resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
September, 2005, Vol. 05, Issue 09
By Elaine Stillerman, LMT
A good friend and colleague of mine attended a professional seminar this past June in New York City called "Challenges in Women's Healthcare: Urogynecology for Primary Care Providers." All of the speakers and most of the attendees were doctors, but there also was a smattering of physical therapists, like my friend, and occupational therapists.The general topic of the seminar was the female pelvic floor, in all its glory and with all its problems.
As my friend relayed to me (and I have the course material to back all this up), one of the doctors gave a speech on "The Effects of Pregnancy and Childbirth on the Pelvic Floor." Supported by many impressive studies, the doctor proffered that a vaginal birth is responsible for urinary and anal incontinence, pelvic prolapse, sexual dysfunction, pudendal nerve damage and pubococcygeal muscle damage. The cure? Cesarean section!
The other doctors fastidiously took notes. A few doctors and several allied professionals questioned the doctor's findings. For instance, were these births augmented and were there obstetric interventions (e.g., forceps, episiotomy)? Were the laboring women in these studies given Pitocin or any pain medications that blocked sensation? How were they pushing during active labor? What position were these women in while giving birth? Were they taught exhalation pushing and how to use their transverse abdominis during labor, or were they directed to "hold their breath, bear down and push?" Were any of these women in the studies taught correct Kegel exercises during pregnancy or given physical therapy during postpartum recovery? Were any of these case studies performed on women who had water births?
None of these valid points was addressed in the lecture, but C-sections nonetheless were hailed as the best way to avoid pelvic floor complications after childbirth.
I'm floored. OK, let's look at the pelvic floor during childbirth. The compression of the fetus on the muscles of the pelvic floor, along with the effects of progesterone and relaxin, softens joints and ligaments and allow these muscles to stretch and bulge. The bladder and ureters also lose their tone during pregnancy (even if the birth is surgical). But Kegel exercises have been proven to maintain and restore functional integrity to the pelvic floor (antepartum and postpartum), and the position in which the gravida labors can have a tremendous impact on the strength of the pelvic floor.
In addition, the directed pushing needed as a result of anesthesia or labor position is responsible for many of the long-term weaknesses of the pelvic floor. Known as the Valsalva technique (holding the breath and forceful bearing down), this method of pushing encourages fetal hypoxia (lack of oxygen), perineal tears, increased intrathoracic pressure, increased cardiac output and blood pressure, slowed maternal pulse rate and damage to the pelvic floor. It might be a vaginal birth, but one that was poorly guided.
During the pushing process, the laboring woman should be in a squatting or semi-sitting position to widen the pelvic outlet and work with gravity, not against it. The woman should exhale, or allow the air to escape from her lungs as she pushes, to reduce pressure on the pelvic floor. Some care providers actually prefer for the woman not to push at all in the early second stage of labor, because the natural forces of uterine contractions move the fetus quite handily down the birth canal. The focused pushing only is used to expel the fetus from the birth canal. In this way, little pressure is exerted on the pelvic floor and little, if any, damage is done.
Prenatal care and postpartum recovery should include exercises and physical therapy, if necessary, to maintain and restore the pelvic floor muscles. Birthing in female- and fetus-friendly ways can do more to keep the pelvic floor intact than a traumatic surgical procedure.
Instead of a surgeon recommending surgery as a preventative measure, why not teach women (and their doctors) the most effective way to maintain and respect their bodies during pregnancy and childbirth?
Click here for previous articles by Elaine Stillerman, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.