Pregnancy Possibilities?

By Riva Preil

Kudos to Rebecca Schuman for sharing her much appreciated and entertaining perspective regarding the recent New York Times pregnancy videos.  The videos featured Clara Horowitz Peterson, an elite distance runner, who maintains her high level of physical activity throughout pregnancies.  Clara shares several tips and techniques with viewers, and she teaches exercises to expectant mothers (Refer to video here).

In case you watched that and thought “WHAT THE HECK?  There is no way that I could possibly do THAT in my X month of pregnancy,” rest assured you are not alone. Rebecca Schuman, a woman in her 29th week of pregnancy, had many insightful and humorous reflections about the videos (November 6, 2014 in Slate, entitled “Stop Fit Shaming Pregnancy”).

According to Schuman, the video portrays a pregnancy fitness level that is unrealistic for your average mommy-to-be.  Clara raises the bar beyond a point of feasibility, and her workouts are non-relatable to most. Schuman begs, “Elite athletes of the world, please know that there is nothing I support more than you distance-running while in labor…But I really don’t want your workouts broadcast on the New York Times as if any old preggo could actually complete them.”  She reminds her readers that from the ultra-marathoner to the more sedentary pregnant woman, the common denominator is that “We are all living in simultaneous joy and trepidation as we wait and hope that our babies come out healthy.”  And while some women can participate in CrossFit or other intense workout routines, others are not physically capable of doing so.  AND THAT’S QUITE ALL RIGHT.

Pregnant and curious to learn several appropriate stretches that can reduce low back pain and help maintain mobility?  Come see one of our specialized physical therapists at Beyond Basics Physical Therapy!  We can help create an individualized exercise program to meet your pregnancy needs.


(More) Kegels for Men?!

By Riva Preil

Women have long been familiar with the benefits of pelvic floor strengthening exercises, colloquially referred to as “Kegels,” in honor of Dr. Arnold Kegel, the individual who first described them in 1948.  Almost any woman who has ever been pregnant has been told by her doctor, sister, or friend to engage in Kegel exercises to help strengthen the muscles that get stretched and weakened during the nine months of pregnancy and during labor and delivery. However, recent conversation in the International New York Times (Pelvic Exercises for Men, Too, July 14, 2014) has turned to the benefits of Kegel exercises for MEN.  Author Roni Caryn Rabin describes how pelvic floor strengthening benefits men with urinary incontinence and possibly even sexual dysfunction.  Research has shown that Kegels are helpful for men who experience premature ejaculation, and they may possibly help men with erectile dysfunction. Rabin interviews urologist Dr. Andrew L. Siegel, creator of a pelvic floor muscle strengthening system for men called Private Gym.  The system utilizes light weights attached to a silicone band that is placed on the penis to provide resistance training to the pelvic floor muscles. Dr. Patricia Goode, medical director of the incontinence clinic at University of Alabama, participated in research in 2006 which proved that Kegels help restore continence in men after radical prostatectomy.  In fact, the results are startling- the group who participated in Kegels post-surgery were ALL, on average, fully continent within 3.5 months compared to the control group (no Kegels performed), HALF of whom were not continent after SIX months. So, men, I challenge you to join your lady friends and join the Kegel club!  If you have no idea how to perform a pelvic floor muscle contraction or have any questions about pelvic floor health, we here at Beyond Basics are happy to assist! Please let us know if there is anything we can do to help.

Kegels for Men?!

While Kegel exercises have typically been prescribed for women’s health, men richly benefit from them as well. Just as with women, the muscles in a man’s pelvic floor are the foundations of urinary and sexual health. As author Roni Carin Rabin writes in an article in this week’s New York Times, “Like all muscles, these weaken with age, doctors say. In order to strengthen them, men are told to tighten the muscles they might normally use to cut off the flow of urine midstream or prevent passing gas in a closed space. The contractions are held for a few seconds, then released, with the motion repeated 10 to 15 times for each workout.”

