RecoverRx Performance and Recovery BlogThis blog is dedicated to all things from recovery to performance. Our industry expert Physical Therapists provide evidence based information and opinions educating our readers on how to optimize their health in order to be able to overcome injuries and live the life they were meant to live!
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By Dr. Luke Greenwell, PT, DPT, CSMT, CSCS Can dry needling help my shoulder injury? Dry Needling can be a very effective treatment strategy for men and women with musculoskeletal pain including rotator cuff injuries with or without tears. What is Dry Needling?? Dry needling treatment involves insertion of solid (non-hypodermic) needles into the muscle or fascia below the skin. “Dry” refers to the fact that there is no medication in the needle. There has been plenty of research to support dry needling (also known as trigger point dry needling, intramuscular dry needling, and needling) as an effective way for Licensed Practitioners (Physical Therapists, Chiropractors, Physicians, and Acupuncturists) to:
There has been a historical misconception that dry needling is used only for patients with myofascial trigger points as a way to “release the trigger point.” However, recent evidence is out there to support other neurophysiological mechanisms for pain relief and muscle tension reduction.  In fact, we use Dry Needling in many of our patients as a way to increase muscle activation and biomechanical feedback when attempting to retrain normal movement patterns and increase strength in the injured extremity. What is the Rotator Cuff and How can it get Injured? Rotator cuff injuries including tears are some of the most common causes of disability across the globe. The rotator cuff is a group of 4 muscles (infraspinatus, teres minor, supraspinatus, and subscapularis) that in isolation can perform different movements of the shoulder but in conjunction have the main function of stabilizing the head of the humerus (ball) in the glenoid (socket) to avoid asymmetrical loading on different tissues that help stabilize the shoulder.
Rotator cuff injuries can either be traumatic (falls, weightlifting, or throwing) or chronic degeneration (small tears that add up over time). Once the rotator cuff is compromised, the normal biomechanical movement properties of the shoulder are affected and can lead to pain, weakness, and compensatory movement strategies. In many cases, strains and small to medium tears can heal with the right treatment strategies but in some cases, with large tears surgery is warranted. I won’t be covering surgical recovery cases in this article, but will mostly focus on how we utilize Dry Needling in our Rehab for our patients with rotator cuff strains or small to medium tears. How Do We Utilize Dry Needling to Treat Rotator Cuff Injuries? Let’s talk about how we address these injuries in the clinic while utilizing Dry Needling as a therapy. The most important start to our process is to develop an accurate working diagnosis of rotator cuff injury via a comprehensive shoulder evaluation. From there we are able to identify
Typically after 1 session of dry needling (this can involve multiple needle insertions to multiple muscles) we do see a very immediate change. With that being said, we typically need multiple sessions over the course of a couple weeks. We like to educate that there will be some soreness in the areas where we see a significant response (known as a muscle twitch response). What do I need after I receive Needling treatment? After the dry needling is performed to the identified areas, we can use the rest of the session to focus on:
This Strategy Works! It’s a tried and true strategy that has worked for thousands of patients we have seen for shoulder pain and although every patient is different, we find this system to be very effective in helping patients recover from rotator cuff injuries. Our 3 step process of Recover (from painful limitations), Rebuild (functional movement patterns) and Redefine (future strength and performance) could never be more true for our patients with rotator cuff injuries. Check out this videos of a Dry Needling Technique: www.youtube.com/shorts/cfXC0UI6xGY. To see even more, subscribe to our YouTube Channel and Follow us on social media @recoverrxpt. If you would like more information on our approach to treating shoulder pain in addition to rotator cuff injuries, please feel free to reach out to us via email at info@recoverrxpt.com. Thanks again for checking in and be on the lookout for our next Badass Blog! Use Every Setback As A Comeback! -Dr. Luke Sources:
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What is intermittent fasting?
