Core Alignment

Bethany Learn's from Fit 2 Be Studio asked me to write something for her blog after she read my belly blues blog post from a few weeks ago. This is what I wrote and what was published on her blog last week. It's about time that I put it up on my own blog - slightly edited. Its a bit on the longer side but it has lots of picture! Here goes:

As you may know, I have a special interest in all things core and I am sought out by mostly women who want to restore their midsections. I am very conscious of the fact that women's self esteem often depends on how happy they feel about their bodies and that the women who come to me put their trust in me to help them. It is my responsibility to keep learning so I get better at my work and to help my clients be in control of their bodies and their health. Luckily for me, its a very fulfilling responsiblity. I find this stuff fascinating.

Anyway, my learning took on a new level of excitement for me when I started taking Katy Bowman’s (biomechanist) Whole Body Alignment course at the Restorative Exercise Institute. And the exciting part about it is that in those  4+ hour covering the core, I didn’t learn a bunch of abdominal exercises but instead I began to understand the relationship between functioning (or non-functioning abdominal muscles) and the alignment of the bones to which the abdominal muscles attach to - the rib cage and the pelvis - and how therefore alignment work can rehab 'broken' abdominals. 

So if your abdominal muscles are split in the middle (diastasis recti) or you’re *just* wider in the waist than in the hips, it’s worth having a look at how you carry your pelvis and rib cage through space. Because alignment of those body parts has a dramatic effect on how the abdominal muscles can do their work. 

Diastasis recti and a bit of anatomy

All of the abdominal muscles (rectus abdominis, internal and external obliques and transversus abdominis) attach to the pelvis and rib cage. The deepest layer, the transversus abdominis, also attaches to the spine. They all ultimately attach to strings of connective tissue (linea alba and 2 linea semilunaris) in front of our abdomen. Katy Bowman refers to it as 3 abdominal raphe with raphe just meaning ‚seam‘.
Now, if the muscles didn’t connect to this collagen containing seam in front but to a nice long bone instead, we would all have toned abs but obviously it would also make living our life and growing a new life much more complicated.

So we were equipped with this raphe which, IF held in the right position and under the right amount of tension, can be as strong as bone and can thus be a solid attachement point for the abdominal muscles.

When there is a gap between the muscle (diastasis recti) it means that the raphe isn’t bone-like anymore because it has lost its shape and therefore its tensile strength.  It is no longer under the right amount of tension to offer the abdominal musces a solid attachment point from which to move and generate force.

The raphe attach to the sternum and the pelvis which is why the position of the rib cage and pelvis really matters when it comes to the tensile strength of this funky part of our body. When the attachment points of any muscle are in the right place, the muscle can get to work in its intended plane of motion, it gets to be at its intended length and, with regular use, can develop its intended strength. Pretty cool.

Neutral Alignment of Pelvis

When sitting or standing the neutral position for the pelvis is when the ASIS is in a vertical line over the pubic bone. A neutral pelvis is key for the abdominal muscles to be aligned. Let's find it:

Sit down how you would normally sit. Are you slouching? Are you maybe sitting on your tailbone? Can you not make out a curve in your lower back? Tilt forward so you are coming off your tailbone until you are sitting on your ‚sitting bones‘ (ischial tuberosity) and you get a curve in your lower back. Your pubic bone is no longer in front of you but stacked underneath your 'hip bones' (ASIS).

Just like this:

 

And absolutely not like this: 

Just to practice finding neutral pelvis, you can rock back and forth and always find the point where you are in neutral. Notice how this feels like.
Once you got this, notice how maybe some or a lot of that movement comes from your upper body. Are you thrusting your rib cage forward? Maybe you even feel some pressure in your mid-back? Try to relax your upper back without losing your neutral pelvis and see if you can align your rib cage over the pelvis.

When I do it, it looks like this:

What you see is my hyper kyphosis which is exposed now that I align my rib cage with my pelvis. You can’t see this but I could feel my abdominal muscles turn on immediately. The hyper kyphosis is another issue altogether.  This photo just shows you how much I need to round my upper back to get my ribs down and in alignment with the pelvis.  How about you?

My favorite part

Now, I show you how I look when I lie on my back and how my abs respond to some alignment changes.

Disclaimer: In any of the above and below photos, my belly is relaxed. I am not sucking it in nor am I consciously contracting my TvA (deepest abdominal muscle) by pulling it towards the spine. What you see is how my abdominal muscles respond to a change in alignment!

Look at my pelvis in this picture. The white dots show you where my ASIS and pubic bone are – now in a horizontal line where they should be. 

My pelvis is neutral (even though my pubic bone white point looks a little higher in the photo – maybe not perfectly neutral after all but you get the idea).

Check out the dodgy black cross on my lowest real rib: it should be in line with the other white dots. But it isn’t.

When you do it at home and you don't have a camera and white dots like me, you can tell if your rib cage is too far forward when

a) your lowest ribs are visibly sticking out,
b) you are able to slip your fingers under your rib cage or
c) your bra line or where your bra line would be is not touching the floor.


So, if you are doing leg lifts or leg slides from here, bolster your head and shoulders so that your rib cage comes closer to the floor and thus can be more in line with the pelvis. Like me in the next photo.

