Mama’s 101 is here! Optimize your Pregnancy and Post-Partum period

Beyond Basics Physical Therapy Downtown is hosting a brand spankin’ new series of classes focusing on pregnancy and post-partum health. Our first class is September 12th. Feeling Good While Pregnant will cover how you can optimize your function during the many pregnancy related changes your body will experience during your pregnancy. It is not to be missed! Register here!

Check out the upcoming Mama’s 101 classes:

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Mama’s 101 is a FREE educational series for mamas focused on how to improve pain-free function during pregnancy and the post-partum period.

Mama’s 101 will be held at our downtown location

Date: September 12th 6pm

Address: 156 Williams Street, Suite 800, NY, NY 10038

 

Physical Therapy and the Prostate

By Fiona McMahon

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We hear a lot about prostate cancer nowadays, as we should. Prostate cancer is an extremely common form of cancer, which affects 1 in 7 men in the United States, according to the American Cancer Society. Over the years, the approach to the treatment of prostate cancer has evolved from a more surgery and radiation focused treatment, to more of a philosophy of watchful waiting. The driving factor behind this decision is that prostate cancer is usually a slow growing cancer that is discovered late in life, and therefore  a diagnosis of prostate cancer in a 65 year old man is not as likely as other cancers to have a significant impact on his lifespan.

Regardless of this new approach to the treatment, there are still many men whose cases require medical and surgical intervention. Prostate cancer is often treated surgically by removing the prostate either through a laparoscopic procedure or an open procedure. Men may prefer the laparoscopic removal of the prostate because it has been shown to cause less bleeding and it allows the surgeon to better be able to visualize the nerves responsible for erections. Other treatments for prostate cancer include cryotherapy, hormonal therapy, radiation, and chemotherapy.

Surgery carries side effects, which can have a profound effect on your life but usually these side effects will go away over time. Side effects that generally go away include urinary incontinence and erectile dysfunction. Some permanent effects from prostatectomy surgery are dry orgasm (orgasm without ejaculate) and loss of fertility. This is because when the prostate is removed, the surgeon must cut the connection between the testicles and the urethra. Because this connection is removed, the sperm that is produced has no way to exit the penis to fertilize an egg.  Some men may chose to cryopreserve or “bank” their sperm prior to surgery.

The ability to achieve an erection and control your bladder returns spontaneously for many men after they undergo treatment for prostate cancer. The return of these abilities can take anywhere from 6 to 12 months. Many men find that waiting for half a year to a year for these functions to return is simply too long. They also often struggle when they compare themselves to other men who have recovered faster. Recently, there have been many studies looking at ways to expedite the return of urinary and sexual function in men who have been treated for prostate cancer.

Urinary incontinence is a frequent side effect of surgery for prostate cancer. In a 2010 study Centemero and colleagues found that participants who completed a pelvic floor muscle strengthening program before and after their prostate removal surgery experienced urinary incontinence for a significantly shorter period of time post-operatively than those who began pelvic floor muscle training after they had had their prostate removal surgery. These results were also reinforced by the work of Hischhorn and colleagues, who found that men who had received pelvic floor training prior to their prostatectomy reported significantly fewer issues with urinary incontinence.

Men have many of the same pelvic floor muscles as females do. Male pelvic floor muscle strength has also found to be an important factor in the ability to have an erection, remain continent, and avoid dribbling urine after one voids his bladder. These muscles can be trained to be stronger, relax better, and behave more effectively to help alleviate urinary and sexual symptoms following prostate cancer treatment. It is possible that strengthening your pelvic floor muscles may expedite your recovery. In a 2004 article by Siegal, pelvic floor muscle strength was found to be stronger in men without issues of erectile dysfunction, urinary dribbling, and incontinence.

