Yoga for Chronic Pelvic Pain

crop faceless lady sitting in zen pose on yoga mat
Photo by Karolina Grabowska on Pexels.com

Kathryn Ahuja PT, DPT RYT200

Patients with chronic pelvic pain (CPP) often ask, “Is there anything else I can do?” They have often been living with pain for a long time and are eager to feel better as quickly as possible. The truth is that there is no fast lane to healing CPP. Healing should integrate the biomechanical, psychological, and social factors, which can all play a part in your symptoms. Yoga can be a very effective way to address each of these players and move you towards increased freedom and function.

Biomechanical factors: How can yoga help?

Previous blog posts,Pelvic Pain Awareness Month Part 1: What is Pelvic Pain  and Pelvic Pain Awareness Month: Part 2: Hope for Chronic Pelvic Pain  have discussed how the muscles of your pelvic floor can lead to CPP. If you have lived with pain in the pelvis, genitals, reproductive and urinary organs, coccyx, or pubic bones for a long time, the pain can alter the way you move in everyday life. People with CPP tend to be less active than their peers, have altered postures, (usually with a more posteriorly tilted pelvis (a tucked tail bone) and an increased thoracic kyphosis (hunch in upper spine), and they tend to adopt ways of sitting or standing that is protective of their painful spots (Zhang 2015). It makes sense! Pain in this area of the body makes us just want to curl up in a ball and stay there!

Being curled up like a cashew all day has a real influence on your pain. Our bodies are designed to move and when we stay in one place for a long time our joints get stiff, blood flow to and from our tissues is impaired, and the muscles that should help us stand tall become weak and tight. It can become difficult to actually differentiate the pain that is coming from your pelvic floor and the discomfort you may feel because of the adaptations you have made because of this pain.

Practicing yoga poses called asanas is an effective, safe way to get you moving again. Standing poses like warrior II (Virabhadrasana II) and crescent lunge (Anjaneyasana) simultaneously lengthen and strengthen the muscles of your legs and hips. When these muscles regain their function, it can help your pelvic floor muscles to back off any chronic holding patterns. Backward bends like cobra (Bhujangasana) or camel pose (Ustrasana) help restore the natural curves of your spine while lengthening any tension in the abdominal muscles. This may make it a little easier to keep your body in an upright posture throughout your day. Supine stretches like butterfly (Baddha Konasana) or happy baby (Ananda Balasana) can help ease tension in the muscles of the inner thighs (adductors) while you are supported by the floor. When these muscles relax, there can be a noticeable reduction in pain since trigger points in the adductors can refer to the genitals and pubic bone.

In a study performed in India, 30 women who attended a 1-hour yoga class five times weekly for eight weeks saw significant reduction in their pelvic pain ratings compared to the start of the intervention. These women also showed a significant reduction in pain scores compared to women who only took NSAIDS for pain relief over the same time. The researchers theorized that the intervention was effective not only due to the effects of the stretching and strengthening, but also because of the relaxation exercises which “modify neurological pain perception which could be the mechanism for pain reduction” (Saxena, 2017). This research suggests that yoga is doing something more than addressing the muscles. It may actually change the brains of those who practice.

Psychological factors: How can yoga help?

Ask any regular yogi and they will tell you that there is much more to the practice than just the asanas. It turns out, there is some really interesting science behind the feel good vibes you might experience after a yoga class.

Yoga is different from many other forms of exercise because there is an intentional focus on your breath. In Hindu philosophy, prana means not only breath, but “life force.” It is believed that one’s breath has tremendous power and in performing pranayama (breathing exercises) we can strengthen and harness that energy. Today, we understand that breathing does more for our bodies than move air in and out and we have even greater appreciation for this ancient philosophy.

