• Skeletal System

The bones are in a position for appropriate loading to stimulate bone growth, and to position the muscles for optimal resting length tesnion.  From a sideview, the Standing plumbline markers for alignment are the earlobe, midpoint of joints: shoulder, hip, knee and ankle.  The ribcage is stacked over the pelvis, and the pelvis is stacked over the ankles.  

• Muscle System

The muscles are able to shorten and lengthen through full range of motion.   Optimal positioning of the skeletal system allows the muscles to be in a better position to move and generate force.

• ​Pressure System

Ability to generate appropriate intra-abdominal pressure.  Normalize pressures: Increased resting muscle tension can create abnormal pressures.  Pushing type strategies (bearing down) for strength and movement increase downward pressures into the abdominal wall and pelvis.

• Nervous System

Regulation of the peripheral and autonomic nervous systems.  Dysregulated autonomic nervous systems increase resting muscle tension (among other things).

Due to the resting tension in the upper abdominals there is more pressure into the lower abdominals and pelvis.  When the muscles are activated in a shortened contraction, even more pressure is created into the lower abdomen.  This constant downward pressure can have an impact on the health of the pelvic organs, abdominal wall and pelvic floor.  
Changing the pressure and muscle activation pattern is essential to recovery.  Typically, this person has no problem breathing low into the belly, but may have a hard time filling the entire abdomino-pelvic canister evenly on the inhale (generation of appropriate intra-abdominal pressure, evenly distributed 360 degrees). Home practice will require breathing practices to connect with the movement of the lower ribcage, side and back body, and then bring this new awareness and pattern into movement and daily activities.

• Lie down on the floor with your legs out straight
• Bring your legs together
• Keep your knees straight and lift both legs off of the floor about thirty degrees.
• Notice: what happens to your abs?  Did they bulge outward?  What does your back do?  Does it arch?  What does your neck do?  Does it tense?

​How did you do?  In my experience, 95% of my clients use a pushing strategy: holding breath, pushing out into abdominal wall and pelvis, arching back and tensing or lifting the neck. Outside of pilates, or working out, this strategy gets carried over into daily tasks such as: getting out of bed, bending and lifting tasks, pushing open a heavy door, etc.   ​

The first step is to become aware of the day to day habits that interfere with optimal breathing:

• shallow breathing into chest and neck
• holding breath
• holding abs
• locking down ribcage or gripping shoulder blades back and down
• lifting shoulders to breathe (over activation of the scalenes, upper trapezius, levator scapulae)
• squeezing butt cheeks (tightens the pelvic floor muscles)
• ribcage and pelvic positions

The second step is to practice breathing.  During quiet respiration there should be movement in the intercostals (the muscles between the ribs), the diaphragm, the abdominals and the pelvic floor.  In order to have strength in the muscles, they need to move through full range of motion: lengthening and shortening. In this video, I talk about diaphragmatic breathing and core function.  Practice lying down, sitting and standing.  Each position places a different demand on the body. 
​Have fun and explore!

The third step is to begin to challenge the system.  Can you maintain the breath as you add a new skill or a new load?  Are you able to get movement into all areas of the thoracolumbar pelvic canister?  Quite often I observe tension and stiffness surrounding the ribcage.  Below I share a breathing drill to get mobility at the lower ribcage and diaphragm and a link from Dr Evan Osar on Three Dimensional 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.

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.

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). 

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. 

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

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.

In my practice, I see many people with back and neck pain.  When I assess the spine, I often find that the thoracic spine and ribs are frozen stiff.  When the thoracic spine is not mobile, the low back and neck may compensate for this lack of motion, which can lead to overuse, tension and dysfunction.
Last weekend I purchased a lecture on the Thoracic Spine by Sue Falsone, PT, ATC from the website Movement Lectures. I was impressed with the material, and was inspired to include some of the exercises that she recommended to regain thoracic mobility into my Restorative Exercise™ class last week.  
I have also been loving my new Yoga Tune Up® self massage therapy balls, so I added some myofascial release into the class as well.
Below I share with you 3 movements to free your thoracic spine.

I would love to know how great you feel after practicing this for one week!