A Pregnant Physical Therapist’s Top Tips for Your Healthy Pregnancy

Navigating the pregnancy literature on proper posture, exercise and sleeping alignment can be overwhelming and the guidelines presented are often not a “one size fits all”. Afterall, everyone’s pregnancy is unique. Below you will find some quick and easy tips that I utilized and found helpful throughout my pregnancy that kept me fit, aligned and pain free throughout my work day as a physical therapist at EMH.

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PelviCorFit™ by EMH Physical Therapy Grand Opening

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Have you been working out for years, but neglecting a crucial muscle group??

At EMH Physical Therapy we recently launched our brand new PelviCoreFit™ program designed to whip your pelvic floor muscles into shape. Proper firing of pelvic floor muscles is not only essential for pelvic health but is also a key factor in overall core strength and fitness.

Visualize this:

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The pelvic floor muscles form a sling that transmit forces from the ground up and from your head down. If pelvic floor muscles are weak and unaccustomed to firing during exercise, you could be promoting a faulty movement pattern in the chain. Neglecting the Pelvic floor muscles can potentially lead to more serious conditions such as chronic hip, back or pelvic pain, urinary or fecal incontinence, GI and bowel disorders, and erectile or sexual dysfunction. At EMH Physical Therapy we will help you identify and strengthen the pelvic muscles during your general workouts to help prevent future dysfunction!

Additionally, did you know that the pelvic floor muscles play a fundamental role in breathing through connections to the diaphragm?  Think about doing cardio, executing a heavy lift, or performing a Vinyasa flow with a sub optimal breathing pattern. Strengthening the pelvic floor muscles can improve breathing which will help to optimize your workout efficiency.

Come try out our discounted  PelviCoreFit™ program, learn about proper activation of the pelvic floor muscles and bring your workouts to the next level!

We offer 2 options:

“PelviCorFit™ #1” – One fifty minute session with a DPT + Fitness Guru that includes 15 minute pelvic floor/core education followed by a 30 minute PelviCorFit™ workout, then Q&A. Regular price is $200. New Client price is $50

“PelviCorFit™ Pack” – Three (3) fifty minute sessions with your DPT + Fitness Guru. The first session is similar to the description above. The 2 follow up sessions include 45 minute PelviCorFit™ workouts plus instruction on how to implement pelvic floor awareness into your fitness program. Regular price is $500 for 3 sessions. New Client price is $130

To register call 212-288-2242

or

email info@emhphysicaltherapy.com

For more information click here

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Good News!: Sex & Tampons Should Not Cause Pain

Do you find that you have pain and difficulty inserting a tampon?

Is it a struggle to allow the Ob/GYN to use a speculum?

Have you experienced pain during intercourse?

Are you unable to have intercourse due to vaginal muscle spasms?

You may be experiencing vaginal muscle tightness, or a fairly common condition known as vaginismus.

What is Vaginismus?

GirlVaginismusPelvicPTMeme

Vaginismus is involuntary vaginal muscle tightness or spasming that occurs when  attempting to insert something into the vaginal canal. It can be extremely painful with patients often describing symptoms as stabbing, burning, throbbing or “knife like” sensations.

Statistics show that 30% of women report pain with intercourse, however, it is difficult to determine the number of women suffering from vaginismus because women are reluctant to report the symptoms, or are unaware that this pain isn’t “NORMAL”. Many women experience vaginal pain beginning in adolescence and become so accustomed to living with discomfort, that it becomes their “normal”. They expect to have pain inserting a tampon, they expect pain with intercourse – so it never occurs to them that these actions should or could be pain-free.

At EMH, we want to make sure you are aware that inserting a tampon, getting a pap smear and engaging in intercourse should be absolutely pain-free! We have helped countless women of all ages tackle vaginismus. The key is to understand the muscles of the pelvic floor and to build a mind-body (neuromuscular) connection.

The muscle tightness you’ve been experiencing initially feels like it is completely out of your control, but luckily we know these vaginal muscles are voluntary just like most other muscles in the body. At EMH we will teach you how to identify, control, and relax the vaginal muscles using a combination of breathwork, meditation techniques, external stretching, internal vaginal stretching and dilators.

While the idea of using dilators (pictured below) may seem daunting at first, have no fear: an EMH Physical Therapist will slowly and gently guide you through the stretching process as well as initiating and progressing dilator use at a comfortable pace.

