January is National Cervical Cancer Awareness Month

By Roseanne Cruz, PT, DPT, LLCC

HPV, or human papilloma virus, is a common virus–more than half of sexually active men and women are infected with HPV at some time. According to the National Cervical Cancer Coalition, six million new infections occur yearly in the United States, and about 20 million people–men and women–are thought to have an active HPV infection at any given time. Most women with an HPV infection will not develop cervical cancer, but it’s very important to have regular screening tests, including Pap and HPV tests as recommended. Cervical cancer is preventable if precancerous cell changes are detected and treated early, before cervical cancer develops. Cervical cancer is a slow-growing condition that usually takes years to progress. This is why getting screened on a regular basis is important; screening can usually catch any potential problems before they progress. Vaccines such as Gardasil® and Cervarix™ that are designed to prevent infection with high-risk types of HPV have the potential to greatly reduce the occurrence of cervical cancer. HPV vaccines will not eliminate all HPV or cervical cancer. The vaccines prevent the HPV types that cause 70% of cervical cancer cases. But there are other types of HPV (not covered in the vaccine) that could cause disease. HPV vaccines will NOT eliminate the need for cervical cancer screening, including Pap testing. Please visit the National Cervical Cancer Coalition at http://www.nccc-online.org/ for more information.

An Alliance for Pelvic Pain Interview with Amy Stein

Hi all!
This is an interview Amy did for her other venture, the Alliance for Pelvic Pain. Check it out!


An Interview with Amy Stein: Renowned Pelvic Floor Physical Therapist in NYC and One of the Founding Members of the Alliance for Pelvic Pain: By Roseanne Cruz, PT, DPT, LLCC

Question 1: Ms. Stein, how was the Alliance formed?
Ms. Stein: Three to four years ago, Dr. Coady, Dr. Echenberg and I were discussing how we really need to organize a patient educational retreat.  There are researched-based and educational conferences geared towards health care providers, but not patient-oriented conferences or retreats. Finally, we all got together and said that we need to do this! Dr. Deborah Coady, Dr. Robert Echenberg, Nancy Fish, Alexandra Milspaw, and I are all working hard on this project and know it will be a great success!

Question 2: How did the Alliance come up with the idea for the retreat?
Ms. Stein: At least 50% of our patients and other healthcare providers have either mentioned it or suggested it in the past. They have said that we need to get the retreat going. Even the IPPS talked about doing something like that, and is still considering this for the future.

Question 3: What would be the message that you want attendants of the course to come away with? What is your objective for this weekend retreat?
Ms. Stein: First and foremost, we want to create a safe learning environment where participants feel comfortable expressing their thoughts, feelings, frustrations, and any fears.  We would like to increase awareness, provide education, and give patients more control of what they can do and how they can seek help.  We want them to have a better awareness towards picking the appropriate practitioner(s), as well as meeting other pelvic pain sufferers/patients.  Our goal is basically to give a medical perspective, PT perspective, and mental healthcare perspective, and give techniques for home-use to help manage their pain and stress associated with their dysfunction. Alex and Nancy will go in depth on how to communicate with other providers, family, and coworkers. We will all educate everyone on how to manage pelvic pain and sexual dysfunction, as well as relay that there is help and hope out there.

Question 4: What types of treatment techniques will attendants of the retreat learn?
Ms. Stein: From a medical standpoint, individuals will learn how to approach their doctor as well as explore various treatment options. From a PT perspective, patients will learn different manual techniques using various massage tools, such as foam rollers and trigger point balls.  We will also go over various stretches and relaxation/breathing techniques to assist in breaking the pain cycle.  In addition, I will go over what exactly is involved in a physical therapy evaluation and treatment sessions as well as what to look for when searching for a pelvic floor physical therapist. From a mental health perspective, the attendees will be going over relaxation techniques and behavioral training, as well as how to communicate and how to manage stress and anxiety.

Question 5: Why is physical therapy so important to integrate with this patient educational retreat?
It is predicted that 85% of pelvic pain has some type of musculoskeletal involvement. The pelvic floor muscles themselves are a group of muscles that form a sling at the base of the pelvis and control bowel, bladder, and sexual function. When these muscles are tight or not working properly, it can result in issues such as bowel or bladder incontinence, retention, or pelvic pain. Pelvic floor physical therapy is an integrated hands-on treatment that works to release the pelvic floor muscles, which are often one of the main causes of chronic pelvic pain. Physical therapy treatment sessions consist of a multimodal and a multidisciplinary approach to each patient’s entire well-being.

