Pelvic Pain Awareness Month: Part 2: Hope for Chronic Pelvic Pain

Mayis PelvicPainAwarenessmonth

Welcome back! In part 1 of this blog we discussed how pelvic pain can affect anyone, regardless of their age or gender. We also discussed that pelvic pain can feel many different ways and may occur in different body locations and be triggered by different activities. Now that we have the basics under our belt, we can march forward and start to explore different ways to manage and treat pelvic pain.

First steps

Now that you have a name for what you are experiencing, it is important to get a handle on the various characteristics of the pain you are experiencing. This information will provide valuable insights to the clinicians who are treating you. Some questions to think about include:

  • How long has this pain been going on?
    • Chronic pelvic pain is classified as pain that has gone on for 3 or more months, this type of pain likely has musculoskeletal involvement and will likely require the help of a pelvic floor physical therapist in addition to medical intervention
    • Also try and think if there were any significant events around the time of your symptoms onset; these events may be physical like spraining an ankle or emotional, like moving or starting a new job
  • What makes it worse and what makes it better?
    • Sometimes you won’t know and that’s ok too.
  • Where is the pain?
  • What does the pain feel like?
    • Describing the character of pain can be really tricky. Here are some words we hear a lot
      • Burning
      • Itching
      • Stabbing
      • Buzzingwork
      • Aching
      • Gnawing
      • Sharp, Shooting
      • Dull
      • Tingling/numbness

Now that you have this information, it’s time to make an appointment with a doctor, who ideally has experience in treating pelvic pain. Your doctor will work to determine if there are any immediate medical concerns that require treatment. It is important to be patient when starting this step. Usually it is not immediately clear on exactly what is causing your pain, especially if it has been going on for some time. Usually chronic pelvic pain is caused by more than one system (i.e it could be a bit digestive and also a bit musculoskeletal). That is why your first visit with a clinician is typically just a jumping off point.

Next Steps

After your initial appointment you may have a referral in hand to see a specialist. Specialities that treat pelvic pain include:

  • Colorectal
  • Gastroenterology
  • Gynecology
  • Physical therapy
  • Physiatry
  • Psychiatry
  • Psychology
  • Neurology
  • Urology
  • Urogynecology

It is important to visit a clinician who specializes in pelvic pain, considering it is a very specialized topic, and unless a clinician has an interest in it, their exposure to pelvic pain may be limited.

The next two pieces of advice I am about to give may seem mutually exclusive, but hear me out. Trust your gut, but also be patient with the process. For chronic pelvic pain, it takes some time to see improvement. Think about it, you’ve had this pain for a very long time, it will take a while to improve. In physical therapy, we expect our patients to see some improvement in 4-6 weeks, and similar timeframes can be expected for other types of interventions. That said, if you feel like the clinician you are seeing is dismissing you or not taking your complaints seriously, that is important. A colleague of mine, who I adore, tells her patients “who knows your body better than you?”. The answer is no one. If you think something is wrong, it is your right to be taken seriously.

First Steps in Treatment

There are steps you can take to start addressing your pain almost immediately. I discuss some of them in this blog. Getting a handle on your stress is really important when dealing with chronic pelvic pain ( I am currently writing this during a global pandemic, so I do recognize this is much easier said than done). This is important because chronic stress can cause the pelvic floor to tighten which can exacerbate pain issues. It is important also to recognize that despite anxiety and stress being strong contributors, pelvic pain is not in your head and your symptoms are real.

It also may be worth your while to experiment with gentle heat or cold. A warm bath or hot pack or cold pack can be helpful. Just make sure to put plenty of layers between you and the cold/ hot pack.

Professional Interventions

Address your muscles. Yes, we are a PT clinic and we will always say muscles are important, but the truth is, with chronic pelvic pain, muscles spasm/tightness is involved in most cases of pain. For those of us on lockdown, physical therapy is still accessible and considered essential. Beyond Basics offers both in person and telehealth appointments to guide you on your way.

A trained pelvic floor physical therapist can help to teach you exercises to do on your own to manage pain, release muscle tightness, and correct poor postures and overuse patterns that may have contributed to your pain in the first place.

