Set up: Lie facedown on the box with naval pulled up towards the spine, chin tucked in with neck lengthened (as if you are holding a tangerine under your chin), glutes engaged, and legs extended. Pull yourself to back bars of the reformer and hold onto the poles with both hands. Use one blue spring for resistance.
Execution: Inhale to lengthen elbows, exhale to bend elbows.
Focus: The main muscle group targeted here are the lats. Think about pulling down from the armpits while the elbows bend and extend. This action will help stabilize the shoulders, keeping them out of the ears. Also, focus on releasing the upper traps and lengthening the back of the neck. The more work we can get from underneath the shoulder blades, rather than above, the better!
Importance: Improves posture! Strong back extensors lead to better posture, especially in this day in age where phones and computers are constantly pulling our shoulders forward and weakening our backs. Incorporate a few lat pulls into your routine and feel taller almost instantly!
Modifications: To make it easier, drop tension to one yellow spring. To make it harder, place a squishy ball between ankles and add hamstring curls or pulses between lat pull sets!
Today, December 1st, 2018, is World AIDS Day. World Aids Day has been held on the first of every December since 1988. World AIDS Day works to spread awareness of the disease and to remind the general public that AIDS and HIV still must be taken seriously and that there is still a lot of work to do in order to prevent the transmission of new cases, as well as to better care for those who are infected with the disease.
What is AIDS/HIV?
AIDS (acquired immunodeficiency syndrome), is caused by a virus called human immunodeficiency virus (HIV). HIV can be treated in order to prevent AIDS, however, there is currently no cure for HIV.
HIV causes AIDS by attacking the immune cells of a person’s body, which can leave a person vulnerable to infections that otherwise would not have made them sick. These infections are referred to as opportunistic infections, an opportunistic infection is a signal that someone’s HIV may have progressed into AIDS.
As we said earlier, HIV doesn’t always have to progress to AIDS. Antiretroviral therapy (ART) can work to help keep the immune system healthy, as well as lower the risk of transmitting the virus to others. People on ART have dramatically improved lifespans. It is imperative to get on ART as soon as possible to lessen the effects the HIV virus has on your immune system.
1 in 7 people infected with HIV does not know they have the virus. Testing is necessary to start treatment and reduce the harm done to your immune system as well as the risk of transmission to others.
According to HIV.gov, you should be tested if:
“you a man who has had sex with another man
you had sex—anal or vaginal—with an HIV-positive partner
you had more than one sex partner
you injected drugs and shared needles or works (for example, water or cotton) with others
you exchanged sex for drugs or money
you been diagnosed with, or sought treatment for, another sexually transmitted disease
you been diagnosed with or treated for hepatitis or tuberculosis (TB)
you had sex with someone who could answer “yes” to any of the above questions or someone whose sexual history you don’t know?
Taken directly from HIV.gov, click here to learn more
HIV/ AIDS and Physical Therapy
Physical Therapists do not treat AIDS or HIV, rather, they can treat some the symptoms of AIDS/HIV and HIV/AIDS treatment, to allow patients to live as fully and independently as possible. Both the disease itself and the treatment for it have effects like increasing fatigue, decreasing strength and endurance, and increased pain. Physical therapy can help by tailoring programs to help with pain, ability to perform everyday tasks, improve heart health, balance, endurance, strength, and flexibility.
You can mark today by doing a number of things:
Wear a red ribbon to spread awareness
Donate to groups that work to help people living with AIDS and help to prevent its transmission:
I love the TV show Mythbusters, I have for the last 15 years, (yes ladies, gents it has been on for that long). If you aren’t familiar with this show, the hosts Adam and Jamie try to prove or disprove popular myths like, is shooting fish in a barrel easy? Spoiler alert: yes, but maybe not in the way you think it is. I’ll let you look that one up on your own. I loved how this show took everyday assumptions and applied real science to see if they were indeed true. In the same spirit of my beloved show, we are going to try and bust some pelvic floor myths. Since I don’t have the funding or ethical review board to conduct large-scale experiments on pelvic floor questions, I am going to the next best (albeit, slightly less glamorous thing) and see what I can find on PubMed, while applying known pelvic floor science to the question. Most of us have probably been told that holding in your pee for a long time can cause urinary tract infections (UTIs), but is it actually true? Can peeing at every single urge cause other problems? Through gathering the available evidence we will look at this time old axiom to determine whether it is true or false.
