a pure heart and mind that truly has the intention to help and heal. I found the experience to feel very uplifting and I felt very cared for..... which is essentially who Susan IS as an expert practitioner. 
 All in all, it was a very positive experience! I certainly felt better and better over the hour we worked, as well as better and better through the day. It was a wonderful “we” experience as a team, a positive home run! 
I would definitely recommend it, especially right now, keeping us safe at home.:) 
I look forward to my own further sessions with Susan as well." -SN

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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Spinal Mobility Drill in Sitting

2/3/2020

 
Spinal Mobility: movement
Improve spinal motion and decrease pain
Healthy spines need movement; healthy bodies need movement!  Every spinal segment is like a cog in a wheel, when one section or vertebrae moves, the other follows suit, just like the chain moving around the crank shaft.  Over the course of our lifetimes we get bogged down by tensions, holding patterns and loads that limit the mobility of the spine.  Our nerves that travel to our organs, muscles, and skin exit the spine and span outward to their destination. For the health of your nerves, your lower extremities, core, organs, upper extremities and head, get a move on!  

Explore your spinal movement

Link to Anatomy in Motion's, Wake your body up!
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.

Epigenetics and its Influence on Life

10/19/2019

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Photo by Liv Bruce. Click on the pic for more of her work on Unsplash.
In my latest module for the APPAH certification training I have been studying epigenetics (the study of biological mechanisms that switch genes on and off).  After listening to Bruce Lipton’s presentation, “The biology of Perception”, I pulled out his book Biology of Belief and reread the chapter: It’s the environment, stupid.
Lipton is a cellular biologist and as a researcher he has examined the mechanisms by which cells receive and process information.  He writes, “When I provided a healthy environment for my cells they thrived; when the environment was less than optimal, the cells faltered.  When I adjusted the environment, these ‘sick’ cells revitalized.” (1)
Lipton goes on to share how scientists started to veer from the environment model after Watson and Crick‘s revelation of DNA’s genetic code.  Genetic determinism has since become the belief of our modern culture: genes determine biology.  Succumbing to the hypothesis that genes control our lives, we have an “excuse” to become victims of heredity. Today’s diseases, like heart disease, diabetes, arthritis and cancer are not the result of a single gene, but a complex interaction of many genes and environmental factors.
The latest scientific research has debunked the hypothesis of gene control to show that “when a gene product is needed, a signal from its environment, not the emergent property of the gene itself activates the expression of that gene.” (1) The birth of epigenetics is the forefront of science.  What we now know is that "the DNA blueprints passed down through genes are not set in concrete at birth.  Environmental influences, including nutrition, stress and emotions can modify those genes." (1)
Similar to Lipton’s cells in a petri dish, babies in utero can be primed for optimal growth and health.  Epigenetic research is revealing that early life experiences can influence brain development towards either social engagement or defense.
The research shows that the quality of early childhood care has a definite impact on gene expression.  If the early environment is safe, and nurturing: full of loving touch, engagement and fulfillment of needs, the baby will be “programmed” for living in connection with other people.  They grow to have more resilience, empathy and cognitive flexibility.  Whereas, if a baby is in an environment that is harsh, inconsistent or insensitive to its needs, then the brain will be “programmed” for survival: being slow to trust, hypervigilant and defensive. They are more at risk for depression, social anxiety and stress disorders (2).

