Teaching Kids to Sit Properly on Their Pelvises

4782496500_273a4c7d29_zI have a son in first grade in public school, and while he has a great teacher who lets them roam around and work on the floor for parts of their working day, there is always the inevitable chair time, and as he gets older, the amount of time with butt in chair will only increase in a public school setting*. And oh the chairs! I volunteer in his classroom once a month and so I get a chance to size up and glare at those chairs on a regular basis. They are plastic, and molded into a C-curve, exactly the shape that puts pressure on the discs and internal organs while also making it nearly impossible to feel supported in your spine. The result? Growing into a schlump and likely into back and neck pain.

Because of what I do for work, naturally my son knows the words "ischial tuberosities" and can locate them on his body. But there's just something not quite inviting about simply saying these two long words, pointing to them, and reminding him to sit on them that doesn't quite capture his attention.

So I came up with a simple way to teach him about sitting on a properly supported pelvis which involves low tech happy and sad face stickers strategically placed. We have done this at home together a couple of times and it's goofy and silly and therefore seems to have imprinted a sense memory on his mind of what it means to sit on his ischial tuberosities vs. his sacrum.

I still hate the chairs, and I hope to have a larger impact in his classroom's alignment and movement options, but hey, for now the simple interventions work.

Make a family "sit on your pelvis" date, or slap on some stickers before dinner one night and see if they start to locate their bodies better in space and get more supported in their spines.

* I, like many, currently only have public school available as an option (I can't afford a more movement friendly private school, and as a single mom with a career home schooling isn't workable). I'm not alone here, and while my son's particular public school is fortunately filled with passionate educators and administration, there is always the bureaucracy- especially when it comes to trying to convince them of the importance of movement on top of their already overfull plates (public school educators are taking a beating out there with these new standards- it's crazy!). All that said, if you're with me and have any ideas or interest in talking about how to get more nourishing movement into this setting, email me! I'd love to talk options. brooke [at] fasciafreedomfighters [dot] com

photo sourced from Yvonne Thompson

Plantar Fasciitis From Leg Length Discrepancy

167794107_e8a7b59b0d_zI admit it, I've spent a long time being overconfident about my ability to easily and quickly resolve plantar fasciitis (a painful condition of the foot caused by the plantarfascia pulling away from the heel bone). Because I work in a fascial field as a Rolfer® I've had a lot of people contact me for help with plantar fasciitis over the years and most of the time I have been able to easily help them. I've written about that approach here, and, in fact, when plantar fasciitis results from a short or gluey posterior chain of tissue (i.e. the calves, hamstrings, gluteals, and low back and spinal muscles), it does in fact respond very readily to to this approach. Tight fascia = loosen that fascia. Easy, right?

Fortunately there seems to be some divine order that says when a person (in this case, me) gets too assured of something (in this case via a formulaic way of thinking about the body), some wonderful opportunity to see the body freshly as the complex unified organism that it is presents itself.

The first time I had a plantar fasciitis client fail to respond was, as these things go, with a dear friend. And while I would love to pretend that I'm an enlightened being, when a friend in pain comes to me I now have my normal desire to help out layered with an egoic desire to be the one who "fixes" them. Ha ha ha! Silly mortal! You cannot fix people! Yes, this whole "be the one who fixes people" drive is usually a set up for a fall.

This was also the first time I had encountered plantar fasciitis as a result of a leg length discrepancy. Or at least it was the first time I became aware of that courtesy of the conversations that she and I, and the wonderful physical therapist who I had referred her to, had as things resolved. Since that time I have met with a handful of other people who were dealing with the same thing and so I wanted to write about it here to save some people the months and years of trying to get better to no avail.

Here's the important detail: if someone is struggling with plantar fasciitis chronically and they are not responding to normal treatment (i.e. smart manual therapy and movement that addresses the fascial and functional movement problems), there is a good chance that they are dealing with a leg length problem, and until that gets resolved the pain is going exactly no where. 

