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)

The Special Care Needs of the LGBTQ+ Community

Happy Pride Month!!!!

We are reposting an old post broadly discussing the LGBTQ+ community, with special focus on transgender individuals. Please keep checking back as we continue to discuss specific issues relating to the care of the LGBTQ+ community.  

Amy Stein PT, DPT and Fiona McMahon PT, DPT

rainbow flag

Who are LGBTQ+ individuals?

At Beyond Basics Physical Therapy, we have been meeting and studying with experts about the LGBTQ + community. LGBTQ+ refers to individuals who do not identify as heterosexual or do not identify as cis- gendered (although these two categories are not mutually exclusive). Cis-gender means you identify with the genital anatomy you were born with. People who belong to the LGBTQ+ community can be cis-gendered (meaning they identify with the genital anatomy that they were born with) and be gay/lesbian/ bisexual/ questioning etc.  They can be trans-gender and heterosexual or some combination thereof. Basically LGBTQ+ is a term that includes people who are not both cis-gender and heterosexual. LGBTQ+ is an acronym for lesbian, gay, bisexual, transgender, queer/questioning, and other individuals.  

Never Assume. Listen, Ask.

We were excited to understand and learn more about how we can help, specifically with patients experiencing pain or weakness in the pelvic floor. We met with an LGBTQ + advocate and he recommended the following when it comes to treating patients both within and outside the LGBTQ+ community.  First rule of thumb:  with all patients, don’t assume and be open to any questions or discussion. Ask if your patient would like you to stay away from certain terms regarding their anatomy, as well as their preferred gender pronoun. Use language that they want us to use.

 As with all patients, we need to use a biopsychosocial approach. With any patient, Richard Green at Bellevue hospital says that we always want to know exactly what is going on with our patient. We must subjectively understand why they are visiting us.  Has there been trauma, surgery, complications, or anything that has worsened their symptoms? What hormones and medications are they on? Don’t single anyone out. These questions are important for every patient.  

We want to get the medical and surgical history during or prior to the visit. There is no standard one surgical procedure or hormonal protocol in trans care. Hormones, either testosterone, estrogen, lupron, puberty blocking, testosterone suppressing can be used in many patients, but are also used specifically to aid in transition in transgender patients. Many hormones have consequences or side effects and our patients need be educated on the various options.  There is research on hormones and bodily changes, however there is no good research on how the hormones affect the pelvic region. Anti-estrogen hormones may result in vaginal drying and atrophy, more tissue tearing, and pain with penetration.  Endometriosis can be worsened with testosterone hormones.  Hormones can be administered via injection, pellets, patches, creams, gels, and pill form.  It’s important to realize side effects and risks of hormones for each patient. Dosage depends on body type, weight, previous surgeries, etc.  Hormone therapy can be given by a primary care provider or endocrinologist; however, many are not familiar with a specific protocol but at the same time each person may have different goals.  Progression of hormones can be monitored for each patient and according to patients wants and needs.  

For those who opt for surgical transition, it can result in pelvic pain and or weakness as organs are moved and or removed. Like we mentioned before, there is no one surgical protocol and it will vary from surgeon to surgeon, from changes in hormones from the removal of certain organs.  Knowing what tissues have been removed or moved and or where scar tissue could have been formed, is important to addressing a patient’s complaints. Also, it’s important to ask if the patient was having these symptoms or pain prior to any of the surgeries or hormonal medications. Surgical transition can take a long time with various surgeries and various symptoms that arise throughout. Some issues that  can occur are fistulas or fissures and when dealing with nerve implants there could be nerve damage and restrictions.

 

How is care for the LGBTQ+ community funded and regulated?

Medical coverage for the LGBTQ + community is non-regulated and different in each state. The Affordable Care Act, (ACA) covers some therapies and surgeries. You can try to appeal with each insurance which have their own policies on gender affirming care.

How can physical therapy help?

At Beyond Basics Physical Therapy, we specialize in abdomino-pelvic disorders, including pain, weakness, bladder, bowel and sexual dysfunction.  We also specialize in orthopedics and functional manual therapy.  We treat the LGBTQ+ community and we welcome any questions at desk@beyondbasicspt.com or call 212-354-2622. We are happy to help and look forward to hearing from you!
Resources: Center of excellence for transgender health.