Optimize Your Environment

Unfortunately, many of us don’t grow up in a nurturing environment.  But as Bruce Lipton says in his book,  “...when the environment was less than optimal, the cells faltered.  When I adjusted the environment, these ‘sick’ cells revitalized.”  As adults we can change the signals to optimize the environment for growth.  Environment and behavior CAN change your life!
When I began my healing journey years ago, I asked myself:  How can I create an environment to allow my cells to be vital and healthy?
In my own personal quest, I have directed my focus on creating an optimal environment for my wellbeing through wellness practices, alignment principles and healing my childhood wounds.  Consistent practice of relaxation techniques, postural alignment, and observation of my movement habits laid the foundation for me to be more efficient in the use of my body, and in that, I was able to come out of 10 years of chronic low back and sacroiliac pain.  Now that I have been out of pain, I continue to nurture my health and healing on a daily basis.
Here are some suggestions to optimize your environment for wellbeing:
  • Stand more and sit less
  • Get good sleep
  • Hydrate/water: At least half of your body weight in ounces
  • Notice your habits: change those that aren't serving you and continue the habits that enhance
  • Hug/touch
  • Limit alcohol, caffeine and processed foods
  • Meditate
  • Walk/Move/Exercise
  • Laugh/sing
  • Receive body work: massage, acupuncture, chiropractic, physical therapy 
  • Engage in therapies: EMDR,  SE, RET, Feldenkrais

References: 
1. Lipton, B (2005). The Biology of Belief. Santa Rosa, CA: Elite Books.
2.  ​Powledge, T. (2011) Behavioral Epigenetics: How Nurture Shapes Nature BioScience 61: 588-592.
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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Pre and Perinatal Psychology

9/11/2019

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Ana Tablas
This August I enrolled in a year long study of pre and perinatal psychology: The Prenatal and Perinatal Education (PPNE) Certificate program.  There are 11 Modules in this program and after each module I have the opportunity to assimilate my learning with an essay, slide presentation, case study, movement or art project. 
As I move through the course work you will see more and more blogs on this topic!
"How we enter the world plays a crucial role in how we live in it." -Thomas Verny, MD and author

What is Pre and Perinatal Psychology?

"Prenatal and perinatal psychology is the interdisciplinary study of the earliest periods in human development, including conception, time in the womb, experiences during and after birth, and experiences with caregivers and the family system through the first year following birth.  Theory and research in multiple disciplines, including embryology, morphogenesis, bioengineering, evolutionary biology, psychophysiology, behavioral perinatology, neurobiology  affective neuroscience, attachment, and traumatology, provide the foundation for the exploration of how experiences during this critical developmental period impact an individual. Knowledge from these fields illuminates the physical, cognitive, social, and emotional impacts of our earliest experiences and how they form enduring response patterns that shape our development, behavior and health over the life span" (1).
The Reader's Digest version of this definition:  Our health throughout our lifespan is shaped in the womb and within the first few years.  Our nervous system, our beliefs & behaviors are primed and imprinted by our environment: our birth mother and our primary caregivers.

Why is the perinatal period important to human development?

  • Bonding/Attachment.  The bond between parent/caregiver and child has been studied since the 1950-60's.  John Bowlby studied the impact of the caregiver's behavior on human development. Bowlby's research supported the importance of consistent, loving, sensitive responsiveness of the primary caregiver to develop a secure bond or attachment that will form the foundation for how the child will relate to others in all relationships throughout its lifetime. In this blog post on understanding the nervous system, I share a video demonstration of one of Bowlby's renown experiments: "The Still Face Experiment." 
  • Epigenetics.  The work of Bruce Lipton, PhD really brought forward the research to confirm that its not just the DNA in the genes that create the human, the environment has great influence HOW genes express.  The environment that affects the developing fetus includes thoughts, feelings and stresses of the mother, as well as chemicals/toxins in the environment from nutrition and pollution.  The take home message here, is that, how parents and caregivers interact with the baby before conception, and in the womb, can influence development of babe, and even future generations.  Supporting families in the first few years of baby's life is vital for lifelong health.
  • ACES study. The Adverse Childhood Experience Study demonstrates the impact between unresolved early trauma and the onset of adult chronic illness, both mental and physical.  The ACE study measured impacts of 10 types of traumas: racism, bullying, watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, involvement with the foster care system, involvement with the juvenile justice system, etc.  "Adults need to understand their history and acknowledge how it affects them in the present. Early difficulty does not need to be re-experienced to be healed. However, the person who has such a history needs to make sense of what happened and feel settled around it. Dysfunctional compensation patterns are part of the survival pattern for adults who had to respond in these ways when the early trauma was occurring. These compensation patterns, which have outlived their usefulness for the most part, are brought to light without shame and then transformed with compassion and the presence of an attuned therapist trained in early trauma resolution" (2).
  • Economics.  In the United States we are seeing an "alarming rise in prematurity, low-birth weights, surgical births, autism, ADHD, childhood aggression and depression, asthma, overweight and obese children, attachment disorders, learning disabilities, and the use of psychiatric drugs to manage children's conditions, as well as a rise in the number of children in foster care, adolescent homicide, child abuse and teen pregnancy" (3).  The research supports that investing in human potential from zero to 3 years of age can build and nurture  families, communities and the future of our economic stability (3).

