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Cassandra McCoy Physical Health

A Tale of Two Births

by Cassandra McCoy MAT, LAT, ATC, RYT

I didn’t think I was going into labor that night. In fact, when my doula told me she was coming out to my house just to check in, I thought man I don’t want to waste her time! Boy, am I so glad she came out on that Tuesday night. 

A tale of two births. 

I can’t tell you about my daughter’s birth without mentioning how my first experience went with my 2 ¹/² year old.  Without it, I wouldn’t be where I am today.

With my first birth, I was told my baby was going to die if I wasn’t induced. I was told he was underweight and not getting the nutrition that he needed. I was also told point blank by my OB/GYN (please ask me her name so I can tell you how much I do NOT recommend her), that she knew I wasn’t ready to have a baby but I needed to be there that night to induce. She made it sound like I wasn’t being a good mom if I didn’t, because apparently I didn’t want him here yet.  So 40 hours after labor was induced, my son was born. 40 painful hours filled with a lot of anger and hatred on my part and 1 hour of pushing on my back scared and tired. At around 38 hours, I finally had to get an epidural because I was so exhausted from 3 days of no sleep and 38 hours of painful contractions. 

They told me “baby is healthy, not underweight, so that’s all that matters”.  But it wasn’t all that mattered to me. I was angry. I was defeated and powerless. I felt like my power had been taken from me and replaced with doubt, sadness and trauma. I was a professional who helped people like me, how did I let this happen?! I ended up with a grade two tear, several other tears in the surrounding tissues and two grade two prolapses, but baby was healthy right?! Who cares about the mom. 

Bringing home Ethan (2018)

I experienced lots of symptoms for the next 1 and a half years trying to recover. I vowed to never have another cold because I was terrified of what could potentially happen or what injuries might occur when I did. 

Then in 2020, we decided we wanted another one, if I could regain my health that had taken a bit of a turn. I was doubtful we would be successful, but sure enough, in May we found out the good news! Two days before I found out I was laid off. 

Getting laid off is still the best thing (besides my kids, husband and education) that has ever happened to me but it threw a wrench in my plans for my birth experience. 

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The thought of having another hospital birth terrified me. I would get flashbacks to my first experience just being near a hospital. But losing your insurance can change things. 

I wanted to go to a birth center, we have an amazing one in town with wonderful professionals. It ended up not working out, we just couldn’t. I was so sad, and at first, terrified because that meant one thing, a hospital birth, during COVID to make things even worse. 

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So I started to do research. What were my options and what factors could I control in this experience that was going to be far from what I had wanted.

With help from my amazing L&D nurse, I found a doctor who was very much against induction and intervention unless extremely necessary. I also found that this hospital was one of the only in the area allowing doulas. So check and check. 

black physician reading document on clipboard at work
Photo by Laura James on Pexels.com

I met with the doctor, who was the closest I had found to my favorite OB/GYN who had moved, that I had met yet. 

I asked him point blank questions and he answered them honestly. He didn’t tell me what I wanted to hear to just pacify me, unless he was straight forward with me anhis approach to birth and that was refreshing. 

I called and booked a doula who also took pictures at birth. I knew my mother in law wasn’t going to be allowed in the room so I wanted to somehow capture the experience for her to see later. I met with my doula twice before the big day and texted with her quite a bit leading up to the big day as I tried to get our daughter to come into the world. 

Our daughter is very headstrong already, so all the things I tried to do to get her to come just weren’t working out. I was progressing nicely, even hanging out at 80% effaced for 2 weeks but all the tricks were not working. 

At 41 weeks, which was a Tuesday,  my doctor did a sweep of my membranes. He was confident it would work this time (we tried at 40 weeks with no response).

I went home feeling the same and my dad come in that afternoon just to be around before the birth. I had made peace with the possibility of not experiencing spontaneous labor. So I was focused on taking in the final days enjoying my little family before we grew by one. 

I was texting with my doula all day Tuesday after my OB/GYN swept my membranes.  I experienced the same false contractions I had been feeling for the last few weeks, nothing more.

So when she told me that she wanted to head my way that evening I was skeptical. I didn’t want to waste her trip all the way out here. But she said she had a feeling and wanted to come hang out, fine by me!

 

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She said she could come around 7pm.

Weirdly enough, around 6:55pm, I started having a different feeling contraction….still irregular but these were different. 

Then when she got here, she applied some essential oils and I starting pumping then alternating with figure 8s on the exercise ball.

In under a half hour, I was having regular contractions a minute apart. That’s the moment I thought, “Oh lands! Somethings happening!” That’s 8pm.

I remember walking into the kitchen  and seeing my doula making tea and thinking what in the world? She knew. 

I don’t think I actually thought “I’m having a baby tonight” until 8:45pm.  Contractions ramped up quickly and soon all I could manage was being on all fours. My loving doula told me to try going to my bed with the exercise ball and draping over it during contractions so I could rock. Boy did that ever help! Before long I had my music playing on my phone, eating a banana, rocking on the ball and starting to roar like a bear during contractions. 

I was able to read and sing with my first born as we put him to bed for the last time as a family of 3.

Photo my doula snapped as I was in mid contraction

My doula calmingly told my husband to start getting ready. Something I said a bit later too, almost thinking we might have waited too long.

I remember asking my doula “Am I a wimp, or did things just get really intense really quickly”

She was kind enough to tell me all signs pointed to me being in transition, so I felt a bit better and that things were moving along appropriately. 

Being in transition during the 15 minute car ride to the hospital was an experience! I held onto the hand hold and lifted myself up with every pothole and contraction. My husband was over in the driver’s seat giddy with excitement. “This is awesome! I’m getting to drive my pregnant, laboring wife to the hospital!” To which I replied “I’m Glad I can make that happen for you now please drive!”. 

two men inside moving vehicle
Photo by Matheus Bertelli on Pexels.com

To set the scene,

He almost missed the exit off the highway. I was yelling “TURN left here!” In the middle of a contraction. We laugh about it now.

At 10:11pm I texted my L&D nurse friend that I was on my way, 10:15pm, she told me that they were set up for me as we were pulling into the ER.

