Fiber is an important part of a healthy diet and most kids are not getting enough of it on a daily basis. Fiber is a carbohydrate that is found in plants that we eat for food. Dietary fiber-found in vegetables, fruits, whole grains, seeds, and beans-helps with digestion and keeps our bowel movements regular. Dietary fiber includes soluble and insoluble fibers. Soluble fiber dissolves in water while insoluble fiber does not. Both of these remain undigested and aren't absorbed into the bloodstream and are excreted from the body. Insoluble fiber absorbs water to bulk up stool and helps move waste through the intestines to prevent constipation. Soluble fiber binds with fatty acids and helps to form a "Teflon coat" of sorts to also assist in digestion.

The prior rule of thumb for recommended fiber requirements for children over the age of 2 until 12 years of age was to take in the number of grams of fiber each day that equals their age plus 5. So, for example, a 7 year old would need to consume 12 grams of fiber. Nutritionists felt that this number was too low. The Food and Nutrition Board of the American Heart Association now recommends fiber intake as follows:

AGE FIBER (grams)
1-3 years 19
4-8 years 25
9-13 years Female- 26 / Male-31
14-18 years Female-26 / Male- 38

Foods that contain over three grams of fiber are considered good sources of fiber while foods containing 5 grams or greater are considered excellent sources of fiber. Food labels list the fiber content on all packaged item and websites such as is a great resource for finding fiber counts along with all other nutritional information.

Ways to add high fiber foods to your child's diet:
  • Look for whole grain breads, cereals, and crackers. Be sure to check the label for the fiber content on breakfast cereals and look for one that has at least 3 grams of fiber.
  • Use brown rice instead of white rice for cooking. Also shop for whole wheat pasta or whole wheat tortillas.
  • Include vegetables or fruits in every snack. Be sure to keep the peel on to maximize the fiber intake.
  • Add whole wheat or oat bran to muffin or pancake mix. Also shredded veggies such as carrots or squash can be added in the batter for an extra fiber boost.
Begin slowly since it does take time for the digestive system to adapt to the new intake and be sure to offer your child plenty of water to prevent any gas or bloating. Remember - fiber is not just for Grandma! Starting healthy eating habits early can lead to a lifetime of good food habits and healthy bowels.
By Jill Menefee, PT

Physical Therapy Treatments for Pelvic Floor Dysfunction
I've done hundreds of Kegels. What else can I do to make my pelvic floor muscles strong?
Here are 16 ways to strengthen the pelvic floor & only ONE of them involves plain Kegels.
(These physical therapy treatments can also be used to treat: urinary and fecal incontinence, pain with intercourse, coccyx pain, pelvic organ prolapse, sacroiliac joint pain, pelvic pain, vulvodynia, endometriosis, interstitial cystitis, pudendal neuralgia)
The pelvic floor (PF) has 3 primary roles: maintenance of continence,1 support of abdominal contents,1 and sexual function.2 The PF also assists in ventilation 3 (breathing), spinal stability,4 postural control,3 and stiffness of sacroiliac joint.5,6 Your physical therapist at CTS will assess the health of your pelvic floor muscles as well as supporting systems. Here is a list of evidence based treatment options we use to support pelvic health.
Strengthen Pelvic Floor (PF) Muscles

CONCEPT: PF muscles are strongest when posture is good.6,10

TREATMENT 1: Static posture and alignment corrections of spine, pelvis, hips, knees, and feet. 6,10
TREATMENT 2: Dynamic posture corrections: Bend and lift technique

CONCEPT: PF muscles are short or overactive making them fatigued or weak and sometimes painful.

TREATMENT 1: Calming nervous system via relaxation exercises to decrease tone of PFM.
TREATMENT 2: Diaphragmatic breathing
TREATMENT 3: Biofeedback12 to learn what it feels like to relax PF muscles
TREATMENT 4: Manual stretches, soft tissue massage, and trigger point release to PF muscles
TREATMENT 5: fascial release of hip and thigh muscles
TREATMENT 6: learn neutral lumbar alignment because neutral alignment decreases the tone on PF muscles.6

CONCEPT: PF muscles need simple strength training

TREATMENT 1: progressive "Kegels" including concentric and eccentric training
TREATMENT 2: Biofeedback12 or electrical stimulation to "wake up" PF muscles.

CONCEPT: activation of transverse abdominal muscle (TA)11,13 and obturator internus8 improves strength of PF muscles.

TREATMENT 1: strengthen TA11 muscle and hip muscle.8

CONCEPT: Timing and coordinating PF muscle contraction

TREATMENT 1: Learn to coordinate a "Pelvic Brace" to support organs during increases in intra-abdominal pressure (IAP)
TREATMENT 2: learn to contract the pelvic brace prior to and during a cough/laugh/sneeze/lift/start of a movement

CONCEPT: The PF muscles and diaphragm work together for optimal respiratory health and pelvic health via maintenance of intra-abdominal pressure.7,9

TREATMENT 1: Learn correct diaphragmatic breath9
TREATMENT 2: release thoracic restrictions affecting diaphragm health14
TREATMENT 3: Diaphragm trigger point release

Crystal Hazelton, PT, OCS

creating power through movement
 heal. nurture. educate. inspire. energize. respect.
In This Issue
CTS welcomes new aides Justin and Savana! Justin is also a personal trainer and will see patients at CTS.

