Why is Pooping So Difficult?

By Stephanie Stamas

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The number of Americans who deal with constipation issues is massive (4 million!)! It seems like every time I mention that I’m a pelvic floor physical therapist another friend pulls me aside with bowel movement concerns. Why is it that so many people have issues? And more importantly – what can we do about it? This is the topic of our next Pelvic Health 101 seminar TONIGHT.

Not only will constipation be discussed but other bowel conditions, such as irritable bowel syndrome, fecal incontinence, bloating and hemorrhoids will be addressed. The lecture will also go in depth on the role of fiber, water intake, toilet posture and pelvic floor muscles in having a successful bowel movement. You will even go home with easy techniques that you can implement immediately to help you get that smooth move! Don’t miss out on this FREE event – it’s a MUST for anyone who struggles on the porcelain throne. Seats are going fast! Register here! PelvicHealth101.eventbrite.com . Light snacks and refreshments will be served.

Welcome Our New Intern, Denise!

By Fiona McMahon, DPT

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On the journey towards becoming a physical therapist, you have to take a lot of classes, days are long and the studying can be more than a little bit arduous. After you build up a sufficient base of knowledge in school, you get to round out your education by getting the experience to learn hands on in the clinic. Beyond Basics takes a Physical Therapy student every year with an expressed interest in the specialty of pelvic floor rehabilitation. We’ve had many students throughout the years, and both myself and Stephanie Stamas did our training here as students.

This year, our student is someone who is already close to the Beyond Basics family. Denise Small has been a Pilates instructor at BBPT for years and has played an integral role in helping our patients get back to their active lifestyle during and after treatment for pelvic floor dysfunction. When Denise decided to go to physical therapy school we were so excited, and we are so glad to have her back in the practice in her new role!

What made you want to go into physical therapy?
Physical therapy has been a constant part of my life. As a professional ballet dancer, I saw physical therapists who helped me recover from  injuries, maintain healthy joint and muscle mobility. While I was a professional dancer in NYC, I realized I needed a job on the side to make money while I wasn’t performing. I decided to get my Pilates certification because the schedule could be flexible and it was training that I had practiced as a dancer. My Pilates teachers were Certified Movement Analyst (CMAs) from the Laban school, and they approached Pilates training in a very unorthodox way. They were interested in using the Pilates method to help people with chronic pain issues and dancers who wanted to investigate their full movement potential. My teachers introduced me to really amazing PTs who went out of the box of traditional treatment, and using movement analysis to help heal chronic movement dysfunction.

Eventually, I came to the conclusion that I wanted to retire from dancing, which is a whole other story. I wanted to transition into something that I would be as passionate about as I was performing. I wanted something that would involve movement and movement analysis, but also something that had job stability, salary, health insurance, etc.  Add all those together and PT seemed like the obvious answer to me.

You have a pretty fascinating background outside of physical therapy, can you tell us what other work experiences you have had and how they shape you as a physical therapist?
Thank you! I think my experience in jobs that were centered around movement, dance and Pilates,  have influenced the way that I work with patients. My main concern is getting people to move more and to enjoy movement. We live in a three dimensional world with many different planes and directions to explore. I feel that most people only explore what’s directly in front of them, and maybe occasionally what’s behind them and what’s to their side. I believe that if people explored different heights, levels, and directions, they can break their habitual patterns and with them their chronic aches and pains.

I also believe that my undergraduate studies in psychology have helped me tremendously in my teaching skills. Realizing that there are many different personalities that are shaped by many different experiences, helps me to teach each patient in whatever way helps them best receive whatever information I have to offer. Basically, it taught me to be flexible to people’s different personalities and learning styles.

