Beyond Basics Physical Therapy: Free Movement Classes are Here

Summer Movement ClassFiona McMahon PT, DPT

It’s summer in the city and maybe the air isn’t the only thing that’s a little stagnant? Could your workout routine use some updating? Are you itching to try something new like yoga, pilates, meditation, or tai chi? Have you been hesitant to try something new because you are nervous because of a past injury or pain condition? It’s time to take the leap and broaden your workout horizons with classes taught by practitioners with decades of combined experience in working with patients with chronic pain conditions. Take some time to read a little bit about this summer’s offerings and see if there is a right fit for you!

On July 6th at 7pm we will be offering gentle Pilates with Denise Small PT, DPT. Denise is a physical therapist at Beyond Basics Physical Therapy, who specializes in the treatment of orthopedic conditions and pelvic pain. She also is a certified Pilates instructor and combines both physical therapy and Pilates to help patients move throughout their world with increased strength and endurance, and with less pain. Denise is also a frequent contributor to the blog. Take some time to check out her recent articles,  on the Coordination of Breath and Movement, the use of Breath in in the Pilates MethodThe Benefits of Pilates with Pain Conditions, and check out our Pilates program here.

On July 13th at 7pm, Dr. Deborah Coady MD will be leading a gentle Tai Chi class designed to reduce stress, improve balance, and improve many other health conditions. Dr. Coady is a pioneer in the treatment of chronic pelvic pain and has a keen interest in the power of movement in aiding healing.

On July 20th at 7pm join Anne Taylor for Yoga. Anne teaches all over New York City and has worked with Beyond Basics Physical Therapy for years to offer private and group restorative classes for men and women with pelvic floor dysfunction.

Our last class is on July 27th at 7pm and will be lead by Ryanne Glasper PT, DPT. Ryanne will be offering a medication class to help you learn how to focus and calm the mind. Ryanne works at Beyond Basics specializing in orthopedic and pelvic floor dysfunction. Ryanne is also a certified yoga instructor and has studied the Franklin Method through the Feldenkrais Institute.

If any of these classes interest you, click here to register today!

Pilates Blog- Rhythm- Coordination of Breath and Movement

PilatesDenise Small, PT, DPT

Today’s Pilates blog will focus on another basic movement principle of the Pilates method, Whole Body Movement.

In the last blog, I wrote about the importance of breathing three dimensionally, both expanding and contracting your abdomen and ribcage when breathing. Joseph Pilates wanted to help exaggerate these physiologic functions with movement, to help bring better awareness of these functions to one’s consciousness. He did that by coordinating both whole body movement and breathing. For example, when one inhales, the ribs and sternum move up and out, like a water pump or the handle on a bucket. You can feel this action by placing your hands on the outside of your ribcage, or on your sternum, as you inhale. When the ribs move up and out or the sternum lifts, the spine also extends because of the physical connection of the ribs into the spine. So, when Pilates gave a movement that involved spinal extension, like cow pose, he encouraged his students to inhale.

Conversely, when one exhales the opposite happens, and the ribs move in and down. When the ribs move in and down, this helps facilitate spinal flexion, because of the ribs physical connection to the spine. So, when Pilates gave a movement involving spinal flexion, he encouraged his students to exhale.

The result is inhalation with ribcage expansion and spinal extension, and exhalation with ribcage compression and spinal flexion. By coordinating the ribcage and spinal movement with the breath, you can maximize your air intake and expulsion. In addition, by coordinating your breath and movement, your body can more easily access its natural rhythms, calming the nervous system and promoting relaxation and healing.

Give it a try in your seat at work. Or come to Beyond Basics and visit me for a Pilates private!

The use of Breath in the Pilates Method

Denise Small PT, DPT

The following series of Pilates blog posts will focus on the principles that define the Pilates method.  Joseph Pilates developed his methodology using eight basic movement principles: whole body movement, breathing, balanced muscle development, concentration, control, centering, precision, and rhythm.  Today’s blog will focus on the principle of Breathing.

pilatesBreathing is a natural phenomenon that is performed thousands of times a day. Our daily intake of oxygen and expulsion of carbon dioxide is needed to cleanse our blood, and maintain the functioning of our body systems.  That being said, there are different ways to manipulate one’s breath to help facilitate certain physiological functions. For example, there have been many BBPT blog posts about diaphragmatic breathing, where one breathes into their abdomen to get a stretch of both the diaphragm and the pelvic floor muscles. Well, Pilates had his own approach to breathing, which was a variation on Diaphragmatic breathing.  Pilates approach to breathing was aimed at getting maximal air intake and release to give the body, what he called, “an internal shower” to rid the body of “toxins”. Pilates focused specifically on lateral expansion of the diaphragm, whereas traditional diaphragmatic breathing focuses on the vertical expansion of the diaphragm. In order to achieve this, Pilates encouraged maintaining the engaged tone of the abdomen, while breathing into the front, sides, and back of the ribcage. See the image below for further explanation.

