This Little Piggy …….


This month’s topic and focus in this session of Pilates is foot health.  Do your little piggies go wee wee AHHHHH all the way home? If so read on and then come to classes or schedule a foot private session to learn valuable exercises to help with your foot pain or alignment problems.

Many changes occur in the feet as we go through life’s journey.  Many use, overuse or misuse problems can cause changes in the shape of the foot, size and location of the fat pads on the bottom of the feet, the integrity of the skin and toenails, the health of the foot bones, range of motion of the joints, circulation and also the sensation of the feet.  Good foot health is essential to your quality of movement and of life. Many foot problems can be avoided by proper prevention and early intervention.

Do you have knee, hip and low back problems that you haven’t been able to figure out the cause of ? Maybe looking down at your feet you may discover the source !

Common foot disorders:

  • Hallux valgus– aka bunions. This is where the big toe drifts toward the other toes. A bunion may form on the outside edge of the knuckle of the big toe and occasionally the big toe may overlap the other toes.  Bunions can also form on the outer side of the foot called bunionettes or tailors bunions, where the pinky toe can drift toward the other toes.
  • Deformities of the lesser toes– In hammer toe, the middle joint of the toe sticks up to form a painful callous on top of the joint due to friction and pressure with the shoe.
  • Degenerative joint diseases such as osteoarthritis– joint pain, weight-bearing, and joint tenderness with pressure may interfere with normal walking.
  • Circulatory changes related to diabetes and vascular diseases such as arteriosclerosis narrowing of the blood vessels can affect the integrity of the skin and underlying soft tissues and compromise healing of open wounds.

Foot problems are often related to footwear, but in our society, as popular as this idea is, going barefoot is not a viable option in my opinion. We wear shoes for foot protection, sanitation , and fashion. Even in good, supportive shoes, our feet suffer because the muscles weaken from lack of use. On the other hand, shoes that do not adequately support the foot contribute to foot deformities and pain by : causing muscle weakness from disuse and allowing  supportive ligaments of the foot to stretch, permanently affecting the foot’s structure.

Fashion, especially for women, is a major culprit. Narrow, pointed toes of shoes squish toes together, causing overlapping, pressure points, and decreased circulation. High heels further compromise the toes, decrease ankle stability, and force the ball of the foot to bear an excessive proportion of the body’s weight.  In addition , long-term wearing of high heels can cause permanent shortening of the heel cord, the toe extensor muscles on the top of the foot, and supportive structures in the arch. Combined, these changes significantly alter the structure and functional capacity of the foot.

When the structure of the foot  has changed this change affects the structures  above. The forces that travel up your leg when you walk will travel differently up the leg and can cause problems at the knee, hip and low back. So  taking care of your feet can help protect other areas of your body as well.

Proper conservative foot care is essential to prevent disuse and dysfunction that can eventually lead to debilitating foot problems. To maintain your healthy feet follow these steps:

  1. Check your feet: Look for changes in skin, color,  shape/ position of joints, calluses.  See a podiatrist if something doesn’t look right, especially if you have pain.
  2. Maintain proper weight:  This relieves a lifetime of pressure on your feet.
  3. Wear well-fitting shoes: Over a lifetime, shoe size usually changes. Adjust accordingly. Wearing heels occasionally is ok but make sure the toe box is wide enough so that toes are not squished.
  4. Make sure to exercise your feet: walking,  flexibility exercises, massage and resistive exercises, all can help decrease stiffness, decrease pain, improve joint motion, release tight tissues and help to realign foot structure.

Build exercises for your feet into your daily routine. It’s not that hard. Most exercises can be done while putting  moisturizer on your feet or while sitting at your desk.

The long-term health of your feet is so important and prevention is key. So start now.  Foot exercises on You Tube are many or you can come to a Pilates class or private session to get your own feet assessed and learn what exercises are best for you.  Read back in this blog for my article on tennis ball stretches to start your own foot exercise routine.

Applying My Pilates Principles to Post-Op Laparoscopic Hysterectomy


As a physical therapist (PT) and certified Pilates instructor (CPI) I am routinely giving advice to my clients as to how to prepare and how to recover from surgery.  My expertise has always been very orthopedically centered. So if you have a knee replacement, shoulder surgery, back or neck surgery, or pain in any of these areas I can help.  I can with confidence apply my knowledge of PT and also Pilates training to give you a program or advice on how to manage your situation and your healing.  However, this female abdominal surgery area was totally new to me. You may be having the laparoscopic approach with punctures and small incision or a full open hysterectomy, but in either case, here’s how my fitness knowledge has benefited me along the way with my experience and recovery.

Of course, in my Pilates classes I focus on all the Pilates principles: relaxation, concentration, control, centering, fluidity, precision, breathing and endurance. What I am constantly reminded of is that in just regular activities of daily living  so many of  these Pilates principles can be applied to most any situation, giving you better control and mastery over your body. This applies to pre-op and post- op situations too!

Recently I underwent a supracervical hysterectomy done laproscopically.  I am  very healthy,  I exercise regularly, teach Pilates classes and private training, eat clean, take supplements, meditate etc. but the issues that I suffered from ( large fibroid, heavy periods and to my surprise endometriosis) were not affected by my healthy lifestyle so medical intervention was a MUST.   I am not alone in this, since many women suffer as I did.