WPATH center for care Endocrine Society

  • speaks on hormone therapy (however some information may be out of date).

 Adolescent Health Center

Building a strong foundation – Treating the pelvic floor in individuals with multiple sclerosis

By: Kaitlyn Parrotte, PT, DPT, OCS, CFMT

MS

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is an “immune-mediated” disease, in which the body’s immune system attacks the central nervous system (1).  The cause is unknown. MS is characterized by injuries (plaques) of the myelin, which is a fatty substance that surrounds and insulates the nerve fibers; nerve fibers themselves may also be attacked. The damaged myelin forms scar tissue that is called “sclerosis,” which is how the disease was named (1,2).  When the myelin, or nerve fibers, are damaged or destroyed at any point on the neural pathway, nerve impulses that are traveling between the brain, spinal cord and the body are interrupted, and as a result, can create a variety of symptoms.(1)

Symptoms:

The more common symptoms seen in individuals with MS are:

  • Fatigue
  • Numbness or tingling
  • Weakness
  • Dizziness or Vertigo
  • Sexual Problems
  • Pain
  • Emotional changes
  • Walking difficulties
  • Spasticity
  • Vision problems
  • Bladder problems
  • Bowel problems
  • Cognitive changes
  • Depression(1)

Types of MS:

There are four disease courses that have been identified in multiple sclerosis:

  • Clinically Isolated Syndrome (CIS) – a first episode of neurologic symptoms in the central nervous system, which lasts at least 24 hours.(1)
  • Relapsing-remitting MS (RMSS) – the most common form of the disease, that is characterized by clearly defined episodes of new or increasing neurologic symptoms (relapses), followed by periods of partial or complete recovery (remissions).(1)
  • Primary progressive MS (PPMS) – characterized by a gradual worsening of neurologic function, from the onset of symptoms, without any relapses or remissions.(1)
  • Secondary progressive MS (SPMS) – follows a course of MS that is initially relapsing-remitting. Most people with RMSS will eventually transition into a secondary progressive course, which is when their neurologic function will gradually worsen over time.(1)

Treatment of MS:

Because of the complex nature of this condition, and because it is not a curable disease, the management of MS requires comprehensive care. One component of that care is physical therapy. A physical therapist will evaluate and address the body’s ability to move and function. Common physical therapy interventions frequently address walking and mobility, strength, balance, posture, fatigue, and pain. However, did you know that physical therapy can also treat issues with bowel, bladder, and sexual dysfunction(1)? These dysfunctions are addressed through treating the pelvic floor musculature and surrounding tissues, which is performed by specially trained clinicians, such as the physical therapists at Beyond Basics Physical Therapy.

 

Bowel Dysfunction:

As previously noted, patients with MS can have various symptoms, including symptoms related to pelvic floor dysfunction, such as bladder, bowel, and/or sexual dysfunction. According to one study from 2016, individuals with MS can have lower anal sphincter pressure (which limits their ability to control stool flow), as well as higher rectal sensitivity (which makes it more difficult for a person to appropriately recognize when they need to defecate). These can increase the occurrence of fecal incontinence (involuntary leakage of stool), as adequate muscle strength and tone are needed to prevent leakage, and appropriate urge is required to ensure a person can get to the bathroom when they actually need to go (3) Even in the constipated individual with MS, there is a decrease in anal sphincter tone, which results in poor muscle coordination, making the release of stool more challenging (3) With these individuals, pelvic floor relaxation is typically needed to allow for easier and complete emptying and to decrease symptoms of bowel urgency.

Several studies from the late 1990s and early 2000s have looked at using biofeedback to help retrain muscle coordination. Biofeedback was applied in two ways: through stick-on electrodes that measured the response of muscles surrounding the anus, and with feedback applied internally in the rectum, with a finger, rental sensor or balloon. With stick-on electrodes, individuals are typically connected to a machine that allows them to see the electrical activity of their muscles, so they can work on controlling them (contract or relax). With internal feedback through a therapist’s gloved finger, with a rectal sensor or balloon, individuals can improve muscle control through gaining better awareness of their pelvic floor muscles. Researchers found that the use of biofeedback yielded some improvement in patient reported disability for those experiencing either constipation or fecal incontinence (4,5).  Physical therapy treatments to address muscle coordination and sensitivity can be helpful to treat those experiencing constipation or fecal incontinence related to MS; however, more research is needed to help enhance care.