The research shows that men can take an active role in speeding up their recovery from prostate cancer by participating in a pelvic floor rehab program with a qualified pelvic floor practitioner. We offer these services at Beyond Basics, so feel free to learn more about them here. By strengthening weakened muscles, stretching tight muscles, allowing for better coordination through biofeedback, pelvic floor physical therapy can help you feel like you sooner.

Sources

American Cancer Society

www.americancancersociety.org/prostatecancer. Accessed: March 10, 2015

Centemero A, Rigatti L, Giraudo D. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: A randomised controlled study. Eur Urol. 2010 Jun;57(6):1039-43

Hirschhorn A, Kolt G, Brooks A.

A multicomponent theory-based intervention improves uptake of pelvic floor muscle training before radical prostatectomy: a ‘before and after’ cohort study. BJU Int. 2014;113:383-392

Siegal A. Pelvic floor muscle training in males: practical applications. Urology. 2014 Jul;84(1):1-7

Pilates with Kierstin! Abdominal Bracing

Kierstin Elliott, Pilates Instructor

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What is it? Abdominal bracing is an activation of the core muscles that help provide support and stability for your trunk. This brace is commonly called upon in almost every single Pilates exercise and is essential for building tone within the deep and superficial layers of the core. Let me take you through two different scenarios where the core should naturally brace on its own.

Scenario one: Imagine kneeling on the floor with one foot forward and back toes tucked. Now if you were to lift the back knee two inches off the floor, how do you prep for that movement? I bet you would find yourself naturally bracing your core as a response to your body calling for additional stability to lift the back knee. Try it. If you do not feel the core engage naturally, it may take some deliberate asking from the brain to activate the core.

Scenario two: Imagine you tripped, but caught yourself! Chances are your whole body tenses up and your abs engage. Your body has to instinctively muster up as much stability as it can manage to prevent you from falling. This is another example of abdominal bracing.

One common question I get when introducing abdominal bracing to clients is, “How do I breathe when I’m bracing?” Don’t expect to get a full belly breath while under an abdominal brace, but do allow your abdomen to stretch and fluctuate a bit to accommodate to the task at hand. If the task is strenuous, strive to find a three-dimensional breath. Expand through the back of the ribs on your inhale. On the exhale while you exert the most force, start to knit your ribs together, draw your pubic bone up and gently pull navel toward spine (finding your brace). This will provide adequate support for your system. If you need prolonged stability throughout an exercise, your breath pattern may feel a bit short and more shallow than a full expansive breath.

Note from a PT

An abdominal brace is a useful tool for you to support your spine and pelvis during moments where you may have to lift something heavy, stabilize yourself from a jossle or bump, or to allow you the stability through your body for explosive athletic movements. That said, it is important not to grip constantly, that can invite a whole host of issues including pelvic floor dysfunction! A good abdominal brace is really like a seasoning. Think cilantro, it may be tasty in small doses on top of a burrito, but you certainly don’t want to eat a salad of it! We are often taught to grip because it pulls in our flab and men and women alike have been taught that “fluffiness” around the waste line is icky for some reason. But it is truly important for your health to let go when you are at rest.

Breathing under an abdominal brace directly impacts our intra-abdominal pressure which leads me to another common question I often get when asking clients to brace, “Is it safe for my pelvic floor?” Yes, bracing but not gripping is safe for your pelvic floor. In fact, not bracing for certain movements could lead to hernias, prolonged diastasis, or more severe pelvic floor issues. Learning the proper way to activate the various layers of your core and then coordinating that activation with proper breathing techniques will take you far; not only in functional daily movement, but in all of your active fitness dreams! If this peaks your interest, or you find it hard to find an abdominal brace on your own, schedule a session with me at Beyond Basics Physical Therapy, and we’ll have some fun exploring abdominal bracing!

