Pelvic Floor Physical Therapy for Men: Regain Strength, Confidence, and Quality of Life

When discussing health and wellness, pelvic floor physical therapy is often seen as a women’s health issue. However, men can also experience significant benefits from addressing pelvic floor dysfunction. Whether you’re dealing with leaking (with or without activity), performance issues, pain in the lower back or hips, pre and post-prostate surgery complications, or bowel issues, understanding the importance of pelvic floor health can be a game-changer.

Why Pelvic Floor Health Matters

The pelvic floor is a group of muscles that support the bladder, bowel, and for men, the prostate. These muscles are crucial for urinary and fecal continence, sexual performance, and overall core stability. When the pelvic floor muscles are weak, too tight, or not functioning properly, a variety of symptoms can arise.

Common Symptoms in Men:

  • Leaking: Urinary incontinence can occur during physical activities or even when at rest, leading to discomfort and embarrassment.
  • Sexual Performance Issues: Erectile dysfunction or premature ejaculation can be linked to pelvic floor dysfunction.
  • Pre and Post-Prostate Surgery: Surgery can impact pelvic floor muscles, making rehabilitation essential for recovery and maintaining function.
  • Pain: Chronic pain in the lower back, hips, or pelvic region can often be traced back to pelvic floor issues.
  • Bowel Issues: Constipation or fecal incontinence can also be symptoms of pelvic floor dysfunction.

The Importance of Assessment and Treatment

A thorough assessment by a trained pelvic floor physical therapist can identify the specific issues affecting you. This process typically involves a detailed history and physical examination to pinpoint muscle imbalances, weakness, or tension. Once identified, a personalized treatment plan can be developed. Our approach starts with an assessment done externally and uses breathwork to help you connect to your pelvic floor. This connection allows for better integration of your pelvic floor into your daily habits. Being more aware of where you hold tension and where you compensate helps us make changes to work on strengthening the right muscles to help you towards your goals. In other settings, an internal assessment may be completed on your first visit. 

Treatment Approaches May Include:

  • Exercises: Once an assessment is completed, you will be provided tailored exercises based on your pelvic floor needs. This could begin with working on relaxing the muscles in order to progress into strengthening the muscles through their full range. Integrating exercises into your daily life allows for improvement of function and reducing symptoms.
  • Education: Understanding your condition and how to manage symptoms effectively. Creating a toolbox of exercises for your symptoms and goals is important to help you feel empowered with being able to make changes to help you feel your best. Most importantly learning the anatomy of the pelvic floor to best understand how to advocate for yourself. 

Empowering Men to Take Charge of Their Health

The goal of pelvic floor physical therapy is not just to alleviate symptoms but to empower men to regain strength, confidence, and control over their bodies. Addressing pelvic floor issues can significantly improve your quality of life, allowing you to engage in activities you enjoy without fear of embarrassment or pain.

Building Strength and Confidence

Through dedicated pelvic floor physical therapy, men can:

  • Regain Control: Effective management of incontinence and bowel issues.
  • Enhance Performance: Improved sexual health and function.
  • Reduce Pain: Alleviation of chronic pelvic, hip, and back pain.
  • Recover Holistically: Optimal recovery from prostate surgery.

By taking proactive steps toward assessing and treating pelvic floor dysfunction, men can look forward to a future where they feel strong, confident, and in control. Remember, seeking help is a sign of strength, and investing in your health now can lead to lasting benefits.

If you’re experiencing any of the symptoms mentioned, reach out to us for an appointment or a local pelvic floor physical therapist. It’s time to take charge of your health and rediscover your potential.

How to Improve SI Joint Pain: 6 Causes & Solutions

Struggling with SI joint pain even after physical therapy? You’re not alone. This pain can be frustrating, but the good news is there are often solutions. In this blog, we’ll explore six common causes of SI joint pain and offer targeted strategies to get you back on track. We’ll go beyond generic exercises and delve into specific approaches to address the root of your discomfort. Here’s how to improve SI joint pain.

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What is the SI Joint?

When looking at the pelvis from the back, consider the bones: the sacrum, a triangular bone, and the ilium on each side. These pelvic bones are connected by various ligaments, including the sacrotuberous and sacrospinous ligaments, creating force and forming closure on the SI joint. Pain typically occurs in the lower back region, often near the bony bumps, but it can also present in different areas around the pelvis.

The SI joint is very stable due to its self-locking mechanism, known as form-force closure. This stability depends on the forces entering the joint. For example, a vertical load creates stability through form, while different forces transmitted through the joint also contribute to stability.

Six Causes of SI Joint Pain and How to Improve Them

1. Asymmetry

Most people with SI joint pain experience it on one side. Our bodies are asymmetrical due to the placement of organs like the liver, pancreas, and spleen. Daily activities, such as writing with one hand, driving, and crossing legs, can exacerbate these asymmetries. This can lead to changes in the diaphragm and respiration, affecting the stability of the entire integrated unit. For instance, a pattern of crossing the right leg may lead to internal hip rotation and weaker external rotation, contributing to pain.