What I was surprised to find is that I was able to take what I have been teaching to my clients for so many years and apply them post- operatively.  I hear myself preaching to my clients about how all energy comes from your center and how the abdominals play a role in all movement. This hits home, and fast, once you have an abdominal incision. I was unpleasantly surprised how much discomfort I had with just the smallest of movements- like drying my hair or even reaching for my water bottle.  So with THAT said, how did I apply my Pilates principles to my recovery? Here’s a list.

  1. Breathing:  One of the biggest Pilates principles is the breath.  When you have pain you tend to hold your breath. So first thing I did was to breathe, using my inhale through the nose, exhale through the mouth- Pilates breath.  This helped significantly during simple activities like resting and most importantly when I moved.  By breathing this way you can decrease your intra-abdominal pressure, which can put strain on your incisions, causing increased pain.  So breathe!! Controlled breathing exercises to reduce pain and relax are available on iTunes.
  2. Relaxation: As I mentioned above, I meditate. I NEED to meditate on a regular basis to help keep my thoughts focused and my emotions in check.  Any perimenopausal or menopausal woman can benefit immensely from meditating on a regular basis. But when you have pain, this is one of the BEST pain relieving activities you can do. It calms your nervous system down, which is on high alert at this point, it calms your breathing, decreases blood pressure and heart rate, and decreases the tension you are holding in your muscles due to pain. You can even decrease tension in incision areas with focused meditation.  Healing meditations are my favorite.  You focus your thoughts on blood flow to the area and actual healing of cells.  In my experience with PT I have found that those clients who meditate to help with healing rehab much quicker than those who do not.  Where do you get healing meditations?  ITunes- has a plethora of healing meditations. “The Soul of Healing Mediations” by Deepak Chopra and “Journey into Stillness” by Ramdesh Kaur are two of my favorites.
  3. Concentration and Control: Now we are getting into the more movement part of your healing.  Once you are feeling like getting up and moving around, your pain is managed, and you are off the narcotics you can start this.  Movement heals- we know that. GONE are the days of bed rest when we used to have people lying on their backs for days on end.  Getting up and moving helps with fluid flow, decreases blood clot risk, decreases stiffness in your joints, back etc.  BUT it can still be painful.  Getting up out of bed and going up and down stairs can just plain hurt. This is where your concentration comes in handy.   If you have ever taken a Pilates class, you should hear your instructor reminding you to focus on your moves, coordinate them with your breath, be precise and controlled in your intention to move.  You can do this with early post –op movement too.  Concentrate on your good spinal alignment, that will decrease pressure on incisions, be aware of your surroundings, and placement of limbs. All of this can help with not only safety but with pain control.
  4. Centering:   About  5 day post-op mark is the time to help those deep core muscles reactivate.  All movement stems from your center.  If you have done Pilates you know how long it took you to feel the connection of those deep abdominal muscles.  Well, here you are again taking baby steps. When a muscle is disrupted during a surgery it can be a little sleepy getting started.  Many people have a sleepy bladder after surgery and the pelvic floor exercises can help with that.

So what to do? There are two exercises – 1. Breathing with transversus abdominus contractions and 2. Pelvic floor exercises.  First – set your phone with an alarm to ring a reminder 3 times a day.  Your first exercises will be pelvic floor.  You can sit, lay or stand.  Inhale and as you exhale draw up the pelvic floor muscles (Kegel) and hold for a long count of 10.  Relax. Then perform 10 quick flicks of the pelvic floor as if lifting and lowering it quickly.  Next, you can sit, stand or lay.  Place your hands on your lower waist, near the pelvic crests (hip bones). Inhale and as you exhale, gently draw in your waist, pulling your belly button to your spine.  This may cause a small pulling on your incision but go slowly and only do as tight of a contraction as is comfortable.  As you do these daily you will find those muscles waking up again.  You can also perform this exercise while walking- which is part of your post- op care.  Wait until you get full clearance from your doctor and then return to your Pilates classes or schedule private sessions to gradually get you ramped up to full power. Since you will most definitely have physical activity restrictions for 4-6 weeks post-op, these small isometric exercises are safe and can help you when you do start up with full activity again.

Note on the sleepy bladder:  If you are having problems urinating or getting the flow of urination going here is a technique from PT you can use to help.  This brushing technique we use in PT is to get a muscle stimulated into a better contraction.  Gently (using a pad of toilet paper) swipe the urethra a few times. This can stimulate the muscles and cause urination to start much less hesitantly.

Now I would be remiss as a PT if I did not talk about a few things I think you need to have at home pre-op to make post –op more comfortable.  Here’s my list:

  1. Loose, drawstring pants – to eliminate any pressure on the lower belly. Your Lululemon yoga pants will be too constricting.
  2. A wedge or large propping pillow- Sleeping the first couple of nights on your back slightly propped can help you feel better since rolling or sidelying is not comfortable
  3. A firm pillow or pillow pet ( J) for bracing your incisions when you cough or good grief-sneeze.
  4. Large water bottle for beside- since you will be thirsty from the pain meds and anesthesia.
  5. Heating pad or cold pack- for lower abdominal incision pain. Remember only 20 mins on at a time.
  6. A small basket- now don’t laugh but this was a huge help. With all my electronic devices; phone, iPad, Kindle, earbuds, TV remotes, pill bottles, etc. it was easier to carry my “stuff” around or move it that way, instead of dropping it. Cuz who wants to bend down and pick stuff up? And you know Murphy’s law right?