The receptionist didn’t realize I was in labor until about 5 minutes and 2 contractions of us just sitting there while she was getting stuff together. I had to request a wheelchair because by that time my whole body was shaking and contractions were very very intense.  My amazing doula pushed me up the hallway and I just remember getting pretty dizzy, thankful for the wheelchair and not having to walk. 10:30pm

By the time they wheeled me into the room and checked my progress,  I was fully effaced,  8cm dilated and baby was at zero station. 10:55pm.

With my doula’s and nurse’s help, I got changed, vitals taken, heplock in and positioned on my knees with my arms over the elevated back of the bed.

Contractions came almost two at a time, with one tampering off then ramping back up immediately. My husband had my right hands and my doula was on my left side. Suddenly, mid contraction I felt my water break! I remember telling him “So that’s what that feels and sounds like!” I literally felt the baby move down.

My doctor asked if I could flip to my back to protect my perineum. My doula knew I didn’t want to deliver on my back so she asked if we could stay here and see if I could relax and push effectively. 

One contraction later, I felt my body push. Like I wasn’t actively pushing out when thinking about pushing, it just happened. I purposefully relaxed. I sent relaxation to my glutes and floor with every breath. 3 contractions later, baby was born. 11:10pm

Her cord was so short, the doctor had to hold her for a minute to let the placenta pulse out a bit. Then my husband was able to cut the cord and hand her to me. Trying to move from on my knees to sitting felt like the end of the hardest, most rewarding workout I’ve ever had! I can’t even begin to describe the joy, excitement and thankfulness I was feeling in that moment. Not that it was done, more that it had all happened. Already, I could feel my pain disappearing, my relief flooding in and my joy taking over.

Photo by Photo Doula

My baby girl was here.

My golden hour was perfect.  The pictures hold my gaze to this day as my pure joy was just too much to put into words. I felt relief that it was over when my oldest was born. With my second, it was joy and thankfulness that I had the chance to experience every moment.

Photo by Photo Doula

My doctor told me everything looked great, a bit of heavy bleeding but no tearing. I repeat, NO TEARING. Slight nick but no tearing, stitches needed.

The tale of two births.  In one, I learned about determination, manipulation and overcoming. In the other I learned to allow, feel empowered and renewed. Both were necessary in making me the mom I am today. 

Photo by Photo Doula

My advice to mamas going into their 1st or 2nd births plus advice for delivering during the age of COVID is coming soon in the next few weeks. I will link to the article here.

As Oklahoma’s only Certified and Licensed Athletic Trainer who is specialized in prenatal/postpartum care and rehab performance exercise, I focus on utilizing the best rehab exercise techniques and whole body science based methods to providing my patients with a comprehensive approach to transforming their health. Certified in numerous manual techniques such as Rocktape, Neurokentic therapy, IASTM and more, my goal is to help my patients recover and live pain free in the way that works best for their body. By utilizing yoga, barre, strength training, functional training and other rehab approaches, I am able to help my patients return to what they love.

I run a small business called Positively Balanced LLC and run a nonprofit branch called the Be HEaRd Women’s Health Platform. As an adjunct professor at Tulsa Community College, I teach Applied Anatomy and Kinesiology, Foundation of Health and other online courses.

.When not empowering women through my business or teaching, you can find me playing with my kids and husband outside, gardening, cooking, teaching yoga, and other movement classes! 

 

Want to return to what you love?

Does incontinence, prolapse, or diastasis keep you from doing the things you want to do?

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Guest Contributor Physical Health

C-Section Scars – Problems and Solutions

by Guest Contributor Allan Guenther LMT

One of the main goals of my practice is to help women to avoid C-sections. In most situations, this means giving the pelvis more mobility. You see, if the pelvis can move properly, the baby can make his way through the birth canal with relative ease. The sacrum (tail-bone) can pivot, the ilium (hip bones) can widen, the pubic symphysis can open up, tearing is reduced (or eliminated) and mom’s recovery can take place naturally. 

But sometimes things don’t go according to plan. Sometimes a C-section is the best option. What are some of the common effects that accompany a C-section and what can be done about it? 

The scar is one of the most significant side effects of the C-section. I don’t mean the outward scar. Usually the scar on the outside is a small, white or red line that is easily covered up by a swimsuit. No, I mean the scar that is on the inside. This is where the real problems can occur. 

The most obvious trouble with a C-section scar is the pain in the area of the scar. Of course there is going to be pain right after the surgery but I am referring to pain that is still there long after the healing should have completed. This can be evident when mom tries to use her lower abs when she is sitting up. It can be present itself when a child wants to sit on her lap. It can lead to discomfort during intercourse, it may cause her monthly cycle to be more painful, or it can mean significant discomfort during subsequent pregnancies.  

Photo Credit Anatomy Trains

In addition to the more obvious trouble, there are a number of more distant issues that are not quite so readily associated with the surgery. The first is neck pain. At first, this might seem quite improbable but there is a significant connection here. You see, when the scar forms, it is intended to lock down and stabilize the area of the injury. This means less mobility in the muscles and fascia that surround the scar. In this case, the abdominal muscles have a constant pull on them. The effect is that the chest is pulled closer to the pubic bone and the head is pulled forward. Our body doesn’t like this. If everything else stayed the same, we would be walking with our head slightly tilted toward the ground. But we can’t do that so we compensate. The compensation is done by the neck. It tightens up in order to bring the head back to level and to bear the extra weight placed on it by the head-forward posture. 

Another area often affected by a C-section is the bladder. Of course, the bladder is designed to expand and contract as necessary but the scarring in the area can mean more frequent urination, or it can be one of the contributing factors of stress incontinence. 

So what can we do about this? What options are available to minimize the effects of the C-section? There are a few things that I have found that help quite significantly. They include castor oil packs, neurostim, and manual therapy. 

The castor oil packs help because they physically soften the scar tissue. When the castor oil is applied with a heating pad, the scar tissue is softened and is much easier to work with. When we go to do the manual work, we find the scar to be more pliable, less tender, and generally easier and more comfortable to work with. 