2. Force Transfer

Asymmetries affect how we transfer force through our bodies. Our fascial tissue, a 3D network, plays a crucial role in this process. The deep longitudinal line, which includes the lower leg, hamstrings, hip rotators, and low back muscles, is essential for force transmission. Compensations and imbalances, such as flat feet or tight lower leg muscles, can impact this line and contribute to SI joint pain.

Optimal stability and reflexive stabilization from the deep front fascial line, which includes the foot, inner thighs, pelvic floor, diaphragm, and even the tongue, are critical for SI joint mobility and stability. Ensuring all the surrounding musculature is stable is essential for effective force transfer.

3. Foot Position

Foot position can influence SI joint pain. Overly everted (turned in) or inverted (high-arched) feet can stress the SI joint. A rotated-in, flatter foot may lack deep stability for proper force generation, while an externally rotated foot can stress the SI joint ligaments. Achieving a neutral foot position through mobility and stability exercises can help balance the lower leg and reduce stress on the pelvis.

4. Breathing

Proper breathing involves positioning the diaphragm correctly, with the rib cage over the pelvis in a stacked position. This allows the diaphragm to communicate efficiently with the pelvic floor. An open scissors posture, where the pelvis is tipped down and the rib cage up, can cause compression on the SI joint. To improve breathing, keep the tongue on the roof of your mouth, breathe through your nose, and focus on a 360-degree breath. Exhale with the abdomen contracting while maintaining a stacked position.

5. Pelvic Mobility

While stability is crucial, pelvic mobility is equally important, especially during gait. SI joint issues often involve mobility problems. The pelvis should move forward, backward, rotate, and side bend for optimal movement. Practicing pelvic movements while lying down and coordinating with your breath can restore natural fluid movement in the pelvis.

 6. Integration

To bring it all together, stability, sequencing, timing, coordination with breath, foot position, and addressing asymmetries are essential. An effective exercise to integrate these elements is the short foot exercise.

How to do the Short Foot Exercise:

  1. Step with one foot forward and the other foot slightly back, creating a small kickstand.
  2. Hinge at the hip.
  3. Breathe in through your nose, exhale, and gently root the tips of your toes into the ground.
  4. Breathe in with the tongue at the roof of your mouth, exhale, and root the tips of your toes into the ground.
  5. If this feels easy, progress to a single-leg stance.

This exercise promotes reflexive stabilization from the foot, enhances breath control, and engages deep stabilizers. It helps integrate stability and mobility for optimal pelvic movement and efficiency.

If this was helpful, please give it a like, share it, and subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

You can always join us in our app, the Movement Paradigm. We have lots of challenges every other month—everything from movement to the nervous system, nutrition, and so on. And we have a great community of people.

You can also reach out to us for an individual appointment for functional medicine or holistic physical therapy. If you really want to get to the root cause, please reach out to us.

Other things that might interest you:

5 Steps to Addressing SI Joint Pain | the Truth About SI

What you need to know about hip bursitis

Why you should consider eliminating gluten and dairy | Elimination Diet

3 Vagus Nerve Hacks for Sleep

Are you having trouble sleeping, or maybe you are feeling tired but wired before bed? You might be looking for practices to downregulate and improve your sleep. Today, we’ll explore three vagus nerve hacks that can help.

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How to Get Better Sleep: 3 Vagus Nerve Hacks

1. Cold Exposure

The first exercise is cold exposure. It might sound unusual before bed, but a small study suggests that cold exposure can stimulate the cardiac vagal reflex, promoting nervous system calmness. You can use an ice pack (not extremely cold) on your lateral neck, where the vagus nerve is located. The study used 16-second intervals, so you can apply and remove the ice pack or keep it on briefly (no longer than 20 minutes). Find a temperature that feels relaxing and soothing, not stress-inducing.

2. The Basic Exercise by Stanley Rosenberg

This exercise involves interlacing your fingers, bringing them behind your head on the occipital area, while lying down relaxed. Then, turn your eyes to one direction and hold it until you sigh, swallow, or yawn. Repeat on the other side. This exercise provides neurological input through your eyes and hands, increasing blood flow around the brainstem (where the vagus nerve exits). This can stimulate the vagus nerve and induce a state of rest and relaxation.

3. Ear Pull

You can perform this exercise on your side. Gently pull your earlobe back and out diagonally. Hold it until you sigh, swallow, yawn, or feel relaxed. Repeat on the other side.

Remember, you don’t have to do all three exercises. Choose one or try this routine before bed to promote relaxation.

If this was helpful, please give it a like, share it, and subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

You can always join us in our app, the Movement Paradigm. We have lots of challenges every other month—everything from movement to the nervous system, nutrition, and so on. And we have a great community of people. 

You can also reach out to us for an individual appointment as it relates to the physical pain that you might be having and any emotional issues that you’re dealing with, such as anxiety or depression. If you really want to get to the root cause, please reach out to us.

