PH101 Something’s Wrong with My What?

Fiona McMahon DPT, PT

Image via PlayBuzz


On September 22, 2016 at 7pm we will be kicking off our fall semester of pelvic health education class, we call Pelvic Health 101 (PH101). In our first class we will be introducing you to the pelvic floor muscles, where they are, what they do, and how they relate to the health and function of your bowel, bladder, and sexual functioning. We will also be covering how things such as alignment, posture, muscle tone and nerves can affect your symptoms. This course is a great starting point to help you understand your pelvic floor and pelvic floor symptoms.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at:

Here is our line up of this and future classes

Pelvic Health 101 Fall- (003)

BBPT Health Tips: Entering Hydration Station

Fiona McMahon, DPT



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.



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

Water, Water, Everywhere!

By Riva Preil

Water is drowning the competition!  Since the 1980s, water has provided seriously stiff competition with soda company sales.  Michael C. Bellas, chief executive of the Beverage Marketing Corporation, predicts that by the end of this decade, bottled water sales will exceed carbonated beverage sales. From 1993 to 2005, sales of lightweight plastic water bottles grew at a rate of 20% each quarter.  Even the First Lady, Michelle Obama, has joined the water bandwagon, and encouraged Americans to drink more water last month along with Coke, (Dasani), PepsiCo (Aquafina), and Nestle Waters. The fact that water has become much more affordable in recent years adds to its appeal, and some stores sell water for as cheap as eight cents a (half liter) bottle!  For more details about the increasing popularity of water, please refer to the New York Times article, Bottled Water Sales Rising as Soda Ebbs, by Stephanie Strom.

From your pelvic floor’s perspective, water is a bladder’s best friend.  As opposed to coffee, caffeinated teas, and carbonated beverages (all of which are IRRITANTS), water is a NON-IRRITANT.  Think of the bladder, also known as the detrusor muscle, as a balloon with elastic-like properties.  It is meant to expand fully and completely upon filling.  Once adequately filled, the stretch receptors in the bladder wall send the message to your brain which indicates that it is time to go to the bathroom and empty the bladder.  However, the bladder is sensitive to the type of fluid that enters.  Certain drinks, such as alcohol, caffeine, carbonated drinks, citrus juices and artificial sweeteners are considered bladder irritants.  This means that even a small amount of irritant can make the bladder “feel fuller” than larger amounts of non-irritant (aka water)!  This fake feeling of fullness causes premature urge sensation, and very often patients will reports that they void frequently, even multiple times per hour, and they also report the feeling of incomplete emptying of the bladder (“I have to go again 10 minutes later”).  Counter intuitively, the solution is to drink MORE water, ideally eight cups per day!  By hydrating the bladder with ample non-irritating water, irritants present in the bladder become diluted, and it allows for improved filling-emptying dynamics.  Also…eliminating the aforementioned irritants (my apologies to all you coffee lovers) helps as well.