You are probably familiar with the idea that slow, deep breathing can help to calm you down. The mechanism that drives this response is called the parasympathetic nervous system (PNS). Deep, slow breathing sends a message to your brain that you are not under a direct threat. The PNS then works to shift you out of “fight or flight” mode and into a calmer, more peaceful state. If you have CPP, your body might live in a constant state of fight or flight. Pranayama exercises have been shown to help quiet those signals and strengthen the signals from your PNS. With a consistent practice of slow, deep breathing you can actually shift your whole body towards a parasympathetic dominant state (Gerritsen, 2018).

Depression and anxiety are common comorbidities for people with CPP. Yoga can help to shift your mood which may also have an effect on your perceived pain. A randomized control trial evaluated the levels of a neurotransmitter called GABA in people with Major Depressive Disorder (MDD) and in a healthy control group. GABA is an inhibitory neurotransmitter that helps to regulate important cortical functions including mood. When compared to the control group, those with MDD had significantly lower levels of brain GABA. After completing a 12-week yoga program however, there was no difference in these levels between groups. Even more importantly depressive symptoms decreased significantly in the MDD group and anxiety levels improved for both groups (Streeter, 2018).

These stunning changes do not seem to be attributable to all forms of exercise. In comparison to people who walked for one hour, those who did yoga for the same amount of time had greater increases in GABA as well as improvements in mood scores (Streeter, 2010). While this study was small, it makes a great case for future research to determine if yoga may be a suitable alternative to medication for those with serious anxiety or depression.

Social factors: how can yoga help?

Persistent pain can have a profound effect on how you interact with the world. Symptoms of CPP are not visible to others and we tend to not talk about them with most friends and colleagues. Throbbing, aching, and stinging sensations can make you more irritable, less willing to put on certain clothing, or cause you to avoid aggravating activities. This can put a real strain on all your relationships. Emotional distress from fraying relationships can be difficult to manage when you are trying to heal and could even stress you to the point of making your symptoms worse.

If you are limited in your daily functions or feel that your quality of life suffers due to CPP symptoms, there is evidence to support using yoga to intervene. Women with pelvic pain had improved emotional well being and sexual function scores after a 6-week yoga course consisting of about 3 hours of yoga per week. At the end of the program, 75% of the participants indicated they felt the yoga program was something they could continue to do without guidance (Huang, 2017). It can be quite empowering to feel like you have control of your symptoms and are not reliant on a doctor or PT to “fix” you. Additionally, a yoga class can be a nice way to socialize while doing something positive for your body.

Yoga may not totally eliminate the pain you feel, but it may help you to manage your symptoms more elegantly. Breathing techniques can assist when symptoms strike at work. Mindfulness about your body can help you determine when it is appropriate to push yourself and when you need to rest. Mastering a tricky posture is very rewarding and may encourage you to open up to other novel challenges.

Ready to give it a try?

As with all new forms of exercise, if you are looking to try yoga for CPP you should seek out a class with a knowledgeable instructor who can offer modifications and cue your alignment appropriately. Start slow and never be afraid to ask your teacher a question if something does not feel right in your body. At first, the hardest part might just be learning to be still and breathe deeply: that’s ok, and it will get easier!

Please consider joining me for our virtual yoga class every Tuesday at 7pm. Click here

for more details.

References

Gerritsen RJS, Band GPH. Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Front Hum Neurosci. 2018;12:397. Published 2018 Oct 9. doi:10.3389/fnhum.2018.00397

Huang AJ, Rowen TS, Abercrombie P, et al. Development and Feasibility of a Group-Based Therapeutic Yoga Program for Women with Chronic Pelvic Pain. Pain Med. 2017;18(10):1864‐1872. doi:10.1093/pm/pnw306

Saxena R, Gupta M, Shankar N, Jain S, Saxena A. Effects of yogic intervention on pain scores and quality of life in females with chronic pelvic pain. Int J Yoga 2017;10:9-15

Streeter C, Gerbag P, Nielsen G, Brown R, Jensen JE and Marisa Silveri. The Effects of Yoga on Thalamic Gamma-Aminobutyric Acid, Mood and Depression: Analysis of Two Randomized Controlled Trials. Neuropsychiatry Journ. 2018;8(6).