I hope this helps you after your surgery. I have always found that the best tips I get are from my clients who tell me their war stories. So I hope my war story has helped you.   Most importantly listen to your body, and listen to your doctors.  They know what is best for your specific situation!  Speedy recovery and Pilates on – once you are all healed up.

Want to get started on your Pilates journey?  Visit for more information or contact me with your questions at

By Donna Gambino, Licensed Physical Therapist, Certified Pilates Instructor and fitness author.



I love myself a big handbag. You name the color I have one and it’s usually big enough to hold all my “stuff”- phone, iPad, make-up, and everything else I feel the need to have with me. But there is a price to having this popular fashion look and it even has a name –Poshitis-muscle strain caused from carrying large handbags.  Do you have POSHITIS?

There are many ways we carry large bags-over the shoulder, over a bent elbow, on our backs, hanging from our hand.  Whatever your favorite purse posturing, it can be the source of your aching neck, back, arm and hand when the bag is too heavy. I know, I know, I cannot change your style- you will buy what you like, fashion first and suffer the consequences. So let’s discuss how to make your body stronger but your bag lighter- without disappointing our inner fashionista.

The combination of the weight of your bag against muscles, tendons, nerves and ligaments- plus the way you compensate with your posture to accommodate the load can lead to many problems like: headaches, upper neck/shoulder pain, back pain, scoliosis, kyphosis and tendinitis in the elbow. When you carry something heavy every day, the accumulated stress can lead to significant injuries that require you to seek medical intervention.  Everyone has seen articles on the effects of teenage posture caused by carrying heavy backpacks.  So how can you change things to improve this situation?


It’s not only the size and weight of the bag but where you carry it. You can make simple adjustments that can help with this.

  1. Change sides: Carrying your bag on the same side all the time can severely overwork muscles, which can over time change posture. Form follows function – meaning if you are always in the same position (form) performing a function, you will strengthen that form- i.e. – change posture to adapt. Switch the side you hold your bag on every 30 minutes to help balance forces.
  2. Purchase Wisely: Purchase bags that you can easily switch from carrying on your shoulder to carrying on your elbow or from your hand. This will give muscles a breather and let posture muscles recover.
  3. Do Your Pilates: If you have been to a Pilates class you always hear about stabilizing, breathing, and engaging your core. Well, here is a time you could do all those things. Heavy bag? Not a problem. Pull your shoulders back and down, stabilizing your shoulder girdle, hold in your abdominals, engaging that Pilates powerhouse. First and foremost this will help you carry the load of your bag more efficiently and secondly make you stand up taller so you look statuesque and more fashionista –like. No slouching models.
  4. Cross Body: If you are traveling and know that you will be lugging around other bags then use a cross body bag. This will minimize swing and allows the muscles of the trunk to carry more of the load so the upper body can relax.
  5. Disperse Load: Purchase wider strap bags, at least 2 inches across, to disperse weight evenly. A narrow strap concentrates force whether on your shoulder, elbow or even the hand.
  6. Downsize: If you are having pain issues then you must try to opt for a smaller size. Package extra necessities in pouches that you can store in your car or desk instead of carrying them around with you. Remember the bigger bag, the more junk you haul around.


  • Buy bags with minimal hardware, and made from lighter weight materials like nylon or fabric.
  • Empty your wallet of the tons of spare change, reward cards (use the APP “Card Star” to store these), and extra credit cards.
  • Lighten your key chain. Remove the keys, zip drives, hand sanitizers etc. you don’t absolutely need and use on a daily basis. Key chains can add up to 2 # of weight to your bag.
  • Purge some of the extra lipsticks, lip glosses, compacts etc. you are storing in your purse.

So you’ve done all I have said but you still experience postural fatigue? You can do a few things.

First consider taking a Pilates class to help you strengthen postural and core muscles. Your strength comes from your center so if you boost up the power there you are less likely to suffer postural fatigue.

Secondly, you can do a few self-treatment techniques that can help you to decrease pain.

  1. Foam roll– Grab your foam roller. Lay on in for 5-10 minutes just to get your posture back in a neutral position. You can also use it horizontally across your upper back to help roll out the kinks. Need help with this?- Check out one of my roller books-
  2. Neck Stretches– Stand tall. Place your right hand near your left ear. Gently pull down toward right shoulder, hold 10-20 secs. Repeat 3 times and switch sides. Be gentle with no tugging or forcing.
  3. Shoulder rolls– Stand tall. Lift shoulders up, pull them back and then down, in a circle 10-20 times, then reverse directions.
  4. Forearm stretches—Hold arms out in front. Flex hands downward, the upward to stretch out the forearm muscles ( Do this if you hold your purse in the crook of your elbow)

Hopefully these tips will help you to avoid “Poshitis” but still help to keep you looking fab. Share with me your favorite bag and how you choose to carry it on my facebook page

Interested in trying out a Pilates class? Visit my website at for a schedule of ongoing classes or private instruction.

Preventing Polar Posture


Polar vortex, polar invasion or just plain winter. No matter what you call it, it’s HERE already and I am beginning to hear and see what this cold weather does to people.  Living in the north I hear the best excuses on why people can’t come to exercise classes- ” it’s dark outside when I get home”, “it’s snowing “, ” I just feel sleepy in the winter “.  Crazy or arctic hysteria I don’t know, but when we give in to those thoughts we sabotage our continued fitness efforts and this can lead to what I see and have now started calling-POLAR POSTURE.  Here’s what it looks like- forward head, rounded shoulders, flexed low back, tight hip flexors-  basically the couch sitting, Snuggie wearing, cocoa drinking posture we assume to hunker down and hibernate in front of our TVs for 5 months. Ughhhh. From lack of sunshine, prolonged sitting, to changes in eating habits all of these winter behaviors can really take their toll physically.