What is possible?

Potential parent/s can prime the environment for baby's success:
  • conscious/loving conception
  • communicate and connect with babe in the womb: talk, sing or play music.  Let babe know that if having an intense emotion such as anger, fear or stress, that it is not about them, it is about the incident that has occurred  
  • understand or tune into their own emotions/traumas/stress that may impact their wellbeing and nervous system (baby is regulating off of your nervous system) 
  • seek good prenatal care and choose minimal intervention during birth, skin to skin contact, breastfeed
References:
1.  Ann Diamond Weinstein, Prenatal Development and Parents' Lived Experiences  (W.W. Norton & Company, 2016), p 5.
2. Kate White, MA, LMT, & Myrna Martin, MN, RCC, RCST,  "Pre and Perinatal Experiences For Health & Healing," Pathways to Family Wellness Issue 36.
3. 
Wendy Anne McCarty, PhD, RN, DCEP &  Marti Glenn, PhD, "Investing in Human Potential From the Beginning of Life: Key to Maximizing Human Capital," Journal of Prenatal and Perinatal Psychology and Health 23 (2), Winter 2008.


 
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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REset & REstore: improving vagal tone

8/17/2019

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In this blog I want to share some simple tools to improve health, growth and restoration via nervous system regulation and improving vagal tone. 

In a prior blog I talked about the autonomic nervous system, and each blog since has built on the next.  In my last post, I shared some breathing variations to tap into relaxation and vagus nerve activation.

If you are not sure what the vagus nerve is, I think this article gives a good review of its function.

Exercises to promote vagal tone

  • If you want to have a deeper understanding of your Vagus nerve and autonomic nervous system, but don't want to sift through the boring science, Stanley Rosenberg has written a great book "Accessing the Healing Power of the Vagus Nerve: Self Help Exercises for Anxiety, Depression, Trauma and Autism".  The video below demonstrates the basic exercise to activate the vagus nerve.
  • Jill Miller has many videos on youtube exploring the vagus.  Here are a couple that I like:
  • If you want to optimize your health and wellness, check out the website of Restorative Breathing.  A few years ago I took a course from Lois Laynee and it was the beginning of my journey into healing my nervous system.  Back in July she posted this on her Facebook page: "Do you know the easiest, natural way to balance the autonomic nervous system? Breathing through your nose all night long [as well as during the day]! If you can't breathe through your nose all night long, the brainstem cannot regulate the autonomic nervous system."  Something clicked for me, and I got back on the protocol that I learned from her training years ago.  In order to keep my mouth closed, every night I tape my mouth shut so my brainstem can settle.  Just in these last 3 weeks of taping, I have almost eliminated a constant twitch in under my left eye, I am waking up more rested and  I have less stiffness in my feet when I get out of bed.
  • Irene Lyon describes herself as a nervous system specialist.  She has one of the first online programs for healing the Nervous System: "Tune Up your Nervous System and Rev Up Your Life". 
  • Connect to the environment using your senses: orienting to bring yourself back into the present, and into your body.

