Stuck on Acupuncture (Part 1)

By Riva Preil

Acupuncture is among the oldest healing practices in the world. As part of Traditional Chinese Medicine (TCM), Acupuncture is rooted in the ancient philosophy of Taoism and dates back more than 5000 years.  Underlying this practice is a unique view of the world and the human body which is based on the ancient Chinese perception of humans as microcosms of the larger, surrounding universe, interconnected with nature and subject to its forces. The body is regarded as an organic entity where the various organs and tissues have distinct but interdependent functions. Restoring health relates to balancing these interconnected functions by aligning a person with their environment, their mind and their spirit.

According to Classical Chinese Theory, channels of energy called meridians run in regular patterns both externally and internally throughout the body, creating a network akin to the circulatory, myofascial or nervous systems. Acupuncture points are gates along these meridians. The energy of these meridians, called Qi, can be influenced and changed by needling or stimulation of the acupuncture points.

The meridians have been compared to rivers that flow through the body to irrigate and nourish the tissues. Any obstruction in the movement of these energetic pathways is like a dam full of impediments. Pain and disease are considered the results of blockages or imbalances in the flow of Qi. Any disharmony of Qi may affect an individual spiritually, emotionally, mentally, and/or physically.

The practice of Acupuncture can be looked upon as a procedure that enhances the body’s healing mechanisms and promotes the body’s inherent ability to heal itself.  It allows for natural restoration of homeostasis.

In Western terminology, acupuncture points are areas of increased electrical sensitivity. When stimulated, they transmit impulses to the hypothalamus-pituitary glands which release endorphins (natural substances in the body that inhibit pain).

Acupuncture has been shown to stimulate the immune system, help promote sleep, increase energy, and decrease inflammation.  It has positive effects upon circulation, blood pressure, rhythm and stroke volume of the heart, production of red and white blood cells, and secretion of gastric acid.

Adapted from material by Paula Haberman, PT, L.Ac

Pilates: Footwork

This week’s blog is taking a cue from Beyond Basics’s move into their beautiful new space, and PT Riva Preil’s recent blog on squatting. We have all heard the instruction to “lift with your legs and not with your back.” However, without proper hip joint mechanics, differentiating your back from your legs may not be possible. In Pilates we have a series of movements called footwork, which mimic the motion of squatting while encouraging healthy joint movement. Footwork is traditionally done on the Reformer, but it can also be performed standing.

Before we begin, we’ll review the boney landmarks of the pelvis. Stand with your feet as wide as your shoulders and put your hands on your hips. Now, slide your fingers down and in towards your pubic bone. The soft area on either side of your pubic bone is your hip joint, where your thigh bones join your pelvis. Keep your fingers there, while you lift your knees one at a time. Feel the movement of your thigh bone rolling back as you lift your leg, and rolling forward as you lower your leg.

Next, put your fingers on the back of your legs, where the top of your leg meets your buttocks. This is referred to as your gluteal fold. Keep your fingers there as you sit back into a squat position and feel your sitz bones move away from each other. Then, as you stand up, feel your sitz bones move toward each other.

Now, with your hands on your hips, we’ll imagine both movements happening at the same time.

To begin, take a deep breath. As you inhale, squat. Imagine your sitz bones widening and your thigh bones rolling back in the hip joint. As you exhale, stand up. Imagine your sitz bones narrowing and your thigh bones rolling forward in the hip joint.

Repeat this action ten times, remembering to breath as you move.

If you would like to try this movement on the reformer, call Beyond Basics and schedule an appointment with me. I am at the office on Thursday mornings.


Stress Busters!

By Riva Preil

Believe it or not, relaxation is within reach. Before spending large sums of money on expensive massages or spa treatments, I encourage you to try the following user-friendly, at home strategies…

1. Designate personal “you” time at least three times per week for half an hour each. Take advantage of this time to engage in activities that are geared solely and exclusively to…YOU! For example, read a book, play a musical instrument, write a letter, or watch an entertaining (preferably humorous) television show or movie. Laughter works wonders for our central nervous system and muscles!

2. Take a nice walk in the park.  Both a nice languid stroll as well as a brisk power walk will improve blood flow and help reduce stress.

3. Hot baths work wonders. Fill your tub or Jacuzzi, light the candles, power up the music (highly recommended is Pandora’s relaxation station!), power down your iPhone, and sink down into the water. Allow the heat to suffuse your body until you can physically feel yourself relaxing. Empty your mind. Listen only to the music, not that to-do list in your head.  (If you are having trouble turning down the volume of that voice shouting out your to-do list, I recommend keeping a pen and paper nearby.  Jot down anything you are afraid of forgetting. Putting it on paper will “permit you to let go.”  It is recorded in a safe place and you can return to it LATER.  This will allow you to live the here and now, the PRESENT, in a more relaxed state.)

4. After your bath, stretch the warmth with a cup of tea- try chamomile or mint, which calm the stomach, or green tea, which tames the body’s free radicals.

