Stuck on Acupuncture…In Utero!

By Riva Preil

UnknownPregnancy is an exciting and wonderful time, but with the many physical and hormonal changes that occur, it can also be a time of extreme discomfort. Many pregnant women suffer from fatigue, nausea, reflux, and back pain. Acupuncture is a safe, gentle and effective way to address these complaints. Prenatal acupuncture has been used for thousands of years to help women support a healthy pregnancy and uncomplicated delivery. Regular acupuncture during pregnancy sets the foundation for a healthy mother and baby. Current research suggests that women who receive acupuncture during pregnancy often have a shorter and easier birth experience.  Several European studies have concluded that weekly acupuncture starting 6 weeks prior to the due date results in significantly shorter labor.

The Traditional Chinese Medicine (TCM) treatment for breech presentation has also been in use for thousands of years. It has a success rate of 75% and carries no risk to mother or baby. It is believed to release hormones that stimulate the uterus and increase fetal activity, which encourages the baby to turn on its own.  This is generally performed between weeks 32 – 36. When successful, the baby will turn within 24 hours of treatment. Sometimes only one treatment is sufficient, or it may take several sessions for the baby to reposition itself.

Acupuncture for labor induction is safe for both mother and baby as long as there are no serious complications with the pregnancy. It is most effective starting the week of the baby’s due date.

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

Could a Massage a Day Keep the Doctor Away?

By Riva Preil

Who doesn’t loooooooove a good massage?  Not only does one feel more relaxed afterwards, but the release of “knots” and trigger points allow the muscles to achieve a better resting tone.  But could there be more involved in the process? Get excited, because…science may be on the cusp of discovering that massage actually creates a positive physiological response in our bodies!

Scientists have been studying the neuronal pathways associated with pain and pressure for many years.  Mechanoreceptors in our skin are primary neurons that respond to mechanical stimuli, and they send messages throughout our body by sending action potentials.  The four types of mechanoreceptors, Pacinian corpusclesMeissner’s corpusclesMerkel’s discs, and Ruffini endings respond to mechanical pressure and distortion.  Scientists have identified that C-fibers transmit the message of pain to the brain.  However, there has been limited research to date regarding how our nervous system responds to pleasant touch.  Dr. David J. Anderson at the California Institute of Technology has recently pioneered research in this direction.  He and his team have identified a unique type of sensory neuron in mice, MRGPRB4, which transmits messages to the brain in response to pleasurable stroking touch.  The receptors of these neurons are located in hairy skin, and they were activated by massage-like stroking as opposed to pinching.  What this means is that the mice physiologically respond well and feel good when stimulated in a positive, pleasant manner. Scientists have yet to perform research in this area with humans- do we also have MRGPRB4 neurons?  Do we too respond in a similar manner to pleasant touch?  Time will tell…

Free Pilates Intro Class!

By Denise Vidal

Free Pilates Intro Class

Have you been enjoying our Pilates’ exercise blogs? Would you like a chance to try out a class for free? Well, here’s your chance!

On Tuesday April 23rd at 6:30pm, physical therapist Dania Kafka and myself will be giving a free Pilates’ Mat class, followed by a Q and A to address your personal needs. There will also be an opportunity for you to try out the infamous Pilates reformer and springboard, as well as a raffle to win a free one hour private Pilates’ session!

This class is open to all, including physical therapy patients and pre- and post-natal women. However, space is limited. So call Beyond Basics today at 212.354.2622 or email Arianna at by April 22, to reserve your spot.

*The first 5 people to sign up will get a free 30 minute Pilates’ evaluation at another time! *

We look forward to meeting you in person!


March to the Beat of a Healthy Drum

By Riva Preil

Celebrate March, the National Nutrition Month, together with us at Beyond Basics Physical Therapy!  In this day and age of Super Size Me and fast food, it’s more challenging than ever to maintain a healthy diet.  In fact, bagel diameter sizes are approximately double what they were twenty years ago (six inches vs. three inches), and a medium sized bag of popcorn contains 11 cups of popcorn vs. a former 5 cups.  Therefore, it is extremely important to be mindful of portion sizes.  The National Institute of Health recommends cutting high calorie foods (such as chocolate and cheese) into smaller pieces, serving fruits and vegetables as snacks instead of junk food, and packing a healthy homemade lunch for you and your family instead of opting for convenient yet unhealthy fast food alternatives.

