Category Archives: Chiropractic

Chiropractic

Tongue Tied

Knowledge of tongue and lip ties has become more and more mainstream these days. We are seeing the impact these have on breastfeeding, oral development, and speech. More practitioners are learning how to diagnose and treat these conditions. This article will be a very brief explanation of what tongue ties and lip ties are, how they can impact you or your child’s health, and how to treat these conditions.

What Is a Tongue or Lip Tie?

First, lets look at what tongue and lip ties are. A tongue tie is when the frenulum, or band of connective tissue that connects the tongue to the bottom of the mouth, causes restriction in the motion of the tongue. A lip tie is when the frenulum that connects the upper lip to the gums causes a restriction in the motion of the lip or causes structural change to the gums. There are also buccal ties that can occur too. These are less common but they form along the upper gum more towards the back teeth on either side. These connect the upper gum to the inner cheek. These tend to not cause the same amount of issues as the tongue and lip ties.

There are different grades to identify the type of lip and tongue tie. So lets start with the tongue tie classifications. There are four types of tongue ties and they are distinguished by where the tongue tie attaches to the tongue. They are not indicative of severity of the tie (type 4 is not worse than type 1). These numbers are based on Dr. Kotlow’s classification system for tongue ties. Pictures of these can be found at here.

– A Type 4 tongue tie is when the frenulum under the tongue attaches all the way to the tip of the tongue.

– A Type 3 tongue tie is when the frenulum attaches at the midline of the tongue.

– A Type 2 tongue tie is when the frenulum attaches to the tongue at a point posterior (behind) to the midline of the tongue.

– A Type 1 tongue tie is when only the posterior tissue is restrictive. This may not be observable without palpation of the tissue and may be hidden under the mucosal tissue beneath the tongue.

Now for the lip tie classification. Again, there are four classes of lip ties and they are distinct for the anatomical variations not based on severity.

– A Class 1 lip tie has no significant attachment to the gum line.

– A Class 2 lip tie attaches exclusively to the gingival (gum) tissue.

– A Class 3 lip tie attaches just in front of the anterior papilla (the edge of the gum tissue).

– A Class 4 lip tie attaches posterior to the papilla onto the hard palate.

Why Do People Have Lip or Tongue Ties?

So now that we know what we are looking at, lets look at why this occurs. During development the body grows as cells multiply and create different tissues. As these tissues grow and shape themselves, cells are produced and some cells are degraded, a process called apoptosis. This process requires different enzymes to have methyl groups (a carbon atom with three hydrogen atoms attached) attached to them so that the enzyme can be functional and do its job of degrading unnecessary tissue. This process runs smoothly for those with no methylation problems. However, more and more people today are expressing genetic anomalies such as MTHFR that disrupt the methylation process and make it harder for a person to add methyl groups to molecules to make them functional. So as a result more babies are being born with midline defects such as a lip and tongue tie. If you have an issue with methylating the best thing to do is start taking a Vitamin B complex that has methylated B vitamins (It should say folate as 5-methylfolate and Vitamin B12 as 5-methylcobalamine). You also want to eliminate any other supplement that has unmethylated B vitamins (these would say folate or folic acid and Vitamin B12). You also want to cut out any processed foods that are fortified with Folic Acid. Many breads and grain products will be fortified with an unmethylated form of Folic Acid.

 

What are Common Symptoms of a Lip or Tongue Tie?

Lip and tongue ties can be difficult to diagnose, but there are some common symptoms that occur when a lip or tongue tie is present. Babies can have difficulty nursing. This can manifest as a painful latch or pain while suckling, clicking, choking or gaging while nursing especially upon milk letdown, inability to transfer milk affectively (this leads to more frequent nursing), shallow latch, or all together an inability to latch. Babies may also have digestive symptoms such as reflux, gassiness, spitting up, or colic. As the mother you may experience pain while nursing, creased or flat nipples after nursing, dryness or cracks on the nipple due to too much friction while nursing, clogged milk ducts, mastitis, or low milk supply. While these are not symptoms exclusive to lip and tongue ties, they are very common symptoms that should influence you toward getting evaluated by a professional.

 

What Can be Done?

Once it is determined that your baby has a lip or tongue tie there are a few options to help resolve the issue. Non invasive solutions include bodywork, myofascial therapy, chiropractic care, and craniosacral therapy. These focus on releasing the tight connective tissue, improving structural alignment, and increasing cranial and dural motion. This can be helpful in cases where the ties are not as severe and there are more mild symptoms. However, a more invasive treatment may be necessary. There are two different frenectomy procedures that are available that involve cutting the frenulum. One involves using scissors to cut the tissue. This procedure is typically done when there is an obvious anterior component to the tongue tie. Typically this procedure does not cut far enough back to eliminate any posterior components of the tongue tie. However, you may find a good pediatric dentist who will do a thourough procedure to release both anterior and posterior components. The other frenectomy procedure involves a cutting laser. A pediatric dentist trained in lip and tongue tie revision will use the laser to remove the excess tissue allowing for immediate increase in motion of the tongue and/or lip. After care requires stretches every few hours to prevent reattachment. Once the laser revision is performed it is ideal to have bodywork, craniosacral therapy or chiropractic care to help release and unwind any underlying restrictions that still remain. The ties are like the tip of the iceberg, there can be a lot of underlying restriction and tightness that is not obvious, but can continue to affect function. Results after the laser revision can vary quite a bit. Some mothers notice an immediate improvement and can feel like the revision completely corrected all the problems. However, there are times when there seems to be little to no immediate improvement. This is when bodywork and chiropractic care is especially necessary. The underlying tightness needs to be released in order to notice improvement and is necessary when attempting suck retraining exercises. If there are still restrictions within the cranium, jaw, neck, upper back and throat, then nursing and suck retraining exercises are going to be hindered. Suck retraining exercises can be given to you by your lactation consultant (the lactation consultants we used are referenced at the bottom of the article).

