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Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
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.
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