Streeter CC, Whitfield TH, Owen L, et al. Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. J Altern Complement Med. 2010;16(11):1145‐1152. doi:10.1089/acm.2010.000

Zhang R, Chomistek AK, Dimitrakoff JD, et al. Physical activity and chronic prostatitis/chronic pelvic pain syndrome. Med Sci Sports Exerc. 2015;47(4):757‐764. doi:10.1249/MSS.0000000000000472

Navigating Life with Chronic Pain: Part II

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Fiona McMahon, PT, DPT

Welcome back to our discussion on chronic pain. In our last blog we discussed why one might experience chronic pain and some common missteps and pitfalls that have occurred in our understanding of chronic pain. If you haven’t yet read part one of this blog, I highly recommend checking it out first so you can get the most out of this post. Click here to read it now.

For chronic pain, we have drugs, surgery, mental health therapy, physical therapy, and what is called complementary alternative medicine (CAM), which includes modalities like yoga, acupuncture, and mindfulness meditation. We discussed earlier how some opioids may actually be harmful in treating chronic pain. Unnecessary surgery can also have risks of actually increasing pain post-surgically, because it can change the brain’s sensitivity to pain. Because, for most musculoskeletal conditions, a course of conservative treatment is recommended for a period of time before turning to surgery, we will focus on non-surgical, and non-medical approaches to chronic pain.

Before we dive into specific treatments, let’s talk about what puts a person at risk for chronic pain. We can divide these risks into modifiable and non-modifiable risks. Nonmodifiable risks are situations or characteristics about ourselves that we can not change. They include socioeconomic status, where you live or have lived, cultural background and genetic factors. Unfortunately, we can’t change these things, but things like alcohol intake, nutrition, and obesity are all things we can change and have been generally understood as modifiable risk factors for chronic pain. Now that we have that in mind, let’s explore different approaches for the management of chronic pain.

 

Mindfulness Practice as Pain Management

Have you tried mindfulness practice? I ask this question a lot. When I ask it, I am careful to frame it in a way that does not give the patient the impression that I think their pain is all in their head, but rather, I try and present it as part of an adjunct to the current physical therapy treatment they are receiving from myself or any of the other PT’s at Beyond Basics Physical Therapy, and any other medical intervention they may be receiving.

Mindfulness and mindfulness meditation are somewhat based on eastern meditation practices.  Not all mindfulness programs are the same, but the basic premise is to allow the participant to observe their thoughts, feelings, sensations, and attitudes without judgment. Giving them the opportunity to reframe their thoughts in a positive manner.

It may sound like a small change, but research is really starting to bear out that changing your frame of mind about pain can have some very real results. In a meta-analysis done by Hilton and colleagues, mindfulness programs were found to have statistically significant positive results on pain, depression, and quality of life.

There are a lot of ways you can incorporate mindfulness into your day to day life. Apps for your phone are really helpful. I recommend both Calm and Headspace. I personally like Calm a bit better, but both are excellent. Headspace is a good starter because it breaks up meditation into more digestible nuggets, which can be a good way to start your meditation practice. Calm, as the name implies, is more soothing.  There are also guided classes you can attend in your area if that’s more up to your speed.

Be patient with mindfulness, I definitely suggest giving it the old college try. Stick with it for a week or two. If it isn’t for you, that’s perfectly okay. It’s not a moral failing, or a psychological one it’s definitely a case of different strokes for different folks.

Psychological Intervention

In a study performed by Macrae and colleagues, it was found that patients who engaged in catastrophizing type behaviors experience post-surgical pain at a significantly higher rate. Catastrophizing is envisioning a situation to be far worse than it actually is. A good example for this blog would be a patient with low back pain, jumping to the conclusion that her back pain will prevent her from being able to work and she would end up on the street, secondary to her lack of ability to secure an income. Although this is a possibility, it really isn’t a realistic one and it fails to entertain the possibility of the back pain remaining stable or getting better.

