Breast Cancer Awareness Month

awareness cancer design pink
Photo by Miguel Á. Padriñán on Pexels.com

Fiona McMahon, DPT

Have you noticed an increase in the amount of pink on just about everything the last couple of days? The increase of pink everything is because October is Breast Cancer Awareness Month.  Breast Cancer is an extremely common cancer. According to the Nation Breast Cancer Foundation, 1 in 8 women will be diagnosed with breast cancer in their lifetime. Men can also get breast cancer, however, it is much rarer for men to develop breast cancer. Luckily with early detection and treatment of early stage and localized cancer, the 5-year relative survival rate is 100%. That being said, early detection is crucial and it is important to catch breast cancer early to ensure the best possible outcome. Let’s take some time to review the signs of breast cancer and recommended screening protocols.

Signs and Symptoms of Breast Cancer

  • Change of Sensation/ texture of the Breast or Nipples
    • Lumps, change in texture in the breast, nipple, or underarm area
  • Change in appearance of Breast or Nipple
    • Swelling
    • Shrinkage
    • Dimpling
    • Change of nipple orientation
  • Discharge from nipple

Detection

Recommended Screening:

Mammogram

  • Recommended every 1-2 years for women who are 40 years old or older.
  • May be recommended for women who are under 40, but have increased risk of breast cancer.

 

Genetic Testing

For some types of breast cancer, there is a very specific link to a person’s genes and her or his risk of developing breast cancer. BRCA1 and BRCA2 are genes that are responsible for the production of certain tumor-suppressing proteins. In some populations, there are mutations in these genes that disable their tumor-fighting properties. These gene mutations are relatively rare and currently, screening is recommended just for individuals with increased risk of harboring these mutations. According to the National Cancer Institute, individuals who are at higher risk and should consider genetic testing are:

  • Individuals who have a male relative who has developed breast cancer
  • History of BRCA related cancers within family history
  • People of Ashkenazi (Eastern European) Jewish ancestry
  • Breast Cancer diagnosed before age 50 in family
  • Multiple cases of breast cancer in family

Individuals that test positive for BRCA mutations may consider increased screening, prophylactic surgery or chemoprevention.

Mastectomy and Physical Therapy

Mastectomy, removal of the breast is currently the most common treatment for breast cancer. Some women chose to have their breasts reconstructed after their mastectomy and others do not. It is obviously a very personal choice.  Like any surgery, mastectomies require close postoperative care to ensure maximal function and recovery.

You may have read the last sentence, and thought, “What is the function of the breast, besides breastfeeding and for sexual pleasure?” The breast lies in an important intersection in the body. The armpit (axilla) contains bundles of nerves, blood vessels, and lymph vessels that course through it, serving the arm down to the fingers. After a mastectomy, their course can be interrupted by scar tissue, radiation damage (if your treatment included radiation), causing painful conditions such as nerve entrapments, frozen shoulder, and lymphedema, ( a backup of lymph fluid, if left unchecked can cause permanent damage and deformation of the arm).

victoria2016Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well ask on our website at:  www.beyondbasicspt.com/lymphedema

Sources:

http://www.nationalbreastcancer.org/. Accessed: September 24, 2016

National Cancer Institute. BRCA1 and BRCA2: Cancer Risk and Genetic Testing. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1. Accessed September 25,2016

http://www.beyondbasicspt.com/lymphedema

Ph101 Why is Pooping so Difficult?

 

toilet

Fiona McMahon, PT, DPT

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 of a 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 on October 11th  at 7pm.

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!  Light snacks and refreshments will be served.

 

Register at pelvichealth101.eventbrite.com today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out or upcoming courses!

Pelvic Health 101 Fall 2018

 

 

Take Charge of Your Health! How to Advocate for Yourself.