Marathoning with Molly: Training Update

Molly Caughlan, PT DPT

Hello blog readers! I am writing this blog a good three or so months into my marathon training and wanted to give an update on how it has been going. Things started off rough: when just two weeks in, I rolled my ankle. Unfortunately, this story is not one of cool athletic prowess where I rolled it sprinting to save a child from a burning building. Rather, I was doing an silly move of “texting while walking the dog” maneuver that lead to a mis-step off the curb. I did a full tuck-and-roll, landed on the ground covered in dirt, and very much freaked out my doggo. I wish someone had caught this trip on camera, because I’m sure it was amazing. I took a minute to sit on a bench and assess the damage. Luckily, the grand theatrics of my trip did not equate to the severity of my injury and I was still able to put weight on it enough to walk home.

Two days later, I had a PT session with Tina Cardenia, where she worked to reduce the swelling and improve the mobility in my ankle. This helped tremendously to accelerate my healing and allowed me to return quickly to my running program. I was back on the pavement in under two weeks! Even though the sprain itself has fully healed, it continues to occasionally feel stiff during and after runs along with a little bit of swelling. Tina continues to focus on my right ankle mobility and stability to prevent future sprains. Pictured in this video below, Tina is performing what’s called a “thrust manipulation” that gives a quick stretch to my ankle joint to help it move more freely.

Disclaimer: This technique should be performed by a licensed professional and is not intended to be reproduced at home.

In addition to my right ankle, I will occasionally have left sided hip crease/groin pain and discomfort. This has come and gone even before marathon training. Based on Tina’s assessment, my left pelvic bone does not move well into extension and this causes some pinching in that area. Treatments have focused on releasing tight muscles and connective tissue in the front of my hip as well as building stability by strengthening my glutes and core.

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Another challenge with training is trying to beat out this summer heat! Compared to Atlanta’s summers (where I trained for my first marathon), this season started out pretty mild. I had been doing well and progressing mileage, but once the end of June hit I knew things needed to change. I remember the tipping point when I set out on a 12 mile run and my poor little leggies could only carry me 10. I recognized afterward my mistakes in that I woke up too late, chose a trail with little shade, and that I wasn’t properly supplementing myself in restoring electrolytes. Since this weekend, I’ve added SaltStick Chews to my regimen and they have really made a big difference. I’ve also been more diligent about really planning ahead when I can get in my long runs.

I’m sponsored by an organization called Team Tisch MS​ that performs groundbreaking research to discover the cause of Multiple Scelrosis, understand disease mechanisms, optimize therapies, and repair the damage caused by MS, as well as offering patient access to the best and most advanced treatment possible. So far I’ve raised $555 and I’m only 11% towards my $5000 goal with just 3 and a half months left to go. Support Team Tisch MS by donating to my fundraiser here.

 

Beyond Basics will be offering matching donations throughout the marathon, so keep your eyes peeled on social media to see how you can make your donation go TWICE as far!

What is Neater than your Peter? A Guide to Penile Health and Function Part 1: Premature Ejaculation

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Fiona McMahon PT, DPT

Ladies and Gentlemen, it is finally time to go for this blog and go on a deep dive to discuss at length (pun not intended), the physiology, health, and function of an amazing organ, the penis! A couple years ago we talked about testicles in our blog, All About Testicles, which remains one of our most popular blogs. Now it is time to travel north and talk about how people with penises can best care for them and how to address things that may go wrong from time to time. This blog will periodically cover different issues that can (ahem) arise with penises. Today we will go over premature ejaculation. But before we can do all that, lets review how the penis works.

As an organ, a healthy penis is an amazingly complex organ despite it’s seemingly simple exterior. It is the tail end of the urinary system, provides amazing sensation, carries sperm to the outside world, delivers a substance that can neutralize the acidity of the vagina in order to make it more hospitable to sperm, and is able to use the muscles around it to raise the blood pressure in the penis higher than that of the outside body, in order to maintain erection.