So first let's talk leg length discrepancies. They vary quite a lot from incredibly subtle to quite obvious. I write this because most people assume that if they have one longer leg that it would be glaringly obvious and they would be aware of it. However if it is the subtle variety (which also happens to be the most common variety) it usually goes unnoticed. Even teeny discrepancies can cause people a lot of grief.

Leg length discrepancies come in two flavors- either a bone length (structural) difference or an alignment and soft tissue (functional) difference. Because everything in our bodies works in sync with one another, sometimes differentiating between the two types can feel like splitting hairs. In fact, the bone length version is traditionally called a "structural" difference, and the soft tissue version is traditionally called the "functional" difference, but I can't really bring myself to continue differentiating them that way here since, well, whether it is bone or soft tissue ultimately you are dealing with a structural and a functional issue no matter what. Everything has its structural and functional components and I don't know why "structural" should refer to just the hardest bits, i.e. the bones. Then again I'm biased. I write a blog with the word fascia in the title. I digress...

Semanitcs aside, here is why it is important to know if you are dealing with primarily a bone length difference or primarily an alignment/soft tissue issue* because depending on which flavor you have, your treatment will be quite different.

A bone length difference happens when either your femur or your tibia is literally shorter on one side than another. This is the more rare scenario and will happen most commonly if you've had a break in one of those bones (particularly if that break happened when you were still growing), or if you've had a joint replacement since that requires actually removing and replacing part of both of those bones in the case of a knee replacement, and just the femur in the case of a hip replacement.

This is important to know because you cannot make your bones longer now. So while I'm not typically an orthotics kind of girl, if you have one leg that is longer than another due to a bone length discrepancy you are going to have to work with someone who can make a very thoughtful lift for you to wear. This will even out your leg length problem and start you on the road to healing.

I say "very thoughtful" because you can't just go to the pharmacy and pick up something Dr. Scholl's produced for the masses. It needs to remedy the situation with precision and not be the cause of new trouble. Think of when you get dental work; If your dentist filled a cavity and left one tooth significantly longer than the other teeth- youch! It will hurt a lot when you try to bite down. And if one tooth is left shorter than the other teeth, your jaw strains to make your bite meet causing a different kind of discomfort that is more joint-centric (TMJ) and less tooth-centric. Your feet become how you "bite down" on the ground as you walk and stand, and a mismatched pair of legs will have repercussions into your ankles, knees, hips, pelvis, spine, and head. Not to mention that persnickety plantar fasciitis.

Even if it is determined that you have a bone length difference, you have still spent a lot of years (usually) walking around on an uneven foundation, so you'll still need some thoughtful bodywork, but sadly thoughtful bodywork in the absence of a lift is not going to stick with you and the pain will return. So in the case of a bone length difference: lift first, bodywork next. And you may need to tweak the lift as your soft tissue compensations resolve.

An alignment issue happens when you have movement patterns, accidents, injuries, or surgeries that cause your soft tissue to become misaligned. This can take many forms and so is less easy to give a bullet point list. It is also more common however, so here are a few examples to give you an idea of what I mean (note the bullet points even though I said I couldn't do that. Maddening, right?):

  • You spent years competing in high jump and so always jumped off one leg, causing one psoas and quadratus lumborum to hike up. 
  • You spent years carrying everything (kids, groceries, big purse, etc) on one side, causing one psoas and quadratus lumborum to hike up.
  • You had an abdominal surgery which caused some scar tissue internally causing one psoas and quadratus lumborum to hike up.
  • You have scoliosis which causes one psoas and quadratus lumborum to hike up.

Ok now I'm just being annoying. I have a rally cry here and in my practice which is, "It's never just one thing!" and that is true. And it is also never just two things like I oh so tidily made it in the bullet points above. It is always the synergy of how everything comes together and what compensatory patterns  emerge to try and help you out. However, if you are dealing with a leg length discrepancy you can be sure that the psoas and quadratus lumborum are a big part of that dance. When they shorten on one side they have the effect not only of creating pelvic rotations and imbalances, but also of making the leg seem to tuck itself up into the pelvis more.

