How do you sneeze while being kind to your pelvic floor? Tighten up and let it go! Are you someone that tries to sneeze discreetly? Do you try to hold it in? Let me tell you what is happening when you don’t let that air out: 

• Sneezing is a way to clear your passageway of something that is not welcome. If you don’t let it fly, the passage isn’t cleared. 
• If you don’t let the air out your mouth and nose, that rapid intra-abdominal pressure increase is going to look for somewhere else to escape. If your deep core is not able to withstand the pressure, this could look like peeing/pooping your pants, experiencing hemorrhoids, pelvic organ prolapse, or hernia.  
• If you don’t have symptoms initially with holding your sneeze in, you might expect it to happen as you age.  

Here’s what to do instead – tighten your pelvic floor (the muscles between your legs) before you sneeze. To tighten your pelvic floor muscles, first, identify the muscles by imagining you’re stopping the flow of urine or preventing passing gas. Once you’ve located them, contract these muscles by squeezing and lifting, without holding your breath or tensing other parts of your body. Then let the air explode out of your mouth when you sneeze.

This is how your muscles work together. If you have difficulty, pelvic floor physical therapy can help. With practice, these muscles will start working together automatically and you can rest assured that you are taking good care of your pelvic floor, pelvic organs, and abdominal cavity through appropriately managing your pressures when you sneeze. 

Pediatric rehabilitation is a journey not only for the child but also for their families. Caring for a child with a disability or undergoing rehabilitation can present unique challenges, both emotional and practical, that families must navigate. From managing appointments to coping with emotional stress, the journey can be overwhelming. However, with the right support and resources, families can find strength and resilience in their role as caregivers. In this blog post, we’ll explore some common challenges and ways of supporting families in pediatric rehabilitation by providing tips and resources.

Challenges

One of the primary challenges families encounter is the sheer volume of appointments and therapies their child may require. Balancing these commitments with work, school, and other family responsibilities can be daunting. To alleviate this challenge, families can benefit from creating a centralized schedule. Utilize online calendars or apps to track appointments and coordinate with healthcare providers to streamline care whenever possible.

Emotional stress is another significant challenge for families. Watching a child struggle with a disability or undergo rehabilitation can evoke feelings of grief, guilt, and anxiety. It’s essential for families to acknowledge and address these emotions, whether through individual or family counseling, support groups, or simply by reaching out to trusted friends and family members for support. Finding a community of other families going through similar experiences can provide a sense of belonging and understanding.

Practical concerns, such as financial strain and navigating the healthcare system, can also weigh heavily on families. Exploring financial assistance programs, such as Medicaid waivers or grants for medical expenses, can help alleviate some of the financial burden. Additionally, working closely with social workers or patient advocates at healthcare facilities can provide valuable guidance and assistance in navigating the complexities of the healthcare system.

Lastly, self-care for caregivers is paramount. It’s essential for family members to prioritize their own physical and emotional well-being to effectively support their child. Taking breaks when needed, practicing relaxation techniques, and engaging in activities that bring joy and fulfillment are all crucial aspects of self-care.

Local Resources that Support Families in Pediatric Rehabilitation

1. Family Outreach Montana. Family Outreach Montana provides support and resources for families of children with disabilities in the Bozeman area. They offer parent support groups, educational workshops, and advocacy services to help families navigate the challenges of pediatric rehabilitation.
2. Gallatin Early Childhood Community Council. This organization works to support families with young children in Gallatin County, including those with disabilities or developmental delays. They offer parent education programs, developmental screenings, and referrals to local resources for pediatric rehabilitation.
3. Children’s Special Health Services (CSHS). CSHS provides assistance to families of children with special healthcare needs, including assistance with medical expenses, care coordination, and access to community resources. Families can contact the Bozeman office for support and guidance.
4. Orchid Club Montana. Orchid Club Montana is a resource for families who have children with special needs or disabilities. They offer support, resources, and community connections for families navigating the challenges of raising a child with a disability.
5. Thrive. Thrive provides local Gallatin Valley families with resources, tools, and support for raising healthy, successful children. They offer mentoring, education, and support to children and families. They help families navigate systems and advocate for inclusive policies, fostering community inclusion.

These resources can serve as valuable support systems for families in the Gallatin Valley who are navigating pediatric rehabilitation. By reaching out to these organizations, families can access the assistance, information, and community connections they need to support their child’s journey to health and well-being.

Supporting families in pediatric rehabilitation requires a multifaceted approach that addresses both practical and emotional needs. By acknowledging the challenges families face and providing them with resources and support, we can empower them to navigate this journey with resilience and strength. Remember, no family has to face this journey alone.

Changes in weather change your activity level. Spring is in the air, and that means more than just blooming flowers and chirping birds. It’s a natural nudge to shake off the winter blues and be more active. Research that looked at the seasonality of physical activity proves this is true. Across a wide variety of countries and populations, people change their activity levels and become most active in the summer.

Since it’s likely that your physical activity levels are starting to trend up, we wanted to give you a few fun ideas to try, and some tips on how to navigate the change. 