Amy discusses this phenomenon in her book, Heal Pelvic Pain. As she writes:

Men typically suffer the same two basic categories of [pelvic] disorder that women suffer—namely, those that result from muscles that are too tight and/or nerves that are irritated, and those resulting from muscles that are too weak. Not surprisingly, the disorders derive from the same basic causes as well:

Maybe it was too many Saturday afternoons at the stadium sitting too long on a hard surface. Or too many long, fast bike rides on that narrow, high-tech, Italian bicycle saddle. Maybe it was the heavy lifting you did when you helped out on your neighbor’s house renovation, or decided you’d like to split the firewood logs yourself, or hauled the summer deck furniture back into the garage in the autumn, or took up weight training at the gym and did it to excess.  The irritation and discomfort that ensue from acute prostatitis can lead to a habitual holding and tightening of the pelvic floor muscles resulting in pelvic floor dysfunction. A simple fall, especially if you landed on the tailbone, or that old sports injury from when you slid into third base last summer and hammered your sacroiliac: any and all of these can result, sooner or later, in a pelvic floor disorder.

One other cause that happens to men only is a prostatectomy—that is, the removal of the prostate—or radiation treatment for prostate cancer or any reproductive cancers. As any prostate cancer patient knows, these therapies for the disease can result in problems of incontinence and erectile dysfunction. In such cases, your oncologist may only be able to promise you that function will come back “within a year or so,” not a terribly cheerful prognosis. What your doctor may not tell you is that a specialist in pelvic floor dysfunction may be able to help.

She prescribes a variety of exercises to perform if you or someone you know is suffering from male pelvic pain, so pick up a copy of Heal Pelvic Pain today to learn more!


In Case You Missed Them: Great Health Resources!

In case you missed them, here are a few great resources and insights about pelvic health from the last few weeks.

Sex Therapist Talli Rosenbaum on The Pelvic Messenger, Interviewed by Alexandra Milspaw, PhD, LPC
On The Pelvic Messenger radio show, internationally renowned sex therapist Talli Rosenbaum spoke with healthcare educator Alexandra Milspaw about using mindfulness techniques to help treat pelvic pain. Check it out here.

Invitation to Dialogue: Alternative Therapies by Dr. James Gordon, The New York Times
With rising healthcare costs, Dr. James Gordon has sought to open a dialogue about the benefits of alternative medicine in place of costly medications and surgeries. Do you think it’s a valuable option? Check out the article in the New York Times here.

Interview with Amy Stein–Author of Heal Pelvic Pain by Sara K. Sauder, DPT
Amy was interviewed by Sara K. Sauder, DPT of Sullivan Physical Therapy! Check out the link to the interview here, and read Amy’s insights into physical therapy’s role in pelvic pain.

C-Section Connection?

By Riva Preil

On Monday, March 3, 2014,  New York Times writer Nicholas Bakalar suggested an interesting and somewhat shocking connection in an article– that babies delivered via cesarean section were more likely to develop obesity as adults. Bakalar reviewed data from 15 previous observational studies and discovered that C-section babies were 26% more likely to develop into overweight adults and 22% more likely to develop into obese adults.  The definition of “overweight” is body mass index/BMI of 25 or more, and the definition of “obese” is BMI of 30 or more.

It was irrelevant whether the vaginal delivery was natural, with forceps, or with vaccum extraction, and it also didn’t make a difference whether the C-section delivery was pre-labor or during labor.  The only factor that was clinically significant in the research was the general method of delivery- C-section vs. vaginal.

But don’t stress just yet!  This obviously does not mean that an obesity weight fate is sealed if you were delivered via C-section, nor does it necessarily mean that you can eat all the chocolate your heart desires if you were born vaginally.  To date, there have been no studies conducted that confirm a causal connection between adult BMI and method of delivery.

That being said, further research is warranted in order to establish clearer connections, which will provide women with more information to assist their decision making process.  Many factors must be considered in the process of making birth method decisions, including maternal and fetal health, and it is important to include one’s obstetrician in this important conversation.

