Welcome Letter

Slowly growing toward motherhood has opened the floodgates for beautiful conversations between myself and the people who lay on my chiropractic table. Beautiful doesn’t mean unrealistic. They know my room is a safe space for not holding back and never to exclude the harsh; the pain, memories of scary medical care, recovery nightmares, or the never-ending learning that birth initiates. I’m not afraid of the negative memories that they share. I’ve learned to help soften the imprint of those fears within their body, sometimes many years after an incident.

Watching bodies melt and soften to my touch near a previously jolting scar has reinforced my belief in what we carry throughout our cells, but more importantly, what we can unload from their memory or perception. Despite all that we put our bodies through, my patients’ goals and confessions all ask for a similar aid; to strive for a peaceful mindset that looks lovingly on the one vessel they’ve been given in this lifetime. Which is why I added the “again and again” to this journal’s title. Learning the language of your pain, potential, and progress is a continuous cycle of accruing awareness before removing the resistances to healing…all before putting that same wash on repeat. As soon as one recovery seems to level out or a heart break softens, we start to date a new version of ourselves and the next level of the psyche that rises to the surface.

Getting to know yourself after trauma

Following the normal stages of dating, we find common interests between our new mindbody and previous versions of ourselves after a physical or emotional trauma. With the right support and consistency, we are most successful when we grow hopeful that the future will include “us” both as we now are (not fighting to get back to pre-trauma). New people, hobbies, and non-negotiables influence our new mental and physical routine until we build lasting behaviors that compliment the direction this new “us” asks us to commit to. Healing of the non-physical mind and the very physical body are a tightly woven thread of the same color, making the individual fibers indistinguishable. Beyond the brain’s ability to store movement patterns (muscle memory),its spectacular connection with each cell of your body enables it to save emotions within the tissues that make the movement possible. The mind wants you to remember what movement will feel like in case it needs to avoid another painful experience or when it misses a fun dance that cheers you up.

Those instantaneous and subconscious reminders to be careful float into our mind when affected parts of our body are touched. It takes a conscious person to “hear” the little messages the body sends to the surface. To most, we only pay attention when the request gets really loud and that pain prevents us from functioning. To learn in detail how the brain makes new emotional memories read my blog on meditation!

Have you heard of a Homunculus? It’s a depiction of our body, but the shape of the body is distorted to represent the distribution of sensory nerves. Meaning, the areas with the most sensory endings that speak to our brain will show up as the largest shapes on the tiny human. With this ratio, the Homunculus shows that we have insane amounts of sensation coming from the hands. After the hands, mouth, nose, and ears, the reproductive organs are highlighted as a prominent region for extreme sensory feedback. This demonstrates the importance of having a healthy relationship with the sensory tissue near the pelvic floor. If someone was raised amongst a sexual or gender involving phycological trauma, even the tiniest and well intended touch from yourself as an adult (or doctor or sexual partner) can trigger a flush of emergency memories in an instant. Imbalanced responses here don’t always reach the surface so we won’t recognize the neurochemical reminders that cause us to clench, flinch, or avoid intimacy; all of which are avoidance techniques to reduce presumable pain. These fight or flight responses will turn off the ability to fuel a healthy sexual interaction because this organ system relies on relaxation and normalcy to function.

My Why

I wanted to write this article as a supplement to the Pelvic Poses workshop that I taught last week in my studio. In that outlet, I’m teaching introductory anatomy of the pelvic floor, pelvic bones, and structures of the core that glue it all together. I hope that continued use of education will empower a society that knows very little about the most intimate part of their bodies. It’s a movement workshop that focuses on practical exercises to implement into daily life, helping improve student’s coordination of muscles to restore imbalances of strength or pain. This class is not my lecture hall, I would teach it very differently to a room of doctors or medical professionals. The student’s attending want to know why they should care about the pelvic floor, that it’s normal to talk about its issues, and that their current issues are not their forever plight.

At the end of this course, I mention the heavily intertwined affect that emotional health plays in the musculoskeletal success of the pelvic floor. This article gives me the space to elaborate on that short slide. For an in-depth dive into the many ways the body can create emotional landmarks, my first book, The Gift of Healing Hands, explains practices to find stored traumas within you. This current article however, will set the stage for what emotions can be packaged within the pelvis.

I’ve already described how body systems sound the alarm when affected parts are touched, reminding us of a previous stimuli (good or bad). The same neurochemical conversations happen even without physical touch. Just by thinking of a body part, we illuminate the nerve paths that speak to that region of the body and in an instant, receive a flush of information back from the brain that includes that region’s catalogue; history of the good, the bad, and what we need to utilize this region.