StethoscopeKaitlyn Parrotte, PT, DPT

Board-Certified Clinical Specialist in Orthopaedic Physical Therapy (OCS)

Certified Functional Manual Therapist (CFMT)

The new year is in full swing, and many of us have set goals to help start things off with renewed energy. One area in which, many people make goals in is health. While some folks vow to go to the gym regularly, or eat healthily, many other individuals commit to having medical check-ups, or taking care of a long-festering issue, such as a painful knee or abdominal pain. No matter what type of healthcare provider you are visiting, it is imperative that you come prepared to make sure you are getting all the facts, and are able to advocate for yourself to ensure you are receiving the best treatment for you.

Come with a Plan

One way you can advocate for yourself is to come prepared to a medical consultation by bringing a list of questions and subjective information with you. Be prepared to discuss what is bringing you to see that health care provider. What symptoms you might be experiencing? When these symptoms began? What makes you feel better and worse? How your symptoms make you feel limited in your daily life, and what you are hoping to get out of seeing that practitioner (i.e. a referral to a specialist, pain relief, etc.,.)? Many questions can arise during a medical examination, so don’t be afraid to ask for clarification, and make sure you understand the information you have been given. Research has shown, that individuals who ask specific questions about their health, may receive more comprehensive care. For example, in a 2015 article from the Journal of Family Medicine and Community Health, researchers found that when older patients were more proactive with communication to their doctors, primary care physicians were more likely to recommend both cancer screening and cancer prevention to their patients.1

On Second Opinions

When you receive a medical result, do not be afraid to get a second opinion. People seek out second opinions for various reasons: to get reassurance on a treatment protocol, to confirm the findings of a particular healthcare provider, to verify the reputation of a given institution, and even due to patient dissatisfaction in the communication or relationship with a practitioner.2-3 Whatever your reason, know that it is your right to have a second opinion to ensure you are getting the best possible care. Some research has found that second opinions have changed the diagnosis and/or course of treatment. In two studies that look at different patient populations with cancer, they found that in cases where a specialized practitioner was consulted, the accuracy of initial staging for a diagnosis increased, treatment and management of the condition was affected in about 20% of cases, and unnecessary surgeries were prevented in about 7% of cases.4-5 Thus, getting a second opinion can be very beneficial to you. Whether it changes the course of a treatment, or simply reinforces what you have already been told, seeking a second opinion can help you make educated decisions regarding your care.

Consider Both Risks and Benefits

If you are given a diagnosis and are informed of your treatment options, make sure to ask about, and consider, the risk-benefit analysis for each. The “risk-benefit analysis” is defined as “the consideration of whether a medical or surgical procedure, particularly a radical approach, is worth the risk to the patient as compared with possible benefits if the procedure is successful.”6 What this means is, it is important to weigh any treatment’s potential outcome on your quality of life, as well as your values and goals, when determining what route of care you’d like to embark on. If the risks outweigh the benefits for you personally, then it may not be a treatment worth trying. However, that is a very specific and personal decision, that must occur between you and those close to you, under the guidance of your health care provider.

Prevent Illness Before it Happens

While it is very important to be well-informed and prepared for a visit so you can better advocate for yourself, taking steps to prevent illness or injury in the first place, is crucial to promote overall well-being. Two major changes you can make in enhancing your health are diet and exercise. According to the Dietary Guidelines for Americans, 2015-2020, 117 million individuals, which is about half of all American adults, “have one or more preventable chronic diseases,”7 which include cardiovascular disease, high blood pressure, type 2 diabetes, some cancers (i.e. colorectal and postmenopausal breast cancer), and poor bone health. Theses chronic diseases are related to poor quality eating habits and physical inactivity. Furthermore, more than two-thirds of adults, and nearly one-third of children, are overweight or obese, which is associated with increased health risks and higher healthcare costs.7 Key recommendations for a “healthy eating pattern” include: eating a variety of vegetables, fruits, grains, proteins, and oils, as well as fat-free or low-fat dairy, while limiting saturated fats, trans fats, added sugars, and sodium.7 Research has found that most Americans do not eat enough fruits and vegetables. However, those that do tend to eat more fruit at breakfast and in snacks throughout the day, while more vegetables are consumed at lunch and dinner.8 This is something that can be added to your routine easily to ensure you are consuming a balanced diet.