Healing the nervous system is a process.  We have many layers to support and unfold.  These five tools above can get you started.  I look forward to support you on your healing journey.
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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Breathing Variations

7/17/2019

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Breathing to restore Autonomic Regulation
A healthy autonomic nervous system (ANS) is fluid, bouncing between the green and yellow zone.
In my last post I talked about the Autonomic Nervous System using the analogy from the Polyvagal Theory of a traffic light:
​
  • Green is the safety zone: our social engagement system.  our heart rate slows, digestion activates, facial muscles are responsive,  eyes are soft and able to make contact, hearing is turned on.
  • Yellow is the danger zone:  our heart rate increases, pain increases, muscles are mobilized for movement, flat facial affect, the middle ear is turned off in order to hear lower threat tones.
  • Red is the life threat zone: our system goes into freeze/immobilization.  This zone leads to metabolic shut down.

Breath is the one thing we can do to mediate the ANS

One of the first tools I go over with clients is to reeducate proper breathing mechanics.  Most of the clients that I work with have pain or are wanting assistance to heal from leaking urine, prolapse or abdominal wall separation.  Getting movement in the core system and regulating the nervous system are top priority for healing, therefore, breathing is the bridge between the range of motion of the core team AND the ANS.  For most of us, breathing is unconscious, and we have developed strategies to just get by, such as shallow breathing, open mouth breathing, shoulder and neck breathing, etc.  In order to heal, we need to get out of a habitual pattern, change the loads, get better oxygen and carbon dioxide balance in order for the blood to deliver the oxygen molecule to the tissues.

Optimal Breathing Pattern.  The importance of CO2 as well as O2

Breathing variations to mediate the ANS: Coming back to the safety zone or green light

  • Canister Breathing: Movement of the muscles in the breath cycle during quiet breathing: diaphragm, abdominal wall, pelvic floor and ribcage all move proportionally together.
  • Balanced Breathing: This breath is great to bring the system into coherence and presence.  Inhale and exhale are even.  Example: inhale is 4 seconds, exhale is 4 seconds.
  • Silent Breathing: This breath is great to do to distract the brain from breathing and give the system a different task: pay attention to the silence rather than the breath.   I give this to clients  who try to "Make" the breathing happen and are doing a lot of "Efforting" and excess to get the abdominal wall to move in 3D.  The quiet helps the system respond more efficiently.  Plug ears so you can't hear inside your head.  Adjust your breathing so you don't hear the breath in/out.
  • Slower Rate and Longer Exhales: This breath allows your system drop into a relaxation response. Slow your breathing rate and let your exhale go as long as you can (make sure you don't force your breath out and push; be gentle).
  • Using sound to enhance the relaxation response:  Let your vocal cords open (typically vocal folds are more open in the lower tone range) as you resonate your sound on the exhale into your lower abdomen and pelvic bowl (many women will do this innately during labor to open the pelvic bowel and the pelvic floor).  I like to use: "voo" as demonstrated in the video, or you could use "Ahh" or "OM".  This method is particularly helpful for high muscle tone in pelvic pain.
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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Understanding our Nervous System

3/19/2019

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The key to health: regulation of the autonomic nervous system
Traffic light analogy of the Autonomic Nervous System

​Understanding and tapping into our innate healing capacity and regulation of the nervous system is key for getting out of pain and improving function.  Many people have learned in school that the brain and the spinal cord are the central processing and relay centers, and the peripheral nerves take off from the spinal cord to drive the movement of our muscles.  More elusive in understanding is the part of our peripheral nervous system that goes to our smooth muscle and organs: the autonomic nervous system.  The autonomic nervous system keeps us alive.  It is important for basic metabolic functions such a breathing, heart rate, digestion, hormone regulation, sleep/wake cycles, sexual response, immunity, repair & regeneration, etc.

