PH101 Potty Issues with Kiddos

PottyFiona 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 using the 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 11th, 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: pelvichealth-101.eventbrite.com

Irritable Bowel Syndrome and Physical Therapy

IBSFiona McMahon, DPT

Hello everyone! April was Irritable Bowel Syndrome(IBS) Awareness Month. Although, we are a bit late, we wanted to take some time to talk about IBS and what can be done to help with its symptoms. IBS can present in different ways. People with IBS may experience diarrhea or constipation, or both. At Beyond Basics, we work with issues associated with IBS, from ensuring that your digestive organs move well in order to function properly, to toilet posture, to training the pelvic floor to have the coordination to help you toilet comfortably.

Tips for living with irritable bowel and other digestive symptoms

Posture

Over the years we have used our blog to discuss many different tips, tricks, and techniques you can use at home to make the process of having a bowel movement just a bit easier. The first thing you can do is super simple: sit on the toilet with good posture. There are heaps of ways to sit on the toilet and believe it or not, there is an optimal way to sit and poop. The reason why the way we sit is so important is the anal rectal angle. The anal rectal angle refers to the angle of your rectum. When we stand and sit our angle is more bent or acute, which makes it harder for poop to drop out of out of our rectums (yay!), which increases our chances of continence. But when we are trying to poop, we want our anal rectal angle to straighten out so it is easier to poop and we don’t have to strain. The position that best allows us to do that is squatting, the way one would over an eastern style toilet. Most of us have western style commodes that don’t allow for a nice anal rectal angle opening squat. So we have to get creative. By placing a stool or the now ubiquitous squatty potty under your feet you can simulate a squat and allow for easier passage of stool. For more on posture, check out Sara Paplanus’s blog on posture and bowel movements.

Diet

veggies

Diet is a very important thing to consider when trying to optimize your bowel movements. The first thing we usually consider is fiber. There are two types of fiber. Soluable and insoluable. Soluble dissolve in water and allows the stool to absorb water and adds mass and heft ( in a good way) to your feces. Insoluble fiber does not dissolve in water and can help push the poo out. The fact is we need to balance both types and most of us aren’t getting enough. In addition, some people need more of one type and some need more of the other or else you can end up with increased gas and bloating. Read how you can increase your fiber intake here. If you are having difficulty balancing the two or are not sure which to add, it is best to seek advice from an expert nutritionist in abdomino-pelvic pain and IBS.

Water Intake

The colon, the last stop for poop before it enters your rectum is the place where water is absorbed from the stool. In cases where you are too dehydrated, your body will recycle water anywhere it can, including your stool. If too much water is taken from your stool, it can be dry and hard to push out. We suggest drinking about one half your body weight in ounces of water daily and even slightly more if you are constipated, sweat a lot or suffer from IBS. For example, if you weigh 200 lbs, drink 100 ounces of water to make sure to ease your bowel movements.water-life-crop

Physical Therapy

Pelvic floor physical therapy can help a lot with issues with IBS. In last year’s IBS awareness blog, we discussed the benefits of pelvic floor PT

“Dysfunction in organs can also cause dysfunction in the skeletal muscles that are close by. This is called the visceral-somatic reflex. One of the most common examples is when someone feels left arm pain when they are having a heart attack. The dysfunction in the heart causes pain and spasm in nearby muscles. The same thing can happen when the gut is irritated in conditions like IBS. Typically, people with IBS will feel pain and spasm in the muscles of their abdomen and pelvic floor as a result of repeated irritation in their gut. To add insult to injury, spasm in the pelvic floor, (specifically the levator ani and sphincter muscles) can adversely affect the passage of stool out of the body and make symptoms even worse.

Pelvic floor physical therapy can help symptoms caused by the visceral somatic reflex greatly. At Beyond Basics we have an excellent crew of pelvic floor physical therapists with expertise in visceral mobilization and pelvic floor dysfunction. Our physical therapists can work to eliminate painful spasms, mobilize restrictions, retrain the muscles and teach self-management techniques to keep symptoms at bay, or to eliminate some of the symptoms in the future.”

 

IBS is an important condition that affects many different people. Although there currently is no cure for IBS, there is a lot you can do to make living with this condition more manageable. If part, or all, of the symptoms are from musculoskeletal dysfunctions of the pelvic floor and abdomen, than there IS a cure and we are here to help! If you are suffering, please make an appointment with us today.

Sources

R Saeed. Impact of Ethnic habits on defecographic measurements. Arch Iranian Med 2002; 5(2) 115-16

Exercise, The Female Athlete, and the Pelvic Floor

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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

Amy is Live with Integrated Pelvic Health!

Fiona McMahon DPT

amy2016What would you ask a pelvic floor physical therapy expert about exercise, or about the pelvic health as an athlete, if you had the chance? Don’t miss Amy Stein, founder of Beyond Basics Physical Therapy and author of Heal Pelvic Pain answer some commonly asked questions in a webinar hosted by well-renowned Jessica Drummond of Integrated Women’s Health Institute. Jessica is a nutritionist specializing in abdomino-pelvic health and dysfunction.  She will be interviewing Amy on the athlete and pelvic floor dysfunction, treatment paradigms, and practical tips for relieving the under active and the overactive pelvic floor.

Details:

Time: Friday, Sept 23, from 12-1pm EST.

Place: www.facebook.com/IntegrativePelvicHealth

Remember this interview can be replayed later if you cannot view it live.

 

 

Resources for Pelvic Pain:

Beyond Basics Physical Therapy: http://www.beyondbasicsphysicaltherapy.com/

 

Heal Pelvic Pain: http://www.healpelvicpain.com/

 

Integrated Women’s Health Institute: http://integrativewomenshealthinstitute.com/

 

Link to hear Amy and many other wonderful pelvic health experts speak in December about the female athlete and pelvic floor dysfunction:

https://km132.isrefer.com/go/WIWH/AStein/

 

Pelvic Health 101 is Back and With ALL NEW Courses Added

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?” as well as some new additions to our curriculum such as “Does my diet really matter?”, a look into how diet can affect pelvic floor conditions, and “ How does pregnancy & birth affect my body?”.

If you have questions, we have answers. Join us for lectures and question and answer opportunities with expert pelvic health physical therapists, childbirth educators, nutritionists, and yoga instructors. 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 Fall- (003)

Why is Pooping So Difficult?

By Stephanie Stamas

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The number of Americans who deal with constipation issues is massive (4 million!)! It seems like every time I mention that I’m a pelvic floor physical therapist another friend pulls me aside with bowel movement concerns. Why is it that so many people have issues? And more importantly – what can we do about it? This is the topic of our next Pelvic Health 101 seminar TONIGHT.

Not only will constipation be discussed but other bowel conditions, such as irritable bowel syndrome, fecal incontinence, bloating and hemorrhoids will be addressed. The lecture will also go in depth on the role of fiber, water intake, toilet posture and pelvic floor muscles in having a successful bowel movement. You will even go home with easy techniques that you can implement immediately to help you get that smooth move! Don’t miss out on this FREE event – it’s a MUST for anyone who struggles on the porcelain throne. Seats are going fast! Register here! PelvicHealth101.eventbrite.com . Light snacks and refreshments will be served.