When I am working with clients who present with pelvic organ prolapse, urinary leakage, back pain or abdominal wall separation, there tends to be a few common patterns:

• Breathing pattern issues
• Misuse of the pressure system
• Excessive tone/tension in one or more muscle groups: neck & jaw, upper abdominals & ribcage, paraspinals, pelvic floor.

Breathing is the first skill to reeducate.  I have written about this here and here and here.  Once the breathing pattern is reestablished in sitting or lying down, it is time to practice adding an additional skill on top of the breathing pattern.  Many times when we workout and even throughout the day as we do certain moves, we tend to hold our breath.  The key to a healthy core is to maintain the flow of breath throughout all movements.

In my last post about breathing I talked about how optimal breathing is key to creating core strength.  The muscles of the core: the glottis (voicebox), the diaphragm, the abdominals and the pelvic floor all need to move in coordination for effective generation of force.  These muscles need to respond reflexively for whatever task is at hand, whether that be loading the dishwasher, working out at the gym, or chasing after your kids.
Healing from diastasis recti, pelvic organ prolapse and urinary leakage is not going to happen with 100s of kegels and abdominal bracing contractions.   Healing happens when we look at the whole system working together as a team.

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.

Knee pain affects 25% of the adult population.  Most knee pain is blamed on arthritis.  Arthritis is joint pain, stiffness, inflammation. But what causes that?  How you move and use your body every day can increase joint loads, friction, and compression at the knee, and can eventually lead to pain, stiffness and inflammation.  So, below is a series of movements to decrease the tension in the muscles surrounding the knee. This sequence is designed to improve blood flow and connective tissue hydration which can help decrease the tension in the muscles surrounding the knee and help to decompress the knee joint.
Save your joints and give yourself some quality ball time!

This blog is for those of you who have hip pain, groin pain, hip impingement, sciatica, SI joint pain, or low back pain. And if you don't have any of these, then you are lucky and prevention is the best medicine!
Hip mobility is paramount for a healthy body and spine. During an evaluation I like to observe a static standing assessment, a functional movement assessment, and then perform a passive mobility assessment.  
People with back/hip/groin pain often have a postural position of "butt gripping" (read a great article about it here Diane Lee).  In this position, the pelvis is thrust forward and the deep hip rotators are contracted. When these muscles are overactive, they push the head of the femur into the front part (anterior) of the hip capsule which can interfere with hip motion: hip flexion (bringing the knee toward the chest) and internal rotation (turning the thigh inward).
On the functional exam I will see an inability to go into a deep squat, or the hips will shift to the opposite side during the squat.  On the passive motion test there will be a limitation in hip flexion, and they may express pain with a combination of movements: hip flexion, adduction and internal rotation.
Standing in alignment and learning how to let go of the grip in the rotator muscles is essential for healing, as well as reprograming the normal glide of the head of the femur.  In normal motion, as the knee moves toward the chest, the head of the femur should glide back and down.  Due to the tightness of the rotators, the back (posterior) hip capsule can be restricted.  Restoring the tissues and the hip motion can be achieved through simple self mobilizations.

1. Standing Alignment: vertical leg, torso stacked over the legs.  Think about a plumbline going through the midpoints of the shoulder, hip, knee and front of the ankle bone.

2. Release Deep Hip Rotators:  Lie down on your back with your knees bent.  Place a tennis ball under your left butt cheek just to the side of your sacral bone.  Rock your knees to the side and return to start position 3 times.  Find a new spot and repeat.  Complete in 3-5 different areas and then switch sides.

In healthy movement, the sacrum moves relative to the inominate bones.  When the sacral promontory moves forward into the pelvic bowl, the motion is called nutation; counternutation is the opposite motion.  The optimal position for the sacrum in standing and sitting is slightly nutated between the inominates.  This is the goldilocks position: not too tight and not too loose. 

During sitting and standing, you can diminish stress on the SI joints by maintaining a neutral pelvis.   

Look around you, most people stand with their pelvis out in front and their shoulder’s and ribcage back (as in the pic below).  
This posture causes the sacrum to fully nutate, meaning that this is the maximally closed position of the SI joints.  This position can create low back and SI joint aching during prolonged standing.

Correct your alignment by shifting your hips back, allowing your trunk to move forward so the line of gravity travels through your joints: shoulder, hip, knee and ankle.  Now the pelvis is in neutral: the pubic bone and ASIS line up vertically, and the SI joints are in optimal position.

Many people slump their spine and pelvis while sitting watching TV, or sitting slumped at the computer.  In this posture, the weight of the body is positioned behind the SI joints.  This places the SI ligaments under load, the sacrum is tucked (counternutated), and pressure is at the tailbone (coccyx).  

The stress of this position will stretch the ligaments of the SI joint, and can also create tailbone pain.  Maybe you can relate to having pain while trying to walk after sitting like this for awhile.  The initial steps are excruciating until you are able to walk it out as the ligaments regain their normal position.

Correct your alignment by sitting on your ischial tuberosities (SITS bones).  The pelvis and spine should be in neutral.