Pelvic floor rehabilitation is a pretty advanced specialty for someone to take on while they are still in PT school. What made you want to undertake such a challenge?
I’m glad you said that. It is a very difficult and complicated subject to explore for a PT student! But I think my age (I’m 36) and my life experience help me to be able to handle and understand all the different variables that go into having pelvic dysfunction. Also I am a survivor of pelvic pain and I received the benefits of what pelvic floor therapist are capable of. I, like a lot of the patients that come to BBPT, saw a few different doctors, body workers, and acupuncturists to try and relieve the pain I was feeling, but no one was able understand or help until I went to Physical Therapy. I want to be able to pay that gift forward and help others who are suffering from that type of pain.

Where did you go and what did you do for your other clinical experiences?
I have had some really wonderful experiences. At my school your affils are established by lottery, so I didn’t know what I was going to get. I was really lucky. I know not all students can say that. My first affil was at King’s County Hospital in East Flatbush, Brooklyn. It was in both inpatient and outpatient settings. I saw so many amazing cases there, working with people who had amputations, gunshot wounds, rare neurological conditions, the specific cases were fascinating and provided me with a wide breadth and depth of understanding of these conditions.

After that I was in an outpatient clinic. This clinic was the type of place you imagine when you think physical therapist’s office. I had a really great clinical instructor (CI), who was very knowledgeable and I appreciated having such a talented CI to guide me. After that, I was at Mt. Sinai on the Upper East Side in the Traumatic Brain Injury Unit. It was incredible. Again, I had such amazingly talented clinical instructors. I learned so much and I really enjoyed the patient population. In the inpatient setting with TBI patients, you are a part of restoring their basic functions like walking, sitting, standing. It was so humbling to watch these patients work so hard to achieve skills that we often take for granted. Mt Sinai was probably my most favorite of the three.

What advice do you have for an aspiring physical therapy student?
Honestly, I would say to establish a movement practice for yourself, meaning start a regime in which you can gain a deeper understanding of your own body, like yoga, Pilates, gyrotonics, tai chi, etc. If you have a deeper understanding of your own body, you can better understand how movement patterns can limit or enhance your patient’s functioning. With that knowledge not only can you have a better understanding of how to treat your patient, you can also be more empathetic toward their healing process.

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Pelvic Health 101: Running to the Bathroom Again?

By Fiona McMahon, DPT

Do you find yourself with a full map of every public restroom along your daily commute in your head? Do you find yourself competing for the aisle seat at movies so you can sneak away to the bathroom? Does it hurt to go? Do you get up multiple times a night? If you answered yes to any of these questions, this week’s Pelvic Health 101 is for you.

On Thursday, March 24th, at 7pm, join Stephanie Stamas, physical therapist at Beyond Basics Physical Therapy, for all of the ins and outs of bladder health. Learn how the bladder works, common bladder disorders, and practical tips for helping your bladder symptoms. Light snacks and wine will be served.

Register at PelvicHealth101.eventbrite.com today.

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Endometriosis Awareness Month

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March is Endometriosis Awareness Month. Endometriosis is a chronic condition in which the lining of the uterus, the endometrium, grows outside of the uterus. Endometriosis or “endo” as it is sometimes called, affects 10-15% percent of women of reproductive age. The growth of endometrium outside of the uterus can cause a whole host of symptoms, that can vary from patient to patient and is not directly correlated to the amount of rogue endometrial tissue in the body cavity. The symptom classically associated with endometriosis is painful periods, but other symptoms also include constipation and bloating, pain with evacuation of both urine and feces, painful sex, heavy periods, as well as other symptoms. Because these symptoms can be considered “nonspecific”, women can wait anywhere from 3 and 11 years to obtain a diagnosis of endometriosis and finally receive medical, including physical therapy, and/or surgical management.

The cost associated with lost productivity and medical expenses associated with endometriosis is estimated to be in order of 22 billion dollars in the U.S. alone in the year 2002. This figure is higher than the cost of both Crohn’s disease or chronic migraine. To read more about symptoms and treatment options for endometriosis, including physical therapy which can significantly help with the pain and dysfunction related to endometriosis, please refer to our blog.