As previously mentioned, physical inactivity can contribute to poor health; however, engaging in regular physical activity helps improve your overall health and fitness, and reduces your risk for many chronic diseases. According to the 2008 Physical Activity Guidelines for Americans, adults aged 18-64 need at least 2 hours and 30 minutes of moderate-intensity aerobic activity (i.e. brisk walking), and at least 2 days of muscle strengthening activities that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, arms). The same recommendations are given to older adults over the age the 65 years.9 That may sound like a lot of time that you don’t have; however, the CDC reports that engaging in aerobic exercise for even 10 minutes at a time can be beneficial.9 So get on your walking shoes and start power-walking to your appointments, or to the breakroom at work!

Ok. That was a lot of information, so here is a recap:

  1. Being well-informed and prepared with questions for medical consultations allows you to better advocate for yourself, and may help you to receive more comprehensive care.
  2. Seeking a second opinion, especially when considering a major medical procedure, is something that is your right as a consumer, and can impact your diagnosis and/or course of treatment.
  3. Considering the risk-benefit of any medical or surgical intervention is important to ensure that a given treatment is appropriate for your quality of life, values, and goals.
  4. While being educated and engaged when dealing with a medical concern is important, helping to prevent illness or injury through diet and exercise are critical for maintaining a healthy life.

If you are saying to yourself, “this is too overwhelming; there is no way I can do this!”, then I will leave you with a quote from Audrey Hepburn: “Nothing is impossible. The word itself says I’m possible!” You have the information; now it is time to get out there and start leading a healthy life, so the energy and inspiration of the new year keep ringing all year long!

Sources:

  1. Kahana E, Lee JE, Kahana B, Langendoerfer KB, Marshall GL. 2015. Patient planning and initiative enhances physician recommendations for cancer screening and prevention. J Fam Med Community Health, 2(9), pii 1066.
  2. Mordechai O, Tamir S, Weyl-Ben-Arush M.2015. Seeking a second opinion in pediatric oncology. Pediatr Hematol Oncol; 32 (4): 284-9.
  3. van Dalen I, Groothoff J, Stewart R, Spreeuwenberg P, Groenewegen P, van Horn J. 2001. Motives for seeking a second opinion in orthopaedic surgery. J Health Serv Res Policy, 6 (4): 195-201.
  4. Sawan P, Rebeiz K, Schoder H, Battevi C, Moskowitz A, Ulaner GA, Dunphy GA, Mannelli L. 2017. Specialized second-opinion radiology review of PET/CT examinations for patients with diffuse large B-cell lymphoma impacts patient care and management. Medicine, 96 (51), doi: 10.1097/MD.0000000000009411.
  5. Lakhman Y, D’Anastasi M, Micco M, et al. 2016. Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care. Eur Radiol;26:2089–98.
  6. “The Free Dictionary by Farlex – Medical Dictionary.” https://medical-dictionary.the freedictionary.com/risk-benefit+analysis.
  7. U.S. Department of Agriculture & U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2015-2020. Washington, DC: U.S. Government Printing Office; 2015.
  8. Moore LV, Hammer HC, Kim SA, et al. 2016. Common ways Americans are incorporating fruits and vegetables into their diet: intake patterns by meal, source and form, National Health and Nutrition Examination Survey 2007-2010. Public Health Nutr; 19 (14): 2535-9.
  9. “Physical Activity Basics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 June 2015, http://www.cdc.gov/physicalactivity/basics /index.htm.

Pediatric Bowel Part II: How to Make Pooping Easier for your Kiddo

poop

Fiona L McMahon, PT, DPT

Hey everyone! We are resuming our conversation about potty issues with kiddos. In our last blog, we discussed how issues with pooping can occur with kiddos and how often times it is easy to overlook long standing constipation in kiddos with fecal and urinary accidents. We learned that although it can seem like someone is doing something wrong, potty issues are no one’s fault. Even though poo problems are no ones fault, they are problems that families can work on together to be solved.