The health and wellness landscape is certainly full of trends, and one nutrition strategy that has gained a lot of attention recently is intermittent fasting. Intermittent fasting, or “IF”, is defined as when a person alternates between periods of eating and periods of fasting. The terms “patterns” or “cycles” may also be used to describe this almost rhythmic type of diet. Using intermittent fasting as a tool does not necessarily mean you are cutting your caloric intake way down, but rather you are consuming your calories in designated windows of time, usually with longer stretches between consumption, and these windows are consistent day to day or week to week. For example, you may choose to only eat between the hours of 9am and 5pm each day. Some methods of this type of diet suggest you decrease caloric consumption on certain days, while also adhering to specific eating windows 
What are the potential health benefits of IF?
The belief behind this approach to nutrition is that your body may become satisfied with smaller portions, and cravings for less healthy foods may also decrease. The outcome of IF may be weight loss, which can also help lower the risk of diabetes, sleep apnea, and some types of cancer. According to Mayo Clinic, some research suggests that intermittent fasting may be more beneficial than other diets for reducing inflammation and conditions such as Alzheimer’s disease, arthritis, asthma, multiple sclerosis, and stroke. What are the potential risks? Intermittent fasting is not recommended for everyone. Those who should avoid this type of diet include pregnant or nursing women, people with a history of eating disorders, people with risk of hypoglycemia, and those with certain chronic diseases. It is always important to consult with your healthcare provider before beginning any dietary changes. What are the different types of IF? According to Cleveland Clinic, there are a few different approaches to intermittent fasting, which is a benefit of the diet overall - there is no one-size-fits-all way to incorporate it into your life. Below are some ways this type of diet is utilized:
How do you know if IF is right for you?
Just like no two people are the same, no two diets are either. Everyone’s lifestyle, preferences, and resources are different, so intermittent fasting may or may not be a good strategy for you. With several methods of IF, it’s important to be open to some trial and error if you decide to give it a shot - one method may work and feel much better than others. Consulting your healthcare provider and being open to trying something new when it comes to your approach to nutrition are great ways to start exploring this diet.
What is NEAT?
Non-exercise activity thermogenesis (NEAT) is the energy your body uses to do everything other than sleep, eat, or formal exercise. In other words, it is the calories that are burned by the movements you make by going through your daily routine, not including those expended at the gym. There are a vast number of activities that fall into this category, including typing at a computer to walking around the grocery store to performing yard work. While some types of movement or activities you do during the day may not seem significant, NEAT can have a big impact on your metabolic rate and overall health. 
The Benefits of NEAT
Research shows that incorporating more informal movement into your day - like biking to work or taking a phone call while walking around the block - could be a critical piece to the weight management puzzle and also help you stay more mobile, agile, and feel better overall. Higher levels of NEAT are also connected with lowered risk of metabolic syndrome and cardiovascular events. A study in 2018 showed that a low level of NEAT is associated with obesity, and that a higher level of this type of physical activity enhances lifestyle. People who report having a moderate-to-high level of activity throughout the day outside of formal exercise also report feeling more energetic and an improvement in mood versus when they experience days of low levels of physical activity. From disease prevention to feeling good both physically and mentally, it’s clear that NEAT is a useful tool. Ways to Boost Your NEAT (and Still Be Productive)
Whether you have a goal to lose body weight, prevent cardiovascular disease, or feel more energetic, NEAT could be your ticket to get there. Little choices and small steps taken repeatedly can add up to big achievements when it comes to your health. There’s no one-size-fits-all approach to wellbeing - find what works for you and your health journey and stick to it!
