Today I am excited to feature a guest post by Dr. Ashley Chandler PT, DPT on Yoga and Pelvic Health PT. Ashley works at Advanced Physical Therapy Solutions with me and has begun to work in the pelvic health field more and more over the past few years. I am very thankful to have her help in writing about why yoga is an important part of pelvic health PT as well as jumping on the pelvic bandwagon with me!
Pelvic floor dysfunction and yoga. They have such a great relationship with each other, the more I learn about both the more I think this.
Let's rewind.
I first met Lacy Kells at Duke University in 2006 when we both started our journey towards our doctorate in physical therapy. We became immediate friends and helped pull each other through the rigorous process that is PT school.
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| Lacy Kells, Ashley Chandler, and our dear friends from Duke enjoying our reunion weekend in Charleston in 2017. |
Fast forward to 2015. Pregnant with my first baby and still mostly uninterested in working with pelvic floor patients. I gave birth in January 2016 with a lovely tear of my perineum. I had sensations of something "extra" in my vagina in the first few weeks following delivery, leading to a panicked text message in which Lacy told me to let myself heal and we'll figure it out when and if we need to. Luckily I have a pelvic health PT as my best friend, because my 6 week check with my delivering MD included a cursory look and a leading question of "everything is going well, right?" Yup, super fantastic (dripping with sarcasm). I'm still weak as can be but thank goodness the prolapse sensations had resolved for the most part.
This lit a fire under my butt to be able to offer other women better care than what I had received. It is ridiculous that my physician didn't complete a more careful examination. It wouldn't have taken long to ask me about leaking or tell me things to watch for and what to do about them (like go visit your friendly, local pelvic health PT for example). So I took matters into my own hands and decided to attend Hermann and Wallace's Level 1 course. Here we go, a weekend filled with giving and receiving internal exams. I don't think many professionals get this level of intimate encounters in their continuing education.
Around this time, Lacy came back into the clinic for more patient care and began seeing almost all pelvic health patients. I became her "assistant" or maybe apprentice is a better way to put it.
I have a background in chronic pain and happen to be a yoga instructor and had found a great relationship between the two, and I soon found that the same can be said of pelvic health and yoga.
To waaaaay oversimplify, the patients Lacy sent to me seemed to be either people who needed to relax the pelvic floor (usually those who are more pain driving and have pain with intercourse, pain with sitting, sometimes accompanied by leaking) and those who needed strengthening because of incontinence. Again, I way oversimplifying the many things that can be going on with a woman but it helped me make sense of things as I eased myself into the specialty.
I did a lot of research, began following a ton of people more experienced than me on social medial and began to find the connection between breathing and the pelvic floor. There is this beautiful dance that happens between the anterior abdominal wall, diaphragm and the pelvic floor. It happens with every breath we take and with pelvic patients I almost always found this to be altered. Luckily, I have been teaching yoga for years and yoga is very much about the breath.
Most fitness or functional cues I use have a yoga twist to them and I already started almost all my treatment sessions or plans of care by watching my patient or client breathe, so I was already very comfortable with this. Combining this with new knowledge of how the pelvic floor and the breathe work together and you get a naturally amazing relationship between pelvic floor dysfunction and yoga. Everything in yoga is tied to the breath and all movement in yoga uses your own body weight as resistance; both things we need to master for our body to work at its greatest potential. There is a component of relaxation, utilization of the parasympathetic nervous system (our relax and digest side) in every class taught which is paramount to happy pelvic floors. Yoga also builds strength, stability, and power. I have always used it in my PT practice, but now that I am becoming more and more involved in pelvic health, I am finding it even more essential. Yoga and pelvic PT definitely go hand in hand, in my totally biased opinion!
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| Ashley on her wedding day in 2008 in the midst of PT school with our three best friends from Duke, back when she was totally sure she would NEVER treat vaginas. #neversaynever |
Ashley Chandler is a certified lymphedema therapist in Fayetteville, NC who leads the oncology rehabilitation program at Advanced Physical Therapy Solutions. She is also manual therapy certified and uses hands on care every day as she makes movement better for her patients. She has practiced yoga since 2002 and has been a yoga teacher for nearly 9 years and uses this daily in her clinical practice. In her free time she enjoys the outdoors, traveling with her family, and baking the most delicious treats you've ever tasted.
You can follow her on instagram @ashleychandleryoga, facebook at Ashley Chandler PT, DPT, CLT. Best of all she has a youtube channel with lots of short yoga flows that you know are safe since she's a Doctor of Physical Therapy AND a yoga instructor.
Dr. Lacy Kells PT, DPT
The Physio Down Low @ Advanced Physical Therapy Solutions
Follow me on Facebook at Lacy Kells PT, DPT
and Instagram @lacykellspt
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