Why Massage Isn't Fixing My Chronic Pain

When most people think about preparing for birth, their minds jump to packing a hospital bag, picking out onesies, or maybe writing a birth plan. And while those are important, there's one powerful piece of prep that often flies under the radar: physical therapy—specifically, pelvic floor physical therapy. Yes, birth is natural. But natural doesn’t mean easy. It’s one of the most physically demanding events a body can go through, and just like you’d train for a marathon, preparing your body for labor and recovery can make a huge difference in how you feel during and after birth. What Is Birth Prep Physical Therapy? Birth prep physical therapy is about optimizing the body for labor, delivery, and postpartum recovery. It typically involves working with a pelvic floor physical therapist who focuses on: Pelvic floor awareness and relaxation Core strength and trunk stability Hip and spine mobility Breath work and pushing techniques Postural alignment Labor positions It’s not about doing Kegels on repeat (actually, in some cases, Kegels might not be what you need at all). It’s about balance—learning to relax and engage the right muscles when you need them most. Why It Matters Labor is like a full-body workout meets endurance event. Physical therapy can help you: Prepare for different labor positions that optimize pelvic space Minimize pain or discomfort during pregnancy, especially in the hips, back, and pelvis Improve pelvic floor mobility, which can aid in pushing and reduce tearing risk Recover more smoothly postpartum, especially if you’ve had a C-section or perineal trauma  Bonus: Postpartum Care Here’s the truth no one talks about enough: birth recovery doesn’t have to start or stop at your 6-week checkup. Physical therapy can support your healing journey sooner (up to 2 weeks postpartum), and can start months (or years!) postpartum, and can help with: Scar tissue mobilization (from tears or C-sections) Core and pelvic floor rehab Returning to exercise safely Managing pain with sex or daily movement Bowel and bladder dysfunction Final Thoughts Birth prep is more than buying the right swaddle. It’s about feeling connected to your body, understanding how it works, and feeling confident heading into labor. Physical therapy is a powerful, evidence-based tool that every birthing person deserves access to. If you’re pregnant, consider adding a pelvic floor PT to your birth team. It might just be the best-kept secret in birth prep and in your postpartum recovery.

Also... what is a pelvic floor?

Why you should keep moving when you have low back pain!

Low back pain: What is it and what steps can I take to improve it? Low back pain is one of the leading causes of disability worldwide, and millions of individuals of all ages suffered from back pain in 2020 (IHME, 2023). It can hinder people from performing daily activities, working, and enjoying a good quality of life. While many instances of low back pain do resolve with proper care, including PT, a significant number of individuals experience chronic low back pain that lasts for weeks, months, and even years. While many believe low back pain is predominantly a musculoskeletal issue, it can also have a huge impact on your social life, mental health, and even have economic consequences from the limitations and restrictions it can create in your daily life. Low back pain is defined as pain in the lower part of the spine. It can range from being mild to severe in intensity and range from being acute, lasting a few days to a few weeks, to severe, lasting more than three months. There are many factors that can contribute to the severity of the pain, including factors that are modifiable and nonmodifiable. Nonmodifiable factors include our age, past medical history of back pain or other injuries endured that cause pain, and our genetics. Modifiable factors include occupation, increased body weight/obesity, lack of quality and quantity of sleep, increased stress levels, poor activity level or sedentary behavior, and poor eating habits. While it is not as easy to change our occupation or age, we can make other adjustments to help improve our pain and therefore, quality of life. Many of the modifiable factors listed above pertain to our behaviors and over wellness, which often have a big impact on our pain and symptoms, severity of discomfort, and even our perception when it comes to addressing our aches and pains. Taking the time to improve these modifiable factors can often help to alleviate the severity of the pain, and help people get back to living a more meaningful life. You can do this by: Aim to get 150 minutes of moderate intensity exercise throughout the week. This will improve activity levels throughout the day and increase blood flow throughout the body. Walk frequently throughout the day Increasing activity levels will help to reduce sedentary time as well as static positions. Posture is often questioned as being a contributor to pain, however, the duration of a position is a bigger cause of discomfort. Reduce screen time up to 30 minutes to 1 hour before bed and aim for 7-8 hours of sleep This can help to improve the quality of sleep, all and allow the body to recover from stress the day before. Work on managing stress levels with meditation, therapy, journaling, and more exercise! Mental health and stress are often big contributors to pain and can often worsen symptoms. Taking time to improve this area can often help alleviate symptoms as well as perception of pain. Lastly, aim to focus on consuming 1 gram of protein per lb of body weight and consuming whole foods Sugar and alcohol can often be irritants for pain, and can exacerbate symptoms. References https://www.healthdata.org/news-events/newsroom/news-releases/lancet-new-study-shows-low-back-pain-leading-cause-disability

