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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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How to Foam Roll Most Major Muscle Groups in 5-10 Minutes

Don’t you wish you could get a deep tissue massage every day? If you said “yes!” then I highly recommend you make a small investment in your own foam roller.

I foam roll every time I go to the gym because it’s the easiest way to self-release all of the major muscle groups. Foam rollers act on the fascia, or connective tissue, that lies above all muscles and organs of your body. When you use a foam roller, you’re making the fascia mobile, which ensures all structures underneath will function without restrictions.

When ordering remember: darker colors usually mean a firmer roller. If you are a beginner try white or a light color. If you want a deeper, firmer tissue massage go with dark grey or black.

Check out my quick video that hits most major muscle groups in just a few minutes. Happy rolling!

Having trouble losing the “Mom Belly” Post Baby?

Why diastasis recti may be your problem and how you may be making it worse…

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If you’re doing a million crunches to get your abs back post baby but can’t seem to lose that last little “pooch,” STOP!! You may be experiencing a very common postpartum complaint: diastasis recti.

 

What is diastasis recti?
It’s a separation of your rectus abdominis (6-pack muscles). As your belly expands during pregnancy, the connective tissue between the right and left sides of the muscle (called the linea alba) stretches to accommodate your growing baby. This separation may persist postpartum and in some women does not naturally reduce. This gap leaves your abdominals less functional, weaker and allows the other soft tissues to hang out. This causes that little belly that most new moms learn to hate.

Do I have diastasis recti?
Lay on your back with your knees bent and feet flat on the floor. Place 2 fingers at your belly button. Now lift your head like you’re trying to look at your belly while keeping your abs relaxed. Do you feel a gap along the midline of your abs at your belly botton, how about above or below the belly button? If you can fit more than 2 fingers in this “gap” you have a moderate-severe case of diastasis recti.test

What can I do about it?
Don’t freak out! You can learn a simple exercise to “brace” your abdominals that will begin to close this gap. Begin on your back with knees bent, feet flat and try to engage your deep abdominals by inhaling and bringing the navel to the spine as you exhale. See the exercise program below (“Other Resources” at the bottom of this blog) for a beginner plan geared towards closing the gap of your diastasis recti. If your goal is to get back to running, yoga, barre classes, spin classes etc., it’s recommended that you attend a few (anywhere from 2-12) PT sessions in order to strengthen your abdominals and avoid stressors that you’re not ready for. For example, planks and crunches are too challenging for abdominals weakened by diastasis recti and can worsen the separation if done improperly or too soon.

Bracing Steps (standing & lying down)

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Other Resources:

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Home exercise program for beginners: View at www.my-exercise-code.com using code: TGQQAGV

http://mumafit.com.au/  A site created by an aussie mom of 3, Maternal Wellbeing Specialist, and International Holistic Life and Wellness Coach. She also has a very popular app that has quick and easy exercise programs for during and after pregnancy.

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Sitting is Detrimental To Your Health

“In the interest of keeping our  current and prior patients healthy (and happy) I am pleased to introduce “EMH Physical Therapy Better Health & Movement Blog”

Today ‘s article is about posture. The key to a healthy spine, pain free neck and lower back is to maintain a neutral spine throughout the day, work or play.

EMH Physical Therapy offers manual therapy to release restrictions,  low level laser therapy to stimulate healing and tailored exercise programs. Yes, we still offer individual 45 minute treatment sessions by one licensed Doctor of Physical Therapist.

The-health-hazards-of-sittingWritten By: Lauren Calado, DPT, PT 

Our bodies have 650 muscles and their function is to contract, stretch, fire up… MOVE.

Did you know that more than 80% of us sit for over 10 hours a day? As technology in the work-place and at home increases, physical activity is rapidly declining.

A New York Times article reported, “Jobs requiring moderate physical activity, which accounted for 50 percent of the labor market in 1960, have plummeted to just 20 percent” (2011). Add on more time dining, watching television and more than 75% of your day could be spent sitting. This is a functional contradiction to human anatomy and physiology and has a negative impact on your health.

The health risks of prolonged sitting include low back pain, muscle weakness, impaired posture, neck/shoulder pain, nerve impingements, decreased flexibility and pelvic floor dysfunction. Other disorders that may develop as a result of long periods of sitting are decreased cardiovascular endurance, obesity, poor circulation and decreased life span. Yikes!

Tips to decrease the health risks of sitting:

• Take one flight of stairs up/down instead of taking an elevator to your floor destination
• Walk to a co-worker to talk instead of calling/texting/emailing
• Stand up during TV commercials
• Perform a few different core/strength exercises such as standing squat, push up, or an abdominal exercise 10 reps twice a day.
• Wear one of the new fit bracelets to track your walking or cardio results
• Park your car further away from the office or your house
• Enter/Leave the subway station that is one stop away versus the closest station to home/work

Research shows that your brain needs a movement break after 50 minutes of working, thinking, sitting. Get up for the last 10 minutes of each hour to take a walk, pet the dog, do a quick errand. Your brain will be refreshed and creative thinking will be enhanced.

