Monday, January 16, 2017

Understanding the basics of flexion and extension

It seems that a recurring theme in my practice and general geekery of my life is explaining our society's tendency toward chronic flexion and how important it is to work ourselves out of said flexion.  So, this entry is dedicated to providing a basic explanation of common patterns of flexion and the counterpoint of the extensor muscles.

Our Daily Postures

Take a moment and really visualize how you hold your body as you go through your day.  
  • Making tea or coffee in the morning - your head is flexed forward and down, your arms and hands are held in front of you while you tinker out your beverage, most average sized persons are bent at the waist to get to the counter.
  • Doing your morning ablutions - again, bent forward with your head thrust forward and down, arms in front as you brush,  polish, and groom to head out of the house.
  • Driving or riding to your job/activity - sitting is all about flexion, everything is flexed.  The seats we sit upon are not designed for active humans, not sure who is designing furniture but I am convinced they are not human.
  • Doing your job/activity - Most of us have work that requires our arms, heads, hands, hips, knees, etc. are all flexed (or bent toward the center - belly - of our body).  There are always exceptions, surfers for example.
  • Phone and computer activity - humans tend to lean in toward the bright light of the screens, again bringing ourselves into gross flexion.  And now, our thumbs in particular are spending more time than any other in human history doing a whole lot of flexion.
  • I think you get my point....
The result of all this flexion is distortion in posture, dysfunction of soft tissue, skeleton, and nervous system, and what makes most of us head to the doctor, pain.  So, what do we do?

Changing Our Habits - Relearning Extension

In order to combat the chronic flexion of American life it is imperative we start to look at how we move and stay stationary in our day to day activities. nonjudgemental toward yourself.  Postural habits can be very challenging to change.  For the average person, it takes about 6 weeks, before the new habit becomes old habit.  When we ask our bodies to change, not only are we re-educating the muscles and soft tissue, but we are re-educating the central nervous system (CNS).  This takes time and patience.  Why extension?
Extension is the opposite of flexion.  Extension is vulnerable, extension is powerful, extension is counter to how the modern world is set up.  So, we have to work harder to make extension happen in our everyday lives.  How do we do this?
Stretch.  Strengthen.  Move.  Change.  As always, easier said than done.  There are so many great methods out there to relearn how to stretch and strengthen.  Pick what is right for you, select something that fits into your life style.  Go take a few classes, do some reading, find a buddy to do it with, but most of all...have fun!!!  Here in good ol' Minnesota metro area, one of current favorites is Restorative Exercise.  We have a few excellent trainers here who can meet with you one on one, or in a workshop setting.  They customize the routine for your body and habits, the rest is up to you.  You do your homework at home, and then if you want/need, come back and check in with your trainer.
Movement.  Movement is hard in our sedentary world.  It's a lot of hurry up and wait.  Drive and wait.  Walk and wait.  Well, while you are waiting, there are so many subtle and not so subtle things you can do to work out as you wait.

  • Pelvic floor exercises in the car, standing in line, waiting in a office.
  • Standup and stretch, your waiting buddies will be jealous and may join you.
  • For the adventurous, why not some burpees, mountain climbers, jumping jacks (be fit enough to do these so you don't hurt yourself).
Fit4Mom  teaches really fun classes in public open air spaces that helps you get comfortable with movement in public.  It's worth checking out, plus, you can bring your little ones to the Stroller Strides classes :-)
Change is hard. You don't have to do something big, start small.  Get up from your desk every 45 minutes and reach for the sky, do a few lunges from your chair, walk around the office the long way, park farther out in the lot, instead of sitting down in front of Netflix - reach for your toes or try some gentle yoga.  There are a million ways to help your body out of flexion and back into it's upright posture.

I hope this was helpful.  Remember, nothing here replaces medical advice from your providers, and this is not medical advice.  The information here is from experience, education, and love of the human body.  Be smart.  Be safe.  And remember, extend yourself in a healthy way.


Tuesday, October 13, 2015

You have a breech...

This phrase can make so many women's/pregnant people's hearts sink, stop, and break.  Especially if they are planning a natural vaginal birth.  Since the Hannah Term Breech Trial in 2000 vaginal breech birth has been struggling to find it's way out of the dust bins of memory.  The Term Breech Trial was declared false by Dr. Hannah, by the way.  Since then, we have been fortunate to have many dedicated obstetrician's, midwives, and nurses studying the reality of vaginal breech birth.  The results have been favorable.  But that is a blog for another day.

Today, let's talk about what to do when you hear this phrase from your provider.

Don't Panic

There are several non-invasive, low risk modalities to encourage a breech to go head down.  Experience shows that integration and dedication gives one the best chance to go from breech to head down.  Get your providers to talk to each other and work out a plan that fits your needs and lifestyle.

Start Early!

