How The Ribcage Can Affect Pelvic Floor Symptoms

Written by: Carlin Davinsizer, PT, DPT

It may be surprising to learn that Pelvic Health Physical Therapists care quite a lot about the ribcage! The ribcage isn’t something that is usually addressed or specifically targeted in traditional exercises. When we think of squats or push-ups, we easily understand what muscles (or even just limbs ha!) these movements are aiming to strengthen. But when a pelvic floor PT brings up the mobility of the ribcage and how to change that through exercise, it may be confusing. 

Why do they care so much about these weird looking bones that make us think of a skeleton? Well, it houses our lungs, various blood vessels and nerves, and the magnificent diaphragm muscle, which lives at the base. THIS muscle is what they are actually after; THIS muscle is what directly affects the function of the pelvic floor. In order for the pelvic floor muscles to do their job well and keep you symptom-free, the diaphragm must be functioning optimally. The way in to the diaphragm is from the outside: the ribcage.  

The diaphragm attaches all along the innermost aspect of the ribs, has a right and left tendon  that attach down onto the lumbar spine, and forms a connective tissue sheath in the center up top, with a hole in the middle for the esophagus, and the lungs rest above. The ribs attach to the thoracic vertebrae of your spine and wrap around to the sternum in your chest, with the last few ribs on each side attaching to each other and floating in the thorax. Together, they are responsible for breathing. 

Normal quiet breathing looks like this:

Inhale:

• Change in pressure pulls air into the lungs

• Diaphragm contracts down, flattening its shape and helping to pull air in

• Ribs expand on all sides (360degrees) like bucket handles, belly and chest rise

• Organs of abdomen get gently pushed down onto pelvic floor

• Pelvic floor slightly relaxes

Exhale:

• Change in pressure lets air leave lungs

• Pelvic floor ascends back to resting position

• Diaphragm ascends back to its normal resting dome-shape

• Ribs come back down and in to resting positions

This is what normal, quiet breathing looks like, however it doesn’t always work this way. If you’re experiencing any pelvic floor-related symptoms, like stress or urgency incontinence, pelvic organ prolapse, diastasis recti, or back, hip or pelvic pain, then likely something in the breathing process isn’t doing what it should. This relationship between the diaphragm and pelvic floor via breathing is what the PTs are assessing and aiming to restore, so that these muscles can be happy and you can be symptom-free. 

By looking at the ribcage and its mobility and control during breathing, they can see what may need a bit of encouragement in the right direction toward improved breathing. For instance, if the whole ribcage moves up and down vertically during breathing, then there is no 360 degree movement of the ribs in all directions, which means that the diaphragm is not acting as the primary respiratory muscle. The secondary muscles of respiration are working to breathe (aka neck muscles) which is indicative of a shallow breathing pattern. The diaphragm doesn’t get to experience its happy dome-shape upon exhale; it is stuck in a short, flattened, inhaled state. The pelvic floor does not like a shallow breathing pattern; it doesn’t have the chance to experience the wave of abdominal organs gently pushing down on it and then rising via the diaphragm. This is when symptoms like leaking and prolapse creep up. Your neck muscles and overall mood might not like this either!

How can this tight ribcage and stuck diaphragm be addressed? By breathing into those sticky spots via various positions, we can encourage the ribs to expand in the needed directions and allow the diaphragm to experience full exhales. This will restore its proper resting length, allowing it to be the primary respiratory muscle again, and help improve pelvic floor symptoms indirectly. Here are examples of two breathing exercises that address the stickiest of spots: the upper back and the sides of the ribs under the armpits. 

Rockback breathing with ball [video]

Sidelying breathing [video]

Give these a try and see if it makes breathing or pelvic floor symptoms feel a little bit better!

Interested in joining our Pre and Post- Partum Group Physical Therapy Classes? Tap here!

GO GREEN with Meal Prep in March

Written by: Tracy Pritchard (MS, CNS, LDN)

With St Patrick’s Day coming up, it is a great time to think about GREEN foods!

I think we can agree that nothing saying St Patrick’s Day quite like cabbage. While it is available at other times of the year it takes front and center at grocery stores in March. For many people this is the only time of year they consume cabbage and they only associate it as a side dish with corned beef. Cabbage is cruciferous vegetable that is part of the Brassica family along with broccoli, cauliflower, kale, and brussels sprouts. It can be eaten raw in salads or coleslaw or cooked in soups, sauteed or stir-fried, roasted, and prepared and eaten in countless ways. For some people, eating raw cabbage may exacerbate digestive symptoms so it may be best to start with small amounts of cooked cabbage. 

Many years ago a good friend of mine established an annual tradition where our families gather and eat a traditional Irish meal together – I love how food brings us around the table for some fellowship and to make memories. Unlike major holidays with an abundance of traditional foods, this one-day celebration is a great opportunity to have some fun and explore the benefits of green foods. I am married to a bagpiper, so that makes this an exciting holiday even though I am not Irish! 

