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Home exercises for pelvic floor tilt with hypermobility/EDS/POTS/MCAS [CC]


I am hypermobile and today I’m going to talk
about some kinds of physical therapy exercises I do that help with that. it’s taken me a really long time to find physical
therapy that actually helps because a lot of physical therapy and stretching and yoga
and all of those things is about working when you’re at the end of your movement and increasing
mobility. When you’re hypermobile, um, you don’t need
help with that stuff. You kind of need help with “How do I stand
when my joints don’t do the things that they’re supposed to do to support you?” “How do I move when the – my joints aren’t
doing the things to support me?” So I um – a lot of these also don’t look like
they’re a lot of work because it’s about working, sort of, in a static position. Because I find if I move too quickly in PT
progression from sort of static isometric exercises where you’re isolating a particular
muscle group to things where I’m moving that muscle group, then I get all excited and I
kind of want to show off what I’m doing or make sure I’m doing it right, make sure it
feels like I’m working, and then I just end up subluxing things or spraining them or injuring
them or myself. [Frame switches to view of abdomen and low
back] OK so what we’re going to do or I’m going to do today are some exercise that are
for lumbar hyperlordosis. [gestures to low back] That’s this extra curvature
in my lower spine, it’s mirrored here. A lot of these issues with hypermobility are
mirrored, because muscle groups come in pairs. So if this muscle group is hurting [gestures
to low back], then this muscle group is the one you want to activate [gestures to abdomen]. But sometimes they’re tensed up because of
a lot of pain, so sometimes you need to do work with, like, body workers or dry needling
or different therapies to help relieve the pain, you know, so that you can actually do
the PT. So, the way that this works is I talk through
what I do. First off, I get my feet in a kind of comfortable
position. It’s going to sound a lot like mountain pose
in yoga, I’m sorry about that. It kind of is. Um, because a big part of this is your feet. This is where is, you know, if you have hypermobile
feet it just transfers up the kinetic chain. So a big thing I notice sometimes, when I’m
doing this, is I’m not actually weighted evenly on my feet. Like I can feel my body more on my heels than
the rest of me. Which I think is why I have ankle issues,
at least partly. Um. So part of what I do first is I try to sort
of rock back and forth a little bit and play around until it feels like my feet are actually
supported and supporting me. I’m doing this with ankle braces on and orthotics
because I need the extra support. Then I have hypermobile knees and I tend to
hyperextend them, which is not great. So I just sort of drop my knees a little bit
is what it feels like. I think this is how other people stand. You can see my posture is already changing. Then, what I do, is a thing that I’ve worked
on first laying down. Um. But. So that Icould do it standing. I’ll try to demo that at some point as well. But basically it’s about activating my abdominal
muscles [gestures to abdomen]. So I do kind of like a tiny Kegel. Not lunch a full clench Kegel, but just a
tiny one. If you don’t have those muscles, I’m not sure
what you activate. Then, the transverse abdominus runs along
here [gestures to sides of lower abdomen], and the way you activate it is it feels like
you’re moving your hips closer together. You do that, then kind of check in further
down the chain. Are my feet still balanced? Good. My knees are still dropped, I haven’t hyperextended
them while I wasn’t paying attention. And then I kind of let that drop [gestures
to abdomen] and breathe *breathes* while I stand here. And you’ll notice, the curvature is not as
extreme. And then kind of visualize a I don’t want
to do the whole yoga visualization of something pulling at my spine, because then I just get
all excited and I end up hyperextending my knees again and then everything gets out of
whack. But just try to visualize sort of like my
chest coming up but while also dropping down at the same time [gestures to hips and abdomen]. Like dropping down here, don’t hyperextend
my knees, and sort of.lifting up my chest like I’m proud or whatever people say. But not so much that I hyperextend the other
way. There’s a lot of playing with this. Um, and then I just sort of stand and breathe. *breathes* and literally this is some of my
PT, and it’s actually way harder than it sounds If you’re not bendy. Or if you are bendy, I mean. So let me do this again with less chatting
about why things happen. So, first, I want to say “where are my feet?” Get them a comfortable distance apart, whatever
that is for me. I want to feel “is my weight evenly distributed
across my feet?” And rock back and forth a little bit, play
with that. *breathes* Once I feel that, um, I am kind
of evenly distributed, then I want to drop my pelvis a little bit and let my knees bend
