Benefits of Yoga

Yoga is an activity that it seems everyone is either doing, has tried, or thinks maybe they should try. There are classes at gyms, formal yoga studios, hospitals, corporate offices, and even in the park when the weather is nice. There is a type of yoga for every person’s goals and hopefully a studio or teacher within a reasonable distance. Yoga has varied aspects: yoga can refer to a physical practice, a mindfulness or meditation practice, a spiritual practice, and a breathing practice. Yoga can mean a way of making choices throughout the day in order to strive towards more kindness and compassion.

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What are the benefits that keep students coming back to their practice, or that entice newcomers onto those sticky mats? While yoga is not generally cardio-intensive like running, biking or swimming, yoga can improve strength, increase flexibility, and improve coordination. And while getting the heart rate up through cardiovascular exercise is important, yoga has been described as improving the efficiency of cardiovascular system functions. Yoga has also been used to support the management of anxiety, depression, and insomnia. Many cancer survivors have found the practice to support not only their physical bodies, but also their emotional and spiritual experiences, leading to an improved sense of community and peacefulness. Combined with other forms of treatment, yoga can be very useful for managing chronic pain conditions.

The yoga practice has often been a tool to manage stress.

How nice is it to get on your mat, and for the duration of class to only be responsible for tuning in to how your body feels? Another gift of yoga is developing body awareness: what’s difficult, where do you feel tight or more flexible, and what’s actually happening with my 5th toe when I try to balance on one leg? Yoga can offer us the opportunity to learn about the body we inhabit and as we learn, we may be offered more choices about how we move and care for our bodies. A down dog may feel very different after a lovely Hawaiian vacation versus during a particularly stressful week at work. That’s so interesting because while it’s the same posture, maybe even within the same month, we can find each moment to offer a different experience.

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Yoga can help a practitioner gain focus.

Mindfulness is en vogue right now, and for good reason. Mindfulness is inherent to the yoga practice. “Be here now, feel what you feel at the present moment, tune in.” As much as yoga is mindfulness, mindfulness is in fact yoga, which means you can practice yoga anywhere, at any time. For example, you can participate in the practice of yoga when you take care of yourself when sick or injured simply by choosing how you place your body mindfully, how you interact thoughtfully with others, and by noticing how you feel as you heal. Mindfulness often lowers a person’s sense of irritability and reactivity to the daily stressors such as traffic. Mindfulness often leads to a sense of well-being, and being aware of your wellness can also reveal when you might benefit from further support such as from a health professional, a counselor or a friend.

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Making rest a priority is a healthy habit.

Our society is great at supporting productivity, striving towards goals, and living a full but sometimes overbooked life. What we often need help in making space for is rest. Doing nothing is really important, and an active or restorative yoga practice may help us rest more fully. Some folks like to have a practice on their own at home. Other times having a structured class environment is more successful because students can know that from 8am-9am its yoga time, the phone is put away, and the teacher guides the class, allowing the student to follow along. Scientifically, yoga helps us balance our nervous system and can lead to increased ease and relaxation, getting out of our “go-go-go” state. With increased relaxation, our bodies may experience decreased blood pressure, decreased release of stress hormones, and healthier gut function too!


If yoga sounds like it would be an interesting addition to your week, consider trying out different styles and teachers to find the best match for you. Sometimes the way the studio feels, or what kind of philosophy the teacher utilizes to frame the class can fit students differently. For example, you might prefer a quiet, private studio or a bright, upbeat environment. There is a practice for everyone, and that may or may not include the physical practice. If you are more interested in the mindfulness or meditative practices, finding a meditation workshop or meditation teacher is a good way to get started. Ask questions of teachers and studios to find the right practice for you, which might change or develop over time. To check out a yoga class at Flow, check out our scheduled (and growing) class list at
http://flowrehab.com/yoga.

New Year’s Reconstitution

The New Year, beyond the darkest day of the calendar, and when the days gradually increase in light, is a powerful time to reflect upon the 12 months that have past, and look ahead with renewal for the coming year. New Year’s Resolutions can be challenging, and if we don’t meet our goals, it’s easy to be hard on ourselves for not following through on sometimes unrealistic tasks. What if this year we tried a variation on the theme and focused on a different word: reconstitution? The word reconstitution has definitions including “building something up again” or to “restore to a prior condition”, to add water, or even to shift something into a different form. At Flow, we’d like to offer some thoughts and ideas for our 2019.

Instead of focusing on losing weight, emphasize gaining muscle.

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Increasing strength has a wide range of benefits including being better able to power ourselves out of chairs, off the floor, up the stairs or up a mountain. Strength training is becoming known for being one of the best ways to lose excess weight when needed, and to build confidence in daily movement. Some folks like to find small ways to fit strengthening maneuvers into daily life, and others like to move heavy things other than their body weight such as sleds, bike wheels, weights, or tires. Working with a rehab professional or strength trainer for a period of time may be the best way to gain expert advice for developing positive habits over time. 