Urinary Dysfunction:

As MS impacts the nerve signal transmission along nerve channels, urinary dysfunction frequently occurs (6) The most common urinary disorder seen in this population is urinary incontinence, which is involuntary leakage of urine. Urinary incontinence is related to fatigue and uncoordinated muscle recruitment, which are characteristic of MS, and can have a significant impact on an individual’s quality of life(2) Another common diagnosis is overactive bladder, which interrupts bladder function and causes a sudden need to urinate(6). This may occur, at least in part, due to hyperactive muscles in the pelvic floor that have become too short and tight over time.

Many groups have looked at the impact of physical therapy to directly address weaknesses that develop in the pelvic floor, and are related to urinary dysfunction (6,7) Two separate articles published in 2016 looked at groups of women with MS, and split them into groups to undergo pelvic floor muscle training with and without some form of electrical stimulation. The emphasis of this intervention was to train the pelvic floor muscles how to activate without compensation from surrounding muscles, over the course of several months (6,7) By the end of one study, women in both groups demonstrated increased pelvic floor strength and endurance, decreased symptoms of overactive bladder, and decreased anxiety and depression (6). In the other study, all three groups exhibited a decrease in pad weight, which measured the amount of urinary leakage, as well as decreased frequency of urgency and urge incontinence episodes(7). This research is showing that direct treatment to the pelvic floor muscles help to decrease urinary symptoms in people with MS, as muscle strength and endurance are increased.

Sexual Dysfunction:

Sexual dysfunction is also common in individuals with MS (affecting 40%-80%)(8). Sexual arousal begins in the nervous system with the brain sending signals through the spinal cord and nerves to the sexual organs. These pathways can become damaged due to the effects of MS on the nervous system, which in turn impacts a person’s sexual response or sensation. Symptoms of this may manifest as difficulty achieving orgasm or loss of libido, as well as erectile dysfunction in men, and altered clitoral/vaginal sensation or vaginal dryness in women (9). Other symptoms of MS, such as fatigue, muscle weakness, and spasticity also negatively impact sexual response in this population (8).

Pelvic floor muscles are responsible for rhythmical involuntary contractions during orgasm. These contractions occur when sensory information travels through nerves to these muscles. Continued, uninterrupted stimulation may allow for sexual arousal to progress and build up to a maximum point. Once this point is reached, the pelvic floor muscles, which have been gradually becoming tighter and tighter, get even tighter, hold this tension momentarily, and then release all tension; this is an orgasm (10). Through various research, it has been shown that weak pelvic floor muscles can lead to a decrease in orgasm and arousal (8) and specific pelvic floor muscle strengthening can help improve sexual function, especially in females (11,12,13).

One study that looks at MS-related sexual dysfunction is a 2014 article published in the Multiple Sclerosis Journal. This article took 20 women diagnosed with relapsing-remitting MS, and divided them into three treatment groups: pelvic floor muscle training alone, pelvic floor muscle training with intravaginal electrical stimulation, and pelvic floor muscle training with electrical stimulation applied over a nerve in the leg. The pelvic floor muscle training in each group consisted of teaching each participant how to contract her pelvic floor without using surrounding muscles as a compensation, and then performing both fast and slow contractions, over twelve weeks of treatments. After the twelve weeks of treatment, individuals in all three groups demonstrated significant improvements in muscle power, endurance, and fast contractions of the pelvic floor. They also reported an increase in the total score, as well as the arousal, lubrication, and satisfaction subscores, of the Female Sexual Function Index.8 What this study has shown is, in women with MS, physical therapy can help to treat sexual dysfunction by enhancing muscle response and activity in the pelvic floor.

Conclusion:

All bowel, bladder, and sexual function rely in part on strong and flexible muscles in the pelvic floor. With Multiple Sclerosis, these muscles tend to lose either mobility and then strength, and/or muscle tone and coordination. Either way, the loss of efficient tissue tension, coordination, and strength, makes the performance of these important functions much more challenging. While various medications or other interventions, may also be necessary to help individuals with MS manage their symptoms, physical therapy has been proven to be an important part of the healthcare team. Here at Beyond Basics Physical Therapy, all our clinicians have specialized training to evaluate and treat the pelvic floor, so each one of us is in a strong position to help you manage these symptoms and improve function! Feel free to contact our office at 212-354-2622, or visit our website (www.beyondbasicsphysicaltherapy.com) for more information!