Embrace the Great Outdoors:

• Trade the treadmill for the trail: As the weather warms, escape the gym and head outside. Explore nature with hikes, bike rides, or even a walk or jog around the park. Soaking up the sunshine not only boosts your vitamin D levels but also enhances your mood and motivation.
• Turn your park into your playground: Public parks offer tons of fitness opportunities. Utilize the equipment for bodyweight exercises, join a pick-up game of basketball, play a round of disc golf, or find an outdoor fitness class.

Incorporate Seasonal Activities

• Get active with seasonal sports: Participating in spring sports leagues like volleyball, softball, pickleball or tennis is a fun and social way to get moving. You’ll meet new people while engaging in friendly competition and getting some exercise.
• Cultivate your green thumb: Gardening is a surprisingly active hobby. Digging, planting, and tending to your garden provides a full-body workout while connecting you with nature.

Navigating Changes in Activity Levels

• Spring clean your activity plan: Just like your home, your exercise routine might need a spring cleaning. Evaluate your current program, identify areas for improvement, and think about what new exercises or activities you’d like to add. 
• Don’t spring forward too fast: Spring is an exciting time with longer days, better weather and new opportunities. Don’t take on too much too fast. Injuries from overuse and overtraining start to get more common in our clinics when people ramp activity up too fast.
• Celebrate your progress: Track your progress and acknowledge your achievements, no matter how small. This will keep you motivated and focused on your goals.

Spring is a season of growth. Let it be the catalyst for your own personal transformation. By embracing the outdoors, incorporating seasonal activities, and refreshing your routine, you can spring into action and experience the joy of a healthier and happier you.

If you’d like someone to evaluate your current plan or develop a new one for you, we’d be happy to help! And of course, we’re always here for aches and pains from too much too soon, or weekend warrior injuries from those spring sports.

References:

1. Sex- and age-specific seasonal variations in physical activity among adults. Journal of Epidemiology & Community Health 2010;64:1010-1016. https://jech.bmj.com/content/64/11/1010.short
2. Impact of Seasonality on Physical Activity: A Systematic Review. International Journal of Environmental Research and Public Health. 2022; 19(1):2. https://www.mdpi.com/1660-4601/19/1/2
3. The Effect of Season and Weather on Physical Activity: Systemic Review https://www.sciencedirect.com/science/article/abs/pii/S0033350607001400
4. Seasonal Rhythms and Exercise https://www.sportsmed.theclinics.com/article/S0278-5919(04)00120-6/fulltext
5. Exercise Assessment and Prescription in Older Adults Webinar https://learningcenter.apta.org/products/exercise-assessment-and-prescription-in-older-adults-and-individuals-at-risk-for-functional-decline?_gl=1*2t7olk*_ga*MTEwNjIzMzg2MS4xNjgxODQyODcw*_ga_ZZJK74HXNR*MTY5NzIwMjg2OC4xMi4xLjE2OTcyMDI4ODEuNDcuMC4w&_ga=2.227565085.1495021570.1697197738-1106233861.1681842870
6. Exercise Attitudes https://www.apta.org/article/2023/03/31/exercise-attitudes

Poor airway health can affect your child in a number of ways. Here are 5 things red flags to watch for that can indicate poor airway health.

Your Child Breathes Through Their Mouth

Firstly, sleeping with mouth open, tongue low posture is an immediate red flag for poor airway health. Mouth breathing also increases the prevalence of having crooked teeth. It allows for the tongue to not be “up” on the palate or roof of the mouth, creating an opportunity for the teeth to move or become crooked.  Tongue up resting posture is ideal for optimal palate expansion and jaw growth.  

You Can Hear Them Snoring While Sleeping from Poor Airway Health

Snoring is another sign that the child does not have their tongue resting on the palate and are not nasal breathing.

You Can Hear Them Grinding Their Teeth in their Sleep

Teeth grinding is more common than you may think. Teeth grinding occurs because the child is attempting to open their airway to breathe better. In the act of the body attempting to open the airway, the jaw is pushes forward, therefore, sliding the teeth together with force. This is a serious sign of sleep disordered breathing.

Presence of Challenging Behavior or an ADHD Diagnosis

All children with an ADHD diagnosis or challenging behaviors impacting daily living should have their airway health screened. Poorly oxygenated air during sleep is linked to poor attention and challenging behaviors. Jaw development, facial structure, and narrow or occluded airway could be a contributing factor to their ADHD and/or behavior.

Presence of Swollen Tonsils and Adenoids

Lastly, acute and chronic swollen tonsils and adenoids create a huge barrier for optimal nasal breathing. Ask your child to open wide so you can see whether their tonsils are inflamed, red, and/or swollen. Current clinical guidelines from the American Academy of Pediatrics and American Academy of Otolaryngology – Head and Neck Surgery recommend tonsillectomy as the first line of pediatric OSA treatment for children with tonsillar hypertrophy.¹ Although removal of tonsils is the gold standard, up and coming research is indicating early palate expansion through dental appliances and implementation of supportive therapies can improve or eliminate obstructive sleep apnea.