Mindfulness meditation can help with catastrophizing behaviors, but sometimes you need a little extra help. Psychological interventions, like talk therapy and cognitive behavioral therapy, can help you get a handle on these thoughts and address your current loss of function, secondary to pain in a more productive manner. Cognitive behavioral therapy as well as other forms of therapy have shown improvement in pain symptoms and quality of life in adults and has shown even more robust effects in children.

Acupuncture

Acupuncture is an ancient form of eastern medicine that is gaining a stronger and stronger foothold in the States. It has been shown to be effective in managing a number of conditions, and chronic pain is no different. Reviews of acupuncture in scientific literature have found that acupuncture can improve pain and function. The same review found that electroacupuncture had even more robust results for pain and stiffness.

Yoga

Yoga is super hip right now. In fact, it now has its own international day on June 21st of each year. It does for good reason. A consistent and solid yoga program has been shown to improve conditions such as low back pain, myofascial pain syndrome, fibromyalgia syndrome, osteo- and rheumatoid arthritis. It can be a great option to continue to add consistent exercise and pain management into your life.

Physical Therapy and Exercise

Exercise is good for you, even if you have chronic pain. The old way of thinking was to put someone on days of bedrest when they have chronic pain. No more. Evidence has shown gentle movement progressing into more functional training can really help with chronic pain. In fact, the National Institute for Healthcare Excellence’s (NICE) osteoarthritis guideline is  “exercise should be a core treatment… irrespective of age, comorbidity, pain severity and disability. Exercise should include local muscle strengthening [and] general aerobic fitness”(NICE 2014) . Geneen and colleagues found in their review and meta-analysis of the current literature that just receiving the advice to exercise alone is not sufficient to produce improvements in pain scales. That’s where the professionals like physical therapists come in, PTs have the knowledge and expertise to prescribe exercise that is not only safe and functional but hopefully kind of fun. PTs also can diagnose and treat issues such as tissues with reduced mobility and poor alignment to ensure you get the most out of your exercise.

Data show that a prescribed and monitored exercise program by a physical therapist can have good effects on pain symptoms and can help facilitate the production of your body’s own natural painkillers.  Additionally, exercise can help individuals lose weight, which can reduce the pressure on one ’s joints and further improve pain.

Aside from exercise and hands-on work, we can use modalities like Kinesio tape at physical therapy. Kinesiotape has been shown to improve not only pain but decrease trigger points, improve range of motion and improve disability rates in individuals suffering from myofascial pain syndrome.

Conclusion

Chronic pain is complex. Rarely is there a silver bullet that will cure it. Treatment requires a multidisciplinary approach, which has been shown to be more effective than traditional treatment alone. Start small, where you feel comfortable when adding something new into your treatment approach. You will find what works best for you. A good place to start is here at Beyond Basics. Our staff not only has the expertise to treat you from a physical therapy perspective, but they also have the ability to guide you towards other traditional and complementary treatments/practitioners that can help you reach your goal. Your treatment for chronic pain does not have to be and should not be passive, please call and make an appointment today to start your journey.  

 

Sources:

 

Achilefu A, Joshi K, Meier M. et al. Yoga and other meditative movement therapies to reduce chronic pain. J Okla State Med Assoc. 2017;110(1):14-16

 

Andersen T, Vægter H. A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls. Clin Pract Epidemiol Ment Health. 2016;12: 49-58

 

Ay S, Konak H, Evick D, et al. The effectiveness of kinesio taping on pain and disability in cervical myofascial pain syndrome. Rev Bras Reumatol. 2017; 57(2) 93-9

 

Eccleston C, Crombez G. Advancing psychological therapies for chronic pain [version 1]; referees: 2 approved]. F1000 Faculty Rev. 2017

 

Geneen L, Moore R, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews ( Review).  Cochrane Database Syst Rev 2017; 4

 

Hilton, L, Hempe; S, Ewing B. Mindfulness Meditation for Chronic Pain: Systematic review and meta-analysis. Ann Behav Med. 2017. 51:199-213

 

Kamper S, Apeldoorn A, Chiarotto A, et Al. Multidisciplinary biopsychosocial rehabilitation for chronic pain ( review). Cochrane Database Syst Rev. 2014; 9.