Origin of photo unknown

The neurostim therapy also adds a significant benefit to the work. This unit uses direct microcurrent to make physical changes to the scar tissue on a cellular level. Because your body already produces and uses its own microcurrent, this therapy can be particularly helpful because it is augmenting something that your body already recognizes as good and helpful and natural. 

As with all of the therapy, it is important that we do this work with the body and not to the body. This means that both the client and I will work simultaneously to attain functionality and full range of motion of the tissue. We want the scar tissue to be strong but we also want it to be organized. We want the scar to enhance and strengthen the area of the incision and not simply lock the area down. 

Even when a C-section was the best option, there will be side effects but those side effects don’t have to be just simply accepted and dealt with. There are significant and often permanent results that can be enjoyed by a woman who is willing to be proactive in her health. 

Once we have softened the scar with the castor oil and done some neurostim work to change the scar at a cellular level, it is time to do some manual therapy. This involves working physically with the scar tissue and with the surrounding tissue. As the scar tissue develops, it will tend to affect the muscles and other organs in the pelvis. We want to make sure that the scar tissue stays more local to the original incision rather than generally tightening everything up in the pelvis. 

About the writer:

Allan is the owner of Motility Bodywork in Tulsa, OK. A bit about Allan’s approach from his website: “We are not simply a composition of many parts but we are a whole being that needs to be treated as such. We have a history that includes our birth, the type of work that we do, accidents, emotional trauma, abuse, stress, and even our eating habits. We cannot simply look at a small part of the body and say that this part works in isolation from the others. When a wholistic approach is used, I am able to better perceive the core issues. When the core issues are addressed, this work is usually significant and permanent.”

Visit Allan’s website here to learn more or schedule a consultation: Prenatal Massage Tulsa | 918-641-4410 | Motility Bodywork Tulsa

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Uncategorized

Pregnancy tights: What type is best and do they actually help?

by Cassandra McCoy MAT, LAT, ATC, RYT

Pregnancy tights. Love them or hate them, they are a staple in many a pregnant woman’s wardrobe. The market is flooded with various brands, promising the best fit for you. However, when I started scouting out some for myself during the third trimester of my second baby, I began to notice a few key things about the leggings I would come across or try.

 Disclaimer: I am not rich, so I haven’t purchased all of the brands available nor have I had the pleasure of being sponsored by a brand to review their products, this is just my humble personal and professional opinion.

Varying person to person, as your baby starts to put on more weight, your tummy starts to make itself known. Whether that arises in less clothing fitting, aches and pains in the back, or other various fun pregnancy things that pop up, just ask a mom and she will tell you that there is a point where you just notice the change. 

When this happens, we start looking for something like pregnancy leggings or support to help us feel more comfortable. 

pregnant woman wearing beige long sleeve shirt standing near brown tree at daytime
Photo by Negative Space on Pexels.com

This didn’t really happen for me during my first pregnancy, as my baby hung out very high in my abdomen the entire time. However, this second pregnancy has been a whole different story. I have definitely shown faster (as expected) but I have also ran into a problem I never expected: varicose veins. Now, I’m not talking about the little spider veins that look like your toddler used you as a coloring book. I’m talking about the fat, nasty, painful veins that make you look like Hulk’s mother. Ouch. So, I needed some help to keep them supported and began looking for a tight that won’t press on my femoral artery/vein just under my growing belly.

I want to tell you about the few tights I got but also the response I felt from my body after wearing them; the good and the bad. 

I ordered 2 pairs of leggings from Blanqi online first. Since I knew they would take forever to get here, I also went on Amazon Prime and grabbed a single pair off there as well. The Blanqi leggings were around $65 each and the Amazon pair rang in around $20. So yay for cheaper and faster shipping, but I was curious as to the quality I could expect.

I received my Amazon leggings first, so let’s chat about those first. They came with a few thread pulls along the seams, but nothing too crazy or worrisome. I put them on ASAP. They slip right on, I didn’t feel like I was going into battle just to get them on. The top of the leggings came right up to my sports bra line and they were super soft. They are not as thin compared to others I have tried on or seen, giving you a bit more of a “free” feeling and less super restricting. I felt my veins were supported enough and the pressure that I was feeling on my pelvic veins from my old leggings was replaced by the freedom of continuous fabric all the way over my belly. They stay up well overall. I still have to readjust them and I am curious how long they will take to stretch out and be more annoying and problematic; aka slip down over the belly. 

A week or so later, I received my Blanqi leggings. I got a black and navy blue pair and I could tell just taking them out of the package that the material was different. The material is a bit more tense, and so therefore, as I put them on, I felt like I was battling a small tiger just to get them up my legs. However, once they were on and up over the belly, I could tell a difference in the compression and support. The material is thicker and more “slip” in nature. Again, not feeling my waist of my old tights digging into my pelvis and belly was a welcomed feeling.They fit tighter and more constricting around the pelvis, so just be ready for that. I feel a bit more congested yet supported in these. I don’t feel like I can do a high kick in these without splitting them….but I also have been too scared to try in fear of ripping these precious things. My belly support is nice and the top of the leggings once again hit just at my bra line. The leggings do stay up well, however, just like with the others, I have to tug every now and then. As my belly grows, I notice that more tugging is needed.

Let’s talk about pregnancy leggings in general and what I have noticed in my body after a month of wearing them.

When I wear the pregnancy tights, I notice I shift automatically into a more kyphotic posture (rounded back and shoulder dropping forward and my chin juts forward). I first noticed an increase in tension in my shoulders which in turn led me to start looking at how I was carrying my body with the tights on compared to when I had my regular tights or other clothes on. It sounds silly but I could almost automatically tell the tendency and pull of my shoulder and head forward. Also, I felt my butt squeezing was worse. A default move for many women, always squeezing our butt can lead to tension and pelvic floor dysfunction.

After experimenting with it, I think it comes down to the high top. In fear of it falling off or just the awareness of it being high on top of my belly, I tend to want to protect it and keep it from falling down, therefore I decrease that distance and pull by taking my upper body forward. This is also accented by the growing belly for sure; however, it was still notably more present with pregnancy tights on.