What is a UTI (Urinary Tract Infection)
A UTI occurs when bacteria colonize or grow in your urinary system, which is composed of your bladder, urethra, ureters, and kidneys. Usually, we see these infections in the bladder. Women tend to get UTIs more often at an 8:1 ratio to their male counterparts. This is because the male urinary system has a substantially longer urethra, as well as the fact that the female’s urethral position makes it vulnerable to bacterial colonization in women who have penetrative vaginal sex. Although it is more common for adults to contract UTI’s, children can too. UTI’s in children can be an indicator of possible bladder conditions, such as vesicoureteral reflux (when urine seeps back into the upper part of the urinary system and can cause infections in the kidneys). Any bladder infection in children should be followed up by imaging to rule this condition out. Untreated reflux can be harmful to the kidneys. Much of the literature I reviewed pertains to women with UTIs but it is possible to apply some of this information to males. That being said, at least half of women will report a UTI at some point in their lifetime.
We can further classify UTI’s by how often one contracts them. Recurrent UTI is defined as 3 positive cultures in 12 months or 2 positive cultures within 6 months. Uncomplicated infection occurs in people who have a normal urinary tract, whereas a complicated infection occurs in individuals with complications in the urinary tract, such as vesicouretral reflux.
Known Risk Factors for UTI
Our main question is, “does holding pee cause UTI’s?”, but what things do we absolutely know are risk factors for UTIs? First thing is having a female urinary tract. The female urethra (where the pee comes out) is shorter than the male’s, making it easier for UTI causing bacteria to get a foothold and cause infections. Along those lines, having receptive vaginal intercourse can make you more prone to get a UTI because objects inserted into the vagina can introduce bacteria to the urethra, which live nearby each other. Pregnancy, diabetes, and immunosuppression have also been shown in the literature to increase the chances of getting a UTI. Being post-menopausal can also increase your risk of developing a UTI as it may thin the tissue of the vulva and make it easier for bacteria to get to the bladder. Other factors include the use of spermicides, catheterization (both indwelling and intermittent), wiping back to front (ladies), diaphragm use, or incomplete bladder emptying (guys and gals, we will discuss this in detail below).
But Does Holding Your Pee Cause UTIs???!!!!!
Yes… and no. The data out there is pretty darn sparse, and what I’ve read has not provided any clear-cut studies examining the issue. Keep in mind it’s a pretty hard experiment to design to prove that holding your pee can cause UTIs. Peeing as a preventative to reduce UTIs works by flushing out the urethra, but you need a good amount of liquid (however don’t force or push out your pee) to clean it out. This is why I advise and will continue to advise patients to pee after intercourse. It flushes everything out.
Now, that being said, if you are peeing too frequently, and only a little bit comes out at a time, you may not be effective in cleaning out your urethra fully. Normal bladder frequency should be about once every 2-3 hours and that is if you drink 7-8 glasses of fluid a day (if you drink less than that then frequency will be less). And, obviously, things will pick up a bit if you’ve had a bunch to drink, (water or otherwise), but that’s the average. Another way to tell if you are on track is if you are peeing for 8-10 seconds (real “one-Mississippi” seconds) and it is a strong, consistent stream. If you train yourself to pee when you don’t have a large amount of pee in the bladder, you could actually be training your bladder to be more frequent, which can be a problem.
What if when you are peeing, you have to strain and only have a dribbly stream and not a lot comes out? This is a problem that could lead you to get UTIs. It is called incomplete emptying. Incomplete emptying happens when the bladder does not empty properly. Because of this, urine is not expelled out of the urethra at a rate that is sufficient to clean out the urethra and that means bacteria may have an easier time getting to your bladder. Symptoms of incomplete emptying can include post-void dribble, having to strain to pee, and or feeling like you have to pee again shortly after your first attempt to pee.
Does Pelvic Floor Health Have Anything to Do with UTIs
It can. Also, problems in the pelvic floor can commonly mimic symptoms of UTIs (burning with urination, frequency, urgency, etc.,.). The pelvic floor is a group of muscles between the tail-bone and the pubic bone, and they surround the urethra, bladder, anorectal opening, and genital region. For people with incomplete bladder emptying, a tight pelvic floor may be playing a role. The pelvic floor has many functions, but one of its functions is to open and close the doors (sphincters) that hold pee in and let it out. If the pelvic floor is tight, it’s hard for the muscles to relax and for the pee to exit. More importantly, when the pelvic floor is held in tension it prevents the detrusor (bladder squeezer muscle) from emptying the bladder well.
