Pieton Physical Therapy & Pilates

I’ll let you in on a BIG secret The interwebs want you to be scared of Diastasis Recti (DR), but you don’t need to be. The fear mongering and misguided messaging that there is such a thing as a safe vs not safe list of DR exercises is a total sham my friends, but I’ll save that for a future post. . Let’s start at the beginning: What is DR? This is a medical term to define the widening of the linea alba (LA) when it is greater than 2.2cm or about 2 finger widths. The L...A is connective tissue that joins the right and left halves of the rectus abdominis (aka your six-pack abs), the muscle that runs vertically from your ribcage to the pubic bone. DR can occur anywhere along the LA, and is most common above and below the belly button. . Who can develop a DR? Any human, but it is most common in birthing people due to the changes that happen during pregnancy. However, 100% of all birthing humans who carry to full term will have an LA that exceeds 2.2cm to accommodate baby(s) growth. YUP! All birthing humans who carry to full term will have DR. That’s one of many adaptation tools the body uses to bring life earthside. . Are there things that can increase DR during pregnancy aside from baby’s growth? Yes, this is possible, just like it is possible to do this to any area of the body if we are loading too much too often for the capacity of those tissues. What’s the best way to know how this pertains specifically to you and the movements you enjoy? Invite a PFPT on your team to work with you and provide you with tools to support your movement long term. . How common is DR postpartum? Current research tells us the following about DR prevalence: 60% at 6wks PP, 45-50% at 6mo, and 33% at 12mo PP. . What does this mean for PP recovery and getting back to exercise? Swipe above ;) . How do you learn to add gradual load to your abdominal system overtime? Connect with a PFPT and/or movement pro who has experience working with clients with DR to help walk you through it. It’s worth the investment in your body to learn and understand the HOW behind how to move well, and often! . What exercises have you been told you can’t do if you have a DR? See more

A love letter to all the mothering souls who yearn to be a mother grieve the loss of a child nurture and raise littles care for others as their own... miss their own mothers do it alone feel overwhelmed struggle with mental health have needed to learn to mother themselves are estranged from their mothers support those in their mothering journeys . I want you to know that I see you, I am with you, and I lovingly hold space for the constellation that uniquely contributes to your identify as Mother however you choose to define it. . As someone who is not a mother in the biological sense, but who’s life’s work has been birthed into a deep devotion of serving and supporting you real-life superheros, I feel immense love and gratitude daily to be invited on your healthcare team. . And through this work together, you have mothered me, have cared for me, and taught me invaluable lessons that I hold near and dear to my heart: There is no one/right way to be a mother. The presence of a child is not a prerequisite to identify as a mother. That I will forever be in awe of the incredible strength that is mothering. That I continue to have a growing appreciation for the beauty, challenge, pain, sacrifice, and deep indescribable love that my mother has experienced for and with me. That mothering energy is the most powerful force, and is one that deserves more opportunities to step into leadership roles to positively change humanity for the better. Your feelings, perspective, and voice matter! That mothering souls remind us of the strength & love that is built in doing hard things together. . To the brave PP mamas who set me on this path in 2015, I am forever grateful that you asked me to help you, even though I wasn’t ready. You served as a catalyst for me to expand my toolbox and step into the most true and heartfelt calling that I couldn’t have imagined for myself and continues to fuel my fire for elevating that standard of maternal healthcare because YOU’RE WORTH IT! . To all the mothering souls out there, I salut you, and raise a glass to you today. There is no other team I could be prouder to be apart of. Happy Mother’s Day See more

