March is national Autoimmune Disease Awareness Month and according to the American Autoimmune Related Diseases Association (AARDA), almost 50 million people have some sort of autoimmune disease. These disorders can mimic many other diseases and have common symptoms such as joint pain, fatigue, and muscle weakness. Often times patients might have to visit four to five different physicians over several years before receiving a diagnosis.

Autoimmune diseases occur from a dysfunction of the immune system, which is designed to fight infection and protect our bodies from harmful bacteria and toxins. In an autoimmune disease the body begins to attack healthy cells, tissues, and organs. According to the National Institutes of Health more than 80 autoimmune diseases have been identified. Some are well known such as multiple sclerosis, lupus, and rheumatoid arthritis but others are rare and difficult to diagnose.

How Can Physical Therapy Help?

Some common symptoms of an autoimmune disorder are chronic fatigue, muscle or joint pain, loss of strength, decreased range of motion, and balance issues to name a few. Your physical therapist at CTS can use a variety of techniques such as stretching, range of motion and mobility exercises, strengthening activities, balance training, soft issues mobilization, and energy conservation techniques to design a treatment program specifically for your needs. Your PT can also assist with a total rehab program to address the lifestyle changes needed to manage the daily tasks essential to maintaining quality of life. Proper diet, appropriate exercise, stress management, and adequate sleep can go a long way with managing the symptoms of an autoimmune disease. CTS is here to help!

Talking about bowel and bladder function can be tricky.

Many women never discuss these sensitive topics with friends. Even the medical community often falls short when discussing such personal issues. At CTS we specialize in all things bowel and bladder and have your most personal questions answered. 

Reservations only. Contact Anne Shea at anne@comprehensivetherapy.com or
858-457-8419. Click to Learn More »

1 in 12 men suffer from pelvic pain and most suffer in silence.

Let's gather together and share our experience and resources. Together we can heal & help others get on the road to recovery. For more information, contact Milan at milan@comprehensivetherapy.com or 858-457-8419. Click to Learn More »

The Glottis, Diaphragm, and Pelvic Floor: It's all about Pressure Control

When most people think of physical therapy, they don't always think of the pelvic floor, they rarely think of the diaphragm, and almost never think of the glottis. However, all of these structures play an important role in pressure control and stability within the body. The glottis is comprised of the vocal folds and the space between them within the larynx. The vocal folds are open, allowing air to pass in and out with breathing. When the vocal folds are closed, airflow is blocked. Speaking, whispering, yelling and singing involve varying degrees of vibration as well as opening and closing of the vocal folds while air is moving out of the lungs. The diaphragm is a dome-shaped muscle that lines the underside of the lungs and anchors down onto the inner border of the ribcage. The diaphragm drives breathing through a contraction that draws the lungs downwards, resulting in a negative pressure system to draw air into the lungs for oxygenation. The diaphragm also assists in phonation. Many people with chronic low back pain have been found to have over-recruitment of the diaphragm and use it as a postural stabilizer. Also, if phonation is poor, the diaphragm may be locked "down" (flat and tense).

The movement of breathing is most often thought to occur in the chest, but ideally, movement should be reaching all the way down to the pelvic floor.

Shape-wise, the pelvic floor mirrors the diaphragm. The pelvic floor is a bowl-shaped sling of muscular layers that support the core from the underside. The pelvic floor lines the bottom of the pelvis and has many important roles ranging from maintaining continence to support of the pelvic organs. Optimal breathing involves the diaphragm and pelvic floor acting together. Inspiration drives descent, elastic loading (lengthening) of the pelvic floor. Expiration drives a lift, muscular contraction (shortening) of the pelvic floor. So, if the diaphragm isn't functioning properly for breathing - as it may be in those with poor phonation or low back pain - the pelvic floor may not be moving properly either. Improper movement of the pelvic floor can lead to decreased circulation and oxygenation to the tissues, pain, weakness, poor coordination, and even bowel and bladder control issues.

The glottis, diaphragm, abdominal muscles, and pelvic floor all play a large role in managing intra-abdominal pressure.

Intra-abdominal pressure is a means through which the body finds core stability, especially during functional tasks such as bending, lifting, and carrying. Pressure is increased in the abdominal cavity through contraction of the aforementioned muscles and breath control (often breath-holding, think closed glottis). Poor control of intra-abdominal pressures can lead to impairments such as stress urinary incontinence, prolapse, diastasis recti, as well as many other conditions. In addition to strengthening the pelvic floor muscles and specific abdominal muscles, training breath techniques are very important in addressing the dysfunctional symptoms.