What Can Happen if Nothing is Done?

So what can happen if you decide to leave the tongue or lip tie alone and not pursue any revision or fascial therapy? There are many possibilities. One being that there may not be any obvious issues, adaptations, or symptoms later in life. However, with the abnormal structure present of a lip and/or tongue tie there will be adaptations necessary, obvious or not, and there is a likelihood that other symptoms would arise. Some common symptoms are speech difficulties, gapping in the teeth, early or worsened tooth decay, narrow maxillary and mandible (jaw) development causing sinus problems or TMJ issues, headaches, neck/upper back/shoulder pain and tightness, reflux, digestive issues, torticollis, plagiocephaly and possibly others. Speech issues can be an obvious sign if the child was not diagnosed with a tie earlier. Most children will have trouble with R, S, L, Z, D, N, T, Y, K, -NG, CH, TH, SH, and –dge although other sounds may be difficult as well. Having a tongue tie can lead to mouth breathing which can contribute to asthma, allergies, sleep apnea, snoring, and enlarged tonsils/adenoids. Ear infections may be more prominent in someone with a tongue tie because the back of the tongue can not elevate enough to equalize the pressure in the Eustachian tubes. This can lead to fluid build up that can not drain properly, allowing for an environment for the growth of a bacteria or virus. When children get older the swallow mechanics are altered due to the tongue tie and can affect drinking from a straw or how the child is able to swallow foods.

 

What Needs to Be Done After a Revision?

If you choose to have the lip and tongue ties revised with the cutting laser or scissors, there are several things to be aware of and to include in the care of your child. As mentioned earlier, there are varied degrees of improvement in symptoms with the frenectomy. Stretches for the tongue and lip should be shown to you at the time of the frenectomy and are typically done every few hours for the first 1-2 weeks and continued at a less frequent rate until the tissue is fully healed (about 1 month). Suck retraining exercises may be necessary to help strengthen the muscles necessary for a good latch and proper suckle. Bodywork, Craniosacral Therapy, and/or chiropractic care is very important regardless of the degree of tie and regardless of the type of symptoms you see. Very commonly, those with lip and tongue ties also have a tight dural tube. The dural tube is the connective tissue that surrounds the nervous system, the brain and spinal cord down to the sacrum. Unwinding the tightness in the dura and throughout the body will help your child feel more at ease and comfortable. Tummy time is another important addition to care after a frenectomy. Tongue and lip ties affect cranial nerve function, restrict normal range of motion and can diminish the baby’s ability to develop proper head control. Along with removing restrictions by utilizing chiropractic care and bodywork, having your baby build the muscles responsible for head control and movement helps to strengthen cranial nerve function and encourage a proper development. Children and adults over the age of 2 may benefit from orofacial myofunctional therapy. An orofacial myofunctional therapist works to help strengthen the tongue and other facial muscles to help correct breathing, chewing and swallowing issues that may still be present after a lip or tongue tie revision.

It is improtant to remember that not every child is the same and there are so many variables that can impact the decision of how to care for your child’s lip and/or tongue tie. Not every tongue tie will need a frenectomy. Some children can reestablish proper function just through chiropractic care and bodywork. Other children may need a frenectomy to be able to reestablish proper function. Tongue ties and lip ties can be a complex and sometimes overwhelming issue to navigate. However, with the right team of care providers on your side it can become a lot more manageable; and you can rest assured you are doing everything you can to help you and your baby thrive together. Below are a few trusted providers that we have used and referred others to.

Holistic Dentist (Lip & Tongue Tie Preferred Provider)

Dr. Preetha Thomas, DMD, Enclave Dental – www.enclavedental.com

Lactation Consultant

Mellanie Sheppard, IBCLC, RLC (and associates) – For Babies’ Sake – www.forbabiessake.com

The Importance of Cranial Rhythm and 7 Ways to Help Maintain Proper Motion

Many of us know that babies are born with soft spots where their skull is not fully bone yet. We also know that the skull becomes all bone, therefore the soft spots or fontanelles, close at a certain point in childhood (the last one closes usually around 2 years old). Most of us, however, do not realize that the bones in our head move in a rhythmic motion from before we are born throughout our entire lives, regardless of whether our cranial sutures and fontanelles close. This motion is vital to not only brain and nervous system function, but it is vital for whole body function.