You never want to look like this when you get ready to do abdominal exercises on your back:

This is far far far away from a neutral pelvis. This is a tucked or posterially tilted pelvis.  You can see how my pubic bone white dot is higher than my ASIS.

It’s easy to imagine that the 3 raphe that go from my sternum down to the pubic bone are far from taut and bone-like. You can also really see my ribs sticking out. My abdominal muscles cannot fire properly in this crappy alignment. You do not want to start doing leg slides or leg lifts in this alignment!

The even better part

So now you know that the ribs should be flush with the abdomen for the lowest real rib is in line with the ASIS and pubic bone. No ribs that are sticking out. Yes? Yes.

In this photo I lift my head and shoulder off the floor to lower by rib cage down so it can be in line with my neutral pelvis.

This is a killer move not to be mistaken with a crunch! All my abdominal muscles are turned on.
Alignment matters big time!








If you want to try it yourself, make sure it doesn’t look like this:

Can you see the bulge or ‚bread loaf‘ grow out of my belly? My ribs are down but my pubic bone is no longer in line with the ASIS.  My pelvis is not in its neutral alignment. My abdominal muscle are not contracting in their intended plane of motion.





But even when you are in neutral pelvis, you can get the bulge. So watch your body.  What you see  is the recti muscle taking over. If you have diastasis recti, your belly would kind of make a tent-shape appearance which you want to AVOID and do more of the basic TvA contraction exercises and releases before moving on to the more advanced stuff.

Important final note: Much much more important than doing a bunch of abdominal exercises every day, is to start noticing where you carry your rib cage and pelvis when you stand, sit and walk around and to correct it into neutral. And to reduce sitting and put more standing and walking into your day. A healthy and functioning body comes from using it properly throughout the day.

Recommended links from Katy Bowman's blog:
Are You A Rib Thruster? http://www.alignedandwell.com/katysays/rua-rib-thruster/
Neutral Pelvis. http://www.alignedandwell.com/katysays/neutral-pelvis/
Exercising vs Natural Movement http://www.alignedandwell.com/katysays/side-effects/

Tight Calves And The Pelvic Floor

For over a year now I’ve been studying with the Restorative Exericse Institute. Before I decided to go for the Whole Body Alignment course this Spring, I took the NoMoreKegels course which is all about pelvic floor health. I learned about the effect of our footwear and posture on the alignment of the pelvis and how this in turn effects the pelvic floor muscles. I also learned specific exercises to restore pelvic floor function. And one of the most fundamental of those restorative exercises is the calf stretch.

The CALF STRETCH? For my PELVIC FLOOR? Yep. It all begins with tight calf muscles. (Well, it all begins in the feet but that shall be another blog post.)

The calf muscle group is made up of the gastrocnemius, soleus and the plantaris. They all attach to the heel of our foot. The soleus attaches below the knee at the tibia. And the large gastrocnemius and the much much smaller, but oh so sensitive, plantaris attach above the knee at the femur.
Muscle always contracts from attachment point to attachment point. Which means that what goes on with the attachment points, i.e. how the bones are aligned, matters a great deal to what goes on with the muscle.

For example, when I wear a shoe with a positive heel, the natural heel of my foot where my calf muscles are attached to, is brought closer to the knee.
As a result the muscle is put in a shortened position. If the muscles are chronically held in this position because I’m in my positive heeled shoes all day, well, then they stay in this shortened position.

A chronically shortened muscle is a tight muscle. And a tight muscle isn’t very good at receiving or pumping blood and lymph and also doesn’t communicate well with the spinal cord. In short, a tight muscle isn‘t a strong, force generating muscle.

Another example is the posture of constant knee flexion. Check out any person running or walking on the street. They all have their knees bent. And then look at all the people sitting around. They also have their knees bent (surprise!).

Because the gastrocnemius and plantaris muscle attach above the knee, any kind of knee bending action puts slack in those muscles. Muscles can’t stay slack because then they have no force generating power so the muscle fibers simply adjust and shorten themselves. Now they can work again.  But because the knees are in flexion all day long (sitting, sleeping, walking with bent knees) the calf muscle is chronically shortened. And a short muscle is a tight muscle is a weak muscle  …

This constant knee flexion is one culprit for the pelvic floor problem. But to understand this, we have to welcome the hamstring group into the discussion.

The hamstring muscles all attach to the lower leg bones (tibia and fibula) as well as to the pelvis. Knee flexion causes slack in the hamstring muscles. The hamstring muscles get short and tight. And these shortened hamstring muscles are pulling and tucking on the pelvis causing the pelvis to be out of neutral (posterior pelvic tilt). Which then in turn puts slack in all the pelvic floor muscles causing the pelvic floor muscle to adjust and shorten.

And a short, tight, weak pelvic floor muscle isn’t very good at holding up the pelvic organs. A short, tight, weak pelvic floor muscle is also not very good at expelling babies. WOW!