Breathwork certainly has received a lot of attention in the fitness and health scene in the past few years, and for good reason. Diaphragmatic breathing, which involves allowing your diaphragm and abdominal muscles to move with your inhales and exhales, has been shown to have positive mental and physical health outcomes. When it comes to strengthening the muscles in your core in order to move well and prevent injury, your breath is an essential piece of the puzzle. Creating and maintaining proper intra-abdominal pressure helps protect your spine, and this pressure has a lot to do with your breath.  When you breathe in, your goal is to use your primary inspiration muscles. These include your diaphragm and the muscles that connect your ribs. Instead, many people use more of their secondary muscles - the muscles in and around your neck and chest - to breathe in, which can cause tightness in the shoulders, tension in the neck, and even hand numbness. By focusing on utilizing your primary inspiration muscles when you breathe in, along with gently bracing your abdominals and engaging your pelvic floor when you exhale, you are setting yourself up with a breathing pattern that supports you both at rest and while exercising, keeping your body both efficient and safe. Have you ever held your breath during a tough exercise or while lifting something heavy? It can be a natural response in the body. By mindfully incorporating a diaphragmatic breath (inhaling to prepare, exhaling on the exertion), you not only protect yourself from back injuries, but you also help keep your intra-abdominal pressure regulated to avoid injuries like hernias, pelvic organ prolapse, and diastasis recti. If that doesn’t motivate you enough, your deep breath helps you engage and utilize your abdominals more than if you hold your breath or only breathe with your secondary inspiration muscles, which helps your core be even stronger. Correcting a shallow breathing pattern can take time, so be patient and practice daily to establish a new pattern. To practice, find a comfortable place to sit with your spine tall or lie on your back. Place your hands on the sides of your rib cage, thumbs behind you and four fingers wrapping around front. Take an inhale, intentionally expanding into your hands, allowing your inhale to travel down and gently expand your belly and relax your pelvic floor. Your diaphragm will move down along with it. As you exhale, think about gently guiding your hands in, bracing your belly, and gently lifting and contracting your pelvic floor. Repeat 10 times.
Your breath is truly the foundation of everything you do, and when you establish a proper breathing pattern, it can help with many other processes and movements of the body as well, allowing your core muscles to fire for stabilization and support.
If you feel like you need more help with coordinating your breath, core, and pelvic floor, reach out to us today to schedule a FREE discovery visit!
In order to effectively treat so many people with shoulder pain, we need to be able to diagnose the problem, create a clear path for treatment, and establish steps for the resolution of pain. We do this on a daily basis without the use of X-rays or MRIs. Although we don't utilize medical imaging in creating our clinical diagnosis, I will explain to you why 2 other aspects of the evaluation are more important than an expensive image. Those 2 aspects are the subjective history and physical examination. When a patient presents to the clinic, the first thing we do is listen and let the patient explain their story- we are looking for key features which help to explain common causes of pain. Subjective history includes:
Physical examination includes:
The information gathered from the subjective history and physical examination will create a clear picture if an MRI is warranted or if treatment can begin in the clinic.
Let's break down 2 patient examples of how a physical therapist would use their skills to determine if an MRI would be necessary.
Patient 2: Shoulder pain began 3 months ago without a known cause, but started to hurt when bench pressing and military press. He denies any history of trauma. Pain is not present at rest but only hurts during reaching in the backseat of his car or at the gym. His pain is the same but not constant. If he avoids bench press and military press his shoulder does not bother him in the gym. Physically he has limited active motion overhead and in rotational motions. His strength is appropriate in all motions but has pain and a little weakness when resisting motion with arm away from body. His joint mobility is limited in rotation in 1 direction and has tenderness along his rotator cuff muscle. He occasionally has numbness in the outside of his arm after sleeping on his side.