 

Macrae W. Chronic post-surgical pain: 10 years on. Br J Anaesth 2008;101: 77-86

 

Mayer F, Scharhag-Rosenberger F, Carlsohn A. The intensity and effects of strength training in the elderly.  Dtsch Arztebl Int 2011; 108(21):359-64

 

Neira S, Marques A, Pérez I. Effectiveness of aquatic therapy vs land based therapy for balance and pain in women with fibromyalgia: a study protocol for a randomized trial. BMC Musculoskelet Disord. 2017; 18(22)

 

Perry R, Leach V, Davies P, et al. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Sytematic Reviews. 2017. 6(97)

 

Saxena R, Gupta M, Shankar N, et al. Effect of yogic intervention on pain scores and quality of life in females with chronic pelvic pain. Int J Yoga. 2017. 10(1): 9-15

 

Singh P, Chaturvedi A. Complementary and Alternative Medicine in Cancer Pain Management: A Systematic Review. Indian J Palliat Care. 2015. 21(1): 105-15

 

     

 

Pilates Versus Yoga

Pilates vs. Yoga Kierstin Elliott, Certified in Stott Pilates

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As a pilates instructor, I am often asked the question, “How is pilates different from yoga?” Although there are many similarities between the two practices, such as developing strength and flexibility, the differences are quite substantial.

Yoga is an ancient practice that has long been established throughout Indian culture. One major factor that sets yoga apart from pilates is the spiritual element. For many, yoga promotes an environment of self awareness in mind, body, and spirit. Although there are various styles of yoga, ranging from the lively flow of Vinyasa to the meditative holds of Yin, you have the freedom to explore and evolve the limitations of your body and mind within the practice.

Pilates is a more recent method of movement created by Joseph Pilates as a form of rehabilitation and was introduced to the States in 1920. Pilates wanted to create a practice in which injured soldiers could quickly rehab with bio-mechanics. Therefore, the apparatus’ used in the practice such as the Cadillac and Reformer, closely resemble hospital beds with springs, pulleys, and slings. Pilates is focused primarily on restoring the natural curves of the spine using these 8 founding principles: breath, concentration, control, centering, flow, alignment, precision and relaxation.

Both pilates and yoga offer numerous health benefits for the mind and body in addition to complimenting each other quite well. If you are looking for a more spiritual or meditative connection through movement, yoga is the choice for you. If you are looking to strengthen your core and improve posture, pilates will be right up your alley. Give them both a try and see what makes the most sense for your body. Finding a practice that not only feels good, but one that you also enjoy, is important for maintaining consistency and progress. Only with commitment and dedication to your practice will you discover the stronger, healthier, and happier version of you!

 

kierstinbbpt_smKierstin Elliot currently teaches Pilates at Beyond Basics Physical, Flex, Kinespirit, and offers in home training. Call the office at Beyond Basics at 212-354-2622 for more information on Kierstin!

Yoga with Anne Taylor on July 20th

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Fiona McMahon PT, DPT

Join us on Thursday, July 20th at 7pm for a really special treat: Yoga with Anne Taylor. Anne Taylor’s approach to yoga, which integrates movement, breath awareness, opening, and grounding to recalibrate the neuromuscular system, to help decrease pain and increase function has been a mainstay of Beyond Basics’ multi-disciplinary approach to improving the health and well being of our patients for nearly a decade.

Join us for a chance to explore the practice of yoga, without the pressure of trying to learn in an overcrowded class in a trendy yoga studio. Learn poses and breathing techniques you can take with you anywhere to help improve your quality of life. Sign up here today.