Origins of Cranial Adjusting/Craniosacral Therapy

In the late 1800s and early 1900s, Dr. William Sutherland, an osteopathic doctor, was the first to recognize that the movement of the cranial bones and eventually uncovered a rhythmic fluid motion that encompassed the entire body.  He called this rhythm the “primary respiratory mechanism”. This mechanism includes the rhythmic motion of the cranial bones, nervous system, and spine along with fluctuations in cerebral spinal fluid flow and shifting tension among dural membranes (connective tissue surrounding the brain and nervous system). These movements are all involuntary and completely separate from cardiac pulse and breathing. Dr. Sutherland believed that a skilled practitioner connecting with this primary respiratory mechanism could bring about a therapeutic effect and therefore enhance health.

Many other Doctors and Chiropractors came to understand the importance of cranial motion and developed their own techniques to ensure proper movement. Major Bertrand Dejarnette developed Sacro Occipital Technique. Dr George Goodheart developed Applied Kinesiology. One of the most well-known and heard of techniques is Craniosacral Technique developed by Dr. John Upledger. Over 50 years after Dr. Sutherland, Dr. Upledger discovered this same rhythmic motion in the dural connective tissue while he was preforming surgery. He notice there was movement of the nervous system and dura that was at a different rate than the respiration and cardiac pulse of the patient. He later performed many years of research that became the basis of Craniosacral Technique. This technique allows a practitioner to contact the sacrum as well as the cranial bones, and due to the dural attachement from the cranial bones through the spinal column to the sacrum, correct the primary respiratory mechanism. Both Dr. Sutherland and Dr. Upledger believed that this mechanism was a mechanism that could be used for self-healing, and that at the hands of a skilled practitioner one could see improvements in health.

More recent histological and anatomical examination of the cranial sutures have validated that they are not completely fused and in fact have intricate articulations that allow specific movements. The 106 articulations between the 22 cranial bones all are shaped and connected to allow for the rhythmic motion of the primary respiratory mechanism. This motion occurs 6-12 times per minute. Disruptions in this motion can affect the entire body and cause physical or emotional symptoms. Dural or fascial restrictions can affect cranial nerve function and stimulation. It can also affect cerebral spinal fluid flow and therefore impact the nutrient and water distribution to different areas of the brain, spinal cord and peripheral nerves. For example, dural tissue attached at the temporal bones is contiguous with fascia of the carotid sheath (this contains part of the vagus nerve), the fibrous pericardium (around the heart), and the respiratory diaphragm. Therefore, a restriction in the dural tissue at the temporal bone can affect vagal stimulation as well as cardiac and respiratory function.

A well-functioning primary respiratory mechanism allows for full cranial and dural movement, as well as proper cerebral spinal fluid fluctuation. With this mechanism working properly, there is no interference occurring in the nervous system and no areas of restriction that would hinder function in the body. However, many things can disrupt this primary respiratory mechanism and cause alterations in cranial motion and positioning. Adhesions and areas of restriction and congestion develop which can have a negative effect on the way the body functions. There are, however, things that you can do to allow for proper cranial motion in your own child.

7 Ways to Help Maintain Proper Motion

1)     Cranial Adjustments

Baby’s cranial bones are very moldable and easily shaped. Often times, babies will be born with cranial bones that have molded quite a bit. This could be from the way they were resting in the uterus or because of the pressures placed upon the cranium during labor and delivery. Nursing can play a huge role in helping initially increasing cranial motion to help return the cranium to a symmetrical and round shape. However, most of the time a trained therapist is needed to ensure that all of the cranial bones are moving properly and there are no overlaps in the sutures or dural tightness and adhesions preventing motion. Chiropractors who are certified by the ICPA are proficient in cranial adjusting as well as therapists trained in Craniosacral Technique. There are many other techniques that can be affective in cranial manipulation such as Sacro Occipital Technique and Applied Kinesiology. Making sure that you find someone who has been trained in cranial adjusting and someone who is comfortable and confident in adjusting cranial bones is important.

Cranial adjusting, as mentioned above not only can bring proper symmetry, shape, and motion to the bones of the skull, but can affect whole body function and can have a positive effect on issues such as colic, digestive issues, reflux, sinus issues, ear infections, sleep issues, etc. Cranial manipulation can impact vagal stimulation and increase parasympathetic activity. This can decrease inflammation in the gut and improve digestive, respiratory, and cardiac function.

2)     Breastfeeding

Breastfeeding is extremely good for many reasons. One of those reasons is that it can help proper development of the cranial bones and mandible.  The sucking motion required for breastfeeding flattens the breast tissue up against the palate which helps shape and mold the roof of the mouth which is also the bottom of the sinus cavity. Breastfeeding allows for optimal shaping of the palate so it is smooth and rounded and not too high and narrow. High and narrow palates will cause the sinus cavity to become smaller and narrower.  This can lead to future sinus issues.  The sucking motion that presses the breast tissue into the palate helps to move the cranial bones and stimulate growth centers in the facial bones. Typically with breastfeeding the baby is held in different positions and he or she nurses on both breasts so the growth centers on each side of the cranial and facial bones are stimulated evenly. This sucking motion also aids in cerebral spinal fluid flow and helps to stimulate pituitary hormone release particularly growth factors.