Other things that might interest you:

3 Pelvic Exercises for Constipation

Are you experiencing chronic constipation or feeling like you’re bearing down when going to the bathroom? Here are three pelvic exercises for constipation you should try!

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The connection between the pelvic floor and bowels is crucial. As pelvic floor therapists, we frequently discuss this, especially if you’re experiencing bowel issues. The pelvic floor and the bowels must work in sync all the time. When constipated, many tend to bear down or push down into the pelvic floor to facilitate bowel movements. Let’s delve into some basic mechanics first before discussing strategies.

Understanding the mechanics

When we’re looking at the pelvis, we want to think about our natural breathing mechanics. So, when we’re breathing in, the diaphragm comes down, and we create this intra-abdominal pressure that fills to the base of the pelvic floor. This should be a 360° pressure, not a downward pressure into the pelvic floor. The pelvic floor is lengthening on your inhale and when we exhale, the pelvic floor is contracting. 

Anytime that we lose these natural mechanics or coordination of our respiratory diaphragm and our pelvic diaphragm, then we begin to have issues. So, for example, if you are doing heavy weight training, unless your are creating a proper valsalva, then you’re pushing down into the pelvic floor, which is what will contribute to leaking. It is extremely important that we have optimal mechanics for healthy bowel movements and life, of course! 

3 pelvic exercises for constipation

1. Utilize a Squatty Potty

The first recommendation that I’d like to give is to use a Squatty Potty. You can use blocks or another object to raise your feet, but this will allow for proper pelvic positioning. When you have your knees a little bit higher than your hips, then you can create an optimal pelvic position to open the pelvic outlet to allow for a healthier bowel movement. 

2. Practice Diaphragmatic Breathing

As soon as you are about to go to the bathroom, you can perform slow diaphragmatic breaths. Inhale through the nose, while having your tongue at the roof of the mouth, creating proper intraabdominal pressure, then relaxing as you exhale, while the pelvic floor gently contracts. You want to create a sense of relaxation. We have to be in a relaxed state to defecate, urinate, and have an orgasm. 

3. Try the “Belly Big, Belly Hard” Technique

When you feel like you are about to push, you want to take that pause and consider using the  “Belly Big, Belly Hard” technique. This is where we want to prevent the downward pressure on the pelvic floor, which creates faulty mechanics and significant pelvic floor dysfunction over time. 

Make a fist with your hand, just like you’re making a straw. Breathe in through the nose, blow into the “straw” for 3 seconds, and then pull away. 

That will create the appropriate amount of pressure to allow you to have a healthy bowel movement without pushing. You’re creating the optimal amount of 360-degree pressure, You’re going to let the cheeks puff up as you’re doing it and as you’re exhaling, it should feel like you’re able to have a relaxed bowel movement. 

It’s a great technique for when you feel like you’re about to push.  You may need to perform a few times. It is extremely effective. 

If this was helpful, please give it a like, share it, and subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

You can always join us in our app, the Movement Paradigm. We have lots of challenges every other month—everything from movement to the nervous system, nutrition, and so on. And we have a great community of people. 

You can also reach out to us for an individual appointment as it relates to the physical pain that you might be having and any emotional issues that you’re dealing with, such as anxiety or depression. If you really want to get to the root cause, please reach out to us.

Other things that might interest you:

How to assess and treat your scars

Have you had an injury or even surgery that left a scar? Have you ever worked on your scar? And do you know why it is so important in your healing? 

Today, we will discuss scars, how to assess them, how to treat them, and why it is so important that we do both.

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Understanding Scars

Let’s first talk a little bit about what scars are. If you look at a tensegrity model, you want to think about our fascial tissue as our three-dimensional network, our glue that holds us all together, our force transmission system. 

What’s fascinating about the fascia, among many things, is that we are able to create tension and elasticity. This is what happens in dynamic movement, whether that is walking, running, stairs, breathing, or whether that’s the motility and mobility of our viscera and our organs.

When we have scars, we form cross-links, which is what makes the tissue strong. That’s exactly what we want from a scar. But it is not elastic. We need this elasticity of the tissue to move freely and generate and transmit force through our body.

Scar Releases

Now, let’s dive into what we do when we’re doing scar releases. First, a lot of times, we think that we’re breaking up scar tissue. Well, we are not breaking anything up because fascial tissue requires thousands and thousands of pounds of force to break. We would have to actually go in with a cadaver and cut the tissue. So, we’re not breaking it up. However, we are influencing it from the sensory aspect because there are tons of sensory nerves in the fascia, and we are helping to improve the elasticity of the tissue by helping to realign the collagen fibers and create elasticity in the tissue. That’s the main goal.

Who Should Undergo Scar Work

Scar assessment and scar work do not need to be aggressive, but they should be very intentional. Who should do this? Anyone that has a scar. It doesn’t matter how small or old the scar is or why you have it. All of these can influence the surrounding tissues.

