Guest Blog: Treating Pelvic Dysfunction in a Functional Way

Blogger's Introduction:

Full discloser, A.J. Grzesiak is my talented, assiduous, and dear brother. He and my sister-in-law Melissa are accomplished Physical Therapists, a field that works in combination with a balanced diet in order to live an active and healthy lifestyle. I am currently working on an piece discussing nutrition and bone health, which will soon appear under the "Nutrition Articles" tab. However, it occurred to me that I am fortunate to have such a resource nearby, and that my brother's wealth of knowledge should also be shared. The StepRight product he discusses his is own creation. If you wish to learn more about it, please visit the website below. Regardless, enjoy the information, take it to heart, love your bones, and please await for more information to come regarding what foods to eat to keep them healthy :-)

                                  Sincerely StuffedNutrition blogger and A.J's loving sister,  Beth

 

TREATING PELVIC DYSFUNCTION IN A FUNCTIONAL WAY

Whether talking about raising a family, starting a business, or initiating a diet there needs to be a strong foundation to build upon.  The same holds true for our bodies in that we require a stable base, or foundation to create and execute appropriate movement patterns.  In human anatomy the pelvic girdle is the keystone that bridges the gap between the primary need for stability while allowing for appropriate levels of mobility to efficiently perform daily tasks and higher level activities.

Pelvic pain or dysfunction causes a disruption in the body system that can ignite focal impairment or create a trickledown effect into other areas of our bodies.  The causes of pelvic pain are varied and range from pelvic joint problems, muscle weakness or imbalance in the pelvic floor or trunk, poor coordination of muscles that control bowel and bladder, and pregnancy or childbirth to name a few.  No matter the origin, issues stemming from the pelvis can make people highly uncomfortable, self-conscious, and affect their quality of life in many ways.

Treatment is dependent on the type of pain or dysfunction present, and the underlying components leading to a crack in the “foundation” of our bodies.  As physical therapists we strive to educate our patients throughout the process as we work to restore and normalize body alignment, muscle activity, and movement strategies.  Initially setting our patients up for success to build confidence allows us to progress to more challenging tasks.  As we work to reintegrate the patient back into their normal routines we know the value of functionally specific training and utilize the concept of specificity to help patients achieve their ultimate goals.

The STEPRIGHT™ Stability System is a new training device geared at enhancing sensorimotor coordination in weight bearing positions to improve overall functional performance.  The unique slip over the shoe design takes unstable surface training to a whole other level while allowing the user to maintain rearfoot/forefoot weight distribution, independent lower extremity control, and the ability to perform reciprocal movement patterns as seen with gait.  Improving body awareness, timing of muscle contractions, and feedforward motor responses are crucial in treating pelvic dysfunction.  STEPRIGHT™ allows you to work on abdominal bracing techniques and kegel exercises from a variety of static foot positions as well as progress toward dynamic, translational movements into the surrounding environment.  Enhancing the patients muscle activation patterns will help to make the difference in rebuilding their “foundation” and living a happy, highly functional life!

Written by:  A.J. Grzesiak, PT, DPT, OCS


For more information or to inquire about purchasing the STEPRIGHT™ Stability System please visit www.steprightstability.com





The Lean Pocket Dilemma: Defining "Healthy"

Scene: While trying to multitask on a particularly hurried morning, I was able to throw a handful of nutritious snacks in my polka-dot lunch box. A small bag of mixed nuts, a fresh apple, cucumber slices, etcetera. However, as the clock continued to tick, and I was suffering the consequences of an overused snooze button, the realization set in that a morning chore had to be sacrificed if arriving to work in a timely manner was going to happen. This instance, the sacrificial lamb was my lunch. Today’s lucky stand-in: a delicious Lean Pocket.

Flash forward to noon. I’m eagerly waiting the minute and a half until the crisper sleeve does its magic and my warmed Lean Pocket is ready to devour. After a tiring morning, I’m quietly lurking around the microwave rather then partaking in the conversation of my coworkers. However, I did not go unnoticed. Caught off guard, the following question was thrown my way, “You’re the dietitian…you know that isn’t healthy, right?”