Start working to get your breech baby head down as soon as you find out.  Do not wait until 36 or 37 weeks gestation.  Often, and especially in this day and age, babies are malpositioned due to stress on the body structure.  People spend a large amount of time in flexion, slouched, only using one side of their body, and so many other habits that contribute to soft tissue imbalance in the body.  A great way to start at home when you are waiting for an appointment to be available is Spinning Babies.  Gail Tully, the Spinning Babies lady, has compiled a series of exercises to do at home, some by yourself, and some need a partner.  Continue integrating the Spinning Babies techniques with any other modalities you choose.

Find a modality that works for you

What a great time in herstory to be out of balance!  There are so many great practitioners in the world who are masters at their craft.  So, which ones are good for helping a breech go head down?

  • Acupuncture - find someone experienced with breech.
  • Chiropractic - be certain your practitioner is certified in prenatal care.
  • Hypnosis - works very well for many people.  Hypnobirthing and Hypnobabies have turn your breech tracks.
  • Massage - ideally the massage therapist needs to be certified in prenatal care.
  • Movement - Keep moving.  What ever that looks like for you.  If you need something more directed Restorative Exercise is a great choice for alignment.

Stress Reduction

Everyone has stress, but it seems more so pregnant people.  Which birth class do we go to?  Are we going to make prenatal yoga everyday?  What kind of diapers?  Hospital, Home, or Birth Center?  Doula or no? (Get a doula!) Shots? Circumcision? Food?  And then if you have a breech....Which modality do you choose?  Do we try an external cephalic version?  (More on that in a moment.)  Do we schedule a c-section?  Oy vey!!! The decisions are endless!!!!  Step back, evaluate what is important to you.  Take quiet time for yourself and tune into your intuition.
Talk to your baby.  Really.  Your baby will tell you what they need.  It's a matter of creating space to hear baby.
Next, delegate.  Ask for help.  Simple things, laundry, meals, cleaning.  Those are all things that people in your community can easily do and help with.  Go do something fun with your friends!  Have a date with your partner!  Doing activities that make you happy and boost your oxytocin do the same for baby.  When you relax, so do your soft tissues.

External Cephalic Version (ECV)

So, you have tried everything, and baby is still breech.  The next step is an ECV.  ECV is done by an OB/GYN or midwife in the hospital.  You will be put on a monitor, an ultrasound will be done to confirm baby's position, and then you have a few choices.  There are medications that can soften the uterine muscle to make the ECV easier.  This reduces the uterus' ability to contract.  An epidural can be used as well for the same effect.  Or you can choose no medication.  The provider doing the ECV can tell you the risks and benefits.  Make sure you ask!  And don't let them tell you there are no risks, there is always risk.  Baby is monitored between each attempt by the practitioner.  So, what is the practitioner doing?  They are trying to turn the baby from breech to head down by pushing on the baby.  Is this risky?  According to the National Institute of Health, there is a 2% risk that something will go wrong.  What is the rate of success?  50% success rate, again according to the National Institute of Health.  Those are pretty good odds.  Find a practitioner who has LOTS of experience.  ECV should be gentle.  It should not be painful.  It is uncomfortable, but not painful.  Now, you may be asking, "But I spent all of that money on the other modalities!  Why am I ending up here?"  Often, my clients say their ECV went so well, baby turned on the 1st or 2nd try.  Practitioners believe this is from the preparation of the soft tissues before the procedure.

Remember, baby has the last word

Sometimes, baby will choose to remain breech.  There is usually a pretty good reason for this choice.  Please explore the literature, scientific literature, stay off the message boards, to find out common reasons for breech.  Today's blog entry explores the soft tissue and bodily restrictions we face day to day.  Physiological reasons are a whole other topic.

Vaginal Breech Birth (VBB)

In the United States this is a scarce option.  There are few who admit to having the skills and even fewer who will attend.  Recent studies, coming out of Brussels, Germany, Australia, England, and Canada, have shown that VBB can be as safe as head down birth.  There are many conditions that need to be present for a safe VBB.  Many VBB practitioners agree that a Frank Breech is the best candidate for vaginal birth.  This where the feet are piked up by the face.  But, the baby also needs to be facing the right direction, RSA - Right Sacrum Anterior.  (Go to Spinning to learn what that means.)  The providers attending the breech need to be experienced in breech and trained in what to do if baby needs a little assistance on the way down.  In general, and hopefully a majority of the time, all hands off the breech.  Hands off the breech has been found to be the best approach across the board in all country's where VBB is practiced.  The person giving birth should be allowed to move freely and be in whatever position they find best for them.  More often than not, breech parents find themselves on hands and knees to give birth.  Breech babies can be born vaginally, safely, and into loving arms.

Cesarean Section

There are times that cesarean section will be the best choice for mother and baby.  Sometimes it is the safest medical route, sometimes it is the best choice for the family, and sometimes the baby will choose cesarean on their own.  What ever the reason it is of utmost importance that families who choose c-section for their birth be supported and not shamed.  Not questioned endlessly about, "Well, did you try this?  Did you try that?"  It's not fair to put anyone through that line of questioning.  I have heard too many sad stories of parents feeling ashamed and unsupported for their decision to have a c-section.  Those parents need as much support, if not more, than families choosing a vaginal delivery.  Cesarean birth has become gentler and more family focused in the last year.  For this, the natural birth community is grateful.  I'm sure the medical community is grateful as well, but I don't dwell there often.  Cesarean is birth too.