Also, I noticed I walked differently. The Blanqi tights are so “tight” (which is a plus and a minus all at once) that I wasn’t taking my normal full stride. During exercise, my range of motion was narrower/smaller as well and I was hesitant. This might be fantastic for someone who is very hyper mobile, so keep that in mind. With my Amazon tights, I really didn’t notice much restriction but still felt that forward pull. 

So what’s the verdict on the tights? Well, it depends. Are you wanting to support your belly and veins during the third trimester? These guys can help with that. Blanqi has more of that compression and material tightness compared to the cheaper amazon purchase. Both are very comfortable. However, if you are wearing them all the time, make sure you take note of your posture. Pregnancy changes your center of gravity and postural positioning quite a bit already, so bringing awareness to your shoulder and head positioning is a good idea anyways. The tights just might accent that a bit.

abdomen active activity belly button
Photo by freestocks.org on Pexels.com

Personally, I will continue to wear my pregnancy tights as well as my regular ones. I will just be bringing more mindfulness into how I carry my body and the tension felt in  my shoulders! However, expect a follow up article over why posture is so important during pregnancy and postpartum and how you can optimize your lifestyle and wardrobe to help make your journey pain free and comfortable.

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Cassandra McCoy Physical Health Uncategorized

Incontinence Happens: Here’s What You Need to Know & What You Can Do

by Cassandra McCoy MAT, LAT, ATC, RYT

Why do I pee myself when I sneeze, cough, run, stand up or can’t make it to the bathroom in time?

Have you Googled a question like one of these before?

Maybe you were chasing your toddler around the living room and you felt something strange. Maybe you were out for your first run postpartum and you couldn’t make it around the block without needing to swing back by the house. Maybe you weren’t even trying to run, you just were walking and all of the sudden (maybe without even realizing it), your panties were wet.

You might have thought “What in the world is wrong with me?” or “I must be broken”. Maybe you think that this is your new normal so you start wearing pads while you are out “just in case”.

I am here to tell you that you are NOT BROKEN and this is NOT YOUR NEW NORMAL.

This involuntary leaking of urine is called incontinence.

don t panic text on toilet paper
Photo by Markus Spiske on Pexels.com

Incontinence Happens.

You are not weird.  You are not broken. We have kept this conversation taboo and hush hush for too long. You do not have to suffer alone and you DO NOT need to wear Depends for the rest of your life.

woman in white underwear holding red rose in a menstrual cup
Photo by cottonbro on Pexels.com

If you are experiencing symptoms, it is your body’s way of telling you there is a bit of work to do to reoptimize your pelvic floor and ovary system. You can get back to the activities you love.

It is COMMON to have incontinence. Not NORMAL. But when it does happen to you, don’t feel lesser, like a failure, or that something is WRONG with you. It is information that you can take and know. It does not equate to your worth or value as a woman. You aren’t broken, you are powerful and you are able to start taking the opportunity to understand what is going on in your body. 

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There are different types.

Did you know that there are different types of incontinence?

It’s true!

Here is a page straight out of my book “The Starting Line Postpartum”:

When you speak with your women’s health practitioner (of any profession) about your symptoms, make sure they are asking questions that will help ID your type of incontinence.  This ensures you are getting the appropriate care, guidance and solutions.

These questions might include:

When do you notice the leaking occur?

Do you leak when you run, laugh or cough?

Do you leak when you can’t make it to the bathroom in time?

How often do you feel the urge to go?

Has there been any change in your diet recently?

If your health professional is asking these questions,  it will lead to you getting the solutions you need.

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Why does it happen?

It can be one factor or several components combined. Pregnancy, labor, injury, prolapse or weak/tight pelvic floor muscles can all cause incontinence. Also, we need to be aware of diet and environmental irritants that can aggravate the bladder and lead to incontinence symptoms.

Age doesn’t matter.

Incontinence doesn’t discriminate. No one gets a pass.

You can be in your 20s, no kids, super active and get incontinence. You can be in your 40s, no kids and have incontinence. You can be 32, with 3 kids and have incontinence.

New studies are currently in the works that I am watching very closely. They look at young women’s risk factors that influence her incontinence, as well as, results of sticking to a rehab program put in place by the researchers. The results could tell us a lot more about the physiology and the psychological behind incontinence.

Current systematic reviews and meta analysis show that many women suffer from incontinence in their 20s, 30s, and 40s and the statistical differences between the age groups are not significant. This tells us that this problem we once thought was just common in older women, is actually common across the lifespan. Only now, we know it is not NORMAL and that there is something we can do to fix it!

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The Fittest Don’t Get a Pass.

Something no one wants to talk about. Athletes, the ones who are the fittest of the fit, experience incontinence. It doesn’t mean they are weak. It means we have one more piece of their training puzzle to optimize in order to enhance their performance.

woman in white tank top standing on concrete surface
Photo by Luis Quintero on Pexels.com

Cassandra discusses incontinence in active women a bit more here: https://www.facebook.com/watch/?v=759949624792414

Incontinence is a message. 

We usually don’t think of it this way.

smiling ethnic woman with blank poster in empty flat
Photo by Andrea Piacquadio on Pexels.com

We think of it as an annoyance. A bother. Embarrassing. I’m right there with you, so I get it.

However, what if we started thinking of it as a message about our training and our bodies? Just like if a specific body part was sore or hurting after a workout, we would say we needed to strengthen those muscles or find out if there was an injury there.

Same rules with incontinence. Are we experiencing symptoms?  That must mean we need to check out our system and optimize so that we can improve our performance and function.

You are not broken. You are strong. You are tuning into your body and the messages it proves. Don’t suffer in silence, be seen and BE HEaRd.

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Good afternoon ladies! Are you ready for our next challenge?

This one’s going to be a ran a little bit differently!