Sources:

  1. National Multiple Sclerosis Society. https://www.nationalmssociety.org
  2. de Abreu Pereira CM, Castiglione M, Kasawara KT. “Effects of Physiotherapy Treatment for Urinary Incontinence in Patient with Multiple Sclerosis.” Journal of Physical Therapy Science 2017; 29(7): 1259–1263.
  3. Marola S, Ferrarese A, Gibin E, et al. “Anal Sphincter Dysfunction in Multiple Sclerosis: An Observation Manometric Study.” Open Medicine 2016; 11(1): 509–517.
  4. Chiotakakou-Faliakou E, Kamm MA, Roy AJ, et al. Biofeedback provides long-term benefit for patients with intractable, slow and normal transit constipation. Gut 1998;42:517–21.
  5. Wiesel PH, Norton C, Roy AJ, et al. Gut focused behavioural treatment (biofeedback) for constipation and faecal incontinence in multiple sclerosis. J Neurol Neurosurg Psychiatry 2000;69:240–243.
  6. Ferreira, Ana Paula Silva, et al. “Impact of a Pelvic Floor Training Program Among Women with Multiple Sclerosis.” American Journal of Physical Medicine & Rehabilitation 2016; 95(1): 1–8.
  7. Lúcio A, Dʼancona CA, Perissinotto MC, et al. “Pelvic Floor Muscle Training With and Without Electrical Stimulation in the Treatment of Lower Urinary Tract Symptoms in Women With Multiple Sclerosis.”Journal of Wound, Ostomy and Continence Nursing 2016; 43(4): 414–419.
  8. Lúcio AC, D’Ancona CA, Lopes MH, et al. “The Effect of Pelvic Floor Muscle Training Alone or in Combination with Electrostimulation in the Treatment of Sexual Dysfunction in Women with Multiple Sclerosis.” Multiple Sclerosis Journal 2014; 2 (13): 1761–1768.
  9. “Sexual Problems.” National Multiple Sclerosis Society, http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Sexual-Dysfunction.
  10. Lowentein L, Gruenwald I, Gartman I, et al. Can stronger pelvic muscle floor improve secual function? Int Urogynecol J 2010; 21: 553-556.
  11. Bo K, Talseth T, Vinsnes A (2000) Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women. Acta Obstet Gynecol Scand 79(7):598–603
  12. Beji NK, Yalcin O, Erkan HA (2003) The effect of pelvic floor training on sexual function of treated patients. International urogynecology journal and pelvic floor dysfunction 14(4):234–238
  13. Zahariou AG, Karamouti MV, Papaioannou PD (2008) Pelvic floor muscle training improves sexual function of women with stress urinary incontinence. International urogynecology journal and pelvic floor dysfunction 19(3):401–406.

Pelvic Health 101 is back and with BRAND NEW COURSES

Fiona McMahon PT, DPT

Our Pelvic Health 101 courses are back! For those of you not in the know about our courses, they are informational sessions provided by top experts in the field of pelvic pain and pelvic function. These courses allow you to dive more deeply into topics such as bowel, bladder and sexual function and dysfunction, pelvic and genital pain, childbirth, diet, issues with kiddos, and much more.

This year we added a Gent’s Only Session to be a companion to our Ladies only session to help answer some of the specific questions you may have about pelvic floor function as it relates to sexual health, bladder and bowel health, as well as pain.

Our first class is “PH101: Something’s Wrong with my What?”, where our own Stephanie Stamas,will be going through the basics of anatomy of the pelvic floor, what can go wrong and how we can fix it. Our first class is on March 7th at 7pm. Register here: pelvichealth101.eventbrite.com, to reserve your spot. Our classes are extremely popular so make sure you register well ahead of time.

Check out

Location:

110 East 42nd St, Suite 1504

New York, NY

10017

Check out all the upcoming classes here:

Pelvic Health 101 Spring 2018 (2)

Marathon Update: Shaving Time off my Race with Physical Therapy and Doing Good in the Name of Multiple Sclerosis Research

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Fiona McMahon PT, DPT

Hi everyone! It’s Fiona from BBPT. I am writing the day after the 2017 NYC Marathon sore, tired, but happy. It was a great training season, in which I pushed myself harder than I had before and had a great physical therapist, Jessica Babich PT, DPT looking after me the whole way.