Musculoskeletal imbalances from posture changes result in back, shoulder and neck pain, and can be impacted by our postural hibernation habits. These imbalances can increase our risk for injuries. So let’s talk about why.  First off,  with the days being shorter and weather worse we spend too much time indoors mostly sitting. Our bodies are designed to stand not sit, and the more we sit, the worse our posture gets, as our spine rounds forward, neck protrudes forward and shoulders round forward. These postures result in increased upper neck tension, stiffness in joints, increased risk of disc protrusions, referred pain like sciatica, shoulder impingement and even more shallow breathing due to the forward posture restricting rib movement.

The cold temperatures do not help.  When we are cold, the body’s response is to curl up to conserve heat. What do we do again? Round our shoulders, round our upper back, flex forward and breathe more shallowly. Sound familiar? Again the same posture as sitting on the couch.

Abdominal core strength is also impacted by this winter postural position. When the core is not used to support the spine in a neutral posture it becomes weak. It weakens from the inside out. So the deep postural muscles are no longer supporting the bony structure as needed to provide stable movement.

In the winter we eat differently too. Summer salads and fresh foods are replaced with warm cozy comfort foods.  We are less active. This combo leads to weight gain and reduced muscle tone. Our muscles lose some of their elasticity from the disuse, making it harder to cope with the above mentioned postural imbalances. This then makes us more prone to strains and injury when we finally do roll off the couch and out from under our fur throw.

So what do you do?  Be aware of all these issues first. Know that you have complete control and the power to make the right choices.  Keep up with your regular fitness schedule. Don’t make excuses because of the weather. You cannot control the weather but you can control your fitness routine.  If you cannot get out of the house because you are snowed in there are many quick exercises you can do to keep that posture in check.

Here are a few exercises that only require a chair and a foam roller.  If you don’t have a roller, you can get one at I like the black axis foam rollers best.

1. Deep lateral breathing exercises- Sit up tall on the edge of a chair. Place your hands on your lower rib cage. Inhale for 10 counts and let your ribs expand. Exhale for 10 counts and feel your abdominals pull your rib cage down compressing all the air out of your lungs. Repeat 5 -8 times

2. Chest Stretches– Open up your rib cage and shoulders by laying on your foam roller vertically with your arms open to a 90 degree angle. Breathe into the pectoralis muscles and feel the chest stretch. Allow the muscles to relax and lengthen. Repeat breathing at your own pace for 3-5 minutes.

3. Chin nods– While laying on your foam roller, inhale and tuck your chin towards your chest as if squeezing a small ball between your chin and chest, exhale and let the chin resume it’s normal posture.  Repeat this 10 times.

4. Upper Back Stretch– Place your foam roller horizontally in your upper back. Place your hands behind your head with your knees bent and hang backwards over the roller stretching your upper back and reversing the thoracic curve. Hold for a few breaths, then lift your pelvis and roll on the upper back muscles to relieve any tension.

5. Hip flexor stretch–  Stand up, hold onto a stable surface, reach back and grab your ankle while bending your knee and pull your leg back. Hold for 15 seconds to stretch the front of you hip and thigh. If you just have to lay down at this point 🙂 you can do this while laying on your side.

These exercises can be done daily to help keep you out of the “Polar Posture”. Remember to keep up with your regular classes for flexibility , strength and cardio too and you should make it out of the Arctic weather season unscathed.

If you would like more foam roller stretches. My e-book-” On a Roll@Home, Stretch and Massage” has all the exercises you need to get you through that long winters night.  Visit my website store page to view retailers.

Need more ? Classes and private training is available , just be warned. You must leave your house during the winter to attend!!



Since we are doing the 8- week Hamstring Challenge in my classes this fall I thought I would write a bit about why those tight hamstrings are a problem. They are really relatively easy to stretch and easy to measure the range of motion, so there really is no excuse for not taking the time to do the stretching exercises.  And you will feel the results happening quicker than you think. Stretching only once is a while can stretch them but the results will only be short lived. The stretches must be done over a period of time to see the long term results. After that then a maintenance program can be done.
You can liken stretching the hamstrings to stretching a rubber band. The rubber band will eventually bounce back to its original length unless stretched again. In that way there is a carry over from one stretch to the next.
A study by J. Yimen et al, found that after a 4- week stretching program at home, straight leg raise angle increased by 25%. participants in his study were men in their 20’s who stretched their hamstrings in standing for 30 secs, 6 reps, once a day. You will be doing an 8 week program and performing the exercises twice a day !


