2nd Appointment

I did my previously assigned exercises 5 out of the 7 days over the past week. The glute one is pretty easy, but I wasn't sure about the ab one. I asked my PT today whether I was doing the ab one correctly, and she said to focus on the lower quadrants. She adjusted the exercise so that I'm not so much pulling back from my hand but using the inner, lower ab muscle (the transverse abdominus or TA) to tilt my pelvis forward.

To do the movement, I lie on my back with knees bent. Then I gently and slowly "tilt" my pelvis forward. The small of my back gets closer to the ground. I put "tilt" in quotation marks because a full-on pelvic tilt uses other muscles, too. The idea here is to activate the lower, inner muscle (the TA). 

If you've ever done Pilates, you know how difficult it can be to activate the transverse abdominus! Why is such an important muscle hard to use? I suppose it's due to our modern-day lifestyles with too much sitting.

I was having a tough time focusing on the correct muscle. It's tempting to suck in my breath (and corresponding rectus abdominus muscle) and pull down and back that way. To help me activate the correct muscle, my PT connected electrodes to me (must have been a TENS machine). She needed a few minutes to find the right level. Too high (11 and above on her device) gave me the sickening shocked feeling like when one bumps into hotwire. Too low, I couldn't feel it at all. Around 9 or 10 did the trick.

I lay there for 5 or 10 minutes and let the intermittent pulses do their work. After that time, my insides felt ever so slightly more relaxed. Kind of like they had a massage.

Following the electrical treatment, my PT had me to do the exercises again. Not only did I do the "tilt," but then layered Kegels upon it, then thigh squeezes. For the thigh squeezes, she brought a little kids play ball for me to hold between my knees. (The ball was Frozen-themed, which is the same one my kids played with at my parents' house when they were little. Happy memory.) I repeated the movements several times: Ease into the tilt, add in Kegels, add in squeezing the ball with my knees, and then slowly back out of each one.

As if that combination wasn't enough, my PT had me incorporate breathing work, too! I rely on my belly too much for breathing, probably due to some bad singing habits developed in childhood. (Shoulder breathing--bad, diaphragm--good... Belly is close to the diaphragm, right?) While doing the exercises, I needed to breathe such that my ribs expanded out sideways. Resting my hands on my mid-section so that my thumbs are on my ribs and fingers are on my belly helped me to learn the technique. It's going to take a lot of practice.

All of these physical therapy movements are going to take a lot of practice! My PT said it will be about a year before I am accustomed to using the transverse abdominus.