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Glute Strengthening

12/9/2016

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Glut Max strengthening
This October I attended a continuing education course: Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PT, PhD, FACSM, FAPTA.
I walked away from the weekend with much more appreciation for the gluteus maximus.  The glute max works in 3 planes at the hip: extension (moving leg back behind the body), abduction (moving the leg away from the body out to the side), and external rotation (rotating the thigh so the knee moves outward).
The glute max is key to controlling the trunk over the pelvis, to the stability of the pelvis and to the lower quarter.  When the glutes are weak, you will see increased leaning of the trunk, excessive pelvic drop on non-weightbearing leg, and poor femur control (medial collapse of the knee & internal rotation of the femur).  Dr. Powers says, "If something isn't being used, something else is being overused."  If you have pain in your back, your hip, your knee, or your foot, stop right now and do this self assessment of your glut max.  Video yourself and observe your trunk, your pelvis and your knee as you step down and back up from an 8 inch step.

Step Down Test

My glutes need some work on both sides, but notice that I have less control with my right leg in this test.  I have a harder time keeping my trunk upright, my pelvis drops, and my knee collapses in and is wobbly.  What I really like about Dr. Powers program is that he provides a systematic 8 level training program for the glut max.  You cannot go to the next level until you are able to pass the lowest one with ease and control.  I have provided the first level of glute training here. Have fun, and may you be blessed with buns of steel!

Glute Max Activation

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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How to sit with a neutral pelvis and spine

11/9/2016

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Decrease back and neck pain by sitting with a neutral pelvis and spine.
There are so many different ways to sit yet most of us spend time sitting in chairs at work, at school, at the movies, etc. And yes, there a lot of different ways to sit in a chair, but mostly when we sit we are leaning back into the chair, allowing our spine and pelvis to collapse. Over time, this constant load onto the flexed spine, the sacrum and supporting ligaments can create muscular and connective tissue adaptations. If we can make some simple changes in our sitting habits, we can change the loads and environment within the tissues to improve blood flow, cellular remodeling to potentially get us out of a back ache or even a pelvic floor issue.

Neutral Pelvis

Neutral Pelvis with Prop

Neutral Pelvis & 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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How to Decrease Neck Pain

8/18/2016

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Neck pain is a big drag!  Neck stiffness is so annoying! How often have you tried stretching and neck strengthening exercises that send you into more pain and stiffness?  I have totally been there!  One of my favorite ways to relax the neck is to start getting movement into the shoulders, shoulder blades and thoracic spine.
3 Movements for a happy & healthy neck (before you begin, check your neck motion: rotate each direction and then bring your chin to your chest.  Notice how far you move and how it feels):
  • Sidelying Trunk Rotation and Shoulder Windmill
  • Shoulder Blade Movement on Hands and Knees
  • Shoulder Stretch
Now recheck your neck motion and notice if it feels different: is it easier, not so stiff, more motion?
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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Know Your Core

6/21/2016

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A big part of my time in a session involves education.  Education and information for the client (anatomy, pain science, muscle function, etc.), and reeducation of the client's neuromuscular system. Our body is super smart; it finds a way to move and will continue to do this movement over and over again even though this particular strategy may not be the most effective for the health of the tissue or system.  Part of my job as a therapist is to see the non optimal strategy and teach the client how to reeducate their system for health and longevity.
One of the biggest areas of poor strategies and body confusion is at the core. The core is an area of the body that has a lot of hype.  Fitness pros are making bank teaching people how to strengthen their core to look ripped and lean. Unfortunately a "fit looking" core doesn't mean it is a functional core.

The Core

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The core is the area where your head and extremities attach. We have an inner core: throat, diaphragm, deep abdominal (transversus abdominis), pelvic floor, deep back (multifidus) AND I personally like to include the psoas. The outer core is all of the other muscles.