For example, if you have a C-section, there is the obvious superficial scar, but then there are effects of cutting through seven layers of tissue. In that particular area where the actual scar is on the outside, it can affect all of your abdominal muscles and your viscera, too. That’s one of the underlying potential root causes of something like SIBO (small intestinal bacterial overgrowth) or any gut dysregulation. 

If you’ve had a tummy tuck, breast implants, or a scar from an injury, all of these things can affect the surrounding tissues as well as distant tissues. Our fascial lines connect us from the bottom of our feet to the top of our toes. Something to consider before you even assess your scar is recognizing the emotional component and potential trauma of scars. 

Depending on why you have the scar, significant emotional responses can occur when addressing it. Make sure that you either work with a professional to do this or do this in a safe place and honor any emotions that may come up because, ultimately, every scar has a story. This is a really important part of scar work.

Scar Assessment Techniques

Imagine you have a scar on your hand. It could be from a recent injury or a past surgery. The first step is to examine the scar closely. Using your fingers, gently pull in different directions around the scar. Notice how the tissue responds. Is there any resistance? Does one side feel tighter than the other? You can pull in different directions, and essentially, you’re looking at the elasticity of this tissue because we want our tissue to move freely.

Now, sensitivity is another important factor to consider. So, does it feel very hypersensitive? As I mentioned, we have a lot of sensory nerves on our fascia. So, it could feel almost burning or super hypersensitive, and in this case, we would do some scar desensitization before performing the actual scar massage. 

Next, if the scar is sensitive, you can use a washcloth and gently massage it over the scar. This will help desensitize the scar. Typically, you only need to do this for a few days—maybe not even—but it could be very, very helpful. It can also be an opportunity to connect with the scar and help with nervous system regulation as it relates to the scar and the injury or surgery that you might have had.

Scar Treatment Techniques

General Technique

To begin, we’ll start with a more general technique. Instead of directly massaging over the scar, we’ll focus on moving the skin over the tissue surrounding it. This allows us to gauge how the scar tissue moves in various directions. As you perform this technique, pay attention to any areas where you feel tightness or restriction. It’s normal for certain areas to feel tender or uncomfortable.

Smudging Technique

Once you’ve identified areas of tightness, you can transition to the smudging technique. This involves applying pressure to the skin and moving it up and down or side to side over the scar. By doing so, you’re promoting better tissue mobility. This technique can be applied to the entire scar area for maximum effectiveness.

Specific Technique

The most targeted approach involves focusing on particularly tight or restricted scar tissue areas. If you notice a specific area that feels especially constricted, gently apply pressure and hold it there. As you maintain this pressure, you may feel the tissue gradually soften and release. This indicates a successful fascial release, allowing for improved movement and reduced discomfort.

Key Takeaway

These are some basic techniques for assessing and treating scars. It doesn’t matter how old your scar is. It is important to honor any emotions that may come up with compassion. Scar massage is an extremely important part of your emotional and physical healing.

For example, if you’ve had shoulder surgery and experience shoulder pain, neglecting scar treatment can impede muscle function, particularly stabilizing muscles, due to potential neurological effects on the scar. Similarly, addressing a C-section scar can be vital for addressing gut issues, and knee scars from falls may relate to hip or knee pain. So, the impact of scars isn’t limited to their immediate location; it can affect distant areas, too. It’s essential to recognize the importance of scar treatment, including tattoos, which are essentially scars, as part of maintaining healthy movement and organ function.

If this was helpful, please give it a like, share it, and subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

If you need more individual help, please reach out for a discovery session. We would love the opportunity to help you in any of these areas. In addition, you can feel free to join our app, the Movement Paradigm. We have monthly challenges, live Q&As, and an amazing community, all geared toward whole-body health. So, we hope to see you there!

Other things that might interest you:

Vagus Nerve Hack | Sternal Release

Are you experiencing any kind of blood pressure dysregulation, heart palpitations, bradycardia, slow heartbeat tachycardia, or faster heart rate that may be associated with your autonomic nervous system? 

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Sternal Release Exercise Precaution

Before we jump into the anatomy, I want to make sure that if you have any concerns about this particular exercise, please check with your doctor or health practitioner to see if it is appropriate for you.

Vagus Nerve Anatomy

With that said, let’s start with the anatomy of the vagus nerve, recognizing that this aspect of the vagus nerve is how we are going to influence it via the vagus nerve exercise. 

The vagus nerve exits the brainstem and we have branches into the ear, throat, and then the area that we’re focusing on today is the influence of how the vagus nerve innervates the SA node of the heart. It passes through the lung tissue, and the diaphragm although not innervating it, and then it moves into the entire GI tract. We can influence the vagus nerve it through the SA node of the heart, as well as a pressure change. We can target the baroreceptors that are lying within the carotid artery and the aorta. Because of this pressure change, we can influence the vagus nerve response and create the relaxation response.

