Celebrating Your Journey to Pelvic Wellness: A Comprehensive Guide to Nurtured Pelvic Health & Wellness
Rachel Kelly, MSOTR/L, CBS, PCES, CCST-I

Hello! It’s a pleasure to join the team and provide pelvic health therapy. If you’re still reading past the first line, perhaps you’re considering pelvic floor therapy. I can imagine you have many questions and may even feel a bit uncertain about how the process may unfold. I hope this blog can offer some background on what to expect. Pelvic floor dysfunction can be a challenging, even isolating, time in someone’s life. BUT, here you are, taking steps towards wellness and health—congratulations! Recognizing that something doesn’t feel right is one thing, but taking the time to explore solutions to help you feel better puts you on the right track. You might be wondering, is pelvic floor therapy right for me? What are the sessions like? In this blog, I’ll introduce you to what most pelvic floor treatments look like at Nurtured Pelvic Health & Wellness. If you have specific questions regarding your condition, don’t hesitate to call or schedule a free 15-minute discovery call at 201-338-0727 or email me at RachelKellyOT@nurturedpelvichealthwellness.com.

So What Does the First Visit Look Like?

You’ll enter the fantastically calming atmosphere of Core Therapies Family Wellness, where the receptionist desk will greet you with smiling faces. At your appointment time, we’ll spend a good amount of time talking. I understand that having an in-depth conversation with a healthcare provider may seem novel—it’s not very common in most healthcare settings. Providers often rush through history taking, but at Nurtured, we have the luxury of taking the time to truly understand your condition, its impact on you, and any relevant health history contributing to your pelvic floor dysfunction. We’ve all experienced those doctor’s appointments where you walk away feeling unseen or unheard, rushed out, or with more questions than answers. At Nurtured, our value is our clients, and we prioritize listening and putting you at ease because being seen and heard is crucial for healing. Beyond understanding you and your health history, a thorough subjective interview helps me zero in on what may be driving your symptoms and determine the most important elements to check during your physical exam.

After discussing your experiences, when they started, and most importantly, how they affect you, we’ll begin the pelvic floor therapy exam. This might be the point where some people understandably feel nervous. A typical pelvic floor exam involves checking the muscles internally and externally for tightness, spasms, weakness, and coordination. This is done as gently as possible with a gloved, lubricated finger. This exam provides valuable insights into how your pelvic floor muscles are functioning, shedding light on the potential causes of your symptoms.

Recognizing that you are the leader of your body, it’s vital to emphasize that consent and comfort are my top priorities. If you’re not ready for the pelvic floor exam, that’s okay. We can spend our time evaluating other parts of the body that affect the pelvic floor. Posture, visceral mobility, and hip strength and mobility can significantly impact the pelvic floor. For those not ready for a pelvic floor exam, these assessments can be a great starting point and go a long way toward identifying the drivers of your pelvic floor dysfunction. Interestingly, these aspects of the physical exam are so essential that I include them in many evaluations, regardless of completing an internal examination or not. The role, strength, and mobility of the hip alone in pelvic floor function merit a whole conversation!

After gathering your in-depth history and obtaining results from the physical examination, the journey toward wellness begins! Together, we’ll create a plan tailored to your lifestyle. Goals and treatment plans will be attainable, allowing you to drive your recovery. Some treatments may involve manual in-office work followed by specialized homework. In other cases, neuromuscular re-education may be necessary to teach individuals to move throughout their day without clenching their pelvic floor in response to stress or heavy physical exertion. Variety and individuality are key, as two patients with similar symptoms may have different causes, requiring specialized and thoughtful care.

At the end of your first visit, you should leave with a good understanding of what’s going on, how we plan to treat it, and a general estimation of how long it should take to feel better. I take time at the end of our first treatment to discuss exactly what we’ll be doing in follow-up visits and why these treatments are essential. It’s crucial to me that you leave treatment feeling confident in your next steps.

Neuromuscular Education

What a term, right? It sounds fancy, but it’s also straightforward and simple. It answers the question, “After therapy, what keeps my symptoms from coming back?” Neuromuscular education is a broad treatment modality used across different disciplines, from teaching stroke survivors to rise from a chair independently to helping office workers with sore necks sit more ergonomically at work.

In the pelvic floor world, neuromuscular education is a significant part of what we do and forms a crucial part of treatment, regardless of the practitioner’s treatment philosophy. At Nurtured, I use neuromuscular education in many ways with the goal of fostering pain-free pelvic floor function.