Let’s not bury the lead any further. As of today, we managed to raise over $3,500 to support research for multiple sclerosis (MS) through NYC Team Tisch MS and as a group Team Tisch raised over $100,000 dollars to further the goal of making TISCH MS history.

finish timeALSO…. physical therapy definitely payed off. I shaved over 17 minutes my last NYC marathon in 2013, going from a time of 4 hours 0 minutes and 4 seconds, to 3 hours 43 minutes and 2 seconds. Not only was it a personal record for the course, but it was 8 minutes faster than my previous all time best at Sugarloaf in 2011.

This was my first time getting physical therapy during training for a race, rather than having to turn to it when some type of disaster struck, be it a rolled ankle, irritable knee, etc. This is the first time I’ve had someone care not only about my core, but whether or not it engaged when it was supposed to.

I would advise anyone who is considering engaging in an athletic endeavor, especially a new one, or when competing in a sport for time, to strongly consider getting an experienced physical therapist with expert skills in manual therapy and a keen eye for function. They can evaluate problem spots from head to toe (literally, in my case, Jessica worked on both my neck and ankles). They can help you tailor your training to get the most out of your exercises to allow you to perform at higher levels. Jessica kept me healthy and motivated, and her work allowed me to train safely and effectively at an intensity I hadn’t yet explored independently.

Thank you all for your support. If you still care to donate you still can here.

If you think you would benefit from PT at Beyond Basics, click here or call today.

Navigating Life with Chronic Pain: Part II

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Fiona McMahon, PT, DPT

Welcome back to our discussion on chronic pain. In our last blog we discussed why one might experience chronic pain and some common missteps and pitfalls that have occurred in our understanding of chronic pain. If you haven’t yet read part one of this blog, I highly recommend checking it out first so you can get the most out of this post. Click here to read it now.

For chronic pain we have drugs, surgery, mental health therapy, physical therapy, and what is called complementary alternative medicine (CAM), which includes modalities like yoga, acupuncture, and mindfulness meditation. We discussed earlier about how some opiods may actually be harmful in treating chronic pain. Unnecessary surgery can also have risks of actually increasing pain post surgically, because it can change the brain’s sensitivity to pain. Because, for most musculoskeletal conditions, a course of conservative treatment is recommended for a period of time before turning to surgery, we will focus on non-surgical, and non medical approaches to chronic pain.

Before we dive into specific treatments, let’s talk about what puts a person at risk for chronic pain. We can divide these risks into modifiable and non modifiable risks. Non modifiable risks are situations or characteristics about ourselves that we can not change. They include socioeconomic status, where you live or have lived, cultural background and genetic factors. Unfortunately, we can’t change these things, but things like alcohol intake, nutrition, and obesity are all things we can change and have been generally understood as modifiable risk factors for chronic pain. Now that we have that in mind, let’s explore different approaches for the management of chronic pain.

 

Mindfulness Practice as Pain Management

Have you tried mindfulness practice? I ask this question a lot. When I ask it, I am careful to frame it in a way that does not give the patient the impression that I think their pain is all in their head, but rather, I try and present it as part of an adjunct to the current physical therapy treatment they are receiving from myself or any of the other PT’s at Beyond Basics Physical Therapy, and any other medical intervention they may be receiving.

Mindfulness and mindfulness meditation are somewhat based on eastern meditation practices.  Not all mindfulness programs are the same, but the basic premise is to allow  the participant to to observe their thoughts, feelings, sensations, and attitudes without judgement. Giving them the opportunity to reframe their thoughts in a positive manner.

It may sound like a small change, but research is really starting to bear out that changing your frame of mind about pain can have some very real results. In a meta-analysis done by Hilton  and colleagues, mindfulness programs were found to have statistically significant positive results on pain, depression, and quality of life.

There are a lot of ways you can incorporate mindfulness into your day to day life. Apps for your phone are really helpful. I recommend both Calm and Headspace. I personally like Calm a bit better, but both are excellent. Headspace is a good starter because it breaks up meditation into more digestible nuggets, which can be a good way to start your meditation practice. Calm, as the name implies, is more soothing.  There are also guided classes you can attend in your area if that’s more up to your speed.