The Autonomic Nervous System: Polyvagal Theory

In 1994, Professor Stephen Porges proposed the Polyvagal Theory.  In this seminal work he describes the autonomic nervous system in more detail.  Rather than a 2 part system balance of sympathetic "fight or flight" and parasympathetic "rest or digest", he acknowledges the evolutionary nervous system development that brings the humaneness into being human such as connection, social engagement, relationship,  and the ability to have team work and community.  One of the best explanations of the Polyvagal Theory that I have heard is by Stephen's son, Seth.  I have posted the video below.  Please watch, and then watch again.
Polyvagal analogy of the traffic light:
  • Green is the safety zone: our social engagement system.  our heart rate slows, digestion activates, facial muscles are responsive,  eyes are soft and able to make contact, hearing is turned on.
  • Yellow is the danger zone:  our heart rate increases, pain increases, muscles are mobilized for movement, flat facial affect, the middle ear is turned off in order to hear lower threat tones.
  • Red is the life threat zone: our system goes into freeze/immobilization.  This zone leads to metabolic shut down.
A healthy autonomic nervous system is fluid, bouncing between the green and yellow zone.  

Nervous System Regulation: The Still Face Experiment

As humans we are wired to connect.  We need to have connection and safety to build a healthy nervous system. If you watched Seth's video above, you now have a deeper understanding of this.  Because the nervous system is so subtle, and because many of us have had "bad stuff/trauma" happen to us, (we can be stuck in a freeze state or amped up into hyperarousal, or stuck in both states) we don't always "get" this understanding of how important it is to heal at a nervous system level.  The still face experiment exemplifies what happens to the nervous system and subsequent behavior when connection and safety is withheld.  
The above video can be hard to watch.  In just 3 minutes of non responsiveness from the mother, the child turns her head and body away; she withdraws with a hopeless expression on her face.  To use the traffic light example, in the beginning we see activation of the green light, then mom becomes non responsive, the child escalates to the yellow light and when mom continues not to respond, the child collapses into the red light.  Fortunately, this was an experiment, and mom comes back to engage and repair to green light.

Now what?  How does this apply to me?

Our nervous system impacts our entire well being: emotionally, relationally, mentally and physically.  Common signs of dysregulation: depression, anxiety, numbed out, brain fog/can't concentrate, procrastination/resistance, chronic pain, gut issues, headaches, severe PMS, autoimmune disorders, hormone issues, pain, etc.  You may also find yourself continually getting injured or wanting to take your exercise to the next level and you end up hurting your back (knee, shoulder, foot, etc), or you keep going to the chiropractor and they tell you that you aren't holding your adjustments or you look in the mirror and notice that your body rests in rotation (one shoulder is higher or your head slightly tilts, etc).   We all have layers and layers of "stuff" that has happened to us over the years, some more than others.  By acknowledging that this "stuff" is held in our nervous system (and thus, our organs and connective tissues) we can start to become more vital by reconnecting & regulating our nervous system.  As Seth mentions in the video above, breath is key to mediating the autonomic nervous system.  In my next blog I will explore some breathing options to facilitate a relaxation response. 
If you are interested in learning how to be more ALIVE in your body, there are some great books and online programs available to get started:
  • Somatopia: this program is super affordable. It is a good place to start if you are completely new to the mind- body connection.  It goes over some of the foundational concepts and beginning techniques.
  • 21 Day Nervous System Tune Up: this is a more thorough self study program that offers a great Facebook support group.  It has explanations of the neuroscience and plenty of neurosensory exercises to keep you busy.
  • Crappy Childhood Fairy: to be honest, I haven't taken this course, but I am impressed by what I see on her videos.  She is not a therapist, or a health care provider, she is someone who had a "crappy childhood" and spent years in therapy.  It wasn't until she started working with the nervous system dysregulation that she started to heal.  Her program is based on the tools that she used to heal.
  • "The Body Keeps the Score", Bessel Van Der Kolk
  • "Healing Trauma: A Pioneering Program for Restoring the Wisdom in Your Body", Peter Levine
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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Quadruped Rocking: Happy Hips and Spine

1/7/2019

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Neutral Spine has spinal curves.  A healthy spine moves!
Neutral Spine has Spinal Curves
Neuromuscular re-education plays a major role to getting out of pain and improving function.  Our body is very intelligent; the nervous system is prepped and primed for movements, actions and behaviors that are similar to what has happened in the past.  This is useful because it frees up our system's energy for more important metabolic tasks.  Unfortunately over time, the way we have done something in the past is not always helpful for the longevity of the tissues involved in the present movement.
Neuromuscular re-education drills help to create new neural circuitry to enhance proprioception, balance, motor control and coordination, which will have carry over to lasting healthy loads to the muscle and skeletal system.