Additionally, tight pelvic floor muscles, specifically in the urogenital diaphragm layer (the superficial pelvic floor muscle layer), can feel a lot like a UTI when they are tight. Some women will experience irritation in this area after intercourse, which can feel a lot like a bladder infection. Women who repeatedly test negative for UTI’s but have symptoms could have pelvic floor dysfunction! It’s wild, I know.
Bladder Tips for us All
Wash yourself and your partner before sex
If you have a vagina, wash it with water before getting it on. The fact of the world, is we are covered in bacteria, if you wash your vagina and vulva before anything goes in it, you lessen the chance of bacteria getting pushed into your urinary tract. Your partner should also wash his or her fingers, toys, or penis as well to avoid infection. Using a USDA organic mild soap with no extra ingredients or additives is best.
Pee After Sex!
Pee after sex. It is so important. It’s better to have a bladder that’s more full than not, so you can clear out that urethra, but regardless try and pee relatively soon after having sex.
Wipe Front to Back
Please excuse me for being indelicate, but if you wipe back to front (anus to vagina), you are helping to drag poo bacteria up towards the urethra, which is something we definitely don’t want to do while we are trying to prevent UTI’s.
Test your Urine
If you have symptoms of a UTI, get yourself to the doctor, nurse practitioner, physician’s assistant, etc. He or she can see if you really do have an infection. The importance of this is two-fold. To nab an infection before it gets worse or goes to your kidneys, and to make sure you actually have an infection, not pelvic floor dysfunction. Making sure you get your urine tested also ensures you won’t have to take unnecessary antibiotics which can negatively affect yeast and gastrointestinal symptoms.
If you have symptoms and no infection or trouble emptying your bladder, come to physical therapy!
UTI symptoms that aren’t a UTI are often caused by pelvic floor dysfunction. A skilled pelvic floor physical therapist will be able to assess whether or not your pelvic floor is playing a role in what you are feeling. A skilled pelvic floor physical therapist will assess whether or not you can open and close your pelvic floor well in order to pee effectively as well as checking the pelvic floor for tightness and for any nerve irritation. If there is something not working well with your pelvic floor, your therapist will partner with you to help treat it and get you feeling better. You will be equipped with a home program and behavioral modifications to ease the bladder symptoms so you can go back to a pain and symptom-free life!
Wanna bust more myths?! Good, we’re working on that!
Wanna learn more about the bladder?! Be patient! We’re cooking up a brand new blog with everyday tips to help you better manage your pelvic symptoms! Stay tuned!
Fiona McMahon is currently seeing patients at our Midtown Location
If you have questions about orthopedic, pelvic, or sports physical therapy, BBPT is offering free phone consults to those living in the greater NYC area for a limited amount of time!
Beyond Basics Physical Therapy
212-354-2622 (42nd Street Location)
212-267-0240 (William Street Location)
Al-Badr A, Al-Shaik G. Recurrent Urinary Tract Infections Management in Women. A Review. Sultan Quaboos University Med J. 2013(13) 359-67
Scholes D, Hootman T, Roberts P, et al. Risk factors for recurrent urinary tract infection in young women. J Infect Dis. 2000;182:1177-82
Chances are doing some traveling over the coming months. The holidays are a time when we haul luggage through airports, Christmas trees and boxes of decorations through your house, or load massive turkeys into the oven. With all this lifting on the docket, I have a pretty good hunch you don’t want to start the new year with a heating pad and lying down in bed, so I am going to share with you, some of my favorite lifting tips.
Get close to what you are lifting:
I mean really close. Maybe hug it if you can. The reason why we should get close to what we are lifting calls back to high school physics. The force on the spine equals the weight of the object being lifted by the distance it is away from the spine. Therefore, the farther an object is away from you, the harder it is on the spine to lift. My co-workers use the term “T-Rex arms” to describe how close they want their patients to be holding what they are lifting.
Don’t lift with your back. You have all heard it a million times, but if you bend forward with your back to pick up what you are lifting, you will end up placing a tremendous strain on the muscles and bones of your spine. Just don’t do it. Instead, bend with your knees to get to what you want to lift, and push through your legs to stand back up.
