Wednesday, 25 October 2017



Diastasis What?!



If you’re currently pregnant or recently had a baby, you’ve probably noticed a few changes to your body. (Understatement of the century!) One of these changes is likely a difference in your abdominal muscles: how they look or feel or function.


In order to make room for a growing bun in the oven, something’s gotta give! That something is the abdominal muscles, which gradually stretch as baby gets bigger. For some women, this can lead to a condition called diastasis recti (DR), a greater than normal separation between the two sides of your rectus abdominis muscle.


Your rectus abdominis is the “six-pack” muscle that runs vertically down the front of your abdomen. We tend to think of it as one big ol’ muscle, but actually it’s a pair of muscles that are connected along the midline by a tendon-like tissue called the linea alba. If there is too much strain on the linea alba and an unusual separation develops between the abs (ie. DR), the muscles can no longer function properly to do all of the wonderful things we take for granted, like sitting up in bed, carrying too many grocery bags, or holding in our tummies!

But why?!


It’s easy to point the finger solely at the baby bump; however the stretching of the tummy as baby grows from poppyseed to watermelon is only part of the equation. Diastasis recti develops when the balance of ALL the forces exerted on the abdominal muscles and the linea alba exceed the tolerance (ie. the strength) of the tissues.


Our postures, positions, breathing patterns, movements or lack of movement all create forces on our abdomen …and just like the Force, they have the potential for good or evil! These forces we unwittingly create on our tummies throughout the day can either contribute to the strain on our tissues OR we can harness them to improve the strength and resilience of our abdominals.


What can I do?!


If you have (or suspect you have) developed diastasis recti, don’t panic! Whether you developed diastasis recti months, years or decades ago, it can be resolved and optimal abdominal function can be restored.


However, there is no one-size-fits-all solution. Since there are many different factors that may be contributing to your diastasis recti, corrective exercises should be targeted to your body’s needs. It can be very beneficial to work with an instructor or therapist (like a Pelvic Health Physiotherapist… wink, wink) with specialized training in this area.


Whether you’ve already developed diastasis recti or you’re trying to prevent it, here are a few first steps you can take towards restoring and maintaining a healthy, happy tummy:


Posture: Take stock of your body parts and try to make sure they’re “stacked up” so that your feet, pelvis, shoulders and head all form a nice vertical line. Especially if you have a growing baby bump or you’re carrying around a little one, avoid shifting your pelvis forward and leaning back to counterbalance the weight. Finally, resist the temptation to stick out your chest. Instead, relax and drop your ribcage, tucking your lower ribs in rather than sticking them out.


Breathing: Did you relax your ribcage? Once you’ve done that, breathe slowly and deeply into the lower ribs, the belly and even the back. Avoid lifting the shoulders and ribcage as you breathe, and try instead to feel the ribs expanding out in all directions, front, back and sides. This breathing pattern will help to decrease tension on the abdominals.


Get Moving: Move your body often and in lots of different ways: bending, reaching, twisting, walking, taking the stairs, lifting your arms and legs, getting down to the floor and hopefully back up again! A healthy variety of movement will engage the abdominal muscles in many different ways, keeping them strong and resilient. Some ideas: walking, gentle stretching, pre/postnatal yoga, swimming, or light aquafit.  


If you’ve been given any activity restrictions, be sure to stay within those limits as well as your own body’s comfort zone!


Here is a registry where you can find Pelvic Health Physiotherapists in Ontario:

http://pelvichealthsolutions.ca/find-a-health-care-professional/ontario-physiotherapists/

Dr. Jessica and Jillian during their Wellness Wednesday interview
For more information or to book an initial physiotherapy or initial pelvic floor physiotherapy appointment with Jillian please visit http://thecoachhousetc.ca/ or call (519) 707 -0599

Thanks for reading.


Wednesday, 18 October 2017

The Hormone Dance

Cramping. Bloating. Breast distention and tenderness. Irritability. Moody. Weepy. Cravings. Digestive Changes.

If I had to rate the concerns that bring people into my office, I think it would be a toss up between digestive issues and menstrual issues for the number one spot. Often times when I ask about menstrual cycle and any premenstrual symptoms I get the response 'Oh, the normal stuff.'