5. Dress in loose fitting clothing- tight clothing can increase skin irritations and can decrease blood flow.

6. Adjust your sitting surface- find a chair or cushion to help alleviate tailbone and or perineal pain.  Search on the internet for “sitting cushions”- many are designed with cut outs to decrease pressure to areas prone to irritation.

7. If Pilates or spinning is your preferred exercise of choice, try substituting a relaxing Yoga class or home DVD instead.  The stretches combined with deep breathing have an extremely calming effect on the body.

8. Last but not least, many people find meditation to be a wonderful stress reduction technique. There are many books, tapes, and online courses that teach the right way to perform meditation. Once you learn how to properly meditate, it’s a great way to gain a sense of calm and stability that lasts. And, like deep breathing, it’s something you can do anywhere, anytime for a few minutes to get a quick hit of relaxation.

Don’t you feel more relaxed already?  Please enjoy any and all of these techniques, and may your body reap the relaxation benefits!

(Adapted from Amy Stein’s Heal Pelvic Pain)

Squatty Potty

By Riva Preil

Ever wonder how to pass bowel movements with greater ease?  Believe it or not, the optimal position for passing a bowel movement is …SQUATTING!  Don’t get me wrong, I’m not recommending that we ditch standard toilets for good old fashioned floor holes, however I am suggesting that we become more mindful of our bodies and of our biomechanical alignment while toileting. An important factor in defecation is the anorectal angle, the angle formed by the junction of the anus and the rectum, which at rest is approximately 90 degrees. The puborectalis muscle (part of the levator ani pelvic floor muscles) wraps around the junction like a sling. Contraction or tightening of the puborectalis decreases the anorectal angle or makes it more acute, for our geometry-oriented readers.  (For those who are not, please refer to the Squatty Potty video link here which provides an amazing visualization). On the other hand, relaxation of the puborectalis muscle increases the anorectal angle which allows for descent of stool from the rectum towards the anus. Therefore, it is important to be able to relax or release the pelvic floor muscles in order to allow for strain-free, pain-free passage of bowel movement.  Squatting facilitates pelvic floor muscle relaxation and straightening of the large intestine.  Therefore, it is recommended to attempt passing bowel movements with both feet atop a stool, thereby mimicking the squatting position.  The Squatty Potty is a wonderful tool that was invented with this in mind.  The Squatty Potty is a user friendly stool that can be inconspicuously stored at the base of one’s toilet.  However you choose to simulate squatting while toileting, best of luck and may you have a moving experience!

Our New Home!

Thank you for entrusting us as your physical therapists. Since the practice was founded in 2003, we have been committed to providing you with the highest quality service and excellence. We are writing with great news that Beyond Basics Physical Therapy is expanding! Because we are growing to fit your needs, beginning Monday, February 18th, 2013 our location will be changing to 110 E 42nd Street, Suite 1504 New York, NY 10017.

Our new location is conveniently located right across from Grand Central Station and easily accessible via Metro north railroad, 4,5,6,7 and shuttle trains and buses M1, M2, M3, M4, M101, M102, M103. It is also a short walk from Bryant Park Station, trains: B, D, F, M.

We are thrilled about our move and we look forward to servicing you at our new, beautiful and bigger space. If you have any questions regarding this transition please call our office at 212.354.2622.

We know that you have options when it comes to healthcare and we thank you for choosing us.

Take a look at some pictures of our new office. Be sure to stop by and check it out!

0 0-1








Pilates: Saw-sational

By Denise Vidal

As promised, I am going to take you through a traditional Pilates exercise called “Saw”. Saw is an exercise which combines the moments of spinal rotation and spinal flexion. Chances are you do this movement several times a day without realizing it, every time you bend over to tie your shoes or reach down to pick up something off the floor. However, in this blog we are going to dissect the movement to increase your awareness and integrate core support.

Before we begin, I suggest you review my blogs on these topics. If you have been diagnosed with a herniated disk in your spine, this exercise is not recommended. Furthermore, if you are experiencing any back or pelvic pain, please consult your doctor or physical therapist before attempting this exercise.

You can do this exercise either standing with knees bent, sitting in a chair or sitting on the floor. Feet are hip distance apart. If you choose to sit on the floor, sit on top of a folded blanket or pillow so that you can have a supported neutral spine. To begin, take a deep breath. As you exhale rotate your spine to the right, feeling the disks between your vertebra soften. In my rotation blog I compared the vertebral disk in rotation to a marshmallow being squished between one’s fingers. Imagine the disks spreading in response to the spinal movement.

Staying in rotation, begin to roll forward on your next exhale. Dropping your chin towards your chest, feel your vertebra sliding away from each other as you articulate through your spine. Remember to pull your abdominals in towards your spine, so that your waist doesn’t collapse as you roll forward. You can also support yourself by placing your left hand on your right knee and your right hand on your waist or the back of your chair. On your next inhale, slowly roll back up in rotation. Once you have stacked your vertebra up to neutral, rotate your body back to center.

