Boost Your Baby’s Brain

By Riva Preil

Simply put, exercise ROCKS.  It improves mood, helps control body weight, fights disease, boosts your energy levels, and improves sleep and sex.  But that’s not all! Recent research reveals that exercise during pregnancy may improve fetal brain development.

Researchers at the University of Montreal in Canada performed a controlled experiment with women who had previously led fairly sedentary lifestyles.  In the study, women were randomly assigned to a control group (non-exercises) and an experimental group (exercised three times per week for approximately 20 minutes per workout, typically running or jogging).  The participants were starting their second trimester of pregnancy when the study began.  Within twelve days after delivering their children, all participants brought their newborns to the study’s lab.  They were fitted with little hats that contained electrodes which allowed the researchers to measure the electrical activity in brains of the newborns.  In general, spikes appear on the monitor when newborns hear a sudden or jarring noise.  The spike is greatest in immature brains, and it shrinks and eventually disappears by 4 months of age as the brain develops and is capable of processing information better.  In the study, researchers noticed that when the babies were exposed to harsh noises, those whose mothers had exercised during pregnancy displayed blunted spikes compared to those whose mothers had NOT exercised during pregnancy.  They hypothesize that healthy chemicals are released in women when they exercise, and these beneficial chemicals travel to the developing fetus and contribute to brain growth.  Therefore, exercise during pregnancy is highly recommended- even ONE HOUR a week (as in the study) can benefit your baby’s brain development!  For more information about what exercises are appropriate for YOU during pregnancy, please contact us at Beyond Basics Physical Therapy, where highly trained physical therapists can help tailor an exercise program to meet your pre-natal needs.

For more information about the study, please refer to this article in The New York Times.

Pelvic Floor Physical Therapy on The Doctors!

By Riva Preil

Last week was a huge week for pelvic floor physical therapy!  Fortunately, a very brave young woman named Nicole agreed to come forward and publicly speak about her near decade struggle with pelvic pain on daytime television.  The popular syndicated talk show, The Doctors, is an hour long daytime program produced by father and son Phil McGraw and Jay McGraw (CBS Television Distribution).  The series is a spin-off of Dr. Phil which itself is a spin-off of The Oprah Winfrey Show.  The show features various medical care providers discussing a wide range of medical conditions.

On last week’s shows (November 13. 2013), Nicole was brought onto the show to share her story with Dr. Jennifer Ashton,  a board-certified Ob-Gyn and attending physician at Englewood Hospital and Medical Center in New Jersey.  According to Nicole, “I know that there are a lot of other people who are living in silence with this and I want them to know that it’s not their fault and they’re not alone.”  After Nicole courageously shared her experience and perspective, Dr. Ashton reassured Nicole, “A lot of what’s really going to help you has nothing to do with what I did in my office, it’s pelvic physical therapy… We get conditioned to think that what’s going to go on in the doctor’s office will make such a big difference, sometimes that’s just the beginning…there are great pelvic physical therapists out there, it’s just a matter of finding a good one, and hopefully you did.”  Fortunately, Nicole’s response was “Yes!”  Thank you, Nicole, for stepping outside of your comfort zone for the sake of the many suffering in silence, and thank you, Dr. Ashton, for promoting pelvic floor physical therapy. May your testimony raise public awareness regarding the benefits of pelvic floor physical therapy and help bring others closer to their healing process.  To see two clips from last week’s episode of The Doctors, please click on the links here and here.

Amy and Dania at the International Multiple Sclerosis Management Practice! Part II

Here’s the second in our series featuring the ladies’ talk at the important institution!
By Riva Preil


4. Multiple sclerosis (MS) is a condition involving demyelination of the central nervous system.  How does pelvic floor physical therapy, which addresses the musculoskeletal system, help individuals suffering from MS, a neurological dysfunction?