Your hamstrings consist of a group of three posterior thigh muscles located on the back of your leg which run from just below your knees up the backs of your thighs, all the way to your gluteus maximus. As the name suggests, your “hamstrings” refer to the string-like tendons (that you can actually feel) behind the backs of each of your knees.There are three hamstring muscles on the backs of each thigh, two on the inside of your thigh and one on the outside of your thigh. The scientific names for these muscles are:

  • Semitendinosus
  • Semimembranosus
  • Biceps femoris (long head)


Your hamstrings actually play a pretty important role in your day-to-day life and can have far-reaching effects on your movement, stability and joint health. Your hamstrings are responsible for:

  • Hip extension
  • Flexing your knee
  • Knee rotation and bending
  • Walking
  • Running
  • Sprinting
  • Jumping (and controlling trunk movement)
  • Deceleration (particularly where your knees are involve


Imbalanced quadriceps are most often the cause of tight hamstrings. Your quads are a large, strong group of anterior muscles located on the front of your thigh just above your knee. When your quadriceps are stronger than your hamstrings, it creates tension because your hamstrings are weaker. When your hamstrings (or any muscle for that matter) is weak or fatigued, you are more susceptible to injury.

In sports such as soccer or running (particularly sprinting events), your hamstring muscles work overtime to help you extend your legs to run fast or jump. It is somewhere during the point where our foot or leg is fully extended, that we are most susceptible to a hamstring injury or strain.

Runners, cyclists, rowers and soccer players are all at higher risks of developing “tight” hamstrings as all of these activities require quite a bit of strong knee flexion. However, other causes of tightness can also be the result of sitting for long periods of time (Hello, desk job and long road trips!).


You often don’t realize you have tight hamstrings until they start affecting movement or start creating back or knee pain. Tight hamstrings affect the position of the pelvis which can directly affect the posture of the spine and this can cause mechanical low back pain. Poor low back posture could also be a sign that your hamstrings are tight. You will see a flattened lumbar spinal curve if your hamstrings are tight.  You also may notice that you have hamstring tightness if you are doing programs like Pilates or Yoga. Tight hamstrings interfere with normal flow of movement and your ability to get into the correct position to execute your moves.  A quick note – is that your hamstrings are not all “equally”tight. Meaning your right and left hamstrings may be different lengths.  This can cause problems too.  You want them even.


This is easily measured by a physical therapist or trainer, and can be done in a variety of ways. My favorite testing method is done while you lie on your back. The hip is bent to the 90 degree position and then the knee is straigthened from there and the angle at the knee is measured. To do a quick test to see if you may have tight hamstrings withoutthe help of  a professional. Sit on the floor with your legs straightened out in front of you. Can you sit with your knees straight while keeping your back in a neutral posture ( meaning good sitting posture with your spine straight)? You should be at a 90 degree angle.

Here is the program that we are doing in the hamstring challenge. Give it a try for the next 8-weeks. If you can get measured at the start and then again at the end it would be a great idea and rewarding to see your progress.
Here’s the plan:

Perform the exercises at least 2 times a day
Perform them EVERY day for the 8- weeks

WHAT YOU’LL NEED – a wall, a yoga strap or belt, foam roller

1. Legs Up the Wall: Lay on your side with your knees bent with your sit bones on the wall. Roll onto your back with the legs extending up the wall. Make sure your tailbone is on the floor, that you are NOT arching your back. Flex your feet and tighten your thigh muscles to touch the back of your knees to the wall. Lay there for 10-15 mins (tip- you can use your yoga strap over your feet to help flex your feet more and stretch the hamstrings)


2. Single Leg Supine Hamstring Stretch: Begin by lying on the back, legs extended and chin tucked in. Place the strap to the arch of the left foot. Inhale and slowly raise the left foot up towards the sky keeping the right leg and hip connected down towards the floor. Grip the strap with both hands and only go to the point where you feel the first initial stretch in the hamstrings. Flex the left foot and contract the quadricep muscles. Stay here for 5 to 10 deep breaths. Repeat on the other side. Repeat 3 times


3.  Foam Roller: Massage hamstrings by sitting on the roller and rolling up and down them length of the hamstring from gluteals to the knee.


Let me know how you did in the feedback !  You CAN rid yourself of tight hamstrings and feel yourself moving more freely and maybe even notice pain syndromes disappearing !

Straighten up Girls !

Being a 6′ tall woman, I have always been particularly aware of my posture. There is nothing worse when you are tall than to slouch. It draws even more attention to yourself. So I have always worked to keep from “slunching” ( combo of slouch and hunch) forward to hide my height. Afterall, I really couldn’t hide it by slunching. Much like the girl who started to blossom earlier and more voluptuously than the average girl, they rounded their shoulders and slouched forward to hide their ample bosom. Or were you the girl who felt self-conscious, not one of the “in” crowd. Did you try to hide behind your forward posture to get lost in the crowd? Or did your posture problems begin with motherhood? Carrying heavy children around on your hip, hauling large carriers around.
Many of our poor postural habits began when we were developing and growing, some reflect our state of emotions, and some have started as we go through our adult lives raising families. Now we are faced with muscles that are lengthened and weak and other muscles that are tightened and short, a spine that has shifted or changed it’s shaped. Postural pain and syndromes are directly related to the way we hold ourselves to face the world and it’s challenges.