Repeat the same movement rotating to the left, remembering to breathe before each movement. If you are interested in private Pilates training, call the office at Beyond Basics to set up an appointment. I am in the office every Thursday morning.

  photo(4)photo (2)

More than Baby Blues

By Riva Preil

The first two weeks post child birth can be like a roller-coaster ride of emotions. Feelings during this time period span the entire spectrum ranging from joy and elation to sadness and feelings of inadequacy regarding caring for the newborn. THIS IS VERY COMMON, and the negative emotions experienced at this time colloquially referred to as the “baby blues” are not cause for alarm.  However, if these feelings develop or extend beyond the initial two weeks, there may be concern of Post-Partum Depression (PPD). PPD  is moderate to severe depression that is associated with increased irritability, difficulty sleeping, appetite changes, decreased pleasure with previously enjoyable activities, lethargy, difficulty concentrating, anxiety, and/or feelings of guilt.  What causes PPD?  Research has yet to identify a direct causative factor, however some hypothesize that pregnancy related hormone changes may play a role in the development of PPD.  Furthermore, non-hormonal factors may contribute to PPD including lack of sleep, pregnancy related body changes, decreased personal time, and anxiety about being a good mother.  There is little research to support the theory that there is a genetic component to PPD (refer to article The Heritability of Postpartum Depression for details here).

PPD untreated may persist for months (or even years!), therefore early diagnosis and treatment is crucial.  The two main components of a treatment program are talk therapy (especially cognitive behavioral therapy/CBT) and medication.  In addition, having a support system is imperative- accept assistance when offered, it is not a sign of weakness!  Also, don’t be afraid to talk about your emotions with an appropriate supportive family member, friend, or professional.  Be sure to schedule personal “you” time- many women focus so much on the needs of their infant that they neglect their own needs.  Try to be self aware, recognize your limitations, and don’t be too hard on yourself- almost perfect is almost always adequate.  Finally, many women experience postpartum pain and/or body changes (ex. pelvic floor muscle weakness, incontinence, scar related adhesions if caesarian section delivery).  Physical therapy can help alleviate the musculoskeletal related issues which will improve mom’s overall mood, health, and well-being.  If you or someone you know may benefit from medication and/or physical therapy, please speak with your health care provider.     

The Birds, the Bees…and the Pain

By Riva Preil

Many women who experience vulvar pain are understandably nervous about how this condition will affect their current relationships.  Furthermore, if the individual is not in a relationship at present, they are concerned that it will interfere with their ability to initiate and sustain a happy and healthy relationship.  “But what will happen when he discovers my secret?  Will he run for the hills?”  This fear is very real and valid, as well as the question about when it is appropriate to share information about the condition.

Dr. Elizabeth Stewart, renowned vulvovaginal specialist and author of The V Book (or as I like to call it, the pelvic floor bible), recommends that one should “keep it simple and straightforward” when relevant.  The information does not need to be shared before accepting a date- every person has personal aspects of their lives that they choose to share as they become more comfortable with their partner.  In regards to vulvar pain, the appropriate time to share this information is when the couple decides to become physically intimate with one another, at which time this information is important to discuss.  This first conversation should probably only include the basics, for example general information about what the individual can and cannot tolerate.  Information such as which positions are most comfortable can assist one’s partner in pleasing them.  Further details (ex. personal history, previous attempts at treatment) and elaboration can wait for future conversation.  No one is required to tell all or to be coerced into sharing more information than they are ready to give.  For couples who decide to wait until they are married to become sexually active, this information should probably be shared prior to engagement.

The way one’s partner responds to the privilege of earning their trust and the sharing of personal information can be very telling.  Are they understanding and supportive, or are they dismissive and/or selfishly concerned about how the pain will affect their own desires?  One’s symptoms do not make them any less worthy of a wonderful, supportive partner, and it should not preclude them from the happiness they deserve.

The Violet Petal Study

By Riva Preil

Endometriosis is a painful gynecological disorder whose symptoms include pain with intercourse, severely painful periods, and/or pain with defecation (refer to previous blogs for further details). Current medical treatment includes injections to help decrease estrogen levels in attempt to alleviate the symptoms.  However, the downside of this treatment are the potential disturbing side effects which include altered mood, hot flashes, and decreased bone density (which puts one at risk for fractures, similar to osteoporosis).  An ideal medication would achieve the benefit of decreased estrogen without the nasty side effects.

That’s where you might be able to help!  Currently, Dr. Sanjay Agarwal is working with researchers at the Department of Reproductive Medicine at UC San Diego School of Medicine in The Violet Petal Study.  This is a two year clinical trial (medical research study) investigating the benefits of a new oral medication, Elagofix, which is believed to lower estrogen without the aforementioned risks.  In this clinical trial, subjects are given either an active dose of the medication or a placebo treatment (a “fake” medication, no drug actually administered).  The participants will then be assessed post treatment (or pseudo-treatment), and the results of the two groups will be compared to determine the effectiveness of Elagofix.  Researchers are actively searching for individuals with whom to participate.  To learn more about the clinical trial and see if you are eligible for the study, please refer to the link below.  If you believe you may be an appropriate candidate, please discuss with your medical care provider prior to joining the study (as with any experimental medication).