The first step of pelvic floor neuromuscular education is to teach the pelvic floor what “relaxed” feels like, what an effective contraction (kegel) feels like, and what an effective “push” for bowel movements feels like. In individuals with pelvic floor dysfunction, these movements can be challenging, and it’s not uncommon for them to believe they are pushing effectively when they are actually closing their anal sphincters—a phenomenon known as paradoxical contraction. By taking time to “teach” the pelvic floor how to contract and, more importantly, relax when needed, we can reduce clenching patterns that may lead to pelvic floor dysfunction in the future.

Strengthening

It’s so much more than kegeling! If someone tells you to “fix your pelvic floor, JUST do some kegels,” RUN! We require more complex training to meet goals like running without incontinence, jumping and dancing without the feeling of prolapse, and much more. No one should be afraid to laugh, cough, or sneeze because they might leak. You should be able to jump on the trampoline with your kids or take that run to clear your mind.

Consider someone who leaks a bit when lifting something heavy. When picking up something substantial, like your toddler, our core muscles need to stabilize our spine, requiring a lot from the pelvic floor. If the rest of our core is weak because we’ve only been doing kegels, we may find ourselves straining and holding our breath to lift our kids. Straining can put a lot of downward pressure on the bladder, resulting in leaks. To address this issue, we must treat the pelvic floor, but for the pelvic floor to have a real fighting chance to keep us dry, we must also address the rest of the core.

Additionally, strengthening outside the pelvic floor allows us to return to the activities and exercises we love, which we may have thought were causing the pelvic floor to over-tighten. As we’ve discovered, the pelvic floor is part of the core, and if the rest of the components are weak or not working at the appropriate time, the pelvic floor can overwork and over-tighten. It benefits us to approach strengthening from a holistic standpoint when rehabilitating the pelvic floor.

How Do I Know If Nurtured Pelvic Health & Wellness Is Right for Me?

This is the question I was hoping you would ask! First off, let’s chat—schedule the discovery call and let’s get you on the road to wellness. Pelvic floor therapy is a specialized niche in the OT/PT world. To become a diverse, well-rounded, and educated therapist, you must love to learn and carry the compassion and understanding of functional movements. Researching pelvic floor practitioners and practices can be overwhelming! I have spent years studying maternal health, pelvic floor, and developmental continuums. My philosophy is and will always be that my clients lead their treatment, with me as the guide. No one knows your body better than you. As a mother myself, I understand the overwhelming nature of pregnancy appointments, followed by the loud, overstimulating, medical delivery with nothing more than a 6-week checkup. I know that recovery and building a team of professionals are essential in your wellness and motherhood journey.

We help optimize your motherhood journey through personalized pelvic health care, taking you from a place of pain, leaking, or discomfort to a place of recovery and wellness. Becoming a mom is incredible, but it’s definitely not like the movies depict it! Recovery from childbirth can be challenging, not just physically. No one prepares you for the combination of physical and emotional challenges of birth recovery. And let’s be honest—a 6-week “checkup” just isn’t enough. Just because some symptoms are common during pregnancy and postpartum doesn’t mean they are normal and you have to live with them.

Still have questions? Call or email today for your free 15-minute discovery call at 201-338-0727 or email me at RachelKellyOT@nurturedpelvichealthwellness.com.

Chiropractic Care for Men: Unlocking Strength and Performance
by Dr. Sebastian Poma

At Core Therapies, we understand that our patient base is likely to consist of more women than men. It’s not because men experience fewer pain ailments, but rather because they often tend to wait it out, believing that the pain will disappear on its own. However, we want to emphasize the importance of addressing these issues sooner rather than later.

When it comes to acute low back pain, which is commonly experienced by men due to their demanding physical activities or strenuous work, it’s essential to recognize that strong backs don’t simply “blow out” without a significant injury. Instead, what often happens is that the structures in the back gradually tighten up over time, accumulating stress. This, in turn, leads to weakened core back muscles and the emergence of “fragile back” syndrome. The result? A seemingly minor movement like bending over to pick up a golf club or a child can suddenly trigger excruciating pain.

This is where specifically applied chiropractic adjustments come into play. Our chiropractors are skilled at realigning and mobilizing the tight joints, restoring proper movement and functionality. By addressing structural alignment and mobility, these adjustments enable the deep core muscles to engage and strengthen, providing the necessary support for the back.