There are several reasons why physical therapy helps patients with MS.  Neurological dysfunctions can lead to musculoskeletal dysfunction.  Therefore, it is important to address the resulting musculoskeletal issues that are affecting the pelvic floor. Furthermore, behavior modifications which can help ANY individual are routinely addressed in physical therapy, especially pelvic floor physical therapy. For example, teaching bladder retraining techniques can be extremely helpful if the patient is suffering from urinary urgency, frequency, and retention like symptoms. Relaxation breathing is one of the many techniques we teach to help decrease the urge and calm down the central nervous system.  Furthermore, we encourage patients to eliminate “just in case” bathroom visits.  Also, bowel education can consist of proper hydration, proper toileting posture, avoiding straining during toileting, and basic nutritional recommendations (ex. adequate dietary fiber).  These, as well as other topics addressed in physical therapy, along with manual therapy and neuromuscular re-education, benefit ALL individuals, especially those with MS.

5. Were there any misconceptions or medical myths that you were glad to correct?

Actually, yes!  Of the practitioners present who were familiar with the concept of pelvic floor physical therapy, many simply assumed that P.T. is all about biofeedback and Kegels. However, we’re not just biofeedback and Kegels!  In fact, for some of these patients, those can worsen the symptoms.  I am glad that we had the opportunity to educate the practitioners about the broad range of modalities and techniques that we employ, as per described above.

Also, we informed them that they don’t need to diagnose the particular musculoskeletal dysfunction- we can tell whether or not P.T. will be helpful.  As the musculoskeletal experts, we are happy to evaluate and treat the dysfunction.

Amy and Dania at the International Multiple Sclerosis Management Practice! Part I

By Riva Preil

On Friday November 1, Beyond Basics Physical Therapy’s very own Amy Stein and Dania Kafka presented a talk to the physicians, nurse practitioners, and physical therapists at the International Multiple Sclerosis Management Practice.  The goal of the talk was to educate the health care providers on pelvic floor physical therapy and how we can help their patient population.  Please enjoy the following interview with Amy Stein as she reflects upon the experience.

1.  How many medical care providers were present?

Approximately 20 people in total were in attendance.

2. Based on the questions and comments from the audience, how much knowledge did the practitioners have about pelvic floor dysfunction?

The knowledge base varied- for example, Stephen Kanter, the supervisor of rehabilitation services at the center, is fairly well-versed in pelvic floor physical therapy.  This is mainly because I have spoken with him at length in the past about the benefits of pelvic floor physical therapy.  He has also read my book, Heal Pelvic Pain, and he found it very beneficial from a practitioner’s point of view.  However, most of those present had NO IDEA what pelvic floor physical therapy is.

3.      What was the highlight of the talk for you?

Both Dania and I were appreciative of how well we were received.  Also, as mentioned earlier, we were surprised how many medical care providers were completely unaware of the benefits of pelvic floor physical therapy.  Therefore, we are grateful that we had the opportunity to enlighten them and open their eyes to the world of pelvic floor physical therapy.  By doing so, more individuals who are suffering can be appropriately referred for help.

Everything You Ever Wanted to Know about Internal Massage But Were Afraid To Ask…

everything that you wanted to know about secAmy Stein has written guidelines for use of internal massages for men and women.  She highly recommends that you seek out a pelvic floor physical therapist to go over the guidelines and what specifically would work best for your needs.  This is to be done in conjunction with the expertise of a pelvic floor physical therapist.

We highly recommend the internal massage provided by Iliana Brockman at IC Relief. Take a look at the link below for the guide, and learn more about internal massage!

Internal Pelvic Floor Self-Massage Guide


Which Twitch?

By Riva Preil

The pelvic floor muscles are composed of two different types of muscle fibers which can be thought of as two “speeds.” Approximately 70% of the pelvic floor muscle fibers are slow-twitch or slow-contraction fibers. The remaining 30% are fast-twitch fibers. The slow twitch fibers fuel endurance. They are the marathoners of muscles, providing support and resisting fatigue. Think of the muscles in your lower back: they are mostly slow twitch fibers that can work for a long time without tiring. That’s essential, because these are the muscles responsible for helping keep you upright. The slow-twitch fibers that comprise the bulk of your pelvic floor are the slow-to-tire, persistently supportive muscles.

On the other hand, fast-twitch fibers provide the swift forcefulness of sprinters. The ocular muscles that move your eyes, for example, are fast-twitch muscles. In the pelvic floor, the fast-twitch muscles assist in controlling the contraction and relaxation that open and close the bladder and bowel and that are involved in sexual function.

