Spring Pelvic Health 101 is Coming

Fiona McMahon, DPT, PT

Pelvic Health 101 is back with some old favorites like, “Something’s wrong with my what?” and “Why is pooping so difficult?” We have also added a new course on pediatric pelvic floor issues.

If you have questions, we have answers. Join us for lectures and question and answer opportunities with expert pelvic health physical therapists, childbirth educators, and nutritionists. Please reserve your spot early at pelvichealth-101.eventbrite.com. Remember spots fill up quickly. As always, light refreshments will be served.

pelvic-health-101-spring-2017

BBPT Health Tip: HOT or COLD? That is the Question

bigstock-illustration-of-thermometers-w-49787687

Fiona McMahon, DPT.

 

What’s better, heat or ice? This is a question that most medical/health type professionals get all the time. The answer is, it depends. Both have fabulous benefits for different sets of circumstances. Let’s explore these cheap, safe and effective pain relievers.

Heat

In the biz, ( no one calls physical therapy “the biz” yet, but if I try hard enough, it may stick) we call heat, thermotherapy. Fancy, right? Thermotherapy is great for pain that is a result of a trigger point, or muscle spasm. Think deep neck, back pain, or pelvic pain. It’s great for menstrual cramps and can  create a nice soothing effect.

For any active inflammation or infection however, heat can be harmful and can actually make it worse. You do not want to place heat over joints affected by autoimmune disease like rheumatoid arthritis. It’s also not good for new, fresh injuries, like a muscle strain or a injury from a fall. Heat is really good for chronic long standing pain conditions.

Heat comes in types, dry and moist. Dry is the kind that’s emitted from like an electric heating pad or a microwaved heating pad. Sometimes people may find that dry heat, dries out the skin. Moist heat comes from things like moist towels or moist heating pads (these are the kind we use in our clinic). Moist heat tends to penetrate deeper into the muscles.  

 

Safety Considerations for Heat:

  1. Don’t over heat. Sounds simple, but in the throes of severe pain, many people may find themselves with the more is better mantra.  It’s not.
  2. Don’t apply to open wounds, on individuals with peripheral vascular disease, deep vein thrombosis, or on people with reduced sensation or ability to remove the hot pack.

 

Cold

Physical therapists have a fancy name for this one too. It’s cryotherapy. Sounds super futuristic doesn’t it? Ice is awesome. It really is. It is great for acute (recent) injuries like a sprain or a strain. There are actually studies that show that ice within 36 hours of injury speeds recovery better than heat. Ice can reduce pain in the area it is applied, reduce guarding and spasm, and reduce swelling.

 

Safety Considerations for Cold:

  1. Never use on people with reduced sensation, ie. Raynauds, actively healing wounds, circulatory issues, or hypertension
  2. Less is more. Keep cold packs on for 20-30 minutes once every 2 hours on newly injured body parts. Keeping the ice pack on for longer can cause increased blood flow to the area which will reduce the helpful effects of the ice.

When in doubt as to if you should use cryotherapy or thermotherapy, consult with your physical therapist or healthcare provider.  At Beyond Basics we treat injuries beyond those to the pelvic floor and we can help with your injury questions. You can also find a physical therapist with the APTA’s PT finder tool

BBPT Health Tips: Let’s Roll!

Fiona McMahon DPT,

Foam rolling. I certainly have a love hate relationship with my foam roller. My IT bands (the tissue on the side of your leg) hate it, but I love how it keeps my knees and joints happy. Foam rolling is a method to release knots in muscle and improve the mobility of tight muscles and joints. If you are a gym rat, runner, or athlete of any kind, consider giving foam rolling a try. In a review published in the International Journal of Sports Physical Therapy in 2015, foam rolling was shown to reduces delayed onset muscle soreness (DOMS), and temporarily increase range of motion.

First of choose your weapon…. I mean roller.

 

White roller: Great for starters: gentle, but can deform over time because it is softer.

white-foam-roller

foamroller6x36fsBlack roller: This roller is not for the faint of heart, it’s the toughest one of the bunch. It’s not a great place to start, nor is it good if you bruise easily, but for the foam roller aficionados out there, it is really great for a tight IT band and hamstring.

 

 

21nc-kpj2l-_sy300_Grey roller: This is a nice in between roller for those of us who need a little more than the white roller, but aren’t quite ready for the black one. It is actually a composite of both rollers.