Depending on your diagnosis you may see other medical specialities who will prescribe medicine, injections, or surgery in some cases, like endometriosis. You may also be referred to a nutritionist, acupuncturist, or mental health therapist as well. Like I mentioned earlier, typically pelvic pain can have many different contributing factors so it is really important to have a team and to make sure your team is communicating well together.

Although pelvic pain can be massively disruptive and upsetting, that fact is people can get better. Have hope, trust your gut, and reach out if you need us.

Beyond Basics Physical Therapy

212-354-2622

How to find a physician familiar with pelvic pain:

International Pelvic Pain Society, Interstitial Cystitis Association

Bonder J, Chi M, Rispoli L. Myofascial pelvic pain disorders. Phys Med Rehabil Clin N Am

. 2017 28(3), 501-15

Speer L, Mushkbar S, Erbele T. Chronic pain in women. Am Fam Physician. 2016 1;93(5):380-7

Van der Velde J, Laan E, Everaerd W. Vaginismus, a component of a general defensive reaction. An investigation of pelvic floor muscle activity during exposure to emotion- inducing film excerpts in women with and without vaginismus. Int Urogynecol J Pelvic Floor Dysfunct. 2001; 12 (5) 328-31

Pelvic Pain Awareness Month Part 1: What is Pelvic Pain

Beyond Basics remains open and is offering both in person and telehealth appointments. Call 212-354-2622 for our midtown office and 212-267-0240 for our downtown office to learn more

Mayis PelvicPainAwarenessmonth

Fiona McMahon PT, DPT

I don’t need to write it out. You’ve already heard it. But I will write it anyway. These are uncertain times. This May, much like March and April, is shaping up to be a May that is very different than ones we’ve ever experienced before. That said, life still marches on. May is Pelvic Pain Awareness month and it seems appropriate to take some time to recognize those who are dealing with pelvic pain as well as spread awareness to what it is and how we can make it better… even in these uncertain times.

What is Pelvic Pain?

Pelvic pain can sound really simple, it’s pain in your pelvis, but let’s explore what that really means. The pelvis is a bowl shaped set of bones, the innominate (literally meaning no name), the sacrum, and the ischium, that connect your abdomen to your legs. Within this bowl lives your reproductive organs, your bladder, and rectum. Surrounding these bones and organs you have this nifty stuff called fascia. Fascia is the organ of shape and helps to both give structures within our body form as well as help them to slide and glide past each other. Like I said, nifty. Also within the pelvis we have muscles, nerves, and blood vessels! It gets really busy down there!

Because there is so much going on in the pelvis, pelvic pain can feel a lot of different ways depending on what structures are involved and even individual differences in how the body feels pain. Pelvic pain can have the feel of a dull ache, which you can feel in your pelvic bones, genitals, and or abdomen. It could also feel sharp and “stabby”, hot and burning, itching,and/or like a bunch of pressure. It can come and go or be a constant sensation. It can be what we call provoked, meaning certain triggers elicit it, or it could come and go seemingly without any obvious cause.

Pelvic pain can come in a lot of different varieties and it can affect everyone, regardless of gender or age. Many people who hear that I am a pelvic floor physical therapist, assume that I only treat postpartum women. The truth is postpartum women are not the only ones who can experience pelvic pain.

People with male anatomy can experience pelvic pain. They may feel burning with urination or climax, pain in the tip of the penis, in the testicles, or in their rectum. Sometimes this pain limits the ability of its sufferer to sit, wear tight clothing, or have pain free sexual experiences Often these symptoms get confused as a bladder, prostate or yeast infection. Although infections can certainly cause these symptoms, many times tight and spasmed muscles within the pelvis can be the culprit. We will discuss this further in part two of this blog.

People with female genitalia can experience many of the same symptoms listed above with obvious anatomical differences. Instead of the tip of the penis, a person with female anatomy may feel pain in their clitoris, or labia. They also may have pain with sexual penetration or arousal. Patients may also experience burning urination similar to the sensation of having a bladder infection. For people who menstruate, the cramps may be so debilitating that they are unable to work or go to school through the pain. All of these different presentations fall into the category of pelvic pain.

Children can also experience pelvic pain. Oftentimes this is caused because of prolonged constipation, but it can also be caused by muscle tightness, and gynecological conditions like endometriosis or lichens planus/ sclerosis.