Pick one body area that limits your activity, and seek help for that issue.

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There are so many wonderful ways to access health, and many philosophies and methods. If you have been told by a provider or by one group of providers that you have to “learn to live with it”, maybe it’s time to try a different approach. Ask your friends what worked for them, look up that one treatment that’s always intrigued you, find a local pain management class at a hospital, or maybe a nearby meditation class. If cost limits access to non-covered care, look for local colleges and training schools that may have student-run (and instructor-supervised) clinics, or free classes at local places of worship, community centers, or other gathering places. If you can overcome or improve one issue in your body, you may be able to move more, sleep better, and gain confidence that you are capable of healing. 

If something isn’t working, can you try something different?

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Maybe you’ve had poor sleep, or you keep trying to get back into running, or your usual daily routine isn’t creating your desired health. Consider adding in a nap, getting into a pool instead of onto the track, or changing up any aspect of health. A goal of returning to the things you love or achieving a desired health goal is terrific, and sometimes we need a different perspective when trying to accomplish such goals. If what you’ve been doing isn’t working, could you shift that focus for a short time, aim for a part of that goal, or talk to a friend or professional to see how you might approach the problem differently? It can be hard to see a new path towards something we’ve always expected our body to be able to do, or to see outside of our habits. 

Reconstitute your life.

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Do you need to drink more water? What a great way to hydrate your tissues, keep your nervous system happy, and make your bowel or bladder’s job easier (concentrated urine tends to make the bladder irritable.) When we are hydrated, we may be more likely to replace sugary or higher calorie beverages with water, and to not mistake thirst for hunger. Find a great water glass or mug, or even a water bottle that is both practical (easy to clean, has a built-in straw) and cheerful (think of stickers on Nalgene bottles, water bottles in your favorite team colors or great patterns) and try to keep that habit going. Beyond being hydrated, are there activities or hobbies you enjoy that have “dried up” in your life? Adding back in satisfying activities such as crafting, outdoor activities, projects, or reading, can make the activities that we feel we “have to” do all the more easy to accomplish because we also choose to do fulfilling things. Keep in mind that to build back in activities, you may have to schedule it so it can happen.

Be more gentle with yourself.

Being more gentle with ourselves doesn’t have to mean treating ourselves all the time, or giving in to the voices that keep us from endeavors that improve our health. But it might mean talking to yourself in the way you talk to a friend, and finding a way to be a cheerleader in your own life. Give yourself a pep talk instead of a scolding. Find ways to negotiate with those voices: “so I didn’t make it to the gym, but I can find an online video to do some exercises at home” or at the minimum not letting negative self-talk be the norm. Do talk to your body. Say nice things like “thanks body for allowing me to take that walk by the lake today” or “come on body, I know if we do these stretches, you’ll feel better in the morning.” When you “fall off” that wagon you hoped would keep on rolling, just climb back on and remember why you set your goals in the first place. Many of us have learned to say negative things to ourselves subconsciously, and it takes some practice to shift those words.

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We look forward to connecting more with our community this year, and reconstituting some of our own habits and goals at Flow. We hope you reach out to learn more about how you can improve your health and function, and take good care of your body for this new year we get to experience. 



















When Sex Hurts

One of the more common issues we hear about on a daily basis in the clinic is difficulty with sexual health and function. Sexuality is a broad concept, and sexual health relies upon many factors. When considering pain with sexual activities, it’s crucial to know that most issues can be healed and sexual function restored. Below are some common pain issues related to sexual health we treat in pelvic rehabilitation:

 

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Pain with arousal

 The mere physiologic function of having increased blood flow into erectile tissues (we’re talking about any gender here) can cause increased discomfort. Perhaps the muscles, nerves or tissues (including the vessels) are sensitive to any change in filling and pressure. Thinking about sex or feeling attraction can trigger such blood flow. This means that even a kind word whispered into a loved one’s ear or a gentle touch, even the thought of intimate acts can be painful. To emphasize this point, the pelvic area can become painful even before a person is ever touched. 

 

Pain with orgasm or ejaculation

With pelvic dysfunction, achieving orgasm can be difficult due to muscle tension, changes in blood flow or physiology, or even due to fear and worry about performance or pain. Orgasm is often associated with ejaculation, and either often involve some really intense muscle contractions. If the muscles involved are painful, or if the nervous system is too sensitive, what should be pleasurable is excruciating. The rhythmic contractions that often characterize orgasm or ejaculation (remember that ejaculation is not for men only) can cause severe cramping, making it challenging for the person to want to engage in sexual activities, or to even avoid achieving climax. 