Be patient with mindfulness, I definitely suggest giving it the old college try. Stick with it for a week or two. If it isn’t for you, that’s perfectly okay. It’s not a moral failing, or a psychological one it’s definitely a case of different strokes for different folks.

Psychological Intervention

In a study performed by Macrae and colleagues, it was found that patients who engaged in catastrophizing type behaviors experience post surgical pain at a significantly higher rate. Catastrophizing is envisioning a situation to be far worse than it actually is. A good example for this blog would be a patient with low back pain, jumping to the conclusion that her back pain will prevent her from being able to work and she would end up on the street, secondary to her her lack of ability to secure an income. Although this is a possibility, it really isn’t a realistic one and it fails to entertain the possibility of the back pain remaining stable or getting better.

Mindfulness meditation can help with catastrophizing behaviors, but sometimes you need a little extra help. Psychological interventions, like talk therapy and cognitive behavioral therapy, can help you get a handle on these thoughts and address your current loss of function, secondary to pain in a more productive manner. Cognitive behavioral therapy as well as other forms of therapy have shown improvement in pain symptoms and quality of life in adults, and has shown even more robust effects in children.

Acupuncture

Acupuncture is an ancient form of eastern medicine that is gaining a stronger and stronger foothold in the States. It has been shown to be effective in managing a number of conditions, and chronic pain is no different. Reviews of acupuncture in the scientific literature have found that acupuncture can improve pain and function. The same review found that electroacupuncture had even more robust results for pain and stiffness.

Yoga

Yoga is super hip right now. In fact it now has its own international day on June 21st of each year. It does for good reason. A consistent and solid yoga program has been shown to improve conditions such as low back pain, myofascial pain syndrome, fibromyalgia syndrome, osteo- and rheumatoid arthritis. It can be a great option to continue to add consistent exercise and pain management into your life.

Physical Therapy and Exercise

Exercise is good for you, even if you have chronic pain. The old way of thinking was to put someone on days of bedrest when they have chronic pain. No more. Evidence has shown gentle movement progressing into more functional training can really help with chronic pain. In fact the National Institute for Healthcare Excellence’s (NICE)  osteoarthritis  guideline is  “exercise should be a core treatment… irrespective of age, comorbidity, pain severity and disability. Exercise should include: local muscle strengthening [and] general aerobic fitness”(NICE 2014) . Geneen and colleagues found in their review and meta-analysis of the current literature that just receiving the advice to exercise alone, is not sufficient to produce improvements in pain scales. That’s where the professionals like physical therapists come in, PTs have the knowledge and expertise to prescribe exercise that is not only safe and functional, but hopefully kind of fun. PTs also can diagnose and treat issues such as tissues with reduced mobility and poor alignment to ensure you get the most out of your exercise.

Data show that a prescribed and monitored exercise program by a physical therapist can have good effects on pain symptoms and can help facilitate the production of your body’s own natural painkillers.  Additionally exercise can help individuals lose weight, which can reduce the pressure on one’s  joints and further improve pain.

Aside from exercise and hands on work, we can use modalities like kinesio tape at physical therapy. Kinesiotape has been shown to improve not only pain, but decrease trigger points, improve range of motion and improve disability rates in individuals suffering with myofascial pain syndrome.

Conclusion

Chronic pain is complex. Rarely is there a silver bullet that will cure it. Treatment requires a multidisciplinary approach, which has been shown to be more effective than traditional treatment alone. Start small, where you feel comfortable when adding something new into your treatment approach. You will find what works best for you. A good place to start is here at Beyond Basics. Our staff not only has the expertise to treat you from a physical therapy perspective, they also have the ability to guide you towards other traditional and complementary treatments/practitioners that can help you reach your goal. Your treatment for chronic pain does not have to be and should not be passive, please call and make an appointment today to start your journey.  

 

Sources:

 

Achilefu A, Joshi K, Meier M. et al. Yoga and other meditative movement therapies to reduce chronic pain. J Okla State Med Assoc. 2017;110(1):14-16

 

Andersen T, Vægter H. A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls. Clin Pract Epidemiol Ment Health. 2016;12: 49-58

 

Ay S, Konak H, Evick D, et al. The effectiveness of kinesio taping on pain and disability in cervical myofascial pain syndrome. Rev Bras Reumatol. 2017; 57(2) 93-9

 

Eccleston C, Crombez G. Advancing psychological therapies for chronic pain [version 1]; referees: 2 approved]. F1000 Faculty Rev. 2017

 

Geneen L, Moore R, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews ( Review).  Cochrane Database Syst Rev 2017; 4

 

Hilton, L, Hempe; S, Ewing B. Mindfulness Meditation for Chronic Pain: Systematic review and meta-analysis. Ann Behav Med. 2017. 51:199-213

 

Kamper S, Apeldoorn A, Chiarotto A, et Al. Multidisciplinary biopsychosocial rehabilitation for chronic pain ( review). Cochrane Database Syst Rev. 2014; 9.