Understanding how the core works

To understand the core, I like to start with the breath.  Little do we know that many of us are 1) holding our abs in all day so that the muscles don't get to fully move and relax or 2) barely breathing.
In an ideal world, when we are at rest whether sitting or in standing, all of our muscles should be at their resting length. Muscles can generate the greatest amount of force at their resting length: not too short, or not too long.
  • Holding in abs:  When we are holding are abs in all the time, the muscles are already contracted in the shortened position.  When the body moves and the muscles are required for support, there is not adequate movement (because it is already shortened) to generate the greatest force.  That means that the smooth orchestration of timing, coordination of the muscles have also been glitched.  Misuse of the core happens and compensations result.  Holding in the abdominals also increases pressure in the system: upward toward the diaphragm or downward toward the pelvic floor.  These pressures and tensions can affect digestion/GERD, menstruation, organ prolapse, abdominal wall separation/hernias.
  • Barely breathing:  Many people breathe shallow, with minimal diaphragm movement and mostly upper chest and neck movement.  This does not allow for the natural active range of motion that should happen with each breath. On the inhale the diaphragm shortens, pushing downward to make room for the lungs to fill with air.  As the diaphragm shortens, the abdominals and the pelvic floor oppose by lengthening.  Then on the exhale, the abs and pelvic floor shorten and the diaphragm goes back to its resting length.  This movement allows for blood flow, oxygen delivery, optimal muscle function and management of internal pressures.  Shallow breathing can lead to a hyper-ventilatory state which can present as:  increased tension, aches and pains, poor concentration and weird sensations in the body (numb, tingling). 
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I love this gif from Burrell Education. If you are interested in living your most healthy self, check out her programs: prenatal, postpartum and peri-menopause. Click on the pic to take you to her website.

The First Step to Strengthening Core:

The first step to strengthening the core is to move all the parts.  The gif above shows the movement of the deeper canister: diaphragm, pelvic floor and abdominals.  The abs and pelvic floor are opposing the diaphragm during inhale and exhale. Can you feel your pelvic floor move during breathing?  Can you feel your abs move?  You might notice that you can only move your chest at first.  See if you can start to bring awareness into: upper abdominals, then belly button, then lower abdominals, then pelvic floor (typically I have people sense the anus- we are used to holding our sphincter muscles to prevent passing gas.  See if you can let the sphincter go on the inhale, then notice if it lifts back up on the exhale). Don't force or try to take big breaths, just direct your focus.  Allow your breathing to be effortless, inhale/exhale are balanced.   Remember your core cannot be strong unless is can access it's full range of motion.  
Know your core: 1) stop holding your core tight all the time (that includes wearing spanx) and 2) learn how to let your core move during breathing. 
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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Chair Busting

2/8/2016

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For many of us, our day is spent sitting at work, sitting at school and then we come home, maybe exercise and then sit and watch TV.
How can we minimize the deleterious effects of sitting? Stand more, walk more, and move more throughout the day.  In this post I have included 3 chair busting strategies that emphasize strengthening the posterior oblique sling: gluteus maximus, thoracolumbar fascia and the opposite latissimus dorsi.  This muscular sling is very important for lumbo-pelvic-hip stability during our gait and rotation patterns.

Get Moving!

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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Improve Breathing & Decrease Tension

1/13/2016

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I know that you have heard it before: "Breath is life". Tuning into the breath is my top strategy for change in the musculoskeletal and nervous systems. Focused breathing creates movement in the body: movement of organs, fascia, muscles and ribs.  Optimal breathing allows for the vital chemistry exchange to deliver nutrition to all of our cells for health and vitality.
Let's face it, life happens, and it's not always full of breath....  We hold, we limit and we restrict.
This movement sequence below is a great way to release the muscles surrounding the chest and to improve the expansion of the ribcage for better breathing.
Breathing better allows the oxygen to flow to our muscles and nervous system which can decrease tension and bring the body into ease.

Soft Tissue Release & Ribcage Mobility 

This movement sequence was inspired by my exploration with Jill Miller's Yoga Tune Up™/Roll Model and Yamuna Body Rolling.
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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Tension Between The Shoulder Blades

12/10/2015

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Help for tension in the shoulder blades
Just looking at the muscles in this picture on the left, you can see that there is a distinct connection between the head and the shoulder blade, and the shoulder blade to the arm.  You don't need to know the names or actions of the muscles to hypothesize that movement of the shoulder blades are key to healthy arms and a healthy neck.

