If you watched the ab+strap video, this is using that technique with more movement. This exercise facilitates the abdominal core through the strap pressure, then we free up the hips to move similarly to walking! This is a fantastic exercise for those who need lower level strengthening or endurance improvement without hip flexor gripping. 

This is a fabulous technique for getting your abdominals to engage. Using your arms to access your upper abdominals often facilitates the WHOLE core. This is a great method for training when you have trouble isolating your abdominals. 

You are not alone! But what do you try? What do all these different medications do? 

REGULAR USE:
The following laxatives are generally seen as non-habit forming. I approve using these regularly, but I am someone who does try to get folks off of these if they aren't needed. Generally speaking, having enough water, fiber, and exercise as part of your regular routine allows for bowel movements to be regular (daily, typically even at the same time each day) and easy (you shouldn't have to strain or bear down and the stool is well-formed, easy to pass). I do recommend a squatty potty (or any stool that is similar) to organize your anatomy for bowel emptying and support good rectal health. 

I'm listing these options in order that I typically recommend them. That being said, I also try to describe which laxative may be helpful if you are having a specific, consistent type of constipation or unsatisfying poo; so if you identify with one dysfunctional type of poo, then perhaps trying its counter first is best for YOU!

Bulking/bulk forming/fiber Laxative:
These help to bulk your stool--ie. make it bigger and helps it all come at once. It does this by pulling water from your intestines. These can be super helpful if you are having several small bowel movements throughout the morning or day that are unsatisfying. Bulking also can help with a more consistent urge for a bowel movement as it makes the stools a little bigger and helps stimulate the colon to send the urge for emptying!

EXAMPLES: 
Psyllium husk (Metamucil)
Polycarbophil (FiberCon)
Methylcellulose (Citrucel)
Prunes! Prune juice - please note that prune juice is very very acidic

Working time: typically 12 hours - 3 days

​Saline Laxative:
These also tend to be gentle. They also help retain water in the colon by salt mechanism and are often best when accompanied by a full glass of water to then help produce a bowel movement. These can stimulate the bowels in a safe and gentle way. This can be great to re-establish a normal bowel movement regimen if you have gotten off track (pooping at different times each day, etc). 

EXAMPLES:
Magnesium Citrate (Natural Calm) *I usually recommend this first over the other options)
Magnesium Hydroxide (DulcoLax - read the label, DulcoLax has many forms, Ex-Lax, Milk of Magnesia)

Working time: 30 mins - 6 hours

Osmotic Laxative:
These are very gentle and typically effective over time. They pull water into the colon and are typically helpful especially if your stools are hard or pebble-like. 

EXAMPLES: 
Magnesium Citrate
Polyethlene Glycol (MiraLAX, Gavilax)

Working time: typically 24 hours (up to 3 days)

Stool Softener/Emollient Laxative: 
I hesitate to use the term "stool softener" since if you read the above, I'd also call those stool softeners...but anyway. This is a different kind that increases water AND fat content into the stool, which sometimes makes it even easier to pass.

EXAMPLES:
Docusate Sodium (Colace, DulcoLax)
Docusate Calcium

**Please note often these are paired with stimulants (see below) so be sure you know what you are buying!**


IRREGULAR USE:
Ok, so none of the above has worked after a few days of trying. It's time to sound the alarm--what else is safe to use? Think of these options as a solution for an acute constipation bout.

Lubricant Laxative:
This coats the stool and intestines to lubricate stools and prevent water loss. This is not necessarily habit forming, but using a lubricant laxative can prevent absorption of good things, so limiting its use is important. 

EXAMPLES:
Mineral oil

Working time: 6-8 hours

Stimulant Laxative:
The following laxatives use water balance but also have a stimulating effect on the colon. For this reason, these are to be used with care as sometimes if a medication does it's job, the colon will become lazy and not want to do it on its own, which would make this habit forming. I have seen these be prescribed prior to surgery to empty the bowels. 

EXAMPLES:
Docusate Sodium (Colace, DulcoLax Stool Softener)
Bisacodyl (DulcoLax, Gentle Laxative)
Sennosides (Senna, Senokot)

Working time: 6 hours - 3 days

IF none of these are working, there are also suppositories and enemas to consider. More on this later.

One of the most frequent things I find in my clients is tension through the anterior thighs. Sometimes this is quadricep (quad) tension, sometimes it's more hip flexor...but did you know one of the 4 quad muscles IS a hip flexor??! 

Quadricep literally means 4 heads. There are 4 muscles that share the patellar tendon as one of their attachment sites. It is typical to have tension in all of them; and then when you start to treat it, you often find that there is actually more tension in one more than the others. 

This is such a common exercise/smash that I finally remembered to video myself doing it after a bike ride. It is one of the most important things for me to do especially after cycling, since it is a rather quad-heavy exercise. Check it out! Try it out!