 

Macrae W. Chronic post-surgical pain: 10 years on. Br J Anaesth 2008;101: 77-86

 

Mayer F, Scharhag-Rosenberger F, Carlsohn A. The intensity and effects of strength training in the elderly.  Dtsch Arztebl Int 2011; 108(21):359-64

 

Neira S, Marques A, Pérez I. Effectiveness of aquatic therapy vs land based therapy for balance and pain in women with fibromyalgia: a study protocol for a randomized trial. BMC Musculoskelet Disord. 2017; 18(22)

 

Perry R, Leach V, Davies P, et al. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Sytematic Reviews. 2017. 6(97)

 

Saxena R, Gupta M, Shankar N, et al. Effect of yogic intervention on pain scores and quality of life in females with chronic pelvic pain. Int J Yoga. 2017. 10(1): 9-15

 

Singh P, Chaturvedi A. Complementary and Alternative Medicine in Cancer Pain Management: A Systematic Review. Indian J Palliat Care. 2015. 21(1): 105-15

 

     

 

The Day in the Life….of a Working Mom Who Loves What She Does and Would do Anything for her Family

By, Amy Stein, DPT (Founder and owner of Beyond Basics Physical Therapy; President of the International Pelvic Pain Society; Author of award-winning book: Heal Pelvic 

Amy was presenting on the benefits of physical therapy in individuals with Multiple Sclerosis(MS) . In addition to our educational outreach, we are collecting money for NYC’s TISCH ‘s MS research arm through the New York City Marathon. Please Click here to donate.  

amy2016I had an amazing, and thank goodness a positive spin during and after my talk at the TISCH Multiple Sclerosis Patient Summit on Sunday. Thank you to Dr. Sadiq, Dr. Kanter, Dr. Williams and Pamela Levin for the invitation to share my expertise. I was so honored and felt blessed to be asked to speak at this conference. There were 1,200 people registered…..no pressure! And when I walked in prior to my talk, I saw the below photos on three HUGE screens! Again, no pressure. I practiced my breathing and my confidence building. Jessica Babich, DPT met me there to set up our table. She was a huge help, considering they wanted me to mic up right away.

I had practiced the material quite a bit so felt confident that it would go well…..and it did! I ran through everything in the 20 minutes I had and then had tons of questions after, of which I could only answer 4 in the time allotted.

A couple questions:

1. Does pelvic PT still work/can it be beneficial while a person is getting botox into the bladder?

Most definitely if the pelvic floor muscles are involved.

2. Does bladder frequency change when you have MS?

It shouldn’t change too much. If it does, as  pelvic physical therapists, we teach you strategies to manage this.

3. How often should you go to the bathroom at night if you have MS?

I am not sure there are any studies on this, but I would say no more than 2 times. We give our patients strategies to help with nighttime frequency as well.

After the Q and A, I felt like I was on cloud nine, because I gave a lot of great info in a short period of time….I sat down, and picked up my phone to take photos and noticed 2 missed calls and multiple texts from my sitter and a friend (my husband was away on a motorcycle trip). I thought….uh oh, because it had only been 30 minutes. Sure enough, the call that all mothers expect at some point, but hope it never happens….My son, Zachary had fallen off the jungle gym and it looked like he needed stitches. Thank goodness for babysitters and good friends! I explained the situation to a few colleagues from TISCH and praised Jessica at her awesomeness for taking charge, and I left immediately. My boy was a champ, and didn’t cry, even when he got the 8 stitches in his head….as I almost passed out!

In the end, amazing meeting and opportunity, and a strong and brave boy. What could a working mom ask for! I count my blessings every day!

J babs and Amy Stein
Jessica Babich and Amy Stein
Screens
These are the big screens I was talking about!
Zacary and Zoe
My Kids, Zachary and