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 GirlVaginismusPelvicPTMeme

Tips for beginning treatment:

Seek treatment early and often for best results

A pelvic physical therapist can evaluate and identify if the source of your vaginal pain is due to muscle restrictions. Make an appointment for a pelvic floor evaluation at your earliest convenience. Begin physical therapy treatment to start the healing process. In many ways, the vaginal muscles are like all othe

r muscles that you would exercise and strengthen at the gym. Commitment and dedication are key. Plan on a minimum of 2-3 times a week.

Take 5:

Take 5 minutes out of your day to focus on breathing. Lying down on your back with your knees bent, take a slow breath in, allowing your belly to expand gently on the inhale and allowing the breath to escape slowly on the exhale. Mentally focus on “melting” the vaginal muscles and allow them to unclench.

Stretch, stretch, stretch:

If you have a tendency to clench your vaginal muscles, chances are you are holding tension in many other muscles groups in your body, especially the hip, thigh and butt muscles that attach directly to the pelvis. Taking 10 minutes out of your day for a quick and easy stretching routine will go a long way in teaching your body how to begin relaxing your vaginal muscles. Don’t forget to breathe!

Some Favorite Stretches:

Figure 4, Child’s Pose and Modified Happy Baby (all pictured below)

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Cited source:

Herbenick, Debby, et al. “Pain Experienced During Vaginal and Anal Intercourse with Other‐Sex Partners: Findings from a Nationally Representative Probability Study in the United States.” The journal of sexual medicine 12.4 (2015): 1040-1051.

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Onward and Upward: Pilates Guillotine Tower

As many of you know, we recently moved up to the 9th floor to offer our patients larger treatment rooms and a tranquil, glass enclosed exercise space. In this blog, we’d like to introduce you to the latest and greatest addition to our gym, the newly acquired Pilates Tower, known by Pilates gurus as “The Guillotine”.  While the name “Guillotine Tower” may send shudders down the spine, evoking images of the historic reign of terror, the Pilates version is actually an easy-to-use, patient friendly, device designed to develop mobility, stability and strength of the hips, pelvis and spine. At EMH, we have taken “The Guillotine” to the next level, adapting basic exercises and stretches to treat the pelvic floor muscles.

 

Pilates Tower

 

Guillotine Tower Benefits:

 

  • Provides incredible feedback: which makes it a great assessment tool for stability, flexibility and articulation. Patients  can easily see when they are out of alignment or overusing a dominant side because the sliding bar will move in a jerky, uneven pattern.  When the bar glides smoothly and silently,  you know you have perfected the movement.
  • Offers  accessibility: The vertical slider allows patients with limited hamstring and lower-back flexibility (you know who you are!) to experience the full benefits of stretching and strengthening exercises.
  • Supplies versatility: Spring attachments of varying tensions can be used to create assistance or increase resistance modifying exercises for all levels in both upper and lower body exercises.
  • Targets the pelvic floor: A combination of common Pilates exercises and general pelvic floor exercises have been adapted by our expert physical therapists to address overactive or weak pelvic floor muscles that may be contributing to your specific diagnosis.

 

Pilates Tower Bar Lift Pilates Tower leg and core workout

Our Therapists Working with Pilates Tower Pilates Tower Leg Lifts

Pilates Tower Bar LIft One Leg Pilates Tower Bar Lift Two Legs

Pilates Tower Flying Back Bend Pilates Tower Core Workout

 

Coccyx Pain: A Huge Pain in the Butt!

Pieter Brueghel the Younger, c. 1616

The term coccydynia was coined in 1659, but coccyx pain, or pain in the tailbone, has likely been afflicting man since the beginning of time. After all, humans have been falling on their behinds for thousands of years.

While there can be many causes of coccyx pain, this post focuses on traumatic injury localized to the coccyx bone.

 

What is a coccyx?

The coccyx is a small triangular bone that forms the very tip of the spinal column. Though it’s a remnant of the tail, it serves as a crucial attachment site for various tendons, muscles and ligaments that contribute to the pelvic floor. It also is a weight bearing structure for sitting.