Here are the details:

Begins November 1st.🎁 Any woman can participate. Mamas, teens, single ladies, retired, etc you get the idea, join in on the fun! I will make an EXCLUSIVE group just for us where all of your fellow challenge members will be connecting, supporting and motivating each other!🎁$20 buy in that keeps you keyed in AND goes towards the Winners Pot (more about that in a sec). Paid via Paypal or CashApp.🎁You will have a score card that will be based on the honors system. 1 points per activity/workout/video participated in.🎁Weekly activities include: ❄ 1 15 to 30 min workout accessible to all levels ❄ 1 healthy eating recipe 🎁 Weekly check ins are not required, however, they are preferred to keep you motivated as well as motivate your follow participants! Cassandra. They help to serve as a tie breaker just in case.🎁 Now for the good stuff: PRIZES ($200+ value!) Winner will be the person will the most points and if there’s a tie, the most check ins! 🎀 75% OF THE POT (money taken in via signups) 🎀 Free tank top ($15 value) 🎀 Free New Year 45 minute consult with Cassandra McCoy MAT, ATC, LAT ($80 value) 🎀 Free ticket into our yearly 8 week mini course Back to Basics where we talk about the different health dimensions and how you can implement them into your life in easy ways in the new year 2021! ($100 dollar value)

HOW FUN IS THAT!?! ARE YOU IN?! Sign up via form here: https://view.flodesk.com/pages/5f90922c359e8b26ffb760f0.

Categories
Physical Health Rachel Warner

The Advice You Should’ve Gotten

by Rachel Warner MAT, ATC, LAT

I didn’t receive helpful advice from my doctor regarding exercise when I became pregnant. I asked all the questions and got the same canned answer, “just keep doing what you were doing before you got pregnant.”  Just for the record,  I was deadlifting  300lbs and playing soccer. Not things I should have been doing without modification, at the very least. Needless to say, I did not leave the office feeling educated or empowered. 

The lack of clear direction tends to make moms overly cautious during pregnancy, oftentimes avoiding exercise all together, and too quick to return in the postpartum period. So what is the actual advice for the American College of Obstetrics and Gynecology? Light to moderate exercise during pregnancy is advised for nearly every pregnant person. It has been shown so many benefits including better sleep, lower rates of depression while pregnant and postpartum, decreased risk of preeclampsia, decreased risk of urinary incontinence, decreased risk of cesarean section, and decreased chance of excessive weight gain during pregnancy. 

So, what could you do if you did not exercise prior to becoming pregnant? First, check with your doctor to ensure that light to moderate exercise is safe for you, there are some absolute contraindications for exercise such as restrictive lung disease. Once you get the go ahead, start with lower intensity and shorter bouts of exercise. Gradually increase the time and intensity as your body becomes conditioned. The goal is to start with 1-2 hours a week broken up into multiple 20 to 30 minute sessions. Keep your perceived effort at a moderate level the majority of the time, you should be able speak sentences, but a full conversation would be difficult. Be sure to listen to your body, stop and notify your doctor if you begin experiencing dizziness, chest pain, muscle weakness affecting balance, calf pain or swelling, vaginal bleeding, regular painful contractions, or amniotic fluid leakage. 

There are a few activities you should avoid while pregnant, to ensure your safety and that of the baby. 

  1. Any activity with a high risk of falling. (skiing, surfing, off road- cycling, gymnastics, horseback riding)
  2. Contact sports. (soccer, football, boxing, hockey, rugby, and basketball)
  3. Scuba Diving
  4. Activities in high temperatures (hot yoga, hot pilates) 

If you are not doing any of the activities above, you are likely good to keep doing what you are doing as long as you feel comfortable. Keep in mind, pregnancy is not the time to PR. Modifications to training are recommended and oftentimes required as pregnancy progresses. If you are accustomed to high levels of activity, it is advised to keep high intensity training short. 

If you are unsure what is safe of how to modify an activity consult a healthcare provider specializes in pre and postnatal fitness. 

Visit Rachel and learn more about what she does at:

www.restorativefitness.com

Categories
Cassandra McCoy Physical Health

The Top 5 Functional Exercises You Should Be Doing During Your Pregnancy

By Cassandra McCoy MAT, ATC, LAT, RYT

Disclaimer: Always consult your doctor before starting any exercise program during pregnancy.

I know I have stated that these are the top prenatal exercises; however, anyone can benefit from these simple, yet effective exercises to help pain in your hips, strengthen the deep core and improve breathing! 

Let’s dive into my top 5 exercises that every soon to be mama needs:

Breathing

     I can’t think of anyone who can’t benefit from this one. A pregnant woman can begin to naturally default to a chest breath, as baby fills her central cavity and presses into the diaphragm. That makes breathing just plain uncomfortable. This is an exercise you should try first on your back with your legs up, and as you get a better connection between inhale and exhale, you can do this anywhere! My favorite time to practice this breath is on my car rides!

  1. Place one hand on your chest and one hand on your lower tummy. Take a deep breath in and try to send the air all the way down to your lower hand. Feel that area exhale and grow. And then as you exhale, send all the air up and out your mouth. Feel your lower abdominal fall back down steadily to its resting state.

   I would love for you to also build to adding the pelvic floor engagement; however, I HIGHLY recommend you go see a pelvic floor physio or a women’s health specialist, because if you happen to have what is called a hypertonic pelvic floor, you will need to be given a specific action to do during breath that will help to lengthen the pelvic floor.

 Bridge into Thrust

This exercise can be done until you feel laying on your back is uncomfortable. Then this exercise can be swapped out for a thrust with your back elevated on a couch. 

    Who doesn’t love the bridge. It is just so adaptable, easy to explain and to do on your own, and its progressable and beneficial for the body. Lay on your back with both knees bent and walk your feet back towards your hips then let them rest on the floor hips width apart. a) Press your ribs down towards your hips and engage your lower abdominal muscles called the transverse abdominals by giving yourself a little cough.  b) Squeeze your glutes (booty muscles) and press through the feet to lift your hips high in line with your knee and shoulders. c) Slowly lower back down to start and relax your muscles. Start with 2 sets of 10 repetitions and go up from there!

     Here are just a few favorite variations that help to stabilize the lumbopelvic area as well as work pelvic floor without you even realizing it.

Here as a great video showing a way to progress from a pelvic tilt into a glute bridge:

    Pillow Squeeze: place a pillow between your legs and squeeze it as you move.

    Band pulse: put an exercise band around your legs just above your knees. 