However, the truth is, though symptoms are common, they aren't normal. It's a pretty novel concept, I know, considering the fact that the majority of women have some sort of symptoms associated with menses.

The other response I get when I ask about cycle details is 'I don't know...' However, this is your body- get to know it and your cycle. I always recommend downloading a Period Tracker App which makes tracking everything much, much easier, and now a days, who doesn't have a smart phone.

Understanding your Menstrual Cycle

Image From SBI- 4U Website
When it comes to female hormones involved in menstruation, there are a couple key players- estrogen, progesterone, LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone), and each has it's own role to play in the menstrual cycle. There are other hormones that will affect menses- testosterone, cortisol, thyroid- to name a few but those are the big four and their levels and roles change throughout the cycle. The full cycle is also broken down into 3 phases.

Phase 1 is the Follicular Stage and includes the actual menstruation. This is like the prep stage where everything resets and starts again. During this stage estrogen and progesterone levels are at their lowest point which allows the endometrial lining (the uterine lining) to shed, this is menstruation. These low levels of estrogen and progesterone are detected in the brain (pituitary gland) and in response FSH and LH is released. FSH acts on the ovary to start producing follicles. As the ovary starts to mature follicles, estrogen, and to a lesser degree, progesterone start to be produced and begin to rise again.

Around Day 13, we enter Phase 2 which is known as Ovulation. This is the time when FSH peaks- follicle is fully developed, and LH peaks- this is what allows the egg to be released. Estrogen also hits it's peak and drops at this point. Once ovulation occurs, the remaining empty follicle, known as the corpus luteum (where the egg developed), starts to produce high amounts of progesterone and estrogen. 

Once ovulation occurs, we enter Phase 3- The Luteal Phase. During this time, the corpus luteum continues to release progesterone and estrogen. These rising hormones signal the body to start building up the uterine lining to accept a fertilized egg. If implantation occurs, the implanted egg begins to produce Hcg which signals the corpus leteum to continue producing estrogen and progesterone until the placenta takes over around 10 weeks. If implantation doesn't occur, the corpus luteum starts to break down, progesterone and estrogen begin to drop and the cycle starts all over again.

So Why The Symptoms?

The hormonal cascade that is the menstrual cycle is pretty amazing, it all works so intricately together however, because of those intricacies, throw off one thing, and everything gets a bit thrown off. 

Generally, when we are seeing Premenstrual Symptoms it's because estrogen and progesterone aren't balanced. Most symptoms are actually related to low levels of progesterone. However, it gets a bit more complicated as progesterone itself can be low OR estrogen can be too high which makes the progesterone low in relation to estrogen. If you check out the image above, what you will notice is that estrogen's main peak is before ovulation, however, after ovulation, during the luteal phase, estrogen has a second rise as the progesterone rises. It's this balance between estrogen and progesterone that will often lead to those common (though not normal) symptoms. This balance also affects the actual menstrual flow and symptoms and even ovulation.

Symptoms of low progesterone include breast tenderness, poor sleep, headaches, bloating and irritability.

Symptoms of high estrogen include mood swings, breast tenderness, cramping, heavy bleeding, bloating, water retention, insomnia, headaches and fatigue.

Notice how many of those symptoms actually overlap since both conditions have low progesterone, even if just relatively low. When hormones get way out of balance we can also see conditions things like PCOS and endometriosis being diagnosed. On the good side, knowing that it's an imbalance causing the symptoms, it means that we can rebalance things and this isn't 'just the way it is.' The trick it just figuring out what part of the system needs the boost.

Hormonal Imbalance What?

So, the next question is, why did these hormones shift out of balance anyway? There are actually a lot of things that can shift your hormones. 

