Ever feel like you wear a lot of hats? 

Mother, wife, employee, friend, etc. 
And sometimes, if you’re struggling in one area, the other areas suffer too?
Well, your pelvic floor is a lot like this too!
It has lots of jobs, and they fall into 3 main categories:

That’s a pretty diverse list!  It’s really kind of amazing that for the most part those muscle run on auto-pilot and just work for us without too much thought or attention.
 
This is why it can be so confusing when we start having trouble in especially the first 2 categories.
 
The good news is that improving the function of the pelvic floor in any one area usually helps the others as well.  The converse is also true: if you have symptoms in one area you may have dysfunction or changes in the other areas too.
 
This gives us lots of options for things to improve when it comes to all kinds of symptoms like leaking urine, constipation, pain with sex, back pain, even prolapse.
 
Seeing a physical therapist to identify your specific contributing factors and having a personalized plan to address them is a great way to approach resolving many of these issues. ​

Avoid jumping jacks at the gym?
Don’t want to take your new puppy to the park because you don’t know if you’ll leak a little or a lot?
Started wearing a pantiliner all the time, just in case?  Or maybe something even thicker?
Maybe you don’t want anyone at dinner to make you laugh.  Or cough or sneeze.
 
This is type of leaking is called stress incontinence.  And you’re in good company if it’s happened to you.
Prevalence is estimated at 15 million women in the US and nearly half of women over 50 years report some instances of stress incontinence.
 
In it’s most simplified explanation, stress incontinence is a problem of more pressure out that pressure in. 
All of the activities above increase mechanical pressure down on the bladder.  If that pressure is greater than the strength of the pelvic floor/urinary sphincters, then the urine leaks out.

Many women avoid this scenario by avoiding the activities that increase pressure down, but you can improve the ability to stop that pressure.
 
This can be done by strengthening the pelvic floor itself, the hip and core musculature supporting the pelvic floor muscles, and improving the overall coordination of the pelvic floor which can include alignment of the LE, pelvis, and spine!
 
Seeing a physical therapist is a great way to start and to find out the best strategy to solve stress incontinence.

​In this last article about how to get your spinal engine revving on all cylinders, we’re going over some aspects of strength and coordination that are important for successful and pain free walking.
 
2 of the most important muscle groups to make sure you have strong are your hips and your core musculature!

These muscles allow you to transfer the weight of the trunk onto the leg without collapsing.

These core muscles work kind of like a corset to stability and support your low back.  They also coordinate and drive the reciprocal rhythm of walking.  

In terms of checking your strength in these areas, simple floor exercises will suffice for many of us to start.

Here are two exercises that I often prescribe for my patients:

These videos are for educational purposes only and are not medical advice.  If you try them out, comment and let me know what you think!

​We’ve been talking about how your walking can be more efficient, effective, and potentially less painful if your walking pattern is spinally generated.
 
Your alignment plays a big role in this.
 
And mobility in the 3 areas plays a big role in your alignment and walking capacity.

All the videos are for educational purposes only.  They are not medical advice.

​So how does our posture affect our walking.  Does it even matter? 
 
Well, the short answer is, “yes”.  It does matter.
 
I talked in the last post about how our walking is ideally generated by our spine and core muscles.  And that while our legs take us further and faster, our spine and core is the generator of efficient and comfortable walking.
 
Our standing posture affects how well our spine and core muscles are able to work together.
 
The connection that our trunk and pelvis is able to make is crucial to our core response and spinal stability. 
 
And the connection they make is affected by their relationship to each other.  Or another way of saying that is their posture!
 
If our trunk and pelvis are not in good alignment, then it’s harder for them to work together.
 
You can think of the top half of your body as a block and the bottom half of your body as a block.  The blocks need to be stacked solidly or the structure isn’t as strong.  

​In the next blog post, I’ll talk about where many of need more mobility in order to achieve an improved posture or starting position for walking and how mobility in our one part of our body greatly affects our ease and efficiency of walking!

​Ever watched a lizard locomote?  Or better yet,  a salamander?

Notice that the legs aren’t really driving the motion?  Where is the movement generated?
If you said spine, you’re right! 
While we’ve come a long way from the lowly salamander, humans also are designed with an innate spinally driven locomotor pattern.  One in which the walking motion is initiated by muscles that attach to the spine (or our core).
In this paradigm our legs are just extensions that carry us further and faster.  It’s not that they’re not important, it’s just that they shouldn’t be getting the party started.
For a lot of us though, we lose touch with this pattern over the years through postural habits, pain, injury, lack of mobility, etc.
When this happens, we don’t move as effectively and sometimes we even end up with symptoms.  Hip pain, knee pain, back pain.  You know the drill!
There are a few key elements necessary to tap into our spinal engine:

1. Posture
2. Mobility
3. Strength and coordination

 
Stay tuned for the next blog post to learn more about these 3 areas specifically with respect to walking…
I’ll get into what posture really means and why it’s important (it’s not just about standing up tall), where you need mobility and how much, and what areas most people need to strengthen!

First, what is it?
High Intensity Interval Training refers to a workout in which you get your heart rate up into anaerobic range (pretty fast) for a short burst, then you rest long enough to allow your heart rate to slow back down.
Why do it?
Well, if you're short on time it's a great way to get a workout in.  Your workout can be short, short, short if you want!  As little as 10 minutes even.  Yes, please!
HIIT can can help you train your cardiovascular system, which we know is linked to longevity.  It has also been shown to improve your metabolism and hormone regulation. Good news at any age, but especially for women entering the phases of peri and post menopause.
Pitfalls of HIIT
I've been in so many group HIIT situations in which I just stayed at my max heart rate the whole time.  In other words: no interval, just high intensity!  You really do have to have a rest interval in which your heart rate slows back down into aerobic ranges.  Don't feel guilty: the REST is part of the deal!!  
If you want to try one that doesn't require any special equipment, try this one below that I created during quarantine!  Just click the image to get your FREE resource.

Hiking is one thing!  One great thing, of course.  But backpacking takes it to a whole other level!  
It's like "this one goes to 11!"
Maybe you're thinking of making the leap from day trips to overnight trips, but you're feeling a bit intimidated by carrying the heavy pack...?
I know this was my experience when I decided to dust of my North Face 30L backpack after oh...about 2o years!
Was I nervous this time around?  You bet.  
So I broke down the areas that I knew I would need to work on if I wanted to have fun filled trip.  One where I felt confident in my body.  One where I wasn't worried if my legs would ache at night and keep me up.  One where I wouldn't regret not having a heating pad for my back, or an ice pack for my knee!  That stuff is hard to come by in the back country!!

So here's what I focused on...

1. Started walking more.  Lots more.
2. Strengthened my butt (it's not as easy as it sounds!)
3. Got my mid back loosened up.
4. Worked on my feet.
5. Practiced carrying stuff.

If you want to read more about the tips, check out the full guide I created here...

Okay,  so it's not much fun!!!   But we're going to talk about it anyway, and I'm going to do it with you!  
Showing you the best way to get the most out this rather unpleasant experience. 
​How to target the stubborn areas.
The ones that get missed.
And often make all the difference.
Let's get to it!!!
We've got trails to blaze and mountains to climb!

Hip pain and tightness is a common complaint I hear from patients.  A lot of us have been advised on foam rolling our ITBand.  That it gets "tight".  In this video, I talk about how to get the most out foam rolling you whole upper leg and how to target some often overlooked areas!