Hopefully reading through the subjective history and physical examination of 2 different patients, you can see that these patients' recommendations may be a little different. I would recommend an MRI for patient 1, but I would not recommend an MRI for patient 2. For patient 1- his injury was traumatic- there is a known cause for a potential significant tissue injury due to the force from a fall. His functioning is very poor with inability to lift arm, his strength indicates a potential significant injury to his muscle system, and his pain is not improving whatsoever even after 7 days. For patient 2- there was no injury that caused the pain so the likelihood of significant tissue injury is very low, his biggest limitation is weakness caused by pain which is typically related to mechanical issues versus structural issues. His functioning is appropriate, his pain is not constant, and it does not limit him outside of the gym. As you can see, there is a lot of information needed to determine if an MRI is appropriate and warranted for each individual case. Seeing a skilled physical therapist for your shoulder pain is the Best First Step to set you on a path to recovery. We will use your subjective reports and physical exam to create a clear diagnosis for you, as well as a treatment plan to resolve the pain and get back to the things that matter most. Learn more about our unique approach to resolving shoulder pain: https://www.recoverrxpt.com/shoulder-pain.html For more on this topic, check out our YouTube Curiosity Corner. Or give us a call to set up a visit: 331-253-2426 Sleep is an essential part of our healing process and very important for our energy levels. During pregnancy, like always, it is recommended to get 8-10 hours of sleep for optimal functioning of the mother and baby. Sleep helps with digestion, energy levels, growth and progress of the baby, and to healthily adjust to biological and psychological changes. 'I haven't been sleeping well, and I figured my body is just preparing for sleepless nights ahead with a newborn.' Not true! Lack of sleep can actually increase risks of high blood pressure which can lead to pre-eclampsia and preterm labor and delivery. It can also prolong your laboring process, worsen labor pains, lead to higher Cesarean delivery rates, and increase chances for postpartum depression and anxiety. Research does indicate that women are experiencing worse quality and quantity of sleep further into their pregnancy. But, at the same time, the body adapts better to the lack of sleep. However, there are strategies to optimize your sleep despite these pregnancy related changes. First, you want to find a position that is comfortable for you. During the first trimester, you can still sleep on your back and stomach if you feel comfortable doing so. Your baby is safely guarded within your pelvis for the first 12 weeks. After this milestone, make sure you are not laying on your stomach to protect your baby from too much pressure. Most health care providers will recommend you lay on your left side the further you progress in pregnancy because the weight and size of the baby can press on your internal vessels, the abdominal aorta and inferior vena cava. These are very large and very important circulatory structures as they transfer blood to/from your heart to your legs, pelvis and the placenta. These vessels lay more on the right side of your spine traveling vertically through your trunk, so laying on your back and right side the baby can narrow those vessels giving your legs and baby less blood. Your body will ultimately let you know that you need to move, by making you feel very uncomfortable.
Finally, a few tips to promote a comfortable sleep environment:
Please reach out to us if you need help with this condition. We offer 1-on-1 sessions to look at your specific situation and invest in helping you live a healthy, happy life where you are confident to care for yourself and your family. If you know of others who could benefit from this information, please share this article with them.
You can also reach out to me directly at ariel@recoverrxpt.com or check out our Pelvic Health page https://www.recoverrxpt.com/pelvichealth.html  This time of year is marked by so many feelings and experiences. From joyful celebrations to memorable traditions, the weeks leading up to the New Year certainly keep people busy, and oftentimes healthy habits are the first things to get dropped when plates get too full. Despite so much focus on festive gatherings, many people find themselves feeling less than merry and more stressed during December than they do the rest of the year. Targeting January 1st as the day to reset and focus on health is tempting, but there’s really no time like December to incorporate small but impactful strategies to help you feel your best and minimize holiday stress in the process. Here are three easy ways to prioritize you and your mental health this month: 1. Exercise daily. According to Mayo Clinic, exercise has proven health benefits when it comes to destressing. First, it may help increase the production of your brain's feel-good neurotransmitters called endorphins. Sometimes referred to as a “runner’s high”, this effect can be triggered not just by running, but even by a walk outdoors or a game of paddle tennis. Exercise can also be a moving form of meditation, as it often requires you to engage in an activity that is repetitive and focus on the task at hand instead of worrying about all the holiday gifts you still need to purchase. Physical activity can also help complete your body’s stress cycle, or fight-or-flight response, resulting in your cardiovascular, digestive, and immune systems getting a boost of protection. Finally, regular exercise has been linked to improvement in sleep, which is often disrupted by stress and anxiety. 