More than just a number...

It is so easy to focus on measurements.  Objective numbers.  We are even trained this way in PT school.  Measurable, quantifiable changes.  We are taught that there needs be something to measure and compare to see progress. 

We focus on numbers in other areas too.  How much we weigh. What size we wear.  How tall we are.  How many inches we have gained or loss. How fast we can swim. 

The numbers don't tell us everything.  The numbers can actually become a distraction.

At The Tummy Team, we focus on core rehabilitation.  In our first physical therapy session, we spend about 30 min of our time asking questions, observing the client and listening.  90% of our "evaluation" can be revealed without even touching the client.  Without measuring the abdominal wall or range of motion or measuring the separation of the abdominal wall (diastasis recti). Of course we do all of these things as well, but the hands on evaluation and assessment often just confirms what we have already suspected from the interview and observation.

Your symptoms, how you hold your body and how you feel is more comprehensive than any measurement we can take.  We are highly trained with our palpation skills so when we do use our hands to assess we can tell what muscles are doing what, we can feel adhesions or scar tissue, we can feel damage and muscle responsiveness, we can feel stability and instability in joints.  However, all of this just clarifies what we already suspect when we listen to you and watch you.

So when you are working on healing your core, you need to look at everything.  Your symptoms, how you feel, what you are able to do, what your pain and energy and confidence and emotional state is telling you. 

Numbers are different.  Sometimes they change dramatically and sometimes they change very slowly.

 To negate the progress you KNOW you have made in your body by having numbers that do not match the changes you feel is crazy.  Yet we see this happen a lot. 

"I feel so much stronger. I can carry my baby without pain.  I can cough without wetting my pants.  I can fit into my pants better and everyone is telling me how great I look.  But I checked my diastasis and I think it has not changed much or at least I think there is still a small separation, so I am not sure if this is working."

What?? 

Why do we allow a number to change our perspective of what KNOW is progress?  Yes the number tells us things, but it never tells us everything.

Sometimes, we have a client who has a diastasis close up very fast.  At the second session there is no sign of the diastasis and pain is better but they still do not have the strength they need for life.  So even though the number looks great, have they fully rebuilt their core?  No!  We still need to build strength, endurance, correct alignment patterns and regain the functional strength needed to fully rehabilitate the core.  They still need a new muscle memory and training.

We have a very comprehensive online program and many people question how we can do "physical therapy" online?  We do this by teaching YOU to understand your own body.  We have you listen to your symptoms and start seeing what your body is telling you and then we give you very realistic and straightforward ways to start retraining your body.  When we become students of our own body, we start to be aware of so much more and sometimes we can start to confuse ourselves with the new information.  The Tummy Team has taken a very systematic approach to teach you one piece at a time and then build upon each piece until you have fully rebuilt your core.

Let us help you see more than simply numbers.  Let us help you restore your core and reclaim your true self.

Mom of 4- 20 weeks pregnant with baby number 5 and having early contractions.

 Current online client...

"I've had irritable uterus (IU) through all of my pregnancies and it's only in the last two that I have come to the point where I said, "enough is enough. There's got to be another answer to this irritable uterus thing that doctors have no explanation for." In my third pregnancy my contractions began at 7 weeks! I just dealt with it that whole pregnancy and tried my best to avoid situations that would trigger it (ie. a full bladder, seat belts, under the belly maternity pants, sitting for periods longer than a few minutes). Then, with my fourth I started having contractions around 9 weeks and they were not the kind I was used to in other pregnancies. They got intense at one point after a doctor had a student perform a PAP smear on me (even though he knew I had IU). After talking with my homebirth midwife I ended up going to a chiropractor that day and he told me about something called a buckled sacrum and he adjusted my tailbone as I stood up against a wall like I was being frisked by a police officer. It felt like he didn't do anything and I was skeptical. I went home and the contractions didn't come back for a couple days (which is unusual for me...I'm used to DAILY annoying contractions). He told me if they came back in the next few days to come back in and I did. He adjusted it again and they stayed away for a week! After that I went in weekly every Thursday to have my sacrum gently coaxed back into place. And I was contraction free. Then, this pregnancy I was shocked when I got to 15 weeks and still hadn't had a single contraction. I thought for sure it had something to do with the core work I had already done with fit2b. But then, in my 16th week they started up My core had reached its limit. After the first day of contractions I got really concerned because I had some spotting the next day, so I contacted Kelly. She spoke with me over Skype and I think we figured out that, for me, the biggest trigger of IU is my posture and alignment. I have a tendency to sit on my sacrum and that's what causes it to buckle. When the sacrum buckles, it tilts my uterus forward causing more pressure on my cervix and stresses the uterus out which causes contractions. So, by strengthening my core I've been able to keep from slumping into that habitual sitting on my tailbone that I do. I've also had to avoid siting in bed and on recliners. Very very bad for me. As long as I am sitting on my sits bones and my core is supporting me I don't get contractions. The only exception is if I let my bladder get too full. That still makes me have contractions. But they stop as soon as I go potty. And I try not to let it get to that anymore.