3)     Lip and Tongue Tie Release

It is seemingly becoming more and more prevalent these days to see a baby with a lip and/or tongue tie. A lip tie is present when the frenulum or connective tissue between the upper lip and gum is overdeveloped and restrictive to the movement of the upper lip.  A tongue tie is present when the lingual frenulum or connective tissue between the bottom of the tongue and the lower jaw is overdeveloped and restrictive to the movement of the tongue.  Lip and tongue ties are thought to be genetic and are midline defects that are associated with genetic abnormalities that impact the body’s ability to methylate, such as MTHFR. Lip and tongue ties can vary greatly in degree and effect on function.  Lip and tongue ties restrict the function of the oral cavity. They affect the amount the jaw can open, the strength, movement and function of the tongue, and the movement, development and growth of the cranial bones. The restriction in the connective tissue extends deeper into the connective fascia that surrounds the cranium, jaw and can affect the tissue extending into the neck, shoulders, and even into the diaphragm, abdomen, hips and legs. Releasing the tongue and lip tie can have greatly relieving effect for a newborn. It is wise to have cranial adjustments, craniosacral therapy, or other fascial release technique performed after the tongue and lip tie release to ensure that all the connective tissue restrictions are released and full function is restored. The tongue tie and lip tie can be release through the use of scissors or through a cutting laser. It is recommended that each parent do their research in determining which method of treatment is available and most beneficial for their child. Release of these ties will help to encourage proper cranial and mandible development and growth. It will allow for proper growth center stimulation in the facial and cranial bones. It will also encourage full cranial rhythm and movement allowing for proper cranial and facial symmetry.

4)     Babywearing

Wearing your baby in a carrier, sling or wrap is beneficial in numerous ways including supporting cranial shape and motion. Babywearing allows the child to be upright off the floor or out of a seat so there is no risk of developing a “flat spot” from lying in one position for prolonged periods of time. The upright posture also encourages suboccipital muscle development to aid in proper occipital alignment upon the atlas (first vertebrae in the neck). Babywearing also has been connected to extended breastfeeding.  The suckling required for breastfeeding increases cranial movement and also stimulates growth centers among the facial bones allowing for full functional growth of the facial bones and mandible.

5)     No Contraptions

Coinciding with babywearing, keeping babies out of contraptions like car seats, bouncy seats and swings will benefit the cranial bones and the primary respiratory mechanism. Contraptions like car seats limit the baby’s range of motion and confine the baby to typically lay in the same position with the same consistent pressure on the same area of the skull. It only takes less than 5grams of pressure to move and influence cranial motion. So if a baby is laying in the same position with the same pressure for extended periods the cranial bones will mold to fit that pressure. This is typically how flat spots develop, and the skull should not have flat spots. Flat spots indicate that there is altered shape and motion to the different cranial bones. This affects the cerebral spinal fluid movement and can lead to adhesions in the dural tissue causing other symptoms. If flat spots do develop despite your best effort to not have them in a car seat or other contraption for long periods, then finding a practitioner who can perform craniosacral technique or other means of cranial adjusting is recommended.

6)     No Headbands or Bows

Having two little girls myself, I know that a headband with a big bow or flower on it can look very cute. However, like I mentioned above, it takes less than 5grams of pressure to influence the cranial bones shape and motion. So placing a tight headband that constricts the cranium will not only change the shape of the head but will decrease the movement of the cranial bones and negatively impact the primary respiratory mechanism. Many parents who have little girls who are bald for a long time will want to always have a headband on their baby since they can not clip on bows to her hair. This will always constrict motion of the cranial bones and work towards altering the shape of the cranium. Typically a headband will wrap around the occiput, temporal, sphenoid and frontal bones. Even slight alterations in the shape or motion of the occiput can cause misalignments in any other cranial bone. This again will cause adhesions in the dura and affect the nutrient saturation of the nervous system. One lesser evil that I encourage moms to do is to keep the headband or bow in your bag and only slip it on for pictures and then take it right back off. Look for red marks and signs of the bow on the head after you take it off. The more marks and redness you see left behind after the bow is off tells you there is more pressure being applied by the headband. Bows and headbands look cute, but have a huge impact on the shape and motion of the cranium.

7)     Vary Sleeping Positions

Many times parents will place their baby in a crib, basinet, or co-sleeper for naps and bedtime. These devices then stay in the same place and the baby is placed in the same position in them. This can cause the baby to develop a flat spot from continual pressure in one area. The baby will often develop a more comfortable sleeping position they prefer to obtain while in the crib or sleeper. Moving the crib around the room or placing the baby in the crib facing the opposite direction will help to vary the position the baby maintains during sleep. It will also give variability to what side the baby is approached from when he or she wakes up. Therefore the baby will not grow accustom to turning one way to wait for mom or dad when he or she wakes up. Altering sleeping positions for the baby will give him or her varied stimulation and change the way pressure is placed on the head due to the direction he or she will look depending on the position of the crib or sleeper. Back sleeping has been supported by the American Pediatric Association to help prevent SIDS but this campaign has also contributed to flat spots due to back sleeping. Ensuring that there are varied sleeping positions and plenty of tummy time is vital to maintaining cranial symmetry and function if the parent chooses to encourage back sleeping.

 

Many things can contribute to proper cranial motion and function. These suggestions can help parents to take actionable steps towards improving their child’s health through properly functioning cranial movement and rhythm.