Besides sapping your energy and making it more difficult to accomplish everything you’ve got packed into your day, poor posture has a slew of health consequences that can put a damper on your fit lifestyle; back pain, neck tension, disc herniations, arthritis, headaches, digestive issues just to name a few.
Learning to perfect your posture, can boost your active life and also your efforts in the gym. Why? Because it’s ALL about alignment ladies. The better your posture, the greater range of motion in your joints and spine, the better your muscles are able to work efficiently. When the spine and joints are in their optimal alignment, the muscles can respond without strain. If you are working out in poor alignment you will encourage and strengthen that poor alignment. If you are in good alignment then you encourage and strengthen GOOD alignment. If aligned you will prevent pain and injuries, boost your flexibility, improve your breathing, and after a workout feel more energized.
So how do you do it, how do you change years of poor posture? Well,first you need to have someone evaluate your posture. A licensed physical therapist can do this. They will be able to tell you where your problems are, which muscles are weak and which muscles are tight, and what position your spine is in. This way you can streamline your workout to focus on only strengthening the muscles that need it and stretching the muscles that need lengthening so you can balance your posture.
Once you become aware of your postural habits you can work to improve them during your daily activities and during your workouts. The therapist will be able to tell you exactly how to strengthen your form and which exercises specifically will be effective.
It’s not too late once your posture has changed. Most of the time with the right program you can stop or even reverse these postural changes. So what is this program? Well, I am knowledgeable in many programs and the reason I felt inspired enough to confidently leave the clinical setting and pursue a new career in Pilates is because it’s the best. I saw changes in clients posture and pain that I never saw with any other exercise program. It is really the most efficient exercise program there is for postural changes and back/neck pain issues. Pilates exclusively focuses on alignment, core strength and breathing that can help change alignment like no other. It will not happen overnight OR if you do not practice and follow through with your exercises at home. TRUST ME ON THIS. You cannot change posture by just doing one class a week with no follow-up exercises. Seriously? You know that right? So if you have done 6 or 8 classes and expect miracles they will not happen. Postural change happens with continued practice and dedication. YUP.

So are you in a class? Once you are upright again in fabulous posture you’ll not only look better visually, but feel better and feel more confident.
Interested in an evaluation and possibly a class? Visit for current classes and to register. You won’t regret it.


There is a group of muscles that are rarely talked about in your exercise classes or anywhere else for that matter, but they are hugely important for both women and men during daily life, while exercising and while at rest. These are your pelvic floor muscles.

Where are they?
These hidden muscles of the pelvic floor are located in the base of your pelvis. They stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone, from front to back, and from one sitting bone to the other sitting bone, from side to side. These muscles should be firm and thick.

What do they do?
The muscles of the pelvic floor have 4 main functions in both men and women:
1)They help support the abdominal and pelvic contents from below.
2)They work with the abdominal and back muscles to stabilize and support the spine.
3)They help control bowel and bladder function.
4) They are involved in sexual response and function.
Like other muscles in the body, if they get weak they are no longer efficient at doing their job.

What causes weakened pelvic floor muscles?
Common causes are childbirth, obesity, chronic constipation, aging, a history of back pain, heavy lifting ( body builders or heavy labor), chronic cough, previous injury to the pelvic region, as in a fall or surgery and finally- not keeping them active.

How do you know if they are weak?
•You accidentally leak urine when you exercise, laugh, cough or sneeze.
•You need to get to the toilet in a hurry, not making it there in time or
constantly needing to go to the toilet.
•You find it difficult to empty your bladder or bowel.
•You may have pain in your pelvic area or painful sex.
• In men, erectile dysfunction and dribbling after urinating.

How do I locate and recognize these muscles?
This is relatively easy. These are the muscles you use to hold back gas or stop the flow of urine. While sitting, envision the trampoline shaped muscle at the bottom of your pelvis, squeeze and lift it up, as if you are trying to make a space between the chair and your pelvic floor. Feel the contraction from front to back. Avoid tightening your buttocks and abdomen to do this. If you are lifting up in your chair you are using your glutes and not your pelvic floor.

Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like any other muscle in your body by doing the contraction mentioned above. Oh and by the way, no one will know you are doing them. So they can be done anywhere.
Here are a couple of exercises that if done 3 times a day, for 3 months can drastically improve if not eliminate your pelvic floor weakness.

THE CLENCH: This exercise works on the holding ability of the muscles, building a strong dam to hold back urine. Exhale as you slowly tighten and lift the pelvic floor and the hold for a count of 10 while breathing naturally. When you release you should feel the muscle relax down. At first you may notice that the muscles do not want to stay contracted for very long. This is a sign of weakness and as you practice this exercise you should be able to hold for longer periods of time.

QUICK FLICKS: This is just as it sounds. You will quickly tighten and lift the muscles and then release, 10 times. This works the muscles that quickly shut off the flow of urine to help prevent accidents.

What is the hardest part about doing the exercises?
REMEMBERING to do them. Go to your smart phone apps and find an app that will ring a reminder for you 3 times a day. SO no matter where you are or WHAT you are doing you can do the exercises. This is fun since you will find yourself doing the exercises while maybe working, cleaning, in the car, shopping, etc ! No one will know you are doing them.

Only exercise the muscles of the pelvic floor, do not tense or contract leg muscles, buttocks or belly. If you are having trouble, do the exercises lying down so there is less stress on the muscles. Bend your knees so you are comfortable and your legs are relaxed.

Keep in mind that these exercises are not just for urine flow problems but help to cover all the other problems listed. Keep in mind when exercising as in Pilates and Yoga, lifting, coughing/sneezing or even just walking, you can practice contracting your pelvic floor.

If your problems persist or are getting worse you should of course seek medical attention from someone trained in pelvic floor dysfunction. There are many treatments available from physicians and physical therapists trained specifically in this area. So there is help out there for you. Clench and flick and you can strengthen up good as new !!

Donna Gambino is a licensed physical therapist, certified Pilates instructor and fitness author. CHECK OUT the her new E-BOOK- “On a Roll @ Home Stretch and Massage” ––home

For more information visit for fitness classes and private training in your area.