How to Do Sternal Release + Reminders

Before performing any vagus nerve exercise, you always want to make sure that you are in a safe environment. Again, you should consult with a healthcare provider if this is necessary and appropriate for you. For example, if you’re experiencing extreme blood pressure dysregulation, this may not be suitable for you at this time. However, you do want to ensure that you’re safe, you feel confident in the exercise, and you approach it with gentle curiosity rather than aggression. If you’re starting this particular exercise for the first time, ensure that you begin with just a little bit and gradually increase your duration over time.

To perform this exercise, grab a medium-sized soft ball and lie over the ball, with the ball directly underneath your sternum. Allow yourself to settle in, taking some nice slow diaphragmatic breaths. Then, when you’re ready, take a breath in through your nose, pretend to cough, but don’t actually cough. Do this as if you’re holding your breath. Then exhale slowly, and repeat this exercise for anywhere from 10 to 20 minutes. However, we recommend starting with a very small volume of it might be very beneficial for you.

If this was helpful, please give it a like, give it a share, and, of course, subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

If you need help more individually, please reach out for a discovery session. We would love the opportunity to help you in any of these areas. And in addition to that, you can feel free to join our app, the Movement Paradigm. We have monthly challenges, live Q&As, and an amazing community, all geared toward whole-body health. So hope to see you there!

Other things that might interest you:

How to Improve Your Knee Pain | Knee Rotation

Are you experiencing chronic knee pain? Maybe you have had multiple issues with your foot, your knee, your hip, or our low back, and you haven’t been able to resolve it. In this blog, we’re going to dive into the rotational component of the knee that is often neglected in most rehab and movement programs. 

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How to Know If Your Knee Lacks Rotation of the Lower Leg Inward

If you notice that when standing, your feet are abducted and turned outward, it could indicate a deficiency in internal tibial rotation, where the lower leg fails to rotate inward.

Another sign can be observed during a squat: if your feet tend to turn out as you descend, this too may signal insufficient rotation in the lower leg. This lack of rotation could also stem from limited ankle dorsiflexion—the bending mobility of the ankle. While issues with the hip and foot may also contribute, for the purpose of this blog, we’re focusing on the inward rotation of the lower leg.

Self-Assessment

To assess this yourself, begin from a seated position. Place your arm under your upper thigh and concentrate on the rotation of your entire lower leg. It’s important to isolate this movement from the foot, as simply turning the foot in and out can be misleading. By stabilizing the upper leg with your arm, you can assist in and out movements, but the emphasis should be on inward rotation. This rotational ability tends to diminish with injuries such as meniscus injuries and other knee-related issues.

What You Can Do About It

If inward rotation feels challenging, start by assisting passively with your hand. Once you’re more comfortable, introduce a slight resistance. You can use a band wrapped around the foot in a figure-eight fashion to provide resistance while moving into internal rotation. Adding resistance helps reinforce this movement neurologically when loaded.

Advanced Progression

For a more advanced progression, try placing a block or a rolled-up towel between your knees. Then, using a smooth surface or a bolster, slowly extend your knees while keeping your toes and tibia rotated inward. Aim for complete extension, then reverse the movement by turning your feet and lower leg outward as you return to the starting position. This exercise requires careful control and deliberate movement to maintain good fascial tension throughout.

Key Takeaway

If you’ve encountered issues like patellofemoral pain or meniscus injuries, it’s often associated with inadequate rotation in the tibia or lower leg. I hope you find these assessments and exercises helpful in your journey. Remember, never work through pain, and approach assessments with gentle curiosity to truly understand the mechanics and choose appropriate exercises.

If this was helpful, please give it a like, give it a share, and, of course, subscribe to our YouTube channel, the Movement Paradigm, for weekly tips on mindset, nutrition, and movement. Our goal is to help you live your best life, heal, transform, and, more importantly, thrive.

If you need help more individually, please reach out for a discovery session. We would love the opportunity to help you in any of these areas. And in addition to that, you can feel free to join our app, the Movement Paradigm. We have monthly challenges, live Q&As, and an amazing community, all geared toward whole-body health. So hope to see you there!

Other things that might interest you:

All About Carpal Tunnel

Are you experiencing chronic thumb pain? Do you feel weakness, finding it hard to open jars and grip things? You might even be feeling numbness, tingling, or a burning sensation in your hand. If so, this blog is for you.

Today, we’re going to talk about carpal tunnel. If you, or someone you know, is stuck in that frustrating cycle where everyday tasks become a pain-filled ordeal, you’re not alone.

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Causes of Carpal Tunnel

Now, what are some of the things that may cause carpal tunnel? 

1. Repetitive activity

Using the mouse all day, engaging in repetitive labor, or activities such as knitting or sewing can trigger carpal tunnel. However, we want to recognize that there’s always an underlying cause.

2. Other causes

Some less obvious factors include hormonal and metabolic issues, inflammatory problems, systemic inflammation, as well as conditions like type 2 diabetes and thyroid disorders, which are correlated with carpal tunnel.

It’s important to understand that carpal tunnel is a specific area. When referring to carpal tunnel, we mean the compression of the median nerve at the level of the carpal tunnel in the wrist after it exits the cervical spine at C5, C6, and travels down the arm into the hand.