People with pelvic pain, regardless of age or gender may also experience pain with voiding, either urine or feces, abdominal bloating, and or difficulty sitting.

What Causes Pelvic Pain?

So now that you know what pelvic pain is, what causes it? Many, many, many different things can cause pelvic pain. As we spoke about earlier in the blog, infections can cause pelvic pain. That is why it is important to get yourself in to see a doctor if you are experiencing this type of pain. She will be able to rule out or rule in infections or other medical causes for your pain. Often the problem causing your pain may be musculoskeletal. People with this cause of pelvic pain may not feel relief with traditional medical intervention. The muscles of your pelvis include the muscles of your abdominal wall, your bottom, and the muscles that live between your pubic bone in front and your tail bone in the back, also known as your pelvic floor. These muscles may be in spasm causing the types of pain I described earlier, (yes even the burning urination pain). It may also be that a muscle group in the pelvis itself or supporting the pelvis may be too weak to do its job properly. When this is the case, it is important to get yourself in to see a pelvic floor physical therapist, who can figure out exactly why your muscles are causing your pain.

Although pelvic pain can seem really bleak, there is a lot that can be done to treat it. It’s all about finding the right qualified professional to treat it. At Beyond Basics Physical Therapy we are the experts in pelvic pain and we treat patients from all over the world. We not only treat musculoskeletal causes of pelvic pain, but also work to connect our patients with other professionals who can help to holistically treat pelvic pain. If you have pelvic pain, please remember that there is hope for you.

Alright readers, that’s the basics on what pelvic pain is and what it looks like in different people. Next week we will go Beyond the Basics (see what I did there?) and discuss how to treat pelvic pain, especially pelvic pain caused by muscle dysfunction, in the clinic and even at home.

For more reading on pelvic floor dysfunction please check out these blogs as well as Amy’s books books on pelvic pain

Treatment

How to Deal with Pelvic Floor Pain From Home

What is Pelvic Floor Physical Therapy

What is Myofascial Release and Why do We Always Talk About it So Much?!

For People with Female Anatomy

Endo Awareness Month: How Endo can Affect your Tummy

Endo Awareness Month: Understanding Endo

Endo Awareness Month ( Part 2 of 4) : How Endo can Affect your Bladder

When it Feels Impossible to Have Sex

For people with male anatomy

All About Testicles

What’s Neater Than Your Peter? Burning Urination

Prostatitis What it is and What to do About it

Bladder Health

Pelvic Floor MythBusters! Don’t eat lemon to avoid bladder pain, true or false?

How to Improve Bladder Health

Books By Dr. Amy Stein PT DPT

Heal Pelvic Pain : available here

Beating Endo: available here

The International Pelvic Pain Society (IPPS) is a multidisciplinary group working to promote awareness and education of pelvic pain, if you care to donate, click here

Back to school: A to Z with No problem with Pee!

back-view-backpack-boy-207697

Fiona McMahon PT, DPT

It’s back to school time! Many of us look back at this time fondly. Reminiscing about the joy of picking out new notebooks, meeting new friends, and trying to put together a perfect back to school look (any 90’s kids remember the Delia*s catalog?) But if you are a kid or a parent dealing with a kid with urinary accidents, the idea of going back to school can be downright terrifying. In this blog, we will go through the causes of urinary incontinence as well as treatments. Here’s the thing, if you only have time to just skim this blog, I want you to know this: Urinary accidents are not your fault, nor your child’s and there are solutions out there to help improve accidents. So keep your and your kiddo’s heads up. It can get better.

In the spirit of back to school, we will start off this blog with some definitions. We can classify bladder accidents in many different ways, which can be helpful when it comes to selecting a course of treatment. Here are ways the medical community may classify your child’s incontinence

Intermittent versus Continuous: Intermittent applies to children who are having discrete individual episodes of incontinence, rather than continuous loss of urine from the bladder. The latter is more suggestive of neurological or anatomical impairment and does require a physician’s attention right away.

Intermittent incontinence can be further classified as primary or secondary. Primary incontinence occurs in children over 5 who have never achieved continence, whereas secondary incontinence occurs in kiddos who have had continence previously for a period of 6 months or more.

Urge Incontinence: Occurs when when a child has a sudden urge to urinate and cannot make it to the potty in time. It is a type of intermittent incontinence.