Don’t be a Hero
Ask for help if something seems too heavy to lift. In the long run, everyone will be better off. Knowing when to ask for help is sometimes the most challenging part of safe lifting practices. If you feel you are asking for more help than you would like or you have back pain that is not resolving, come see us at Beyond Basics to help you get back into lifting shape. The sooner, the better. You don’t want it to become a chronic problem.
Fiona McMahon PT, DPT practices at our Midtown location
Any persistent pain or chronic back or pelvic pain can be tough. It is tough to have and often times it can be extremely isolating. Many of our patients have to go through a number of clinicians before they even get a diagnosis of pelvic floor dysfunction. If you are reading this blog, you probably have some questions about pelvic floor dysfunction and if physical therapy is right for you.
We are here to help. If you are living in the Greater New York Area and have some questions about orthopedic, sports or pelvic floor dysfunction and if physical therapy is right for you, I encourage you to call our office. For a limited period of time, we are offering free 15-minute phone consults with our licensed physical therapists to patients in the greater New York Area. For those of you living outside this area, a fee may apply to the consult but can be applied towards payment for a PT visit if you chose to visit us. Don’t miss this opportunity to learn more about your pelvic floor and what PT can do for you.
The Physical Therapists at Beyond Basics also treat orthopedic (sport and joint injuries), pediatric pelvic floor dysfunction and orthopedic injury, and much more. Give us a call to discuss how PT can help with any one of these issues!
Having a baby is exciting, fascinating, and nerve-wracking. If you have never been through the process before, chances are you have a lot of questions and concerns about what changes your body will go through during your pregnancy, what the birthing process entails, and how your recovery will go once you’ve had your baby.
Join us and childbirth specialist, Ashley Brichter, in our Pelvic Health class to discuss the ins and outs of having a child.
Have you noticed an increase in the amount of pink on just about everything the last couple of days? The increase of pink everything is because October is Breast Cancer Awareness Month. Breast Cancer is an extremely common cancer. According to the Nation Breast Cancer Foundation, 1 in 8 women will be diagnosed with breast cancer in their lifetime. Men can also get breast cancer, however, it is much rarer for men to develop breast cancer. Luckily with early detection and treatment of early stage and localized cancer, the 5-year relative survival rate is 100%. That being said, early detection is crucial and it is important to catch breast cancer early to ensure the best possible outcome. Let’s take some time to review the signs of breast cancer and recommended screening protocols.
Signs and Symptoms of Breast Cancer
Change of Sensation/ texture of the Breast or Nipples
Lumps, change in texture in the breast, nipple, or underarm area
Change in appearance of Breast or Nipple
Change of nipple orientation
Discharge from nipple
Recommended every 1-2 years for women who are 40 years old or older.
May be recommended for women who are under 40, but have increased risk of breast cancer.
For some types of breast cancer, there is a very specific link to a person’s genes and her or his risk of developing breast cancer. BRCA1 and BRCA2 are genes that are responsible for the production of certain tumor-suppressing proteins. In some populations, there are mutations in these genes that disable their tumor-fighting properties. These gene mutations are relatively rare and currently, screening is recommended just for individuals with increased risk of harboring these mutations. According to the National Cancer Institute, individuals who are at higher risk and should consider genetic testing are:
Individuals who have a male relative who has developed breast cancer
History of BRCA related cancers within family history
People of Ashkenazi (Eastern European) Jewish ancestry
Breast Cancer diagnosed before age 50 in family
Multiple cases of breast cancer in family
Individuals that test positive for BRCA mutations may consider increased screening, prophylactic surgery or chemoprevention.
Mastectomy and Physical Therapy
Mastectomy, removal of the breast is currently the most common treatment for breast cancer. Some women chose to have their breasts reconstructed after their mastectomy and others do not. It is obviously a very personal choice. Like any surgery, mastectomies require close postoperative care to ensure maximal function and recovery.
You may have read the last sentence, and thought, “What is the function of the breast, besides breastfeeding and for sexual pleasure?” The breast lies in an important intersection in the body. The armpit (axilla) contains bundles of nerves, blood vessels, and lymph vessels that course through it, serving the arm down to the fingers. After a mastectomy, their course can be interrupted by scar tissue, radiation damage (if your treatment included radiation), causing painful conditions such as nerve entrapments, frozen shoulder, and lymphedema, ( a backup of lymph fluid, if left unchecked can cause permanent damage and deformation of the arm).
Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well ask on our website at: www.beyondbasicspt.com/lymphedema