Pelvic Potential Physical Therapy

Are you like me and would it be nice to get some more activation at your hips when you run? Enter STEP UP TO RESISTED KNEE RAISE! I love this exercise because it is SO running specific. I use my hand on the same side as the knee that is going up to provide RESISTANCE to make that hip have to work a little harder. I also get my toes UP on the leg that is coming up, as that drives a better core and hip muscle response in most people. When doing this, I try to get the thigh... of the leg that is coming up parallel to the ground, as we find that flexing the hip at or above 90 degrees brings on the glute on the OTHER leg! The arm positions also exaggerate the arm positions performed during running, which further solidified this movement in our brains When I worked in acute rehabilitation with neurologic patients, we would sometimes get them into a high march position (that I get into at the end of the exercise) STANDING ON THEIR SEMI-PARALYZED LEG (obviously with a ton of cross blocking and other PT's around to assist for safety) to get their glutes to fire again! It was rad...sidenote....I will miss the "highs" of working in acute rehab forever....sigh.....sending love to my friends at @vallejopnf AND a shout out to my old co-worker @philip_villa83 who convinced me to sign up for my first marathon on a lunch break... repping that @nvmarathon shirt in this video!! Anyways, try it and let me know what you think!

There, I said it. And you might be doing it! I’m guessing you are doing this because you are leaking when you run or have feelings of heaviness in your pelvic floor. But think about it: is there any other muscle that is locked in one place the whole time you run? Your quads are lengthening when your knee is bent and shortening when your knee is straight. If they stayed locked, you would be running on a stiff leg! That is the equivalent of holding your pelvic floor in... a Kegel the whole time you are running! Think about your bladder as a water balloon and your pelvic floor as the hands that are going to catch it. A stiff pelvic floor is like a toddler who is learning how to catch: arms stiff and outstretched ready to catch, but once the water balloon hits their hands, it bounces right off and bursts on the floor (aka: leaking urine!!!!). An efficient pelvic floor is like a person who has learned to relax their arms as the water balloon comes to them, being able to catch it well without the water balloon bursting. So how does this work in real life? I like to cue patients to think about looking into the TOP of their pelvis and relaxing deep into their hip joints and the bowl of their pelvis (the hammock of muscles that is attached to your pubic bones, sits bones and tailbone). If the problem is heaviness in the front part of the pelvis, relaxing the BACK part of the pelvic floor can also help (I’ll post more on this in the future). And really think of relaxing deep in the hip joints: stiffness in the deep hip muscles can REALLY contribute to urgency and leakage! Now I’m not saying that strength is not important! But just like you don’t hold your quads tight the whole time you run, let the pelvic floor find IT’S own rhythm too!

Wanted to share a great exercise to hit your Hips AND Core (which includes pelvic floor)! Enter SIDE BOOTY SIDE PLANK WITH ISOMETRIC ABS! This motion is GREAT because it works the muscles on opposite sides of the body IN THE PATTERN THEY NEED TO FIRE IN WHEN RUNNING/WALKING, especially targeting parts of those motion that people post partum particularly need work in (like hip abduction, hip flex ion and general activation of abdominals): 1.) Get on your elbow and push throu...gh your arm to lift the side of your ribcage away from the floor 2.). Bring your top knee up towards your chest with TOES UP. Push your top hand into the end of your quads, slightly tractioning out along the length of your thigh bone, APPLYING RESISTANCE TO YOURSELF to turn on abs and hip flexors 3.). Stay here if this is hard or painful (especially in pubic symphysis), especially if you are newer post partum. IF IT FEELS OKAY, lift up into a side plank on the side of your knee (as pictured). 4.) If it is too hard to do what is pictured/in #3, just hold #2 and ADDITIONALLY try to just do a side plank on knee with the top leg just stacked on top of the bottom one. 5.). For extra credit, exhale, close and lift pelvic floor before step 2 or step 3!! Happy strengthening!