In this blog, we are going to discuss right here and right now what you can do today to help your child poop easier. Some of the changes are astonishingly simple while some may require a bit more work and change from the whole family. Keep in mind in order for anyone’s bowel to change ( not just kids), you must be consistent, and these changes may take a very long time to occur. Be patient, you and your child will get there. Let’s go over ways to get back on the right track now.

STEPS to help with bowel issues:

Step 1: Allow your kiddo enough time to poop

Ever have to catch an early morning flight and noticed that you skip pooping that day, or even worse, you get a little bound up in the following week? Getting up early and rushing in the morning can constipate anyone and the thing is that’s what most kids are having to do. Many children have between half an hour to an hour to scarf down their food, dress, and brush their teeth before rolling out to school, leaving very little time to sit on the toilet and have an effective bowel movement. Kids then often find themselves at school with public bathrooms or single bathrooms within the classroom that don’t lock, making it hard to be comfortable enough to have a bowel movement. Then they usually must rush to extracurriculars and complete homework before bed. There simply is not enough time to poop.

Allowing your child 10-15 minutes to sit on the toilet 10-20 minutes after they eat can allow them to use what’s called the gastrocolic reflex. Basically what that means is when you eat, the body makes room for the new food by moving everything down further in the digestive canal. Therefore, after meals is the time when we are most likely to have a poop.

Allowing more time in the morning is the most easily modifiable part of your routine to start with when trying to improve your kiddos pooping habits. Get up about 30 minutes earlier to allow your child time to eat and to sit on the toilet. Follow with sitting on the toilet after lunch and after dinner.

Step 2: Fit the toilet to you child; don’t fit your child to the toilet

Studies show that toilet posture is imperative to good poops. My colleague, Sarah Paplanus, DPT, explains in detail the importance of having your knees above your hips while pooping in her blog on the squatty potty. Step stools will help your child get their knees above their hips, just remember to make sure that they keep their legs somewhat separated. Also, for the little littles, a child size toilet seat will help make sitting on the toilet more comfortable for kiddos with little tushes.

Also, check out this video on potty posture, with fellow peds therapist, Victoria LaManna PT, DPT, CLT

Step 3: Improve Diet

Most adults are aware that diet is important, but diet is equally as important with children. Making sure your child is getting enough fruits and veggies (approximately 5 servings daily), skipping sugary and refined foods like white bread, pastries, candy, and chips, and getting enough water (about half their weight in ounces) is so important to keep their stool soft and moving.

Step 3: Recognize Progress and Hard Work

Bowel issues are hard work for all involved. Make a sticker chart to track how often your child is compliant at sitting on the toilet, eating well, and having bowel movements. Make a goal for how many stickers your child will earn and celebrate when they achieve their goal. It is a long process so make sure to recognize even the smallest of victories.

Step 4: Get Help from Professionals

There is help out there. Make sure you go to a knowledgeable doctor and physical therapist to ensure your child gets the best chance at improving their bowel issues as quickly as possible. Do not accept any medical professional telling you it is normal for children to have accidents past potty training age, (age 5), or that it is your fault as a parent, or it is the child’s fault. It’s not. A knowledgeable doctor will run appropriate tests to rule out dietary allergies that could be contributing as well as starting your child on medicine or supplements to help improve bowel movements.

Pelvic floor physical therapy is a mainstay of care for kids with bowel issues, Skilled pediatric physical therapists will help your child re-learn how to use their pelvic muscles to better hold in waste as well as eliminate it when appropriate. We will teach you how to use techniques to help stool move more effectively, and we can perform hands on work to reduce pain and discomfort associated with bowel dysfunction. In addition to our clinical skills, we will help you to find doctors to help compliment the treatment your child is receiving in PT. If your child is suffering from bowel problems, don’t waste another day, call our front desk to make an appointment today!