I hope you find this entry helpful in your breech journey.  Best wishes!

Disclaimer:  This is not medical advice, not meant to substitute or replace medical advice.  All information is shared in the spirit of returning lost knowledge to the people.  If one is in doubt as to whether anything here is appropriate, ask a provider.

Sunday, October 11, 2015

Stabilize Your Pelvis

Having low back pain?  Are you getting shooting pain down your legs?  Soreness in your tush?  Achiness in hips?  Is one leg shorter than the other?  Pubic bone pain?  Incontinence?

All of these issues can be traced to soft tissue imbalance in the pelvis.  An unstable pelvis can cause so much pain and discomfort in pregnancy, and out of pregnancy.  Here I will share suggestions made and collected over the years to help stabilize the pelvis.

"The Granny Swing"

I LOVE this one!  It's so simple, easy to do, and almost everyone can do it.

  • When getting in and out of the car, keep your knees and feet together.  Sit on the seat first and then swing your feet in/out together.  
  • When getting up and into bed, swing your legs together.  If you need help, ask your partner.  
  • When getting in and out of a chair, keep your knees and feet together.  Plant your feet on the ground before you take off a toddler or errant four-legged child.  

"The Shimmy"

This move is exactly what it sounds like.  My wonderful belly dance teacher, Anna Melzer, taught me this one.  It is best done right out of the shower.

  • Stand with your feet under your hips.
  • Make sure your knees are soft.
  • Quickly shake your bottom from side to side.
  • Keep your gluteals as soft as you can.  The softer your glutes the better the shimmy.
  • When you can hear your skin slapping together, you're doing it right!

Why do we do this?  When muscles are stimulated like this it wakes them up.  Literally.  There are nerve receptors (motor gamma neurons) that are stimulated to help allow the muscle to relax enough so it can contract in a more efficient manner.

Roll It Out

Here we are using a tool to apply self massage.  Grab a tennis ball, a small yoga ball, a Miracle Ball, a foam roller, what ever you have at hand, place it on an area of the pelvis that is tender, sore, tense, uncomfortable and roll out the discomfort.   Be gentle, go slow, keep yourself stable.  This is a common sense tool.  If it hurts, don't do it.

Spinning Babies

I would be remiss not to list this resource as well.  I have found Spinning Babies techniques useful for pregnant and non-pregnant people.  Using the Three Sisters (Balance, Gravity, and Movement) to loosen the soft tissues of the abdominal and pelvic cavities is one of the best approaches I have found, personally, and in practice.  Check out the site and have fun!

Get Some Bodywork

An obvious suggestion coming from me.  Bodywork can be any number of modalities.  We are fortunate in the Twin Cities to have a plethora of talented and dedicated practitioners in the area. Here are some of my favorite modalities:

There are so many great ways to get help to balance your body.  Be kind to yourself and your body.  Explore what works for you in your life style.  Pelvic stability improves your core functions, alleviates pain in the body, and for those who are pregnant - an improved chance for baby to be in an optimal position for birth.

Have a great week!

Disclaimer:  This is not medical advice, not meant to substitute or replace medical advice.  All information is shared in the spirit of returning lost knowledge to the people.  If one is in doubt as to whether anything here is appropriate, ask a provider.

Wednesday, October 15, 2014

Loss and Grief in Pregnancy

Today is the first blog I have written in a long time.  Life and work have kept me away from the keyboard but today is a day I want to honor for myself and so many of my friends.  Today's entry is dedicated to all families who have experienced the loss of a pregnancy.

How many children do you have?
For 3/4 of families this is an easy question.  Their children survived pregnancy and are thriving in life and will hopefully continue on to live productive and happy lives.  For 1/4 of families this is a much harder question to answer.  Some have experienced the loss of a pregnancy, some have experienced the death of their babe or child.  Upon reflection over the last month I am having difficulty deciding which is worse.  Currently, I feel they run in equal course.  
Our society has trained us to only mention the children people can see and touch and hear.  I am beginning to see that this is detrimental to everyone for so many reasons.  Death is a certainty.  Death of a child is horrible and traumatic.  Why are we asked to keep loss quiet?  Why are asked to not discuss death with our villages more openly?  What is it that has made the subject of loss so hard for humans to face?  Yes, it hurts.  Yes, it is uncomfortable.  Yes, people handle loss in so many different ways but I know too many who feel so incredibly isolated by their loss.  Some even feel shame.  Loss of a pregnancy is very rarely the fault of the family.  Nature is a cruel mistress at times.  