We haven’t chatted about this in awhile, so I thought it was important to bring back the idea of the 5 minute workout! If you are a long time Pelvic Potential follower, you might remember how much I SWEAR by these for getting in your dumb PT exercises and/or getting more strength training into your very full life (or likely BOTH). I like 5 minutes because it is SO do-able time wise, AND you can always repeat the whole thing a few more times if you have more time then you ...though (hello cancelled ZOOM meetings and miracle marathon baby naps!). A lot of times, the key is to incorporate some type of fast paced movement that really gets your heart rate up. My 5 minute workout (that included those Skater Slo Mo’s from my last post) was: 30 seconds of high knees quick feet dribble drill 1 minute of a single leg dead lift variation on each leg 1 minute of of the Skater Slo Mo’s (from one of my last posts)! 30 seconds box jumping 30 seconds side plank on one arm with leg lifted (on each side) 1 minute practicing getting into a handstand (2021 goal! Pictured above!) What are your must-have moves in your five minute workout??

Sure, lateral jumping is sexy, but it’s more practical cousin, Skater Slo Mo’s are UNDERRATED! Why am I obsessed with these for runners, particularly those with pelvic floor dysfunction? Because: Runners usually only work on going straight ahead, yet, our hips and pelvis joints have to control a little bit of side to side and rotation motions (and getting stronger in them makes US stronger overall).... Hip muscle strength, motor control and AWARENESS play a role in controlling pelvic floor symptoms Many of my patients have leakage or pain with unstable surfaces or unanticipated movements, so working in many directions helpful in training mobility on top of stability! Let’s try it: 1.). Stand in a mini lunge position with your shin about perpendicular to the ground and weight over your WHOLE FOOT (see prior post on lunge with leg on wall if you can’t figure this out). 2.). With hands on pelvis, rotate pelvis down towards the leg that you have forward and then as you rotate back up, step your back leg out to the side. Bring your weight over that WHOLE foot again (aka weight not only in your heel!), keeping your shin almost perpendicular to the ground and then step the other leg back into the mini lunge position you were just in with legs reversed 3.). Repeat until you get tired! Really focus on OWNING your stability in the lunge position each time before you go into the pelvis rotation! For me, this looks like making sure my weight is far enough forward and slightly pushing my knees apart. Remember that as you rotate your pelvis and ESPECIALLY when you push off, that front knee should not dip inward. You can even picture you are slightly pushing that front knee out to the outside. Let me know how it goes!

One thing that stood out in all the FABULOUS interviews during the @instituteforbirthhealing summit last week was the power of listening to people’s stories. This is something I have valued for a long time in my practice and is what makes PT an art. I have hundreds of stories about touching places in people’s bodies and having them sporadically talk about something (sometimes while saying I don’t know what made me think of this, but ____) and as they talk, the area LETS G...O. The same way we have a specific muscle firing response in our bodies to throw a ball, our bodies have specific muscle firing responses linked to emotion and trauma (both, like @michaelgervais calls little t trauma and big T trauma). I truly believe that owning and sharing our stories can release muscle tension that is causing dysfunction in our bodies. I believe that sharing our stories can set us free, even when we aren’t solving our problems. Case in point, the great conversation I had with my internet turned real life colleague @dpt.melia last week. We talked on the phone and shared our stories about common struggles we are having professionally. We had SO many things about our stories in common and agreed that at this time, neither of us had the answers to our questions. We got off the phone agreeing that while we haven’t found solutions to our problems, the act of being truly HEARD, especially by someone in a similar situation was SO EXTREMELY LIFE GIVING AND AFFIRMING! I woke up the next day happier and more free. It actually gave me the clarity to see some mini solutions that were right in front of my eyes. Most importantly, it taught me the power of sharing your story to a trusting ear. So how can this benefit you in real life? If you feel comfortable and safe doing, place an hand over an area that is painful. Before doing ANYTHING, have a moment of profound gratitude for your body, saying thank you for holding this tight to protect me up to this point. Then ask yourself what could I let go of to help this let go. Or what happened during birth or another time in my life that is making my brain want to hold this area tight? And see what happens