Soooooooooo, if you have plantar fasciitis or heel pain or crampy, tingly, tired legs or knee pain or pelvic pain or if  you are leaking urine when doing jumping jacks or you have back pain or you were told you have have a hypertonic pelvic floor or prolapse or prostate problems, there are many things you can do right now to get better. Here are a few suggestions:

1) Stretch your calves and click this to read and see how.
2) Assess your shoe wear. If you wear really high heels, get into a smaller heel. And if you wear running shoes with a bit of a heel, consider getting a truly zero heel shoe. (Here is a list for minimal or ‚barefoot‘ shoes)
3)Increase barefoot time
4)Get out of the chair every 20 minutes and stretch your calves.
5)Get the Every Woman's Essential Body kit from the Restorative Exercise Institute (and I don't benefit from this recommendation in any way other than the fact that I was the source that led you to some amazing and cheap self help tools and knowledge)
6)You could even take the NoMoreKegels course yourself.
8)If you are in Ottawa, come to class or book a private session

PS: I can't let you go without saying this:
The abdominal muscles attach to the pelvis .... calf stretch anyone?

Belly Blues And What To Do About It

For many women the belly is a problem zone laden with negative emotions. Maybe you feel totally disconnected from this area of your body. Maybe the look of your belly in the mirror triggers a sense of hopelessness and depression.

So what do you do? You suck it in. You might suck it in to hide it. You might suck it in because you think this is what „engaging the core“ is all about. Well, sucking in your belly is disrupting the normal pressure in your abdomen  and has nothing to do with contracting your deepest abdominal muscles.

You CAN re-connect with your belly again. Over time you can even flatten it so you like looking in the mirror again.  All you need to do is get the muscles to work again. And the first step is letting it go!  Release your belly. Let it be as big as it wants to be. The hardest thing of all. But now the muscle isn’t “stuck“ anymore and it can actually contract.

Getting ready to contract the deep abdominal muscle (transversus abdominis aka TvA) correctly

How you position your pelvis and rib cage really matters to the proper functioning of your TvA  – after all the muscle attaches to large portions of both. Check it out on this image from Gray's Anatomy.

How should the pelvis be aligned?
Your ASIS (Anterior Superior Iliac Spine) and your pubic bone should be in a vertical line when standing or sitting. It will give you a nice curvature in your lower back. To find your ASIS you can just put your hands in your groin area and then walk them up until you can palpate the part of your iliac spine that most protrudes. Or maybe it makes more sense if I tell you to put your hands on your hips and find the point that protrudes in front.

So when you are sitting it should look like this.

Now that you are sitting in neutral pelvis, relax your belly and check in with your rib cage. Do you feel a strain in your upper back? Are you thrusting your rib cage forward? Try to relax your rib cage back and lower it down so it starts to align with your neutral pelvis. Relax your belly again. And breathe.

Some cues for you:
Take air in through your nose and let the air fill your rib cage.
If you notice your shoulders coming up to your ears when breathing, focus on sending the breath into the lower half of your rib cage.
Exhale through your mouth.
Take your time.
Your belly stays relaxed the whole time.

Once you get the hang of it and this feels natural, you can start doing some TvA contraction exercises.

Contracting the TvA
The TvA wraps around our waist like a girdle and contracts like one. Pretty cool.

So.... inhale again and now as you exhale through your mouth you draw your belly button towards the spine. Maintain the neutral position of your pelvis as you do this.
Also make sure that your rib cage is not thrusting forward.
Let your belly relax after each contraction and check in with your pelvis and rib cage and re-set if necessary.

How many? It's up to you. More doesn't necessarily mean faster results. Focus on maintaining neutral pelvis and dropping the rib cage as you go throughout the day and when doing the exercise. And ... relax your belly. Now that you know how to contract the TvA properly you can hopefully see that your habit of sucking in your belly has nothing to do with contracting your abdominals.

PS: One day you don't even have to think about contracting your abs, they will do it for you. Like they are supposed to. If only we used our bodies the way we should. Our habit of excessive sitting is not exactly helping. The exercise shown is a good starting point - since we sit all the time, we might as well sit properly and wake up our core. When you're done with it, get out of the chair, do a calf stretch, put a pair of really flat and comfy shoes on and go for a walk. It will help with the belly blues!

PSS: A quote from Katy Bowman, biomechanist, about core strength.
Core strength does not mean abdominal exercises! It is the ability to stabilize the bones in the upper body, rotate the torso with proper spinal curvature, and maintain pelvic position while sitting, standing, and exercising! It’s the ability to control the bladder, stabilize the ligaments of the knees with the lower abdominal wall, and breathe correctly while doing all of these!

Oh, The Sarcasm Of My Last Post and A Contest

Last Thursday I wrote a post with the title 'Fall Into A Habit Of Walking'. I thought it was a funny game with words since its fall and falling into a habit of walking sounded like a really witty title. I wasn't laughing the next day. I did walk on Friday morning like I said I would. But I also did the falling part. No, not that kind of falling. But the literal Falling Down The Stairs.

I thought I got to the end of the stair case and wanted to keep walking but there was another step left and I stepped into the air and then fell and twisted my foot. I can't tell you how dumb I felt. And how painful it was. This is what my foot looked like on Friday:

 See the bump on the outside of my foot. OUCH.

I became a certified Healthy Foot Practionioner in September and know what a delicate and complex structure our feet are. Leonardo da Vinci called the foot 'a masterpiece of engineering and a work of art'. Since my feet are a good example of what our shoewearing lifestyle does to this masterpiece (think crooked toes and bunions in my case and fallen arches, plantar fascitis and calluses maybe in your case), I felt extra angry that this had to happen to me.