A while back a good friend of mine helped me to create some video content of me performing and explaining the exercises I often give for core strengthening. They may seem really simple and nit-picky, but this is how I rehabbed myself from a pretty debilitating back injury in my 20s. 

If you have just injured yourself, especially if it was in your back, this series of exercises is meant to bring your core back online. These are particularly helpful if you are finding that the "core workouts" you have been trying don't really seem to be actually targeting your core. Or, if you've been trying to do workouts and feeling pain and soreness in places like your back.

​Check it out!

Have you ever experienced acute neck or back pain? The way you know is that...well, you sort of can't move without debilitating pain. And, it totally sucks. Unfortunately, this just happened to me so I want to write about it. Self-management during this time in THE MOST IMPORTANT thing you can do. Let me explain.

Here's what happened to me: a few days ago I woke up and my neck was stiff. This is odd for me--though I do have a history of a neck injury back in 2013. I noticed it; and I did very little other than ignore it. That was Sunday. I woke up Monday feeling a little more stiff in my neck - so I did some movement - body weight stuff. Then Tuesday it was maybe even a little more stiff in the morning. I decided to do a bike ride. It initially loosened up, but by the evening I could hardly turn my head at all without pain. Tuesday night was pretty awful--I couldn't move my head/neck at all--even bending over (without even moving my neck!) hurt. When I lay down to sleep I realized I had a familiar related pain: deep aching pain in my R shoulder blade. 

WHAT IS HAPPENING???
What is happening is that something is WRONG. Something is injured and your body is trying to talk to you about it. In my case, I had some warning signs -- AM stiffness -- that progressively worsened that I ignored. This morning stiffness is often a sign of inflammation. Any time this is present the ideal situation is that subsequent mornings are the same or LESS stiff. More stiffness means you are still doing something to piss things off. In my case: I was exercising and moving quite a bit thinking I needed the muscles to get warm and release. HOWEVER, the first time I injured my neck, it was REALLY CLEAR IMMEDIATELY that something was wrong--one moment I was fine and the next moment I couldn't move my neck in any direction more than millimeters.

ANALOGY TIME
Let's make an analogy here that I use for myself and my clients that helps drive this point home. Let's say you get a nasty paper cut right on your knuckle--maybe your thumb. That initial injury where the skin tears is often pretty obvious (for me this was Tuesday night, but in my initial injury (many years ago) it was right away). Now, in order for a open wound on your thumb knuckle to heal it has to remain closed, which often means you can't bend your thumb. Right? Because in order for the skin to repair itself, it has to have the 2 pieces of separated tissue near enough to one another to create a healing bridge. This is actually the SAME for the spine!

If you have an injured bit (this post is mostly about spinal pain though it can be extrapolated), then stretching or exercise or movement might NOT be the right thing because the injured structures need to heal. The stiffness you feel is your body trying to heal!

WHY DOES IT FEEL LIKE I SHOULD STRETCH???
In the spine when there is a structural injury, the muscles around the area will often go into spasm to try to make things more still--like with the thumb analogy, things need to be moving a little (or a lot) less for your tissue to repair itself to be able to move again. So, the spasms feel awful and painful in and of themselves, but often they are your body's way of protecting itself. However, if we think back to the analogy of the paper cut, perhaps we can appreciate why stretching the injured tissue will only...injure the tissue further or at the very least, prevent the body from doing the healing it knows how to do. 

If we revisit my recent experience: I got some warning signs that things were inflammed. I kept pushing it until I really likely re-aggravated my old neck injury. Why do I think this? Well, the pain is basically identical though less intense. I want to note that part of the reason it feels less intense is because I recognized it and so it was less scary. I also knew what I had to do: stop tearing that paper cut back open!

HOW LONG DO I NEED TO LET HEALING HAPPEN?
This answer I base on the science behind tissue injury. Acute (new) injuries often take 7-10 days to heal. They can heal faster, but I advise 7-10 days of allowing stiffness. I call this period the "Protect and Defend Phase." This is the time to NOT push it. Any pain is a signal your body is giving you to NOT do that thing you just did. Usually, if this period is going well, ie. you aren't pissing things off, then the pain will reduce significantly. This is also a good time to use some pain medicine. I often actually recommend NOT using an anti-inflammatory (ibuprofen/advil/aleve) because that inflammation is what is going to heal you! Now, there are extreme cases where you may need something because the pain is too intense or you can't do anything to reduce the pain. These are more special cases. 