When can I get back to running post c-section? This is the million dollar question! . Answer: Save and swipe though the guide above to find out, but I’ll give you the cliff note versionIt takes longer than 6wks . Not because you’re doing anything wrong, but because tissues require a lot longer than that to heal + regain strength BEFORE they’re ready to run ... . A more comprehensive it depends answer to this questions is one I navigate individually with each and every one of my patients, because YOU deserve that kind of 1:1 care instead of a blanket statements of listen to your body, ease back into things, because it depends on a variety of factors vs X wks PP. . And also c-sections are a significant abdominal surgery, AND also because you may have gone down the road of a vaginal delivery with all the laboring and pushing, and then had to change course to a c-section delivery, which means you and your body experienced the challenges of BOTH deliveries simultaneously, so the healing timeline needs and deserves to be extended for your body to heal most fully. Adding high impact loading like running in those early weeks PP is a lot to ask of a body that’s already doing SO much. . And also because I’m thinking about the long game for your body vs the short term brain game your mind is playing on you. Your is ready to run waaaayyyyy before your body is PP, but that doesn’t mean we can’t start preparing your body for that return in your early weeks postpartum. Getting fit (I.e. STRONG ) to run vs running to get fit is what I want to invite you to think about . Your OBGYN is an expert in delivering babies, but not in PP recovery and return to exercise/running. Inviting a PFPT on your team to support you through this next stage of your PP journey is so valuable and you deserve that type of intensional step-by-step support. . C-section mamas, when did you feel ready to return to running? See more

What no one tells you... C-section scar massage is the missing link for so many birthing humans in their PP recovery journey, and so many don’t get access to this important info. . I can’t tell you how many patients that have come into my office suffering from low back pain, hip pain, pelvic pain, pain with intimacy, urinary urgency/frequency, and/or decreased core strength (just to name a few) and have been shocked to learn that the primary driver of these symptoms linked ba...ck to their c-section scar(s). . YUP! Read that one more time! . Scars influence HOW tissues move and DON’T move. . This then influences how our bodies begin to move more in some areas to make up for less movement in others. These adaptations challenge our body’s ability to move well over time. . This applies to all scars, but I’m talking c-section scars specifically for this post. If you want to better understand the 7 layers involved, check out my previous post where I covered the anatomy portion of this All 7 layers have to undergo their own healing, and lay down their own layer of scar tissue to help prevent those c-section tissues from re-opening in those early weeks postpartum. Limiting the stretch and unnecessary tension on the scar for those first 6-8 weeks is important for this reason. . BUT after that point, the tissues need to learn how to glide, stretch, and move together again. This doesn’t magically happen on it’s own at X weeks postpartum. . Scar massage is KEY for optimizing c-section healing, improving circulation to these tissues, and re-teaching them all how to move, stretch, and gilde again. When the tissues move well, muscles that live BETWEEN these layers will then be able to move and generate force well, which helps the whole system move well, again! . It’s NEVER TOO LATE to begin c-section scar massage, SERIOUSLY! I’ve taught mothers to massage their scars whose children are 1,5,10,30+ years old and they have been amazed at how much it has helped in such a sort amount of time. . Swipe above to learn how to help your scar! And will you help me spread the important word by sharing this or tagging friends below so more c-section warrior mamas know this, too?!

C-section doesn't mean you failed, Mama. I understand why many feel this way when discussing their c-section deliveries. For many of my patients, this wasn’t in their original birth plan. They had been preparing for a vaginal delivery, envisioning a vaginal delivery, and then for reasons outside of their control had to surrender to a significant change in their course trajectory. That’s hard, even scary at times, and often disappointing, especially during such an important mo...ment in one’s life, with no time to grieve and process this change so suddenly. . It also makes me upset that our medical system uses terms like failure to progress, in these moments where vaginal deliveries shift to a c-section path, which feels incredibly insensitive to me. That mother didn’t fail. That mother needed something different, but the word failure is what is heard and internalized so often. It also makes my heart heavy when I hear my patients share that they felt rushed through their laboring process and wonder if things could have gone differently if they had been given a little more time...Those feelings and wonderings are valid. . Regardless of delivery method, you are a warrior, Mama. You did a superhero feat of bringing life into the world, and deserve to feel proud of that even if your little one(s) came earthside through the sunroof, instead of the ground floor This analogy came from a sweet L&D nurse who shared this with one of my patients as she was being prepped for her delivery. She said it brought her so much calm in that moment of uncomfortable change. . There is nothing wrong with wanting to have a vaginal delivery - BUT - I’d like to invite a more inclusive perspective for ALL delivery methods. And instead of asking mamas, "Did you have a vaginal delivery?", what if we asked, "How was your delivery for you?". I wonder how much more supportive that type of question would feel for many during their PP recoveries? I’d love to hear your thoughts on this. In honor of April being Cesarean Awareness Month, I want to give a special shout out to all the C-section Warrior Mamas out there - I see you and salut you! See more

