PH101: Pain and Sexuality: Is it all in my head?

cute-couple-with-umbrella-in-blossom-field-web-header

By Fiona McMahon, DPT

Sex should feel good… really, really good. But when it doesn’t, you may start to wonder, what’s wrong with me? Am I broken? Am I a prude? Am I frigid? Painful sex isn’t something we talk about. No one would look at you twice if you walked into work complaining of pain in your elbow, but if you walk into work complaining about pain in you vagina or penis, you may end up having a meeting with HR.

On October 6th at 7pm, we at Beyond Basics are breaking down those taboos and having an educational seminar, followed by an optional question and answer session at the end. We will discuss the many causes of sexual pain and how physical therapy can help.  The event will be hosted by one of our therapists, Stephanie Stamas, DPT, ATC. Stephanie will give a detailed seminar about pelvic health and take time to clear up some common misconceptions many people have concerning their bodies and sexual function.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth-101.eventbrite.com

Here is our line up of this and future classes

Pelvic Health 101 Fall- (003)

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!

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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/

 

Happy World Physio Day!

hands

Fiona McMahon PT, DPT

Mary McMillan
Mary McMillan, Mother of American Physical Therapy 

September 8th is World Physio Day! Phyisos aka “Physical Therapists” as they are are called in the States, help people in many different ways.  In America, the founding mother of physical therapy was Mary  McMillan. In 1922, she founded the American Physiotherapy Association.  Physical Therapists started their profession in the early 1900’s as rehabilitative professionals called, Reconstruction Aids, to help with the influx of injured soldiers during the first World War.

Early physical therapists also worked to help rehabilitate patients who had suffered the debilitating effects of polio. Throughout the years the reach of the physical therapist has broadened to incorporate the treatment of many different conditions. In many states, like New York, which has limited direct access, physical therapists can evaluate and treat patients without direct orders from a physician.

Currently, Physical Therapists graduate with a Doctorate in Physical Therapy, although there are experienced clinicians in the field who still hold Masters and Bachelors in Physical Therapy. When we graduate, we are generalists, capable of entering most settings and developing our skills in a particular speciality. As we develop our skills we may chose to become specialists in a particular skill. Some of the specialities physical therapists work in, include:

  • Geriatric Rehab*
  • Orthopedic Rehab*
  • Sports Rehab*
  • Pelvic Floor Rehab*
  • Neurological Rehab
  • Wound Care
  • Cardiac Rehab
  • Pediatric Rehab
  • Pediatric Pelvic Floor Rehab*
  • Lymphedema Rehab*

*Indicates services provided at Beyond Basics Physical Therapy

As physical therapists, we are honored to be able to participate directly in improving the quality of life of our patients. If you feel you could benefit from any of the specialities listed above, either give us a call to schedule an appointment or find a clinician on the APTA website below. Happy World Physio Day!

 

APTA Find a PT: http://aptaapps.apta.org/findapt/default.aspx?UniqueKey=
handsSources:

 

APTA History.  http://www.apta.org/History/. Assessed: September 31, 2016

 

Moffat M. The history of physical therapy practice in the United States. Journal of Physical Therapy Education. 2003.

 

September is Prostate Cancer Awareness Month

Blue ribbon

Fiona McMahon PT, DPT

September is Prostate Cancer Awareness Month. Here at Beyond Basics Physical Therapy, we treat many men both before and after treatment for prostate cancer. We focus on restoring the health of the pelvic floor and tissue surrounding the prostate to restore normal sexual and urinary function. For more information about how physical therapy can help you or someone you love who is going through prostate cancer, read our blog on prostate cancer: https://beyondbasicsptblog.com/2015/04/07/physical-therapy-and-the-prostate/

Beyond Basics itself has an outstanding program in pre and post operative prostate care:

 

Beyond Basics Physical Therapy

Pre-op/Post op Prostatectomy Program

110 E 42nd Street, Suite #1504, NY, NY 10017

T: 212-354-2622

Beyond Basics Physical Therapy offers a unique and comprehensive rehabilitation program focused on the healthcare needs of people who have

  •      Incontinence or sexual dysfunction due to prostate surgery
  •      Pain and/or bladder retention, frequency or urgency due to prostate treatment (with or without surgery)

Our physical therapists that work with these clients have extensive training and knowledge in pelvic related issues.

Pre-operative: patient will be seen by a therapist to not only evaluate their prior function, but also give them exercises to do before and after surgery.  The evaluation will include:

  • Muscle strength testing including pelvic floor and lower extremities
  • Biofeedback evaluation using either internal rectal sensors or external anal sensors
  • Education on what to expect and things to do to optimize surgical outcomes
  • Overall posture evaluation

Post-operatively: patient will be seen 2-6 weeks after surgery. Treatment will include the following

  • Muscle re-education utilizing biofeedback
  • Bladder re-education/timed voiding
  • Postural education
  • Overall core stabilization when appropriate
  • Behavioral Modifications

We treat our patients for 60-75 minute sessions in private rooms and use state of the art biofeedback technology.   If you have specific questions, please do not hesitate to contact us.

As always, our programs are tailored to your specific needs.

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.