Diastasis Recti and the Importance of Your Core



There are several different muscle groups that make up your abdominal muscles, or your core.  The importance of these muscles is to contain your internal organs, connect your ribcage and upper torso to your pelvis, allow for a wide range of movements, and stabilize your low back and pelvis.  There are four major muscle groups that make up your core: the rectus abdominis, the internal obliques, the external obliques and the transverse abdominis. The rectus abdominis runs vertically from the bottom of your rib cage to the pubic bone. It is divided into two rows, one on each side of your belly button. A thick connective tissue called the linea alba connects the two halves of this muscle. The external obliques run diagonally from the bottom of the rib cage (as well as portions from the serratus anterior and latisimis dorsi) to the top of the iliac crest (hip bone), inguinal ligament and pubic bone.  The internal oblique muscles run diagonally, perpendicular to the external obliques. They attach from the thoracolumbar fascia and iliac crest to the bottom of the rib cage.  These two sets of oblique muscles have tendinous portions that wrap around the rectus abdominus and into the linea alba. The transverse abdominis runs horizontally around the body connecting into the lumbodorsal fascia in the low back (this attaches into the sacrum, lumbar vertebrae and the posterolateral aspect of the iliac crest). This muscle also attaches into cartilage of the lower six ribs, the top of the iliac crest and into a portion of the inguinal ligament in the front of the pelvis.  The transverse abdominis also wraps around the rectus abdominis muscle and contributes to the connective tissue that makes up the linea alba.  For a great visual of these muscles, check out this image.

The most important muscle of these core muscles is the transverse abdominis muscle. It is the deepest of the core muscles and acts like a built in weight belt or corset. The action of the muscle is to pull the belly button to the spine. This action increases intra-abdominal pressure, which helps decreases vertical pressure on the intervertebral disks by converting more of the vertical force to hoop force. Transverse abdominis activation also increases low back stiffness to protect against excess movement between vertebrae that may damage the intervertebral disks or cause inflammation and spasms.  This muscle is vital in stabilizing the pelvis and low back as well as allowing for maximal efficiency and power during use of the upper and lower extremities. A toned transverse abdominis will naturally activate or contract before movement of the upper or lower extremities. This helps to stabilize the pelvis and low back and protect the vertebrae and intervertebral disks. In some one with a weak transverse abdominis, the activation of the core occurs after the movement of the extremeties. This puts the vertebrae, intervertebral disks, and other supporting musculature at risk for injury. The transverse abdominis muscle works in tandem with the multifidi muscles (small muscles along the side of the spine) in the spine to stabilize and protect the vertebrae and the intervertebral disks while movement occurs. If one has a weak transverse abdominis it can lead to less stabilization and more reliance on the small multifidi in the back. This can cause more back pain, pelvic pain, higher chance of disk bulge or herniation, and less efficient and powerful extremity movements.

One of the most common injuries that cause a weakened core is called a Diastasis recti. This is an injury in which the two halves of the rectus abdominis have separated laterally (to the side) and have caused the linea alba to become very thin. This condition occurs because of an excessive increase in abdominal pressure from weight lifting, performing abdominal exercises incorrectly, pregnancy, excessive coughing or sneezing, etc. The outward pressure against the rectus abdominis pushes the two halves of the rectus abdominis apart as it stretches and thins out the connective tissue that makes up the linea alba. A diastasis recti injury is more likely to occur when the transverse abdominus muscles are already weak. Having a diastasis can cause many other issues. As mentioned above, the abdominal muscles, especially the transvers abdominis, stabilize the low back and pelvis. With a diastasis most if not all of this stabilization is lost. This can cause postural abnormalities, and depending on the severity of the diastasis, it can allow for the displacement of internal organs. This can affect their function and lead to things like digestive problems.

Diastasis recti injuries are most commonly found in women who have had a child. However, it is also found in children and men. Upwards of 70 percent of women develop a diastasis recti during pregnancy. Some of them will reconnect postpartum, but most will need extra help to heal. The most accurate way to identify a diastasis recti and evaluate the severity of the injury is to seek the support of a qualified individual, whether that person is a diastasis-aware physical therapist, chiropractor, or physician. There is a very simple way to do a prelimiary check for diastasis recti. While lying on your back place your fingers on the middle of your stomach pointing up or down.  Then lift only your head off the floor. Pressing down very gently you will be able to feel a valley in between the two halves of the rectus abdominus. You should check at a point right below you rib cage, at your belly button and right above the pubic bone. Most women will have a diastasis that can be corrected without the use of a brace or slint. Those who measure their diastasis at a finger width of 3 (3cm) or greater will probably need the help of a brace in order to heal the diastasis.

 

How to check Yourself for Diastasis from fit2b.us.

 

There are several things that you can do and a few things to avoid when trying to heal a diastasis.  Things that you should not do include any type of sit up, crunch, or plank. Once you have a diastasis and the connective tissue that forms the linea alba is weakened you should refrain from ever doing regular sit ups again. These cause the abdominal pressure that is built up to push outwards against the weakened connective tissue, essentially working against your goal of healing your diastasis.  Never sit straight up from a lying position or do any type of pike movement.  Refrain from slouching and sitting hunched back on your sacrum. This weakens you transverse abdominis and can prevent progress in healing the diastasis.  Never sneeze or cough without bracing your core first. When you feel a sneeze or a cough coming on, sit or stand straight and bring your belly button to your spine, activating your transverse abdominis. This will help lessen any possible damage the sudden intense increase in abdominal pressure may have on your diastasis.