…sigh…exasperated head shake…

When your occupation is filling brains with food knowledge, if you are spotted with a snack that falls short of being purely organic or unprocessed, the odds that your choice will be speculated are high. Truthfully, I get it. I can’t say I wouldn’t have the same reaction if I witnessed a trusted psychologist being admitted to a mental health ward. To a certain degree I signed up for this, yet this notion towards nutrition is gravely concerning to me. The question itself is harmless, but the attitude that manifested its formation is in my eyes one of the preeminent barriers to improving one’s nutritional health. After some contemplation, I wondered if the true underlying issue is the belief that in order to eat “healthy” one must strive for perfection.

If this is true, suddenly the achievable seems impossible. Excuses begin to feel justified:

-       “Eating healthy is too expensive”

-       “I don’t have time for it”

-       “It’s just so confusing”

Food manufacturers add fuel to this blazing fire, by adding words like “all-natural” and “100%” to their product labels. Popular diets emerge, such as the Paleao diet, which encourages only foods that could be found by scavengers before the Neolithic Agriculture Revolution (meaning, before we learned how to farm). Frustration is not directed at the principles of the diets themselves, but more so the exclusionary, all-or-nothing approach. As with any behavior or attitude that reaches an extreme, there is a term for when a fixation to only consume “healthy” or “pure” foods dictates one’s life, that being orthorexia.

What may start as a good intention to improve nutritional health can result in social isolation due to fear of eating out, along with anxiety concerning meal choices and planning.

Additionally, it is often argued that the definition of “healthy” is ambiguous. Granted, the field of nutrition is rooted in science, therefore known and researched facts about certain dietary components and their influence on health have emerged. For example, over eating refined sugars and saturated fats can increase risk for obesity, diabetes and heart disease. However, with a wide spectrum of food choices that contain a myriad of nutrients, what is deemed healthy is distinctive to each individual. Many factors come into play, such as the type and amount of nutrition one’s body biologically requires, as well as what their dietary habits were prior to implementing improvements. If a Sausage McMuffin and hashbrown was replaced with a regular Egg McMuffin and apple slices, I would say that was a “healthy” switch.

As with any endeavor in life, striving for perfection can be a double-edged sword. When an ideal is not reached, feelings of incompetence and disappointment ensue. We are talking about your life here. If you are lucky, you will have to make meal and snack decisions on a daily basis, multiple times a day. It would be foolish to never expect a piece of birthday cake to pass those lips. Rather than perfection, why not strive for improvement?

In my personal opinion, a dietitian’s role is not to enforce strict dietary regulations, but rather to foster a salubrious relationship with food that can be sustained throughout a lifetime.

In case you were wondering, after acknowledging the lunchtime comment and reciprocating with a un-amused shrug combined with a civil smile, I returned to my desk and proceeded to thoroughly enjoy my Lean Pocket. It may not have been the best, but it could have been worse. Like each and every individual who steps through my door, I also am striving for my own nutritional balance.

The Calorie Mentality

When browsing the website recipes, you will find one word is noticeably absent: Calories.

The primary focus of STUFFED is to help others understand food and how it can be used to generate energy to live. Therefore, tossing the word aside is seemingly foolish. It appears I am choosing to neglect the nuts and bolts of what is deemed the key to achieving weight loss: balancing calories burned with calories ingested.

On the contrary, I am embracing a different approach. I continue to encourage this balance, but am deciding to take away the calorie’s starring role in the equation.

The calorie is the globally known unit of measure that identifies how much energy-producing value a food has. So, why I am I being so harsh on it? Simply stated, balancing your calories does not solely equal good nutrition, and there is much more to a calorie than what meets the eye (or in this case, stomach).

I do not despise the concept of calorie “awareness.” Words like this, as well as mindfulness, are trending among the nutrition world. I’ll admit, despite their “kumbaya” overtone, I believe their concepts to have imperative value.

I find this awareness necessary, in order to get a ballpark idea of the amount of energy you are giving your body to deal with. Undeniably, the saying “too much of a good thing” rings true. However, often I have seen counting calories embody the end-all-be-all of a diet plan. If 1,989 calories are consumed, one wouldn’t dare eat 35 calories coming from 10 grapes that would surpass their 2,000 allotment.

Realistically, a 2,000 diet plan could look like this:

            Breakfast: Medium Cappuccino with sugar, apple crumb donut (710 kcal)

            Lunch: Fried fish filet sandwich, small serving French fries (620 kcal)

            Dinner: 2 cups macaroni and cheese, 20oz Soda Pop (640 kcals)

            Snack: 6 jelly beans (24 kcals)

Grand total for the day: 1,994 kcals. Within the goal, and 6 calories left to spare! However, as a dietitian, a small part of me cringed inside typing this because it is all too real. Noticeably lacking: vitamins, minerals, fiber, and many more of their healthful friends.