Stress Incontinence: Occurs when kiddos lose continence with activities like coughing, laughing, and sneezing. It is a type of intermittent incontinence.

Eneuresis or Nighttime Incontinence as the name would imply, this is intermittent urinary incontinence that occurs at night.

So here’s the thing, your child may experience just one type of incontinence or they may experience many types, (i.e. urge, stress, and bedwetting). Regardless of the type of incontinence your child is experiencing, they are not alone. Bedwetting is experienced in nearly 5%-10% of 7 year olds and daytime incontinence is experienced by 5-15 percent of kiddos between 5- 9 years old. It can be helpful to share this fact with your kiddo when they feel alone and isolated. Let them know that there may be several people in their class experiencing the exact same symptoms.

What Causes Incontinence in Kiddos?

In most kiddos, it is rarely one thing exclusively. One of the most common causes of incontinence at BBPT is constipation. The rectum and the bladder are neighbors sandwiched between two relatively immobile bones, the pubic bone in front and the sacrum in back. When a child, or an adult is constipated the rectum can become distended, like a big ol’ balloon. When the rectum is full of poo it squishes the poor little bladder leaving very little room for pee to collect before a child has to go. Furthermore, all that junk in the pelvic floor reduces the feeling that it’s time to go until it is much too late. Even a child that is pooping daily may be constipated. How can that be you may ask? Well, kiddos that are constipated may actually be incompletely evacuating resulting in a build up of stool in the abdomen. Signs besides bowel frequency that your child may be constipated include, abdominal pain, large painful bowel movements, itchy tushes, or even poo accidents. If you are still unsure, some doctors may do an abdominal x-ray to confirm the presence of large amounts of backed up poo in the abdomen

The pelvic floor is another huge player in urinary issues. The pelvic floor refers to the group of muscles between the pubic bone in front and the tailbone in the back. These muscles help regulate the flow of pee and poo out. Sometimes these muscles are too loose to hold everything in. Often times they actually may be too tight, which can lead to constipation, incomplete urination, and believe it or not, these muscles may also be too weak to hold in waste during play!

We see other factors linked to pediatric incontinence. Keep in mind these factors are correlated with incontinence and may not be necessarily causal. Kinda like a chicken and the egg situation. One may have caused the other or one may have no effect on the other. With correlations, it is often impossible to tell. Here are factors found in the research that have been linked with urinary incontinence in kiddos:

  • Younger age
  • Male sex
  • Black race
  • History of urinary tract infection (UTI)
  • Family history of bed wetting.
  • Difficult infant temperament
  • Early toilet training before 2 years
  • Late toilet training after 36 months
  • Attention-deficit Hyperactivity Disorder
  • Stressful life events

What to do About Pee Accidents

We have established that having urinary accidents as a child is pretty common. So the first thing to do, and I’m serious here, is remind yourself and your kiddo that you are not alone and that it is not your fault. Keep saying it until it sinks in. Potty issues can come with the extra burden of guilt and shame. Let it go. It is no longer serving you or your kiddo.

Now, it’s time to get the ball rolling. Although childhood incontinence has a 15% spontaneous cure rate every year after age 7, it leaves out a whopping 85% of kiddos who deserve being able to play and go to fun activities like sleepovers without fear of accidents.

First, get yourself a proactive doctor who will screen for UTI’s. They often don’t show up the same way in kiddos as they do for adults. UTIs can cause incontinence and left untreated, they can be dangerous.

Then get yourself to a qualified pelvic floor physical therapist who has experience working with kids. A qualified pelvic floor physical therapist has the ability to assess the muscles of the pelvic floor in a non-invasive manner to see if weakness or tightness could be a potential culprit. They also are qualified to assess the abdomen to determine if backed up poo from constipation is worsening accidents. Based on what they find, they will taylor a program to help fix any potential barriers your child could be facing on their way to continence.