Energy is a form of currency P. Last week I shared why it’s helpful to audit our energy earning/spending habits. I find many of my patients are overdrafting their bodies into aches, pains, and chronic injuries, without realizing this BIG contributing factor and how that needs regular nurturing, too to support their healing efforts. . This week I’m following up this discussion with 5 ways to nourish our energy bank accounts. And I say our because this applies to me, too t...o best support our bodies for longterm movement w(h)ealth. . Full disclosure: I don’t believe there is a perfect energy credit score, but rather a helpful range that is unique to each individual. My goal with this post is to invite awareness around what habits grow and deplete our energy stores most often, and encourage us to explore ways that enable small yet regular contributions to our energy bank accounts more oftenthat’s the secret sauce! . These 5 suggestions include [save and swipe thru!]: Fueling Listening Rest & recovery Movement diversity Asking for help That last part especially Serve as overdraft protection tools, monitoring when our energy balances start to dip into our savings, sending us a helpful signal to check-in. We’re human, happens, and occasional dips won’t shut the system down. BUT regular dips, too often, put the system at risk for insufficient funds that no one can afford. . And Mama, we both know you and your fam don’t have time for you to not be operating at your full superhero capacity. Exploring ways to refill of your energy cup have a powerful effect. They help you AND help keep your squad better energized, too!! And you practicing/modeling these habits with your kiddos helps them learn these important life skills, early on. Who doesn’t enjoy that energy win-win?! . Which of these 5 areas do you find easiest and hardest to keep nourished? Can you guess mine? I’ll share my answer in the comments below See more

Make it Obvious . Sounds simple enough, right? How obvious are the daily habits you’re using to help you reach your goal(s)? In some places of my life, I’m definitely a work in progress on this. For today’s post, I’m sharing how I nurtured my strength training habit into a permanent one - aka how I made it obvious . Make it obvious is the first law of four out of James Clear’s book, Atomic Habits. I highly recommend adding it to your list if you’re looking for help ...in the habit building arena. . Make it obvious consists of three main ingredients: Get clear on your behavior, and then dial in the time/location. This helps our brains remove extra resistance from decision fatigue. I’ll work out tomorrow, is vague and makes it easy for all the other structured commitments to take priority. Use habit stacking: After doing [current habit], I will do [new habit]. Use the momentum of a habit that you already do regularly/automatically to help you create a new one. Design your environment so that it reminds you of the habit you’re working on, thus making it obvious and visible. Bonus points if you can make that environment fun, and a place you actually want to be! . How I used these ingredients to build my strength training habit: 1 In the beginning I got clear on committing to 10min of strength work 3 days a week at home in my living room or outside on the deck. 2 Habit stacking: I added those 10mins of strength work to my existing cardio schedule on Tues/Thurs/Sat. In the beginning, I hated strength work, so making it happen when I was already consistent with my running/cycling sessions made it easier for my brain and body. I also tricked myself by saying, It’s just 10min 3 Last August I carved out a corner of our living room that is now designated as our movement corner. This is where a yoga mat, weights, foam roller, etclive permanently. Seeing them in plain view everyday makes it obvious for me and my husband to take movement breaks and keep our fitness routine regular. I also added a salt lamp to make it fun! . What has helped you build habits that lasts? Have you found making it obvious helpful in achieving your goals? See more