 

 

 

Artisanal Foam Roller: This one retails for about 120$ on Amazon and is good if you are super fancy. I haven’t tried it because I’m not very fancy.13187983_252069785150011_953005372_n

 

The Stick and other hand rollers:

 

48d2a548-59cd-437f-b9a1-7a145ae1e592This one is good for those who travel often, because it occupies relatively low amounts of space in carry-on luggage. It is also great for people with tight inner thighs and tightness closer to the pelvic bone, which can be difficult to get to using regular foam rollers. Retail names include: “The stick”, “the tiger tail”, and others.

Other Rollers:

There are other rollers that come in a variety of fun colors and designs. These rollers are less standardized so you may want to experiment if you feel like opting for one of the less classic varieties.

 

Now that you’ve picked your roller, let’s get rolling!

When foam rolling, you can adjust the weight you place on the roller by reducing the amount of support you give yourself. The more of your body weight you put on the foam roller, the more intense it will be.  If you find a particularly tender part oscillate your body on that spot to facilitate release. In addition, you can flex and straighten the area that you are working on to help with additional lengthening of the tissue.   Attempt 10-15 passes for each body part to help improve your function and tissue mobility.

 

ITB band rollingitb
Quad rolling

quads

 

Hamstring rolling

hams

 

Back rolling

rolling-back

 

Adductor rolling with stick

the-stick

 

Sources:
Cheatham S, Kobler M, Cain M, et al. The effect of self-myofascial release using foam roller or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. Int J Sports Phys Ther. 2015 Nov;10(6):827-38

Exercise, The Female Athlete, and the Pelvic Floor

active-image

Fiona McMahon PT, DPT

In honor of National Women’s Health and Fitness Day ,September  28, we are exploring the benefits of regular exercise for women as well as addressing some pitfalls (pelvic floor included), that female athletes can fall into too. It is far too often that women find themselves sidelined from their favorite sports and fitness routines secondary to issues like orthopedic or sports-related pain or incontinence. Although all the issues outlined in this blog can occur to both genders, many of these conditions are more likely to happen to females, secondary to their pelvic structure and physiology.

 

Exercise and Its Benefits

heart-health

 

The benefits of exercise are too numerous to discuss every single one here and span the physical to the emotional. There are a number of conditions that have profound effects on the health of women nationwide. Let’s explore some of exercise’s specific benefits for these conditions together.

Heart Disease

According to the American Heart Association, Heart disease is the number one killer of women in the US and is responsible for 1 in 3 female deaths.  Exercise and a healthy lifestyle have been shown to reduce the risk of heart disease by 80%. The American Heart Association recommends 150 minutes of moderate activity or 75 minutes of vigorous activity to stave off heart disease.

Osteoporosis

Osteoporosis is unfortunately a common affliction among white and asian urban dwelling females.  It is characterized by reduced bone density, which causes bones to be fragile and increases the risk of fracture in individuals that have osteoporosis. Exercise has been shown to be helpful in both reducing the risk of osteoporosis as well as improving the bone mineral density of those who already have osteoporosis.

Other benefits of regular exercise include:

  • Reduced risk of diabetes
  • Reduced risk of colon cancer
  • Improved psychological well being
  • Maintenance of healthy body weight

Remember, it is important to consult with a trained healthcare professional before commencing a new fitness routine.

 

The Female Athlete Triad- Aka the Downside

All things in moderation. Although exercise is beneficial it is easy to over do it. It becomes easier to slip into an unhealthy relationship with exercise, especially in women who are training at elite levels, have eating disorders, or body dysmorphia issues.

The  female athlete triad consists of three disorders that can have severe health consequences in both the near and long term. The three disorders that compose the female athlete triad are:femaletriad

  1. Disordered Eating
  2. Ammenorrhea (absent periods or periods that are irregular)
  3. Osteoporosis

The female athlete triad is often attributed to the expectation that women keep a slender appearance. Girls and women who have body image issues may be at greater risk. The female athlete triad is dangerous and has the potential to be deadly. Osteoporosis can result  in fractures and eating disorders can seriously impact fertility, or even throw off the delicate balance of electrolytes in their system, putting them at serious risk for a cardiac event.

Warning signs of the female athlete triad include:

  • Yellowing of skin
  • Stress fractures
  • Rapid fluctuations in weight
  • Development of baby hair over skin
  • Daily vigorous exercise to an excessive level

 

The female athlete triad requires a multidisciplinary approach from medical, to psychological to nutrition.  It is important for someone who is suffering from the female athlete triad to seek help in order to safeguard their health and emotional well being.