Endometriosis in the Media:
If you are a fan of Lena Dunham, writer, producer, director, and actress in the HBO hit, Girls, you may have heard a lot of information about her battle with endometriosis. The actress recently announced a hiatus from her work, secondary to a flare in her symptoms. Shortly after her announcement, she was hospitalized with a ruptured cyst on her ovary, related to her endometriosis.

In the wake of these announcements, there has been a lot of focus on this common, but little talked about disease. With the glut of information hitting the media in response to Lena’s announcement, there was unfortunately some misinformation reported by some mainstream media outlets. It was erroneously reported that the only treatment for endometriosis is a hysterectomy. This is categorically untrue and caused a frenzy of healthcare providers to contact the media and squash this myth. According to the National Institute of Health, a hysterectomy does not guarantee a cure from the pain associated from endometriosis. Furthermore, treatments like diet changes, use of oral contraceptives, hormonal treatments, physical therapy for the musculoskeletal involvement and precise excision surgeries all have been shown to offer relief from endo related symptoms. With the misinformation that remains in the media and even in the medical profession, there is a need to promote evidenced based information to healthcare professionals as well as the public at large about this common and debilitating disease.

A new documentary:  Endo What?
Endo What? Is a feature length documentary that brings awareness of the stories of women who are currently suffering with endometriosis and explores the many treatment options available to these women, including medical and physical therapy treatments and surgical options. Endo What? puts human faces on the experience of those who are suffering with Endo and is a phenomenal tool to empower women to make educated choices on how to best manage their symptoms. Their website is here if you wish to find out more about this documentary or attend one of their worldwide premieres.

 Developments in Endometriosis Diagnosis and Treatment
In February of this year, a study entitled, Soluble Tumor Necrosis Factor-alpha Receptors in the Serum of Endometriosis Patients was Published in the Journal of Obstetrics & Gynecology and Reproductive Biology. The authors found that a substance called tumor necrosis factor-alpha (TNFa) was significantly higher in women with endometriosis (previously diagnosed via laparoscopy)  than those who did not have the condition. This finding can be useful in finding medical interventions  for the disease as well improving diagnosis of endometriosis early on in a woman’s development of the disease by testing for elevated TNFa in the blood.

Resources for Endo:
Living with endometriosis can be hard. People often find themselves feeling like they are missing out on a lot of the things their friends can do with ease. It is also difficult because endometriosis doesn’t make you look sick. It can be difficult to explain what endometriosis is like to someone who doesn’t have disease. Support groups can keep you informed about current developments, treatments, and tried and true strategies for living with endo. Endo Warriors is a great New York City area resource for local events and international resource on social media. Visit their website at endowarriorssupport.com. The Pelvic Messenger, an extremely informative radio show with some of the top experts in the world, sponsored by Beyond Basics Physical therapy and the International Pelvic Pain Society, has done many interviews on endometriosis with Dr. Andrew Cook, Dr. Frank Tu, Md, Jill Fuerisch and Nicole Malashi of Endo Warriors and others, and will interview Shannon Cohn, producer of Endo What? At  the end of the month.  The Endometriosis Association and the Endometriosis Foundation of America, at are also excellent resources for endometriosis support.

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Beyond Basics wears yellow in support of endometriosis awareness month

 

Sources:

American Congress of Gynecologists and Obstetricians. Million Women March for Endometriosis Fact Sheet.http://www.acog.org/about_acog/news_room/~/media/newsroom/millionwomanmarchendometriosisfactsheet.pdf. [Accessed March 11, 2016]

Bonocher C, Montenrgro M, Rosa e Silva J, et al.  Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology 2014, 12:4

The Mayo Clinic. Diseases and conditions: endometriosis.http://www.mayoclinic.org/diseases-conditions/endometriosis/basics/symptoms/con-20013968 [Accessed: March 11, 2016]

Mechling L. Explained: here’s what you need to know about endometriosis. Vogue. February 18, 2016