As mentioned earlier, you may experience weakness and pain in basic activities, such as using your phone. However, jumping straight to surgery isn’t always the solution. Carpal tunnel compression can occur at multiple levels, starting from the spine, through the scalene area in the neck, pectoralis minor, and down to the pronator teres in the forearm.

Patients often consider surgery immediately, but this approach can lead to more scar tissue, trauma, inflammation, and additional problems. Successful outcomes from carpal tunnel surgery are rare in my experience with patients. While specific cases may warrant surgery, considering anatomical differences between individuals, such as gender-related structural variations, it’s important to always evaluate the mechanics involved.

Assessing Carpal Tunnel

When assessing carpal tunnel, we don’t focus solely on the affected area. We examine everything happening in the neck and spine. 

Check Range of Motion 

Firstly, check your cervical spine’s range of motion for any discomfort. Can you touch your chin to your chest, look up with your face parallel to the ceiling, and turn fully to both sides without pain or symptom reproduction? Ensure symmetry in movements between both sides and check for compensatory patterns.

Breathing

Now, assess your nasal breathing. Are you able to breathe nasally? Are you able to maintain your tongue at the roof of your mouth? This position allows for proper expansion and contraction of the abdomen during nose breathing, avoiding unnecessary strain on the neck and shoulders.

These basic assessments are important because any compensation in these simple patterns indicates a potential issue higher up in the chain. For instance, someone complaining of thumb arthritis and weakness may trace the problem back to median nerve issues caused by neck involvement.

When considering surgery for carpal tunnel, it’s vital to weigh numerous factors and examine all reasons comprehensively. I’ve witnessed numerous individuals successfully avoid carpal tunnel surgery by addressing underlying issues and achieving higher functionality, even engaging in activities that may strain their hands. It’s essential to explore these alternatives and delve into the root causes of movement, pain, or health issues whenever possible.

What Can You Do

Now, what can you do? 

1. Immobilize affected area

During the acute phase (1 week) of your carpal tunnel symptoms, especially as you’re trying to figure out why it’s happening—be it repetitive use or any of the other factors I mentioned—it’s crucial to immobilize it as much as possible, particularly if you need to continue activities. 

If you’re typing or using a mouse extensively, it’s helpful to use a brace to stabilize the carpal tunnel in that acute phase, even while sleeping. This can prevent uncomfortable positions during sleep and waking up with excruciating pain and weakness. Consider it a protective measure that can gradually be phased out as you start feeling better.

2. Identify repetitive activities and make changes

Identify those repetitive activities causing the issue and make some changes. Implement basic ergonomic adjustments at work, use wrist support, take breaks—the most crucial thing—and optimize your posture. Note that perfect posture doesn’t guarantee injury prevention, but you can observe where you might be compensating.

Throughout the day, focus on breathing and movement variability rather than fixating on the ideal desk posture. Every 30 minutes, change positions, move around, take short walks—think of them as movement snacks. This approach aligns better with your body’s preference for avoiding prolonged static positions. Spending hours with your neck forward or in one position can contribute to pain and inflammation.

3. Address inflammation

If the nerve is inflamed, there are things that you want to think about from an overall health standpoint. Looking at things like your diet, is there anything that you are eating, or maybe even drinking alcohol or excess coffee, or things that might be putting you in a more inflammatory state? 

You can check out some of my other videos to understand that, but ultimately, there could be potential inflammatory triggers such as stress, food, bugs, toxins, trauma, and hormones.

4. Work on your movement

It’s important to note that everyone’s experience will be different, as the issues they face vary. For instance, do you struggle with instability in your shoulders? Or perhaps your core isn’t as stable as it could be? Another factor is motor control, which refers to your ability to sequence, time, and coordinate your movements. If any of these problems are present, it may cause you to compensate at the wrist and elbow, perpetuating the cycle of discomfort.

Working with a professional is really important. Get a great movement assessment or a physical therapist so you know how you’re moving and what you need to do to correct that.

5. Nerve glide

When the time is right, which is not in the acute phase of your carpal tunnel syndrome, is nerve glides. To do this, stand up and use a wall for support. Place your opposite hand on your shoulder and press it down firmly. Then, with your fingers down and your elbow bent, straighten your elbow, flatten your palm, and turn your head. It’s important to remember to depress your shoulder while doing this exercise. You can start doing it without a wall, but using a wall for guidance can be helpful.

Go back to the center. Breathe in and breathe out. You only want to go to the point of tension; do not create more symptoms. If doing a few of these worsens your symptoms, it’s not suitable for you right now. If you feel fewer symptoms, you likely have more nerve tension, making this exercise appropriate. I recommend starting with one set of 10; assess and feel how it goes. If it feels good, limit it to no more than three sets a day. Ideally, work with a professional to ensure appropriateness.