Squat

   Who doesn’t love a good squat? Well if you are pregnant (even if you aren’t), squats are essential for prehabbing the pelvic floor. Doing squats is also working the whole hip muscular through your maintainable range of motion, while working balance and low impact cardio depending on how you execute the exercise. One key thing to remember is that you need to be breathing throughout the movement.

  1. Stand with your feet a little wider than hip width apart. Toes can turn out slightly depending on what feels comfortable to you. Press your ribs down and give that little couch precontraction of your lower abs. Pretend like you are sitting back into a seat behind you while keeping your chest proud, ribs down, glutes engaged and knees pressing out in line with your toes. Sit down as low as you feel comfortable while maintaining the engagement.
  2. Press through your feet while maintaining engagement of your core and glutes and c) come back to standing

Hinge (deadlift)

   You do not have to have a barbell or special weight to do this exercise throughout the day or during your workout. We need to make sure we have an understanding of what a deadlift (hinge moment) is versus what a squat movement is. This is good prehab for life PRE AND POST baby. Picking up things off the floor has never been such a reality than it is now.

  1. Stand tall with no weight to start with and then add the weights resting on your thighs. Keep your chest wide and ribs down throughout the movement. Pretending like you have a string around your waist that pulls you straight back, send your hips back towards the wall behind you and allow your knees to soften and bend. b)Remember to send the hips back, not down. You might feel tension in your hamstrings.

C )Engage your hips and send them forward to come back to standing.

Farmer’s carries

    No mom goes a day without grabbing a car seat out with one hand while reaching for a bag with the other. Or maybe holding your baby at the hip while grabbing grocery bags out of the trunk for the famous “one trip into the house”.  Also, during pregnancy, our core training strategies need to change, as we move into focusing on proper breathing and engagement while not front loading the abdominal wall at all.

   As we begin our prehab for pregnancy we always need to think about those everyday activities we will need to be strong in, post birth. So working the body with multiple different loads.

With farmers carries, try to carry a weight on one or both sides (maybe pull out that carseat for a test run). Everything from the waist up stays engaged and does not move at all. Be sure you are firmly gripping whatever you are holding to improve shoulder health. Now begin to walk as normally as possible around your home or down the hallway, again keep the upper body nice and tight. 

Don’t forget to start light and slowly progress up as you feel comfortable. Contact your local pelvic floor physical therapist, women’s health athletic trainer or pregnancy exercise specialist to help you dial in these exercises as you need!

Next up: Top 5 Functional Exercises You Should Be Doing After  Baby

Categories
Guest Contributor Physical Health

Groin and Front Hip Pain in Women

Written by Dr Michael K. Van Antwerp, Edited by Andrea Vasquez

Groin and Front Hip Pain

Groin and front hip pain are common areas we see in women’s health. These can have a host of causes with some more evident than others.

Some of the causes of pain in the groin and front hip can be: hip impingement, labral tear, sports hernia, hip flexor strain, hip adductor strain, inguinal ligament sprain, endometriosis, cam or pincer deformity, hernia, arthritis, osteitis pubis, round ligament pain, stress fractures, nerve entrapments, interstitial cystitis, pelvic floor dysfunction, gynecological or urological pathologies, pelvic or hip surgery complications, SI joint dysfunction, sacral or pelvic plexus injuries.

In the first article of this series, we will look at the musculoskeletal causes.

Functional Hip Impingement

Functional hip impingement is caused by malpositioning of the ball in the hip socket which causes pressure or rubbing to occur in one area. This can be caused by prolonged sitting postures where the hip is flexed with tight hip flexor muscles and tissues. Although it seems simple, it can be debilitating in more severe cases.

Femoroacetabular Impingement (FAI)

In structural hip impingement, bone growth is present at the ball-and-socket joint limiting movement usually with some type of cam or pincer deformity. This structural limited movement and pain is referred to as a femoroacetabular impingement (FAI). It is possible for FAI to lead to osteoarthritis or labral tear. It seems plausible that limited hip movement can also lead to pelvic instability including pubic and sacroiliac joint dysfunction as well as low back pain in addition to the presence of groin/front hip pain.

Labral Tear

The labrum is a gasket-like ring of cartilage that runs around the outside of the hip socket and acts like a suction cup. It can tear due to trauma, structural abnormalities or repetitive motions. An MRI with contrast dye (MRI arthrogram) is the best way to view a labral tear since an MRI without contrast dye can give false negatives. Sometimes labral tears will need surgery; oftentimes, they can be managed with conservative therapy, sports chiropractic and rehab.

Sports Hernia

A sports hernia is often defined as any sprain/strain of ligament, muscle or tendon in the lower abdomen or groin area. However, it may be more specific to an injury of the transversalis fascia with pressure on genital branch of the genitofemoral nerve or it might be an injury to the pubic aponeurosis. It is a different injury than a traditional hernia which is why it is sometimes referred to as athletic pubalgia and more recently core muscle injury (CMI). In the past, it was referred to as Gilmore’s groin.  A sports hernia will often have no anterior bulge; whereas, a traditional hernia often has bulge from the internal organs pressing or pushing through tissue. The presence of femoroacetabular impingement and pelvic instability seem to lead to increased risk of sports hernia. A sports hernia can be quite painful with difficulty in sitting up or moving and has even ended sports careers.

Hip Flexor Strain

The psoas and iliacus are front hip muscles that help flex the hip. They can be strained in activities such as running, but oftentimes can start hurting from prolonged sitting. In addition, the upper quadriceps and upper sartorius muscle can be tender and/or strained as well. This can often mimic FAI, athletic pubalgia and labral tears initially.

Hip Adductor Strain

The pectineus, part of adductor magnus, adductor longus, adductor brevis and gracilis all attach at the pubic bone. These muscles pull the thigh inward from the hip joint and control the rate of outward movement of the thigh. These muscles can often be strained in sporting activities.

Inguinal Ligament Sprain

The inguinal ligament runs from the front point of the pelvis to the pubic bone, and one is present on each side of the pelvis. It forms the angled crease we have in our groin area. On occasion it can be sprained. In other cases, it can be quite tender although a definite sprain may not have occurred. The lateral femoral cutaneous nerve, femoral nerve, femoral artery, femoral vein, inguinal lymph nodes and genitofemoral nerve all run across this inguinal area.

