The Intro: Why FEM?

 

Functional. Evidence-Based. Movement.

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Why women? First, why not? You’re being ridiculous. Secondly, I don’t do anything that I don’t overthink. So, serving this population was intentional. There is a need. I have a heart for women and girls. And the first step to every new project is to define the problem…read on.

  • We comprise 50.8% of the population = not a special population. (2010 census)
  • Women make 80% of the health care decisions. (US department of labor, 2017)
  • Over 400,000 women in the US have a hysterectomy every year and 1/5 of them may not be medically necessary. The same study concluded that 38% of these patients weren’t offered a non-surgical option. (Perry 2015)
  • In 2005, 48% of individuals 75 or older living in long-term care facilities alone were female.
  • A survey of US women in 2004 concluded that women wanted more professional guidance regarding hormonal therapy and alternative therapies for menopause.
  • 50% of postpartum depression goes undiagnosed (Luke 2009)

So, there you have it people. Get ready to live and learn.

Functional

A word the fitness, rehab, and “movement” industry has really latched onto in the past 10 years. Hello! It’s the first word in my sweet practice name acronym, “FEM.”

But it also kind of drives me crazy every time I hear someone call Olympic lifting, functional fitness, or closed-chain exercises, functional exercises, or animal flows, functional movement. Yes, those all have their amazing benefits and I’m a huge fan, however, these aren’t appropriate for everyone all the time.

You know what isn’t functional for a woman with a prolapse without proper rehab? Box jumps or max back squats. Not bad, just maybe not appropriate for that time. You know what isn’t functional for a swimmer or aerialist? Only closed-chain exercises.

I’m a big fan of thinking of the body’s response to gravity and chain-reactions of joints and muscles; it dictates my entire treatment thought process. But, working with women of different ages with different goals has changed my tune. I now ask, listen to, and value what the patient wants to get out of therapy, not threat what I think is text book “optimal movement.”

I want to meet the patient’s goals by giving them strategies and movement options. I want to help them be their own problem solver. So, I guess I should replace “functional” with “goal-oriented,” but GOEM is a weird name for a women’s health practice.

Evidence-based

I value evidence in decision making, for my own health, my patients’ treatment decisions, and to continue learning to give the best care possible. I’m getting my PhD because I fell in love with the research process and am already excited about a sabbatical one day.

With that said, research is a controlled environment, where only one factor is altered. For example, is stretching every muscle for 2 mins everyday better than 2 mins 3x/week for increased hip range of motion in underwater basket weavers? I kid you not, this is real research life. However, women are the most complex freaking onions in the world, with so many layers that your trainer, therapist, and practitioner need to consider. You are your own N=1 experiment sometimes. So, the term is evidence-based, not evidence-dictated.

Be wary of online ‘experts” who can’t back up their thought process. Individuals who pass along information like medicinal folk lore, is the biggest disservice to desperate women trying to heal themselves. Remember, expert opinion is the lowest level on the evidence pyramid.

And for clarification, the lack of evidence on a subject does not dismiss its efficacy, it just hasn’t been studied yet. With women’s health, that’s where we are right now. So, we take evidence from other body parts and sciences and extrapolate it to the pelvis, or hormones, or fascia. I will try my best to pass along that thought process or evidence. If I pass along something old or wrong or questionable, call me out.

Movement

For better or for worse the type of movement and exercise we participate in effects our mood, our confidence, our body image, our friend group, how we handle stress and our relationship with food. But, I thought I would pass along some uplifting facts about movement and women to over-ride some of the guilt, body-shaming, unrealistic expectations when it comes to female fitness, postpartum recovery and women in sports.

  • Regular exercise can reduce the risk of dementia and improve mental function and energy according to the Alzheimer’s association.
  • Load bearing exercise can be the most important thing you can do to prevent osteoporosis. (University of Arizona)
  • Regular exercise can help prevent constipation (Gastroenterological Society of Australia)
  • Participating in exercise you enjoy regularly can prevent a relapse in anxiety and depression. (Mayo Clinic)
  • A workout in the middle of the day improves confidence at work, improves productivity and improves time management. (American College of Sports Medicine)
  • Risk of lung, breast, and colon cancer is reduced in women participating in regular activity
  • More isn’t always better; low level aerobic exercise, yoga and deep breathing lowers levels of cortisol and adrenaline to help regulate blood sugar, blood pressure, and insulin resistance.
  • Improves your view of others: Positive attitudes towards individuals with disabilities, increased tolerance and sensitivity were some of the confirmed benefits of participating in integrated outdoor experiences. (McAvoy, 2001)
  • Exercise with a partner: literature reviews consistently find that husbands and wives who spend their leisure time together tend to be much more satisfied with their marriages. (Orthner & Mancini, 1991)

Thanks for joining this journey! – Dr. Laurel Proulx

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