What Should You do with Airway Health Concerns

If you have concerns, have your child’s airway health and jaw growth assessed by an airway focused dentist. Your pediatrician can help assist with referrals to a recommended dentist and your local pediatric rehabilitation clinic providing oromyofunctional therapy and/or behavior therapy.

References

1. Yoon A, Abdelwahab M, Bockow R, Vakili A, Lovell K, Chang I, Ganguly R, Liu SY, Kushida C, Hong C. Impact of rapid palatal expansion on the size of adenoids and tonsils in children. Sleep Med. 2022 Apr;92:96-102. doi: 10.1016/j.sleep.2022.02.011. Epub 2022 Feb 19. PMID: 35390750; PMCID: PMC9213408.

A pediatric stander is a supportive device for children who have great difficulty or are unable to stand or walk achieve and maintain an upright standing position. 

What are the Benefits of a Pediatric Stander?

• Improve bone density and decrease risk osteoporosis. Weight bearing through the legs and hips stimulates bone growth. 
• Improve range of motion and decrease risk of contractures. Standing stretches tight muscles in the hips, knees and ankles to help maintain joint mobility and prevent contractures.
• Improve hip congruency and reduce risk of hip dislocation. Bearing weight through the hip joints in the proper alignment can help improve hip joint congruency and prevent hip dislocations 
• Improve bowel and bladder function. Being upright facilitates more complete emptying of the bladder and bowel compared to sitting or lying down. This helps reduce constipation and urinary tract infections.
• Increase muscular strength. The weight bearing and upright posture provided by standers allows strengthening of the back, neck and core muscles. 
• Prevent pressure sores. Standing reduces pressure on the skin over bony prominences compared to sitting or lying down for long periods. This helps avoid skin breakdown and pressure sores.
• Improve respiratory function. The upright posture helps expand the lungs more fully and decreases risk of respiratory infections. 
• Increase alertness and attention. The change to an upright, weight-bearing position provides new visual and spatial input to the brain which can increase alertness and attention span.
• Facilitate independence and social development. Being upright promotes head and trunk control and allows children to actively participate in play with peers, self-care, and activities at home and school. 

The decision to use a stander is generally made by a team of professionals based on the child’s specific condition and needs. Standing frames must be the proper size, and monitoring will occur initially to ensure optimal positioning and tolerance. Talk to your pediatric physical therapist to learn more and see if a pediatric stander is right for your child. Learn more about getting your child standing here.

Have you become part of the pickleball craze yet? It’s a sport that has been gaining popularity in recent years, attracting people of all ages and skill levels. If you’re curious about pickleball and want to learn more about it, you’ve come to the right place. We’re going to cover the basics of pickleball, from its origins to the rules of the game. So, grab your paddle and let’s dive in!

What is Pickleball?

Pickleball is a paddle sport that combines elements of tennis, badminton, and ping pong. You play pickleball on a court similar to a tennis court, but with a smaller size. You can play the game in singles (one player on each side) or doubles (two players on each side).

Equipment:

To play pickleball, you’ll need some basic equipment. Here’s what you’ll need:

• Paddle: Pickleball paddles are usually made of lightweight materials like graphite or composite. They are slightly larger than ping pong paddles but smaller than tennis racquets.
• Ball: Pickleballs are plastic with holes, similar to a wiffle ball. They come in different colors, but yellow is the most common.
• Court: A pickleball court is 20 feet wide and 44 feet long, with a net in the middle. The court is divided into two halves, with a non-volley zone (also known as the kitchen) located on each side.

How to Play:

The objective of pickleball is to hit the ball over the net and into your opponent’s court, aiming to score points. Here are the basic rules:

• Serve: The game starts with an underhand serve. The server must stand behind the baseline and hit the ball diagonally across the net. The serve must clear the non-volley zone.
• Volley: Once the ball is in play, players can either volley it (hitting it in the air without letting it bounce) or play it after it bounces once on their side.
• Non-volley zone: Players are not allowed to step into the non-volley zone and hit the ball in the air, however, they can enter the zone after the ball bounces.
• Scoring: The serving team is the only one who scores points. The first team to reach 11 points (with a two-point advantage) wins the game. Usually, you play matches as best of three games.

Pickleball Strategies and Techniques:

While pickleball may seem simple, there are various strategies and techniques to master. Here are a few tips to improve your game:

• Placement: Aim to hit the ball strategically, placing it where your opponent has difficulty returning it.
• Dinking: The dink shot is a soft shot that lands in the non-volley zone. This forces your opponent to hit the ball from a difficult position.
• Communication: In doubles, communication with your partner is essential. Coordinate your movements and shots to cover the court effectively.

Pickleball is a fun and engaging sport that is easy to learn but challenging to master. Whether you’re a beginner or an experienced player, the game offers a great way to stay active and socialize. So, grab a paddle, find a court near you, and give pickleball a try. Who knows, you might just fall in love with this sport! Are you like me and have trouble staying with new hobbies or exercise? Check out  Sticking to Your Exercise Program to make pickleball a lasting hobby!