Thank you, Ms. Stein, for your time! We wish you, and the other members of the Alliance, much success with the retreat!

Pilates: Spine Stretch Forward

By Denise Vidal


Building on the twisting movement of the last blog, I would like to share with you a traditional Pilates exercise called the Saw. However, before we progress to the full movement, there is one more fundamental we need to discuss.

We need to take a closer look at spinal flexion, and for that we need to take a closer look at the vertebra of the spine. Each vertebra has different protrusions which serve specific functions for spinal movement. Today we are going to look at the protrusions both above and below the vertebra, called facets. When I imagine the facets of the vertebra, I think of window blinds, how each blind fits above and below the others.

When you flex your spine, it is similar to drawing the blinds closed, with each facet sliding away from the others. When you extend your spine, it is similar to drawing the blinds open, with each facet sliding towards each other.

See if you can take this image and put it into movement. You can do this exercise either sitting down or standing up. Although, if you do this standing up, keep your knees slightly bent to lessen the force of gravity. To begin, take a deep breath. As you exhale drop your chin towards your chest and start to roll your spine down. In your mind’s eye, see the facets above and below your vertebra slide apart as if you are drawing the blinds closed. You need only to roll as far as you begin to flex at your waist. When you arrive there, take another deep breath. When you exhale, begin to roll your spine up. In your mind’s eye, see the facets slide over each other, like drawing the blinds closed.

Repeat this action two more times, being sure to begin and end each movement with breathe.

Pilates: Year in Review

By Denise Vidal

This time of year is filled with family, friends, good food, and lots of laughter. However, with all of the goodness that the holidays bring, there can also be a lot of stress and anxiety that come with the season.  To combat these stressors, take a moment for yourself to review some of the Pilates exercises that we have done thus far. Whether you choose to focus on your breath, mobilize your spine, or stabilize your pelvis, these exercises can work as meditations to calm you during the stress of the holidays and new year.

In this blog we’ll review one of my earlier entries. As always, if your experiencing any back or pelvic pain, consult your doctor or PT before attempting any of these exercises.

You can do this exercise either lying down (preferable with knees bent), sitting or standing.

We’ll start by focusing on your breath.

Believe it or not, there are different ways to breathe. You can breathe into your belly, or you can breathe into your ribcage. The Pilates method focuses predominantly on ribcage breathing, however, for a healthy core one should be able to access both types of breath.

Put your hands around your waist and inhale through your nose. Imagine your breath swirling down to the base of your pelvis, and as you exhale imagine your breath floating up into your ribcage.

Do this 5 or 6 times to slowly open and extend your breath.

Once you have made this connection, use the following visualization to engage your core:
Imagine a soft, squishy ball inside you abdomen. Inhale as described above, then, as you exhale imagine both your navel and your spine moving towards each other to squeeze the ball.

On your next exhale, imagine that the sides of your waste are narrowing to squeeze the ball.
Progress your abdominal engagement by imaging both visuals at once: the navel and spine narrowing towards the ball as well as the sides of the waist narrowing towards the ball.

Do this exercise once a day to lessen your stress and increase your strength.
Have a Happy New Year!

Pump That Purell!

By Riva Preil

Look out for the person coughing next to you on the train, because flu (short for influenza) season is in full swing.  In fact, according to the Center for Disease Control and Prevention, this year’s strain of the virus may be worse and more severe than in the past (refer to The Washington Post article link here).  The common symptoms of the flu include fever, coughing, nasal congestion, coldness, achy joints, headache, fatigue, and watery eyes; however 33% of infected individuals are asymptomatic.  The flu vaccine and proper hygiene are recommended for prevention of the disease.  This includes proper hand washing with soap and water (recommended length of time is twenty seconds, or the equivalent of singing “Happy Birthday), avoiding direct contact with your eyes, mouth, or nose, and covering your nose and mouth when coughing and sneezing.  In addition, the flu can spread through direct surface contact.  Therefore, sanitizing areas that have come in contact with those who are sick is recommended.  Treatment of the flu includes drinking adequate fluids, resting, and taking medication (ex. acetaminophen) to decrease musculoskeletal pain and fever.  Unfortunately, antibiotics do not help treat the flu (which is caused by a virus); however taking proper precautions will help reduce the risk of developing the flu.  May you and your loved ones have a happy, healthy, and safe new year!