Additionally, I hate to burst a calorie-counter’s bubble, but after meticulously calculating the calories ingested for the day, the odds of that number accurately reflecting the exact consumption are low. There is a reason the calories listed are rounded off to the nearest 5th or 10th. They are estimates.  

Google calories in a banana. What pops up on the top of the screen is “105 calories” followed by the description of the size of the banana that this number would pertain to. Honestly, how many bananas are exactly 7-7.5 inches in length.

What truly troubles me, is the negative connotations the meek yet mighty calorie has gathered. By counting calories, suddenly food is something to be feared or immediately rid of. The word has morphed into the driving force for an obesophobic environment.  Eat a 200-calorie cookie; you must do aerobics for 30 minutes to burn it off. It is a vicious mind game, and one that I don’t have time to bother with. Enjoy that cookie, but understand that it is a treat, not nourishment.

Here’s my challenge: eat a food because you know it is good for you. Think of what the food will do FOR you, not TO you. Eat slowly. Listen to your body. Read labels, but don’t stress over them. In fact, go for foods without labels (these tend to be fresh produce). Exercise because you like the feeling your muscles have after. Move because you want to age gracefully.

Live.


**To learn more about calories, I highly recommend the following article. It tackles many of the truths and myths surrounding food and its caloric value. The author is Ryan Dunn, a science writer and biologist at North Carolina State University. It is an excellent synopsis of why a disproportionate amount of emphasis is placed on "calorie counting" when speaking about health and nutrition.

http://blogs.scientificamerican.com/guest-blog/2012/08/27/the-hidden-truths-about-calories/


Thoughts and such -- Welcome :-)

There is no lack of nutrition information on the internet. Whether you crave recipes, articles, or reviews (basically everything this site also offers), within a few Google searches you will have every answer you seek.

Despite the convenience of finding this information, why are we still so fascinated, and perplexed, by food? I'll be honest...I don't have the answer to that.

Like you, I have my guesses. Perhaps it is the everlasting struggle of finding that delicate balance we call "eating in moderation." Why does a massive plate of pasta primavera makes us weak in the knees, yet we can pass by a bowl of lima beans without a second glance? How is it fair that from an anatomical standpoint, we are expected to go easy on the Italian goodness if we want to keep our health in check? When that plate is in front of us, moderation seems a little less likely (and cruel). However, the cold hard facts don't change, and we have seen the consequences of decadence all day every day.

What has been baffling me, and is essentially the reason for starting this website, is that regardless of the multiple television networks, magazines and blogs that discuss nutrition, fewer and fewer people are actually cooking.

In 2009, Michael Pollen submitted an article to The New York Times, entitled, "Out of the Kitchen, Onto the Couch." In it, he describes the American society going from a time when cooking seemed doable and relaxed (think Julia Child), to the current daunting atmospheres of "kitchen stadiums" and other highly competitive arenas.

Suddenly, cooking has transformed from something fun to intimidating. I grew up in a blue-collar Michigan city, therefore kale, chia seed and duck confit were not dinner staples. Due to a fear of crashing and burning, for a long time I turned to the grocery store isle and picked out my favorite colorful box. Heated it up. Then threw it on a plate. My career as a Registered Dietitian showed me that my old ways were still very much alive in society today. It soon became obvious that hot dogs, instant mashed potatoes, and macaroni and cheese were regularly invited dinner guests, and the fresh vegetables were the Cinderellas not chic enough to join.

So here's my point, let's all just chill out and branch out. I'm not saying don't ever eat these things. What I am saying, is stop and think for a second. Understand the impact nutrition has on your body. Redefine what you consider to be cooking. Rediscover your grandma's favorite nutritious vegetable, or try a new one that a foreign culture has made mainstream -- Just. Try. This website is a challenge for myself as well. An opportunity to be pushed out of my comfort zone in many ways.

Full disclosure - I'm still a terrible cook, and I'm a dietitian! But that doesn't stop me from trying. If 50% of my weekly meals are burnt, the way I see it the other 50% were bearable.

Enjoy, get some ideas, and have a little fun. I am not re-inventing the wheel and giving you new information, but rather trying a light-hearted perspective that once again gets those wheels turning.