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: Improve your Birthing Experience

Fiona McMahon, PT, DPT

pregnancy

Having a baby is exciting, fascinating, and nerve wracking. If you have never been through the process before, chances are you have a lot of questions and concerns about what changes your body will go through during your pregnancy, what the birthing process entails, and how your recovery will go once you’ve had your baby.

Join us  and childbirth specialist, Ashley Brichter, in our final Pelvic Health class of the year to discuss the ins and outs of having a child.

Register at pelvichealth-101.eventbrite.com  today.

Location:

110 East 42nd Street, Suite 1504

New York, NY

10017

Time: 7pm on May 4th, 2017

pelvic-health-101-spring-2017

Ph101 : Pelvic pain, meditation workshop with Ryanne Glasper, DPT & restorative yoga, calming down your pelvic floor

Fiona McMahon, DPT,

Enlightenment in nature

Earlier this summer, we discussed the nature of pain. In Putting Pain Into Context, We discussed how pain is comprised of two distinct components: the physical stimulus and how our brain interprets that stimulus. Both meditation and yoga are helpful techniques to help retrain how your brain responds to pain.

Join us on October 13th at 7pm for an introduction to both restorative yoga and meditation. Learn more about the science and try it out yourself with Anne Taylor, yoga instructor specializing in chronic pain and Ryanne Glasper, Physical Therapist and yoga instructor.  Come find out how these techniques may be helpful for you!

 

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out our upcoming courses:

Pelvic Health 101 Fall- (003)

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

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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

Beyond Basics’, Victoria LaManna Receives Lymphatic Drainage Therapy Certification

victoria2016Victoria La Manna, PT, DPT, CLT of New York, NY successfully completed Norton’s School of Lymphatic Therapy’s Lymphedema Certification Program. The certification signifies advanced skill in the application of complete decongestive therapy (CDT) in the treatment of lymphedema.

Lymphedema is the abnormal accumulation of protein rich fluid due to a disorder of the lymphatic vessel or nodes. It is a chronic condition that will usually worsen over time if left untreated. Complex Decongestive Therapy is the conservative treatment of choice for lymphedema and is reimbursable in New York by medical insurance. CDT involves a regimen of manual therapy, medical compression (bandaging, wrapping of the area), skin care, aerobic conditioning, and isotonic exercises done during the therapy session and at home.

Manual Lymphatic Drainage (MLD) Therapy is a gentle hands-on modality used to stimulate lymph flow and its specific rhythm, direction, depth, and quality over the entire body. This technique is used to aid excess lymphatic fluid to healthy neighboring territories and return it to the intact lymphatic system. The effects of MLD consist of:
• Relaxation, analgesic, diuretic
• Increases performance of the lymphatic system
• Re-routes fluid from congested area
• Softens connective tissue

MLD may also benefit these conditions:
• Lipedema
• Phlebo-lymphostatic
• Post-trauma or post-surgical swelling and healing
• Chronic Regional Pain Syndrome (CRPS)
• Cyclic-Idiopathic Swelling
• Inflammatory Rheumatism
• Migraine Headache
• Sinus Headache
• Scleroderma
• Chronic Fatigue
• Fibromyalgia
• General Relaxation

Victoria La Manna, PT, DPT, CLT earned, and successfully received, the 140-hour Lymphedema/CDT Certification which fulfills the requirements to sit for the national certification testing with the Lymphology Association of North America (LANA). Dr. La Manna is an expert physical therapist at Beyond Basics Physical Therapy, which is located in midtown Manhattan. She began, and is currently the head physical therapist for, the Lymphedema Program, which addresses the upper and lower extremities and the trunk region in men, women, and children. She is a member of the Women’s Health and Orthopedic sections of the American Physical Therapy Association and the National Lymphedema Network. Victoria is also a member of the National Vulvodynia Association and the International Pelvic Pain Society.

Bring out the Laser! Cold laser (Low Level Laser) …that is!

services-cold-laser

Fiona McMahon, DPT

When you think laser you may think of lasers for hair removal, tattoo removal, as surgical instruments, or if you are a child of the late 80’s early 90’s like me, you may think of Dr. Evil from the Austin Powers movies. These lasers are all examples of thermal lasers, ( ok, I didn’t check on Dr. Evil’s laser), which use heat to treat tissues. These examples may be all you think of when you think of lasers, but did you know that a different type of laser, cold laser, is a new and effective tool that the therapists at Beyond Basics are using to help treat their patients who suffer from a broad range of conditions from orthopedics injuries, pelvic pain to post operative recovery?

 

What is Cold Laser and how is it thought to work?

Cold laser or low level laser light therapy (LLLT) differs from the conventional lasers mentioned above in that they have a much lower light density than that of the lasers used in hair removal or surgery. Cold lasers do not emit heat, thus the moniker, cold laser.