Ever hear of athletes contributing their success to mental imagery? Before an event, they animate the practiced memory of how they feel physically AND emotionally performing the stages of their movements. This “oils the machine” before movement, waking up the right muscles to coordinate the motion. It also asks the mind to align with the necessary mood for success. We may not all be Olympic athletes but we can use this same technique in our daily lives. On my table, I often witness the detrimental affect of that mental imagery being used to reinforce a fear pattern or preemptive pain. An easy example; after pulling a weed in your garden and throwing your back out, the mind saves deep bending in the no-no category in the future. Now even though your lumbar disc is healed, bending forward sets off the alarms that “this dummy is heading back into pain territory.” In response, muscles tighten and lock up joints to limit your freedom as you inch towards perceived injury. Despite the healing that took place since your initial injury, the mind needs to witness many examples of pain-free encouragement (often in the presence of a trusted provider) before it releases its grudge with that movement.

Forward bending is a large example of muscular movement when compared to the tiny examples that are virtually invisible to the eye and difficult to verbally explain. Without showing someone a personal example of how they feel before and after a pain memory is released, we can be skeptical that this gift lives within us. I’ve watched patients have miraculously changes in mindset and neurology on my table; witnessing a previously locked joint, numb scar, or unstable movement completely normalize after intervention. Luckily, feeling our ability to rewrite mental stories and our physical limitations is infectious so these happy movements at the end of sessions seem to ignite the internal question of, “what else can I do?”

Pelvic Floor Taboo

Due to the personal nature (and many internal surfaces) the pelvic floor is a difficult area to assess dysfunctional tissues and to then help someone rehabilitate it. In a chiropractic realm, I work on external tissues surrounding the hips, glutes, and low back. I don’t utilize internal exams like an OBGYN or a pelvic floor physical therapist. What I can do is verbally guide a patient to become comfortable searching for muscle control in the area and how connected their pelvis is with “easier to notice” joints of the body. Most people can’t tell if they improperly clench the floor when moving, but the can feel knee pain and how that pain changes after a few proper sessions of breathwork. (More on breath below)

When it comes to healing the pelvic floor, I follow a very loose (no pun intended) protocol aimed at tackling a few stages of care:

• Learning how to communicate with the muscles of the pelvis

• Understanding the importance for successful breath and movement

• Treating the areas of physical AND mental resistances that block that communication

• Then training the now aligned body to maintain a healthy relationship moving forward.

Each stage looks different for everyone and depending on how early I meet people along their pelvic floor experience, has different paces of success. Young teens with only minimal sexual experience and limited comfort with discussing the area, do well with focusing on the physical aspects of a strong core (pelvic floor included). Women who have struggled to get pregnant or have comfortable sex will need to focus on the relaxing portion of the protocol to encourage the mindbody to open; to become a present and peaceful partner. Expecting mothers are my favorite to work with! These women go through a rollercoaster of changes in how they perceive their bodies’ capabilities. I’m shocked when I hear them ask if it’s okay to deeply rub a tight muscle near the stomach or if comfortable exercise will harm their pregnancy. With guided examples of strength and pain reduction, I get to see their frail and timid beginnings blossom as they learn the powerful relationship they have with the magical unknown of their womb. The same goes for mothers of many years who have finally taken the time to prioritize their own health and physical wellbeing. I get to commend them for asking for help and ensure them that their current incontinence or perceived weaknesses are able to change. We focus on the training portion of my protocol with these ladies mostly to re-write some of the traumas their bodies have lived through with past pregnancies, surgeries, and aging accidents. This aims to deliver their mentality away from their past and into the now or healing. A woman who has shed the paradigm that common ailments are medically or functionally normal, is unstoppable.

I often feel like I’ve been a mother already after having so intimately walked through the mindset of healing mothers as they share their experiences. The women that I describe above, of all ages and very different physical goals, have many of the same jokes and questions in regard to their pelvis. So in an effort to raise the bar of common knowledge and shatter the thin ice that they walk upon when asking for help….we begin.

Kegel Choreography

So where do I to start while demonstrating the importance of a healthy pelvic floor? Usually, I get to know the patient and their main complaint before casually sneaking in some questions throughout the visit about pelvic alterations; “Do you know if your back pain gets worse at a certain time of your cycle?” “Any issues with leaking when you run, cough, jump, or sneeze?” “Have any long standing issues with your jaw?” Etc.