Othman EHornung DHussein M, et al.Soluble tumor necrosis factor-alpha receptors in the serum of endometriosis patients

Eur J Obstet Gynecol Reprod Biol. 2016 Feb 20;200:1-5. doi: 10.1016/j.ejogrb.2016.02.025. [Epub ahead of print]

National Institute of Health. What are the treatments for endometriosis.https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/Pages/treatment.aspx. [Accessed: March 11, 2016]

Nothnick W and Alali Z. Recent advances in the understanding of endometriosis: the role of inflammatory mediators in disease pathogenesis and treatment [version 1; referees: 4 approved]. F1000Research 2016, 5(F1000 Faculty Rev):186

(doi: 10.12688/f1000research.7504.1)

Wahooo! Postcard from: Cycle for Survival

By Fiona McMahon, DPT

I am writing you, dear reader, absolutely giddy from Beyond Basics’ day at Cycle for Survival! Cycle for Survival is a fundraising organization that raises money for rare cancer research by hosting one heck of a spin-class party. We biked our hearts out, danced to great music, and were inspired by the stories of people who were affected by cancer.

We were proud to be part of a team that was comprised of our clinic’s staff as well as other members of the community who raised over 47,000 dollars to directly fund rare cancer research. Our team, Team “Fran/Donna” honors all those who have fought cancer or who are currently battling the disease. Cancer unfortunately touches nearly all of our lives and we thank you from the bottom of our hearts for your donations and support to help make cancer history!

If you still want to make a donation, don’t worry there’s still time! Donations close on April 1st. It would be tremendous to push our total contribution to $50,000. Just click here: http://mskcc.convio.net/site/TR/CycleforSurvival/CycleforSurvival?team_id=50856&pg=team&fr_id=2600&_ga=1.21235963.1501594132.1453665194

We had so much fun. We encourage you and your company or family to participate next year. You won’t regret it! Just in case you need any more convincing, below are some pictures from this year’s AWESOME event.

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East Coast Team Fran/ Donna celebrate after a job well done!

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Melissa has the eye of the tiger!

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Go Amy!

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The pom poms couldn’t hold up against our dance moves

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Victoria is powering through with the Amy’s constant support!

Spring Pelvic Health 101 Classes are About to Start!

Come Learn With Us! Free Pelvic Health 101 Classes at Beyond Basics Physical Therapy!

By Fiona McMahon, DPT

It’s that time of year again, temperatures are rising, the days are getting longer, and we at Beyond Basics Physical Therapy are gearing up and getting ready to start up our hugely successful Pelvic Health 101(PH101) classes for the spring and we couldn’t be more excited!

Our upcoming Pelvic Health 101 Course is the third in our series of PH101 courses. Our courses cover a variety of topics from male and female sexuality, bowel and bladder health, nutrition, as well as complimentary medicine for pelvic floor dysfunction. In this blog we will sit down with one of Beyond Basics’ Senior Physical Therapists and the creative force behind our Pelvic Health 101 Classes, Stephanie Stamas, to get more information on this wonderful resource.

FM: Why did you begin PH101?
SS: I began the Pelvic Health 101 seminar series last fall out of a desire to help more people. There are a lot of people out there who have consistently been told there is nothing wrong with them, it is all in their head or they should just get over it. I wanted to put together an educational series that would validate people’s suffering as well as give them tools to heal and return to a normal life. I believe that information is power, and that power gives people freedom and hope – two things that are often lacking in patients suffering with pelvic floor dysfunction.

FM: Who is the intended audience for PH101?
SS: Current patients, prospective patients, healthcare providers who have questions about how to better treat pelvic pain – really anyone. I tailor these classes so they are understandable to the general population, but I also try to give more in-depth information than one might find elsewhere. I really want class participants to leave with a clear picture of what is going on with their bodies.

FM: Do you have to be a current patient at BBPT to go?
SS: Not at all! Most of the participants have been prospective patients looking for more information and seeing if physical therapy can be helpful for their condition. We’ve also had plenty of other healthcare providers come to learn more about the musculoskeletal component to bowel, bladder and sexual dysfunction.  Everyone is welcome!