For example, lifting a child from the ground into their car seat requires a significant amount of strength. In a postpartum woman who has decreased abdominal - and likely pelvic floor - muscle activity, they may hold their breath and even contract their diaphragm as a compensatory strategy to find that stability during the task. If the intra-abdominal pressure exceeds what the pelvic floor muscles can counteract, then urinary or fecal incontinence may occur. In addition, low back pain may result as can dysfunctional breathing patterns. In fact, the mechanics of normal respiration can be compromised even during pregnancy. And research has shown that spontaneous restoration of diaphragmatic breathing postpartum is impaired. Luckily, biomechanics can be retrained, and its negative effects can be improved.

Unproductive coughers may have a diaphragm that is over-recruited all the time and cannot relax well to push the phlegm up to clear the airways. This can be improved by lining up the airways by lengthening through the top of the head. Stress urinary incontinence with sneezing may be corrected in the same manner. Tightening the pelvic floor muscles may not be the most helpful strategy for everyone. Instead, lengthening through the top of the head to create tension in the system can help to move the pressure up and out, decreasing the load on the bladder and pelvic floor muscles.

Don't be surprised if part of your physical therapy treatment includes a significant focus on breathing, both in isolation and with your exercises. It's all part of treating the whole picture.

Emily Cozine, PT, DPT

CTS Helps Against Stress

Stress is common, in fact, it could arguably be the #1 cause of death. Stress often leads to mental and physiological changes that include headaches, neck ache, back ache, muscle spasms, chest pains, excess anxiety and depression, and the list goes on and on. It's hard to think of any disease in which stress cannot play an aggravating role or be the reason for the problem. The one great thing about stress is that it can be managed! With all the striking effects on the body stress causes, you are in a position to do something about it.

Great practices to reduce stress include exercise, considering supplements, using essential oils, and massage. CTS is here to aide you in taking these steps to reducing your stress!

1. Exercise: in the form of Pilates!

We have Rose and Kristen that offer Pilates instruction one-on-one or in group setting, whichever your preference. According to Better Health, Pilates has been shown to improve flexibility, posture, stabilization of your spine, concentration, stress management and relaxation, among many more benefits.

For more info on benefits of Pilates - CLICK HERE

2. Consider Supplements: CBD Tinctures!

We carry Theramu pure hemp extract, a CBD oil, that has many aiding properties such as reducing pain, anxiety, and helps promote restful sleep. CBD and marijuana has been used as far back as biblical times, this plant has many healing properties, the amazing technological advances and abilities to isolate CBD with no trace of THC is great and eliminates the psychoactive effects that THC causes. One of our wonderful physical therapists would love to give you more information during your next visit to CTS.

For more info on uses of CBD oil - CLICK HERE

3. Essential Oils: DoTerra!

We have DoTerra oils available for purchase. Essential oils are extracts from plants, capturing the plant's scent and flavor through distillation. Essential oils are used for aromatherapy and have many soothing and therapeutic properties. Some of the most common oils used to reduce stress are lavender, jasmine, and chamomile.

For a longer list of stress reducing essential oils - CLICK HERE

4. Massage: Luna's here to help!

There are many well-known benefits to massage, an important one: reducing stress. Incorporating massage at least once a month will have lasting effects. Massage therapy is calming and is not only for reducing stress but also for pain reduction and enhancing immune function. Luna incorporates soothing music, essential oils via aromatherapy diffuser and massaging into the skin (if desired), into every massage. Each massage is tailored to your needs providing a wonderful therapeutic touch incorporating multiple modalities which include Swedish, sports, deep tissue, trigger point therapy and structural. Luna is also trained in Prenatal massage, so all of you expecting moms get to enjoy all the benefits too. Don't wait to schedule your massage, treat yourself to a well-deserved massage by calling in to schedule!

To read "Social Touch, CT Touch and Massage Therapy: A Narrative Review" - CLICK HERE

We hope these tips to reducing and managing stress have helped. We are excited to work with you and get you on track to feeling great!

Wishing you good health and happiness. 

We'll see you soon,
Your CTS Family

Jessica Luna, Massage Therapist