Conditions and Diseases

Life After Catastrophic Injury

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Life After Catastrophic Injury requires a multi-pronged approach to healing.

In the course of my Pilates career I have worked with many clients who were recovering from catastrophic injury and illness.

  • One woman was paralyzed below the waist after a toboggan accident (she crashed into a trail marker head first) and wanted to dance at her wedding (it happened!).
  • Another was hit by a car while she walking on the sidewalk, leading to a serious brain injury along with physical issues.
  • A third client fell and crushed a vertebrae in the lower thoracic/lumbar spine region, leading to many surgeries and years of pain and dysfunction.

What they all have in common is a catastrophic injury. What they don't share is the multi-pronged approach to healing.

Catastrophic events where we are not injured affect us after. We can have psychological, behavioral, and social issues that arise. Anxiety, shortness of breath, inability to sleep, tension, anger, and depression can all arise after trauma.

We can feel helpless, hopeless, and completely stressed out.

Add to that a bad physical injury that causes chronic and acute pain, especially debilitating pain or nerve damage and/or paralysis, and there are multiple levels of injury that need healing.

What to do?

  • First, make sure you have great primary physicians and surgeons.
  • Second, make sure you have great physical therapists and other physical support people - massage therapists, personal trainers, etc.
  • Third, find a trauma psychotherapist or psychiatrist whom you like and are comfortable with. This is the key person that many trauma patients are missing!
  • Finally, keep a close social network of friends and family to keep you happy, bring you presents, slap you when you need it, and remind you that there is still a world outside of your injury.

You must trust all of your practitioners, because there will be times that therapy will make things feel worse as they are getting better. The extra pain can be extra disturbing if you don't trust the people who are helping you.

You may have your physical stuff in order, but without the social and psychological counseling you will not have all the support you need to enter life fully again.

Remember, address healing on all levels or you will never fully heal.

Pilates after Hernia Repair

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Pilates after hernia repair offers a crucial piece of the exercise puzzle - pelvic floor and deep abdominal support!

Lately I have received several requests for exercise suggestions to help either repair small existing inguinal hernias, or assist in maintaining a hernia repair after surgery.

First of all, what is a hernia?

According to the NIH,

A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. This layer is called the fascia.

Basically, a hernia is an area where the intestines start to protrude through a weak area in the abdominal wall. Hernias are named for location (inguinal - groin, umbilical - belly button, hiatal - upper abdomen, femoral - upper thigh).

Hernias are caused by straining while abdominal pressure is increased - it can happen on the toilet, opening a window, or even lifting weights and/or doing abdominal exercises incorrectly.

Yes, you read that correctly. Poorly executed exercise can cause hernias and make existing ones worse.

However, correctly done exercise can help heal a hernia, especially after repair.

Exercise recommendations for pilates after hernia repair are similar to those for diastasis recti.

Once you have been cleared by your physician to exercise, it is important to avoid straining while increasing abdominal pressure. This requires careful monitoring of breathing patterns while moving and exercising.

At the beginning you should avoid most traditional abdominal exercises, such as crunches. You should also avoid overhead presses.

Focus on exercises that help engage your pelvic floor muscles, diaphragm, and deep abdominals.

Breathing correctly is the first challenge.

Listen to the first breathing exercise in my back pain video. This is the basis for moving correctly in any exercise.

Living With Chronic Pain

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Living With Chronic Pain is not easy. Here a few tips on navigating the world when you aren't feeling great.

I spent about 15 years of my life (from 15-30) living with chronic pain. I had severe endometriosis (where the lining inside of the uterus shows up outside, sitting on nerves and inflaming tissue) and interstitial cystitis (where you feel like you have a urinary tract infection all the time, with no infection present), along with crazy PMS.

Weeks when I had my period were the worst, but no time was really pain-free.

I was routinely seeing specialists, getting tested, and taking a lot of painkillers. Basically, all of my non-working life was defined by my pain.

So I know how difficult it is to stay out of the abyss.

I have been pretty much free of chronic pain since my hysterectomy in 1996, and now am able to define myself in other ways.

Here are some tips that really helped me get through that time:
  • Make sure you eat well and drink enough water, especially if you are on a lot of medication.
  • Exercise and move regularly, even if you don't feel like it. Movement will ultimately help a lot. There are plenty of mellower things you can do, such as walking, swimming, yoga, tai chi, and Pilates.
  • Get out of the house often.
  • See a therapist. Seriously. If your pain is due to a bad accident or trauma, then you will need a professional to help you move away from that and navigate the Post Traumatic Stress Disorder (PTSD) that will inevitably result.
  • Find others with your condition. A support network of people going through the same thing will help.