So if you have plantar fasciitis that has not resolved with manual therapy and you also have sacroiliac pain, low back pain, tight IT bands, piriformis syndrome, lateral knee pain, or gait problems (i.e. limping, or a strongly externally rotated leg), you may very well be dealing with an underlying leg length discrepancy which needs to be addressed in order for the pain to resolve. However, if the main "buddies" that come with your plantar fasciitis are tight hamstrings, calves, and gluteals, and you just plain have a tendency to overexert the hell out of yourself (hellooooo ultra marathoners!) you will likely do quite well with and get some long term resolution with manual and movement therapy alone.

And if you think you might fit this description and are wondering which side you are longer on- the pain usually starts on the longer leg.

* Yes, I got all uppity and italicized with the "primarily" because if you have a bone length difference you can be sure that you will also have an alignment issue. Also "Soft Tissue Issue" is a great name for a band and someone should steal that. 

Research references: http://www.japmaonline.org/content/100/6/452.abstract

photo by Iacovos Constantino

 

Born Again Mama Bodies

4556551742_4e30fb0355_z Hi all! Lately I've had a bundle of diastasis recti questions coming my way from new and veteran mama friends, and also from mama FFF readers. Many of those conversations have ended with this statement, "Well if you don't recommend splinting what do you recommend?" Which would lead into a conversation about alignment and breath, and well, a whole lot of other stuff. It's kind of a long conversation, so I was hoping to find someone whose postpartum conversation was right on the money. As the fates would have it, this coincided with discovering Wendy Powell and her Mutu System, and she was gracious enough to donate a guest post to the blog here. So here is what you've been craving straight from the expert's mouth! Thanks for all your great questions and keep them coming. You all know who you are- and this post is dedicated to you!

Enter Wendy: 

Many mums have had a light-bulb moment when they realize that postpartum recovery hasn’t got an awful lot to do with the race to fit into skinny jeans. It has a lot more to do with being whole again:

  • Walking without pain
  • Exercising without leaking
  • Lifting your child without hurting
  • Being able to keep your innards IN

MuTu System programs have been created to offer a body and mind re-boot. I’ve learned that this is desperately needed, from my own personal and professional experience, and from conversations with hundreds of mums.

What Matters to Mums?

That light-bulb moment I mentioned? It usually hits us around about the time we put our back out lifting our child, or we wet ourselves a bit when we sneeze, or we try to do abdominal crunches and notice our tummy doming (yes, that’ll be your vital organs poking through your weak abdominal wall).

Our bodies tell us in no uncertain terms that our jellified tummy is the least of our worries. Right about then, we stop Googling ‘baby bulge diets’ and start searching for ‘how to fix a pelvic floor’.

And that’s a really good change in priorities!

InfographicV4Back to Basics

So how can we get our body back to its best, inside and out?

On the surface, there are two problems to overcome: pelvic floor weakness and diastasis recti (abdominal separation).

Linked to this unstable core, mums may be suffering from back pain or pelvic floor dysfunction (which could mean urine leakage, faecal incontinence, pelvic pain, pelvic organ prolapse and hernia). And they may be stuck with ‘mummy tummy’, unable to firm up and strengthen their mid-section.

While initially caused by making room for and supporting a growing baby in the uterus, these issues are exacerbated after childbirth by excessive intra-abdominal pressure. The healing process can’t start until the pressure lowers in the abdominal cavity – and to do that, we need to check our alignment.

Misalignment is a brick wall in the face of post-natal wellness – it’s what prevents intra-abdominal pressure from returning to normal after giving birth.

If your body was not aligned properly before having babies, it sure as hell isn’t afterwards. Any glitches in our alignment and musculature that have crept up on us over the years are aggravated by that monumentally physically demanding process.

To reduce pressure, many of us need to start from square one: learning how to walk and breathe right. That is the first step to full post-partum recovery.

New Foundations

Breathing right, standing right, walking right, learning how to connect our minds to the muscles of our core and pelvic floor, so that we use them with every move we make: none of this can be skipped.