Welcome to Beyond Basics Physical Therapy’s monthly “Tip from your Physical Therapist!”

Fiona McMahon, DPT

We are rolling out a new tip monthly to help you increase your fitness and general health. Today we will be going over a stretch. Before we get started, let’s go over some basics.

The most common question I get asked when I give people a stretch to do is, “ should I do this stretch before or after I work out?” My answer usually is, whenever you are most likely to remember to do it. The best stretch or exercise is one you actually do”. I then go on to explain that you get a little more bang for your buck if you do it after exercise. In a Cochrane review, researchers show that stretching before exercise typically reduces delayed onset muscle soreness (DOMS) by ½ point on a 100 point scale and stretching afterwards reduced muscle soreness by 1 point on a 100 point scale.

Reading that last paragraph, you probably thought, “small potatoes, Fiona, 1 point is not worth disrupting my routine for”. But stretching has many other benefits. The Mayo Clinic Reports that regular stretching has been shown to improve athletic performance, improve blood flow to the muscle, and reduce risk of injuries. Do I have your attention yet?

Let’s introduce July’s stretch:

Adductor Stretch

Adductor Stretch- melissa Stendahl
Staff Physical Therapist, Melissa Stendahl demonstrates

Muscles involved: The adductors, or inner thigh muscles. These muscles primarily serve the function to bring your legs together and are commonly involved in “groin tears”

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

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

Directions: Hold this pose for 30 seconds to a minute; repeat. You may increase the intensity of this stretch, by hinging at the hips and bringing your torso forward over your legs. Remember, to keep your back straight and that this should be a gentle stretch and should not be painful.

Learn more about Melissa Stendahl here!

Sources:

 

Herbert R, de Noronha M, Kamper S. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Review.  2011.
Mayo Clinic Staff. Stretching: Focus on Flexibility. Mayo Clinic. 2014. http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931?pg=1. [Accessed: July 23,2016} 

Worth the Breath: Why You Should Eat Onions for Health

Onions have gotten a bad rap in the food world: sometimes the mere thought of that stinging sensation while you cut them is enough to put you off of them entirely. But did you know that onions actually have an incredible amount of health benefits?

Screen Shot 2016-03-01 at 1.09.15 PM
via Instagram user @cobbgrill

Onions are a part of the allium genus–which also includes garlic, shallots, chives, and more–which overall has been reported to reduce the risk of stomach and colorectal cancers. This is likely due to the presence of sulfur and sulfuric compounds in the vegetable. Onions’ cancer-reducing properties also stem (no pun intended) from their high selenium content. Selenium has been shown to “influencing cancerous tissue by interfering with cell growth and division, and influencing apoptosis, which can be thought of as a “self-destruct” mode for old and/or damaged cells,” according to this article in Designs for Health.

There are also different kinds of phytochemicals in various types of onions that have positive effects on health. For example, red onions contain a phytochemical compound called quercetin, which is good for heart health. What’s great, too, is that these health properties are not lost when you cook them so we don’t have to go around eating raw onions and breathing on people if we don’t want to.

Another of the big health benefits of onions is their ability to regulate inflammation. Onions have long been recognized for their ability to work against arthritis and clotting, not to mention their ability for regulating liver enzymes, which aid in the stabilization of glucose levels.

If onions aren’t a part of your regular diet, it’s definitely worth thinking about all the health benefits you might be missing before you toss those onions off of your salad or burger!

Winter Weather Wisdom

By Riva Preil

“Frozen” means more to us than the title of one of this year’s most popular movies- it also represents the way many of us have been feeling thermostatically due to the EXTREMELY cold weather!  While the cold and snow are annoying, I feel responsible as a health care provider to address the HEALTH RISKS presented by the weather conditions.

According to the National Institute on Aging (NIA), part of the National Institutes of Health (NIH), older adults are especially susceptible to weather related risks, such as hypothermia.  This is due to the fact that their bodies are less equipped to respond to cold weather and their impaired self-regulation capabilities (either due to underlying medical conditions or medications that they are taking).  The signs of hypothermia include slurred or slowed speech, drowsiness, confusion, shivering, stiff extremities, slowed reaction time, poor motor control, and/or weak pulse.

The tips recommended by the NIA for older adults are applicable to one and all…well, at least those of us not living in Los Angeles or Miami.  The NIA advises adequate home heating- temperatures should be set to at least 68 degrees.  Furthermore, multiple layers should be worn, including socks and slippers, even around the house.  (My personal favorite find of the season is fleece lined leggings!)  For those who must brave the outdoor weather, please remember to wear a hat, scarf, and gloves to prevent body heat from escaping though the head and hands.  Furthermore, individuals with impaired balance should be especially careful on the ice and snow.  Appropriate assistive devices (ex. straight cane) should be used at all times, even if you are just taking the garbage out to the corner!  Fall prevention is one of the most important steps (pun intended) towards maintaining health in the older adult population.  Hopefully, all of the aforementioned advice will be irrelevant soon, because we will be busy discussing summer sun safety instead.  Until then, I hope this brief overview has been helpful.  May we all be “chilling” out on the beach very soon- the best type of frozen that exists!