New Year’s Resolutions: Weight Loss

Fitness and health

Fiona McMahon PT, DPT

It’s that time of year again. We are all nobly setting out on our self improvement journeys. Resolutions are often deeply personal goals we set for ourselves and can involve spiritual, physical, and emotional aspects. Overwhelmingly, one of the most common goals people have is weight loss. The desire to lose weight often goes beyond aesthetic. People can be motivated to reduce pain in their joints, improve heart health, and to have more energy. As physical therapists we see the harms of the burden of carrying around extra weight on aching joints as well as the fallout from initiating a program with a little too much vim and vigor.

Goal Setting

Goal setting is something almost every article on New Year’s resolutions addresses, for good reason. Goal setting properly is imperative to success. We can think of goal setting in two ways. Sometimes we think of goal setting like a wishlist, “it would be great if I achieved x”. These kind of goals are great for getting you to look at the final picture, but provide no direction on how to get to your end result. Writing down a goal to lose 10 pounds is all well and good, but without a solid plan, you are left without any real steps to put in motion.

In goal setting I suggest you borrow some tools from us physical therapists. When we assess patients we develop short and long term goals to get them to their ultimate fitness and health goals. The short term goals we make, allow us to zero in on small and discrete changes we can make towards the ultimate goal.

Think about what habits you currently are doing that are holding you back from weight loss. Are you having an extra glass of wine at night you could cut out, are you not getting enough sleep, so working out seems impossible? Break things up into small behavioral changes to concentrate on. Keep in mind goals can also be positive, what things are you currently doing that are helping you on your path that you would like to continue doing. It’s important to recognize where you are being an absolute rockstar already and use that positive energy towards things that might be harder to change.

Track your goals and think about how often you want to make sure you are doing them. Personally, I find it helpful to track my goals to see if I am generally sticking to them. There are apps out there, that you can install on your phone that will help track your success in sticking to your goals. I use a free app called “Productive”.  It allows me to make a recurring checklist for my goals. You can use the app to schedule out what time of day you would like to do your goals, how many days a week you’ll do them, and provides stats on how regularly you are achieving them.

Finally, it is important to be realistic with your goals. Goals that are too easy or too hard are less likely to get you where you want to be. Allow yourself some flexibility, to keep your journey less of a burden. Over time, check in with your goals you may find you have outgrown them or they are unrealistic. It is perfectly okay to tailor as you go.

 

Eating

We all know diet plays a major key in weight loss. A friend to the clinic, Nutritionist, Jessica Drummond will often say, “ You cannot exercise your way out of a bad diet”. Poor diets can stymie any exercise plan.

Dietary needs vary widely from individual to individual, but overall it’s best to avoid highly processed foods. These foods tend to be chalk a block with salt and easily digestible sugars that can spike appetite. No good.

Be wary of fad diets and health crazes. Gluten free foods are all the rage right now. I, myself am gluten free for health reasons, but if you do not have celiac disease or non celiac gluten sensitivity, reaching for the gluten free pizza or cookie is not the wisest choice as a weight loss strategy. In addition to usually being more expensive, gluten free options, like cookies, bread, and pizza often are higher in calories than their “glutenful” counterparts. It only took a quick stroll over to my refrigerator to prove this point. I compared a slice of traditional bread next to a gluten free slice. As you can see in the photo below, the traditional bread is larger than the gluten free bread. Not only do you get more food for serving with the traditional bread, the traditional bread has 20 fewer calories per serving than the gluten free bread. This goes to show that regardless of your dietary needs, consuming foods that are not processed like sweet potatoes, quinoa, and rice, over processed food like bread, is a good way to avoid hidden calories.