Things to do now:

  1. Explore Irritants: Certain foods can irritate the bladder and cause accidents. Check out this list {HERE} to explore potential bladder irritants. Keep in mind, not everything irritates everyone. What I would suggest is a blander day followed by a day where you add back in a potential offender. Bladder irritants usually cause irritation within 2 hours, so if you don’t see anything in that timeframe, that item is most likely off the hook.
  2. Schedule the Potty: Kids are so scheduled these days but we need to add potty breaks to the agenda. Having your child attempt to urinate, whether she wants to or not can help. I suggest starting at once every hour during the day and gradually increasing the interval as they succeed. There are watches like the WOBL watch that can help kiddos out, but I also find teachers to be extremely helpful getting a kiddo to visit the bathroom regularly.
  3. Pee at the transition times: This one is from my clinical experience. Make sure your kiddo goes to the bathroom immediately before leaving camp or school. The on the way home accidents are usually the last to clear up . So nip it in the bud ahead of time.
  4. Drink water! But not to close to bed: Your child should be drinking enough water to keep his stool soft and his urine dilute. Dehydration can worsen bladder irritation and constipation, which can in turn worsen incontinence. Just stop water intake 2 hours before bed.
  5. Manage Constipation: Give your kiddo enough time to poo and make sure her diet is varied so her stools are formed but not pellets. If you struggle with this, come see us.

Wrapping it up:

One more time for the people in the back. You are working so hard. I never met a family who is not trying everything for their kiddo. Incontinence is tough, but with PT and support it can get better. If trying these steps is not working for you, come see us.

 

Check out Amy’s book Heal Pelvic Painwhich includes a chapter on the pediatric pelvic floor.

Baird D, Seehusen D, Bode D. Enuresis in children: a case based approach. American Family Physician. 90(8) 2015

Maternik M, Krzeminska K, Zurowska A. The management of childhood urinary incontinence. Pediatr Nephrol (2015) 30:41-50

Vasconcelos M, East P, Blanco et al. Early behavioral risks for childhood and adolescent daytime urinary incontinence and nocturnal enuresis. J Behav Pediatric. 2017; 38 (9): 736-42

Von Gontard A, Kutwertz-Bröking. The diagnosis and treatment of enuresis and functional daytime incontinence. Dtsch Arztebl Int 2019; 116 279-85

The Benefits of Pilates While Healing Diastasis Recti

Ta facilitation pic

Kierstin Elliot

Almost all postpartum women experience some degree of diastasis recti, or separation of the rectus abdominis or 6 pack muscles. Think about it, your abdomen is stretching continuously for a solid nine months! Something’s got to give. The linea alba (line of connective tissue that splits your rectus abdominus right down the middle) separates as a result of a growing baby. On some women, this separation naturally heals itself within the first year postpartum. In other women, the separation is so severe that they need a little extra attention and care to fuse their rectus abdominis back together again.

Once you’ve given yourself enough time to heal the inflamed tissues from giving birth, usually about 6-8 weeks, then you can start implementing some basic Pilates principles into your routine. Drawing attention to the breath, the transversus abdominus (TA), and the pelvic floor without creating excess pressure throughout your system, will be essential while moving towards healing your diastasis.

Connecting to your breath and your TA should be the first step. Deep three-dimensional inhalation to the back of the ribs and mindful exhalation, tapping into the TA will be crucial. During the exhale you should feel as if your abdomen is hugging or wrapping around your waist like a belt. This is TA activation. Once you’ve established the TA activation, focus on drawing your bottom ribs towards your naval and narrowing your ASIS (hip bones) towards each other. Imagine a drawstring; when you pull the drawstring, the opening of whatever object you’re trying to close, draws together from all sides evenly. That is the effect we are trying to create with the abdomen. Visualize your naval as the center of the opening and your exhalation pulling the drawstring closed.

Once you’ve mastered connecting breath to the TA, shift your focus to the pelvic floor. The easiest way to achieve this is by lying on your back with a neutral pelvis with knees bent and feet flat on the floor. Visualize the tailbone unfurling and your sits bones widening as you inhale allowing the pelvic floor to gently stretch and relax. On the exhale, as you engage the TA and obliques, feel the pelvic floor tighten slightly and if appropriate (after a pelvic floor check from your PT) find a kegel. The ultimate goal is to be able to contract and release your pelvic floor without any problems. After practicing this breathing exercise every day for about 8-10 reps, you should start to feel stronger throughout your core and find some closure or firmness in the linea alba.