Diet

This is often a major cause and I have a lot of surprised patients that come in after two weeks of diet changes amazed that their menses was completely shifted. Our food is what provides all the nutrients that our body needs to make our hormones. Did you know that hormones are made from cholesterol. Yup, it's true- guess what happens to our hormones when we follow these "anti-fat diet" fads or even
a vegan diet since the ONLY source of dietary cholesterol is animal sources. High sugars will also shift our hormones and add to the inflammation in our bodies. Dairy is naturally hormonally active, even if it's dairy raised without added hormones. Just like breastmilk has (beneficial) hormonal affects on babies, cow's milk has hormonal effects. These hormonal effects are great for calves, not so great for humans. Any individual food sensitivities can impede nutrient absorption and increase inflammation. Throw in the mix the Standard North American Diet (SAD) which is already high in refined, processed foods that lack nutritional density and we are peaked to have hormonal imbalances.

Stress

This is another epidemic of our time and can totally mess up our hormones. When we are under stress our adrenals produce cortisol and adrenaline. These days, we are constantly in sympathetic mode, always running from one place to the next, filling our plates to the brim and never stopping until we conk out at night exhausted. The problem is, cortisol not only increases our inflammation but progesterone is also a precursor to cortisol. Which means, as your body pumps out cortisol, your progesterone gets depleted. Ever notice that under a super stressful period, your menses is 'off.'

Detox Pathways

This can relate back to diet and needing a nutrient rich diet to provide all the building blocks needed for proper detoxification. However, the big player in hormone regulation is your Liver. This is where cholesterol is actually converted into our main hormone precursor which is then converted into all our specific hormones such as estrogen and progesterone. However, the liver can get backed up when it's constantly trying to keep up with the car exhaust we breathe, the chemical and pesticides we ingest, the chemicals in our personal care products we use every dang day and all the other things our bodies are constantly exposed to.

Sheer Overload

We are constantly bombarded with xenoestrogens. Plastics leach these into our foods. Chemicals in personal care products are huge endocrine disruptors and xenoestrogens. Did you know, the average female is exposed to over 100 different chemicals from personal care products every. single. morning. Even our drinking water has been shown to contain hormones. With the number of women currently on oral birth control pills (OCP), our water is actually showing detectable levels of these OCP hormones. These hormones are urinated out, which then enter our water system and our current filtration systems don't filter these out. And guess who gets to deal with all this....the liver.

This is why as a Naturopathic Doctor, we try to look at all the factors. Balancing out hormones isn't a one size fits all solution and is very multifactorial. 

Why Birth Control Pills Aren't the Answer

From an allopathic model, menstrual issues and concerns are treated with oral contraceptive pills or hormonal IUDs. Though this may 'stop' symptoms, it most definitely is NOT fixing the issue or making your hormones more balanced. Hormonal birth control methods work by giving you a constant dose of hormones which shuts off those feedback mechanisms to your brain that signal FSH and LH to be released (see that great chart above). By doing this, your ovaries aren't told to develop a follicle or release an egg. You still get the bleeding not because it is an actual menses, but because your body is going through hormone withdrawal. Of course, your body still tries to keep making it's own hormones which is why there is still kind of a cycle happening. But often, after time, the exogenous hormones build up so much in your system that even the withdrawal bleeding can stop. 
Though estrogen and progesterone might be the main hormones that run our menstrual cycle and reproduction, this isn't actually their only role. Females need progesterone and estrogen for muscle development, bone development, thyroid function, metabolism, mood, etc. No one would even tell a man that he only needs testosterone for reproduction, but we are very quick to ask females questions like "why are you so attached to your menses."

I see OCP as a necessary evil. On one hand they allow women great control over their reproduction decisions without having to rely on any one else. So I completely understand why women who are trying to avoid pregnancy are on OCP. However, as a means to fix hormonal imbalances, these aren't the answer and often lead to greater imbalances down the road. Even just being on OCP will deplete nutrients like B vitamins.

The female body and it's hormonal intricacies are pretty amazing when you see how everything works well together. Every process in our body has an effect on every other process. By looking at all the factors that may be affecting your menstrual cycle we are often able to tailor a treatment plan to help balance hormones and resolve all those symptoms that are too often thought to be 'normal.'

Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. This information shouldn’t take the place of seeing a Naturopathic Doctor or your primary care provider for individualized health recommendations.