It is important that you eat enough to sustain your metabolism, your energy, and your mood, and furthermore, to allow your diet to be a sustainable change you can carry out long term to ensure success. There are apps on your phone that can help you track your calorie input, how many calories you have burned off, and what the composition of your macronutrients are. Macronutrients are protein, carbs, and fats. A diet higher in protein is generally used to help build muscles, which can in turn, burn more fat. These apps, like Myfitnesspal and Lose It! can give you target calorie intake for your desired weekly weight loss. It is important to set your target with some element of moderation so it is easier to stick to. Caloric restrictions that are too extreme can backfire by tanking your metabolism, energy, and triggering food binges.

Exercise

Exercise is so important. In addition to helping you progress towards your weight loss goal, exercise has so many health benefits that will pay dividends well into the future. From stress reduction, cardiovascular health, bone health and more, exercise is an essential element of self care even for those who do not wish to lose weight.The

American Heart Association recommends adults exercise at a moderate intensity for at least 30 minutes five times a week or vigorous activity for 25 minutes 3 days a week. In addition to moderate to high intensity  strengthening activity at least 2 days a week.

Finding the right exercise can be daunting. This is where having a physical therapist can be a tremendous advantage. Personally, I don’t believe in “the one best exercise”. Everybody is different and every body is different. Physical therapists are the movement specialists of the healthcare world. We can help you find good workouts for where your body is now, as well as strengthen your body so you can do the workout or event of your dreams while avoiding injury. Take a look at the series we wrote chronicling how physical therapy prepared my body for the rigors of the New York City Marathon and allowed me to complete it in record time, to see a great example of what physical therapy can do for you. I have included our blogs on physical therapy and exercise at the bottom of this article.

Once you have an idea of where to start and where you want to go, then slowly get started on trying out different routines. I once heard a quote from an exercise physiologist who said, “the best exercise is one you actually do”. So remember when starting your exercise program, it is okay to not like a certain exercise routine and move on. You might abhor the treadmill, but find tremendous joy in a Zumba class. Finding  a workout that brings you joy, and at the very least, does not bring you dread is imperative. It’s kind of like dating, keep trying different routines until you find what works for you.

Once you find your dream routine, remember moderation. Allow yourself at least a day of recovery if you are a seasoned exercise veteran, and more if you are an exercise newbie. Rest not only prevents injury, but it gives the body time to get to the job of laying down more muscle fibers and making you stronger.

Injury can happen with new exercise routines and really, nothing is more frustrating than being super gung ho about a new program only to be sidelined with an injury. Again this is where having a good PT on your side really helps. Seeing us before starting exercise can help us spot both literal and figurative achilles heels in your posture, strength, and flexibility and will allow us to address these issues before they become mega impairments later on. We can help you decide when it is time to progress and how to do so safely. Additionally we can help you recover from an injury faster and prevent injury recurrence if you see us when you do have an injury.

 

Failure and Success

Repeat after me, “ I am a person, not a machine”. You will fail at certain elements of your plan. Notice I used “will” and not “may”. When you do overindulge, miss a workout, or whatever else. Remember it is a process and small failures do not indicate that you will fail in your ultimate goal of greater health. Nor is failure in any way an indicator of your worth as a human being, neither is the number on the scale, by the way. Progress will be slow, but you will likely get there if you are consistent. Failure is a good time to re-evaluate your goals. Maybe five workouts a week is completely unrealistic and maybe sticking with three is a much better balance. Regardless of what obstacles you face in your journey, remember to be kind to yourself, you are doing the best you can. Find what changes you can stick with and go from there. It can take a lot to change up your whole routine, but keep working at it and you will find success.

Check us out at BBPT!

Although we do specialize in orthopedic and pelvic floor physical therapy at Beyond Basics, we do so much more than that. All of our physical therapists are trained in orthopedic and sports rehab, and many of our therapists have earned prestigious orthopedic certifications like the OCS and CFMT. We can help you to figure out where to start, how to progress your exercises appropriately, and how to keep your body healthy so you can continue to achieve all of your goals.