The penis is not one tissue all the way through. It has what’s called the tunica albuginea which is the wrapping for the erectile parts of the penis. This guy is really important because it closes off the vein returning blood flow from the penis to keep the penis erect during arousal. Inside the tunica albuginea is the corpus carvernosum and corpus spongiosum. No, these two tissues are not Harry Potter spells, but critical parts of penile infrastructure. The corpus cavernosum fills with blood during erection and helps make the penis hard. The corpus spongiosum keeps the urethra from getting clamped shut during erection so the sperm can get out.

How Does The Penis Get Hard?

Usually, in response to sexual stimulation, the smooth muscles (the involuntary ones, not the pelvic floor) will relax allowing the small blood vessels within the penis to fill with blood, the result is the tunica albuginea ( the wrapping of the erectile parts of the penis) will compress on the veins of the penis, thus preventing the blood returning back to the body. The trapped blood in the penis will cause the penis to get hard and stand up. The lovely muscles of the pelvic floor, specifically the ischiocavernosus will contract to further increase the blood pressure within the penis and keep the penis erect.

What Happens with Ejaculation?

Ejaculation occurs with orgasm. It is possible to have an orgasm without ejaculation if you have had a procedure like a prostatectomy. For a normally functioning penis, ejaculation occurs with orgasm and is what carries the sperm and other fluids to the outside world. The contractions felt in orgasm are what propel the sperm through the penis and to the outside world. The bulbospongiosus is responsible for these contractions and is part of the pelvic floor.

Premature Ejaculation

Here is where I would normally supply you a pithy little statistic like “ 1 in 4 men will experience premature ejaculation in their lifetime”. Unfortunately, I cannot provide any such statistic for this subject because so few people talk about this problem. The clinical definition of premature ejaculation is a little wonky too, and has not consistently been used in research, therefore prevalence data are likely inaccurate. The International Society for Sexual Medicine (ISSM) , in an attempt to improve the medical definition of premature ejaculation defines it as:

  • Ejaculation that always or nearly always occurs within about 1 minute of vaginal penetration from the first sexual experience (Defined as lifelong premature ejaculation)
    • OR
  • A clinically significant reduction in latency time, often to about 3 minutes or less (defined as acquired premature ejaculation)
  • Inability to delay ejaculation on all or nearly all vaginal penetrations; and
  • Negative personal consequences, such as distress, bother, frustration, and/or avoidance of sexual intimacy (Althof 2014)

If you are a gay or bi-man, or a man who does not have vaginal intercourse you are probably well aware how problematic this definition is. Currently, it is the ISSM’s stance that there is insufficient evidence to draw up criteria for men who have sex in ways other than vaginal intercourse.

As you can tell by the definition, premature ejaculation is divided up into 2 subgroups, lifelong and acquired. The distinction is relatively new in the research and can help patients find better ways to treat their premature ejaculation.

Potential causes of premature ejaculation include:

  • Hypersensitivity of the glans( head) of the penis
  • Issues with serotonin
  • Erectile dysfunction*
  • Either stopping or starting drugs
  • Chronic pelvic pain syndrome*
  • History of rushing early sexual encounters
  • Prostatitis*

*These are conditions treated at Beyond Basics Physical Therapy

What to do about premature ejaculation?

Don’t ignore it. Performance anxiety and premature ejaculation can often become a vicious cycle, where one will promote the other. Regardless of how your symptoms started, there is a lot that can be done to improve your sex life.

If you have prostatitis or chronic pelvic pain come to physical therapy. Did you know 90-95 percent of cases of “prostatitis”/chronic pelvic pain are musculoskeletal in nature… ahem… this is one of the most common conditions we treat at Beyond Basics. Overactive muscles, those in the abdomen, legs and pelvis can contribute to symptoms of prostatitis/chronic pelvic pain, (i.e. burning urination, painful ejaculation, sitting pain, genital pain, defecatory pain, urinary or bowel frequency, urgency, retention, incomplete emptying, etc.,.). Physical therapy can go a long way to treating and curing these symptoms by relaxing and lengthening your overactive muscles and strengthening weaker muscles. Prostatitis is a vast subject that requires its own blog. Luckily for you, I already wrote one. Check it out here.

