Do you know the difference between soreness and pain?

The attached article describes the difference between soreness and pain. People often don’t seek help until they are experiencing pain that limits them from participating in their fitness regimen of choice. We can help you stay injury free on your path to becoming the best version of yourself.

Our bodies move in the path of least resistance, meaning if you have limited range of motion in one area of your body, another area will pick up the slack. This is often referred to as a compensatory movement pattern. Over time with increased training loads and volume this can lead to injury. By having a movement assessment performed prior to starting a fitness program we can help you restore movement patterns and decrease your injury risk while improving your performance.

Call us today to schedule your movement assessment and let us guide you to optimal performance. 504.324.8345

Why Ab Separation Happens During Pregnancy

Pregnancy Ab Separation Treatment Therapydia

What is a Diastasis Recti?

Most of the physical changes that come along with pregnancy are strictly temporary. Unfortunately, some physical issues don’t resolve immediately after you give birth. Abdominal separation, or diastasis recti formation, is commonly seen within the pregnant/postpartum patient population with 2/3 of women experiencing some degree of separation pre or postpartum. Abdominal separation happens when your rectus abdominis or abdominal muscles become lax and disconnects midline at the linea alba. If you recently had a baby, it’s key to know how to identify if you have abdominal separation before returning to any workout routine in order to prevent injury and further separation.

Unbalanced Abs, Unbalanced Body

Abdominal separation is usually something a new mom might not even know she has. However it is important to check seeing how it interferes with the way your core muscles work together, leading to postural deficiencies and increased risk of injury centered around your body having an inability to stabilize your core. These deficiencies can result in or contribute to a variety of symptoms such as:
• Low back pain
• Sacroiliac pain
• Hip pain
• Stress incontinence (urine loss when laughing coughing or sneezing)
• Prolapse (when internal organs fall or slip out of place)

How To Check If You Have Ab Separation?

You can identify if you have a diastasis recti by doing a simple self-test.

• Lie down on your back with knees bent at 90 degrees and feet flat
• Place fingers of one hand horizontally across midline of abdomen at the belly button
• Slowly raise your head and shoulders a few inches off the floor
• If a separation exists your fingers will sink into a gap/ditch with your right and left muscles to the side
• Note the number of finger-widths that can be placed between the muscle bellies
• Check at your belly button, above, and below

If you feel a separation of 2 to 3 finger-widths or greater you are considered to have a mild Diastasis Recti, and 4 to 5 fingers width is a moderate to severe separation.

Healing Your Deep Core

First of all don’t panic or stress if you feel you have an abdominal separation. This is a very common problem where there are specific exercises that can help with the healing process and facilitate for full abdominal closure. To enable healing it is important to limit abdominal stressors involving lumbar flexion. This is characterized as the forward movement of your body such as crunches or when moving from your back to sitting upright when getting out of bed. Movements like this potentially lead to greater abdominal separation rather than closure. Correct movements are targeted towards having strong deep core activation with targeted transverse abdominis activation.

Transverse Abdominis Activation

Therapydia Pregnancy Physical Therapy

• Maintain a flat back with a chin tuck and shoulders over wrists
• Keep your hips and toes tucked under
• Inhale while causing for outward and upward movement in your back body/ribs
• Then exhale and pull your ribs up and in from your stomach
• Perform 6 to 7 breaths of 3 sets while being careful to not over breathe to limit any lightheadedness or dizziness

Closing The Gap

Your abdominal separation is something that should be reassessed every 2 to 3 weeks checking for closure with a proper exercise program established.

Experiencing ab separation postpartum is unique to everyone’s body and pregnancy journey. If you feel limited or uncomfortable because of the weakness in your core, don’t hesitate to contact us if you have any questions. Although some cases may be mild enough to solve on your own, some cases may need to be seen by a physical therapist who specializes in women’s health and pelvic floor therapy.