By opening a door to the conversation in a very approachable and appropriate manner, I hope to illuminate how normal the abnormal has become with pelvic health. It’s such a common part of my daily conversation that I forget how weird it can be for someone to discuss their reproductive region and functions. This is why tact and timing is key! Most women who have had children are an open book about their bodies and experiences so I aim to help women before that crucial stage of enlightenment become comfortable speaking about themselves, and I mean ALL of them!

More popular than ever, a Kegel exercise has become the first line of defense for manual therapists to address a pelvic floor dysfunction. A Kegel exercise was named after the gynecologist in the mid 1900’s who researched the effects of muscular contractions of the vaginal wall in post-partum women. I recently learned that a true Kegel exercise was designed to work together with the stimulus of an internal probe, squeezing in and around a cylindrical resistance stationed inside the vagina. If that’s the case, then in the presence of an internal provider (who has diagnosed an internal issue and has the equipment to address it), this is a very suitable technique for lack of muscle activation. In most cases though, women practicing Kegels are sitting at work, walking the dog, and posing at yoga. They are using a method designed for internal stimulation without the main component! This often leads to misfiring the pelvic floor to get the job done or feel like something is working.

The type of muscle contraction their practicing is called a concentric contraction, or a shortening of the pelvic floor muscles. The group of muscles makes a funnel shape, complete with left and right halves of tissue that work together to squeeze up and inward when contracted. This squeezing or relaxing, influences the openings to urinal, vaginal, and rectal passages. Most people think the only other job of the pelvic floor is to lengthen and relax while it’s not being squeezed. In that mindset, the pelvic floor has a zero to one hundred ability aligned with “I pee” or “I’m safe.” Like most of the muscles in the body, the pelvic floor’s ability to tighten against pressure is matched by a similar ability to lengthen under the same load. As if you lower a bicep curl while holding a dumbbell, the pelvic floor has the same firing patterns to control weight as you make your bicep muscle short OR long! You couldn’t clench a bicep curl midway down and expect it to keep lowering just as the pelvic floor cannot stay in a Kegel as the force of a cough, sneeze, or jump demands it to lower (lengthen). We so often hear cues in yoga aimed to stabilize your core such as, “pull your pelvic floor up as you exhale” and “suck your navel to your spine.” Both of these well intended cues are perpetuating a society of women who over-clench in the floor.

Clenching and holding a Kegel, often looks like holding your breath or synching at the waist. To a chiropractor, or someone who trains the body to evenly distribute the forces of pressure as we move and breath, these clenches limit the space for your deep core to protect the spine and actually turns off the natural patterns your brain wants to use to ensure healthy aging.

Jaw, Meet Your Partner, The Pelvic Floor

One reason for abnormal clenching around the hips and pelvis is that the body has adapted this movement as a protective mechanism in an attempt to find stability. If you feel wobbly in a squat, walking up stairs, or doing jumping jacks, it’s much easier for the brain to contract the muscles you CAN find versus taking the time to recruit stabilizing muscles you don’t normally fire. If something is missing in your body’s stabilizing system (strong core, aligned skeleton, shared pressure from breath) the body will tend to enlist clench regions such as clamping down the teeth, curling the toes, locking into a Kegel, or shrugging the shoulders when it feels vulnerable.

These coping mechanisms and signs of instability work to stabilize the deep core which is our internal foundation of support. The problem? Most clenching muscles are tiny muscles designed for short bursts of energy. Compared to the endurance holds of big muscles like the thoracic diaphragm or glutes, the muscles of the jaw, superficial neck, and outer hips fatigue much sooner when stressed. It’s up to mindfulness to first become aware of clench sights and the emotional triggers throughout the day that stimulate them but then it’s vital to see a provider who restores the natural neurology of the body. Once the brain can again have full connection to muscles of the core and the extremities’ feedback, clenching sights are normalized and peaceful tissue returns.

Peaceful tone in the tissue of your body doesn’t mean you are a limp noodle; true neurological control ensures that you have the coordination to decide (instantaneously) to contract or relax a muscle. Most pain imbalances I treat are caused by someone losing this ability (due to misaligned bones, injured tissue, or lazy training patterns) to be on both sides of the spectrum. Releasing the clench of your pelvic floor does not ensure collapse. A taught pelvic floor is a sign that the body knows how to share the weight of stressors so that the legs, spine, and core pressure don’t depend on that tiny Kegel. When the stress of muscle usage disappears, so does the need for the pelvic floor to activate.