Quite often clients come to see me with "knots" between their shoulder blades, rock hard upper traps, or a sensation that someone is stabbing them in the back with a hot poker. When I assess the movement and ability for the shoulder blades to move over the ribcage, the motion is almost non- existent.
In the video on the right, I share with you one of my favorite ways to get motion to the shoulder blades and freedom to the entire upper extremity!
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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Healthy Nerves, Healthy Body

9/21/2015

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Central Nervous System
Do you know what it takes to have healthy nerves? 
Our nervous system is comprised of 3 parts:
  • The central nervous system: brain and spinal cord.
  • The peripheral nervous system: nerves that exit the spinal cord and go to the head, torso and extremities.
  • The autonomic nervous system: responsible for control of the bodily functions not consciously directed, such as breathing, digestion, etc.
The brain, spinal cord and nerves are protected and encased in connective tissue. There are 3 membranes that line the skull and vertebral canal and enclose the brain and spinal cord.  These layers are called the meninges: pia mater, arachnoid mater and dura mater.
Dura surrounding the brain
The falx cerebri and the tentorium cerebelli are folds of the dura mater that separate the hemispheres and the cerebellum.
Dural Tube
The dura mater surrounding the spinal cord. The dura mater is the outer most layer and is the strongest of the membranes.
The filum terminale
The end of the spinal cord comes to a cone and then a fine strand (the filum terminale) attaches to the coccyx.
The outermost membrane, the dura mater extends from the base of the skull to the sacrum and coccyx.  The dura is attached to the lining of the base of the skull and the upper cervical vertebra. Through the remainder of the vertebral canal, the dura does not attach to the vertebra until the end of the dural sac at the second sacral vertebrae. Extensions of the dura surround the nerve roots and continue into the connective tissue coverings of the spinal nerves.  So this tube that protects the brain, spinal cord and the spinal nerves is pretty important!  In order to have healthy dura and healthy nerves we need proper movement, hydration, nutrition and sleep to keep the connective tissue vital.  A lot of our days are full of stress, spent in static positions that lead to neck or sacral compression (sitting at the computer, driving in the car) or repetitive movements that can stress and dehydrate the tissues.  Try these movements to keep your nervous system healthy.

Exercises To Mobilize Your Nervous System

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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Hip Mobility

6/19/2015

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Improve Hip Mobility with this kneeling lunge stretch
Kneeling Lunge
The hip is simple in it's joint configuration, but very complex in its function.  Like the shoulder, it is a ball and socket joint.  That means that the thigh bone has a spherical head (femoral head) that fits into a cup-like socket (acetabulum) of the pelvis.  This type of joint offers high freedom of motion to allow us to get down into a squat, high kick, dance, karate, etc.  Compared to the shoulder, the hip has a little less motion in order to provide stability, and the femoral head can sit deeper in the socket of the acetabulum in order to prevent dislocation.
Because the hip is ball and socket, the joint is multi-axial, meaning it can move in many many planes of motion. When the foot is not touching ground (open chain) these actions are:
  • Abduction- moving the thigh away from midline
  • Adduction- moving the thigh toward the midline
  • Flexion- moving the thigh toward the chest
  • Extension- moving the thigh toward the back
  • Internal Rotation/External rotation- rotation about the femoral axis
  • Circumduction- moving the joint in a full circle

As I mentioned above, the joint is simple, but the function is complex because the hip joint, like any other joint in the body, does not work/move in isolation.  Lack of hip range of motion can effect the health of the shoulders, spine, pelvis, knees and feet.  Improving hip joint motion is one of the key steps to ensure proper mechanics of the extremities and the spine.  How are your hips?  Try these moves for better movement.
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.

3 Comments

Breathing and Core Stability

2/16/2015

7 Comments

 
Core stability
I just did a search on the internet for the best exercises for core stability.
Here are the top exercises that came up in the search:
  • Modified plank on knees
  • Plank
  • Side plank
  • Bridges
  • Bird-dog on hands and knees
  • Crunches
  • Obliques crunches
  • V sits
  • Plank with an exercise ball
  • Dying Bug
These exercises are great for building the global muscles of the core: abs and back muscles, but what about the intrinsic muscles of the core? In my practice, many people have come to me who have already been doing their "core exercises" and yet they still suffer from back pain, SI dysfunction and pelvic floor disorders, etc.  The key to true core stability is to develop motor control, timing and coordination of the intrinsic muscles first, and then develop the abs, obliques and back muscles once the inner stabilization system is firing and wiring together.

Intrinsic Core Muscles

Breathing and Core Stability
Burrell Education has incredible courses. Check them out!

Diaphragmatic breathing is a great way to reconnect the inner core muscles

The Rhythm of the Respiratory Cycle:

  • During inhalation, the diaphragm contracts while the pelvic floor and the deep abdominal muscles relax.
  • During exhalation, the diaphragm relaxes while the pelvic floor and deep abdominal muscles contract.

Establishing Core Stability Through Diaphragmatic Breathing

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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