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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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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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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.
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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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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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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:
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  • 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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    Susan McLaughlin,
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Contact:  Susan McLaughlin, PT 801.859.4142
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