I recently finished reading, well actually listening on Audible, Atomic Habits by @jamesclear. If you’re looking for a solid personal development book, I highly recommend adding it to your list. His framework for adopting new habits, breaking those that don’t serve us, and better understanding the psychology around the how and why we do certain things was quite insightful. I also appreciated how his four laws of creating a new habit lent themselves to all aspects of life, a...nd especially to those I’m often supporting my patients with as they build new habits to support their healing and long term movement goals. . I’ll be using his framework to share my top four ways of building a strength training habit over the course of this month - stay tuned! . The piece that stood out to me the most from this book, though? James’s point about spending less time on crafting the perfect goal, and instead focusing on what processes we are using to get there. What systems (aka habits) are we putting in place to regularly help us reach those goals? . Our process has so much more influence on the attainment of our desired outcomes than the setting of the goal itself, and yet that’s where most of us put the majority of our efforts. I’m totally guilty of this myself. If we spend most of our time crafting our goals without nurturing the systems we’re using to reach those goals, how do we know if we’re on course to get there? . This point really hit home for me. It’s simple in concept, but by no means easy to execute. I’ve often gotten distracted by my desire for what I think the end result (the goal) should look like, that I’ve forgotten to give my processes the same amount of attention and thoughtful consideration. This goal oriented approach has also prevented me from appreciating the journey on my way to the destination more often that I would like to admit. Can anyone else relate? . So in the spirit of honoring the journey and getting curious about our systems - I’d love to hear a goal you’re working towards and what habits you’ve found to be most helpful in your journey so far? See more

Mamas, break it up to build it up! So you don’t end up broken down . Being intentional with your breaks will help you get back to running after baby sooner. This is where SO many mother runners sideline themselves by adding too much volume too quickly. I know your brain is ready to get back to it, but your tissues need more time. .... Cliff note version: Mamas begin with run/walk intervals to give your tissues intermittent breaks as you ease back into things in addition to having breaks between your running days - these are the VITAL ingredients that can make or BREAK your return to running PP. . Here’s WHY First off, I want to acknowledge how HARD it is to embrace BREAKS, esp when you’ve been patiently waiting to get the all clear from your doc to get back to running for what feels like an e-t-e-r-n-i-t-y. Maybe you’ve been reading all the things you can find on Dr. Google, IG, and mother runner FB groups about when others got back to it, and comparing that intel to yourself for reference. I get it, and would have done this, too if I was in your shoes. . Hit the BREAKS Mama, and slow your scroll. Comparisons aren’t fair. Everyone’s pregnancy, delivery and recovery is different Comparing one mother runner’s return doesn’t mean that’s right for you Comparisons of the milage pre-pregnant-runner-you are used to and expecting the PP-runner-you to pick up where you left off is definitely NOT fair either (not saying forever, but for this season) Comparisons interrupt the return to run process and increase the risk for injuries, some of which can become permanent. . There is NO magic number of X weeks PP that your body is suddenly ready to accept single leg jumping while supporting 2.5-4x your body weight for X miles - ps: this is what running is & requires! Being able to successfully support such loads happens after retraining following: Breath work Building your Base Balance and Bounce not sure that I mean by these? Check out my most recent posts! Then a run/walk(break) program is your next step . What has been the hardest part for you in your return to mother runner journey? See more

