Tag Archives: diastasis rectus

Post-Partum Health, TMJ and Domains of Pelvic Health

Happy Monday everyone! I hope you all enjoyed last month’s topics revolving around detoxing!  This month we are changing gears and talking all about Post partum health, since it is one of the most overlooked things I see in my practice with women’s care. We will be diving into many aspects of what this entails, but to start this week we will go over specifically what happens with the pelvic floor, its relationship to the jaw, and how to keep it healthy post birth.

Let start first with what is the pelvic floor?  The pelvic floor is a multitiered group of interweaving muscles that surround the lower openings of your body, and also serve as a shelf for your reproductive and digestive organs.

 
The first tier, makes sure sex and elimination are working optimally.  This group is important for birth, because the baby’s head stretches them considerably, and if they are too taut or don’t have enough time to adjust, they may not soften enough and may tear when your baby emerges.

The second tier, these make sure your organs stay in place.  When this tier gets strained or pulled, the organs start to slip below where they are meant to be, which causes sensations of heaviness and fullness.  

Almost all women who come in for care, are sure their pelvic floor is not strong enough, however most come in the middle between women who could use more support and those who need to let go and relax….

Horseback rider, runner, yoga practitioner, pilates or barre method junkie?  You’ll most likely have a very strong and tight pelvic floor…
While those that maybe aren’t as active, will have a weak pelvic floor.

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How does the jaw come in?  Well in a popular book from a midwife of birth, Ina May says “open mouth, open cervix”.  This means relaxing the jaw to relax the pelvic floor.  Because of receptors in the jaw and the sacroiliac joint, they speak to one another as our centers of balance.

That meaning, if you are a clencher, or have jaw dsyfunction, you pelvis will not relax and heal.  And vice versa, if you have a pelvic injury ( like birth, or car accident, or yoga, or weight lifting), your jaw will not heal.  Clenching the jaw and tensing muscles are sympathetic nervous system fight responses.  Imagine a dog growling and defending its territory.
There’s many things you can do to relax the TMJ joint, but I find a lot of the work is temporary unless you actually fix the dysfunction in the joint, which will then allow the receptors and muscles to relax.  How do you fix the dysfunction?  
With advanced craniopathy and dentistry. 

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During pregnancy, your uterus is stretched to more than five times its normal size, your organs were squeezed to the sides, and perineal skin stretched.  C-Section, you had at least 4 layers skin, connective tissue, muscle and organ cut through.  Anesthetic?  It takes time to leave your system, and then theres a dramatic flood or surging and dropping and rebalancing of hormones after birth. 

All across the board, there is agreement that women should spend the first 15 days after giving birth in total repose.  This allows for restoration at the deepest levels.  Pelvic fibers can reknit themselves and heal, internal organs can recalibrate and settle.  This means you will need help!  But the first step is just REST.

According to Kimberly Johnson, postpartum care expert, when it comes to pelvic health, there are 4 domains that hold the key to our healing.  You may feel great in 3 of the areas, but the one your haven’t considered could be the root cause of whatever your symptom is.  The four domains include Biomechanics, Biochemistry, Emotions and Scar Tissue.

1. Biomechanics.
Or posture and flexibility.  How you stand affects the position of your pelvic floor.  Pregnancy will usually exaggerate posture tendencies that you already once had.  When the spine has its natural curve, your pelvic organs have a little shelf on your pubic bones.  Large curve in your low back?  Your uterus may get pushed onto your bladder.  Tucking in your pelvis and flattening your buttocks, the bladder and uterus lose their shelf of support and this can contribute to pelvic floor dysfunction like prolapse and incontinence.
Some of this is genetic, but other parts can be helped through specific bodywork care, like what I provide in my office.  Pelvic sprains are huge after birth and need proper rehab.

2. Biochemistry.  
Or the internal environment of your body.  Mostly influence by diet and nutrition, but also by exposure to pollutants and what you take into your body through food, and how the food is absorbed.  Hydrated?  Is blood moving?  Anesthesia?  We will go more into the diet of postpartum women in another blog.

Biochemistry also includes hormones.  After delivering the placenta, there is a steep drop in progesterone and estrogen as the body shifts toward healing and break mild production.  Your ovaries now have to take over, and if you have hormonal imbalance prior, it will not just go back into regulation.  Proper hormonal testing is usually needed to see where levels are at. 

3. Emotions.
These play a huge role in healing most tangibly when women have had either preexisting trauma or birth trauma itself.  Women can use words like broken, damaged or even eviscerated to describe how they feel.  Because the injuries aren’t visible on the outside, they remain untreated but not unfelt.  Or maybe there’s shame seeking help or care for these injuries.  After all, you’re supposed to be a superhero after birth?  Or you don’t want to tell your partner so they won’t see you as damaged.  Disentangeling the emotion from the physical injury is often a key piece of healing, and is why working only with the biomechanics isn’t always effective.  I use NET in my office and refer for other work that is needed.

4. Scar tissue.
Fascia is the wrapping of the body.  Think of an orange, and peeling the rind off, the white layer underneath is symbolic of our fascia.  Cutting each layer of the orange you see how it is all connected as well.  If you remove our skin we are wrapped in a sheet of connective tissue.  These layers need to slide over each other.  Muscle “knots” are often wadded up fascia that is not sliding.  This tissue is made up of 7 kinds of fiber.  Over 80% of women come through childbirth with some kind of scar tissue in their pelvis.  You can also have preexisting scar tissue from gynecological procedures, surgeries, miscarriages, endometriosis, sexual abuse or abortion.  

A couple of ways I like to deal with scar tissue is using fascial tools for the outside of the body.  I used instrument assisted soft tissue work in my office, and also recommend using something like the fascia blaster at home all throughout the body and pelvic region.  Keep in mind the tissue works best when heated up as far as breaking up the scars.  If the scar is internal, you can soak an organic tampon in organic castor oil and place it inside for 20 minutes.  Then work internally after taking it out relaxing the tissue.  (pelvic floor specialists are better for this).  

Next week we will go into some of the medical realities, that happen post birth such as incontinence, diastasis, tearing and prolapse.