I'm new here but I'm actually doing week three of the prenatal rehab program online and am just now getting a moment to come over here and say hello. I have four little boys and am on my 5th baby (7th pregnancy) now and am already feeling and seeing huge success from the rehab and my skype session with Kelly. My core is getting stronger and my posture and alignment is so much improved. I am getting to the point where I can sit correctly unsupported for much longer now. Here is a post I put on my wall today....

Halfway there!!! 20 weeks pregnant with baby #5. Did some great work on my abdominals after baby #4 thanks to @fit2bstudio! Now, I have taken a short break from my fit2b membership for just 6 weeks while I am doing an actual prenatal abdominal rehab program through www.thetummyteam.com with physical therapist Kelly Dean. I've seen amazing changes in my core strength and I've worked on my alignment and am not having contractions anymore due to an irritable uterus (it's not irritated when it's locked in place where it should be). ‪#‎nomorecrunches‬ ‪#‎nomoremommytummy‬ ‪#‎youdontneedsurgery‬"
 

Why Core Rehab??

I am surprised at how often people do not taking fixing their “tummy” as a priority.  When you really think about it, it is actually shocking how much we think this is simply vanity or not important.  Perhaps it is because we feel some pressure to have a flat, “photo shopped”, blemish free, media pushed stomach.  We rebel against the pressure, not ignoring that it is there but recognizing in the rational portion of our brain that that body is not ours, it might not even be real and if it is real it may not be what our body was meant to look like.  So we rebel, we stand up and say “Forget it! I am not buying in to one more scheme that says I will look like something that I will likely not.”  I absolutely get that.  It was the main reason that I myself was so skeptical about seeking answers to what might be wrong with my own tummy.  Everything, I looked into was so geared to how you will look and how to look better and how to look skinnier and how to look like you never even had a baby.  That marketing works, I know.  But it is impossible to not feel sucked into the gimmicks and sucked into the vanity of it all.  So we rebel and possibly miss something vital.

To be honest, this is how The Tummy Team began.  Even though, I knew it was more than just losing the tummy, we were really primarily promoting how to lose your tummy post babies.  That was before I really completely healed my core.  That was before I fully understood all that was involved and all that was at stake when dealing with weak and inactive deep core muscles.  I did not fully get it, because you really do not know how bad things are until they are better.  You really do not understand how weak you are and how much you ignore pain and how much you modify your life until you start really rebuilding your core at the most basic level.  

“You know what you know, until you know better, and then you do better.”  

So even though nothing we did caused any damage in the first year and a half of our business, we did not fully address all the details involved in completely healing the core.  Many people were helped even from our very first classes and sessions, but looking back, I see now how that was a mere nugget of what we now know is essential for healing.