Lasers were invented in the 1960’s and they were quickly used for therapeutic purposes.  1967 lasers were applied to the backs of shaved mice and the hair of the mice treated with laser grew back quicker than the mice that did not receive the laser treatment. Shortly after that study was conducted, lasers began being used to stimulate wound healing in non-healing ulcers.

Even though initial research on lasers started in the early 60’s, the mechanism by which lasers do their work is still not fully understood. There is strong evidence to suggest that laser therapy aids in ATP production ( the energy of cells), collagen production, cell turnover, and release of endorphins. The use of laser for therapeutic purposes was deemed safe by the Food and Drug Administration in 2002.

 

What can the use of cold laser help with?

Cold laser can be a brilliant adjunct to standard physical therapy treatment; however it is a component of treatment and does not correct the underlying factors that caused the original injury, therefore traditional physical therapy treatment of strengthening weak muscles and stretching and lengthening tight ones, correcting alignment, and improving overall fitness is essential to provide patients with truly long lasting results.

 

The use of laser has been found in many studies to be effective in reducing pain. In a meta-analysis conducted by Huang and colleagues, laser was shown to have a significantly  greater effect at lowering pain scores over placebo in patients with chronic low back pain.

 

In another study conducted in 2003, low level laser therapy was found to be more effective than placebo in reducing pain in patients with myofascial pain syndrome. In this study, both groups were given stretching exercises, but one group was also given  LLLT.  Immediately following the experiment and at the 3 week follow up pain levels were found to be significantly lower in the group that received LLLT.

 

Another study conducted by Foley et al, examined the “return-to-play” times for college athletes who were treated with laser versus their projected “return-to-play” times based off of historical data for the players’ given injuries. The study found that laser treatment shortened the “return-to-play” times by 9.6 days, which was statistically significant. The athletes required 4.3 laser treatments on average before they could return to their sports.

 

Laser is a great adjunct to traditional physical therapy and is a great help to patients where nothing nothing else has been effective. At Beyond Basics PT, LLLT complements our expert manual and orthopedic skills to treat pelvic pain, incontinence, post-surgical injuries, and orthopedic conditions. If you think LLLT may be right for you, make an appointment at Beyond Basics Physical Therapy today!

 

Foley J, Vasily D, Brandie J, et al. 830 nm light-emitting diode (led) phototherapy significantly reduced return-to-play in injured university athletes. Laser Ther. 2016; 25(1):35-42

 

Chung H, Dai T, Sharma S. The nuts and bolts of low level laser (light) therapy. Ann Biomed Eng. 2012; 40(2) 516-33

 

Hakgüder A, Birtane M, Gürcan S, et Al. Efficacy of low level therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med. 2003;33(5): 339-43
Huang Z, Ma J, Shen Bin, et al. The effectiveness of low-level laser therapy for low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015; 17: 360.

 

A Fitbit for your Vagina?!

Fiona McMahon, DPT

Elvie

 

For a while you could find me strolling around the clinic with a little fitness tracker on my wrist. I used it to track my steps, sleep, and heart rate. I’m a girl who loves gadgets and apps. From Venmo to Spotify, technology enriches my life and makes it easier. So when Elvie sent their kegel trainer to Beyond Basics, I jumped at the chance to volunteer myself guinea pig, to try out this new fitness tracker.

 

Unboxing, Aesthetics, and Set Up

Man, oh man is the product design gorgeous on this one. It comes in a beautiful silver embossed box with the tagline “ your most personal trainer”  ( wink, wink, nudge, nudge). Inside there is an inch diameter cylinder “vessel” for lack of a better term, which houses the Elvie tracker. The vessel functions as both a carrying case and a charger. It’s pretty slick looking.

The Elvie itself looks like a little tadpole with a tail. It’s about an inch long and half an inch in diameter not counting its little tail. There is also an optional cover provided in the box, which may be more comfortable for some ladies.

The whole set up: The tracker had the feel of opening an iphone, in that the directions provided in the tracker were kept pretty minimal. There was a small pamphlet with cleaning instructions, on charging, how to insert, and exercise. As a pelvic floor physical therapist, I definitely felt that the instructions on how to properly kegel left a lot to be desired. The instructions were literally two bullet points instructing the user not to hold her breath or tighten her buttocks, while she lifts her “pelvic floor”. For many of my patients, I find that they come to me with little knowledge of how to properly kegel or are doing it wrong, “lift the pelvic floor” is rarely a cue that allows for a fully correct kegel.

My next step was to download the Elvie app. I have an iPhone 6. You need a smartphone to run the elvie. They recommend iPhone 5 or later or Android phones running version 4.3 or later. The app download was easy. It was time to get started.