just a tiny bit so that they’re not hyperextended. Then, I’m going to activate my core muscles. Um, by feeling like my hips are moving a little
bit closer together. We’ll work on transverse abdominals later. Um, then I kind of want to work on my upper
spine, just going up the kinetic chain. Um, how is that feeling? Feeling centered over the rest of me? Did I overcompensate and put myself too far
in a particular way? And just sort of being aware of all up and
down that kinetic chain. How is my body doing? The added stuff that you can do, if you’re
comfortable, is um to put one hand on your abdomen and one hand just lightly touching
your forehead. Um, and kind of adjust where your shoulders
are so that they’re upright um not hyperextended just sort of what people who are not bendy
call “neutral position.”And then just sort of stand like this. and if it’s too hard to
do it standing at first, we can work on doing it laying down. You don’t have to start out with like a huge
extended period of time. You’re not some sort of superhero. You just want to do a little bit at a time
until you work up to things like this. And hopefully things like doing this and stepping
this leg forward without it thunking out of its socket so much because you bent it the
wrong way. [angle changes to include more of upper body]
Ok, I’m just going to do this a couple more times so you can see more of my body and what
it’s doing Sorry I can’t get a good full body shot in this room. And sorry my cat is crying outside the door. So, again, you want to kind of feel your feet. Is your weight evenly distributed? Are they in a good spot? Then, once you’ve got that, you kind of drop
your pelvis down. this lets you keep your knees from hyperextending. Then you activate your core muscles um and
pull this in [gestures to low back] if you can. That’s part of that Um. [mumbles] It’s really
easy to overdo that and then end up like this [gestures that hips are further forward] which
is not what you want. Feet, legs, hips, core. And then extend up, but not so far up that
you’re hyperextending the other way. And try to keep your neck even and then put
like one arm up here [places fingertips on forehead] just breathe like that. Switch arms. Carefully. The idea behind this is that eventually it
becomes easier to maintain this posture so that you can stand and walk and do without
being permanently hyperextended all the time. Um, And also there’s this thing called muscle
memory, so you’re sort of developing your muscle memory for “what does it feel like
to be in this position?” OK. [angle switches to blankets and pillows on
floor.] So this is again my physical therapy set-up,
what it looks like when it’s not just a pile of things in corner. I have a pillow for lumbar support, I have
my heating pad on top of the pillow, because my SI joint gets cranky, Ihave a cat scratching
a scratching post, *laughs* I have stuff on the ground,Ihave a pillow, I have a hand towel
rolled up for um, cervical neck support. And then that other pillow over there is so
that I don’t hyperextend my hips when I’m doing this stuff. [angle switches] So getting into this set-up
is the challenging part. Um, maybe something people have trouble doing. Um, so I use this the ottoman to lower myself
down. You can also do this on a bed just have pillows
to substitute for the leg thing. um. so I’m going to activate my – hi cat – And
I’m going to turn like this and then skooch forward then I want to make sure this is in
the right spot [adjusts pillow under low back]. the reason I have this pillow here in my lumbar
area is because again, I’ve got the extra curvature, if I don’t have it there, it’s
made of pain. I put the hand towel in my cervical spine
and then I’m ready. So for a bunch of months, this was the only
way I’ve done these exercises. It’s fairly new to the standing You can see
it’s like I’m standing, just laying down. Which means I have enough oxygen for my brain,
which is really helpful if you have POTS or a CSF leak or something that makes standing
hard. So, um what I’m doing here is I’m just focusing
on this area [gestures to abdomen]. This lets me isolate it pretty nicely, and
I don’t have to do all the stuff with my feet. Um. So, again, just kind of naturally I’d be like
this. or like this. You can see there’s some extra curvature in
my low back. So what I’m really doing, I’m going to be
working on pushing my back against this pillow. Um, and before I do that I’m kind of, again,
activating my core muscles. So what that looks like is you can look up
doing a Kegel elsewhere, um, but um my transverse abdominus is right here. If you put your hand in the fold of your hips,
and play around, you can tell when this muscle has been activated because it pulls in a little
bit. And the way Ithink of it is kind of a moving
my hip bones closer together. Not actually my hip bones, I hope? But it is this muscle. Then I’m going to tighten it hard. You can see it kind of engages all the way
up here [gestures to upper abdomen.] Um, but we don’t want to do it super clenched,
because you’ll get tired out super easily. And the exercises won’t be as effective. So it’s just a really light, like if it’s