So even more work for me. Why more work? Because my feet were in my very own rehab even before the stupid fall. Our feet are the foundation we stand on and since I don't want to have chronic back pain and a knee replacement when I'm older, I want it to be a good foundation.

Here are a couple of exercises that I do with my injured foot to get the blood flowing and the lymph draining in there. The exerices also innervate the many small and completely underused muscles inside the foot. And these exercises are key to healthy feet in any case - acute injury or not.

I lift my big toe keeping the others on the floor. With the swelling in my foot, this is hard work. I am taking it easy.

The swelling somehow causes my big toe to adduct (turn in). Like the beginnings of a bunion.Maybe your toes looks like that?

So I spread my big toe out (abduction).

See if you can lift your big toe while keeping the other toes connected with the ground. If you can, work on lifting up the other toes one by one. If not, keep practising. For the health of your feet and your whole body. Because 'the foot bone is connected to the leg bone and the leg bone is connected with the hip bone and the hipbone is connected with your spine' and so on.

Book recommendation:
Katy Bowman (2011) Every Woman's Guide To Foot Pain Relief   
DVD recommendation: 
https://www.alignedandwell.com/shop/fix-your-feet/

Contest:

The first person who can tell me how many joints are located in each foot, wins the book. (I got some copies as part of my training so I might as well make use of them and hand them out.)

 




 

Fall Into A Habit Of Walking

This morning I had some unscheduled time. So after my husband and I got the kids fed, dressed, packed and walked to day care and after I responded to some emails, I was faced with the following choices:
a) do some bookkeeping
b) get some study time in for my Whole Body Alignment course so I get closer to my goal of being a Restorative Exercise Specialist
c) write a blog post to share a bit of what I'm learning in the just mentionned course
d) walk to the store to buy new woodchips for our guinnea pig so he can get a fresh house today

Bookkeeping is boring. So this was out from the start. Since the pig's house was in a stinky state and the sun was shining and walking is so good and walking in alignment practice is part of my course, I decided to put my shoes and backpack on and go for a little walk. Mind you the store is only 800m away from our house. So walking back and forth is a mere 1,6km. With our morning walk of 2km to and from day care I'm at a whopping 3,6km. Plus 2 more km when we pick up the kids later this afternoon. 5,6km. 3 miles. Not all that bad. And good decision making, right!

Walking the way we are biologically supposed to, i.e. in alignment involves half of the over 600 muscles in our body. And the more muscle we use, the more blood those muscles can pump into more areas of our body and thus the more cell regeneration occurs. More cell regeneration = more health. And we really are supposed to use our body in a way that gives us the most chance of survival, i.e. health.  (In the past, I wrote a little bit out what our sedentary life style does to our immune system).
 
So what is walking in alignment? This is what I'm learning from Katy Bowman, biomechanist, in the course I am taking. It should not involve bent knees or bouncing hips or powerwalking arms (read an article from Katy herself). Natural walking should also not involve shoes with a positive heel. Even the regular running shoe has a positive heel, i.e. inside the shoe the natural heel of your foot sits higher than the ball of your foot (read a rather lengthy scientific essay by Dr Rossi about why shoes make proper gait impossible). So for us shoe-wearing, chair lounging and asphalt walking people, it's actually really really really difficult to walk naturally. And I'm nowhere near it.

I want you to start appreciating a walk and encourage you to start walking on a regular basis. And to walk with your kids. Our kids are now 3 and 4,5 years old. We always walked the 1km to our day care but finally banned the stroller this spring. The first day was tough and maybe the second too. I don't remember actually. There probably was some whining. And it might have taken us 45min to get to day care. But we made it a priority. And now it's a habit. We all walk in the morning and in the afternoon and its fun and sometimes its not and it often takes much longer than I'd want.

And maybe you think 'Ha, I wish I had time to walk my kids to day care, school, activities!' - and I will just tell you to Make Time! Because walking is the one movement we absolutely NEED to do every day for optimal health. And children need it for their healthy development. When I was a kid I walked to school every day. 1,9km one way. I google-earthed it. When did your 6 year old kid last walk 1,9km?

And if you are a new mom with only a baby and no toddlers ... well ... you can get out first thing in the morning tomorrow. (after you packed the diaper bag and put yourself some clothes on and waited for baby to wake up and nursed and changed the baby, ect. - I remember it well!)

And just in case you want to think about your alignment when walking, here are some first main pointers:

1) Keep your feet straight. Align the outside edge of your foot with a straight line. If the feet are not pointing forward when walking, the muscles of the legs and the muscles around the pelvis don't work properly. And those muscles are kind of like your engine for proper walking and also ensure that your pelvis is in its neutral position and the spine isn't overly taxed from walking with your tailbone between your legs.  

notice turned out feet - no lateral hip and gluteus involvement

that is better 

When you try this and you feel pigeon toed and your knees turn in, it means that you need to practice externally rotating your thigh.

2) Find a shoe with a truly flat sole. If you are a high heel wearer, get a smaller heel and come closer to the ground over time. In addition to a zero heel, the shoe should have a flexible sole and your toes should have lots of space to wiggle around. The same applies to your baby's or your child's shoe. Keep your kid in soft soled, roomy shoes as long as possible. Robeez and Soft Start Shoes are great choices for kids. Katy Bowman recently compiled a comprehensive list of minimal shoe brands for kids and adults.