For me, just spending a day not moving my neck means that my shoulder blade pain is gone. Whew! What a relief! For me, that shoulder blade pain is a referred pain and it is a spreading of pain. ALMOST ALWAYS: MORE PAIN IS MORE PAIN = BAD. This means that the shoulder blade pain is an indicator for me that things are NOT moving in the right direction. It's actually what really got my attention with this particular episode. Any time you have an additional pain add on like this, we call it peripheralization. This means the pain is moving away from the original site of injury. This is, in my words, your body trying to spread the pain to get you to PAY ATTENTION!!! As soon as I started paying attention and heeding my body's call that something was truly wrong in my neck, I stopped trying to use my neck like normal and now my shoulder blade symptom is reducing. In low back issues peripheralization often looks like pain into the leg (hopefully just one, but sometimes both legs). One sign that you are doing it right is that your pain will move back to the back or neck only. We in the biz call this centralization. Centralization of pain is a good sign in this instance. Though something to note is that often when the pain moves back to the place of injury, it can be more intense. This is still a good sign because the pain is at the site of injury and not somewhere else. 

WHAT HAPPENS AFTER 7-10 DAYS?!
After that initial 7-10 days, which I call the "Protect and Defend" time. You will likely be able to tolerate a lot more. You might regain significant motion, muscle spasm should reduce, pain should be waning. This is a great time to start moving again but CAREFULLY. Typically, the same main movements that aggravated you will be remain the same, but you may be able to do mini versions of that movement. Generally, this is also a great time to start seeing a provider you trust to nip this in the bud. After an acute period of injury, core muscles become inhibited (they go on vacation) and this is the period to get them back online so this doesn't become a habitual thing. This is the subacute phase and it tends to last until it's been about 3 weeks from your injury. If you make it through this period without any more big painful moments, you are likely good! However, if you have a big painful moment...you could have just reset the clock back to day 1, which is a total bummer. If this happens, this is also a great time to call your trusted provider to get some help getting ahead of the pain!

A little while back I had some videos made! The video here shows me discussing and demonstrating diaphragmatic breathing. I also explore using the diaphragmatic breath to reach the pelvic floor. Finally,  I explain and demonstrate how to activate the abdominals and the pelvic floor. This is a very mindful, low level, safe for everyone video of movement, breath, and awareness. This is a particularly good video if you have pain.

I gave this workshop for my colleague, Hélène Stelian, and her THRIVE Personal Growth Community. This is an awesome (though generalized) talk on effortless posture and ways to practice this in your daily life! I had fun and I hope you enjoy listening!

I recently was invited by my mother-in-law, Ann-Marie Downing, to speak again at The Transitions Network (TTN) in Chicago. Last time I spoke about ergonomics. This time I gave one of my favorite talks about the pelvic floor! There's some anatomy, talk of the functions of the pelvic floor--and what the dysfunctional pelvic floor can look like. If you are interested in a really basic overview of the pelvic floor, this might be of interest to you!

Check it out here!

The pelvic floor is the group of muscles that reside in the bowl of the pelvis. The most traditional naming of the pelvic floor muscles is "levator ani," which, as you may guess, literally means "lifting the anus." There are 3 muscles on the right and left that comprise the levator ani: pubococcygeus, iliococcygeus, and puborectalis. 

What is the pelvic floor's job? 
1. Core/pelvic organ support: (see core post) The pelvic floor is a critical piece of the core, and in high demands of the other core muscles it, ideally, is also contracting in response to the demand placed on it. The pelvic organs live just above this layer of muscles. The pelvic floor supports them and does not let them fall out!

2. Continence: The pelvic floor is responsible for closing off some critical openings in your pelvis, which include the urethra (urine's exit) and the anus/rectum (bowel's exit). The pelvic floor has a resting tension (even at rest!) that maintains closure of these exits. When there is an increase in demand (think: cough, sneeze, laugh, jump, run, etc.) the pelvic floor has to increase its force to maintain closure of these openings to prevent leakage.

3. Elimination: The pelvic floor is also responsible for allowing the exits to open. Thus, it is a relaxation of your pelvic floor that allows you to urinate and defecate. It is also a profound relaxation and stretch that is required for vaginal delivery of a baby!

4. Sexual function: The pelvic floor responds during arousal and is the muscle group providing the muscular contraction of an orgasm! It is also worth saying that in order to participate in any form of penetration, the pelvic floor needs to be accommodating or flexible enough to allow for any object or body part being inserted. 

5. Breathing: Perhaps the least known function is the role that the pelvic floor plays in breathing. Every muscle has an opposing muscle: the is often called an antagonist muscle. The antagonist muscle of the pelvic floor is the respiratory diaphragm. Thus, when the diaphragm is contracting (you are breathing in) the pelvic floor is relaxing. When the diaphragm is relaxing (you are breathing out or exhaling) the pelvic floor is returning to its resting level of tension. For me, the easiest way to remember this relationship is to consider sneezing and coughing: these are forceful exhalations and they require strong support from the pelvic floor to maintain continence, to keep from leaking!