Unfortunately, Bakalar did not present a hypothesis regarding WHY c-section deliveries are correlated with high adult BMI.  At first glance, the two factors seem highly unconnected.  Therefore, I invite you, dear reader, to share your thoughts.  Why do you think there is a connection between birth method and adult BMI?  The response that generates the most likes on Facebook will be entered into a raffle to win a free massage stick!


Discovering it A.L.L.!

By Riva Preil

The New York Times reported recently that Belgian scientists discovered the existence of a new ligament in the knee, the anterolateral ligament (A.L.L.) which stabilizes the knee joint by connecting the femur to the tibia.  The information was initially greeted with excitement by the medical community, however shortly thereafter, skepticism and doubt crept into the reaction of some.  How is it possible that medical practitioners have MISSED this for so long?  Could this simply be a conspiracy devised by doctors eager to perform ADDITIONAL surgeries and generate more profit?

ABSOLUTELY NOT- this ligament is the real deal, folks.  A careful dissection analyses in 41 cadavers confirmed that this tiny ligament, which measures approximately 1.5 inches length, is in the same location and has the same origin and insertion in all the studied knees.  The human body is sometimes expected to be a nicer and neater package than it actually is.  To quote The New York Times author, Bill Hayes, “The body is murky.  Muscles don’t neatly separate for you in order to display their various parts.  What lies beneath the chiseled beauty that is a six-pack, to cite one example, is wet and messy” (“The Secrets Inside Us,” December 3, 2013).  The natural variation amongst individuals, along with the internal changes that occur with the aging process, disease, and injury, make it easy to understand how such a small ligament could go undetected for so many years.

If this concept holds true regarding the knee, try to imagine how much moreso it translates to pelvic floor anatomy!  The pelvic floor, a region of the body which often gets considerable less attention during anatomy lab dissections, is a big question mark to many. Fortunately, we live in a day and age when technology affords us the opportunity to learn, discover, and analyze the many structures that are hidden within the private recesses of our bodies. The pelvic region, an inner sanctuary housed deep within our bodies, is actually a highly congested area filled with muscles, tendons, ligaments, nerves, arteries, veins, and connective tissue.  It is truly a miracle when everything works well and our bodies function smoothly.  However, when that is NOT the case, it can manifest as pain, bladder and /or bowel dysfunction, or sexual dysfunction.  Fortunately, treatment is available, and pelvic floor physical therapy can help address the musculoskeletal and neurologic components of this region. If you or someone you know has questions regarding whether or not this type of intervention is appropriate for you, please contact us at Beyond Basics Physical Therapy- we are happy to help!

Pesticides = Endometriosis?

By Riva Preil

Pesticides, plant protection products, have been linked with irritation of the skin and eyes, nervous and reproductive system problems, and possibly even cancer. Unfortunately, recent research has revealed that pesticides are associated with endometriosis. There is no clear cause of endometriosis, a condition characterized by an overgrowth of the uterine lining outside the uterus, painful periods, pain during intercourse, and infertility. However, Kristen Upson, lead author of the study (available online in Environmental Health Perspectives) identified pesticides as a possible contributing factor (see link here to article in The New York Times on November 5,2013, by Nicholas Bakalar). Upson’s research measured blood levels of two pesticides, mirex and beta HCH, in women with surgically confirmed endometriosis compared to healthy women. According to the study, women with the highest exposure to mirex had a 50 percent increased risk for endometriosis, and those exposed to high levels of beta HCH had a 30 to 70 percent increased risk. Upson proposes that the pesticides adversely affect estrogen levels and function thereby contributing to the development of endometriosis. Future research in this field is definitely warranted. Hopefully, by determining the direct causes of this painful and debilitating condition, women will no longer suffer from endometriosis. However, in the meanwhile, please allow us here at Beyond Basics Physical Therapy to help- we can help treat the pelvic floor muscle dysfunction often associated with endometriosis. Please feel free to call if you have any questions, we would love to assist with alleviating the pain!