3) When you can, keep your arms free and start swinging your arms. Not pumping forward with the elbow in a 90° angle! Let your arms hang. Swing back actively and let the arm swing forward passively.
If you push a stroller, push it with one arm only and swing the other arm. It will prevent you from using the stroller as a crutch as a nice side effect :) The arm swing is there to make walking a symmetrical activity. One leg goes forward, the oppostite arm swings back. It minimizes any twisting of the pelvis and spine when walking. It also allows the lymph in your armpit to flow and this is good news for breast health in general and nursing mothers in particluar.

And, btw, during my little walk to the store this morning I was so busy checking in with my feet and butt muscles that I completely forgot about the arms.

Happy Walking!

Ps: And here the picture my husband took of me and the kids walking home this afternoon. It was cold and started to rain. And the 3 year old didn't want to walk because she was too cold but didn't want to wear all the extra clothes we brought..... So I carried her. What can you do? It wasn't much fun and walking in alignment with a 3 year old is well ... another story. But we walked. And we will walk tomorrow.

Women Hold Up Half The Sky

‚The Freedom in a country can be measured by the freedom of birth.‘Agnes Gereb

Last night I went to see the world wide premier of ‚Freedom Of Birth‘ – a movie that any woman and man supporting a woman in childbirth should watch. A movie that slaps it right into your face that childbirth is a human rights issue. And after it has slapped you in the face, it stabs you into your heart. At least this is what happened to me.

Meet Agnes Gereb - the subject of the documentary. She is a Hungarian obsetrician and midwife and international homebirth expert. She was taken into custody Oct 5, 2010 after a woman had gone into unexpected labor at Agnes' birth centre. As I understand it, Agnes had advised this woman to give birth in hospital but the woman rejected the idea and happened to go into labor during a class at Agnes' birth centre. There must have been some trouble because Agnes immediately and rightly decided to call an ambulance. With the ambulance that took the labouring woman to hospital, the police came to arrest Agnes. The reason? Reckless endangerment of life committed in the line of duty. The woman gave birth to a healthy baby and was soon discharged from hospital.

Three months after Agnes was jailed the European Court of Human Rights established under Article 8 (right to private and family life) of the European Convention that any woman has the right to choose where to give birth. (case of TERNOVSZKY v. HUNGARY) Agnes Gereb was freed but is still under house arrest!

This is Hungary! In the year 2012! A member country of the European Union since 2004! REALLY!!!

I deeply care about women's rights in childbirth. And it pains me that I don't see enough women really care about it. Or don't realize they should care. Or at least don't show that they care.

I'll quote Dr Nancy Salgueiro - the Ottawa woman who you might have seen give birth live on camera 11months ago. She is also a childbirth educator and women's advocate (and chiropractor). In her talks with women she finds that:

Women are given misleading information making them feel as if procedures are necessary when they are not. - Induction or Oxytocin anyone?

Women are being told they are incapable of birthing their own baby and must trust in a system that does not support normal birth. - Ever been told during check-ups that your baby is large, maybe too large for you to birth vaginally?  I hear stories like that ALL THE TIME.

Women are being forced to birth in institutions because of lack of access to birth attendants outside hospitals. -We are lucky in Gatineau to have the Maison de Naissance but I felt like I won the lottery when I landed a midwife there to give birth to Elise outside the hospital. Ottawa residents are lucky to have quite a few midwifes and many homebirths. But not enough! Ontario is going to get 2 birth centres though. So there is a shift happening. Slowly but surely.


Women are abused and assaulted by procedures done to their bodies without consent and even after consent is withdrawn - Too many nurses, doctors and student nurses check how dilated you are? You just accepted it and realized later how much you disliked that? I gave birth in a Ottawa hospital to Joshua. It was an easy birth without any intervention and I didn't have a single tear. My vagina felt pretty good actually. Yet, I remember having to turn my naked butt to at least two nurses (one was a student, I believe) who checked for hemorrhoids. I felt uncomfortable to say the least. And 5 years later I still think about it. So, yes, I feel kind of violated! My midwife who cared for me after Elise's birth in Gatineau never felt the need to look at my perineum because she knew from the birth that I didn’t have tearing and she knew I would tell her if I had some trouble down there. After all I know my body best. Not to mention the fact that most women are automatically supplied with oxytocin at Ottawa hospitals. I didn't believe it but an ex-hospital nurse at last night's talk said that she cannot think of a single case under her watch where oxytocin was not given - with or without consent. I still find it hard to believe actually.
 
Women are being told they have no choices and must comply with medical orders or be threatened that their child may be taken from them. - I don’t know about a case in Ottawa but looks like Nancy does.


So women here in Ottawa are being violated and discriminated against under the Article 8 of the European Convention of Human Rights. We just have to start owning this! This room last night was half-full. It should have been packed! Too many women do not know the facts about the effects of interventions on the outcomes of childbirth. Too many women do not know that a C-section is major surgery and does come with risks. We can't just wait for the system to change and hope that one day doctors will give us truly informed choice. I totally believe that change has to come from the top. But I believe just as much that change has to be iniated by you and me first. After all, Women Hold Up Half The Sky!

Check out the Informed Choice Coalition and come to the next screening on October 12.