By Whitney Braswell Fedor, PT, DPT, Specialized Woman’s Health Physical Therapist via Herman and Wallace Institute, Kineticore Dry Needling Level 1 and 2 certified practicing at Therapydia NOLA in Metairie. She can be reached at (504) 324-8345.

Preparing Your Body For Pregnancy

Pregnancy Physical Therapy Therapydia

Pregnancy is a time of wellness accompanied with tremendous musculoskeletal, physiological and emotional change. Many women experience these changes with pain and discomfort, which can actually be prevented. There are specific muscle groups that can be trained to help you adapt and better prepare your body for pregnancy. The idea is to combat the strain that is put on the areas of the body that are carrying the weight of the growing baby by improving muscular support and strength. These areas include the lower back and sacroiliac joints.

How Does Your Body Change During Pregnancy?

During pregnancy there are many different changes that occur within you body, but for the sake of this blog, let’s focus on the changes related to the musculoskeletal system.

Most important of all the connective tissue changes occur primarily with the release of hormones, relaxin and progesterone. These hormones cause tendons and ligaments throughout your body to become more elastic, allowing for a greater stretch to occur across joints, and in turn causing for overall joint hypermobility. This “stretch” is a good thing because it allows your body to accommodate the growing baby, and also helps facilitate the baby coming out during delivery. However, with this increased elasticity comes your body’s need to rely more on muscular support and stability within the pelvis to combat joint hypermobility.

Also, core muscular changes occur primarily due to the stretching of muscles, specifically within your abdomen and pelvic floor. This stretching increases as the baby grows, which in turn, decreases your ability to elicit a strong muscle contraction due to the muscle tension relationship. However, if these areas are trained and/or strengthened prior to or during pregnancy, they can help combat this stretch for decreased episodes of lower back pain and stress incontinence.

In this article, we are specifically looking to help decrease the occurrence and severity of the common issues of pregnancy:

• Lower back pain
• Sacroiliac/pelvic pain
• Hip pain
• Urinary stress incontinence

Building Body Core Strength

Avoiding strain on your body during pregnancy involves strengthening the muscles around your core and pelvis area. If you go into pregnancy with strong core and hip stability, you’re going to be able to help combat these issues allowing for an easier time carrying the baby and for a faster recovery post-baby.


Therapydia Pregnancy Physical Therapy

Therapydia Pregnancy Physical Therapy

• Lay on side with hips in a stacked position towards the ceiling
• Knees at a 90-degree angle and hips in line with knees
• Keeping ankles together, raise top knee towards the ceiling
• At the same time, lift at the hip and keep hips forward
• You can place your hand behind your hip to keep your hips from rolling backwards
• Return to start
• To increase resistance you can add a cuff weight around the lateral thigh or apply an elastic band slightly above both knees
• Perform 30 repetitions once a day

This is important with pregnancy to help strengthen the muscle surrounding the sacroiliac joint by helping to prevent sacroiliac issues with enhanced glute and hip external rotator stability.

Kegal/Abdominal Bracing:

Therapydia Pregnancy Physical Therapy

• Lay on back with knees bent
• Pull up and in with the vaginal opening as if you are trying to stop the flow of urine
• Make sure to not squeeze your bottom and to not tighten your muscles in a way that will change the neutral position of the spine
• Perform 30 repetitions with a 2 second hold 2 times a day

This is what I call a secret exercise because when performed correctly the outside observer will see no movement. This exercise is important to help counterbalance the stretching of the pelvic floor that occurs with pregnancy which can help to decrease incontinence issues during and post-baby.

Quadruped Multifidi Activation:

Therapydia Pregnancy Physical Therapy

Quadruped Multifidi Activation

• Start on your hands and knees (shoulders and hips at 90 degrees)
• Tighten your back and your stomach by pulling your belly button to your spine internally and holding
• Without shifting your pelvis and keeping the neutral position of the spine, pick one knee up slowly while also making sure to hold the opposite hip in the same position
• Then perform with the other knee as well
• Perform 20 repetitions on each side (pain free exercise)

When performed correctly, this exercise helps to strengthen your core in the back and abdomen region. It also helps to strengthen your hip external rotators causing for greater sacroiliac and hip stability.