Well meaning advice can hurt.
It's for the best.  The child is in a better place.  You can always have another.  And on, and on it goes.  Please be mindful of words meant to be comforting.  Often those statements only make grief worse and leave the family feeling they cannot discuss their feelings of grief.  Acknowledge what they are feeling, sit and quietly listen to tears, anger, rage, disappointment, and the cornucopia of other emotions that come with loss.  Keep conversations open ended.  And know that sometimes a person just needs to sit in silence with another person.  

A request.
I would request that if you have suffered loss reach out and gather those to you that build you up and can make you whole again.  Let your community know.  It's okay.  Light returns, sometimes it just takes so much longer than we want it to take.  I request of the community and society that we don't make so little of pregnancy loss.  It hurts, deeply.  Find your compassion and empathy - pass it to the person who is saying, "Oh, it's no big deal.  It happens all the time."  Well it does happen all the time and it is a big deal.  But they don't know that.  We need to share that pregnancy loss is just as difficult as loss of a child.  Compassion, love, and a good ear for all parties can help heal the losses and rift of misunderstanding.  

I am grateful...

for my two beautiful children and the experience of two pregnancy losses in my life.  The great wheel of life has kept it's balance for me and shown me the greatest of joys and the deepest of sorrows.  I am fortunate and privileged to have the resources and community to hold me up in times of both occasion.  I wish this kind of generous support for all families in times of joy and times of loss.

Now go outside and enjoy the beautiful day!  

Humbly yours,

Disclaimer:  This is entirely opinion.

Tuesday, August 6, 2013

Massage, Bodywork, and the Cesarean Section

I am thrilled to be presenting at this months International Cesarean Awareness Network meeting on August 12 at 630 pm in Minneapolis.  The meeting will take place at Holy Cross Lutheran Church, 1720 E. Minnehaha Pkwy, Minneapolis, MN.  I will be talking about the benefits of massage and bodywork in preventing a c-section and also what can be done after a c-section.  Today I am going to give a little over view of what will be talked about and what we will be doing on the fine Monday evening.

The Cesarean Section and the Woman's Body

When women are asked (and often not asked) to undergo c-section it is rarely explained to them that the procedure is major abdominal surgery.  It is rarely explained to them that the scar tissue is not only superficial in the skin but can potentially form deeply into the abdominal and pelvic cavities.  Too often women are not fully informed about this everyday surgery that is performed, sometimes unnecessarily, sometimes lifesaving, and what the long term ramifications will be in their lives.  Surgeons are not leaving out soft tissue information out of malice or even ignorance - simply because they don't think about it.  Traditionally trained medical doctors in the United States rarely consider that scar tissue lays itself down in a random pattern, nor do they think about how this random pattern will effect the function of muscle, tendon, ligament, bone, and organs that are near the scar tissue.  There main concern is keeping everyone alive.  Now that being said, I have met a handful of fantastic surgeons that do indeed think about these things are very careful about when and why they cut and whether or not they are cutting into previously formed scar tissue.  So please, understand I am talking about surgeons that slice and dice to get their share, and I truly feel this breed of surgeon is becoming more rare.  I guess I'm an optimist.

The Scar

There are many different shapes, sizes, and thicknesses of scars.  My own mother has a "zipper" scar from her pubis up to her navel from two c-sections.  It has caused her physical, emotional, and spiritual pain for many years.  I have also seen the tiniest, faintest scars just above the bikini line that never caused a days discomfort.  I give you these two extreme examples to show that there is a broad spectrum of what the scar can manifest in women.  Let's talk about the physical scar.

Scar tissue is the body's way of quickly healing itself when there has been a violation to the skin or deeper tissues.  When scar tissue forms it does so in a random pattern.  It is not striated like muscle tissue, nor does it have a predictable pattern.

The above is an image produced by BodyScientific International.  You are looking at a micrograph of the random  pattern that scar tissue creates within the soft tissues.  When this random pattern is mixed with the predictable patterns of non-damaged tissue in the body a few different things happen.

  • Reduced Range of Motion (ROM)
  • Possible Pain with Motion
  • Possibility of Micro-Tears forming in the surrounding tissue
In the past manual therapists have been taught to apply deep cross fiber friction for several minutes over the scar tissue fibers with the claim that this alone will realign the tissue.  I personally have never found this to do much other than cause inflammation and pain.  I was fortunate in my quest immediately after graduating from massage school that I found James Waslaski.  The following three years I devoted my study to his techniques and learned from him that scar tissue requires multidirectional friction to address the random pattern of lie in the tissue followed by pain free movement and eccentric contraction of the muscle the scar tissue is present in.  Waslaski has revolutionized the field of massage therapy with this gem of a technique.  The really cool part that has not been explored, at least to my knowledge, is that even when the scar is present in organs, which are involuntary muscles (that means we do not consciously control their movement), the organs will contract with the scar tissue having been realigned in the soft tissue surrounding itself and hopefully take the hint and realign the tissue within itself with the automatic contractions that organs go through every minute of every day.  Part of the reason I believe this is possible is because of the fascia.