Hard pressed for healthy snack ideas?  Allow me to enlighten you and share some of my favorites…from the dairy department, you can enjoy half a cup of fat free pudding, 6 oz. of fat free plain yogurt (ex. Chobani is an amazing option chock full of protein!), half a cup of low fat cottage cheese, or 1 oz. of low fat cheddar cheese. From the fruit and vegetable department, help yourself to 1 medium sized apple, 1 small banana, 1 cup of whole strawberries, half a cup of canned fruit cocktail (sorry, hold the syrup), 1 cup of cherry or grape tomatoes, 18 small celery sticks, 12 baby carrots, 1 cup of raw cauliflower, or 2 cups of raw mixed veggies with 2 tablespoons of fat free dressing.  Hungry for a carb snack?  2 multigrain rice cakes, 4 while wheat crackers, half a whole wheat English muffin with sugar free jelly, 3 cups of air-popped popcorn (no butter), 2 graham crackers, or 8 baked tortilla chips with salsa are your best bet.  If you need a quick protein fix, go for 10 almonds or 1 large hardboiled egg.  Believe it or not, but these snacks or all 100 calories or less!

Finally, make wise decisions when cooking and shopping.  Choose oils that are low in saturated fat, trans fat, and cholesterol, such as canola oil, safflower oil, or sesame oil.  Steer clear from palm oil, butter, and coconut oil!  While creating your shopping list, plan ahead for healthy meals and select products accordingly.  Try to refrain from shopping on an empty stomach- it’s much easier to grab that carton of ice cream or snatch those appetizing chips off the shelf when your hungry eyes (and stomach) are trying to derail you from your health mission.  Good to luck to you on your road to healthy nutrition!

On Laurie Edwards and WISH

By Riva Preil

Kudos to Laurie Edwards for her recent contribution to The New York Times regarding gender differences in experiencing pain and in responding to medications! Ms. Edwards, a writing teacher at Northwestern University and author of “In the Kingdom of the Sick: A Social History of Chronic Illness in America,” herself suffers from a rare genetic lung disease. Ms. Edwards faced many trials and tribulations over years of misdiagnosis and medical mismanagement, including not being taken seriously by doctors. It is therefore especially appropriate and appreciated that Ms. Edwards advocates in her article on behalf of all women who are faced with similar challenges.

To summarize her wonderful article (which I strongly encourage everyone to read), Ms. Edwards discussed that due to a variety of reasons (ex. hormonal, genetic, and environmental), women respond differently to medications than men.  In fact, the FDA recently adjusted the recommended dosage of Ambien for women to half the amount recommended for men because women tend to remain drowsier for longer periods of time. Furthermore, women do not respond to ibuprofen and anesthesia as well as men. In addition, women experience pain differently than men, and they are more likely to develop chronic pain conditions (ex. chronic fatigue syndrome, rheumatoid arthritis, and multiple sclerosis) than men. In fact, women are NINE TIMES more likely to be diagnosed with fibromyalgia than men.

The bottom line, ladies, is that men are from Mars and women are from Venus.  Unfortunately, much of the research that has been performed to date has focused primarily on men and on how their bodies respond to pain and to medication.  As Ms. Edwards points out, it is crucial for equal time, energy, and resources to be spent on research with women.  On that note, I strongly urge you to sign the Women’s Initiative in Sexual Health petition and to encourage the U.S. government to support women’s health research.  Raise your voice in support of Ms. Edwards and in support of women worldwide in attempt to prevent others from experiencing similar hardships.

The Irate Prostate


Men, do you or have you ever experienced pelvic pain, urinary problems, sexual dysfunction, and other health issues, like feeling tired and depressed, or do you know someone who has experienced these symptoms? These are 4 symptoms of prostatitis. What is prostatitis? According to the Prostatitis Foundation, prostatitis is an inflammation of the prostate gland often resulting in swelling or pain. The prostate is a reproductive gland located just beneath the bladder, in front of the rectum. It wraps around the urethra, a tube that carries urine from the bladder. The prostate produces most of a male’s semen. Up to 50% of men in the US with experience prostatitis in their lives.

