An Ounce of Prevention

Join us at Beyond Basics Physical Therapy in celebrating this September, “Fruit and Veggies- More Matters Month” with the Produce for Better Health Foundation. Fruits and vegetables are an important part of maintaining pelvic floor health by providing fiber, a crucial bulking agent that contributes to normal stool consistency. In addition, adequate fiber intake promotes the normal movement of stool through the large intestine (colon).

There are two main types of fiber, soluble and insoluble.  Soluble fiber allows for proper sugar absorption in the stomach, and it decreases the amount of harmful low density lipoproteins (LDLs) in the bloodstream.  Soluble fiber is found in oat bran, dried peas, prunes, psyllium husks, nuts, barley, oranges, pears, peaches and apples.  Insoluble fiber is directly related to the passing of regular bowel movement, to preventing constipation, and to maintaining a healthy pH in the large intestine.  Foods that provide insoluble fiber include whole wheat products, brown rice, popcorn, green beans, potato skins, cauliflower, and flax seeds.

Constipation prevention and maintaining normal bowel movements is an important piece in pelvic floor health.  Otherwise, excessive straining and bearing down while attempting to pass a bowel movement can overly stretch and stress the pelvic floor muscle.  This may result in pelvic organ prolapse.  Healthy, normal bowel movements stimulated by proper fiber intake is the best form of prevention.  Nutrition labels can be include information about the amount of dietary fiber per serving, so try to be mindful of your fiber intake- aim for 25-35 grams per day.  Just make sure to drink enough water to ensure proper movement of the fiber through your system- aim for 8 cups of 8 fluid ounces of water per day.   Happy fruit and veggie month!

Botox where?

Every day women visit plastic surgeons for Botox to relieve wrinkles in their forehead.  In addition, Botox has been used to a variety of pelvic floor related dysfunctions including neurogenic detrusor overactivity, (bladder spasms due to nerve related pathology), overactive bladder, urinary urgency-frequency, and interstitial cystitis.

Doctors also use Botox injections to treat pelvic floor muscle related pain.  Dr. Kristine Whitmore, MD, from the Pelvic and Sexual Health Institute of Philadelphia, has successfully treated pelvic floor trigger points in over 200 patients.  How does the Botox work? The mechanism, according to Dr. Whitmore, is that “the toxin inhibits release of acetylcholine from motor nerves that make muscle contract, so it ‘freezes’ … muscle…” (ICA Update, Spring 2012).  In other words, the injection helps “turn off” muscles that are “on “ too much by blocking the neurotransmitter to the muscle which otherwise causes it to contract and tighten.  This allows the muscle to relax more completely which results in decreased pain (ex. during intercourse- refer to this article from Marie Claire).  The procedure itself can be painful, so she occasionally injects a pudendal nerve block prior to the trigger point injection to interfere with the transmission of the painful stimulus (the injection) to the brain.

Botox most effective when followed up with muscular re-education with a pelvic floor physical therapist.  Pelvic floor therapists can help facilitate motor recruitment as well as prevent shortening or tightening of the muscle after the injection.  If you or someone you know may benefit from pelvic floor injections and/or pelvic floor physical therapy, please consult with your licensed medical care provider.

Pink Noise for a Peaceful Sleep

Chronic pain tends to cause a loss of sleep, and occasionally white noise machines can help. But did you know that pink noise machines might actually be better? “Pink” refers to the color the sound would be in a similar light power spectrum, and includes sounds like rain on pavement and wind rustling. Learn more in this article from Prevention and NBCNews.com.

When “Relaxin” Can Be Disturbing

By Riva Preil

Pregnant women experience many anatomical changes, in large part due to the various hormones circulating through the bloodstream while pregnant. One of these hormones, relaxin, causes a loosening of the ligaments, the structures in the body that keep bones securely connected to one another. On the one hand, this ligament laxity is important because it allows for widening of the pelvic bones in order to allow room for the fetus to grow, develop, and eventually emerge from the mother. However, just like chocolate cake, too much of anything, even something good, can actually be harmful. If there is too much ligament laxity, the pelvic bones may move out of alignment and the pubic bones may separate from one another which can be very painful. This separation, known as pubic symphysis diastasis (or pubic bone pain), may cause a pregnant women to feel pain just above the mons pubis, especially during prolonged walking, standing, and during activities that involve separating the legs (ex. stairs, donning pants).

Several helpful hints to help alleviate this type of pain are to stabilize the pelvic bones with a pregnancy belt. The belt can help provide the extra support which the lax ligaments are not providing as efficiently. In addition, a pregnant woman experiencing pubic bone pain should try to avoid activities that involve separating the legs or reciprocal movement (ex. when entering a bathtub or getting up from bed, swing both legs together over the edge rather than one at a time). In addition, prolonged standing and walking should be avoided, and she should take rests as needed. If pain persists, one should seek advice from their ob/gyn and a skilled physical therapist trained in prenatal/postpartum rehabilitation.

Healthy (?), Wealthy, and Wise

Throughout our lives, we’ve heard phrases like “Take your vitamins!” and “Stretch before you work out!” But what this article, “26 Healthy Habits That Really Are’t So Healthy,” shows is that those tried-and-trues may not be so at all!

For example, “Granola and granola bars are both calorically dense and often contain a ton of sugar. You may as well eat a candy bar…” Crazy!

Take a look and check yourself before you wreck yourself!