 

Pilates- Ribcage/ Chest breathing versus Belly/Diaphragmatic breathing

This is an overly simplified view of the actual mechanics. However, both versions are very important. With the ability to differentiate between ribcage and diaphragmatic breathing you can offer your diaphragm a 3-dimensional stretch and the ability to work on abdominal contraction as well as endurance. If you have any questions you can ask them in the comments section. Or come visit me at Beyond Basics for a Pilates Private session!

Benefits of Pilates with Pain Conditions

By: Amy Stein, PT, DPT & Denise Small, PT, DPT
deniseDenise Small, Physical Therapist and resident Pilates instructor spoke on the differences between Pilates’ practices, and what aspects are important for her patients with chronic pelvic pain. Denise is third generation instructor of Joseph Pilates’ technique. She has also taken supplemental training courses with Eric Frankel and Thomas Myers, both well-known body workers and movement therapy practitioners.

Denise explores movement patterns in her patients that may have caused pain in the past, and are now labeled as something to fear. Patients try to avoid these movements; however, they are necessary for healthy functional mobility. Denise uses the Pilates method to explore these movements, and to make them pain free and more familiar. Denise is guided by Pilates’ 8 movements principles, which are the staples of Joseph Pilates’ methodology.

They are:

1. Whole Body movement- all structures are involved, even if they are not moving.

2. Breathing- Pilates refers to this as an internal shower, or a massage for your internal organs. This also helps coordinate your movement, using breath as your internal rhythm.

3. Balanced muscle development: concentric and eccentric movements happen in synchronicity with the use of the Pilates’ springs.

4. Concentration and focus: Required for all of the above to be performed together

5. Control- Pilates is not about repetitions and muscle bulk. Pilates is about Form and coordination of all the movement principles. If all of the movement principles are being incorporated, one needs only to perform 8-10 repetitions of each exercise for maximum benefit.

6. Centering- Pilates heals the mind and body, by bringing your attention to your core. That is: the abdominal wall, the diaphragm, the pelvic floor, and the deep spinal extensors.

7. Precision- If the movement is specific, there is very little room for error

In addition to being guided by the movement principles, Denise has a few staples of her own, that she uses to frame her sessions. First, Denise believes that you need to have tissue mobility before stability. For example, one needs to be able to move their abdominal muscles before they can begin strengthening their abdominal muscles. If a patient’s abdominal wall is hard, then it is not necessarily strong. A strong abdomen is a part of a strong core. A strong core requires fluid coordination of the diaphragm, pelvic floor, the spinal extensors, and the abdominal wall with movement. This lack of coordination may be observed when a patient is performing an abdominal strengthening exercise. Does the patient hold their breath? Are they tucking in the tailbone and gripping their pelvic floor muscles? Does their abdomen bulge? Many of these compensations can be avoided with the use of breath while performing more subtle core exercises, like marching, before progressing to more advanced exercises.

Second, Denise always highly recommends rolling out your patient’s feet before doing any mat or reformer work. Studies have shown that the fascia of your feet is directly connected to the fascia of your core, pelvis, and spine. So, if you release your plantar fascia, you can release restrictions all the way through your legs and torso. Once the muscles and fascia of your feet are more pliable one can better align their skeleton, from the domes of their feet to the roof of their mouth.

Lastly, Denise likes to use as few cues as possible to not confuse or overwhelm the patient. In addition, her cues are oriented around the bones. Bones are easier for patients to visualize, and focusing on the bones alleviates the possibility of dysfunctional muscle recruitment; i.e. gripping. For example, for pelvic floor muscle tightness and pain conditions, Denise cues widening the sits bones with squatting and inhalation. The patient/client needs to work on letting go of the muscles and the sits bones, while we work on eccentric control. To learn more about Denise, visit her bio and our Pilates program .  Also see her recently published health tip to get started.

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

Spring Pelvic Health 101 Classes are About to Start!

Come Learn With Us! Free Pelvic Health 101 Classes at Beyond Basics Physical Therapy!

By Fiona McMahon, DPT

It’s that time of year again, temperatures are rising, the days are getting longer, and we at Beyond Basics Physical Therapy are gearing up and getting ready to start up our hugely successful Pelvic Health 101(PH101) classes for the spring and we couldn’t be more excited!