2. Practice gratitude. Dr. Robert Emmons, a scientific expert on gratitude, confirms that people who have a regular gratitude practice are happier, healthier, and can cope with stress and anxiety better than people who don’t. You don’t need anything formal or fancy to reap the stress-busting benefits of a gratitude practice, but if you’re not sure where to start, consider simply pausing and reflecting the next time you find yourself worrying, and ask yourself, “What opportunities do I currently have that I am grateful for?”, “What did I get to experience in the last month that brought me joy?”, or “What has someone done recently that helped me?” If you prefer a practice that is a little more tangible, you could keep a gratitude journal and write down three things you are grateful for each night before bed. 3. Set Boundaries with your Calendar Schedules can fill up quickly this time of year, so it’s important to take inventory of your family’s calendar and keep expectations reasonable. Every family is different, so discuss with yours how many activities or events feel good to participate in each week or weekend, and then prioritize obligations with your boundaries in mind. By giving yourself some down time each week, you will be better able to rest and recharge before the next family event comes around, which will prevent your stress level from becoming overwhelming. Plus, you might even end up starting some low-key family traditions without even leaving home.  While stress may be an expected part of your holiday experience, it doesn’t have to be. By taking small steps to care for your body and mind, you can start a new tradition of feeling well from the inside out this holiday season. Whether it’s endorphin-filled exercise, a new habit of gratitude, or setting boundaries with your social calendar, put yourself at the top of your priority list this month, and get ready to start the New Year feeling less stressed and more energized! Learn more about how exercise can help eliminate and prevent stress in Dr. Sarah's Curiosity Corner: By Dr. Ariel Sernek, PT, DPT  Urinary incontinence (UI) is very common. In fact, incontinence is reported in 48% of young female athletes (Rebullido, 2021), 41% of pregnant women (Moossdorff-Steinhauser, 2021), and 37.1% of older adults around the world (Batmani, 2021). However, these percentages are likely underestimated because most people do not want to report that they are having issues. This issue can be embarrassing, demoralizing, and just out right disappointing. Why isn’t my body working how it should? There are a multitude of reasons why this might be occurring, but let’s look at some risk factors that might influence why some people experience this more than others. The most important factors that the above studies found included age, obesity, diabetes, women’s education, delivery rank, hypertension and smoking. When we are talking about age related changes, this is due to a decreased ability of our bladder to hold larger amounts of urine and our bladder and pelvic floor muscle getting weaker. Obesity can cause leakage because of the added weight and load to the bladder and pelvic floor muscles. I found the education of women to be a very interesting risk factor, but ultimately the more people are educated to seek help or know that these symptoms are not normal the more likely they are to improve their symptoms and ultimately their quality of life. Diabetes can cause nerve damage to the bladder if not under control, and elevated sugar in your bloodstream increases the amount of urine you produce. In order to answer the question as to why you are having UI, it’s important to know the type. Stress urinary incontinence (SUI) is when there is a force or pressure on your bladder that cannot be controlled and urine is lost. Urge urinary incontinence (UUI) is when the bladder gives such a strong sensation to use the restroom and you cannot make it on time. Mixed urinary incontinence means that both types are present. I also see overflow urinary incontinence which is when your bladder is so full that any normal activity could cause leakage, but the important part here is that you are not aware that it’s happening.  SUI is treated by identifying the stresses that cause the leakage. Sometimes that could be a jump, cough, sneeze, laugh, or picking up heavy objects. Once we know the stress that causes the leakage, then we have to train you to control that pressure. We do this through retraining your diaphragm and how your body moves through the event that causes leakage. We also strengthen your core, hip, back, and pelvic floor muscles and address postures that can make it harder for your muscles to work together. With UUI, we have to identify the cause of the urge. Is it an environmental trigger: running water, pulling into the driveway, or putting your hand on a door knob? Is it a food/drink trigger: carbonated beverages, caffeine, tomato based products, acidic fruits? Or is it a change in medication? Once we have the cause, then we train you to manage and overcome that urge with brain, bladder, and body strategies so that you can safely make it to the restroom without an accident.  