Mobilizing Your Pregnancy Muscles

Knowing how your body is going to change is key to preventing physical discomfort and pain during pregnancy. Strengthening specific areas can lead to a smoother pregnancy, birth, and rehab post-baby by combatting any musculoskeletal imbalances.

Contact Whitney Braswell at Therapydia NOLA if you have any questions about prenatal care and strengthening. We can work with you to design a treatment program that’s unique to your body and your pregnancy.

By Whitney Braswell Fedor, PT, DPT, Specialized Woman’s Health Physical Therapist via Herman and Wallace Institute, Kineticore Dry Needling Level 1 and 2 certified practicing at Therapydia NOLA in Metairie. She can be reached at (504) 324-8345.

Why Kegels Aren’t Enough: Pelvic Physical Therapy

Therapydia Pelvic Pain Treatment

Many women do not normally associate pelvic pain with physical therapy. They feel pain and notice the symptoms, but can’t tie a physical reason to the discomfort they’re feeling. Unfortunately, conditions related to pelvic health can take years to diagnose and treat. This gap develops because most of the time it’s hard for providers and patients to realize that musculoskeletal problems are at the root of their pain. At least a quarter of women suffer from a pelvic floor disorder—and these are just the reported cases. Considering the statistics and how these conditions can affect a woman’s quality of life, it’s important to educate women about what can be done.

Breaking Down Pelvic Pain

Anything related to pelvic health has to do with the bladder, bowel, sacroiliac joint (joints at the bottom of the spine), and low back. The pelvic floor is a sheet of muscles suspended from the SI joint in the middle of the pelvis to the tailbone. It provides support for your core and internal organs. These muscles can dysfunction in many different ways, but in general they are either hypotonic (weak) or hypertonic (tight/painful) which causes for pelvic floor dysfunction. Someone with a weaker pelvic floor could present to physical therapist with issues of incontinence while someone with a tight pelvic floor could present with pain.

A pelvic disorder doesn’t necessarily only cause pain in your pelvis. Organs in your pelvic area (i.e. bladder) could also be experiencing discomfort. Any muscular problems you’re having could manifest as incontinence or prolapse, when your pelvic organs drop down from their normal positions. You may also feel increased urgency or pain when urinating or during bowel movements. Having unexplained pain the the lower back and pelvic area may also be a sign.

Kegels Aren’t For Everyone

There’s a general myth that only older women or women who have had children need pelvic floor treatment. The truth is these conditions are common in many different age groups. Numerous situations can cause dysfunctions that may have no connection to childbirth. Kegel exercises help to strengthen your pelvic floor, but that’s not all treatment comes down to. Are you really performing your kegel exercises correctly? Chances are that you aren’t.

Pelvic floor physical therapist can ensure you are performing your exercises with the proper techniques. Additionally, there are some women with pelvic floor disorders, where kegel exercises should be avoided. In these cases, doing kegels may actually make the pain worse. This is why you should always seek the help of a physical therapist to ensure proper guidance is in effect.

Empower Your Pelvic Floor

Physical therapy is a great way to get your life back—and feel like you again. Consider when you would ever go to a physical therapist. If you had injured your lower back or had some knee pain, you would most likely go see a physical therapist for treatment. The same applies to pelvic disorders. It all comes down to relaxing, strengthening, and healing muscle tissues. Treatment can include the use of hands-on treatment methods that can range from manual therapy and therapeutic exercise to dry needling. Devices for electrical stimulation and biofeedback electromyography (measuring muscle response) can also aid with healing.

Having incontinence, pelvic pain, and lower back pain are not a natural part of the aging process. These are certainly not conditions one should just have to deal with. If you feel you may be suffering from a pelvic floor dysfunction, follow through with physical therapy treatment.