In Michigan, May is usually the time that most of us are ready to get out into our yards and garages to do some spring cleaning. You have all the right tools for your project but are you prepared physically? In our excitement to make things shine once again we often tend to over-do-it and injure ourselves.

Fortunately, you can lessen your risk of injury before you go down the garden path by making sure you are using proper form while doing spring clean- up. One of the most important things you can do to protect your back and neck is to always make sure you use good body mechanics.

Everyone has heard “bend with your knees and not at your waist” but here are just a few additional ideas to add to your list.

  1. Start with a warm-up. If you are physically unconditioned this is really important. Think of your yard work like a workout. What’s the first thing you do before you begin a run? Warm-up right? So go for a light walk, a slow bike ride, or do an exercise class before jumping out into the yard right after breakfast. Warming up the muscles and joints so they are not cold will help prevent injury. Try 10-15 minutes of low intensity movement before you grab that rake.
  2. If you need to lift something heavy (like those incredibly awkward lawn bags), keep the item as close to your body as possible. Always lift straight up using your legs exhaling while you lift. Exhaling during exertion can lower disc pressure helping to protect them from herniation. Avoid twisting while you lift. Twisting can damage the discs in your back, so turn your whole body toward the load before lifting or setting an item down and bend with your knees to lower it- just like you did to lift. Use a cart to take loads long distances.
  3. If you will be spreading mulch or dirt. Take smaller loads in your wheelbarrow. Instead of bending over to spread the load, use a small “manageable” rake or sit down to distribute it. Using tools that are too big for you can strain muscles. There are numerous ergonomic tools available now at most garden centers. Try on your tools for size and comfort.
  4. If planting flowers -don’t squat. This can put a lot of pressure on your knees and back.  Sit on a pad or small garden stool keeping your back in good alignment facing what you are doing. Hold in your abdominals and lengthen your spine. Don’t lean if something is out of your reach. Just get up and reposition yourself closer. Prolonged awkward positions can cause backs to strain unnecessarily.
  5. When raking up yard debris, soften your knees so that they are not locked, exhale as you pull the rake towards you holding in your abdominals. Make the movement come from your abdominals and not just your arms. Switch arms every now and then too to keep arm strain to a minimum.
  6. If cleaning or trimming something overhead. Be aware and keep your head and neck in good position. If you need to strain to reach use a steady stool to help you get at a better height. Over-arching your neck can cause pressure on these tiny discs and leave you with a sore neck the next day.
  7. Take care of your hands and wrists. Wear gloves and if you will be trimming with garden trimmers take breaks. Marathon pruning sessions can lead to hand pain and even tendinitis in the hand and wrist. Stretch, and vary your activities giving the small hand muscles a break.
  8. Don’t overdo it. Many injuries happen when you are over tired. Spread out your chores doing a little at a time, especially if you have recurring back problems. If you notice your back is feeling tight, consider this a red flag! It will only get tighter from there. Take a break, lie on a foam roller or stretch over a stability ball OR stop for the day.

FUN FACT: Depending on weight, activity and intensity level, it’s possible to burn anywhere from 250-500 calories and hour. But watch out for signs of strain.

It’s very easy to lose track of time when you are working in the garden, especially if you enjoy it. If you overdid it use an ice pack wrapped in a wet towel for 20 minutes at a time. Take anti-inflammatories for pain and perform your stretching and gentle movement exercises. If pain continues for more than a couple days or if you experience radiating pain, numbness or tingling in your leg or arms, see your physician.

If you can follow these easy tips you can keep your entire body feeling happy all season, get your work done and actually get in a great workout out all at the same time. Happy gardening!!


Donna Gambino is a licensed physical therapist, certified Pilates instructor and fitness author. For more information visit for fitness classes in your area. NEW CLASSES starting soon !

Taking Care of Yourself with a Tennis Ball?


Besides playing catch with your dog or tennis with your kids a tennis ball can be a very beneficial therapeutic tool for the treatment of some common pain issues in your body. 

Very similar to getting a deep tissue massage or using a large foam roller to relax spasms, the tennis ball can be a more point specific treatment for getting deep into your bodies tissues.  Here are a few examples working from head to toe!

  1. Neck Massage:

 Muscle tension at the base of the head is a common reason for headaches. If you have your head tilted down looking at your IPAD or phone all day then you know what I am talking about.  Grab two tennis balls and place them in a sock. Place them at the base of your head, high up on the neck at the bottom of your skull with one ball on each side of your spine. Close your eyes, breathe deeply, nodding your head up and down to massage the muscles. Stop nodding and now just let the weight of your head do the work as you breathe and relax.

   2.   Upper back massage:

Upper back tension is one of the most common problems for people who are at a desk and computer all day. This tension can not only cause headaches but shoulder pain and even pain radiating into the arms. 

Grab the tennis balls. Lay on your back with your knees bent. Place the tennis balls under your upper back between your shoulder blades with one on each side of your spine. Once you find the painful spots in your muscles (called trigger points) stay on those spots, letting your body weight sink into the muscles as you breathe deeply. Wait for the pain to lessen and then move the tennis balls to a new spot down the spine.  Moving down the length of these muscles will help them to relax and lengthen, decreasing your pain.