 

Additional Blogs Exercise and Fitness:

Time to PUMP SOME IRON! September is Healthy Aging Month

Exercising While Pregnant

Preparing for the Marathon with Physical Therapy at Beyond Basics!

Beyond Basics’ Marathon Prep Program: The Evaluation

Marathon Prep with Beyond Basics: Weeks 1-3

Marathon Update: Sickness When to Run and When to Take a Break

Marathon Training Update

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

 

Sources

American Heart Association. American Heart Association Recommendations for Physical Activity in Adults. Updated Dec 14, 2017

 

 

 

Ph101 Why is Pooping so Difficult?

toilet 2

Fiona McMahon, DPT

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 of a 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  on  October 11th at 7pm.

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!  Light snacks and refreshments will be served.

Register at pelvichealth101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out or upcoming courses!

Pelvic Health 101 Fall 2017

 

Marathon Update: Sickness When to Run and When to Take a Break

thermometer-temperature-fever-flu

Fiona McMahon PT, DPT

Hi everyone I am writing you from week 22 of training for the NYC marathon. This year I am running the marathon, sponsored by Beyond Basics Physical Therapy, in order to support New York’s Team Tisch in raising money for multiple sclerosis research. Currently, we are only about 1000$ from our goal, time is getting tight so don’t forget to donate today. Click here to donate to Team Tisch MS NYC Marathon to support research for treatment and prevention of multiple sclerosis.

Today, I want to write about a fact of life for almost every human being, illness. Getting sick can be vexing for just about every marathon runner. It puts us in this nearly existential running dilemma, “Do you run and risk getting more sick?” or “ Do I take the rest, and miss a potentially race making run?”. The question can sometimes make you feel even more lousy than whatever you are actually sick from.

In my training for this marathon, I have been confronted with this question way too many times. I’ve been sick 4 times in the last 22 weeks, total bummer, but I live in a super crowded city and work with children so I am not surprised. P.S. Working with kiddos is the best thing ever and is totally worth whatever puke, snot ridden illness I get, so I am definitely not complaining.

A lot of runners have “the neck rule”. I first came across this rule as a high school runner, and I see it all over running publications. It has been a useful tool for me for years in determining when to take a knee and focus on feeling better. The neck rule is not necessarily running exclusive, so feel free to apply it to most workouts. Basically it goes like this, if your symptoms are above the neck, i.e. congestion, sore throat, etc, you are generally safe to run. If your symptoms are below the neck, i.e. fever, vomiting, diarrhea, muscle aches, etc, it is time to give your body a rest and let your immune system do its thing. It can be so frustrating to skip a run, especially when your illness falls on a major training session, but in the long run, you will end up healthier and you will be able to return to your prior level of performance sooner. This doesn’t necessarily mean that head only symptoms mean you absolutely should run. It’s a basic guideline: if you are feeling too run down and fatigued to run, listen to your body, it’s pretty smart.

When you are starting to feel better go back into things slowly. Once your fever has been gone for about 24 hours without fever reducers, vomiting or diarrhea have cleared, and you can eat and drink normally, ease back in. Plan your next run on a treadmill or in short loops by your home so you can cut it short if need be. You don’t want to be stuck 8 miles out from home, finding you are still really worn down from being ill. Been to that show and got that T-shirt.

Marathon training is as much mental as it is physical. The mental challenges can present themselves in surprising ways. One of the biggest pitfalls runners “run” (oops, not sorry about that pun) into following an illness, is the desire to cram all of the mileage they have missed into a few days following an illness. Don’t do it. Most training plans are designed to challenge the body at a level it can tolerate as well as provide enough rest to build up strength and functional reserves. Adding a huge glut of extra miles in the middle of it, can really throw things off and put you at a greater risk of injury or even additional illness. Let those miles go and be confident in the fact that you allowed your body to heal and get to full strength.

Please click here to donate to TISCH Multiple sclerosis research.

Additionally, check out my progress in physical therapy here:

 

And for more on training while sick, click here.