Many patients are confused when we spend up to half of one visit to work on their jaw aimed at fixing a pelvis issue, that’s when I show them this picture! This diagram displays the functional connection between many layers of muscles throughout the body. These layers are known as fascial lines which are groups of muscles interconnected by fascia, the collagenous web that surrounds and connects muscles. There are many of these lines but the applicable line for pelvic floor issues and it’s direct chain to the jaw is the Deep Front Line which is what I consider “your core.” If you look at the picture in side view, you can see how the chewing muscles of the Temporalis, breathing muscles of the midsection, funnel muscles of the pelvis, and gripping flexors of the toes, are all connected in one long chain while working together to stabilize movement. A weakness somewhere along the chain will alter compression along the entire portion and can cause distant muscles to work overtime to compensate.

Weakness, caused by hypermobile joints or muscles that your brain cannot find to properly fire, is one of the many gifts that a chiropractor can re-wire. One of my favorite things about working alongside of a physical therapist is that her gifts with training the body on weight bearing equipment, reinforces the alignment work that I set up. The repetition of seeing a physical therapist is sometimes the key needed to help my work “stick.” So now you’re aligned and glued to prevent things from collapsing again? Perfect. Now these chains of gliding tissue can work with the many other chains of muscles to optimize healthy movement and aging.

Breathwork 101 for Spinal Normalcy

In between exaggerated muscle tests and the more active movements of the day, the pelvic floor is responding to the pressure caused by each breath repetition. If breathing low enough and in a diaphragmatic way the pelvic floor should feel the exchange of pressure sent down by the lowering diagram during each inhalation. Between the rib cage’s diaphragm and the resistant pelvic floor, a powerful pocket of core pressure is created, called Intra-abdominal Pressure. On average, a healthy person takes 15-20,000 breaths per day. That’s a lot of behind the scene work for both the diaphragm and the pelvis but luckily, they are built to sustain us. Most modern influences will encourage women to suck in at the waist and synch their core breath. To make things worse, this collapsed core waist is stuck in a sitting posture for many hours of the day. This combination causes them to take tiny, rapid breaths throughout the day which places too much pressure on the muscles around the upper chest. Breathing this high often leads to midback stiffness, neck pain, and headaches. High chest breathing also turns off the need to feel your pelvic floor and glutes throughout the day. This gluteal amnesia blocks the brain from encouraging the sitting muscles to fire... Until you cough… then surprise! Your pelvic floor wasn’t ready! So, if you’d like to take less breaths that are more effective for core stabilization and nervous system tone, low belly breaths are a great place to start.

I take this concept to the next level using a technique called Dynamic Neuromuscular Stabilization (DNS). This therapy hopes to realign the firing patterns and movement ability of adults using the fascination of baby’s developmental patterns. When learning how to roll, crawl, kneel, and sit into squat, babies have to rely on a full canister of belly breath to succeed. Unfortunately, modern positions and influences to look a certain way on the surface has replaced the beauty of our primitive systems with cheap, easy to access software. Luckily for us, that hardware for clean breath and movement still exists in the nervous system. It only takes a few sessions with skilled providers to remove the harmful habits that block our inner child. Once skeletal alignment is restored, soft tissue issues are resolved, and the conscious brain’s awareness is directed toward proper positioning, the floodgates open! The only glue I have in my chiropractic arsenal to keep things this way is breath rehabilitation. Breathing is the key link between the subconscious and conscious part of our awareness. Proper breathing can access the darker parts of our control that daily life forgets to shine light on. In conjunction with safe exercises, the breath is what I call the “control alt delete” for the nervous system. Breath asks the brain to return to factory settings and embrace these new motor patterns we work on during care.

In Summary

Making peace with your pelvis can start right this second. Again and again, breathe low into the belly and send mental resources to each of the areas you may have lost touch with. Each section of your hips that rebel and act tight because they’ve been forgotten is asking for improved communication. The regions of scar tissue that hurt if you breath or rub them along the inside of your jeans are ready to release their story. The spasming low back is begging for more buoyancy inside the core that surrounds it. Breathe there to start the healing process today.

In my yoga mindset (the voice that compliments all of my chiropractic care) I ask patients to mentally and visually send their breath to the regions we aim to heal. Obviously breath repetitions are located inside of the lungs but the idea of sending new fresh nourishment alongside of a breath is a universal concept. The pressure created by breath can be influenced and encouraged toward a region in need. So until you feel ready to seek the help of a provider for some of your pelvic concerns, get to know yourself and your full capabilities by breathing. Breathe tall, breathe low, breathe broad, breathe easy. It’s the best medicine that we have.

Thank you for reading, I am so passionate about this subject….You know what? Let’s make this the inspiration for my second book’s theme. Stay tuned xoxo