While both types of muscle fibers lost strength as the body ages, the fast-twitch fibers do so more readily. The slow-twitch muscles that make the pelvic floor a center of endurance and support generally maintain their power and function longer, unless there is trauma or injury. In a sense, the power to endure remains while the power to perform some of the pelvic floor’s key functions can diminish. That’s natural! As we get older, our powers diminish. That’s why it’s so important to stay fit for as long as we can; physical strength and vigor are the best defense against the aging process. If you have any questions regarding how to maintain a healthy and strong pelvic floor (ex. post partum mother or post abdominal surgery) please contact us at Beyond Basics Physical Therapy– we are happy to help!

Adapted from Heal Pelvic Pain, by Amy Stein

Pesticides = Endometriosis?

By Riva Preil

Pesticides, plant protection products, have been linked with irritation of the skin and eyes, nervous and reproductive system problems, and possibly even cancer. Unfortunately, recent research has revealed that pesticides are associated with endometriosis. There is no clear cause of endometriosis, a condition characterized by an overgrowth of the uterine lining outside the uterus, painful periods, pain during intercourse, and infertility. However, Kristen Upson, lead author of the study (available online in Environmental Health Perspectives) identified pesticides as a possible contributing factor (see link here to article in The New York Times on November 5,2013, by Nicholas Bakalar). Upson’s research measured blood levels of two pesticides, mirex and beta HCH, in women with surgically confirmed endometriosis compared to healthy women. According to the study, women with the highest exposure to mirex had a 50 percent increased risk for endometriosis, and those exposed to high levels of beta HCH had a 30 to 70 percent increased risk. Upson proposes that the pesticides adversely affect estrogen levels and function thereby contributing to the development of endometriosis. Future research in this field is definitely warranted. Hopefully, by determining the direct causes of this painful and debilitating condition, women will no longer suffer from endometriosis. However, in the meanwhile, please allow us here at Beyond Basics Physical Therapy to help- we can help treat the pelvic floor muscle dysfunction often associated with endometriosis. Please feel free to call if you have any questions, we would love to assist with alleviating the pain!

Water, Water, Everywhere!

By Riva Preil

Water is drowning the competition!  Since the 1980s, water has provided seriously stiff competition with soda company sales.  Michael C. Bellas, chief executive of the Beverage Marketing Corporation, predicts that by the end of this decade, bottled water sales will exceed carbonated beverage sales. From 1993 to 2005, sales of lightweight plastic water bottles grew at a rate of 20% each quarter.  Even the First Lady, Michelle Obama, has joined the water bandwagon, and encouraged Americans to drink more water last month along with Coke, (Dasani), PepsiCo (Aquafina), and Nestle Waters. The fact that water has become much more affordable in recent years adds to its appeal, and some stores sell water for as cheap as eight cents a (half liter) bottle!  For more details about the increasing popularity of water, please refer to the New York Times article, Bottled Water Sales Rising as Soda Ebbs, by Stephanie Strom.

From your pelvic floor’s perspective, water is a bladder’s best friend.  As opposed to coffee, caffeinated teas, and carbonated beverages (all of which are IRRITANTS), water is a NON-IRRITANT.  Think of the bladder, also known as the detrusor muscle, as a balloon with elastic-like properties.  It is meant to expand fully and completely upon filling.  Once adequately filled, the stretch receptors in the bladder wall send the message to your brain which indicates that it is time to go to the bathroom and empty the bladder.  However, the bladder is sensitive to the type of fluid that enters.  Certain drinks, such as alcohol, caffeine, carbonated drinks, citrus juices and artificial sweeteners are considered bladder irritants.  This means that even a small amount of irritant can make the bladder “feel fuller” than larger amounts of non-irritant (aka water)!  This fake feeling of fullness causes premature urge sensation, and very often patients will reports that they void frequently, even multiple times per hour, and they also report the feeling of incomplete emptying of the bladder (“I have to go again 10 minutes later”).  Counter intuitively, the solution is to drink MORE water, ideally eight cups per day!  By hydrating the bladder with ample non-irritating water, irritants present in the bladder become diluted, and it allows for improved filling-emptying dynamics.  Also…eliminating the aforementioned irritants (my apologies to all you coffee lovers) helps as well.