Yup, this is a thing. Postpartum hormones are a doozy in more ways than one, and especially when it comes to your joints and surrounding muscles and tissues. When I share this with my patients, they often respond with, that explains a lot, and why doesn’t anyone tell us these things?!. Mama, I hear you! . There are a number of hormone changes that are in flux as your body transitions from pregnancy to delivery to postpartum, and none of that is back to normal at 6wks. It ...fluctuates for a number of reasons, one BIG one being to support milk production for breastfeeding (BF). . Remember relaxin hormone during pregnancy? That’s the helpful one that makes your body have that superhuman stretching ability to accommodate all the growth of baby. Well that stretchy business doesn’t immediately revert back once baby is earthside. It takes several months of recalibration in fact, making this an especially important consideration when mamas begin to resume exercise. . The postpartum hormone cocktail, as I affectionately refer to it , keeps your body in that hyper-flexible loosey goosey state ALL OVER to support breastfeeding efforts, and research shows that that often lasts for up to 3months AFTER you fully stop BF yup, for that long after! . Hyper-flexible joints, muscles, and tissues need extra support to counteract the s-t-r-e-t-c-h. Without it, there’s a lot more stress and strain on your joints - insert aches and pains here - and is also why your balance can feel extra wobbly when you try to move quickly or do single leg activities without adding more support to the system. . So what’s the best way to help with this? STRENGTH training. This is why it’s so important for mamas to begin their PP healing journeys with breathing and strength work BEFORE lots of cardio and high impact movements. My last few posts have been talking about these points in more detail, so be sure to check those out if you haven’t already . Mamas, how did your PP hormone cocktail make you feel? If you had to compare it to a mixed drink, which one describes yours best? See more

One of the more challenging components of getting back to running after having a baby is relearning how to balance & bounce on one leg! Your body has gone through an incredible transformation to create life, which required A LOT of physical changes to your muscles, soft tissues, and joints. These changes don’t immediately disappear postpartum. . Then add on sleep deprivation, tissue healing thats occurring, the hormone cocktail that’s supporting breastfeeding that’s also keep...ing your joints hyper-flexible for longer btw, not to mention a top heavy loaded milk supply you may be carrying, etc...so it’s a whole new world getting back to running from what you and your body remember pre-baby. . Then add in the very confusing all clear at your 6wk PP check-up with the generic, just ease back into running, and listen to your body... What does ease back in mean? What are you supposed to listen for? Mama, let me clear up the confusion - your mind may be ready but your body is definitely NOT, and I say that with a lot of love. . Running requires the following: Balancing well on one leg Shock absorbing 2.5-4x your body weight BOTH of those have to happen with every step, and Your abdominals + pelvic floor also have to relearn how to shock absorb this much, too! regardless of delivery method. None of this magically happens at Xwks PP. . In order to prepare for such running loads, you need: Breath training to re-coordinate your core Strength training to build your base Time to integrate your breath + base . How long does this take? It varies, but it’s much longer than 6wks PP for most. The body needs 8-12wks of regular strength work to set a foundation. This is where working with a Pelvic Floor Physical Therapist is especially helpful for assessing your individual baseline, and determining a breath + base plan tailored to YOU. This is how you get to the balance & bounce phase, and eventually the begin to run phase. . If you didn’t catch my breath and build your base posts - be sure to check those out! Would you like to see some drills I use with my clients in this balance & bounce phase? Let me know in the comments below See more

As is true for all ladiesam I right?! The theme in my office this week was inviting my patients to turn down the volume on trying so hard to control all the things, and instead turn up the volume on trusting their pelvic floor’s to respond to a task. I got a lot of confused looks in the beginning, followed by reactions of disbelief + relief. They noticed they felt stronger, noticed they felt less pelvic symptoms, and noticed they felt a heck of a lot more FREE to MOVE in the...ir bodies. They were able to redirect their focus towards organizing their breath, which then made space to let them feel the movement in their bodies instead. . Doing more things, doesn’t always mean better. This can be especially true when we’re learning to reconnect with our pelvic floors. . Even with the best of intensions, trying to micromanage your breath, then your Kegel, then your abdominals, then movethen, Omg what am I supposed to do now? I don’t know if my Kegel is still engagedI don’t think I did that right?! [insert downward spiral of ??? and fear and the internal dialogue of I’m not good enough right here]. . Doing more with less is where she, your pelvic floor, shines - less cues, less rules, less confusion. She appreciates being invited to respond with your breath, while also being supported by a strong squad (aka the muscles that surround your pelvis). I recently talked all about her squad in my previous post . I wonder what might happened if we supported all of our fellow ladies this way? Less rules, more trust, more invitations to breathe, and more support from a strong squadwhat do you think? See more