Prostatitis is diagnosed by a physician through urinalysis, and a prostate exam. Physicians may also do a prostate specific antigen test through blood testing. Both prostatitis and prostate cancer can elevate a patient’s PSA level.

There are several different types of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic pain non-bacterial inflammatory, and non-inflammatory prostatitis, and asymptomatic inflammatory prostatitis. Acute bacterial prostatitis may be as a result of bacteria, a virus, or an STD, Symptoms may include fever and chills, LBP, frequent and painful urination, weak urinary stream, and infrequent urination, which is best treated with antibiotics, bed rest, stool softener, and increased fluid intake. Chronic prostatitis may be caused by a bacteria or inflammation of the prostate. Symptoms may include frequent bladder infections, frequent urination, and persistent pain in the lower abdomen or back, which is treated with medications, often antibiotics, and changes in diet, biofeedback, and nonprescription supplements.

Non-bacterial prostatitis may be due to pelvic floor dysfunction, usually pelvic floor muscle tightness, trigger points, and myofascial and connective tissue restrictions. Some urologists believe that the pelvic floor dysfunction is an involuntary reaction to the pain of an underlying infection. Even if the work up and lab tests come up negative, some urologists view that there must be an underlying, undetectable treatment for nonbacterial prostatitis. THis can include physical therapy, anti-inflammatory medications or muscle relaxants, taking hot baths, drinking extra fluids, and relaxation techniques. Physical therapy for prostatitis includes manual therapy, stretching, pelvic floor muscle retraining, core stabilization, postural re-education, and other modalities in order to stretch out and relax the pelvic floor muscles in order to reduce symptoms.

Physical therapy can be a great treatment technique for bacterial prostatitis in treating the pelvic floor muscle dysfunction secondary to any infection, bacteria, or STD, as long as those medical issues are or have been treated.


Protect Your Pregnancy

By Riva Preil

Downton Abbey fans across the world were shocked and heart-broken over the tragic death of Sybil Grantham Branson due to pre-eclampsia.  Even though Sybil is a fictitious character, pre-eclampsia is very real and lethal.  Therefore, I have decided to blog about this condition in order to raise public awareness and knowledge.

Pre-eclampsia, the most common of dangerous pregnancy complications, is not fully understood.  However, researchers believe that it is caused by shallow implantation of the placenta which does not receive enough oxygen through maternal blood flow.  This results in the body creating an immune response against the placenta and paternal antigens.  Furthermore, inflammatory chemicals are secreted which act on vascular endothelium and create vasoconstriction (narrowing) of blood vessels.  This results in elevated blood pressure, and it also causes a rise in protein levels.  Blood pressure readings of >140/90 on two separate occasions (spaced apart six hours minimum) along with proteinuria (> 300 mg of protein in 24 hour urine sample) is considered pre-eclampsia.  Pre-eclampsia is also often correlated with edema (swelling) of the hands and face, headaches, vision difficulties, and epigastric pain, however these are not included in the diagnostic criteria.

Pre-eclampsia may develop as early as the 20th week of pregnancy, however it usually does not present until the 32nd week and beyond.  It affects approximately 6-8% of pregnancies, and it may even develop until six weeks post partum (the first 24-48 hours are the most dangerous).  It is more common during a woman’s first pregnancy compared to subsequent pregnancies, and it is also more likely to develop in women who have pre-existing diabetes, hypertension, renal disease, obesity, and autoimmune disease (ex. Lupus).  The only treatment to date for pre-eclampsia is removing the “offending placenta” from the mother either via delivery (labor induced or Caesarean section delivery) OR abortion.  Pre-eclampsia untreated can develop into eclampsia, a fatal condition characterized by seizures.  Therefore, maternal blood pressure monitoring as well as being aware of the aforementioned signs and symptoms is crucial.

Pilates: Variations in Footwork

By Denise Vidal

In one of my first blogs, I wrote about the importance of calf muscle tone.  By stretching and strengthening the calf muscles, we not only increase the blood flow throughout the entire leg, we also allow for better ankle mobility. Healthy ankle mobility, as well proper hip joint movement, is essential for efficient posture and gait. Therefore, we are going to build on last week’s footwork blog to include an ankle movement, similar to how you would push off the floor when walking.