an elevator you’re not going up to the penthouse, you’re going up to the first or second floor
of tightness. So, I’m just tilting my pelvis back a little
bit so that I’m practicing a little bit of range of motion, um, rather than doing a fully
static exercise. But because I’m supported, the way that I
am, it’s easier for me to keep in a healthy range of motion as opposed to accidentally
going to the end of my range of motion and then past it to hypermobile subluxation land. So I’m just – I’m not supposed to talk while
I’m doing this. *sighs* Okay, I’m taking a break. I’m just, again, gently tilting my hips back
and forth. And there are ways you can sort of level up
this exercise. Rather than just tilting back and forward,
you can – again I don’t need to go this way [gestures up] because I’ve got the hyper curvature
already. But if you act like your body is like a wobbly
table and it doesn’t have the legs quite right, you can sort of do – activate the muscles
first – um you can sort of practice movinging your pelvis like on this plane or on this
plane [motions diagonally from hip toward opposite shoulder]. And I’ve kind of tired out these muscles now. Um, but this just again helps with core stability
and is important for holding your posture and body in the “neutral” position. So that you don’t hyperextend things and hurt
yourself. The other thing you can do, if you’re leveling
up from this, you’ve done this for awhile, and you want to move toward a standing physical
therapy thing, is very carefully just lift one leg not super high but just a little bit
off. Or you can if it’s hard to keep the muscles
balanced, you can do both at once. Again, I’m stabilizing here first, and using
these [abdominal] muscles to lift the legs. This is good practice. This is hard. Don’t start with that. Um. Another thing I want to mention, is that with
sort of ankle instability. It can be really tempting to be here and be
like “oh Im so relaxed,” is to do a bunch of like ankle things like this [rotates wrists]
and have your ankle pop out. So I put my braces on, um I also try and keep
my ankles in sort of a neutral-ish position. Ok so again, walking through what this looks
like. *breathes out* we’re going to kind of let
ourselves find our center. Maybe that’s what the yoga people actually
mean. Um, but then you pull the elevator up a couple
floors. And then just chill. Pull your hips back a tiny bit And actually
what I’m going to do now is instead of tilting back and forth I’m just going to keep these
engaged a little bit. And then relax. Do it for the length of time that is okay
for you, don’t push yourself on these. Because it’s real easy to injure yourself,
then you can’t do PT for a few days, um, so I’m pulling muscles in and engaging. When you’re actually doing this, you want
to be taking deep breaths. Which I’m told helps your lymphatic system
do its job. *breathes* Now it’s possible, if you’re like
me and your SI joint kind gets cranky, your piriformis muscle, which is this muscle in
your ass, gets tight and angry. so what I do sometimes, this is partly why
I have the heating pad, but also sometimes if I’m like “oh, I accidentally pushed myself,
I take this, which is literally just a racquet ball in a long sock so I can grab it, and
I kind of tilt and I put this under that muscle. And then I just kind of relax here because
honestly, this position feels pretty good. For awhile, and rather than doing a foam roller
for something like this, um, where you’re moving a lot and again, really easy to injure
yourself, I just kind of tuck a racquet ball there and let it put some pressure on those
fascia and on the muscle and get it to calm down and open up and release a little bit. Um or if you have two of these, what I sometimes
do is I balance them and put it on both sides um. Not doing a whole lot of moving here because
this is more sort of like a wind-down. So, I hope this was helpful, again, talk to
a medical professional if you have one that you can talk to about hyper mobility. If you don’t, ask bendy people. You can maybe find someone good, because while
our bodies are similar sometimes we have different issues. And really this is for if your pelvis is tilted
forward. I don’t have exercises for if it’s tilted
like this [gestures side to side] or if it’s tilted backward because that’s not what my
body does. But because it’s so hard to find a knowledgeable
PT, I’m sharing this in the hopes that it helps someone or at least gives them some
ideas of what kind of exercises are possible. My physical therapist and I modded this really
heavily, because there are a lot of exercises that — well part of the mod is having this
pillow in my lower back and the heating pad and having this racquet ball. Some of these I came up with myself, some
of them I just kind of checked with her. [images changes to at in a cat tree] here
is some bonus footage of my little furry friend who was keeping me company through this video
and making all the noises. And here’s my other kitty, who was sitting
under the foot stool for this entire video.

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