Focused core exercises have their place – and intensive workouts too when your body is ready – but it’s the day to day stuff that is crucial.

Alignment, breathing, moving a lot and in the right way: That’s your pelvic floor pension plan right there.

Getting Bodies to ‘Just Do It’

There is a lot of gadgetry in this industry – pelvic floor toning devices and belly binding splints remain popular ‘solutions’ to diastasis recti and pelvic floor dysfunction.

I’m not here to pour water on other techniques, I can only tell you what I believe – which is that bodies are capable of being strong, mobile and fit for life. They can do it on their own, with a little bit of commitment on our part.

The mental connection is important. Lots of mums understandably ‘switch off’ from ‘down below’ after giving birth: It doesn’t feel right and (if they dare to look) it sure as hell doesn’t look right. It’s a lost cause.

The brain needs to talk to the muscles to activate them. It needs to open up the dialogue again. Simply sucking in your stomach, or using a splint, is not the same as activating your core. It does nothing to strengthen or tighten the muscles to help them work properly on their own.

In fact, sucking in, or binding, displaces mass upwards and downwards like a tube of toothpaste squeezed in the middle, placing more pressure on the diaphragm and pelvic floor – doing the opposite of what we want to achieve.

Fighting Fit

Weirdly, having babies is a chance to get fully fit: our post-natal‘ re-boot’ is often the thing that helps us re-focus our energies on wellness. Not just looking good, but feeling energetic and having a body that works.

So many mums tell me that their post-natal fight back was the start of a better lifestyle for them. They come to know and love and respect their bodies in a way they never did before. The skinny jeans are just a bonus.

                                                                                                                                                                 

About the Author

Wendy_Avatar_Sep13-02Mom of 2 Wendy Powell is founder of the internationally recognized and sought after MuTu® System program. She has over 12 years experience, proven record and study in the pre and postpartum fitness industry.

MuTu System includes online coaching, DVD’s, online support and community, fully endorsed by Specialist Women’s Health Physiotherapists and Industry Experts worldwide. It is fresh, personal, progressive and motivational, and it gives Moms the answers, guidance and support they need to restore body confidence inside and out. Wendy has an established international social media following and industry reputation.

MuTu System covers fitness, fat loss, nutrition, hormone balancing and motivational strategies for busy Mums.

Wendy’s specialist area of expertise is pelvic and abdominal reconnection and restoration after childbirth: functional core strength, diastasis recti, pelvic floor and related alignment issues.

Wendy writes for the Huffington Post and has appeared in numerous magazine features, including Red magazine, Health and Fitness and Zest. Health and Fitness magazine UK also commissioned Wendy to write their Get Your Body Back book, published September 2013.

mom and baby photo by Adam DeClercq

DIY Friday: Therapy Balls Vs. Lacrosse Balls Vs. Foam Rollers

diyfriday (2)

*Do it yourself! Every Friday we do a roundup of great posts, videos, or other resources around a theme that help people to turn their bodies from cranky to happy.*

This DIY Friday I'll point you all to an article I put up on Breaking Muscle this week where I get into the difference between Yoga Tune Up® therapy balls (my self care tool of choice), and the two other most prevalent tools; the lacrosse ball and the foam roller. I get asked about this all the time, so here you go! Complete with a research study and everything... All that information lives here. 

ytutherapyballslimeweb

Also,  just last night I had the great good fortune to also be pointed to one of my Yoga Tune Up colleague's hilarious and fantastic videos about, you guessed it, the balls. We love our balls in the YTU world. So for some funny ha ha, here is Amanda Zerbini's  video:

Are You at War With Your Fascia?