If you had a traumatic birth experience and feel ready to work through it, there is the amazing Julie Keon with her Making Peace With Your Birth workshops.

Tough Workout or Whole Body Movement?

I have a love-hate relationship with facebook. I love it when I see a link to really cute minimal shoes like these ones. But I get rather turbulent flow in my blood vessels when I come across people saying stuff like:
'I had an awesome leg workout. I had to take the elevator down because my legs were so sore.'
or 'Great workout. I hobbled home'. Haha.

It stresses me out big time. Why on earth do people think this crazy pain is good? I'm not talking about a bit of muscle soreness that we get from using a muscle that we haven't really been using before. I mean the 'I can't walk anymore' kind of muscle soreness. This is just our body saying This-Is-Enough loud and clear. And the way I see it, it is just not natural behaviour to feel happy and proud when our body is saying NO. Or am I alone here?

Imagine you are a paleolithic person and you live fully in tune with your body because listening to your body's signals means the difference between life and death. Imagine one day you feel that all this natural living stuff stinks and you want to have a bit of fun and show everybody how cool/strong/able you are by doing something nobody has ever done:  You climb up and down 15 trees as fast as you can followed by lifting 5 big rocks and a 30minute chase after a mammut (or whatever). Imagine you made it and everybody is cheering. You feel the rush of adrenaline. It feels great. You also feel sore and have to lie down. Not so great. You actually feel too weak to embark on the 5mile trek to the next food source. Not great at all. You are left behind. The End.

Had the paleolithic people and the people after that been abusing their body like this, well, we wouldn't be here. Humans survived and evolved because they spent their days doing whole body movements like walking and carrying their children (or dead animals.) And then they rested. No CrossFit or treadmills or crazy leg workouts needed to live and thrive. Just walking and carrying stuff in their arms. And maybe the occasional climb up a tree or fight with an animal. And then a period of rest.

What happened to us? This big fitness boom. It's only been around for the last 40 or so years. Before that people just moved more throughout the day. They didn't need to work out. Now we sit on our butts for most of the day. Most of us don't even wash the floor on hands and knees anymore. (I do! I do!) And because we know we are so deconditioned, we take our completely underused body with its 600+ muscles (most of them way too tight) into a gym and give it a tough workout. Then it makes us feel great. But, really, for our body it's only stress. On every level. Muscles, tendons, ligaments, connective tissues, organs, blood vessels. Each and every cell really. And it shows. Foot, knee, hip, back, neck and shoulder pain anyone? Feeling tight? Not able to walk up or down the stairs? Needing to take the elevator after a workout???????? It just doesn't make sense to me!
...

Oh, and at the end a little help for all of you out there with tight calves from a tough workout, from wearing heels or from sitting too much: THE calf stretch. A rolled up towel will do too.

Sucking in your belly - Good or Bad?

BAD. Very bad. Very, very bad. And before you say 'hang on a minute, I was told to pull my belly in', let me explain:

Your deepest abdominal muscle (the TvA) contracts when you pull it towards your spine with the pelvis and rib cage in their neutral alignment. When you carry your pelvis and rib cage outside of where they should be, you don't work your core. But this is another blog post (If you can't wait, click here and here). Getting your TvA muscle closer to optimal functionning is absolutely crucial for the health of your spine, pelvic floor, cardiovascular, digestive and reproductive systems. Not to mention the good looks we are all after. 

Sucking in your belly has nothing to do with contracting your TvA. I have seen and talked to so many women who want to get their bellies in shape. And they all do it: They suck in their bellies. Even men suck in their bellies. And you suck in your belly propably right now. I know it. Because even I suck in my belly. Especially yesterday. And when I do it, you do it, too. (Very good reasoning on my part!)

When we suck in our bellies, the motion is up under the rib cage and not at all back towards the spine. Feel the pressure just under your ribs? This habit of sucking in our belly doesn't make the belly smaller because the abdominal muscles just aren't innervated. Instead we create unwanted pressure in our thoracic area - especially at the diaphragm. So much for healthy breathing! We need the diaphragm for expelling stuff (think vomiting or coughing). Not for pressing the contents of our abdomen against it. When we are so busy sucking it all in and up, then our bodies have a much harder time with all these very necessary downward motions like birthing babies or pooping or menstruating.

If you want to get your abdominals to work and if you want to breathe, oxygenate, digest, poop and birth freely and get a flatter belly as a bonus, you have to start with this: let your belly relax.

Let it hang. All of it. Breathe. And let it hang. The best position for releasing it is on hands and knees. (click here for pictures) Then you can start working on your TvA - with the ribs and pelvis in neutral!

We were just not made to suck in our bellies. Just think of how happy this pig must be. (Though it might be time for pig to learn some TvA contractions. He doesn't even have a lumbar curve. Oh well. Maybe not so happy after all...)

Fit Pregnancy Or What?

You know that exercising during pregnancy is good for you, the pregnancy and outcome of the birth. The Society of Obstetricians and Gynecologists of Canada (SOGC) even considers it a risk to not exercise during pregnancy.  But what does this exercise thing really mean?

If you are like most women in Ottawa, you have an office job and sit all day long. You know you need to start exercising. So you enroll in a prenatal aqua or yoga or fitness class once a week. Good! Maybe you start walking during your lunch breaks. Better!