This first step is HUGE. After 2-3 weeks of consistent breath work and core activation, layering more extensive exercises will become safe and accessible. Keep in mind that it is not wise to go from zero to one hundred, but rather continue to build and progress slowly. It may feel tedious, but I can’t stress enough how imperative it is to lay this foundation and rebuild your core after birth. Once you feel you’ve made considerable progress with breath work, add in marches (leg lifts) targeting lower abdominal stabilizers and add in a side lying series to challenge pelvic and core stability while also strengthening glutes. Try a side plank starting on knees and then progressing to feet. Any exercise in quadruped is a safe bet that targets shoulder stability, core, glutes, and hamstrings!

One thing to note is that women with more severe cases of diastasis should avoid abdominal curls, rollups, or flexion of the rectus abdominis until there’s been a considerable amount of progress with the deeper core muscles. If you fall under this category and constantly wonder if you’ll ever close your diastasis, yes! You can! And you will if you dedicate the attention and mindfulness to connecting to your body. Think you’re doing everything right, but still feel like no progress is being made? Feel free to book a session with me at Beyond Basics Physical Therapy! I’d be more than happy to help you out on closing your diastasis and transitioning you back into the wonderful world of pilates 🙂

A Holiday Gift for You! BBPT is Offering Free Consults for People Living in the Greater NYC Area!

Group Serious 2

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!

All the best,

Beyond Basics Physical Therapy

212-354-2622 (42nd Street Location)

212-267-0240 (William Street Location)

PH101: Potty Issues with Kiddos

Fiona McMahon PT, DPT

Did you know kids can suffer from pelvic floor dysfunction too? Pelvic floor dysfunction in children can result in pain, bladder holding or constipation, embarrassing soiling accidents, frequent nighttime accidents, as well as trouble going potty. For most kids, there is an underlying physical component that needs to be addressed by an expert pediatric pelvic floor physical therapist.

It is very upsetting for a parent, guardian or caregiver to see a child suffer with pain or embarrassment, but there is so much that can be done to help out children with these issues. We use positive charts to develop short term and achievable goals to reinforce  behaviors and steps towards healthy toileting. Simple techniques like improving toilet posture, practicing deep breathing with bubbles, using a timer to assist in times voiding, educating the parent/guardian/caregiver on the colon massage, developing a core stability and stretching program, and more can go a long way towards improving bowel and bladder symptoms.

If your child is suffering from urinary or fecal accidents, bed wetting, skidmarks, or painful defecation, join me on  May 2nd at 7pm , to discuss pelvic floor dysfunction in children, common conditions affecting pottying, and practical tips you can use to make potty time easier.

This is our last Pelvic Health 101 class of the spring series. We want to thank for an awesome season! Keep your eyes on the blog for the Fall’s PH101 classes!

RSVP here

 

To Learn More Today, Check out our other blogs on the pediatric pelvic floor!

The Scoop When Kids Have Trouble with Poop

Pediatric Bowel Part II: How to Make Pooping Easier for your Kiddo

Pelvic Health 101 Spring 2018 (2)

 

Beyond Basics is Visting Brooklyn!!!!

Brooklyn

 

Fiona McMahon PT, DPT

Have you got pelvic floor questions? Have you desperately wanted to go to one of our PH101 classes, but can’t swing 7pm in midtown in the middle of the week? Well, I have great news and GREATER news. I know, right… how much great news can you handle? The first bit of awesome, is that Beyond Basics’ Physical Therapists’, Dr. Fiona McMahon and Dr. Sarah Paplanus are hosting a forum and open discussion on pelvic floor health and treatment on Saturday, April 28th at The Floor on Atlantic (310 Atlantic Avenue in Brooklyn) at 12 noon. We will be there to explain the ins and outs of the pelvic floor, what can go wrong with it, and best yet, how you can heal it. It is a must go to event. RSVP here. Also, it’s FREE!

So what’s the other news, Fiona? Well, it’s that although we are not in Brooklyn, we have opened another office just across the river from Brooklyn, Beyond Basics Physical Therapy Downtown. In enlarging our footprint we hope to expand access and convenience to patients living downtown and in Brooklyn. We will be hosting a Grand Opening and 15 year anniversary celebration at our new location: 156 William St, Suite 800 New York, NY 10038 on Thursday, April, 26th from 4pm – 7pm. Come and enjoy food, drinks and meet our Physical Therapists. RSVP here.