FM: What is your favorite topic to cover?
SS: I really love the bowel lecture, “Why is Pooping so Difficult.”It’s fun to be an adult and get to talk about pooping! Potty talk is often not socially acceptable but I like to open the floor to talk about issues that are often swept under the rug. I also really love our Ladies Only Night. It’s a safe place where women can come and ask any of their questions concerning pelvic health in a friendly, fun, women only environment. It almost has the feel of a girls’ night in with your friends, minus the pajamas and pillow fights.

FM: What are some of your favorite reactions from last years’ class?
SS: I love seeing “light bulbs” click on when people discover anatomical and physiological reasons why they are experiencing symptoms. People get so much bad information along the  way and often times are told everything is in their head. I love the smiles and hope on people’s faces when they hear the good news that it is not, and that there is a solution to their symptoms!

FM: What should people do who are interested in taking the class?
SS: They should sign up online as soon as they can at PelvicHealth101.eventbrite.com. The classes are free but space is limited so they do fill up quickly. Light refreshments will be provided. Check out our class schedule below!

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Multiple Sclerosis Awareness Week

By Fiona McMahon, DPT

MS Awareness Week 2012

The week of March 7 through March 13 is recognized as Multiple Sclerosis (MS) Awareness Week. In an effort to help raise awareness for this condition we wanted to dedicate one of our blog posts to the subject of MS, how it affects people with the disease and how we at Beyond Basics Physical Therapy work with patients with MS.

MS is reported to affect 2.3 million people worldwide. Multiple sclerosis is an autoimmune disease that affects the ability of the nerves to send messages to the body. The typical age of onset for MS is between 20-40, however there are known cases where MS can arise later or in childhood. The immune system of people with MS begins to attack the fatty covering or insulation of the nerve cells, over time the covering of nerve cells scars down, which slows or impedes the messages sent to the body from the brain. The reason why the immune system turns on its own body is unknown and is one of the major areas of research into MS.

The symptoms of MS are variable and some are more common than others. Not everyone presents with the same systems, which is why it can take some time for someone with MS to be properly diagnosed. Common symptoms of MS include, fatigue, tingling in the arms and legs, vision issues, difficulty walking, sexual issues, and issues with bladder and bowel function. There are other symptoms associated with MS and these symptoms can change over time. What is difficult and frustrating for patients with MS as well as their health care providers, is that these symptoms are nonspecific and don’t necessarily rule out or rule in anyone specific disease, whether it be MS or something else. There is no one lab test to diagnose MS, but MRI (magnetic resonance imaging) as well as clinical findings may lead to a diagnosis of MS.

As of now, there is no cure for MS. But fortunately there are a lot of resources that can help people with MS lessen the disability caused by MS. Medicine has come a long way to alter the course of MS with disease modifying agents. Drugs now exist which can slow the progression of the disease, manage relapse, and help correct specific symptoms like depression, fatigue, and pain.

Physical therapy can help a multitude of symptoms associated with MS. Most general physical therapists are qualified to help patients with MS walk more efficiently, manage fatigue, and improve their daily function. Pelvic floor physical therapists can also help to manage specific issues such as urinary issues, bowel issues and bladder issues, as well as the symptoms mentioned above. We at Beyond Basics Physical Therapy are skilled at treating both the orthopedic and pelvic health aspects of MS. We encourage prospective patients to call our office to speak to a physical therapist if they have any questions.

Although MS is manageable, there is still a lot of work that needs to be done. A single test to diagnose MS is still not available, nor is there a cure for this disease. The National Multiple Sclerosis Society is an excellent resource if you want to learn more about MS, donate to research, participate in fundraising, or find support in your area.

 

Sources:

National Multiple Sclerosis Society. http://www.nationalmssociety.org [Accessed March 5, 2016]