 

Elvie: Day 1

The moment of truth had arrived. Time to insert one of the cuter inanimate objects I had come accross “up there”. “Bye, little guy. Safe travels” I thought as I bid Elvie adieu. Insertion was no problem. For me, it was pretty comfortable, the caveat being, I have a pretty healthy pelvic floor. The one thing I did not like was that Elvie’s tail kept bopping me in the clitoris, which wasn’t very comfortable. Other than that no complaints.

The first thing I did was try and trick Elvie into thinking I was kegeling when I wasn’t (I really want to ensure this thing is fool proof). Elvie is unfortunately a gullible little thing. Bulging my pelvic floor, ( mimicking the action you would do to have a bowel movement, essentially the opposite of a kegel) and thrusting my hips tricked Elvie into thinking I was doing a really good job when I wasn’t. My favorite activity to trick Elvie was to do a little dance around my bedroom, while wiggling my bottom. Thank goodness my doors lock.

But enough goofing off, it was time to give Elvie a good old honest college try. The package recommends either standing or lying to do your kegel exercises, but they say to pick a position and stick with it. I chose lying down.

The minute I got on the bed, Elvie’s connection was lost. Poor Elvie! It was deep inside a strange place with no connection to the outside world. The app instructed me to move my phone closer to my vagina, which restored the connection but was pretty awkward, kind of like my lady parts were trying to facetime someone.

Once I got through the technical difficulties, I loved the way the exercise program was set up. They have 3 different stages that work on pulsing or “quick flicks”, endurance, and pure power. I was mediocre at all three, but it gave me a good start to go with.

Screengrab
Screen grab from the Elvie App

 

Elvie Day 2:

Today was the day I decided to experiment with how distracted one can be while using Elvie. We all like to multitask, so I decided to try it out while continuing my current Netflix binge. It was a bad idea, I missed a lot of my targets and kept forgetting to keep my legs open to allow Elvie to stay connected. It was clear to me that Elvie requires your full attention to get any benefit from it. I did improve on my ability to pulse and my endurance, which was super gratifying.

After I was done with my workout I spent some time exploring the app. Nestled in the “help” section, were much more detailed and helpful directions for performing a correct pelvic floor contraction. I wish this was more easily accessible. I think the lack of concise directions was a major failing of this product.

 

Elvie Day 3:

I decided this would be my last day using Elvie. I run on the tighter side of things, and I know from my clinical experience that doing kegels on an already tight pelvic floor can cause a whole host of issues from constipation, fecal leakage, painful sex, even urgency urinary incontinence!

I decided to give my all out full attention to the vagina workout ahead of me, but first I would try and cheat again. Lying down I tried my old tricks, wiggling my butt, thrusting my hips, but Elvie was not fooled! It appears that lying on your back is a way better way to train your pelvic floor using Elvie.

My last day, I really had the hang of things. I had no connectivity issues and was able to complete the whole workout uninterrupted. The only bummer was that on two of the three measures, I regressed!

 

Thoughts on Elvie

My thoughts on this device are mixed. It is so rare that I see someone walk into the clinic only needing strengthening of the pelvic floor. Usually there is some component of tightness or boney (structural) malalignment that needs to be corrected before kegels can be done effectively or safely.

For those patients who only require strengthening, I think Elvie can make an excellent motivator to regularly do your kegel exercises. I would eliminate the pure power part of the Elvie exercise program. Doing a max contraction of the pelvic floor usually does more harm than good. In a perfect scenario, I see Elvie being used by patients under the guidance of a pelvic floor physical therapist and only doing the “pulse” and “hold” portions of the program. These are patients who have been screened for any tightness or trigger points that may need treatment before starting out with strengthening

 

Pros and Cons of Elvie

 

Cons

  • Not appropriate for everyone
  • Poor connectivity to iphone
  • Not always consistent in measuring a true kegel versus a fake one, especially in standing
  • Requires a later model smart phone
  • Only brief instructions easily accessible
  • Max contraction not very helpful

Pros

  • Charts on the App to track your progress
  • Incredibly adorable product design
  • Much more comfortable than many other biofeedback sensors
  • Structured training program to target many components of muscle function

Pro Tips for Elvie

  • Use Elvie lying down; it’s way more accurate that way
  • Use a water based lube for insertion, silicone lubricants usually don’t mix with instruments designed to go into the vagina
  • If you have pain, Elvie is definitely not for you. Even if you don’t have pain it is wise to consult with a pelvic floor physical therapist to ensure that your muscles are not in fact, too tight and that you are doing the exercise correctly.

Disclaimer: Product was provided by Elvie. No other form of compensation was provided by Elvie for this review.

Welcome Our New Intern, Denise!