We also want to send a warm farewell to David, who will be starting the DPT program at USC this fall!

Find Balance with Acupuncture.
Receive $20 OFF your first Acupuncture treatment with the mention of this CTS Newsletter offer.
We are now in network with all major providers.
Connect with us on Facebook for tips on health and wellness, exercise video tutorials, special promotions and more!

Community Education
plays a meaningful role to the members of our CTS family. We strive to do our part to provide top notch education and information. 
Here's how:

Cindy Furey - Teaches at St. Augustine and San Diego State University

Crystal Hazelton - Blogs on pelvic floor with post-partum issues

Mandy Johnston - Teaches core activation at Mesa College PTA program. - Presents using Pilates for rehab at San Diego District Chapter Meeting for the APTA

Elizabeth Leeds - Teaches pregnancy/post-partum topics at the YMCA

Maureen Mason-Cover - Clinical trial on Diastasis Recti intervention

Comprehensive Therapy Services focuses on great traditions to heal, educate and empower patients, family and friends. Take advantage of our programs to help you meet your wellness goals.


Take advantage of our Pilates classes and private instruction, Massage and Acupuncture - what a combination to help you meet your health and fitness goals! Check out our class calendar - CLICK HERE»


CTS also offers Mindful Meditation with Jim Cahill. During these sessions, Jim will work with you to enhance your physical and emotional well being while teaching you techniques you can use for self practice. For more information, CLICK HERE» 

As always, the therapists and staff at CTS strive to offer you the best Physical Therapy in town. We promise to provide the most up to date treatment techniques. Let us empower you to make NOW your time to shine!

Beach Yoga

Open Monday-Friday
from 7am - 7pm
(858) 457-8419

5677 Oberlin Drive,
San Diego, Ca 92121


Quick Links

  1. Raizada V, Mittal RK. Pelvic floor anatomy and applied physiology. Gastroenterol. Clin. North Am. 2008; 37:493-509
  2. Dean N, Wilson D, Herbison P, Glazener C, Aung T, MacArthur C. Sexual Function, delivery mode history, pelvic floor muscle exercises and incontinence: a cross-sectional study six years post-partum. Aust. N. Z. J. Obs. Gynecol. 2008; 48:302-11.
  3. Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourol. Urodyn. 2007; 26:362-71.
  4. Smith MD, Russell A, Hodges PW. Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Aust. J. Physiother. 2006;52:11-6.
  5. Pool-Goudzwaard A, Hoek van Dijke G, Gurp M, Mulder P, Snijders C, Stoeckart R. Contribution of pelvic floor muscles to stiffness of the pelvic ring. Clinical Biomechanics 2004; 19:564-571.
  6. Capson AC, Nashed J, Mclean L. The role of lumbopelvic posture in pelvic floor muscle activation in continent women. Journal of Electromyography and Kinesiology 2011; 21:166-177.
  7. Hankyu, P., Dongwook, H. (2015). The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. Journal of Physical therapy science. 27: 2113-2115.
  8. Tuttle, L., DeLozier, E., Harter, K., Johnson, S., Plotts, C., & Swartz, J. (2016). Journal of Women's Health Physical Therapy.
  9. Park, H., & Han, D. The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. (2015). Journal of Physical Therapy Science, 27, 2113­2115.
  10. Sapsford, R.R., Phty, D., Richardson, C.A., Maher, C.F., Hodges, P.W. (2008). Pelvic floor muscle activity in different sitting postures in continent and incontinent women. Archives of Physical Medicine and Rehabilitation, 89, 1741­1747. doi: 10.1016/j.apmr.2008.01.029
  11. Sapsford, R.R. (2004). Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Journal of Manual Therapy, 9, 3­12. doi: 10.1016/S1356­689X(03)00131­0
  12. Herderschee, R., Hay­Smith, E.C.J., Herbison, G.P., Roovers, J.P., & Heineman, M.J. (2013). Feedback of biofeedback to augment pelvic floor muscle training for urinary incontinence in women: Shortened version of a Cochrane systematic review. Neurology and Urodynamics, 32, 325­329. doi: 10.1002/nau.22329
  13. Ghaderi, F., Mohammadi, K., Sasan, R.A., Kheslat, S.N., & Oskouei, A.E. (2016). Effects of stabilization exercises focusing on pelvic floor muscles on low back pain and urinary incontinence in women. Journal of Urology, In press. doi: 10.1016/j.urology.2016.03.034
  14. Bordoni, B. & Zanier, E. (2013). Anatomic connections of the diaphragm: Influence of respiration on the body system. Journal of Multidisciplinary Healthcare, 6, 2 81­291.
20% OFF
If your birthday is in the month of June, you are entitled to receive 20% off any massage purchase at CTS. Print this coupon and present it in person to CTS at the time of purchase. Birth date must be validated by one form of identification for offer to be valid. Promo code: BDAYJUNE16
Offer Expires: July 15, 2016
Receive $20 OFF First Prenatal Massage!

Present this coupon at CTS to receive $20 off your first prenatal massage. First time clients only.
Promo Code: PRENATAL2016
Offer Expires: July 15, 2016