When it comes to overflow urinary leakage, we have to retrain your bladder to go at a normal frequency and to recognize when your bladder is full. We may also have to release the pelvic floor muscles and soft tissue tension to help your ability to evacuate normally and with less retention of urine. There may be some other factors influencing the leakage too, including urgency or inability to manage pressure that we have to address and treat. Ultimately, urinary leakage can be treated in a variety of ways, but we have to find the root cause of the leakage first. A full head to toe evaluation, addressing posture, strength, range of motion, pelvic exam, and movement patterns can help us find the cause of leakage. Come in for an evaluation and let’s address this very common, but NOT NORMAL symptom!  Thanks for reading the blog, and please don't hesitate to reach out with additional questions. You can reach out to me directly at ariel@recoverrxpt.com or check out our Pelvic Health page https://www.recoverrxpt.com/pelvichealth.html. Also, view our Curiosity Corner on this topic, and be sure to subscribe to our YouTube channel for more great health videos. References:
Rebullido, T; Gómez-Tomás, C; Faigenbaum, A; Chulvi-Medrano, I. (2021) The prevalence of urinary incontinence among adolescent female athletes: A systematic review. J. Funct Morphol Kinesiol. 6(12). Moossdorff-Steinhauser, H, Berghmans, B, Spaanderman, M et al. (2021) Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: A systematic review and meta-analysis. Int Urogynecol J. 32, 1633–1652. Batmani, S, Jalali, R, Mohammadi, M et al. (2021) Prevalence and factors related to urinary incontinence in older adults women worldwide: A comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr. 21(212). By Dr. Sarah Greenwell, PT, DPT, CSMPT As a physical therapist, I cannot prescribe medications. However, as a Doctor of PT, I am here today to prescribe a daily dose of M.E.D.S. But not the kind that comes in a pill. The MEDS I am talking about are: Mindfulness Exercise Diet Sleep  Most people come to physical therapy because of pain. Or because they cannot workout or participate in life the way they want. But along with strengthening muscles and mobilizing joints, many of these issues can be significantly improved with a healthy and daily dose of Mindfulness, Exercise, Diet, and Sleep. And along with improving joint and muscle pain, daily M.E.D.S. can help improve stress, anxiety, lack of energy/motivation, poor mood, and upset stomach. Let’s quickly break these down. Mindfulness: is achieved by focusing on the present moment, accepting your thoughts and feelings, and being able to focus on what you CAN control. Instead of mindlessly going through the motions of your day, take time to think about what your goals are for the day. In the morning, ask yourself: What do you want to accomplish or what do you have to do to overcome the day’s challenges? Or in the evening, reflect on what went well, what didn’t, and what can you learn from today to make tomorrow better. Don’t focus on the obstacles. Focus on the progress. Progress gives you purpose, energy, passion, enthusiasm, joy, gratitude, and hope for the now and the future.  Exercise: It is recommended that adults get at least 150 minutes of moderate to intense exercise per week. But if you are not there yet, start with something. Make it a daily routine to do at least 20 minutes of physical activity. Try to include a mix of flexibility, strength training, and cardiovascular exercise. A daily walk or a beginner yoga session is one place to start getting your body moving. We are learning more about the protective effects of muscle mass and strength on lifelong health and aging while maintaining an active and Independent lifestyle. So make sure to pick up some weights a few times a week. If you need any help or guidance, shoot us a message or give us a call today! 331-253-2426  Diet: We are not talking about a short-term weight loss strategy. Rather, your diet is the way you fuel your body to perform. Although it can be confusing and conflicting in today’s world to know what is healthy, most nutritionists would agree that if it is a plant – eat it; if it was made in a plant – don’t. Try to stick to food in its more natural form and with ingredients that are found in nature. And although added sugars may taste good, they do not provide your body with nutrition. Instead, they add inches to our waistline and increase inflammation in our gut and skeletal system.  Sleep: Adults need 8-9 hours each night to function at our best (and kids need even more)