Think of it like flossing your teeth; just as dental floss moves through teeth, your nerves floss through muscles. You’re not stretching the nerve but encouraging it to glide through the tissue more freely. This is crucial when addressing chronic issues.

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Neck Pain Causes and Solutions

Are you experiencing chronic neck pain? Do you feel like you’re always holding tension in your neck, and no matter how many stretches you do, it just does not seem to resolve? Today, we’re going to talk about some root causes of neck pain. Also, of course, some solutions for it. 

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4 Neck Pain Causes

1. Breathing and/or airway dysfunction

Let’s start with one of the biggest issues, which is some type of breathing and/or airway dysfunction. This means that we can be in a sympathetic state, indicating that we’re in that fight or flight state. This means that we’re going to be breathing from our neck and shoulders. 

We breathe 25,000 times a day. So, if every breath is coming from here, you can appreciate how tight this is going to be. We can also have an airway dysfunction, indicating that there could be a deviated septum, a narrow airway, or changes in the jaw. Even poor tongue posture can play a role in exacerbating these issues.

In essence, many things might indicate that there is an airway issue contributing to poor breathing throughout the day and during sleep. 

2. Posture

Although there’s no clear link between posture and neck pain, we want to think about any potential compensatory patterns that we have in our body, as they can ultimately lead to compensation in movement and, potentially, pain.

For instance, if you spend long hours at your desk staring at a computer, you might develop certain habits. If you’re always looking at the screen to the left, your muscles and tissues may adapt to that position over time, becoming shorter and possibly causing discomfort.

This doesn’t mean you can’t move your head in different ways, but it’s worth paying attention to regular activities to see if there’s a chance to adjust and put yourself in a better position. Making small changes might help prevent potential pain down the road.

3. Headaches or migraines

If you’re experiencing any ongoing headaches or migraines, this often can be associated with neck pain. But, once again, we want to understand the underlying causes of that. Many times, it can be associated with jaw clenching, which can be correlated with airway dysfunction.

4. Lack of stability or motor control

Neck pain occurs when the neck compensates for a lack of stability or motor control, which we refer to as sequencing, timing, and coordination, somewhere else in the body. A good example of that is our core or abdominal area. It’s a beautiful balance of having the respiratory diaphragm work in synergy with our pelvic diaphragm, and all these muscles need the right coordination to stabilize our spine. This way, we can generate force and move efficiently in everything we do.

If we lack stability in the core, then something in the body has to figure out what to do for that. So often, that can be the neck. For instance, if you are trying to do a core exercise on the ground, and instead of the core really doing what it’s supposed to do, you start to get tension and abnormal tension in your neck. It’s a perfect example of how this could happen.

5 Neck Pain Solutions

So what can you do about it? 

1. Optimize your breathing

Let’s talk about some key points. First, address your tongue position. The resting tongue position should be on the roof of the mouth, gently touching the top teeth. This allows our airway to open so we can get optimal breath. We want to think about breathing in through the nose, and instead of breathing straight back, think about breathing up. As you breathe in, aim for full expansion in the abdomen. Think of it as a 360-degree breath—front, back, and sides of the abdomen. This creates inter-abdominal pressure. As you exhale, the abdomen contracts and the ribs come down.

If you feel like you can work on your breathing and improve it over time, that’s amazing. If it seems challenging to improve, you might need to explore other options to identify if there is indeed some structural airway issue that may need addressing.

2. Stop stretching

Often, when we have neck pain, our instinct is to stretch and stretch. When anything is tight in the body, these muscles are doing exactly what we need at the time—they’re protecting us. So if there’s a lack of stability somewhere else, if breathing is not optimal, then our body is doing what it needs to do to compensate and maintain homeostasis or balance.

We want to be kind to it. If we just take away that compensation, it might have a temporary fix, but it won’t be an ongoing solution. Instead, I love recommending the salamander stretch

You’ve probably seen this in my other blogs and videos, but it’s worth repeating. This is based on Stanley Rosenberg’s work. Interlace your fingers, bring them behind the back of your head, and relax your arms. Keep your arms down, side bend your upper body and look with your eyes in the opposite direction. Hold this for about 30 seconds. You might experience a sigh, swallow, or yawn—a sign of relaxation. Come back to center, then switch to the other side, eyes in the other direction, holding for 30 seconds. Before and after you perform this exercise, I recommend checking your range of motion. Normally, there is an immediate improvement afterward.

3. Identify any habitual patterns

Is your computer screen over to the left? Can you move it right in front of you? Are you on your phone for hours looking to the right? Just observe these things that you might be doing all day long and consider making some modifications. You don’t need to have perfect posture all day long—I’m not suggesting that. But it might be beneficial to change some of these habits that you’re doing for hours and hours a day.

4. Create stability and strength in the rest of the body

Learn how to build a resilient body. I know that might sound like a lot, but when we think about becoming stronger from the ground up, from our feet up, we can establish a strong connection and have a foundation for stability, strength, and mobility. This way, our neck doesn’t need to compensate all the time. When there’s chronic neck pain, unpacking things such as optimizing breathing, building stability and mobility (for example, in the thoracic spine), and then building strength can truly shift the trajectory of your pain in a lasting way.