Things that you can be doing to help heal a diastasis recti include active sitting, active standing, and squats. To perform active sitting, sit in a chair that allows you to have your knees and hips bent at 90 degrees. Sit up on the front of your ischial tuberosities (sit bones) with your head over your shoulders and shoulders over your hips. Bring your feet and knees together. This is active sitting posture. From here you can contract and relax your transverse abdominis along with your breath.  While you breath out, contract your transverse abdominis (bring your belly button to your spine). While you breath in, relax your transverse abdominis.  Active standing is very similar, except you are standing with your feet about shoulder width apart. Stand up straight with your head over your shoulders and shoulders over your hips. Then contract and relax your transverse abdominis with your respiration like described above.  Squats are a great exercise, not only for strengthening your core, but also your quadriceps, hamstrings, gluteal muscles, and pelvic floor muscles.  To perform a proper squat, stand with your feet shoulder width apart and your transverse abdominis activated. Then maintain transverse abdominis activation the entire way down and back up. Your heels should remain on the floor for the entire squat. If you are unable to perform a complete squat, then you can use a door handle as support until you develop enough strength to perform a complete squat without support.

Though some people with a small diastasis recti may be able to heal their core injury on their own with some exercise and lifestyle changes, it is necessary for most people to seek a diastasis-aware physical therapist to help them, or to commit to a core rehabilitation program. There are many great core rehab and diastasis safe workout programs available to people working to heal their core. Dr. Dodge has worked with an excellent women’s health physical therapy specialist in the DFW area – let him know if you’d like a referral.

Here are a few options for healing and protecting the core online:

 

Tupler Technique – The Tupler Technique is a program designed specifically for strengthening the transverse muscles, bringing the separated abdominal muscles back together, and healing diastasis. https://diastasisrehab.com/

 

The Tummy Team – The Tummy Team is a comprehensive physical therapy resource, focused on healing diastasis recti, restoring alignment and posture, and core-friendly fitness. The Core Foundation program works to restore the core and pelvic floor muscles. https://thetummyteam.com/programs/?ap_id=DodgeFamilyChiro

 

Fit2B Studio – Bethany Learn from Fit2B Studio has many videos and workouts on her website designed with fitness for the whole family in mind.  She has a passion for helping women restore core strength and has created many videos focused on building transverse strength. There are also downloadable information pages you can take to your trainer or other health professionals that explain what a diastasis is and how they should be caring for it to help you heal it.

Babywearing While Pregnant, Part Two (Guest Post for Onya Baby)

Be sure to check out Dr. Dodge’s guest post for Onya Baby – Babywearing While Pregnant, Part Two: Safe Carrying Options. It follows to Babywearing While Prengant, Part One over on the Onya Baby Blog. Dr. Dodge is often asked by his prenatal chiropractic clients if it is safe to continue babywearing an older child while pregnant. It is important that mothers chose methods of placing the older child on their back that do not involve twisting, so Dr. Dodge’s second post covers a few ways to put the baby on your back safely. Happy Babywearing!

Babywearing While Pregnant: Part One


The first in a two-post series about babywearing while pregnant, written by Dr. Daniel Dodge, DC, CACCP

Photography copyright Dodge Family Chiropractic

The wonderful team at Onya Baby invited Dr. Dodge to guest blog for them! He wrote a two-part blog post about babywearing while pregnant! We hope you enjoy it!

“It is completely safe for most women to continue to babywear throughout pregnancy. There are many benefits to babywearing, for mother and baby, and these benefits do not have to end when expecting a new brother or sister. To ensure that babywearing continues to be safe and comfortable for both the mother and toddler, there are additional factors to consider during pregnancy. The health of the mother, her level of babywearing experience, the stage of pregnancy, and the weight of the ‘wearee’ should all be taken in to account, as well as any recommendations given by a healthcare provider.”

Be sure to read the full post here!

Be sure to read the follow-up post for this two-part series: Safe Carrying Options for Babywearing while Pregnant!

Chiropractic and Breastfeeding

 

Happy World Breastfeeding Week! Special congratulations to all mothers and babies that have been working hard to continue to breastfeed! In honor of the week, we’d like to share an article from Pathways to Family Wellness, written by Jeanne Ohm. It touches on how chiropractic care can be that missing link between breastfeeding difficulties and successful breastfeeding. One reason Dr. Dodge prefers to see newborns for an initial wellness exam in the first two weeks is because many babies, even after simple, natural births, have cervical subluxations, cranial misalignments, and fascial restrictions. Chiropractic care with a provider who performs cranial adjustments and myofascial release can significantly influence a baby’s ability to breastfeed successfully. We’ve seen many babies turn their heads better and nurse more comfortably on one side than they had minutes before, or moms that immediately noticing less discomfort when latching. Read the full article to learn more!