Our Pelvis, Spine And Head Are Mobile... or I should say, We Want Them To Be Mobile

Many of the clients who walk into my office with hip, back or pelvic pain share some common features:
  • Inability to isolate pelvic motion and/or rigid spinal motion
  • Limited hip mobility in all ranges, especially hip flexion, adduction (moving toward midline) and internal rotation
  • Hypertonic spinal muscles (increased mass and tone in the lower thoracic or lumbar area).  

Movement drills to bring in neuromuscular re-education to these areas:

1.  Get the spine moving; Get the pelvis moving.  A great drill for this is pelvic tilts (click on link for a video of pelvic tilts on the floor).  The video here demonstrates the pelvic tilts in sitting.
2.  Get the hips moving.  Explore hip flexion and extension in quadruped (hands and knees or forearms and knees).  Make sure that the spine is neutral (refer to the spine pic above for a visual of our spinal curves) so you can make sure to get into the hips.  If the lumbar spine moves into flexion as you rock back, this means that you are not accessing the tissues of the hip joint.  
3.  Teach the erector spinae muscles that they don't have to 'HOLD TIGHT' all the time.  This requires patience and lots of neuromuscular re-education time (maybe I can do some videos for the next blog).  I like the client to connect to this in quadruped  and then bring to standing with hip hinge and bending/ lifting drills.  A good test to reveal the state of the muscles is to get into quadruped and see how the muscles respond (in this position they should soften and drop into extension).  For many people who overuse their back muscles, the erectors will be hard and pronounced like a steel rod.  The goal of rehab is to teach the muscle to let go and move into shortening (extending) and lengthening (flexing), which when held, doesn't perform either action very well.
Erector Spinae tension and hip/back pain
Notice the two mounds on each side of the spine just below the shoulder blades. You can see that the left side is just a bit more pronounced than the right.
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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Breathing Circuit

12/4/2018

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As a pelvic health specialist and a general orthopedic physical therapist, addressing the health of the "core" is essential to every client walking into my office.
What is the first and foremost requirement for healthy tissue?
MOVEMENT: 
  • Muscles can fully lengthen and shorten
  • Joints have the space, glide and spin for full active and passive range of motion
  • 3D Movement is available in all planes: rotation, sidebending and forward/backward bending

A healthy core is a core that moves.

Breathing brings vital movement to the core: expansion/compression of the ribcage, diaphragm, abdominals and pelvic floor. How do you breathe?  Where do you breathe?  Can you feel your ribs expand on inhale and compress on exhale?  Does your pelvic floor lengthen on inhale and shorten on exhale?  Does your back move with your breath?  For most people, the answer is "I don't know."  I really like to have my clients load the body in different positions in order to explore variations of breathing which can help them connect to their core. 
In the breathing circuit video posted below,  I go through 3 positions plus a typical "core stabilization" exercise: 
  • crocodile pose: on inhale, once the abdomen hits the floor (which is right away) take your breath into your back body.
  • child's pose: same as above
  • sitting: place hands on the side of the ribcage to feel the expansion/compression on inhale and exhale
  • bird-dog exercise:  typically when this exercise is taught, people are cued to draw in abs before lifting the arms and legs.  In this drill we want to maintain steady breathing with no holding of the core.  Be mindful as you lift your leg off of the floor.  Do not over extend the hip, as this will compress the spine.
​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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    Susan McLaughlin,
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