So that makes 30-60min of walking every day and 1hour of structured exercise a week. What about the other 23+ hours in the day? Do we really think that 1 hour of exercise can outbalance 23 hours of sedentary behavior? Seems crazy, yet, it’s exactly what we do: Oh, I ate this extra slice of cake while reclining in my comfy chair. I really have to go to that class tomorrow and get fit again.

Fit. Fitness. Prenatal Fitness. There is something wrong with the way we use the word Fitness. According to my Oxford Dictionary it is ‚the state of being physically healthy and strong‘. Being fit for something means `the state of being suitable for something‘. So here it gets a little sketchy. Fit to swim 20 lanes? Or fit to have a pregnancy without back pain? Fit to give birth without intervention? Or fit to be pregnant without walking like a duck.

The achieve this we need to do a little more than this one exercise class once a week. And I don’t suggest you take an exercise class every day. How about just getting out of the chair for starters?

While the positive effects of exercise have been extensively studied and written about, more and more researchers are looking into the other sedentary 23 hours of our day.  What has come to light is that the health outcomes are just as bad – for the non-exercisers as well as the exercisers IF both sit on their butts for the biggest part of the day. It's the sitting that ails us. Thus, we need to be more active throughout the day to be healthy and, naturally, to have healthy pregnancies.

We don’t need fitness in the sense we use the word. We just need to move our bodies.  Throughout the day.  Every day.  And we need to move our body the way it was designed to be moved (excluding all those bad slouchy and thrusty habits).

Maybe you can do 15 push-ups on the edge of the pool during your prenatal aqua class but you know something is missing when you do the duck-walk on your way back to the change room only to notice that your back pain has come back.  Right?!

To Do List:
-get out of your chair every 30minutes and do the calf stretch
-consider signing up for Kangaroo Fitness‘ new prenatal exercise/education class? ( I know, it’s a little bit ironic…..)

Preventing Postpartum Back Pain – Proper Lifting Mechanics

I wrote this article with Jillian (who is a Restorative Exercise Specialist and just awesome) for the fall issue of From Belly To Baby which is a free pre/postnatal mag that comes out every 3 months. I have always loved reading it - ever since I got to Ottawa with my pregnant belly. You can pick it up at some locations in Ottawa or read it online.
And because I like German efficiency, I will just publish it as a blog post.
Here we go!

You say: “I’m starting to get pain in my lower back“. 
Your  doctor/friend/neighbour replies: “Well, you are pregnant. That’s normal. It’s part of the the common aches and pains you get“. 

Pain during pregnancy – and postpartum -  is so common that we mistake the word common with the word  normal.  It is NOT normal.  Our bodies were made to be able to accommodate a pregnancy without aches and pains. Our bodies were also made to be able to lift things (think baby, diaper bag and groceries) without getting a spinal or sacroiliac joint injury. We just have to use our bodies the way they were designed to be used.

Most back injuries happen when we lift things, and new moms tend to lift heavy loads every day. Let’s look at proper lifting mechanics then!  But really the best time to learn proper lifting technique is before you even get pregnant. Don’t worry though, a lot of back pain can be alleviated and prevented by starting to lift correctly right now.

Lift with your butt and legs and keep your lumbar curve. The curve in your lower back is there to absorb loads we place on our spine – our yown body weight from standing and additional loads from lifting.  What we  usually think of as excessive lumbar curve actually comes from what happens further up the spine: from thrusting the rib cage forward.  By maintaining the curve in your lower back and drawing the rib cage down, you get your spine where it needs to be. Bend your knees, but don’t let them drift over your toes: keep your knees over your heels and stick out your butt. Not easy, but the more you stabilise your spine and carry loads with your legs, the happier your back will be.

Lifting While Twisting places much more stress on your lumbar spine and SI joint than lifting with your shoulders and chest in line with your knees and feet. For example, we tend to get the car seat out by facing the car with one side of our body. This ultimately results in an excessive load being placed on the spine from a twisty lift. Square yourself in front of whatever you are lifting and then lift as decribed above, loading your legs and stabilising your spine.

Lifting after C-section, if you have diastasis recti or a weak pelvic floor calls for a lot of caution. Your body’s mechanisms aren’t really working the way they should and the additional load from lifting can place dangerous pressure on your pelvic floor, abdominal wall or even diaphragm. You can control the pressure by learning to check in with your body. Do I feel pressure on my pelvic floor? Do I feel/see a bulge where my abdominal muscles should be? Avoid the activity if you can. If you can’t avoid it, apply the above tips for lifting. Try to use your deep abdominal muscles while you lift. You can counteract the pressure when you exhale and draw belly button towards the spine before you lift. Or sneeze. Or have a bowel movement.

not like this

more like this:
knees over heel, curve in lower back and butt out, rib cage up

Tips: You can reduce some heavy lifting by keeping the car seat in the car and just carrying the baby in your arms. It’s better for your back, a great upper body workout and it allows for the optimal spinal, muscular, and vestibular development of your baby.  Not to mention it’s bonus snuggle time for you and the babe!
When you lift an older child, you can save your back by just reaching under your child’s arm pits and lifting with your arms and shoulders.

The end!