 

Pain with positions limiting comfort

 A couple’s usual positions for engaging in sexual activities (or even new positions) may cause activation of tender areas in the thigh, cause a cramp in the hip, or lead to aching in the back or pelvis. A severe case of sacral pain can make any prolonged position challenging to tolerate, and can feel worse with any added motion or weight. General orthopedic issues like arthritis, a joint replacement, a torn hip labrum, or tailbone pain can get in the way of lovemaking or sexual health.

 

Pain limiting penetration

This is a really common problem. When the goal of the sexual activity is penetration of a canal, the opening or canal may be so tight, so tense, or so painful that the muscles and soft tissues do not allow for penetration. This can lead to frustration within relationships, more pain, avoidance of activity (or even avoidance of all sexual relationships) and may lead to harm if the person who has pain ignores the body’s tension. In the clinic it is not so unusual to meet a couple who has been trying to consummate a marriage for a very long time. 

 

Pain following sexual activity

Even when sexual activity is tolerated, some people describe increased pain or cramping, aching, even burning for several days and sometimes 1-2 weeks after engaging in sexual activities. It’s no wonder that a person might give up on engaging in sexual health activities when these types of pain are present.  

 

Pain limiting sexual health is very isolating, and not only within the relationship. Many of the people who come to the clinic describing limitations in sexual health think they are the only one to experience such challenges. When hearing that we in pelvic health work with people every day who have similar issues, this information can feel reassuring and hopeful. Some typical conditions that pelvic rehab specialists work with include sexual health following surgeries, in relation to cancer care, as part of healing pelvic pain, and for postpartum recovery. In all ages of life, from adolescent to adult, to older ages, all deserve to experience healthy and pleasurable sexual activities. This may include masturbation, or sex with a partner or partners, and the rehabilitation process may require a multidisciplinary approach. Knowledge from sex therapists or relationship counselors may be needed to bring about a return to healthy sexual activities.

 

Although pain with sexual activities is common in cases of pelvic dysfunction, other issues can be going on. Sometimes lack of healthy blood flow, difficulty keeping blood flow into the erectile tissues, or difficulty getting the increased flow out of the pelvis afterwards is difficult. Some folks have low arousal, have issues related to hormones, and some have neurologic conditions that affect sexual health. As part of a team approach, pelvic rehabilitation is essential in helping people recover. If you have questions about the care that could be included in your recovery, find a local pelvic health therapist, and find out more about how to optimize your sexual health.

14 Ways to Love Your Pelvis!

 

Your pelvis does so much for you, and much of the time, asks for very little in return. How can you give your pelvis and pelvic floor muscles a little more appreciation and attention? Read along to see a few of the many ways that you can love your pelvic floor.

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1. Give your pelvic muscles a squeeze!

When you contract your pelvic floor muscles (the ones that help you hold back gas or stop the flow of urine) you can protect against the forces created by a blasto sneeze or a strong cough. Think of this as good body mechanics for the pelvis! Similarly, if you are lifting something heavy, giving the pelvic floor muscles a gentle squeeze can help counteract the pressures from the strain of lifting.

2. Stop holding in your gut!

Did you know that when many people tighten their abdominal wall, other muscles like the pelvic floor can tighten too? Sucking in your gut unnaturally and for long periods can create too much tension and create soreness in your muscles from all of that clenching. This situation can make it difficult for the pelvic floor muscles to contract when you really need them, or rest and recover.

3. Go for a walk!

You don’t have to do high-intensity workouts to have many of the benefits of exercise. Moving your body by going for a walk gets your limbs, trunk and pelvis moving, your heart pumping, and keeps your pelvic floor active. Just about any exercise that you participate in will get your pelvic floor going, especially total body exercises like swimming, hiking, playing soccer or tennis.

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4. Don’t push when you pee!

Emptying your bladder should not require much effort from you. When you pee, your pelvic floor muscles are supposed to relax, and the muscles surrounding your bladder are the ones doing the squeezing. If you are pushing to pee, there might be too much tension in your pelvic floor or you might be in too much of a hurry! Slow down a little, breathe, and let it flow. 

5. Don’t strain when you poo! 

Let your pelvic floor muscles relax when you have a bowel movement too. Just like when you empty your bladder, the lengthening and relaxing of the pelvic muscles helps the body empty during a bowel movement. A little effort with a bowel movement is ok, but straining for long periods of time or with outrageous efforts can harm your pelvic floor muscles. 

6. Sit down on the toilet!

If you are hovering over the toilet, your pelvic floor muscles will not relax. See #4 and #5 for why this is important. If you *hate* public bathrooms, pack some travel size toilet seat covers in your car or purse, and use them if it helps you sit down. If you are accustomed to squatting or find that your legs dangle when sitting on a toilet, try using a small foot stool. Your pelvic floor will thank you. 