Stand with your feet shoulder width apart and put your hands on your hips.  Inhale and sit back into a squat position, feeling your sits bones widen and your thigh bones roll back in the sockets. As you slowly exhale, feel your sits bones narrow and your thigh bones roll forward in the socket to stand back up. While standing, imagine your lower leg, upper leg, and pelvis stacking on top of your ankle bone. Keep this relationship while attempting to lift your heels off the floor. As you do this, your sits bones will continue to narrow, and your pelvic floor muscles will contract. Inhale as you slowly lower your heels. When your heels touch, move right into another squat position and continue with the sequence above: squat, stand, lift heels, then lower heels.

Do this ten times in a row, remembering to coordinate your breath with the movement.

This variation of footwork can also be done on the reformer, with an added bonus of a calf stretch as you lower your heels. If you would like to give it a try, give Beyond Basics a call and schedule an appointment.  If you have any pelvic pain, bladder or bowel frequency or retention, you should speak to your pelvic floor physical therapist before attempting to do any pelvic floor contractions, because this may cause the muscles to tighten even more and increase your symptoms.

Stuck on Acupuncture, Part 2

By Riva Preil

Pelvic Pain Disorders consist of a wide range of problems that affect multiple facets of a person’s quality of life. Since acupuncture works on many levels simultaneously, many of these problems can be addressed in a single session.

From a symptomatic point of view, many of the problems that manifest as pelvic floor dysfunction are common ailments that are regularly treated by acupuncture. Problems such as incontinence, pelvic pain, IBS, vulvodynia, interstitial cystitis, genital pain, urinary or bowel burning, frequency or retention, constipation, and diarrhea are routine ailments treated by acupuncturists.

Pelvic Floor Dysfunction has an integral relationship with the structure of the musculoskeletal system. In some patients, problems in the musculoskeletal system can be the underlying origin of their complaint. Tight or weak muscles and/or structural misalignments create imbalances in muscle tone which then lead to further postural asymmetries. Trigger points in the abdomen, iliopsoas and external oblique muscles cause vaginal, labial and groin pain as well as constipation.  Tightness of the quadratus lumborum can cause internal pelvic pain, pain with intercourse, pain in the perineum, testicular and genital pain and well as cause constipation or diarrhea.  Hamstring tightness can create pain in the obturator internus.  Tight adductors refer pain to the groin, and piriformis and gluteal muscle tightness can compress the pudendal nerve. When the trigger point is “dry needled” by acupuncture, this mechanically disrupts the integrity of the dysfunctional endplates within the trigger area, and results in mechanical and physiological resolution of the trigger points.

Furthermore, according to the traditional Chinese meridian theory, the external and internal genitals are traversed by a number of channels: the Liver or Foot Jueyin channel, the Spleen or Foot Taiyin channel, and the Kidney or Foot Shaoyin channel. Thus both internal and external genital pain can be accessed from reflex points along these channels. Points along the shin, at the ankle and on the medial knee can be used to decrease both genital pain and pain in the perineum.

A treatment regime consisting of regular acupuncture treatments in combination with Physical Therapy is the ideal approach for chronic pelvic floor dysfunction.

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

It’s National Lymphedema Awareness Day!

By Roseanne Cruz

Today is National Lymphedema Awareness “D” Day! Each year, on March 6, the National Lymphedema Network and the lymphedema community celebrate Lymphedema Awareness “D” Day, a special day to honor inspirational lymphedema patients: those who have contributed to the community or who have shown great courage in their struggle with disease. We show the world lymphedema is no longer a rare condition by honoring the many people living with it today, and the exceptional health care providers who, with dedication and support, have touched their lives and hearts. In past years, some have been honored at gala events, some in small, intimate gatherings, and others, one-on-one by their health care provider, family, or friend.  This day provides us with a special opportunity to alert our local media, medical community and neighborhoods about lymphedema; to create awareness about the condition, who is at risk, and available treatments, so not one more person will be told they just have to live with it, that nothing can be done.