Okay, that being said, let’s look at the abdominal wall and the core like we would any other body part.  For example, imagine severally spraining your ankle, so much so that you can hardly walk, that it is painful to move and that when you do walk you have to limp in a way that makes your knee, hip and eventually you’re back hurt.  What would you do?  Would you just power through?  Would you think “oh that is vanity to fix that ankle.”? Would you start jumping on a trampoline?  Would you strap on some roller blades and go for a 5 mile romp?  Not likely.  And if you did do any of these things, you absolutely would not expect the ankle to get better.  Instead, you would likely seek medical help.  You would brace it or if it is severe you would cast it.  You would likely use crutches to keep your weight off of it.  Then you would slowly start moving your ankle; slowly start putting a little weight on it at a time.  Slowly start doing a few trials without the ankle support or without the crutches.  As the ankle heals you will start building up more strength, more mobility and more stability.  You would gradually strengthen and start using it functionally again.  But, it would take some time before you would safely run or jump on that ankle.  It is not like you would never run or jump again but you would need to build up some solid strength for that.  You might even use a brace or a wrap for a while when you start exercising or jogging again.  And if you over do it, jump ahead before that ankle is solid, you might reinjure it, you might have a set back, you might have to slow down again and do a bit more rehab before you move forward.  This all makes sense, right?  It sucks.  No one wants to be injured.   No one wants to take the time to heal something properly but we can all agree that this seems like a reasonable course of action to fully heal a vital part of our body so we can eventually return to the activities we love to do.  However, even once it is all healed, we will always be aware of that ankle.  We would never intentionally place the injured ligaments and tendons of that ankle in the weakest positions over and over again without knowing we are risking re-injury in some capacity.  Once you take the time to feel better, to function better, you will be sure you take care of that ankle.

Some of you see where I am going with this.  Your deep internal core is just as important if not more important than your ankle.  If your deep internal core is weak, inactive, unstable, disconnected or you have a separated abdominal wall (diastasis recti)- you need to rehabilitate and rebuild that muscle.  As with any injury, you will likely need to modify your activities, splint and support the injury and be care how you proceed with exercise and other activities.  Depending on how severe your symptoms or injury, this process may take a little time (likely more time than you thought). 

Your core holds your entire body together.  Your core connects and stabilizes your rib cage to your pelvis, supports your organs and stabilizes your spine.  It is important. A strong core helps your arms and legs move properly.  A strong core maintains your posture and dictates your ability to run and jump and simply to stand and lift and sit without collapsing.

It is not vanity to want to have a strong core!

Diastasis recti is an injury to your abdominal wall.  It is usually the result of a weak internal core and an over- active external core combined with chronic compensations that cause the connective tissue in the center of your abdominals to pull apart.  This is not something you live with.  This is not something you power through and hope will go away.  This is an injury to a vital part of your body that needs Core Rehabiliation! 

Diastasis Recti is much more common than most people realize.  However, it is also extremely common to have a weak deep core and no diastasis.  

YOU DO NOT NEED TO HAVE A DIASTASIS TO NEED CORE REHABILITATION. 

If we were to ask you how you felt about your deep internal core, more often that not people say “very weak and completely disconnected”.  It is extremely difficult to engage and use a muscle you cannot feel.  If your deep internal core muscles are stretched out and resemble more of a deflated balloon around your waist than a solid meaty corset then you need Core Rehabilitation. 

Do not treat your tummy like it is vanity to try to fix it.  A weak core results in a multitude of serious health issues and leads to chronic medical care for these side effects.  A weak core often reveals itself in low back pain, sciatica, pelvic floor issues, pelvic instability, upper back pain, intestinal issues, prostate issues, constipation, abdominal pain, rib pain and rib instability, hip pain, knee pain, foot pain and can make you more susceptible to abdominal hernias.  

At The Tummy Team, we address the cause of these symptoms not just the symptoms.  We work individually with clients of all ages and stages of life to help them rebuild their core and regain the all day strength at our office in Camas, WA.  If you cannot come see us personally, we have developed a very comprehensive online Core Foundations 8-week Program.  This program gives you access to weekly video instruction, downloadable exercises and stretches, weekly encouragement and problem solving and access to a private FB forum to get support from other Tummy Team clients.  We also offer private Skype sessions to help you meet your personal needs 1:1 with me, the founder Kelly Dean.  

Call our office number 360-952-2673 (PST) for more information. And check out our online programs as well. 