Sunday, 15 October 2017

Our Trip to the Farm

Trekking to the Farm



By now, it probably comes as no surprise that eating fresh, local, sustainably grown food has many benefits from the health of the environment to the health of our bodies. If you are like myself and lack a green thumb (mine is more black to be honest...) finding a local CSA (Community Supported Agriculture) can mean you get a weekly supply of all freshly grown and harvested veggies without concern of your (lack) of gardening ability. For my family, we are members of Henceforth Farms which is a small organic farm in Harriston that offers a weekly delivery of fresh veggies every week for 20 weeks. This past Wellness Wednesday we took a drive up to the farm to chat with Stephen, one of the farmers who runs Henceforth, about how he got involved in offering a CSA and why he chose organic farming. Check out the full interview above in our Youtube video, and a few photos we were able to snap while having a little tour of the farm- complete with a trip to the hen house for REALLY fresh eggs!


Stephen, Henceforth Farm's Founder and Farmer
A little example of what a weekly share looks like!

Some apples in the farm store located at the farm in Harriston.



Henceforth and Reroot also have a few bee hives for fresh honey.

Checking out the barn damage/collapse that happened last year.

  
The farm puts on dinner events like Farm to Table to help raise money to make repairs.

Checking out the pinto beans currently drying which will be part of our last CSA share!





A little trek to the hen house for some very, very fresh eggs!!







CSA shares go on sale early in the year (January/February). Stay tuned for another blog post comparing the various ways to utilize local produce (CSA vs Online Farmer's Markets vs Farmer's Markets) in the coming weeks!


Tuesday, 10 October 2017

Mental Health

Today is World Mental Health day, so let's talk about Mental health. For many people, this is an uncomfortable conversation; there is a cultural association that links Mental Health with the concept of Mental Illness, often as a negative trope used to spread fear and misunderstanding. The result of this association is a pervasive stigmatization, particularly when it comes to talking about oneself. Mental Health is a multifactorial framework influenced by genetics as well as social and physical environments. The complex nature of Mental health and the view of mental illness in our society makes this a difficult topic of conversation. Unfortunately, the lack of dialogue around mental health allows the negative stigma to prevail. The resulting discomfort creates serious barriers for individuals when it comes to accessing the support and care they require. Currently two thirds of Canadians suffering from Mental illness do not seek help because of stigma.





What is Mental Health ?

Mental Health reflects an internal state of wellbeing that includes feeling good and functioning well. Individuals with positive Mental Health feel able to cope with their stress and remain in control of their lives. People with positive Mental Health can experience difficult times and negative emotions without experiencing a Mental Illness. Mental Illness defines a range of medical conditions that affects the Mental Health of one in every five Canadians. In most cases Mental illness can be managed to include a life with positive Mental Health for the individual affected. When Mental illness is left unmanaged, Mental health can deteriorate, having a negative impact on the individual's life.

The quality of an individual's Mental health is closely linked to the quality of their physical health. Not only is overall health and performance affected by mental health, so too is one's greater sense of enjoyment of life and sense of purpose. Everyone can benefit and improve their overall health and happiness by investing in their mental health.






Mental Health & Wellbeing

When we take time to care for our mental health and wellbeing we improve our overall physical health. Having a sense of wellbeing fosters an individual's self esteem, resilience, and sense of purpose. Other benefits of positive mental health & wellbeing include:

  • Improved sleep
  • Improved immune function and resilience
  • Increased self esteem and worth
  • Improved productivity
  • Decrease stress
  • Decrease pain
  • Decrease fatigue




Supporting Mental Health


A community benefits when mental health is encouraged and supported. The Mental Wellness Network of Waterloo Region is a local public health committee that believes every person has the right to be supported in living a healthy positive life. This local initiative has launched a mission is to promote mental health and wellbeing for people across the span of their lives and to foster stronger, connected communities where everyone feels they belong. The Mental Wellness Network has adopted The Ways to Wellbeing, a simple five-pronged approach to supporting mental health within our community. There are several ways each individual can support these pillars of mental health you, and may even being doing some of these things already!




CONNECT
When we have meaningful relationships, we   feel like we belong, we feel valued, and we have support when we face challenges.



BE ACTIVE
Being active helps reduce feelings of worry, improves our mood, increases our self-esteem, and helps us cope with stress.





BE MINDFUL
Being mindful helps us control our emotions, makes us aware of our needs, and helps us enjoy the world around us.


