Throughout the 40 or so weeks of pregnancy our core weakens as the rectus abdominis slowly separates to accommodate the growing uterus and baby.  The separation happens in almost all pregnancies and is often viewed as functional since it allows for increased space to baby. As this separation occurs, unfortunately the core weakens - many women have a tough time engaging the rectus abdominis and deeper layers of the core including the transverse abdominis and multifidi. These muscles all work together in coordination with the pelvic floor to manage abdominal pressure and provide support and strength throughout the core as we lift, move and go about our day to day activities.  The weakness experienced can be even greater for women who experience a cesarean delivery, as the core expands and separates throughout the pregnancy and then experiences 7 layers of tissue being cut through for delivery. 

After getting MANY requests over this last year, Bespoke Physical Therapy is excited to announce a new specialty: Pregnancy, Postpartum, and Pelvic Floor Rehab!

If you aren’t familiar with Pelvic Floor PT, you aren’t alone.  Although this specialized care can make incredible improvements in quality of life, it has not been easily accessible here in Polk County (until now!).

Here are just a few things that Pelvic Floor Rehab can help with:

By the 3^rd trimester of pregnancy, between 66% and 100% of women will experience DRA, leading researchers to believe that this stretching is “functional” to provide essential room for growth.

We all know that January is for resolutions, but there’s no need to lose the ground you’ve gained while working with your physical therapist!  Below are a few tips that have helped my clients over the last few years.

Plantar Fasciitis is a condition that we commonly treat at Bespoke Physical Therapy.  These are the answers to the most common questions I hear, but if your question isn’t answered below, please don’t hesitate to reach out!

A warm up is often used before any type of physical activity in order to help prepare the body for the increased stress soon to be placed on it. A warm up should address multiple body systems including cardiovascular, muscular, and neuromotor. The great thing is that the pieces of a warm up are not mutually exclusive - meaning your muscular and neuromotor activities can be part of your cardiovascular warm up. When a proper warm up is performed some of the benefits include: 

1. Reduction of injury risk during activity 

2. Optimized performance 

3. Minimize pain for discomfort in cases of injury or chronic conditions.

Dry needling is a modality that is used, as part of a treatment plan, to alleviate pain and movement impairments. With this technique, a physical therapist inserts a thin filiform "dry needle” (a needle without medication) into areas of a muscle to stimulate underlying myofascial trigger points and muscular and connective tissues that would otherwise be unreachable.

The piriformis muscle is fairly small, and can easily become overworked if the surrounding muscles are under-active. For example, if the glute muscles aren’t working as much as they should, often the piriformis muscle picks up the slack. Over time the piriformis can become overly tight from this extra work which in turn can cause irritation of the sciatic nerve.

In general, a physical therapy can help stretch tight muscles, and strengthen weak muscles to help take pressure off of an arthritic joint. Ever heard of the phrase “motion is lotion”? This rings true especially with arthritis. Movement helps to lubricate even arthritic joints, by increasing synovial fluid within the joint.

People have strong opinions as to whether or not running is actually beneficial to our health. The phrase “Running is hard on your knees” is a favorite that we all have heard more than a few times (I heard it yesterday in fact). We know running has tons of global health benefits like reducing stress, decreasing depression, and weight loss, and that it is great for our heart, lungs, and brains, but what about for our joints?

After hearing this feedback over and over, I have decided to do something about it- implement a pre-surgical class series to fill this information void! This series of classes are called “prep talks” and are focused around answering the questions people commonly have, so that they can head into surgery equipped with information, or decide to give alternatives to surgery a try if they haven’t already.

Some people who get BPPV will have a resolution of their condition, only to have it return months later.  In my experience these people often report BPPV coming back perhaps every 6 months or every 12 months.  This return of symptoms in a cyclical manner may be caused by chronically low vitamin D.  Why is this?

In addition to the fun factor, according to a 25 year study with a thousands of participants (The Copenhagen City Heart study) there is a correlation between participating in racket sports, and increased life expectancy. More specifically they found that, versus the sedentary group, those who played tennis had an increase in life expectancy by 9.7 years and badminton by 6.2 years. Of note “health club activities” only added 1.5 years by comparison.

Arriving just in time for the new year, Bespoke is now the proud owner of the *best pilates reformer on the planet. With this addition, the clinic is now fully outfitted, and my vision has been completely realized (at least for now)!

What is a pilates reformer you may ask? It’s a piece of exercise equipment that uses springs and a rolling carriage to make a movement easier, or add challenge to a movement. Because of this versatility, I love it as a way to help my clients achieve their goals while keeping their comfort top of mind.

Dr. Gray, the lead author of this study, told Medscape, "We found an obvious dose-response relationship between anticholinergic drug use and risk of developing dementia: the higher the usage, the greater the risk.” Dr Gray continues that, “The pharmacist or doctor may not even know. Education on this issue is key, and both the public and doctors need to be encouraged to use alternative treatments where possible."

Question: Do I really have crystals in my ears?

Answer: We don’t actually have “crystals” in our ear, but we do have tiny pieces of calcium carbonate (sand) in our inner ears that are commonly referred to as “crystals,” Bonus info: Technically speaking, these are called “otoconia.”

When it comes to muscles, both length and strength are both important. When trying to improve muscle length or overall flexibility, here are some of the most common mistakes I see in my practice:

We are Moving- Downtown Bespoke Physical Therapy Office Opening August 1!

If someone has an issue that isn’t in my wheelhouse (for example someone who is experiencing incontinence, has had a traumatic brain injury, is experiencing TMJ dysfunction), I would much rather refer them to a local colleague than cross my fingers that what I am recommending helps. This doesn’t help my numbers in the short term, but in the long term building trust is far more valuable than pushing everyone into my door.

The following week, Angela returned and both she and her husband exclaimed that, for the first time in over 40 years she was able to now lay down without severe dizziness… or any dizziness at all for that matter! We both are overjoyed that she gave it a shot, and may have both even gotten a little teary-eyed in our elation.