 

Athletics and The Pelvic Floor

d14e2-tipsforahappyandhealthyvaginaLike any muscle, the pelvic floor can get fatigued, strained, or even go into a painful muscle spasm. The thing about the pelvic floor muscles, is that they have to work in almost every athletic pursuit. They work in partnership with the multifidus of the back, the transverse abdominus of the belly, and the diaphragm to stabilize and protect your spine. They also contract with every step during running activities to prevent your pelvic organs from dropping down in your pelvic cavity and to prevent urinary and or fecal leakage. Things can go wrong when the pelvic floor or other core muscles don’t function properly. Athletes’ pelvic floors can become tight and restricted, preventing closure of sphincters and support of pelvic organs. They may go into spasm from working too hard to stabilize the spine, if one of the other core muscles is failing to pull its weight.

Recently there has been more work to investigate the link between athletes and pelvic floor dysfunction. A recent study found that self identified female triathletes suffer from urinary and fecal incontinence at rates as high as 37.4% and 28.0%, respectively. Similar results were also found on a group of runners. Of the triathletes studied, nearly a quarter of them fit the criteria for female athlete triad, discussed earlier in this post.

Does this mean you have to give up your penchant for running? NO! (hellooooooo the author of this post is a runner), but if you find yourself experiencing incontinence, pain, constipation, and or painful sex, something is wrong and you must intervene in order to protect your long term health and your ability to participate in your favorite sport. At Beyond Basics Physical Therapy we combine orthopedic and pelvic expertise to help return athletes to their sports in a more functional and less painful condition. We relax tight muscles of the pelvic floor, train the core, including the pelvic floor if needed, to do its fair share, and return normal postural and structural alignment to our patients. We work one on one with you to develop a home exercise plan to help you reach your goals and prevent a reoccurrence of your pelvic floor or core disorder.

 

Please come see us so you can return to your sport in a better and more optimal condition than when you started: http://www.beyondbasicsphysicaltherapy.com/

 

 

Sources

American College of Sports Medicine. Information on … the female athlete triad. https://www.acsm.org/docs/brochures/the-female-athlete-triad.pdf. Accessed September 19, 2016

 

American Heart Association. Facts About Heart Disease in Women.  2016. https://www.goredforwomen.org/home/about-heart-disease-in-women/facts-about-heart-disease/. Accessed: September 6, 2016

 

Bø, K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Medicine, 34(7), 451-464. 2004.

 

Illinois Department of Public Health: Women’s Health. Facts about  women’s wellness exercise . http://www.idph.state.il.us/about/womenshealth/factsheets/exer.htm Accessed: September 13 2016

 

Loyola University Health System. “Female triathletes at higher risk for pelvic floor disorders.” ScienceDaily. ScienceDaily, 23 August 2016. <www.sciencedaily.com/releases/2016/08/160823165743.htm>.

 

Stampfer M, Hu F, Manson J, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. The New England Journal of Medicine. 2000; 343(1). 16- 22
Todd J, Robinson R. Osteoporosis and exercise. Postgrad Med J. 2003; 79:320-23

Beyond Basics’s Pro-Bono Clinic for PT Day of Service!

201510_blog_globalptdayofservice

Victoria LaManna, DPT

October is around the corner! And a busy month for many. Whether you are getting back into the swing of school or work after summer vacation, preparing your Halloween costume or getting ready for all the upcoming holidays right around the corner – there is a lot going on!
This time of year is also an opportunity to do good and give back. October is National Physical Therapy Month, where physical therapists celebrate their amazing field of healing and getting people back to optimal function. In addition, many of the PT’s throughout the U.S. give back to their communities during this month. This year we are taking it up a notch. Physical therapists WORLDWIDE are getting involved for the second annual Global PT Day of Service Saturday, October 15th. Whether it is by hosting a pro-bono clinic, serving in a soup kitchen, participating in a 5k for a cause, or cleaning up a community garden – physical therapists globally as a profession are coming together to make a positive impact on the world around them.
At Beyond Basics, we have decided to host a pro-bono clinic Saturday, October 1st to give back to those in the New York City area who may not have insurance or access to physical therapy. We are providing 30 minute one-on-one evaluations and recommendations for home programs to up to 30 participants. For more information and to sign up please visit: http://signup.com/go/Nu1T4Q
You can also check out PT Day of Service here and follow on twitter (#PTDOS) to see how the day unfolds! http://ptdayofservice.com/
The American Physical Therapy Association (APTA) is also involved in hosting National Physical Therapy Month. This year the APTA’s focus is on it’s national public awareness campaign, #ChoosePT. This campaign lets consumers know about the risks of opioid use and that physical therapy is a safe, non-opioid alternative for managing pain.
I encourage you to check out educational resources provided by the APTA (www.apta.org) and Move Forward PT (http://www.moveforwardpt.com/Default.aspx). Learn all about how physical therapy can help you overcome pain without the use of opiods, improve mobility and maintain independence throughout your lifetime.

day-of-service

BBPT Health Tips: Quadriceps Stretch

Quadriceps Stretch

 

Hello folks! Beyond Basics Physical Therapy’s latest health tip is the quadriceps stretch!