Energy, agility, and endurance are crucial for most activities we engage in daily. However, misalignments in the body, impaired nerve function, and weak muscles can drain your energy and limit your performance. With chiropractic care, your body can regain its ability to focus its energy on the things you want and need to do. Even after just a few visits, many men report noticeable improvements in their energy levels and overall performance.

It’s important to recognize that prevention is key. Many men tend to adopt the mindset of “If it isn’t broken, don’t fix it.” Unfortunately, this often leads to delayed treatment when the problem could have been easily prevented. In fact, studies show that one-third of untreated lower back problems eventually escalate to become persistent and disabling. By seeking chiropractic care, you can take a proactive approach to your health and well-being.

At Core Therapies, our chiropractors will provide you with a comprehensive assessment of your condition before embarking on a mutually agreed-upon course of treatment. Our approach extends beyond pain relief. We develop a strategy to improve movement, prevent the recurrence of injuries, and promote healing and strengthening of the back.

Don’t let pain hold you back or wait until it becomes a chronic issue. Take charge of your health and schedule a consultation with our experienced chiropractors today. Let us help you regain your strength, energy, and overall well-being, so you can live life to its fullest potential.

Tendon Health
By: Dr. Matt McGowan, D.C

As I reflect on my journey back from a ruptured bicep tendon over the last 4 months, I felt it imperative to pass along important information regarding tendon health. My injury was 100% due to overuse. “Overuse is often synonymous with terms like ‘Chronic Degeneration or  Repetitive Stress’.” Over time if we continually use a joint in the same repeated patterns under any load, we can be causing a long term negative effect on our tendons integrity at that joint.  A person can be very active, and in relatively good health and have unknown problems brewing at their tendons. Statistically, males in their 40’s-50’s tend to be subject to tendon failures the most, but it can honestly happen to anyone who repeatedly loads their tendons.  

So what does it mean to cause repetitive stress on a joint?  It can be a multitude of scenarios; an example can be someone who works with their hands often, a mason lifting and cutting stones over and over again. It can be the pickleball newbie that is so excited about the game that they play 4 times a week for several hours at a clip. It can be the person who has been doing the same exercise routine in the gym for the last 30 years with little to no variation. Any of these scenarios can demonstrate how simple activities that we take for granted can be causing a long term overload on the tendon.  

The hardest part about these injuries is that there are often no warning signs. I never had any pain in my bicep, it never felt tight. In fact most people who rupture their Achilles tendon, never have any warning sign until it pops. The good news is that there are ways we can alter our training to help avoid these tendon issues and ruptures. The most challenging part is staying self aware of our activities and loading patterns and being self accountable to make ourselves do the preventative work. This is where I failed myself. I did not respect the amount of load I was putting on my biceps on a daily basis. If I had taken certain steps in how I train, this may have been avoided.

What I feel are the most three most effective ways to avoid major tendon failure are:

1. Proper nutrition. Avoid any foods that have an inflammatory effect on your body. Try to limit cheat meals and highly processed foods.
2. Vary your activity as much as you can control it. Obviously if your job is working on a factory line, you cannot change this, but if you are a runner who loves to jog on a treadmill 5-6 times a week and you never change from that, then adding in other forms of exercises in replacement on 1-2 days can go a long way. 
3. The most important thing you can do is include eccentric loaded exercises to your routine. The eccentric phase of the exercise is commonly known as the negative phase. The most simple way to explain a negative phase is the phase in which you return the weight back to its starting point. It is when the muscle is elongating. For example with my bicep, normally when people lift weights for biceps there is a smooth cadence of 1-2 seconds pulling up, and often 1 second going down. The key for tendon health is loading the muscle on the way down in a slow and controlled manner.  

A great start for anyone who feels that they may find themselves undergoing repetitive load or stress should take the following steps:

1. Figure out what joint/tendons may be under repeated stress.
2. Figure out what exercise can be done to load that tendon directly.
3. Perform 3 sets of 12-15 repetitions of that exercise with following cadence:

2 second concentric phase (shortening phase)/ 5-7 second eccentric

(lengthening phase)

Not every exercise of every workout has to be done in this manner, but adding this in every few weeks is very important to preventing tendon breakdown. If you feel like you may be exposing yourself to tendon overload but do not know where to start or what exercises to do, come in and get it evaluated and we can certainly help you out. 

“Why we chose Waveblock”
By. Dr. Melissa Sonners

Hey moms,

I don’t know about you, but I feel like I’m constantly juggling and doing my best to balance our kids’ exposure to technology.