If you are experiencing erectile dysfunction along with premature ejaculation, get thee to a doctor. I already explained to you how amazing the penis is as an organ. Its function is reliant on blood flow, thus problems with erection, especially in younger people may be an early sign that something may be up with your vascular system. Once systemic causes have been ruled out, get thee to physical therapy. We spoke earlier about how the penis requires blood flow and muscles to work properly; pelvic floor physical therapy can restore the function and improve the vascular health of the muscles vital to erection. Erectile dysfunction is yet another subject that could use its own blog. Again, luckily for you, I already wrote one. Check it out here.

If you don’t think erectile dysfunction, prostatitis, or chronic pelvic pain is causing your premature ejaculation, there is still a lot you and your urologist can do. There is new work revealing that certain medications and psychotherapy can really help reduce premature ejaculation. You are not alone in this and you deserve to start feeling better.

Thank you so much for reading our blog, if you think physical therapy can help you. Please give us a call at either our midtown location 212-354-2622 or our downtown location 212-267-0240. We are offering free phone consultations at both offices for a short period!

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Fiona McMahon PT, DPT is currently practicing from our midtown location

Check out our other Neater Than Your Peter Blog:

What’s Neater Than Your Peter (a series on male sexual dysfunction): A Bend in the Road: Peyronie’s Disease

 

 

Althof S, McMahon C, Waldinger M, et al. An Update of the International Society of Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). Sex Med. 2014; 2(2) 60-90

Anderson R, Sawyer T, Wise D. Painful myofascial trigger points and pain site in men with chronic prostatitis/ Chronic Pelvic Pain Syndrome. J Urol. 2009;182(6): 2753-8

Anderson R, Wise D, Sawyer T. Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. J Urol. 2005;174(1):155-60

Chronic nonbacterial prostatitis (chronic pelvic pain syndrome). Harvard Health Publications. Harvard Medical School. 2007. http://www.health.harvard.edu/newsletter_article/chronic-nonbacterial-prostatitis-chronic-pelvic-pain-syndrome. Accessed December 11, 2016

Dean R, Lue T. Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction. Urpl Clin North Am. 2005; 32(4): 379-v

Herman H. “Male and Female Health Wellness and Sexual Function”. New York. 19-20 May 2018

Quinn P. A Multinational Population Survey of Intravaginal Ejaculation Latency Time. J Sex Med. 2005; 2(4) 492-497

Check out Corey’s Interview with Mongoose Bodyworks!

Below is a repost of an interview that Corey Hazama did with Moongoose Bodyworks. Corey is a physical therapist and the co-owner of our Beyond Basics Physical Therapy downtown location.

Pelvic Floor Health in NYC

COREY HAZAMA IS A PHYSICAL THERAPIST AND CO-OWNER OF “BEYOND BASICS PHYSICAL THERAPY”, A CLINIC THAT SPECIALIZES IN ALL CONDITIONS AFFECTING THE PELVIC FLOOR IN MEN, WOMEN AND CHILDREN. WE LOVE THIS AT MONGOOSE BODYWORKS, AS SO MUCH OF OUR PILATES CORE WORK IS RELATED TO THE PELVIC FLOOR.

HALLE: Tell me a bit about your practice .

COREY: We specialize in treating all conditions affecting the pelvic floor in men, women and children. We are a manually based orthopedic clinic and treat patients one-on-one for an hour.

HALLE: How did you come to focus on women’s health and pelvic floor issues ?

COREY: I had been treating orthopedic injuries for some time and was seeing more and more complex cases of back, hip and tailbone pain, etc that didn’t resolve with traditional PT. In treating these patients I started to feel that the source of their pain was coming from something else, something I didn’t understand completely, the pelvic floor. I had the opportunity in 2015 to work and train with Amy Stein who has revolutionized the pelvic floor field in New York City. I decided that I really needed to train more and understand this region of the body better so that I could help these patients.