 

A traumatic injury, such as a fall or a difficult vaginal delivery may cause a shift or fracture of your tail bone which can lead to a change in pelvic floor muscle length and give rise to a cascade dysfunction. In addition to tenderness at the tip of the tailbone, injury to this structure can cause pelvic floor muscle spasm or muscle weakness. If left untreated, symptoms can progress, manifesting  as pelvic pain,  difficulty with  urination and defecation, or even urinary and/or fecal incontinence.

 

Symptoms of true coccydynia include:

  • sitting pain at the tail bone or sitting intolerance
  • pain with moving from a seated position to a standing position (pain usually resolves while standing)
  • pain in both glutes (butt cheeks) and/or both hamstrings

 

What to expect for evaluation of coccyx at EMH Physical Therapy:

 

First, the therapist will perform a posture analysis to determine spinal and pelvic alignment. The therapist will observe the pelvis and palpate (feel) the coccyx externally to determine if it is shifted, rotated, curved or extended.

 

She will then assess the muscles that attach to the coccyx externally to determine if they are painful and tight, or weak and overstretched.

 

An internal exam will then be performed in order to reach the anterior surface of the coccyx and the full length of the pelvic floor muscles to confirm the diagnosis.

 

An internal sensor may be used to get objective information with regard to exactly how the pelvic floor muscles are firing.

 

Based on the results of the evaluation, the therapist will treat your tailbone pain by mobilizing the coccyx, releasing the tight muscles and strengthening the weak ones in order to restore normal alignment and function.

 

Lastly, the therapist will design an individualized home exercise program to reinforce the techniques used during the physical therapy session that will address both the local coccyx pain and the global, full body strength and alignment.

 

For best results, research shows that it is best to seek physical therapy treatment within the first six months post injury. So hang up your “donuts”, “butt cushions” and heating pads, and treat yourself in 2016 by making an appointment at EMH physical therapy to kick coccyx pain’s butt!

Leaking is More Common Than You Think

Hmmm…. How to put this delicatelyWoman jogging on a track

Do you often find yourself leaking urine while exercising?  Squat… leak a little, overhead press… leak a little more, jump… forget about it, pants are soaked!

If this describes YOU, know that you are not alone. You likely fall into the 25% of women between the ages of 18-44, or the 44% of seniors, or the 33% of female athletes who experience varying levels of incontinence. These astounding statistics represent only those who have come forward to report symptoms. If you are skeptical, just take a look at YouTube (search “girl peeing while lifting weights”). You will find solidarity; everything from women admitting to leaking during exercise, to videos of complete loss of bladder control while executing a heavy lift. Today, there are even T-shirts glorifying urinary leakage during workouts in order to empower women and banish feelings of shame.

It is wonderful that women are finally coming forward to bring this previously taboo topic out into the open.  Just last week, Kate Winslet explained that she no longer jumps on trampolines for this very reason.  Leaking when exercising, sneezing, or coughing is so normal that Winslet’s admission was received with more “it’s nice to know she’s normal” reactions than surprised ones.  Yet, shockingly, statistics show that women will wait, on average, 6.5 years before reporting incontinence, because as normal is it may be, women rarely speak of it, even to their medical providers.  It’s no wonder urinary (and fecal) leakage has generated a $28 Billion dollar industry in the US alone.

If you are leaking while exercising, it is likely that your pelvic floor muscles are just not firing properly in order to withstand the load. We call this Stress Urinary Incontinence (SUI) which describes urinary leakage that occurs particularly with physical activity or exertion. While this issue is extremely common, it is not something you want to leave untreated. Whether you are losing a few drops or outright “peeing your pants”, help is out there, in some cases, right around the corner.

First you must understand that the pelvic floor muscles are just that: muscles. Therefore, you can strengthen them like any other muscle. We spend hours in the gym attempting to perfect every muscle in the body, but somehow forget the pelvic floor, a keystone to our overall health and fitness.

The tricky part is that you can’t easily see these muscles. As a matter of fact, you may not even be able to feel them. That is where Pelvic floor rehabilitation comes to the rescue. At EMH, we teach you how to identify, isolate and strengthen the pelvic floor muscles to restore normal function. We then help you integrate pelvic floor techniques back into your exercise routine so that you can squat, overhead press, and jump “leak free”.

So at your next holiday party, just think to yourself — 1 in 4 of the women in this room are currently peeing in their pants. Luckily, you don’t have to be one of them.