The Fascia

Fascia is a delicate yet strong fibrous net that runs throughout the human body.  It is helps maintain the form of soft structures, create lubrication between those structures, and when it is injured is plays a big role in letting us know that there is damage to an area.  The fascia connects and separates simultaneously because of its nature.  When there is a scar in the area the fascia is compromised by reduced blood flow and having its net structure disrupted.  Recently, scientists have discovered that fascia carries nerve receptors that communicate pain to the body (nociceptors) (Tersarz, et. al. 2009) and it contains contractile fibers (Schleip, et. al. 2007).  When the soft tissue is damaged by a cut so is the fascia.  Fascia surrounds our fat cells just below the skin, surrounds the muscle, tendons, organs, ligaments, separates the cavities of the body, and then it is also present microscopically gently supporting each fibril of muscle, each whisp of periosteum.  So you can see that when the body is cut, this dynamic web that helps to hold us together can get damaged and cause great pain not only in the area where visible damage is, but it can also cause pain in areas that may completely mystify you.  Think about what happens when you pull one strand from a spider web.  The web folds in on itself and those intricate patterns are changed.  It is the same concept with the fascia when it is cut or damaged.  The damage will reverberate throughout the body.  The following is one of my favorite youtube videos of the fascia.  It shows the net/web of fascia magnified 25x and explains what you are looking at.  It will help you understand how interconnected the tissues are in the human body.

The Recovery

Recovery from a c-section is as different for every woman as birth is.  No one is the same but everyone shares the common bond of the incision.  It is important to keep in mind that soft tissue has a memory.  Every event of your life is stored in your body.  Sometimes our mind remembers it and sometimes an event has to be stored elsewhere until we are strong enough, ready enough, sure enough to let it out, let it go, and accept the event for what it brings to our life experience.  Christine Courtois, Ph.D., states that  "Although the victim may make a psychological escape, the body is left 'holding the bag,' so to speak."  She is specifically speaking of sexual abuse victims in this quote but the statement has been found to be true for all types of trauma to the body.  The next point I would like to make about recovery is that it si a continuous journey.  As our body travels towards optimal health and rebalances itself, leaving us feeling great for a time and then suddenly we will fall back again, to need another guiding hadn to move us farther along our journey to health, whole health.  Working with several practitioners in various fields can help speed the recovery from an unwanted c-section.

Prevention of Cesarean Section with Massage and Bodywork

Before I begin this section I want to make it clear that not all c-sections are preventable.  Circumstances will arise that necessitate the intervention of a c-section.  Barring those circumstances, this is what you can do to try and prevent a cesarean section.  
First, get a doula.  Simply having a doula present at your birth lowers the incidence and need for interventions (Hodnett, et. al. 2011).   Better yet, find a doula that has Spinning Babies training.  You cannot start too early using the techniques that are found at Spinning Babies.  They help you learn to use Balance, Gravity, and Movement to get your body ready for the big day.  
If you are having pain, discomfort, or difficulty moving find a practitioner in a modality you are comfortable with, that you trust, to help you resolve those issues.  Again, the sooner you begin addressing those issues, the better.  Who are these practitioners?

  • Chiropractors
  • Acupuncturists
  • Physical Therapists
  • CranioSacral Therapists
  • Massage Therapists
  • and many more....
Ask your friends who they like and go from there. 
Why shouldn't I just grin and bear the discomfort?  Why spend the money?  Well, having your body balanced before you are late in your pregnancy and it is more challenging to redirect soft tissue will make your pregnancy more comfortable, your labor potentially easier, and potentially reduce your risk of cesarean section.  
Next, regular, fun, enjoyable exercise.  Whatever you conceive that to be, that is what you need to do everyday.  Maintain your strength, increase your endurance, but most of all - have FUN while you exercise!  It is good for you and the baby.  
And of course all of the other goodies your prenatal provider advises for you - good nutrition, restorative rest, regular check-ins with said provider.  

Communication, Collaboration, and Integration

To take a genuinely holistic approach to the healing process it is important to be open with the people you employ to guide through your healing journey.  And yes, I mean your medical doctors too.  Everyone needs to be on board with what is right for your experience.  You have the right to get good information on the B.R.A.I.N.N. of your course of treatment.  What is B.R.A.I.N.N.?

  • What are the Benefits of this treatment?
  • What are the Risks of this treatment?
  • What are the Alternatives to this treatment?
  • What does my Intuition tell me about this treatment?
  • What happens Next if I proceed with this treatment?
  • What happens if I do Nothing?
I first learned of the acronym from the Childbirth Collective in Minnesota.  I have found it to be useful not only in birthing situations but in any situation.  This is where your Communication begins with your providers.  It is your responsibility to get the information, learn it, and make a sound decision about your care for recovery.  Once your have taken those steps ask your providers to Collaborate.  This opens Communication between disciplines and will make the road to recovery easier for you.  And finally, Integration - don't be afraid to tell your general practitioner that you went to see a Reiki Master, or a Reflexologist, or a spiritual helper.  Everyone involved in the recovery process needs to understand that the scar you carry goes deeper than the tissue.  Everyone involved will step up and follow the course of Communication, Collaboration, and Integration if they are allowed.  You get to be the CEO of your care for your scar.  Everyone else is just a guide to remind your body, mind, and spirit where it wants to go to recover from the scar.