3965901338_8b663c765f_b“Stand up straight!”, “Don’t slouch!” Blah, blah, we all had childhoods, and particularly teen years, filled with phrases like these. Sadly, most of us learned how to “have better posture” from vague admonishments like these from our parents. But here’s the thing, if all it took was for us know that we should to stand up straight* or to stop slouching, well then we would all have flawless and effortless posture. Clearly something is off, because judging from what I hear all the time from readers and clients in my private practice (not to mention friends, family, etc) we all universally think our posture sucks and want it to be better. We pull ourselves up, but something pulls us back down again into our familiar slouch. To a certain degree that something is gravity, but more precisely it’s how gravity is interacting with our fascia, aka our connective tissue. If we are aligned well fascially, i.e. we have happy soft tissue and joints, then we are what we call “on our line” in gravity. Which is to say we are supported in gravity rather than dragged down by it because the organ of support and structure in us, our fascia, is doing its fabulous springy upright suspension bridge thing and keeping us aligned and upright.

But for most of us we have a myriad of compensatory patterns in the fascia that get us “off our line” and therefore we feel pulled down in gravity. Let’s visualize the fascia a bit first to get a better handle on this; Imagine that you have a tightly knit sweater lying just under your skin. This is your superficial fascia. From there,  this sweater under the skin dives deep to wrap each and every muscle (and organ), spinning continuously into tendon which attaches muscle to bone, and ligament which attaches bone to bone.  From there, this tight knit sweater dives yet deeper, forming the interior architecture of each muscle in your body. To visualize this interior architecture fascia, I often tell people to take a bite out of an orange slice and then look at it. What you’ll see are tiny pods of juice that are contained by these thin, translucent fibrous walls. Without those walls, it would just be juice with no structure. Our muscles are similar. Without fascia, we’re just juice (we’re somewhere around 78% water, remember?).

Now attach this tight knit sweater in your mind to the nervous system. As in, it’s not an inert sweater, it’s a living sweater. And the nervous system tells it when, where, and how much to knit more based on the sensory input it is receiving from you. So for example if you work at a lab hunching over a microscope, your nervous system detects your constant forward hunch position and says, “Ah! I get it. You want to maintain this hunched, bring the shoulders around the ears and strain the neck forward position more easily. I’m on it! I’ll help you out by knitting the fascia up nice and tidily to hold you there. Aren’t I super helpful!?” The same goes for anything you are, or very importantly aren’t, doing with your body on a regular basis*.  Which, of course, means that when you leave your job at the lab, or more likely leave your desk or couch at home and go to straighten up, you meet with some pretty fierce resistance. This is being at war with your fascia.

Because he’s A) a gifted genius and B) he explains this more elegantly than I do, I give you the famous fuzz speech from Gil Hedley of Integral Anatomy (be aware that if you watch this video you will see some cadavers):

So what’s a knit-up-in-all-the-wrong-places person to do? First, we are you, you are us, we are all dealing with fascial restrictions to one degree or another. So take a breather, this is not dire (yet). Before it turns into unpleasant pain conditions or surgeries however, you have two options which, naturally, work best when combined.

  • First, move regularly in multi-dimensional ways. You’re best off moving in ways our ancestors regularly did , which makes MovNat  and things related to it a good option. But you can also just work on your squat, carry stuff, balance, walk, reach for stuff, and lift yourself up and over things (go climb a tree while you’re at it!). Or just go have some fun. It's also no secret that I love Yoga Tune Up® and Restorative Exercise™ for smart movement. 
  • Second, you can check out some of the manual therapies that free up the fascia. Rolfing® and other forms of Structural Integration are great because they deal with the whole which tends to have more thorough and longer term results (I’m biased), and there’s also myofascial release and ART.

Imagine feeling supported by your body from the inside out, pretty appealing right? I encourage you to check out some of the resources I just mentioned above. It's never too late to wave the white flag and make friends with your fascia.

*Footnote: "Stand up straight" is an unfortunate and vague sentence that typically elicits a movement wherein people flatten out their spines, tug their head up, and shove their shoulders back while flaring their ribs forward. Sadly, this is ripe for creating a host of new compensatory patterns and the chronic pain conditions that come with them, so please avoid making this shape, and just try to forget that anyone ever told you that this weird military meets ballerina posture was good for you. It's not. 

Photo by Marmite Toast