By Fiona McMahon, DPT

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On the journey towards becoming a physical therapist, you have to take a lot of classes, days are long and the studying can be more than a little bit arduous. After you build up a sufficient base of knowledge in school, you get to round out your education by getting the experience to learn hands on in the clinic. Beyond Basics takes a Physical Therapy student every year with an expressed interest in the specialty of pelvic floor rehabilitation. We’ve had many students throughout the years, and both myself and Stephanie Stamas did our training here as students.

This year, our student is someone who is already close to the Beyond Basics family. Denise Small has been a Pilates instructor at BBPT for years and has played an integral role in helping our patients get back to their active lifestyle during and after treatment for pelvic floor dysfunction. When Denise decided to go to physical therapy school we were so excited, and we are so glad to have her back in the practice in her new role!

What made you want to go into physical therapy?
Physical therapy has been a constant part of my life. As a professional ballet dancer, I saw physical therapists who helped me recover from  injuries, maintain healthy joint and muscle mobility. While I was a professional dancer in NYC, I realized I needed a job on the side to make money while I wasn’t performing. I decided to get my Pilates certification because the schedule could be flexible and it was training that I had practiced as a dancer. My Pilates teachers were Certified Movement Analyst (CMAs) from the Laban school, and they approached Pilates training in a very unorthodox way. They were interested in using the Pilates method to help people with chronic pain issues and dancers who wanted to investigate their full movement potential. My teachers introduced me to really amazing PTs who went out of the box of traditional treatment, and using movement analysis to help heal chronic movement dysfunction.

Eventually, I came to the conclusion that I wanted to retire from dancing, which is a whole other story. I wanted to transition into something that I would be as passionate about as I was performing. I wanted something that would involve movement and movement analysis, but also something that had job stability, salary, health insurance, etc.  Add all those together and PT seemed like the obvious answer to me.

You have a pretty fascinating background outside of physical therapy, can you tell us what other work experiences you have had and how they shape you as a physical therapist?
Thank you! I think my experience in jobs that were centered around movement, dance and Pilates,  have influenced the way that I work with patients. My main concern is getting people to move more and to enjoy movement. We live in a three dimensional world with many different planes and directions to explore. I feel that most people only explore what’s directly in front of them, and maybe occasionally what’s behind them and what’s to their side. I believe that if people explored different heights, levels, and directions, they can break their habitual patterns and with them their chronic aches and pains.

I also believe that my undergraduate studies in psychology have helped me tremendously in my teaching skills. Realizing that there are many different personalities that are shaped by many different experiences, helps me to teach each patient in whatever way helps them best receive whatever information I have to offer. Basically, it taught me to be flexible to people’s different personalities and learning styles.

Pelvic floor rehabilitation is a pretty advanced specialty for someone to take on while they are still in PT school. What made you want to undertake such a challenge?
I’m glad you said that. It is a very difficult and complicated subject to explore for a PT student! But I think my age (I’m 36) and my life experience help me to be able to handle and understand all the different variables that go into having pelvic dysfunction. Also I am a survivor of pelvic pain and I received the benefits of what pelvic floor therapist are capable of. I, like a lot of the patients that come to BBPT, saw a few different doctors, body workers, and acupuncturists to try and relieve the pain I was feeling, but no one was able understand or help until I went to Physical Therapy. I want to be able to pay that gift forward and help others who are suffering from that type of pain.

Where did you go and what did you do for your other clinical experiences?
I have had some really wonderful experiences. At my school your affils are established by lottery, so I didn’t know what I was going to get. I was really lucky. I know not all students can say that. My first affil was at King’s County Hospital in East Flatbush, Brooklyn. It was in both inpatient and outpatient settings. I saw so many amazing cases there, working with people who had amputations, gunshot wounds, rare neurological conditions, the specific cases were fascinating and provided me with a wide breadth and depth of understanding of these conditions.

After that I was in an outpatient clinic. This clinic was the type of place you imagine when you think physical therapist’s office. I had a really great clinical instructor (CI), who was very knowledgeable and I appreciated having such a talented CI to guide me. After that, I was at Mt. Sinai on the Upper East Side in the Traumatic Brain Injury Unit. It was incredible. Again, I had such amazingly talented clinical instructors. I learned so much and I really enjoyed the patient population. In the inpatient setting with TBI patients, you are a part of restoring their basic functions like walking, sitting, standing. It was so humbling to watch these patients work so hard to achieve skills that we often take for granted. Mt Sinai was probably my most favorite of the three.

What advice do you have for an aspiring physical therapy student?
Honestly, I would say to establish a movement practice for yourself, meaning start a regime in which you can gain a deeper understanding of your own body, like yoga, Pilates, gyrotonics, tai chi, etc. If you have a deeper understanding of your own body, you can better understand how movement patterns can limit or enhance your patient’s functioning. With that knowledge not only can you have a better understanding of how to treat your patient, you can also be more empathetic toward their healing process.

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