I hope you can join us Monday the 12th for a live version of this post.  I will also be demonstrating and teaching some self-care techniques for those who have scars that are uncomfortable.  

Rebalance, Renew, Rebloom

Source List:

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. Continuous support for women during childbirth (Review). The Cochrane Library, 2011, Issue 2, p. 13, 57

Schleip R, Klingler W, Lehmann-Horn F 2007 Fascia is able to contract in a smooth muscle-like manner and thereby influence musculoskeletal mechanics. In: Findley TW, Schleip R (eds.) 2007 Fascia research – basic science and implications for conventional and complementary health care. Elsevier GmbH, Munich, p.76-77

Timms, Robert, Connors, Patrick, Embodying Healing: Integrating Bodywork and Psychotherapy in Recovery from Childhood Sexual Abuse.  Brandon, VT: Safer Society Press; 1992. p. ix.

Tesarz J 2009 The innervation of the fascia thoracolumbalis. In: Huijing PA, Hollander P, Findley TW, Schleip R (eds.) 2009 Fascia research II – basic science and implications for conventional and complementary health care. Elsevier GmbH, Munich, p.37

Friday, June 21, 2013

A Mama-story of how her practice morphed

Happy Birthday Turtle Man!

Two years ago yesterday I birthed my little boy with a fantastic team of providers and my husband.  My son’s conception changed how I handled my pregnancy, gave me the gift to see how small changes in the everyday pregnancy can affect the outcome at birth, and motivated me to follow through with a wish and conversation had in a NICU under his big sister’s isolette.  Today I am going to share with you what the changes were, the gift he gave me and my family, and a peek into the wish and conversation.

Conception and Change  - A Second Chance for a Better Birth

As most readers will know, my daughter’s birth was full of excitement, trauma, and a journey we never expected.  She was a breechling who surprised us with her sensitivity to birth and her amazing resilience for recovery.  Here is a link to her birth story.  Bruce, my husband, and I, had initially planned to have our children 14 months apart but Miss. Magnolia wanted a little more space   between   herself and her sibling.  So, when Bruce and I finally got up the courage to have the discussion about getting pregnant again, I think we accomplished it the same night. ;-)  We agreed that I would get time and support to tandem nurse as long as possible, be able to go to yoga as often as needed, get counseling, and receive chiropractic and massage as often as possible.  We were determined to repair my pelvis and create as much space as possible for Baby 2 to be in a head down (vertex) position, and hopefully occiput anterior – for the geeks out there.
My eating for this pregnancy changed immensely from Magnolia’s pregnancy.  I ate what I wanted, when I wanted with as much protein as I could ingest.  During my first pregnancy I took everyone’s “advice” about, oh don’t eat that it has too much fat, don’t eat this it might cause blah, blah, blah.  I didn’t know any better.  This time around I learned a girl has got to eat.  So, lots of trail mix, avocados, and wild caught and organically raised meats.  A HUGE THANK YOU to Jack Bull for the deer and Robin and Gigi of the Nitty Gritty Dirt Farm for the organic foods.  It nourished the little Turtle Man and me. 

Our next big change was our birthing method.  We had used Birthing from Within for our first, and this time we took Bradley Method from Karen Bruce.  Bradley was an excellent method for my concrete thinker of a husband.  He walked away from the classes feeling like he really, finally, understood what labor and birth looked like. 

An aside:  I think it is important for everyone to find the birthing class that fits their needs.  There are so many wonderful techniques out there.  To name a few… Hypnobabies, Hypnobirthing, Lamaze, Calm Birth, and I am certain there are a multitude of other methods out there.  Research them, pick one, and invest in taking a class that goes beyond the weekend crash course at the hospital. 

Our friends Pete and Terri graciously took little Magnolia for us to be able to take the Bradley classes.  Thank you so much for giving up your Tuesday nights for 10 weeks.  This leads me to the next change.  Ask for help.  When your friends ask, “What can I do for you?” tell them.  Raising children really does take a village.  On the other end, after you have gotten your children out of babyhood and into toddlerhood, you can pay it forward to the next generation of family that needs support.  We have heavily relied on our friends to help us out with childcare and support.  This made it possible for me to stay home with the both kids for three months after the Turtle Man’s birth, a great gift to Bruce and I, and especially the children. 

Back on track, I get easily distracted.  I started going to yoga every Sunday, with Clare Welter, at about 12 weeks.  Very little deterred me from going.  I felt my body become stronger, my pelvis became more stable, and my endurance was getting better.  In the last month to month and a half I added yoga classes at Blooma because I wanted a workout that would build more tone and really push my endurance.  Thank you Sarah Longacre for the fun, juicy classes!  In addition I was getting out for long walks as often as possible.  I really was feeling much stronger and more prepared.  Squatting was my life! 