HALLE: Who can benefit from this type of therapy?

COREY: Any individual who is having pain or discomfort in their pelvic region, which is the area from the top of your pelvis to your sit bones. This includes the Sacroiliac [low back] region as well as the groin. We can help patients who are having genital pain, or pain with intercourse. We also treat issues with bladder which can be incontinence after a vaginal delivery, or increased urgency and frequency, incomplete emptying which can affect women and men. We also see a lot of patients who are having pain with bowel movements or constipation, bloating, and pain. We also have pretty much seen it all, so we can offer insight if PT has not worked in the past, or a patient wants to know if their complaints are muscle/joint related. We treat the hard cases, the people who tried traditional PT for their hip or groin pain and the exercises either made them worse or didn’t help.

HALLE: Do you think people are ever embarrassed to contact you?

CORY\: I hope not. We are all very approachable and we offer phone consults if a person wants to know if PT can help or if they are a candidate for Pelvic Physical Therapy.

HALLE: Why do you love this work?

COREY: I feel I have a special skill set and knowledge where I can help a lot of people where their symptoms are scary and distressing and they have not been able to get the answers or treatment they need. The symptoms of pelvic floor dysfunction can be scary and these patients get bounced around from doctor to doctor without getting answers. I also feel like I have a lot of tools at this point, I have spent a lot of time taking continuing education classes to learn new ways that I can help.

HALLE: What gets you out of bed in the morning?

COREY: My brain is always going, I have always wanted to understand how things work. I used to take apart VCRs and radios when I was a kid because I wanted to see how it worked. I feel the same way about the body. I want to understand how everything works together and is related to the whole so that we are pain free and functional.

HALLE: Do you have a favorite exercise?

COREY: I really like to roll my arches on a pinky ball. I have really tight feet and calves and I am on my feet all day so it feels really good to do that at night when I get home.

HALLE: What’s your experience with Pilates? Do you have a favorite Pilates exercise?

CORY: I have been doing private pilates now for a little over a year. It has really changed how I move and my posture. I feel stronger through my core and better grounded when I am working. I don’t know if I have a favorite exercise, but I do know which one kicks my butt the most! I have never been able to do a complete curl up/roll up. Using the arc and roll down bar I can finally do it (with a little help from the bar). I also found out that my whole life I was doing the ab curl wrong and it has been very enlightening to learn how to do it correctly and also to work through my own limitations that prevented me from being able to do it correctly.

HALLE: How does Pilates relate to your work?

COREY: In doing Pilates myself, I have learned so much about the benefits of working with a skilled Pilates instructor to identify my own limitations and also learn how to correctly activate the correct muscles. In the work I do I find that eventually all my patients get to a point where I have been able to restore normal muscle tension through their pelvic floor muscles, abdomen, hips, and spine, and now they need to start to learn how to use these muscles in an optimal alignment and what better to do that than pilates! The men and women who teach Pilates are masters of observation and I trust them entirely to make sure my patients are not compensating with the exercises. It is the compensations that occur, when we don’t even realize it, that get us into trouble in the long run.

HALLE: What do you do when you are not being a PT?

COREY: I am a knitter and a foodie!

HALLE: Anything you’d like to share about home life?

COREY: I have a wonderful husband, who is also a PT, he is an amazing teacher in regards to PT, but it is more his teaching me to not be a PT all the time that has really done so much for my work life balance.

THANKS COREY!!!

Not From NYC?! Come see us as an “Out of Town Patient”

high rise building
Photo by Nicolas Poupart on Pexels.com

Fiona McMahon PT, DPT

So you’re reading the blog, you’ve seen us on Instagram and you keep thinking “ ughhh if only I could get to Beyond Basics Physical Therapy”. Well, if you have the ability to get to NYC, Beyond Basics Physical Therapy (BBPT) offers an intensive and comprehensive physical therapy program to help our patients living out of state or even out of the country to get started on their own individual path to healing.