CrossFit Open 2025 Your Guide to Preparation and Recovery The CrossFit Open is here, and whether you're a seasoned athlete or a first-time participant, it's an event like no other! I've been participating in the Open for the past few years—not as a professional CrossFitter, but just for the sheer fun and challenge of it. The energy at Shoofly Athletics, where I compete, is unmatched. The cheers, the adrenaline, and the personal breakthroughs make it an incredible experience. Somehow, I always find strength I didn’t know I had! As a physical therapist, I know firsthand how important it is to prepare properly and recover effectively. Here are my top tips to help you get the most out of the Open, stay injury-free, and recover like a pro. Preparing for the Open 1. Have a Performance-Based PT on Call Having a knowledgeable performance PT can be a game-changer. If you don’t have one, let me be that person for you! Even if you're not a patient at our clinic, I’m happy to answer your questions. Feel free to text me at 919-948-0881 or email amanda.brewer@evolveptnc.com. 2. Prioritize Mobility and Accessory Work Make sure you're dedicating 3-4 sessions per week to mobility and accessory exercises. If you need a plan, follow us on Instagram @EvolvePT.NC , where we’re posting Open Prep videos to help you stay on track. Game Day: How to Perform Your Best The Night Before Fuel your body with a well-balanced dinner rich in carbohydrates and protein. The Open is a marathon, not a sprint, and proper fueling will make a difference. We’ll be sharing some great pre-Open meal ideas on our Instagram and blog! The Day Of Fuel Up 2 hours before: Eat a balanced meal, such as eggs, potatoes, toast, and fruit or a Greek yogurt bowl with fruit and granola. 30 minutes before: Have quick carbs like gummies, applesauce, or a banana to give you a final energy boost. Warm Up Properly A 15-20 minute warm-up that mimics your workout is essential. Don't just hop on a bike or rower for five minutes—this won’t prepare your body properly and increases your risk of injury. We’ll be sharing optimal warm-ups for each Open workout on our Instagram @EvolvePT.NC —so be sure to check them out! Recovery Between Workouts 1. Schedule a Recovery Visit Nagging issues won’t disappear on their own, and pushing through pain can lead to injury. Even if you feel fine, maintenance techniques like dry needling, cupping, and scraping can help muscles recover efficiently and prepare for the next workout. We offer 15-minute complimentary Recovery Room visits after each session, including Normatec Boots, heating pads, and red light therapy. Want to schedule a session? Text 919-948-0880, and Sarah will set you up! 2. Keep Up with Mobility and Accessory Work Recovery isn’t just about rest—it’s about active recovery. Keep your body moving with targeted mobility work to ensure optimal performance throughout the Open. Post-Open Recovery Plan 1. Refuel Your Body Your muscles need protein to repair and grow. A good rule of thumb is 1 gram of protein per pound of body weight . For example, if you weigh 200 lbs, aim for 200g of protein per day to support recovery. 2. Meet with Your Performance PT After the Open, it's crucial to assess any aches, pains, or weaknesses that surfaced during the workouts. A professional evaluation can help prevent future injuries, accelerate recovery, and improve performance for next year! Ready to Crush the Open? By following these steps, you’ll not only perform at your best but also recover efficiently so you can continue training without setbacks. Want to set up a personalized plan for the CrossFit Open? Fill out our contact form here: Evolve PT Contact Form Let’s make this year’s Open your best one yet! 💪🔥

Pelvic floor dysfunction can encompass a wide range of issues related to the muscles and organs housed in the pelvis. These muscles help with childbirth, bowel and bladder movements, supporting our internal organs, sexual activity, and supporting our skeletal system. There are a wide variety of signs and symptoms for dysfunction, including hip and low back pain, tail bone pain, bowel and bladder incontinence, constipation or difficulty voiding, and increased urgency to void. However, did you know that pelvic floor dysfunction can also present as pain with intercourse and difficulty achieving an orgasm? Sexual health can be one of the most commonly over looked issues with pelvic floor dysfunction. Orgasm and sexual experiences are a complex process, and pelvic floor dysfunction can interfere with this process at a mental level, musculoskeletal level, and interfere with nerve stimulation (Handa et al., 2008). Overactivity, heaviness, or weakness of the pelvic floor muscles can make it difficult to achieve muscular contraction or may even cause pain with insertion. If nerve damage or increased sensitivity of the nerves are noted, this can negatively impact sexual health by increasing or decreasing sensitivity of the genitalia (Handa et al., 2008). Lastly, these changes or lack of sensation and muscular imbalances can create psychological challenges with sexual health and reduce libido (Martinex-Galiano, et al. 2024). If someone has pain with intercourse, this can create fear or anxiety with sexual activity which can negatively impact the physical symptoms experienced. Collectively, this can create a cyclical pattern between the physical symptoms and mental concerns, and can often worsen symptoms and experiences associated with one’s sexual health. Luckily, pelvic floor physical therapy can be a tool to help address these issues and address the deficits with muscles, nerves, and mental barriers when it comes to sexual health. Performing a thorough assessment can allow a pelvic floor PT to help develop a plan of care to help address these symptoms utilizing manual therapy techniques, exercises, education, and different tools to reduce discomfort or pain with intercourse, as well as improve the experience and discuss ways to enjoy intimacy with your partner! References: Handa, V. L., Cundiff, G., Chang, H. H., & Helzlsouer, K. J. (2008). Female sexual function and pelvic floor disorders. Obstetrics and gynecology , 111 (5), 1045–1052. https://doi.org/10.1097/AOG.0b013e31816bbe85 Martínez-Galiano J.M., Peinado-Molina, R.A., Martínez-Vazquez, S., Hita-Contreras F., Delgado-Rodríguez, M., & Hernández-Martínez, A. (2024).Influence of pelvic floor disorders on sexuality in women. Int J Gynecol Obstet , (164), 1141-1150. doi: 10.1002/ijgo.15189 Zhuo, Z., Wang, C., Yu, H., & Li, J. (2021). The Relationship Between Pelvic Floor Function and Sexual Function in Perimenopausal Women. Sexual medicine , 9 (6), 100441. https://doi.org/10.1016/j.esxm.2021.100441

Read below things that you can do to help improve the quality of your sleep!