The Team:
Bruce and I agreed that planning a homebirth again would probably put us over the edge.  What if the Turtle Man had an unknown disorder like his sissy?  What if something odd happened during birth again?  All the usual questions filled with anxiety.  We agreed that Denny Hartung would help with the birth of our second.  He was so wonderful and respectful taking us on so late in our last pregnancy, we could hardly imagine birthing with another OB.  Besides, as we all know, he is the gold standard for hospital birthing care in the Midwest.  Denny was the only team member from our last birth we kept.  I spoke at length with Magnolia’s doula, Vanessa Plantenberg, and we both agreed it would be alright for me to use a different doula.  So Bruce and I settled, almost immediately, on Sarah Biermeier of Genea Birth – who is now a fantastic midwife!  Sarah was a great fit for us and it turned out that our Bradley instructor Karen Bruce was her back up.  It could not have worked out better. 

My complimentary care team changed as well.  Amber Moravec, D.C., of Naturally Aligned Family Chiropractic did my adjustments for me throughout the pregnancy and postpartum.  We had delightful and informative conversations about chiropractic care.  Magnolia fell in love with her too!  We miss Auntie Pop!  My massage therapist was Gina Potgeiter – colleague, friend, and amazing therapist.  It was so nice when I did get to see her.  Busy schedules make for difficulty in scheduling, but when you make these appointments hold them like a dental appointment.  And my ever patient counselor, Maureen Campion, guided me through the anxiety of this pregnancy, helped heal some of the guilt from the last birth, and made me feel more empowered to be able to have the birth I wanted.

The unsung hero of this pregnancy, of course, is Gail Tully.  I followed her around like a puppy learning as much as possible about BellyMapping and reading up on Spinning Babies.  I was religiously doing the Spinning Babies techniques and going to every workshop she had in the cities that spring.  She graciously palpated my silly tummy every time I asked, answered my incessant questions, and assured me this little guy was head down but occiput posterior – sunny side up.  

 I even got my belly painted by her and my belly graced the first pair of testicles she drew on a mama belly!  I LOVE that!  It was perfect because Turtle Man was direct OP so it was meant to be, and we knew he was a boy.  

Our co-madre relationship was born after a Belly Mapping workshop at Blooma in the parking lot.  I will tell that tale a little later on.

The other part of this pregnancy that was vastly different from the first was that we kept the prenatal appointments to ourselves, left the family out of the loop, and firmly decided that no one would be contacted in the last few weeks of the pregnancy until 24 hours after the Turtle Man arrived.  Well, Turtle Man surprised us with arriving three weeks before his estimated due date, the night before Sarah was supposed to leave on vacation.  I still feel a little bad about that. 

How did the labor and birth go?  Fast!  Water broke all over my beloved, aged dog West who just looked up and went back to sleep.  And the contractions started at 4 minutes apart and 30 seconds long and increased to 3 minutes apart, 1 minute long in a half hour.  Of course it was 2 am.  When else does this happen?  Magnolia got picked up by a good friend, Sarah arrived and started pushing on my sacrum – posterior babies make for some incredible back labor, and Bruce, well Bruce was packing and trying to wrap his head around being awake before 9 am.  Once I was dressed and had my contacts in, I decided I didn’t want glasses on during labor; I hustled outside to get in the car to head to Hudson – from South Minneapolis.  I will never forget the 430 am air, cool, crisp, loamy, earthy, lovely smell.  If I had been near the woods I would have marched in, found a pool, and birthed there.  Sarah pulled around in her van, fresh from the API camping trip, Bruce was not exiting the house quickly enough for me so I got into Sarah’s van and we headed east.  (Turns out the van was almost out of gas, I am told we arrived on fumes.  Thanks for holding the faith Sarah!)  I got on my knees in the front seat, used the dash as a counter pressure on my sacrum for contractions, and Sarah navigated us out to 94.  I distinctly remember when the Turtle Man turned to occiput anterior.  I had a very intense contraction, we had just crossed a river, and I felt him rotate and drop.  I have to say being more aware of your pelvis for the second birth is phenomenal and exciting.  It almost seemed like this little one was going to be a Hwy 94 birth but we made it to Hudson.  We got into the L&D to the water tub room and the nurses were a buzzing.  The noise was something else.  Nothing overtly loud but the click, click, click of typing, the whispered chatter, the tense voices.  I was checked because they were not confident that contractions that were 2 minutes apart and 90 seconds long meant the baby was on the way.  Nor were they willing to accept that I could feel the baby at +1.  They finally called Denny and I was allowed to get into the tub.  The water was amazing!  The discomfort from the contractions halved themselves and I was able to relax more.  Sarah stayed right by my side.  When Denny arrived the entire room calmed and quieted.  Thank you for being able to make that happen Denny!  I believe I labored for another hour and began pushing in the next hour.  (Bruce says I squatted for “Like an hour and a half!”  Those squats paid off!)  The sensation of that baby coming through the birth canal, rocking back and forth with the contractions, rotating with the contractions, crowning, and birthing out into that perfect startle posture was otherworldly.  I was told to scoop him up – and I did.  