Although I don’t love them being on iPads, iPods, computer games etc, I do also realize this is and will continue to be a big part of their world.  We give our kids (age appropriate) authority in making their decisions allowing them to have a sense of control, freedom and engage in critical thinking.   If there is something they’re interested in, we have conversations and listen to them on why they’re interested in it, why they think they’re mature for it and what healthy boundaries they’ll create around it. 

Recently, Levi has been wanting wireless earbuds.  We spend a decent amount of time on airplanes and our phones unfortunately no longer have headphone jacks.  On a recent cross country flight, he forgot his headphone adapter which is what prompted this conversation.  

Earbuds emit high levels of EMF/radiation.  Although it is still unknown exactly HOW exposure to high levels of EMF impacts us, there is emerging evidence that these can contribute to a variety of malignant tumors.  Although more studies are needed, some researchers feel there’s already enough evidence of harm from long-term, low-level exposure that EMF’s should be classified as a Group 1 known carcinogen.  Kids are especially sensitive to these EMF’s due to the rapid development of their brain and nervous systems.  

EMF’s are also suspected to contribute to: 

-Sleep disturbances

-Headaches

-Depression

-Irritability 

-Tinnitus (ringing in ear) 

& more 

Although Levi made some great points on why he deserves earbuds, this was a NO for us due to all of the above.  His determination led him to some searches on the internet looking for a solution and he came across Waveblock.

Waveblock has created an anti-radiation sticker that has been lab tested and proven to block the majority of EMF’s from earbuds.  

The founder of the company is a father of three and went on a mission to create a solution after realizing other countries limit EMF in nurseries and schools because of the impact they have, particularly on children.   

So we reached out to them and asked if we could try out their products.  We instantly tested the earbud wraps with our EMF meter and sure enough, the majority of the EMF’s were blocked! 

We were very surprised to also see that earbuds with waveblock on them created LESS exposure than a cellphone to the ear.  

So, Levi now has earbuds and is super happy- although he is only allowed to use them in extreme moderation, we feel at peace knowing his exposure is low. 

The products were so easy to apply, he did it himself and they didn’t negatively impact any sound quality or other features of the earbuds.  

If you haven’t already, check them out.  They have a variety of great products.  We also got the protective sticker for the back of our cellphones.  

https://www.waveblock.com/?rfsn=6669409.2632ad9&utm_source=refersion&utm_medium=affiliate&utm_campaign=6669409.2632ad9

Their prices are super affordable and you can also use our code SONNERS15 for a discount.

Let us know what you think! 

Travel Tips for Those Traveling with Lower Back Pain.
By Dr. Matthew McGowan

With upcoming holidays, camps, and summer vacations causing a spike in extended travel, we have been fielding a lot of questions on how to keep one’s back steady while traveling.  

If you are taking a long car trip and you suffer from low back pain, it would be a good idea to stop after 2 hours of driving if possible and do a quick 3 minute stretch.  The two most common stretches I suggest that can easily be done while stopping for gas or at a rest stop are the standing figure four stretch and the standing hip flexor stretch.  

For Air travel, you can follow the same guidelines allowing yourself to walk to the back of the plane near the restrooms where you can also do a hip flexor stretch or a standing figure 4 stretch.  Here are photos of both of these stretches:

Standing figure 4:  you can hold onto the side of the car with one hand, cross your ankle at your opposing knee and sit back and down until you feel a stretch across the butt on the side of the crossed leg.  Hold this stretch for a minimum of 30 seconds and do 3 per side. 

Standing hip flexor:   you can place your front foot up on a guardrail, a tire, or even inside the base of the car with a door open.  Before lunging forward it is important to contract the butt muscle on the trail leg and keep it squeezed as you lunge forward.  This will ensure you feel the stretch down the front of your trail leg and keep the lower back safe.  Hold this stretch for a minimum of 30 seconds and do 3 per side. 

• For shorter intervals of driving or times when you cannot stop, it can also be a good idea to use the seat controls and change the position you are sitting in.  Varied seat positions will keep you from getting stiff in one continuous position.
• If you are a person that deals with sciatica, you can place a folded beach towel on the seat so that it lifts the butt upwards and keeps the front part of the seat from digging into your sciatic nerve.  Also try to pick your foot up fully when going from gas break rather than just pivoting on the heel.  Leaving the heel down on the carpet and having the foot rotated out towards the gas pedal for long periods of time can irritate people with sciatica as well.  

While travel can be tough on people with low back issues, these tips or tricks can sometimes make it a bit more manageable.