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Victoria LaManna, DPT, PT, CLT at Beyond Basics

Muscles involved: The quadriceps. The quadriceps are a muscle group that has four separate muscle heads, (quads (four), ceps (heads), get it?). If you walk, you put these guys to work everyday. They work to extend (straighten) the knee and one of the heads, (the rectus femoris) works to flex (bend) the hip.

Stretch Type: Static: Best if performed after workouts on warm muscles. Exercise caution if stretching cold (unwarmed up) muscle.

Caution: This stretch is not advisable for those with balance issues

As always: No stretch should ever be painful. If a stretch is painful, stop and consult your physical therapist for modification.

Directions:  Standing with support in front of you if you need support. Bend your knee and hold your leg at the ankle. Be careful not to abduct your leg (or let your knee move laterally away from the body).   Hold this pose for 30 seconds to a minute on each leg and repeat.

Learn more about Victoria here!

BBPT Health Tips: Entering Hydration Station

Fiona McMahon, DPT

water-life-crop

 

The dog days of summer are here, folks! Walking from the subway to your apartment feels akin to walking on the surface of the sun and it’s nearly impossible to avoid sweating through the back of your shirt on your way to work. It’s time to think about your water intake.

At Beyond Basics, you can often hear our therapists ask this question over and over, “are you drinking enough water?” But how much is enough? Can you over do it? And lastly, why is it important for me to be drinking so much water?

 

Benefits of Hydration

 

  • Body Temperature Regulation: The body needs water to produce sweat to cool your body, without enough water the body cannot cool itself, which can be dangerous especially in hot weather. This is especially important in children and older adults
  • Physical Performance:  Decreases in athletic performance have been seen with as little as 2% body mass water loss. Ensuring you are hydrated ensures a better workout.Dude running
  • Brain Power: Even mild dehydration can put you in a bad mood, as well as affecting memory and alertness  study lady
  • Bowel Function: Not consuming enough water can slow down the movement of stool and lead to painful constipation  Excellent-toilet-paper-holder
  • Heart and Blood Pressure: Dehydration decreases the volume of blood in the body. With decreased blood, the heart has to work harder to circulate the smaller volume throughout the body, resulting in increased strain on the heart. This is of particular concern in those with heart conditions.  hearthealthy
  • Bladder:  Drinking enough water can reduce risk of urinary tract infection by keeping bacteria in low concentrations in the urinary tract. It can also reduce general bladder discomfort by reducing the amount of bladder irritants present in the urinary tract.

 

 

 

What should I Drink?

How much and what to drink isn’t always clear. I often get asked, what counts. Does decaf coffee count? Does juice count? My answer in the pelvic health world is no, water is the only thing that counts as water (even sparkling water doesn’t count). My aim is to reduce the amount of bladder irritants present in the bladder, in addition to adding all the other benefits outlined above.

So How Much Water Do I Really Need?

–  The advice for how much water to drink is varied. One common adage is to drink 8- 8 ounce glasses a day. This is a great starting point and doesn’t take into account an individual’s size or how much s/he perspires. We also can’t always rely on our own thirst. In both the elderly and children, the sensation of thirst does not always occur strongly enough or frequently enough to prevent dehydration. The common rule of thumb is to drink half your bodyweight in ounces. So take me, for example, your average 140 pound physical therapist:  Half my bodyweight is 70 lbs, so I should drink approximately 70 ounces or 8.75 cups. If I exercise, I should increase my water intake to match the amount of water I lose in sweat. Other reasons to increase water intake include, hot days, history of constipation or if you are breast feeding.

Another little saying I often say to my patients is, “If you are going to pollute, dilute”. What that means is, if you are going to indulge in a little caffeine or alcohol, follow it with an equal volume of water to prevent any dehydrating effects.

 

Sources:

Popkin B, D’Anci K, Rosenberg I. Water, hydration and health. Nutr Rev. 2010 Aug; 68(8): 439–458.