We Care About Your Flare!

By Riva Preil

With only two sessions remaining to the “semester,” have YOU taken advantage of your opportunity to learn at The School of Pelvic Health yet?  If the answer is no, bear in mind it’s never to late to educate– we hope to see you at the next class on Tuesday, November 11, at 7:00 PM.

At the next class, Stephanie Stamas will discuss My Symptoms Keep Flaring, Is That Normal?  Unfortunately, as many patients can attest, flare ups are often part and parcel of the therapeutic process. In fact, I try to educate patients at their initial evaluation about the potential for a “flare-up” (i.e., feeling worse immediately following physical therapy prior to feeling better).  When patients know what to expect, they are less fearful and worried when flare-ups occur as a result of treatment.

The way I explain a flare up to my patients is that it is the body’s way of telling us that this work is necessary and beneficial. The muscles, fascia, and connective tissue have become accustomed to a faulty shortened position. What feels “normal” to them is actually pathologic and tight. Therefore, after manual therapy that involves stretching and manipulation of the shortened tissue, the body is adjusting this new healthier state. Even though the adjustment phase may be uncomfortable and sore, it is EXTREMELY GOOD in the long run and it is a part of the healing process.

An analogy I give to explain the concept relates to when I educate patients about proper posture. After teaching correct sitting and standing posture, patients often report that it feels “weird” or “unnatural” even though it is BETTER for their body than the previous poor habits.  Creating new habits feels strange and awkward, even if the changes are improvements.

The same applies to the pelvic floor muscles and connective tissue- the changes made in physical therapy are beneficial and healing, despite feeling initially painful and uncomfortable.  To learn more about flare-ups and how to manage them (HINT: Think “Ice Ice Baby…”), be sure to attend Stephanie’s class on Tuesday! We look forward to seeing you there!

Which Twitch?

By Riva Preil

The pelvic floor muscles are composed of two different types of muscle fibers which can be thought of as two “speeds.” Approximately 70% of the pelvic floor muscle fibers are slow-twitch or slow-contraction fibers. The remaining 30% are fast-twitch fibers. The slow twitch fibers fuel endurance. They are the marathoners of muscles, providing support and resisting fatigue. Think of the muscles in your lower back: they are mostly slow twitch fibers that can work for a long time without tiring. That’s essential, because these are the muscles responsible for helping keep you upright. The slow-twitch fibers that comprise the bulk of your pelvic floor are the slow-to-tire, persistently supportive muscles.

On the other hand, fast-twitch fibers provide the swift forcefulness of sprinters. The ocular muscles that move your eyes, for example, are fast-twitch muscles. In the pelvic floor, the fast-twitch muscles assist in controlling the contraction and relaxation that open and close the bladder and bowel and that are involved in sexual function.

While both types of muscle fibers lost strength as the body ages, the fast-twitch fibers do so more readily. The slow-twitch muscles that make the pelvic floor a center of endurance and support generally maintain their power and function longer, unless there is trauma or injury. In a sense, the power to endure remains while the power to perform some of the pelvic floor’s key functions can diminish. That’s natural! As we get older, our powers diminish. That’s why it’s so important to stay fit for as long as we can; physical strength and vigor are the best defense against the aging process. If you have any questions regarding how to maintain a healthy and strong pelvic floor (ex. post partum mother or post abdominal surgery) please contact us at Beyond Basics Physical Therapy– we are happy to help!

Adapted from Heal Pelvic Pain, by Amy Stein