Round Ligament Pain

The round ligament is a round band of fibromuscular tissue that connects the upper front part of the uterus to the groin. One is present on both the left and right sides. It is part of the several supportive ligaments of the uterus. Normally the cardinal ligaments support the uterine angle, but during pregnancy the round ligaments help maintain this angle. As the round ligaments stretch, they can cause a sharp pain and/or spasm feeling on one or both sides of the lower belly or groin. Rapid movements such as sneezing, coughing or quick exercise can set off the pain. It is often considered a normal sign in pregnancy and is more common in the second trimester. A technique for helping create space for a baby to turn when in the breeched position called the Webster Technique uses relaxation of the round ligaments along with sacral positioning.

Stress Fractures

Stress fractures can occur from repetitive stress to the bone from impact activities such as running. They can also occur from non-impact activities in individuals with osteopenia or osteoporosis.

Hip Arthritis

Osteoarthritis (osteoarthrosis, wear-and-tear, degenerative joint disease) can affect the hip. The joint space of the ball-and-socket area can thin along with having bone spurs. This can be caused by wear over time. However, a previous injury could also be the cause of hip degeneration over time. In a lot of cases, movement and rehab can help keep the hip moving. In severe cases, a hip replacement can be helpful.

Osteitis Pubis

Osteitis pubis is inflammation of the inner pubic bones at the pubic symphysis (cartilage disc between the two pubic bones) and the surrounding muscle insertions. It can be caused by pelvic surgery, pregnancy, trauma or sports injury. The sports that this occurs more often are ones that involve repetitive quick changes of movement such as soccer, rugby and racewalking.

Sacroiliac Joint Dysfunction

Sacroiliac (SI) joint dysfunction can refer pain to the front of the hip and groin even though the problem is in the back. In the absence of hip ball-and-socket pathology, it makes sense to look at the lumbar and SI joint. It has been found that SI joint dysfunction was more likely to cause groin pain than lumbar disc herniation and lumbar spinal stenosis.

Discussion

An evaluation by a licensed healthcare provider that specializes in the hip and pelvis is a good place to start in figuring out the cause of groin and hip pain. Since we are discussing musculoskeletal causes today, an extremity chiropractor, physical therapist and athletic trainer can be good place to start for this type of evaluation. Imaging with x-ray or MRI may be ordered if needed. A diagnosis is developed along with a treatment plan. An orthopedist or other surgical specialist might be needed depending on the severity of the condition. A physiatrist and pain management specialist might also be needed depending on the condition.

Functional hip impingement, hip flexor strain, hip adductor strain, inguinal ligament sprain, round ligament pain and SI joint dysfunction can all be managed with conservative care if they do not have any higher-grade tissue ruptures. They do will with rest, manual therapy, extremity chiropractic, physical therapy and eventual progression of rehab exercises. There are maneuvers that really open up movement of the hip joint as well as maneuvers to help the muscle and other soft tissue. For example, I use the wishbone maneuver by Whyte-Ferguson to aid in mobility of the hip joint and reduce anterior pressure. Mobility exercises progressed to stability and strength can be quite helpful. Eventual progression to full daily and sports activity is usually the goal.

Osteitis pubis often needs rest and removal of activities that irritate it with eventual progression to a rehab program.

FAI can often be managed conservatively, but sometimes needs surgery if the cam or pincer is too progressed and is limiting any recovery.

Suspected stress fractures need rest from impact activity, but often need imaging to confirm their diagnosis; if they are confirmed, they need to be seen by an orthopedist.

Labral tears can be managed conservatively, but need MRI arthrogram to properly visualize them with an orthopedic surgeon consult if found to be present.

Hip arthritis develops over time as is expected with wear-and-tear. Maintaining movement through a mobility and strength program along with some therapy can be helpful. It is possible that a severely arthritic hip might need a hip replacement.

Round ligament pain during pregnancy can be conservatively managed by healthcare providers experienced in therapy with a pregnant patient. There are techniques in prenatal chiropractic such as Webster Technique that can help. Therapy techniques with a physical therapist experienced in pelvic floor and prenatal can be helpful. There are specialties in athletic training and yoga for pregnancy that can be quite useful.

I am always fascinated how front hip pain can occur. It can be simple but difficult to figure out. For example, I have treated intense front hip pain from a patient that hooked one foot behind the leg of their office chair. After several weeks we finally figured out that this position tractioned the front hip at an odd angle which caused the front hip pain. I had a friend that swore they needed hip replacement because their hip was hurting so badly, but it turned out after asking questions that they were sleeping with one hip in frog-legged position. This was the cause of their intense front hip pain. A skateboarder friend who had multiple falls common to the sport turned out to nut just have impact injury and old hematomas but revealed a cam deformity that was the cause of their pain. We were able to manage it conservatively. Earlier on in practice, I was working with a racewalker that was having pubic area pain; I discussed this with a colleague who had worked as an US Olympic Team chiropractor and he gave a suggestion to check for osteitis pubis; I went back and checked, and it was; I have found this with several racewalkers since. Even though athletic pubalgia is more common in males than females, I have seen several cases in gymnasts, soccer players and dancers.

Thank you for your time. We will explore nerve impingements and organic causes of groin and hip pain in future articles.

Dr. Michael K. Van Antwerp

Dr. Michael Van Antwerp is a specialty chiropractor called a Certified Sports Chiropractic Physician (CCSP). There are only ten CCSPs in Oklahoma, and he is the first one in Tulsa. He has trained with the top extremity chiropractic practitioners in the United States and has developed his own specific hip and shoulder treatment protocols. About half of his practice involves working with extremity issues. Besides athletes, he has a full practice treating a wide variety of patients from infants to seniors. He sees patients during pregnancy and treats a variety of pelvis and hip issues.