You do not have to ignore this issue.  We have helped hundreds of clients and have hundreds of clients currently in our online programs.  Let us help you systematically restore your core and reclaim your true self.

The importance of intimacy….

This blog is a long time coming.  It is a sensitive subject and one to likely make some if not most people a little uncomfortable.  However, I think I get more personal messages and private emails on this subject than any other subject related to core rehabilitation. Most people do not want to post a Facebook question about their personal sex life, so in respect of privacy I have written a short but hopefully helpful blog to answer as many of the questions as I can.

Let’s be clear, I am not a specialist in this area.  Nor do I feel like I am a specialist in pelvic floor (although it is very intimately connected to the core so I have learned quite a bit over the years). Bottom line- sex is important.  Intimacy is essential in a healthy marriage.  Unfortunately, it can get a bit lost in shuffle in the early years with babies and toddlers.  Even in that season, we encourage you to remember that sexual intimacy is the key ingredient that sets your marriage apart from a partnership or friendship.  Without that key ingredient, we can lose sight of our spouse and become disconnected and too independent. 

Eventually, (hopefully) our children will become productive adults and leave our homes to have their own lives and families and we will have our marriage.  You cannot ignore the intimacy in your marriage for 18 years and have it be there when the kids are gone.  (I know that seems like an extreme statement but it happens- too often.)

In Core Rehabilitation, we educate  clients about all the activities and positions that cause damage and can continue to damage  the connective tissue of the abdominal wall.  We instruct to avoid all crunches and crunch-like movements.  We help people with alignment and proper activation of the internal core muscles.  We instruct against bulging the abdominal wall out, holding the breath, flaring the ribs and minimize plank type positions when the connective tissue is thin and vulnerable.  We know there is no way to eliminate all of these movements but our goal is to increase awareness, and minimize as much of the stress these movements have on the connective tissue as possible to allow it to heal and restructure.

So as intimacy can create some of these vulnerable positions, inevitably we receive many question and concerns about sex. 

Some examples…

“What positions are ok?”

“I noticed my stomach crunches during sex and the diastasis bulges.”

“During orgasm, there is no way I can control not bulging out my tummy.”

“To avoid damage during this healing process, I told my husband we need to be on a sex fast.”

And many more even more personal and detailed questions.  I really did not think I would ever write a blog about this but I also realize this is important.  I feel blessed that people feel comfortable enough to ask such vulnerable and personal questions.  I feel it is important to address it because sex is a normal and healthy part of our married lives.

My answers are simple.  Sex is important.  Use common sense.  If something, anything, causes pain then you need to modify what you are doing. 

When we talk about looking at your lifestyle postures and positions and movement patterns, we want you to focus first on what consumes most of your day.  Sitting, standing, lifting, exercises, etc.  Unless you are on your honeymoon, sex is likely not consuming most of your day.  The small amount of time you are in these positions and the even smaller amount of time that your body is “out of your control” is very minimal and likely is not the ultimate cause of your core issues.  J

That being said, I completely understand that for some (likely a small percentage) of our clients that have very severe diastasis and vulnerable abdominal walls it can be very difficult to knowingly put yourself in these situations.

So here are my second set of simple answers.  In most cases, I feel you should be free to take your splint off for sex.  If this feels too vulnerable for you, it is possible to wear the splint and still enjoy yourself.  Do your best to avoid extreme positions (no elaboration here- you will have to use your imagination for what I as a PT talking about neutral alignment might think is an extreme position).  If you can, exhale and engage your core during the event- sometimes that actually helps ‘things’.  And last, I encourage you and your spouse to experiment with positions that may put you in a better position to keep your core safe (again no elaboration here- this is your personal experimentation time). J

Hopefully, that tastefully answers the most common core related intimacy questions.  If you are having further concerns or pelvic floor issues that are contributing, I highly recommend a Skype session with myself or our other PT Gillian who specializes more in this area.  We would love to help you. 

Sex is important, you do not need to eliminate it in order to completely heal your core. So now let yourself be free of fear and enjoy your spouse.