Pilates Day, an annual, international, community event celebrated on the first Saturday of May, spotlights the joy experienced through Pilates - in health, community and quality of life. At CTS, we're honoring Pilates Day by offering 10% OFF Pilates Packages for current clients.

New to Pilates? Take advantage of our $10 Introduction to Pilates class - Friday, May 27th at 12:30pm - where you'll learn basic principles, form, breathing, mat and equipment exercises (new clients only). Call the clinic for more details - 858-457-8419

Springtime is a time of new beginnings. It reminds me of my post-partum period as my kiddos were born at this time. As I reflect, I realize how fortunate I am to have access to information to help understand the changes in my body and assist in decisions about what exercises would be optimal with pregnancy and recovery. I have an appreciation for the importance of the post-partum period and retraining the body to a foundational level to help restore my system back to its new normal. It is my hope to inspire you to have an appreciation for some of these changes as well as how they can be addressed to help you restore function. There are lots of changes which can be addressed and I will start with three.

1. Your ribcage expands which can affect your breathing and intra-abdominal pressure regulation, which helps with digestion and spine stabilization.

The diaphragm connects to your ribs. As you inhale, the diaphragm moves downward and as you exhale it moves upward. With the downward movement of the diaphragm, the pelvic floor can be facilitated to relax. With breathing out, the diaphragm can assist the pelvic floor to tighten. With pregnancy, the diaphragm may flatten out due to the ribcage expanding toward the sides and the uterus growing. With this flattening, it can be more challenging to not only take a deep breath, but also tighten the pelvic floor.

Thus in the post-partum period, it is important to help restore the ribcage to a more neutral alignment. Learning to balance the ribcage over the pelvis, stretches to lengthen tighten muscles and exercises to strengthen are just some elements to consider in an exercise program. For example, notice the difference in tightening the pelvic floor and/or core in a slouched or exaggerated upright posture. When the ribcage aligns itself over the pelvis, the muscles are in the most optimal alignment to work. If you can look in the mirror and retrain your alignment, then go for it! However, if you are like myself and others who need some assistance, then work with your physical therapist to help you.

2. Your feet can flatten leading to greater strain and pain to the feet, as well as, poor loading into the knees, hips and back.

Hormonal changes coupled with weight changes can contribute to the arches flattening. With these changes, the feet become less of a shock absorber and can inhibit the ideal mechanics of the lower body, especially the hip. Weakness of the gluteals (a group of muscles which brings the leg behind you into hip extension) can place greater strain on the sacroiliac join or low back. Furthermore, there is a hip to pelvic floor connection. When hip activation is altered, the pelvic floor may compensate leading to weakness or pain.

In the post-partum period, it is important to note how the foot is loading in standing. In other words, have the arches fallen given the appearance of a flattened foot? Do you feel any knee, hip or low back irritation that seems to linger despite continued exercises? Is your pelvic floor not working optimally to allow you to control urine or bowel in everyday or recreational activities? Talk to your therapist if you note any of these changes, as s/he can assess the mechanics and provide you exercises from your feet to your core.

3. Abdominals can separate. This is called diastasis recti, which can effect breathing, digestion, spinal stabilization and urinary and bowel continence.

The abdominals are connected in the middle by a thick piece of fascia called the linea alba. Fascia is like a plastic wrap which covers our organs, nerves, muscles and blood vessels. Basically it wraps itself around and through the body interconnecting us head to toe. The linea alba is located on the front side with connections from the ribcage to the pelvis and it connects the right and left sides of the abdominals. It helps to support the spine and assist with intra-abdominal pressure regulation. Intra-abdominal pressure regulation is important for such functions as spine stabilization, urine and bowel continence, digestion, breathing, and organ support (prevention of prolapse). During pregnancy, the linea alba can separate or overstretch due to the ribcage expanding, the growing fetus and poor postural mechanics. Post baby, the linea alba may remain stretched. Over time diastasis can contribute to incontinence, pelvic and/or back pain, and prolapse.

One's post-partum care would ideally include a diastasis check by a trained physician, therapist or trainer. However, rarely are women checked. Treatment of the diastasis is multidimensional in that posture, breathing (remember the ribcage section ☺), manual work, taping and core exercises are just a few aspects of treatment. Whether you had your baby years ago or just recently, it is wise to have your abdominals checked.

It is amazing how the body changes with pregnancy! Even if you have had an uncomplicated easy breezy pregnancy or one that has had challenges, the body is still adapting to the fetus. Although the extent of the biomechanical and physiological changes can separate pregnancy experiences, it would benefit us as mothers and women to encourage each other to seek help in restoring the body and returning to life as you design it!
Elizabeth Leeds,

After the birth of child, we commonly see new moms want to get back to their prenatal weight. Most of these moms choose running as the ideal exercise, due to the ease of timing and the ability to push their baby in a stroller. Here are some pointers on making sure you are ready to return to, or start, running:

1. Wait until your six week checkup to be cleared to exercise by your OB.

2. If you must push a stroller, try to use a light-weight stroller that allows your elbows to be bent at 90 degrees. Ideally, running form is best without pushing a stroller. This may be a good activity for your partner or running buddy to do instead of you.

3. Do exercises for your core and gluts prior to starting a running program. Gluts and core activation tend to be the top areas of weakness post-partum, which can cause serious faults in your form.

4. Work on the mobility of your thoracic spine. This can be done with a foam roller, stretches and multi-planar motions. The thoracic spine tends to become stiff towards the end of your pregnancy and with holding a tiny baby in your arms. Nursing positions also encourage a hunched over position.

5. Start slow. Run for only 5 minutes at a time and slowly increase time. In between intervals, continue walking or stop in the grass and do a few exercises for the whole body.

6. Check your form. Your body has changed very quickly in order to accommodate that little baby. The joints, muscles and coordination of your body are trying to adapt and may compensate in patterns that could instigate injury.

7. If you need more guidance, Comprehensive Therapy Services can help you with each step (except for #1). Pregnancy is a beautiful process but can also create some difficulties with all of that change.

Happy Running!
April Douglas,

creating power through movement
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In This Issue
Receive 20% OFF any book purchase in the month of May. Stop by the clinic to take advantage of this special offer! 

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.
2016 Wellness Workshops
CLICK HERE for dates and class descriptions.

Instructor: Elizabeth Leeds, DPT
Don't miss our raffles for free Doterra Products!
Reserve your spot - call (858) 457-8419 or email »
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


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20% OFF
If your birthday is in the month of May, 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: BDAYMAY16
Offer Expires: June 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: June 15, 2016