Summer Movement Class

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 acute and chronic pain conditions and sports and dance injuries. 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 orthopedics, dance medicine, 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!

BBPT Health Tip: Happy Baby Yoga Pose

Fiona McMahon PT, DPT

Guys! This is one of my favorite stretches ever. Both for myself personally and also for my patients. It’s called the happy baby pose, which comes from yoga. I mean, how cute is that. If you’ve ever seen a baby try and stick his feet in his mouth you know where the name comes from. This stretch is awesome because it stretches a ton of muscles at once, even the pelvic floor. It is an integral part of my stretching routine and I hope it becomes part of yours.

Muscles involved: Hamstrings, glute (butt) muscles, pelvic floor,

Stretch Type: Static: Best if performed after workouts on warm muscles. Exercise caution if stretching cold muscle, because unwarmed muscle doesn’t stretch as well as warmed up muscles.

Caution: If you feel pinching in your hips or pressure or discomfort under your kneecap, move your hand position to back of the thighs. If you still feel pain while attempting this modification, it is definitely time for a physical therapy appointment.

As always: No stretch should ever be painful. If a stretch is painful, stop and consult your physical therapist for modifications.

Directions: Lying on your back, grip your feet on the outside of your feet and bend your knees up towards your armpits. If this is too difficult, grasp your legs at the calves. Make sure that your neck is relaxed and hold for 60-90 seconds and repeat. Add deep breathing to enhance the relaxation. Enjoy!

 

Check out our student showing off her great happy baby pose!

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)

Exercise, The Female Athlete, and the Pelvic Floor

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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

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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

Interview with Ryanne Glasper, Physical Therapist at Beyond Basics PT

Fiona McMahon, DPT
At Beyond Basics, we are lucky to have a great crew of Physical Therapists, who come from ryanne2015diverse training backgrounds and experiences. It is some of these different experiences that betters our practice and allows us to grow as clinicians. We took some time out from our wonderful patients, to sit down with physical therapist, Ryanne Glasper, to find out what sets her apart as a physical therapist.

What sets your orthopedic approach apart from approaches seen in other orthopedic clinics?

I can tell you that I love biomechanics. I’m obsessed with how the body moves. I’d consider myself a movement scientist. Moving is such a joy to me that I not only want to facilitate my patients recovery, but also help them better understand their bodies and efficient movements. I want them to leave my office and feel empowered. Like most therapists, I create individualized programs for my patients, but I make it a point to individualize every aspect, including the manual techniques I choose, even the language I use. I try to figure out what works for them, meet them there, and then challenge them to expand, whether that be in knowledge, strength, flexibility, clarity of mind, et cetera. I

Tell us about your background and what type of conditions you saw before coming to BBPT

Before BBPT I worked at PhysioArts Physical Therapy for nearly 10 years. I worked first as a physical therapy aide while in school, and then as a therapist. I worked with a remarkable group of therapists. When I started, I was the youngest and least experienced. I worked with therapists that had ten-plus years of experience and I was incredibly lucky to be mentored by them, especially my boss Jen Green.
At PhysioArts we worked with the performing arts community, professional dancers, actors, singers …. all of Broadway basically. I think I’ve worked on every joint in the body, from the foot to the cranium! From the usual ACL reconstructions, hip replacements, rotator cuff tears to the lesser known cuboid sprains and rib torsions.

How do you integrate that experience into your role as a PT at BBPT?

While at PhysioArts I actually coordinated care with a [former] therapist at BBPT Dustienne Miller (now in Boston Area, Mass). We shared a few patients. I loved the team effort. You don’t learn much about the internal aspect of the pelvis in PT school, so her work was always kind of a mystery to me. But she helped people in a way that I couldn’t! Working with Dustienne gave me even more of an appreciation for the body. Joining BBPT just expanded my tool box! I’m not sure that I integrated my past experiences into BBPT, I’m the same therapist. I just know what’s going on inside [the pelvic floor] now!

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!

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