Any less, and our bodies struggle to repair tissue, store memories, support immune function, and fight fatigue. Napping and caffeine do not replace the need for consistent quality sleep. The physical and emotional stress that we put our bodies through during the day needs a full night of rest to recover and prepare for the next day. So instead of an ‘apple a day to keep the doctor away,’ try to take your M.E.D.S daily, and reach out to us if you have any questions or would like some trusted resources on any of these topics! Dr. Ariel Sernek, PT, DPT DRA stands for Diastasis Rectus Abdominis. It can be tricky to pronounce but you can just call it DRA, and we’ll know what you’re talking about. First, it helps to understand a bit of the underlying anatomy and terminology. Your “six-pack” muscle is called the Rectus Abdominis and diastasis means “the separation of normally joined parts” (Dictonary.com). So a DRA is a separation of your six pack abdominal muscles. Now, your muscles are not actually splitting apart, there is a ligament between your right and left sides of your rectus abdominus called the Linea Alba. The linea alba is meant to be flexible and this structure is what stretches and recoils back to its original size. Pretty Cool, right?  How common is this? DRA is most commonly seen around pregnancy and post-partum, in fact 100% of pregnant women will have a DRA to accommodate for the growing baby after 35 weeks gestation. Fun fact: men can also have this too; think “beer belly.”  "Do I need surgery?" This is something I hear all the time. Surgery can fix this, but primarily if there is an abdominal hernia. This is when part of your intestines protrudes through a hole in the linea alba. This can cause abdominal pain and dysfunction with bowel movements because there is now a kink in your bowels limiting stool from moving as it should. Surgery is not the only fix, physical therapy can also help! How does physical therapy help? First, we need to get a global assessment of your rib angle, your thoracic spine mobility (your mid back), posture, abdominal strength, and MOST importantly- how you manage pressure through breath work and correct timing of your core. Your core is not just your abdominals, but your diaphragm, your pelvic floor and your lower back muscles. These muscles have to work together in order for pressure to be managed and your body to work properly. Imagine the last time you coughed or sneezed, you probably felt your belly pooch out and maybe down. That’s the internal pressure we have to manage that can pull apart your rectus abdominis muscle.  Picture a can of pop, it’s pressurized until you open the tab and then the pressure can escape. Now, imagine the middle of your abdominal wall being the open part of the can. Pressure is going to travel wherever there is weakness or an opening. This is why surgery does not always fix the issue. Sure they can stitch the rectus abdominis muscle together, but if you cannot manage abdominal pressures, the surgery can fail and you can separate again. This is not a good situation.  People don’t like to hear this, but the distance of the muscles is not my main concern. The strength and tension created by your linea alba ligament and how you manage abdominal pressure with your daily activities is my main concern. Some people have separation, just as some people have stretch marks or looser skin. These are normal changes with pregnancy and post-partum and are okay to have. Genetics, diet, water intake, previous history of exercise and training regimen, and current exercise can all influence the cosmetic look of your abdominal wall. In addition to pressure management and addressing core dysfunction, we also address urogenital symptoms of urine leakage, urgency, pelvic organ prolapse, constipation, musculoskeletal pains, and anything else that can influence your core. We are then able to load and progress your abdominal muscles based on where you are at with your activation and control. If the activity is something that causes you to have coning, we back off. That just means your body isn’t ready for that exercise yet. We would also need to address gluteal strength, posture management, strengthening your deep core and pelvic floor, how you move in/out of positions, and teach proper bracing to address… you guessed it, PRESSURE! Hopefully this article has answered some of your questions surrounding DRA and how you can address your symptoms without the need for surgery. Please reach out to us if you need help with this condition. We offer 1-on-1 sessions to look at your specific situation and invest in helping you live a healthy, happy life where you are confident to care for yourself and your family. If you know of others who could benefit from this information, please share this article with them. You can also reach out to me directly at ariel@recoverrxpt.com or check out our Pelvic Health page https://www.recoverrxpt.com/pelvichealth.html Also, check out our youtube Curiosity Corner!
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AuthorsDr. Luke Greenwell, Dr. David Bokermann, Dr. Sarah Greenwell, & Dr. Ariel Sernek are Performance Based Physical Therapists with extensive backgrounds in treating the injured athlete. At RecoverRx, they are passionate about returning people to the sports & activities they love. Check out more about them by visiting our About Us page. Categories
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