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Halloween has come and gone, so you should probably put that mask and cape away.  The GSM team thinks YOU can be your own superhero any time of year and we want to replace your cape with our new wristband!

It turns out we breathe a lot, all day long, and if we aren’t doing it correctly we may feel the results of poor spine stability, poor oxygen exchange and poor stress tolerance. The hardest part of intentional breathing is incorporating it into our daily lives and making it our new normal. But how do we remember to do it all day long? 

First, you could use pain as a catalyst for change. Do you have neck tension? Use that as a reminder to exhale longer. Or maybe your low back gets sore? Use that as a cue to maintain abdominal tension and breathe into your lower back ribs.  

Do you perform certain activities regularly? Identify an activity that you can use as a cue to focus on breathing and bracing. Washing dishes, commuting to work, picking up your grandchild, moving hay bales, or lifting weights are all actions that would be enhanced with bracing through breath.  

Or even better, stop by the clinic and pick up a GSM wristband that has the words right on it: Brace! Breathe! Not only will it remind you to focus on the techniques, you will feel like a GSM superhero. 

Our next topics will include stacking your spine and hip hinging, so stayed tuned over the next few weeks to build on this knowledge. In the meantime, build your foundation!

Go superhero! Go!

In case you didn’t pick up on it, I've been on a kick to spread the word on how beneficial bracing and breathing is for our wellbeing. Why am I so fired up? Because it has helped me tremendously with my back issues! I can say with a few small changes in the past couple years, I feel stronger and have less pain at 45 years old than I did at 35, and I want to share this information with everyone!

Our recent blogs on breathing and bracing may seem like information overload, but the primary message is simple.

- Focus on your exhale breath to create abdominal tension, which will calm down your nervous system.

- Then inhale into your lower back ribs.   

Now of course, this is much easier said than done and is a motor skill that needs to be learned, practiced and integrated into your daily activities. I always use the analogy that intentional breathing is no different than learning to play an instrument. You need to practice your chords before you can strum with John Mayer.  Know what I mean?

Start in the position that is most comfortable for you: on your hands and knees, lying on your back, or standing with your back against the wall. Use the trick we talked about last week and place a belt around your lower ribs for tactile input to inhale into your lower back ribs.  Practice this often throughout your day to create the new motor pattern. Once it becomes easier and more accessible, integrate it into a static activity such as standing at the kitchen sink or while driving on your commute. (Remember exhale breath is great for stress and neck tension!) After some time you can incorporate it into higher level activities such as hiking or lifting hay bales. Then all of a sudden, you may notice that you feel stronger with less spine pain, have more tolerance of cardio activities and have less stress. Eureka!  See why I’m fired up?  

Written by Darcy Cook, MSPT

Last week we introduced intentional breathing and today we are going to continue to expand on how proper bracing and breathing can make significant impacts on your health. If you’ve been practicing your exhale breath this week, you may have noticed less neck tension, improved posture and hopefully a sense of calmness! Another awesome benefit is the recruitment of your abdominal muscles or what we refer to as “bracing”.  Recruitment simply means connecting to your muscles, or turning them on. Did you happen to notice that you were engaging your abdominal muscles while breathing intentionally? It was happening, even if you didn't tune into it.

I’ve been practicing for more than 17 years and I’ve seen the label “core exercises” applied to all sorts of activities (from sit ups to back extension machines to sitting on a therapy ball).  I have great news for you: bracing is much simpler than all those crazy core exercises. Recruiting our core muscles is more about sequencing than it is about doing some complicated exercise, and the exhale breath is the first step of the sequence. So instead of doing 100 sit ups every day (which makes your six pack look amazing, but offers your spine zero, let me say that again, zero stability), let’s just focus on the muscles that turn on at the bottom of the exhale breath and keep them recruited while you inhale. 

You might think that this would be easy, but it can be a difficult motor skill to master because the majority of us are not using our diaphragm to inhale. Think about how you’re breathing right now. Are your shoulders moving up and down or is your chest rising? The diaphragm is a horizontal disk-shaped muscle at the bottom of our rib cage that contracts when you inhale creating a vacuum effect to pull air into your lungs. Your spine needs to be in an ideal or stacked position for the diaphragm to function and there must be some abdominal tension for the diaphragm to contract. We’ll talk more about “stacking” later. 

Stick with me on this because I know it’s a difficult concept to get your head around, but when you do it can be life changing. Picture sitting on a stool and pushing off the ground with your feet to spin. Your feet represent your diaphragm and the floor is your abdominal tension. Now try to spin without pushing off the ground. Hmmm, not an option right?  If you don’t have some light tension in your abdominals, your diaphragm has nothing to push off from and thus, throws its proverbial hands up in the air and turns off. 

For years I taught my patients to belly breathe, or let your stomach rise or pooch out when you inhale. However, the new research shows us that the diaphragmatic breath involves us inhaling into our lower ribs, especially towards the sides and back. We will continue to discuss breath in more detail over the next few Thursdays, so stay tuned!

For now, exhale completely, feel that tension in your abdominals, and try to maintain about 20% of that tension as you inhale into your lower side ribs. For the tactile learners in the group, put a belt around your lower ribs and cinch it down at the bottom of your exhale. When you inhale, push your lower ribs into the belt throughout the entire circumference. The inhale movement should be in your lower ribs, and if you're maintaining tension in your abdominals, your chest and your belly should not lift. 

Not only does abdominal bracing and diaphragmatic breathing increase spine stability and decrease spine pain, this action sharpens balance, enhances digestion, and boosts your ability to completely fill your lungs. This improves the oxygen exchange throughout your body, which is especially good for you in high altitude areas, and can help to enhance your mood, decrease anxiety and even boost your immune system.  Awesome, right?