Post Long Weekend Stretching

We just got back from a weekend camping trip with the kids and the canoe. Despite the 4 of us sleeping on a rather uncomfortable air mattress my body feels great - no aches, no pains. Must be from all that bare foot walking in the woods, climbing on rocks, squatting to pee, splashing in the lake and just being relaxed!
Or, now that I'm thinking about it, maybe there is just a bit of a tense trace of that air mattress in my back ....
And just in case you have some aches and pains from the weekend or otherwise, here are two of my favorite stretches.

The first one must be the Calf Stretch the restorative exercise way:

I am using a piece of foam roller sliced in half but a tightly rolled up towel or a couple of books work too. Get the ball of one foot on the item on hand, keep the heel on the floor, place the other foot next to the one stretching. Or behind or in front. Depending on how tight your calfs are.
Make sure that your feet don't turn out and keep your hips square. Try to relax your quadriceps muscles so that your knee cap is released.  Hold it for 30second and work up to holding it for 1minute or longer.

This is just the BEST! And maybe you can feel it all the way into your lower back.





The other one that can even be done while lying in bed is the Crescent Stretch and it stretches the side of your torso (obliques) and you can even get some IT band action if you are lucky.

Lie on your back with your arms and legs extended. Check if your bra line is touching the floor: your rib cage should ideally have contact with the floor (unlike mine in the pic). You can put a pillow or two under your head to help. Make your shoulder blades nice and wide as well.

Then do this: 

Start forming a crescent or c-shape with your body and as you do it focus on getting your hip further away from your rib cage - to really lenghten the side of your torso. 











Then just plonk the outside foot over the inside foot and .... breathe.

Hold both of these stretches for at least 30 secs, ideally for a minute and by all means for longer. And I know it's unnecessary to add but ... stretch the other calf and the other side of your body, too.

Good night!

Why Sitting Is Bad For Our Health

It’s time to finally start writing my first blog post. I have all these ideas in my head. Should I write about lifting mechanics as it relates to mommyhood or universally answer one of the questions about diastasis recti that I find in my inbox every day or should I write about my journey so far as a student of the Restorative Exercise Institute or should I write about walking with my children or should I maybe write about the terrible effect sitting has on our health?

I was mulling this over on Monday while washing the kitchen floor for the 73rd time that day. In between 1001 times of hearing the word ‚mommy‘ I even had a minute to read one article in Saturday’s paper. It happened to be an article about the growing body of research that shows that sitting is killing us softly. I liked it because the author suggested that chairs should be made really, really uncomfortable so we spend less time sitting in them. I like extreme measures. I’m known to tell clients to stop hanging out in their LazyBoys (how is it spelled again?) or, better, to throw out their couches. One was able to convince her husband to not buy a second couch to keep more room for stretching and hanging out on the floor. These are the kind of client stories I like :)

Anyway, my decision was made. My first blog post would be about the first thing I tell anyone who wants to listen: what terrible things sitting on chairs does to our bodies. Just in more detail.

Our body has over 600 muscles. We are supposed to use all of these muscles by means of moving our bodies. We are alive because our heart is pumping oxygen-rich blood through our arteries. Imagine your arteries and venes like a highway that runs through your torso and limbs. But our body is much more interesting than that: there are side roads branching off the highway, and more streets branching off those roads and finally little alleys – the capillaries - at the end of those roads. The heart doesn’t pump the blood all the way there. This is where the muscles have to come in. They compress the blood vessels and thereby direct some blood away from the highway so that it can supply ALL cells in our body.

Basically, the more muscle is innervated (stimulated), the more blood cells can branch off into the side roads of our circulatory system and finally into the little capillaries. The blood cells carry waste products through the walls of the capillaries into the lanes of our lymph system. The lymph fluid carries the blood cells with the waste products straight to the lymph nodes via these lymph lanes. There, white blood cells are being formed and the fluid is treated for any bacteria and then taken back via the capillaries into our blood vessels.

Ok, so what does that have to do with sitting? Well, we don’t exactly use many muscles when we sit.
Our major lymph nodes are located behind the knee and deep in the groin, abdomen, chest, neck and arm pits. When we sit on our computers or in the car, our knees and hips are bent. That means these major muscles are kept in a shortened, non-innervated position. Our abdominal muscles are not exactly on overdrive either. Our breathing isn’t optimal in any case. We pull our necks forward like we are turkeys and there is no movement in our arms or shoulders either. And while we work and stress away and think of our next break which we’ll be spending on just another sitting device, the muscles and lymph nodes in all these body parts can’t do their job. Non-working  muscles, non-working lymph nodes, no clean blood, no defense for disease. Sitting is defenitely not healthy!

So, since I’m reaching my word count and promised myself to only write kind-of short posts, I get to the WHAT TO DO part.
-    When you must sit, sit straight and breathe freely.
-    Start to include some sitting on the floor, ideally on some pillows or a yoga block to get your spine more into its neutral curve and therefore into a better, healthier place

not like this

more like this

-    when sitting for long time is part of your work day, stand up every once in a while, e.g. when talking on the phone and find reasons to walk around the office.
-    Determine a place in your neighbourhood that is 1km away and where you frequently drive to and start walking there.
-    Stop watching TV in the LazyBoy and hang out on the floor instea
-   Do this sitting quiz to determine how much much time a day you really spend sitting