3.     Low Back Massage:

Prolonged sitting postures can cause back muscle strain.  You can use the tennis balls to help relieve this tension quickly.  Lie down on your back, with your knees bent and place the balls under your lower back, with the balls on each side of the spine.  Lift your pelvis off the floor slightly so that you can move around on the balls to massage the tight spots.  You can tilt your pelvis forward and back or even side to side strumming the muscles to help get a release.  Breathe deeply and let the muscles soften.

 4.  Piriformis or Glute massage:

 If you have ever suffered from low back pain, sciatica, or leg pain that accompanies disc problems then you know how painful this can be. The piriformis muscle stretches across the glutes and when in spasm can press on the sciatic nerve. Take the tennis balls and sit on the floor with your knees bent, put the foot of the painful leg on the other knee. Place the tennis ball under the painful glute, transfer your body weight onto the ball.  Locate the spots that hurt, move around to massage this area, breathing deeply while you massage, until the pain lessens. Then move on to another spot.

 5.      Foot massage:

If you stand all day, wear heels, run, or have plantar fasciitis these are the best stretches to reduce foot pain.  Grab one tennis ball.  Stand up and place it in the arch of your foot. Place ALL your body weight on the foot. Hold for 30-60 seconds and then move the ball under the ball of your foot. Drape your toes and foot around the ball and again place all your weight on it and hold for 30-60 seconds. When you step off of the ball you will be able to feel how you have released the tissue in that foot compared to the other foot. Repeat on the other foot.

Tennis balls are an easy way to help get into the nooks and crannies of your body and release tight muscles.  A big advantage is that you can take them with you in your gym bag, brief case or suitcase.  Give it a try. You will enjoy having the power to treat your own pain when these little muscle spasms become a nuisance.

  By Donna Gambino, licensed physical therapist and certified Pilates Instructor

To learn more of these exercises, find out about classes, private training or Donna’s books, visit

Computers + IPad+ IPhone = I Hurt!


Our continually changing technology is amazing isn’t it?  The ability to be connected to everyone and have the knowledge of the universe at our finger tips is something we never dreamed of. However, as with any change in our environment there are changes that occur in our bodies to adapt to this change.

As someone who works with people to help them control and eliminate pain, technology has really added a new dimension to my work. The biggest problem created by our new fun devices is the change in posture that occurs from their continual use.

What are the changes? Most of them occur from the positions you get in to use your devices. You know you have seen it- the slumped forward, flexed posture of almost all of America.  Let me list the chain of events that happen in the key areas of your body, so you can decide if you are one of these people.

  1. Forward head posture– This is when the head shifts forward on the spine. This causes more load to be placed on the vertebrae and can cause pinching of the spinal nerves.  The average head weighs about 12 pounds. Did you know that for every inch that the head moves forward on the spine, it increases the effective weight of the head by 10 pounds? Do you have a 42 lb. head because of bad posture?
  2. Rounded Shoulders– This is when your shoulder blades widen as you hunch forward, allowing the muscles to become lengthened and weak.  At the same time, your chest muscles become shortened and tight. This keeps you tied up in a closed, forward flexed posture.
  3. Flexed low back – Since everything above the low back is flexed forward over your device your low back follows right along. A flexed low back causes strain of the muscles, ligaments and discs.
  4. Hip muscle tightness– Sitting for prolonged periods of time causes the hip flexor muscles to become tight.  Tight hip muscles affect your pelvis position, and pelvis position affects your low back. 

Do you see the pattern? From top to bottom it is a cruel chain of events.  Everything is connected and what happens in one area will affect the areas above and below.

So unfortunately you have become a rounded version of yourself, letting your spine curve forward, your muscles lengthen and weaken and all of your joints to take on more stress then they are capable of handling.

 “But I work out each day. I lift weights, I do cardio, doesn’t that help?”  My brutally honest answer to this is- No.  “Form follows function”- meaning whatever position you are in the majority of your day is what your posture will become. Working out for 1 hour in the gym, a few times a week is great for your heart and muscles yes, but good postural alignment must be followed through with consistently in your daily activities and also in your workout. Does your iPad time equal your gym time?  I’ll bet you that if I saw you working out in the gym, those postural bad habits would probably display themselves in your workout routine.

 So what are some things you can to do help combat these postural strain symptoms?1

1. Think- A, B, C– This is a quick posture check list that you can use.

A – Abdominals. Are your abdominals pulled in and up? If you do this, chances are you will sit or stand up straighter, allowing your low back to straighten out of that flexed posture.  Think of the belly button being pulled to the spine.

B- Back – The upper back specifically, pull your shoulder blades back and down. This will open up the front of the chest and make the posture muscles of your back engage to keep you from hunching.

C- Chin– The position of your head is important. Pull your chin toward the back of your body, lengthening your neck and keeping it out of that flexed position.

   2. Adjust your computer/laptop– Adjust your screen so it is at eye level. Have your forearms supported, and your legs at a 90 degree angle. Adjust your chair accordingly. Have your low back supported allowing you to sit tall.

   3. Lift your arm up—When using your phone, lift your arm up to see the screen rather than flexing your head down.  Remember     that 42 lb. head!

   4. Take regular tech breaks– Every hour get up and move. Do a few postural stretches for the neck, chest, hips and low back. 

   5. Take a fitness class – Take a class or a private session with a professional that focuses on your postural problems and correcting them. The more aware you are of what your postural faults are the better you will be at making the right changes that are for your specific needs.

 Donna Gambino, Licensed Physical Therapist, Certified Pilates Instructor, and fitness author.