Why make the Trip to BBPT?

Beyond Basics Physical Therapy has been pioneering pelvic floor physical therapy for the last 16 years. Founder Amy Stein has worked throughout her career to educate clinicians and patients alike about pelvic pain. She is the author of Heal Pelvic Pain and the co-author of Beating Endo with co- author, Dr. Iris Orbuch and creator of the video: Healing Pelvic and Abdominal Pain. The staff physical therapists have extensive training in the treatment of pelvic floor disorders in men and women. Many of the therapists at BBPT have contributed to medical textbooks on treatment of the pelvic floor and do educational seminars and talks on the subject. All of this is to say, we feel very passionately about pelvic floor treatment and education. What makes Beyond Basics stand out is that pelvic floor treatment is a high percentage of each physical therapists’ (PTs’) caseload. All of our therapists see men and women for pelvic floor treatment on a daily basis, which is an advantage over a clinic that may only see a few pelvic floor cases a week.

That being said, we also treat orthopedic conditions like hip, back, and neck pain and often times, treatment of these areas are regularly addressed in pelvic floor dysfunction because it is all connected. Many of our clinicians also have additional certifications and training in the treatment of non pelvic conditions and they are experts in this field as well.

What to Expect

Every body is different and everybody is different. But that said, there are a few things that are consistent across patients. For our out of towners, we usually schedule 2 hour appointment blocks multiple times a week while our you are in the city. What these long blocks do is allow us time to really get to know you and your history so we can really delve into making you feel better.

During your exam, your physical therapist will address things like your strength, core stability and mobility, posture, and range of motion of the muscles, tissues and joints, much as you might experience in a typical physical therapy session. If you have pelvic floor complaints, with your permission, your therapist will examine your pelvic floor. She may do this by looking at the pelvic floor externally and asking you to contract and relax your pelvic floor. With your permission, she may place a gloved and lubricated finger in the vagina or rectum to assess for pain, mobility, and strength.

Once your PT has completed her exam she will sit down with you and detail your findings to help you better understand why you may not be feeling so well. She then will go to work in session by performing a variety of techniques typically consisting of manual therapy, nervous system downtraining, exercise, behavioral and postural modifications and more. Every single treatment at BBPT is individualized to your needs, so there is no one uniform treatment across patients. Read more about a typical pelvic appointment here.

Another super important element of our treatment is the home program. Your physical therapist will curate an individualized home plan to help you maintain what you have gained with us and continue to improve once you return to your home. It is super important that you try out you home program while you are in NYC so we know if we need to modify anything before you leave.

During your course of treatment, we may find that additional help may be needed to jump start your healing. We may suggest you see our colleagues in medicine, mental health, or nutrition to help you improve faster and more completely. Beyond Basics has close relationships with top pelvic floor specialists in other disciplines and can facilitate connections between you and these experts.

As PT winds down we will try our best to find some way for you to continue your care back home, whether that be helping you to find a qualified PT or other movement practitioner to help you continue healing.

How to Set Up Your Visit

Obviously, getting into NYC needs some pre-planning, on both our ends! Given the intensive nature of our program, we need to find time on our PT’s schedules to get you in, so the earlier you know you’ll be in NYC and schedule, the better. This will also give you more access to appointment times that will allow you to take some time to explore the Big Apple! When you call we will send you forms that will allow you to detail what you are experiencing so your PT can hit the ground running. You also will get a chance to speak to our billing manager who can help you figure out the ins and outs of insurance coverage.

If you have been suffering, come visit us. We would love to meet you and help jump start your healing journey.

For more information on becoming an out of town patient, click here.

If you are ready to learn more about our out of town program, give the front desk a call at 212-354-2622