Pathways Article: Breastfeeding Difficulties and Chiropractic

“In the case of breastfeeding difficulty, as with many childhood disorders, the cause of the problem often traces back to undetected biomechanical injuries to the spine and cranium at birth. The failure to recognize these biomechanical injuries and their relationship to difficulty in breastfeeding leads to incorrect conclusions and therefore, inadequate recommendations and treatments. Without real solutions, mothers become discouraged, successful breastfeeding is not achieved, and women stop trying out of frustration.”

Patient Story – Chiropractic Care During Pregnancy

I am blessed, as a prenatal and pediatric chiropractor, to serve families during a very special time in their lives – growing their families! Pregnancy is an exciting time, but as a mother’s body changes to support a new life, she can experience many discomforts and challenges.There are few things more rewarding than helping a patient through those concerns so that they can enjoy such a joyful time! This is the story of a patient who had just that experience.

Photo courtesy of Brooke Shelby Photography, local Coppell Family Photographer

 

While I had heard of chiropractic care during my first pregnancy, I never thought about what it could do for me as a pregnant woman. And truthfully, I was afraid of neck cracking! I was blessed to meet Dr. Dodge and his family not long after our our sons were born. When I got pregnant again, I noticed that I was experiencing pain already in the late first trimester. It really hurt to walk, and I still had quite a ways to go until my baby would be born. I asked Dr. Dodge about chiropractic care, and the techniques he uses. He was very kind and explained in layman’s terms about his work and how it could benefit me as a pregnant woman. And there would be no scary neck cracking. Sign me up!

I started seeing Dr. Dodge around 21 weeks in my pregnancy. He asked me several questions about my overall health (mental, physical, etc.) and about the pain I was experiencing. He explained that while relaxin (the hormone that helps loosen ligaments in preparation for labor) is released in the third trimester with first pregnancies, it is released as soon as conception occurs with second pregnancies (and any thereafter). This explains why I was already out of alignment and in pain. Carrying around a nearly 30 pound toddler on my hips certainly wasn’t helping, either!

At the beginning of each appointment, Dr. Dodge made sure to ask how I’d been feeling, and what we needed to focus on for the appointment. I always felt so much better after an adjustment. Toward the end of my pregnancy, I got the usual “How are you feeling?” question from people constantly. I was able to truthfully say, “I feel great!” I have no idea how women make it through pregnancies without chiropractic care.

I also had Restless Leg Syndrome in both of my pregnancies. I thought it was odd that it was brought on by pregnancy, but I’ve heard from other women that have dealt with it, too. Dr. Dodge was able to help rid me of the nagging RLS symptoms, and recommended a Cal/Mag supplement to help as well. I didn’t notice RLS symptoms for the rest of my pregnancy – a huge blessing!

When I had my second son at home, he had a slightly stuck shoulder. My midwife had to help free it, and she recommended that I have my son adjusted sooner, rather than later. I e-mailed Dr. Dodge, and he was at our house nine hours after my son was born (letting us settle in as a new family of four, first), gently adjusting him, and adjusting me to help me recover from the rigors of childbirth, as well. He is truly dedicated to the well-being of his patients.

If God blesses our family with another sweet baby, I will be diligent in receiving chiropractic care again. It was hugely helpful in making this pregnancy feel like a breeze, and I would recommend it to anyone I know – pregnant or not!

 

 Courtney Smith and her husband are parents to two sweet boys. She is a birth advocate and serves as a chapter leader for Dallas Birth Network. The Dallas Birth Network is a non-profit organization that aims to bring awareness to the Mother-Friendly Care Initiativethrough community education and outreach. Dallas Birth Network hosts free monthly meetings and other community events in an effort to help local families becomed more informed and supported in birth choices. Stay connected with Dallas Birth Network for updates on meetings and events by “liking” DBN on Facebook!

 Chiropractic for Babies? Yes!

 

Did you know that 95% of newborns have misalignments in their cranial bones, atlas, and/or cervical vertebrae due to the stress of birth? Even the most gentle of births can result in subluxations. The alignment of the spine sets the foundation for building a healthy immune system and for normal childhood development. Chiropractic adjustments also help with many childhood conditions and concerns! Read more about why children get adjusted!

The primary techniques I’ve chosen to use in my practice are non-force and very low-force – they are safe for all ages, including newborns. The pressure applied to a newborn is approximately the pressure it would take to indent a soft pillow with a finger. If you are choosing a chiropractor in your area to treat your children, I recommend you call and confirm their training or certification with the International Pediatric Chiropractic Association.

Chiropractic Care for Newborns and Children

 

 

Children develop 65% of their nervous system within the first year of life and 80% by the time they are two years old.

A very common question I receive fairly often is “Can chiropractic help my child with this?” My response is typically yes – chiropractic care can likely help with a number of childhood concerns. More and more parents are asking about chiropractic care for their children, as they hear anecdotal stories and read research of how chiropractic care helps with the symptoms of colic, reflux, allergies, ear infections, etc.  As I talk with parents about how adjustments help common concerns, many parents are still surprised to hear the many benefits of chiropractic care for newborns and wellness care for children. I’ve found that a quick explanation of how chiropractic works helps families understand why regular adjustments are important for developing children and for taking a wellness approach to the family’s health.