KEEP LEARNING
When we learn new things, we feel a sense of purpose and achievement and we improve our self-confidence.



GIVE BACK

Giving helps us feel good, allows us to grow closer to one another, builds our trust, and helps us to feel thankful and positive.



What’s great about the Ways to Wellbeing is that it allows you to create a resource for activities you can practice daily to help maintain mental health. As you practice these small acts of self care, you foster a sense of resilience which further strengthens positive mental health. The website has a great resource page for both individuals and healthcare practitioners to refer to which helps us mindfully incorporate the five ways into our daily life. To find out more about the Ways to Wellbeing or to access individual resources please visit: https://www.waystomentalwellbeing.com.


Let’s end stigma and change the conversation around Mental Health. Practicing the Ways to Mental Wellbeing can be a valuable resource to preserve and nurture positive mental health. When we invest in our mental health we not only strengthen ourselves as individuals but as a community.

Some additional blog posts you might be interested in are;


Finding Balance

Busting Stress

Mindfulness Self Care

Family Friendly Stress Busting Yoga






Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. This information shouldn’t take the place of seeing a Naturopathic Doctor or your primary care provider for individualized health recommendations.

Wednesday, 4 October 2017

Deep Diaphragmatic Breathing - How to engage the Relaxation Response

Deep Diaphragmatic Breathing 




Deep breathing can help combat stress response and symptoms

When we are affected by stress it changes our breathing. When outside factors increase our stress the body engages a fight or flight response. This stress response was designed to help us escape from imminent danger. It sends blood to the muscles of the body, releases stress hormones such as cortisol and adrenaline to improve concentration and focus. Over time and prolonged stress stimulus and stress hormones begins to have negative effects on our health. Negative effects of prolonged stress can include high blood pressure, suppressed immune function and adrenal fatigue. Prolonged stress increases an individual's risk factors for heart disease, anxiety, depression and common illnesses. Over time prolonged exposure to stress increases the demands on the system eventually creating systemic fatigue and burnout leaving the individual's overall health compromised.


The Relaxation Response

The good news is that the negative effects of the stress response can be balanced by engaging the relaxation response. The relaxation response, which is a physical state of deep rest, engages our parasympathetic nervous system which helps our body heal and repair. A technique known as Deep Diaphragmatic Breathing was developed at Harvard Medical School by a cardiologist named Dr. Herbert Benson in the 1970’s. Deep Diaphragmatic Breathing, commonly known as belly breathing, is a corner focus of triggering the relaxation response. Several alternative practices exist to engage the relaxation response. Other popular relaxation response practices include meditation, yoga, massage.


There are several ways to engage the relaxation response but certain traits are always common to support a state of relaxation. In order to relax you need a safe and calm environment.  Try to sit or lay somewhere that you stay comfortably for up to a half hour. Your environment should be a comfortable temperature to support relaxation, if you get cold easily you may want to keep a blanket on hand.


Belly Breathing

One of the fastest and simplest ways to increase relaxation is practicing belly breathing. Belly breathing is responsible for increasing relaxation and oxygen to the bodies tissues. The health benefits don't end there however, belly breathing improves concentration, promotes feelings of well being and reduces muscle tension and fatigue. Other health benefits include improved immune function, lowered blood pressure and increased lung capacity. Belly breathing also makes us feel better by calming the mind and releasing endorphins that combat stress hormones.


Method:



Lay or sit comfortably, lay on your back or by sitting up straight. Bring one hand to your belly and the other to your chest. Begin by taking a deep breath into your belly. Allow your belly to expand like a balloon into your hand as you inhale, exhaling allowing the belly to empty. The hand on chest should move only minimally.


The best part about a breathing practice is that it can easily be done anywhere. It can be as fast and simple as three deep breaths. This can be a great exercise to do before bed at night and before getting out of bed in the morning.

Thank you for taking the time to read this blog and watch the video. We hope you enjoyed and are going to give these easy breathing exercises a go. Enjoy some zen time today, you deserve it!

Stay tuned to our Wellness Wednesday and biweekly blog posts to help improve your well-being.

Some additional blog posts you might be interested in are;