Written by Darcy Cook, MSPT

Physical Therapy was a natural career fit for me as an athlete and active community member, but my specialty as a Pelvic Floor Physical Therapist typically generates questions. I’m often asked “Why the pelvis?” or “Why focus on bowel, bladder and sexual function?” Throughout my teen years, I battled urinary stress incontinence, which changed to pelvic pain as I got older. I chose this career because I’ve been there myself, struggling with isolation and no answers. I have been pain-free and continent for years now and I want to share this knowledge to help others feel in control of their bodies and confident in social situations.

1 in 4 Americans struggle with bladder dysfunction. 20% of adults battle with bowel and digestive dysfunction, and 1 in 4 Americans cope with chronic pain. Incontinence, bloating, cramping, constipation and sexual dysfunction are just a few of the symptoms that many of us suffer through, not realizing how many other people face the same struggles. Pelvic floor therapy is focused on normalizing and overcoming those situations. My passion is creating a safe, private space to provide support for women and men to connect with their bodies in a positive way and I’m grateful for the science pertaining to a region of the body that has been ignored for far too long. My WHY is because I want to help my neighbors understand what is “normal” for their body and to give them the tools to feel centered and confident throughout their day.

Let’s work together and get you back out there hiking, dancing, or skiing with your friends (without being distracted by the nearest restroom.)

On average, we take about 20,000 breaths per day. Yet how often do we really consider how we’re doing it? Breathing has a profound impact on neck pain, spine stability, digestive health, and stress response, just to name a few. 

Let’s start with the basics. Breathe normally for a few moments. Notice the sensations as air enters through your mouth or nose, fills your lungs and leaves your body. This “intentional breathing” is very calming for your nervous system and counts as meditation.  

Now let’s take it to the next level by focusing on making your exhales longer than your inhales. Exhale completely and pause before you inhale through the nose. Then slowly exhale through the mouth again pausing before the inhale. Try practicing this for a few minutes when you can throughout your day. Breathe intentionally while you are driving, walking the dog, or doing house chores and appreciate how favorably your body responds.  

Next week, we will discuss creating abdominal tension and correct diaphragmatic breath as you inhale. You’ll be amazed at how beneficial breathing can be!

Jennifer and Darcy had the good fortune to participate in the PCCF Discovering Wellness Retreat this weekend. Our lovely leaders Kristine Backes and Karen Stenseth lead us through a variety of mindful practices including breath work, yoga, and meditation. Not only was it relaxing and grounding work, we were able to connect with thirteen fabulous women that dedicate enormous energy and intention to our community. We want to remind you that meditation can be incredibly beneficial for your body and your mind. There are more ways to meditate than there are to cook an egg, so explore and find your favorite method! Meditation can involve taking in an awe-inspiring view, like Jennifer is doing in this photo on our “self-care break” over the weekend. Stay tuned for our Thoughtful Thursday tip on how to change your breath pattern to affect your stress response, or in other words, meditate!  

A big thank you and good luck to Max and Barb on their new adventures! Max is moving to Whitefish and is starting his own practice. More to come on that!  You will still see Barb’s smiling face around town and at the Park County Clerk and Recorder’s Office. They've both been amazing team members and we're sad to see them go. But onward and upward to the next chapter of life!  We will be closing today at 4:30 to send them off in style!

This inspiring video encourages us all to assess not what we do but WHY we do it, and the GSM team ate it up. So first up for Moving Mondays, Darcy’s Why.

I get asked regularly “Why did you go into business for yourself?” and I think my answer is much more detailed than anyone expects. First off, as many of you know, being a small business owner certainly doesn’t equate to more money or free time, at least not yet! What drove me was the opportunity to make a positive impact on the wellness of our awesome little community. GSM was designed to be a place of healing that is accessible and welcoming to everyone.  I also sought to offer an outstanding place of employment in rural Montana that cultivates team spirit and truly supports work-life balance. Let’s face it - we spend a lot of time at work and loving what you do makes the time fly. I’m proud to say that if you've been into GSM lately, you know we're crushing it! We have an outstanding team that loves their work and sincerely believes in what we do. So, what is my WHY? In a nutshell, it's caring for my community. Oh, and their dogs too!

Healthcare is constantly changing, which can be daunting to most people. The GSM team is made up of self-proclaimed super nerds and we find the majority of the changes really exciting. Common phrases heard around our clinic are “Do you know what I just read?” and “I can’t wait to share this podcast with you.” We read peer-reviewed journals, attend outstanding continuing education classes, and work closely with our colleagues to improve our skills. We’d love to share relevant information with our family of patients to help you live your best life!

So, let’s make a deal. We do the research and you get the short version written in a language you can understand. We have a lot to talk about and we want to make sure you don’t miss anything. Visit http://www.granitesportsmedicine.com/blog/ to sign up for specific topics you may be interested in or have them all sent to your email inbox.

Look for Email Notifications on the right side of the page near the bottom. You get to choose your level of nerdiness, but you know at GSM, we're all in. If you’re into social media, you can also follow us on Facebook or Instagram.  Follow us, we have lots of cool things to share!

- Does your knee hurt after hiking 8 miles chasing that elusive bull? 
- Is your back stiff after playing on the ground with your grandkids? 
- Are you training hard to crush it at the state competition this year?
- Are headaches running your life? 
- Do you sometimes “leak a little bit when you run”?

If any of these scenarios sound familiar, your physical therapist can help! We have many skills and tools, from dry needling to movement-based solutions, which will use to customize your treatment for the best outcomes. We look at the full body and the full person to give you the most complete and individual assessment.

We don’t do cookie cutter healthcare so expect our PTs to ask “what are you looking to get out of your visits?”