Chiropractors are doctors that work to optimize the health and function of the nervous system.  They achieve this by performing an adjustment to restore motion and balance to the spine, which frees the nervous system from interference.  “Interference” is what we call it when nerves restricted or otherwise negatively affected by misalignment or subluxation – this disrupts the signal the body receives and sends via those nerves. When the nervous system is free of interference then many of the symptoms of disease dissipate because the body is able to heal itself and function properly.  The adjustment delivered by the chiropractor can come in many forms. There are many techniques that can be utilized to restore optimal health to the nervous system.  Many chiropractors will cater to each patient in order to give them the type of adjustment that will best suit them and help achieve optimal function. This is true in the case of adjusting children, infants and newborns.  The same force that a chiropractor may utilize to adjust an adult patient is not the same force they will use to adjust your newborn baby.  Chiropractors trained through the ICPA (International Chiropractic Pediatric Association) have been trained on how to properly and safely adjust a newborn, infant and older child. Chiropractors normally will use just the tip of their finger to place light pressure on the vertebrae of a newborn (typically as little pressure as you can place on your eye comfortably). These 6-8 ounces of pressure is enough to realign an infant’s spine and restore optimal nervous system health. There is never any rotating or twisting of the baby’s neck or back. It is a very gentle and safe process.  There have been studies performed that have proven the safety of chiropractic care for children. The most recent published study stated the following in the discussion:

“Of 1161 clinical cases presenting the gamut of both non-musculoskeletal and musculoskeletal complaints, less than one percent reported minor adverse events spanning 10, 249 office visits. Sixty-six percent reported improvements in their presenting complaints while another 8% reported improvements unrelated to their presenting complaints.”1

But why would a newborn need chiropractic care? Well, just like any other person, newborns and children experience a variety of stress on their bodies and nervous system. Initially, babies can experience physical stress in utero from obtaining a less than optimal position (transverse, breech, asynclitic, ect.).  They also experience the pressure and force of contractions and the trauma of the birth process. Many babies have their head pulled during a Cesarean section or a vacuum or forceps extraction. But even a completely natural birth with no interventions is a very stressful event for an infant with an immature nervous system. One study by G. Gutmann stated that 80 % of newborns, out of one thousand examined, had nervous system dysfunction. Another by V. Fryman, which examined 1,250 five-day-old babies, showed that 95% had misalignments in their neck. Children develop 65% of their nervous system within the first year of life and 80% by the time they are two years old. It is important to have a newborn checked by a chiropractor to ensure that their nervous system is free of interference and can develop and grow in an optimal state. When the nervous system is functioning optimally, children are able to focus and learn better, digest and absorb nutrients from food better, and they spend less time expressing illness because of a fully functioning immune system. The nervous system controls the function of every cell, tissue and organ in the body. Therefore, if a child has interference that is not detected and corrected by a chiropractor, they may develop symptoms later in childhood such as colic, reflux, allergies, ear infections, fussiness during tummy time, breastfeeding difficulties, sleeping difficulties, and many others.

As children grow and get older it is a good idea to have them checked at milestones or after any experienced trauma or accident.  When a baby learns to sit up, crawl and walk, there are different stresses place on the spine, which could lead interference to develop in the nervous system.  Many children have falls on the playground or are in the car during a motor vehicle accident and should be checked to make sure that they are functioning properly and their nervous system is working optimally. Children today are eating a lot more processed foods that lack nutrition. This exposure to the different chemicals in their food can lead to imbalance in the body and interference in the nervous system. Chiropractors can help remove the imbalance in the body and also guide parents to help them make healthier decisions for their children.  Many Chiropractors who work with children and families are more holistically inclined and can help improve the overall health of the family children. Families that are visiting the chiropractor regularly benefit from his or her expertise in wellness – chiropractors take numerous courses in nutrition and healthy living.

The immediate result of chiropractic is to remove interference to the nervous system through use of the chiropractic adjustment and allow the body to function better, but the long-term effects and goal is to help adults, children and families live healthier, happier lives.

 

 

1)    Alcantara, Joel BSc, DC, Kunz, Derek  BS Ohm, Jeanne, DC. (2009, September). The Safety and Effectiveness of Pediatric Chiropractic: A Survey of Chiropractors and Parents in a Practice-Based Research Network Explore: The Journal of Science and Healing.http://www.explorejournal.com/article/S1550-8307(09)00207-9/fulltext

2)    Siddle, Belinda D.C. (2008, June). Chiropractic Care for Children. Pathways to Family Wellnesshttp://pathwaystofamilywellness.org/component/option,com_crossjoomlaarticlemanager/Itemid,271/aid,1461/view,crossjoomlaarticlemanager/

3)    (2009, Winter). Adjusting to a New Life. Pathways to Family Wellness.http://pathwaystofamilywellness.org/component/option,com_crossjoomlaarticlemanager/Itemid,164/aid,1824/view,crossjoomlaarticlemanager/

 

*While most chiropractors are taught how to adjust children in the standard doctorate program, the International Pediatric Chiropractic Association offers an extensive diplomate training and certification program. To ensure that your choice of chiropractor is optimally prepared to adjust each member of your family, ask if they are ICPA trained or certified, or check out icpa4kids.org’s directory.