5. Identify causes of chronic pain

And last but not least, whenever we have chronic pain, we want to consider a couple of other things. First, is there any systemic inflammation occurring? Are there factors such as certain foods, hormonal imbalances, or chronic stress playing into this systemic inflammatory response, especially when the pain persists? Additionally, we want to distinguish between acute pain and chronic pain. 

Chronic pain involves central sensitization, where our brain perceives a high alert of pain all the time. We need to learn how to use nervous system regulation and other strategies to down-regulate the nervous system, recognizing pain as information and shifting from a heightened sense to pain associated with a specific movement pattern. In chronic pain, there is no tissue damage at that point, whereas in acute pain, there can be tissue damage.

As always, I hope this helps you understand your neck pain a little bit more and, of course, some of the things that you can do to begin to change your pain and improve your health.

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4 ways to improve pelvic mobility in your gait

Are you experiencing hip pain, back pain, or even knee pain when walking or engaging in other dynamic activities such as climbing stairs or running? Do you find yourself constantly searching for the perfect shoe or feeling like something just isn’t quite right? Your gait is one of the most powerful assessments of movement efficiency, revealing how you interact with the ground. The way you absorb impact and utilize it as energy is profound. 

Today, we’re going to delve into the topic of pelvic mobility and how it influences your gait cycle. We’ll also explore some exercises that can help you improve your walking, dynamic movements, and even running if that’s something you’re interested in.

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What you need to know about pelvic mobility

When walking, we encounter 1.5 times our body weight in force. When running, we encounter up to three to four times our body weight in force. And when we’re jumping, it could be up to eight times our body weight in force. That means that we have to be efficient about how we interact with the ground.

After doing probably thousands of gait assessments at this point, I’ve realized that there are some common themes, and one of them is something that is often ignored: pelvic mobility

We’re always thinking about what we need to stretch or what we need to strengthen. But we also want to consider how the pelvis moves in our gait cycle. We actually need proper rotation of the pelvis, side bending of the pelvis, and forward and backward motion. Any excessive movement or limitations in these aspects can affect our stride length, how we interact with the ground, and the impact force coming through our body.

So, although there are many things to talk about with gait, we’re going to zero in on pelvic mobility today. For example, Kim et al. showed that in chronic stroke patients, an anterior pelvic tilt, which is when your pelvis is forwardly tipped, affects balance and symmetry. These simple factors can have a significant impact on our overall function.

Ways to improve your pelvic mobility

1. Pelvic mobility from the floor

Place your hands on your hips and forward bend, tipping your pelvis forward and arching your back. Then, bend the pelvis backwards, flattening your back to the floor. Repeat this motion a few times, initially assessing if you feel any discomfort, if the motion is smooth, or if there’s any shaking. Notice if it feels limited in one direction more than the other.

Next, move into side bending. From here, bend your hip toward your shoulder, then return to the center. This can serve as both an assessment and an exercise. When using it as an exercise, focus on your breath. Inhale and exhale as you flatten your back in the forward backward bending, and if you’re doing the side bending, inhale deeply with a diaphragmatic breath and exhale as you go into a side bend. Once again, observe if there’s symmetry between the sides or if one side feels painful or crampy. All of these observations are essential.

2. Table position

Come up into a table position, and you’ll perform the same exercises from here. Focus on initiating the movement from the pelvis, not the upper back. As you go into the forward bend, tilt the pelvis forward, and as you go into the backward bend, tilt the pelvis backward. Coordinate this movement with your breath. Inhale as you tilt the pelvis forward, allowing the abdomen to expand. Exhale as you tilt the pelvis backward.

When moving into the side bend, think of it as “wagging the tail.” Breathe in, and then exhale as you perform the side bend. Pay attention to whether there’s symmetry on both sides or if it feels restricted. All of these observations are essential for how you would perform the exercises.

3. Pelvic rotation in table 

From table position, straighten one leg and rotate the pelvis toward the stable leg on the ground. Take a breath in, and then exhale as you drop your pelvis into this hip, and then bringing it back up to neutral. Inhale, and return to neutral. This exercise is really helpful for working on rotating the pelvis into a stable leg.

4. Airplane exercise

This exercise focuses on maintaining a stable hip while moving the pelvis toward the stable leg. Stand on your right leg and position your left leg as a kickstand. You can start with a breath in as you rotate your pelvis into your right leg and exhale as you bring it back to neutral. You can also progress this to single leg (no kickstand). Inhale and exhale as you return to a neutral position. This is a challenging exercise, and I recommend mastering the others first before advancing to this one.

All of these exercises can be powerful in improving your gait and how you interact with the ground. I recommend performing them in order, ensuring you can do the first-level exercises before moving on to the standing ones. Of course, you can integrate these into a comprehensive program that includes strength, stability, and mobility exercises. This can significantly impact your overall gait.  

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