Back to green….. let’s consider all of the vitamins and minerals in green foods:

*Calcium: helps build and maintain strong bones; helps the heart, muscles and nerves to function properly

*Iron: helps prevent against anemia; adequate iron is essential for maintaining healthy energy levels

*Potassium: supports blood pressure, plays a role in fluid balance

*Vitamin C: enhanced vision, strengthened immunity, wound healing, skin health

*Vitamin A: vision and immune health

*Vitamin K: heart health, bone health and helps prevent blood clotting

*Folate: tissue growth and healthy cell function

In addition to vitamins and minerals, green foods contain a variety of phytonutrients that offer various health benefits. Phytonutrients are compounds found in plants that act as antioxidants and protect the body from disease. Some of the benefits may include anti-cancer, anti-inflammatory, metabolic health, hormone health, and many others. 

There are many ways to add more green foods into your diet, including adding more green foods into a St Patrick’s Day celebration. Imagine a St Patrick’s Day inspired tray or charcuterie board full of green fruits and vegetables. A veggie tray could include cucumbers, celery, green bell peppers with a side of guacamole for a healthy dip. A fruit tray could include granny smith apples, kiwi, pears, and green grapes – you get the idea. Using this theme may also help kids get excited about eating more fruits and vegetables, while learning that healthy eating can be fun and festive!

There are many green vegetables to try or rotate into your meal planning at some point, even if not on St Patrick’s Day itself. Even those picky eaters who think they don’t like green foods may be surprised at how long the list is. There is a large variety of leafy greens, green beans and broccoli, and don’t forget about edamame, avocado, and zucchini.

Not all vegetables have to be in a salad or stir-fry… you can get creative and shred zucchini to add to a muffin or bread. Tomatillos may be a favorite green food in a salsa along with some corn chips. Lastly, there are a lot of green herbs and spices as well. Not only do herbs and spices enhance a food’s flavor, they also provide other health benefits such as antioxidant, antiviral, and antimicrobial effects. Some green herbs and spices include basil, chives, cilantro, dill, mint, oregano, parsley, and more. 

There also benefits to some GREEN beverages. Green tea is rich in antioxidant compounds including epigallocatechin gallate (EGCG) that protects cells from damage. Studies have also found that green tea may support better cardiovascular health, brain health, weight management, and bone health. Green tea can be served hot or cold and enjoyed many different ways. One way to enjoy it is with some lemon and honey to give it a fresh taste with a hint of sweetness. 

Consider adding a cup of dark leafy greens into your daily routine. This could mean adding some spinach to your morning protein smoothie or egg bake, adding a salad to lunch, or adding some chopped greens to a soup or stew. Take a look at your meals to see where and how you can add a little bit of green even if it means snipping some parsley or cilantro onto your dish!

What are your favorite green- themed foods? Which ones did we miss?

Leave us your ideas in the comments below!

Support of a Social Worker: The Benefits for Individuals Impacted by Trauma, Anxiety, and Depression

Written By: Leslie Wells

March is Social Work Month, a time to honor the dedication, compassion, and critical roles of social workers everywhere. When working with individuals impacted by trauma, anxiety, and depression, social workers play a pivotal role in providing the care, support, and healing to make movement toward recovery. 

At Hope and Healing, our clinical staff includes several social workers, and in addition to sharing how much we appreciate them, we hope to explain exactly how they make such a difference in the lives of so many.

Social workers are often at the heart of mental health care. For treating individuals experiencing trauma, anxiety, and/or depression, they are not only therapists but also advocates, guides, and connectors to resources that help individuals heal and thrive. 

Here’s how our social workers make a difference at HnH:

1. Case Management and Resource Coordination

For many individuals struggling with trauma, anxiety, or depression, navigating the mental health system can feel overwhelming. Social workers can help guide clients through the process and make the right connections with valuable community and/or government resources. This helps the client focus on healing rather than trying to figure out where to turn next.

2. Therapeutic Support

Social workers are skilled in “meeting clients where they are” and providing therapy that meets the unique needs of the client. Whether dealing with past trauma, struggling with anxiety, or feeling overwhelmed by depression, social workers use various approaches like Cognitive Behavioral Therapy (CBT) or trauma-informed care to help clients work through emotions, rebuild self-worth, and develop coping strategies for life’s challenges. 

3. Crisis Intervention and Immediate Support

When in a moment of crisis, social workers are trained to step in and provide immediate support. They offer stabilizing strategies, ensure your safety, and help individuals through the crisis, all while maintaining a perspective of unconditional positive regard for their clients. 

As we celebrate Social Work Month, we recognize the invaluable work that social workers and therapists do in the mental health field. Their dedication to supporting individuals is a lifeline for so many; helping to rebuild lives, restore hope, and empower healing.

If you’re struggling with mental health challenges, remember that you don’t have to go through them alone. 

Contact Hope and Healing Therapy and Wellness Center today for a phone consultation, 

or pay us a visit online.

Don’t forget… we also post FREE mental health resources on Instagram and Facebook!