Our upcoming Pelvic Health 101 Course is the third in our series of PH101 courses. Our courses cover a variety of topics from male and female sexuality, bowel and bladder health, nutrition, as well as complimentary medicine for pelvic floor dysfunction. In this blog we will sit down with one of Beyond Basics’ Senior Physical Therapists and the creative force behind our Pelvic Health 101 Classes, Stephanie Stamas, to get more information on this wonderful resource.

FM: Why did you begin PH101?
SS: I began the Pelvic Health 101 seminar series last fall out of a desire to help more people. There are a lot of people out there who have consistently been told there is nothing wrong with them, it is all in their head or they should just get over it. I wanted to put together an educational series that would validate people’s suffering as well as give them tools to heal and return to a normal life. I believe that information is power, and that power gives people freedom and hope – two things that are often lacking in patients suffering with pelvic floor dysfunction.

FM: Who is the intended audience for PH101?
SS: Current patients, prospective patients, healthcare providers who have questions about how to better treat pelvic pain – really anyone. I tailor these classes so they are understandable to the general population, but I also try to give more in-depth information than one might find elsewhere. I really want class participants to leave with a clear picture of what is going on with their bodies.

FM: Do you have to be a current patient at BBPT to go?
SS: Not at all! Most of the participants have been prospective patients looking for more information and seeing if physical therapy can be helpful for their condition. We’ve also had plenty of other healthcare providers come to learn more about the musculoskeletal component to bowel, bladder and sexual dysfunction.  Everyone is welcome!

FM: What is your favorite topic to cover?
SS: I really love the bowel lecture, “Why is Pooping so Difficult.”It’s fun to be an adult and get to talk about pooping! Potty talk is often not socially acceptable but I like to open the floor to talk about issues that are often swept under the rug. I also really love our Ladies Only Night. It’s a safe place where women can come and ask any of their questions concerning pelvic health in a friendly, fun, women only environment. It almost has the feel of a girls’ night in with your friends, minus the pajamas and pillow fights.

FM: What are some of your favorite reactions from last years’ class?
SS: I love seeing “light bulbs” click on when people discover anatomical and physiological reasons why they are experiencing symptoms. People get so much bad information along the  way and often times are told everything is in their head. I love the smiles and hope on people’s faces when they hear the good news that it is not, and that there is a solution to their symptoms!

FM: What should people do who are interested in taking the class?
SS: They should sign up online as soon as they can at PelvicHealth101.eventbrite.com. The classes are free but space is limited so they do fill up quickly. Light refreshments will be provided. Check out our class schedule below!

ph101m16

 

PT In-Service: Alignment and Core Exercises

By Amy Stein

Our famous Dania Kafka, who is an amazing physical therapist and Pilates instructor, recently discussed alignment, posture and core exercises correctly at our latest PT In-Service. She helped us with proper cueing because we don’t want pelvic pain patients to utilize the pelvic floor muscles, or limit their use, with any core stabilization exercises. We went over how to gently engage the transverse abdominus, which is one of the core muscles and helps with pelvic and trunk stability. If this muscle is weak and the patient is overusing their pelvic floor, they can end up with pelvic pain. Core and trunk muscle imbalances can be one of many reasons a patient ends up with pelvic pain and/or pelvic weakness. Therefore, it is important to have a strong and balanced core. Dania proceeded to lead us through a series of transverse abdominus exercises that were adapted by Shirley Sahrmann, PT, and we incorporated diaphragmatic breathing with each exercise. We practiced neutral spine versus posterior pelvic tilt to compare the difference, and discussed with which populations we would use which position.

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With any pain condition, if there are active trigger points, tightened and/or shortened tissue, you need to address these impairments prior to strengthening these muscles. Otherwise you can exacerbate trigger points and continue to shorten tissues. It is essential to make sure these conditions are resolved prior to starting a core exercise to that specific area.

With regard to pelvic floor weakness, including incontinence and post surgical weakness (prostatectomy, prolapse, etc.), it is important to strengthen the pelvic floor muscles correctly and the transverse abdominus correctly, as well as the rest of the core muscles.

Monitoring each patient with each exercise, is essential for their recovery, in order not to worsen any condition. Starting slow and in a controlled environment is key.

If you have any questions with regard to Pilates and core exercises and when to introduce them for pelvic pain, or pelvic weakness, feel free to call us and ask for any of our PTs. Or, attend our upcoming Pelvic Health 101 this spring!