We let the cord pulse out, I got out of the tub, and the placenta was born.  That little boy did not leave the arms of either parent for anything or anyone.  We discovered that the Turtle Man shares his birthday with Dr. Dennis Hartung, what a wonderful gift for us!  I only hope that my little man becomes as wonderful as Denny.  Later in the afternoon Gail and Clare visited us!  Another wonderful surprise!  Of course he chose to have his birth on a day when a breech workshop was happening…when else? 
The little Turtle Man was named later in the day…Bodhi Lee Johnson.  Bodhi is Sanskrit for the banyan tree, which is the tree the Buddha became enlightened under.  Lee for Bruce’s mother, and of course Bruce’s surname. 

A Wish and A Conversation

About three and a half years ago Gail and I were sitting on the floor in Magnolia’s NICU room talking about what had happened, why we thought it happened, and what can be done to change this type of outcome for other families.  (By the way, my daughter is quite well.)  We both knew that at some point we would end up working together.  My wish was, and still is to contribute my knowledge of anatomy and physiology to the Spinning Babies techniques.  

Let us jump ahead a two years.  I had been reading as much of Gail’s work as I could get my hands on and head around plus following her around town like a puppy.  I had signed up to go to a Belly Mapping workshop she was giving at Blooma and she invited me to talk about the psoas and do some demos with the other participants.  It was joyful!  We had a great time!  Gail was painting tummies, Nickie Kerrigan (a wonderful midwife as well) was doing CranioSacral work, and I was releasing psoas’.  Of course the evening passed too quickly and the sun was setting as Gail and I strolled into the parking lot.  For many months I had been getting up the courage to ask if I could write for her and help with curriculum.  I finally asked.  She said yes!  Can you believe it?  I couldn’t.  So I started writing up a storm and doing research and putting stuff together and the next thing you know it is eighteen months later and we are presenting at the 3rd International Breech Conference in Maryland together!  My wish came true!  It still is coming true!

Since then we touch base as often as possible with two very full lives working together.  We have collaborated on a few projects and had the joy of teaching together again.  Gail has taken me in and given me a way to shape my skills in a way that I hope will change lives.  Thank you for that!  As I move forward I continue to learn about birth and women’s bodies not only from Gail but also the plethora of talented birth workers in our community here in Minnesota and Wisconsin – well, and for that matter all over the world.  I am hoping to bring massage and bodywork into pregnancy and birth as a tool that can be used to ease pregnancy, help mothers recover from past injury and trauma to prepare for their next or first birth, teach families what they can do to create space for baby to be in optimal position for labor and birth, and make the postpartum recovery more comfortable.  My next post will begin to outline what I do with the tools I have and who has gifted me each tool.

Thank you everyone for being there for me, supporting me, and helping guide my hands to where they are now.  I am humbled by your love.

Monday, May 13, 2013

Happy Mother's Day - An Ode to All Mothers

There is rich history behind the celebration of Mothers.  Written history shows it began in Ancient Greece with a celebration of Rhea, mother of many gods, to a three day Roman festival of Cybele, to the Christian honouring of the Virgin Mary.  Then the celebration of the Mother disappears...until the end of World War II as a way to increase sales.  

Modern Mother's Day celebration begins with Julia Ward Howe, who initiated Mother's Peace Day observance to fall on the 2nd Sunday of June (This is now celebrated as Father's Day).  It would be glorious is our world could consider having a day of Peace for Mothers.  I think we need to look back to the time when it was possible to hope for a world with no war.  A world where we do not have to worry about our children being taken away to do the bidding of those who wage the wars of the world.  Can we consider having a day where not one single shot echoes across the ether?  Would the leaders of our world honour their own mothers by declaring peace and cease fire for all peoples on May 12?  A day when mother's around the world will know their sons and daughters will come home in one piece.  I know I am asking a lot - honour the  women who have carried you in their womb, loved you unconditionally, given their hearts and soul in bringing you to the light of the world - one day with no gun fire, no bombings, no starvation, no sabotage.  Let's make Mother's Day a day of world peace so every mother, everywhere can have a day where they do not have to grieve their children.

Today, a vote on the Minnesota Senate floor is up to make marriage legal for ALL people who love each other.  There has been singing, chanting, hugging, tears, praying, debate, and conflict of beliefs.  It is my hope that all mothers of every gender identification can legally be recognized as mother and have the same rights as hetero mothers have had for a very long time.  The right to see their child in the hospital, the right to pick their child up from school, the right to take their child to the doctor, the right to file legal documents for their child, the right to adopt a child, the right to foster a child, the right to be a mother - not only in name and action but also in the eye of the law.

Next, we must work toward ensuring that mother's that have fled their country of origin to escape torture, persecution, rape, slavery, and horrors beyond most American's imagination are not surreptitiously ripped from the arms of their children because the White Privileged of this country have forgotten that they are immigrants too.

Solidarity to all Mothers!