In addition to his chiropractic degree, he has the additional professions of Certified Strength and Conditioning Specialist (CSCS), Certified Pedorthist (CPed), and Fellow of the American Society of Acupuncture (FASA). He also has a host of certifications including Chiropractic BioPhysics (CBP), Kinesio Tape (CKTP), CrossFit Movement and Mobility, MovNat and Neurokinetic Therapy (NKT).

Dr. Mike became interested in chiropractic through injuries in martial arts. He later transitioned to marathon running and cycling. He is active in yoga and climbing. He works with a variety of coaches and trainers in town.

Categories
Jessica Wilkerson Mental Health Physical Health

Diary of a Fit Mom

By Jessica Wilkerson

I see you Mama… you have just received your new mama cape and have achieved a whole new level of “Wonder Woman “ status.

You’ve just carried a young one in your womb for 9 months, creating life, creating breath, and creating the precious little child you’ve been so meticulously chosen to care for. You’ve labored and breathed your way through contractions bringing you to bear down and bring your little one earthside. No matter if you were unmedicated, had assistance, or birthed your baby via C-section… your body has gone through a marathon.  Nine months of hormone fluctuations, bones and body parts rearranging themselves to make room for that precious baby have culminated on the joyous occasion of your baby’s birth day. 

Mama don’t rush this beautiful journey.

As new moms, we are put under a tremendous amount of stress to “get back to pre-baby weight” or to “get back to our pre-baby body.” Let me tell you, that body no longer exists. The minute you conceived, that “pre-baby body” started to fade away.

What you are left with, is a body that is capable of so much more than it was before. You grew a human, you birthed a human, and now your body is different.  Your “Mom bod” is beautiful, your “Mom bod” is strong and you need to care for it differently. 

When you think about that Mommy pooch you’re carrying around, don’t think of it as the last five pounds you need to lose. Think of it as the five pounds that are hanging on so that you can feed your baby and produce enough milk to help your baby grow big and strong.

Mama, don’t rush yourself to get back to that place you once were, you’ll have plenty of time to do that in the future. If you’re not done having kiddos, guess what?  You’re in for a whole new round of changes with baby number two. 

I’m not saying don’t take care of yourself.  You still have to eat right and exercise, so that you are at your best to take care of you and your family.  What I’m saying is don’t stress about this societal pressures that come from every direction.

Would you rather spend your time at the gym getting back to where you “once were?” Or would you rather spend that time with your precious new little one, getting to know his face, getting to know his cues, exploring each other and growing together? 

There are so many pressures to lose weight after your baby is born. Blogs, Facebook groups, postpartum posts all steer conversation to losing the baby weight. But I saw a post the other day on Facebook from Kindred Bravely that said, “Your rolls are their pillows” and it made me think… We are told not to rush the baby stage; to soak it all in. So why then do we worry so much about losing the weight?

Take it from someone who couldn’t wait to get back to working out once I had my son. I thought that the sooner I jumped right back in, the less chance there was that I would lose all the progress I had made before I got pregnant. But boy was I wrong…

I promised myself that I would wait a full 6 weeks before I started back. I promised myself that I would give my body the time it needed to heal. Fast forward to 2 weeks after I had my son, and due to circumstances as a business owner I was forced back into teaching group fitness.

At two  weeks postpartum I was teaching group fitness classes again. Not the place I wanted to be, not the position I thought I would be in as a postpartum Mama. I knew there was a chance I could injure myself and that I could potentially create bigger issues.

What I didn’t know was that starting back so soon; even if I was “taking it easy and not doing the whole class”, was causing me to delay the natural healing process my body should have been going through.

I had hemorrhoids (I know, the not so glamorous side of delivery) and slight pelvic prolapse. I found that these are not two things you want to take lightly. The pressure I was putting on these two areas of my body from the inside was tremendous, even if I did think I was taking it easy. My whole reproductive anatomy had gone through an earth shattering process just a couple of weeks before and I was asking my body to do things it was no longer capable of doing in my delicate postpartum state.

You may be thinking to yourself, what is a prolapsed pelvic floor and how do I know if I have a prolapsed pelvic floor? According to an article published by Crystal Run Healthcare, a minor prolapse may not cause symptoms. In fact, in many cases, a woman’s doctor may discover prolapse during a routine pelvic exam. If you do have symptoms, they may include:

  • A feeling of fullness, pressure, or bulging in your pelvis (many women describe this as a feeling of sitting on a small ball)
  • Feeling that something is falling out of your vagina
  • Difficulty with urination or defecation
  • Chronic constipation
  • Low back pain
  • Painful sexual intercourse and/or bleeding with intercourse
  • Discomfort while walking

Symptoms of pelvic organ prolapse often become worse when standing, jumping, or lifting heavy objects. There are also different stages of prolapse ranging from 0-4. A zero would represent a strong pelvic floor with no sign of prolapse, a four would indicate that the entire organ is outside of the vagina.

If you think you may have any level of prolapse, the first step is to get assessed by a professional, either by your doctor or a pelvic floor specialist. After you have been assessed and diagnosed, the next step would be treatment.

When seeking treatment, be sure you find a professional who knows a woman’s anatomy and can give you good direction on how to heal. If you suspect that you may have prolapse, contact someone in your area to assess you for an official diagnosis. If you are not sure of where to start or want to start on your journey to healing, book a consultation with Cassandra (our founder) here: https://square.site/book/RWSTPNNZR77YF/positively-balanced-llc-collinsville-ok

https://square.site/book/RWSTPNNZR77YF/positively-balanced-llc-Collinsville
Book now!

This a way that you can create your game plan and find out what you need to do in order to improve your health.

So Mama remember, there’s no hurry to get back to your pre-baby body. That version of you is a past version of you.  Now you have a chance to embrace the new you, the “Strong Mama” version of you.

Another great resource:

Founders Note:

As you read “organ falling out of the vagina” you might automatically visualize your bladder or rectum falling out . The actual prolapse is the organ pressing on the vagina which is what is seen upon diagnosis and what is felt when you might feel a bulge. Sometimes it freaks women out as they think their bladder is literally outside everything. It is not. More importantly to note, you can improve over the next 18+months post birth and see a major reduction in your prolapse. if you begin to rehab your body while giving yourself rest. – Cassandra