7. If it hurts, get help. 

If your pelvic floor muscles hurt when you try to tighten them, sit, have sex, when you are toiling, or during any other activity, talk to a healthcare provider. Getting a referral to a pelvic rehabilitation provider may be the first step in easing your pain. Although these issues may seem tough to talk about, rest assured that others area dealing with these same issues, and that you deserve to have any concerns heard.

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8. Check things out “down there.” 

How are you going to know what your genital area is supposed to look like if you’ve never checked it out? Use a mirror and see what your tissues look like. See what your pelvic floor muscles do during a contraction and relaxation! If you have questions, ask a healthcare provider for more information about what you see and what is normal for you.

9. Stop calling it “down there.” 

One of the healthiest things we can do for ourselves and for our loved ones is to stop calling our body parts cutesy, strange names or avoiding using the anatomy terms out of embarrassed or because that’s what we were raised believing it should be called. Your pelvic floor muscles, vagina, or testicles are amazing parts of your body with really cool jobs, and deserve to be properly recognized. 

10. Wear clothes that feel good. 

If you aren’t comfortable or can’t move well because of the clothes you are wearing, or if you simply don’t like how you feel, try changing things up! Some folks like boxers, some like briefs, maybe it’s thong versus granny panties. Do jeans feel restrictive or skirts feel best? Wear what feels comfortable, and choose fabrics that allow your body to feel good. 

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11. Drink plenty of water. 

Your body feels best when you are properly hydrated and when you are eliminating with ease. If you are dehydrated, your bladder can get irritated, or bowel movements can be painful to your pelvic floor. Keep some fresh water nearby and keep reaching for it! 

12. Have more sex.

Healthy sex keeps the pelvic floor muscles active, in addition to other terrific benefits to the body and soul. Whether you are having sex with others or solo, sexual activity can be a great part of a pelvic health regimen. If you would like to learn more about your sexuality, finding a sex therapist or counselor can be of great benefit.

13. Buy some new underwear.

You read that right- some new underwear. While they may not directly impact your pelvic floor muscles, when you put on some well-fitting underwear that still retracts after being stretched, life feels a little bit better. Choose some in your favorite color, or that make you smile when you pull them on- remember Underoos and the power of the underclothes?

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14. Find a pelvic health expert who lives nearby.

This last one is really important. When you feel confident that you are doing the right stretches, performing your Kegels correctly, or have a qualified person to help ease your aches, you’ve got a lifeline to some really intimate and valuable care. Even if you don’t need pelvic rehab today, keep in mind that at any age you or a loved one may benefit from expert care. 

What Keeps You Moving During Pregnancy?

Across any group of people, beliefs about physical activity and exercise habits vary greatly. During a pregnancy, many hope to be as healthy as possible, and may even choose to start a new exercise program. For those who already have an exercise habit, it’s common to want to continue with usual activity as able. Because every pregnancy is different from the next, and because the goal of a pregnancy is both a healthy mother and fetus, a person’s desire to be physically active may not match what is possible or best. For example, conditions related to nausea and vomiting, blood pressure issues, a cervix that softens too early, or health challenges in the mother or fetus can mean that rather than exercise, bed rest or light activity only is recommended.

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So what keeps women motivated? When their body gets heavier, when swelling and joint aches increase, what is it that helps a person keep moving? A recent research article (reference below) identified attitudes and perceived barriers for being active during pregnancy. The authors found that being tired, a lack of time, and discomfort related to pregnancy were barriers to physical activity during pregnancy. Discomfort included a range of symptoms from nausea to pain, or even a sense of "awkwardness" from body changes. The factors that aided in more movement included a belief in the value of improving health for both mother and fetus, goals of decreasing stress, increasing fitness levels, have social support and having access to pregnancy-specific programs. 

Social support was the most frequently cited interpersonal enabler of physical activity, particularly partner support and family/friend’s support.
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When pregnancy is complicated, a medical provider may tend to provide vague recommendations to err on the side of caution, and provide general information about modes of exercise such as “swim but don’t jog.” If more detailed information is desired, working with a person trained in pregnancy-related fitness and wellness may be needed. It’s always critical to follow a medical provider’s advice, yet unless that medical provider is with you when exercising, it’s unlikely you will have detailed guidelines on how hard to exercise or how to modify the activity in real time.

If body aches and pain are limiting your participation in physical activity, during or after pregnancy, find a rehabilitation provider who is trained to optimize your comfort and movement so you can stay as active as possible. The more active you are during pregnancy, the easier the transition may be from early postpartum recovery to increased physical activity.

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