If you are experiencing sitting related problems, consult a physical therapist. Physical therapists have 7 years of education in advanced anatomy and physiology, movement science and interventional healing therapies. The Direct Access law allows you to consult a PT first, so you don’t have to see a doctor, get a prescription and be referred to physical therapy. We can help you heal from sitting related dysfunction.

 

Pelvic PT highly rated in new IC Guidelines

The American Urological Association (AUA) released a new update to their 2011 Guideline on the Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). The original guidelines included research studies up through 2009. This new revision includes research studies through 2013. Read the amended guidelines here!

“Although the science relevant to IC/BPS is continually improving and evolving, it is still a challenging and complicated condition to diagnose and treat,” said Philip Hanno, MD, who chaired the multi-disciplinary Panel that developed and updated the Guideline. “…this Guideline is fully aligned to the latest science and provides physicians with a relevant blueprint to treating patients.”

Developed as a treatment guide and planning tool, the 2011 guidelines introduced a six step treatment plan. Newly diagnosed patients generally begin with strategies outlined in Step One and then, if those strategies do not bring symptom relief, are advised to try Step Two treatments and so forth. The treatments are classified within the steps based upon their risk of adverse events and/or if the treatment is reversible. Surgery, for example, would never be used as a first line intervention because it is irreversible and could cause very serious complications. Rather, surgery is listed as a Step Six treatment and would only be considered after the patient has tried and failed the therapies listed in Step One Through Step Five.

Two Key Changes

Comprehensive Physical Therapy Encouraged

In Step Two, Pelvic Physical Therapy was suggested for patients who present with pelvic floor tenderness with the highest review possible, Grade A. It states:

Appropriate manual physical therapy techniques (e.g., maneuvers that resolve pelvic, abdominal and/or hip muscular trigger points, lengthen muscle contractures, and release painful scars and other connective tissue restrictions), if appropriately-trained clinicians are available, should be offered to patients who present with pelvic floor tenderness. Pelvic floor strengthening exercises (e.g., Kegel exercises) should be avoided. Standard (Evidence Strength Grade A).

Botox Therapy Rating Improved!

Botox A was reclassified from Step Five to Step Four. New research emerged which showed that using BotoxA at a lower dosage, (from 200u to 100u) substantially reduced the risk of a troublesome complication, the need for self-catheterization. If a Botox treatment silences the nerves which control urination, a patient may be forced to self- catheterize until the effect wears off, often for months. One criteria for the use of Botox is the ability of a patient to self-catheterize if necessary. If a patient is unable to do so, this therapy is not recommended. The guidelines state:

Intradetrusor botulinum toxin A (BTX-A) may be administered if other treatments have not provided adequate symptom control and quality of life or if the clinician and patient agree that symptoms require this approach. Patients must be willing to accept the possibility that post-treatment intermittent self- catheterization may be necessary. Option (Evidence Strength- C)

Learn more about IC Treatments, including all treatment options in the AUA Guidelines here!

Pelvic Pain App developed by Evelyn Hecht, PT

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“She inspires us to not accept the status quo, to strive for wonderful things and not just acceptable things. There’s a lot of good nuggets of wisdom and interesting ways of looking at the profession. Some Apps are fun but the best are more about life”-  Dr Joe Simon

 

I felt this quote was the best to describe my thoughts about this interview. Dr Evelyn Hecht has been treating patients with Pelvic Floor Dysfunction (PFD) longer than there has been a doctorate program at my alma mater. But innovation is not the key to riches. Evelyn saw a need in the marketplace and decided unlike many in our industry not to wait for someone else to do it .

Lately i have consulted with more and more physicians and surgeons on their legacy or exit strategy. Evelyn is no where near the end , matter of fact , she is on the cusp of a new road in healthcare. Apps are a highway of free traffic from possible clients from around the world. Evelyn has just made it easier for the vast population to accept her as the expert in the field.

Pelvic floor therapy is a growth factor for practices across the country. This new specialization is growing with a medical network from physicians, physios & psychologists.

INTRODUCING, PELVIC TRACK a new app to help PATIENTS and practitioners to work together. The challenges associated with communication with the therapist dealing with pelvic floor therapy. Again , it was not looking for a better mousetrap but to create one that doesn’t exist from the need of her patients and her therapists.

The motivation for our new grad and younger (not age but career wise)  listeners. Evelyn has made strides and conquered the niche market. Marketing pelvic floor therapy through facebook, through her blog and now through her App is something i would ask all my listeners to take a deeper look at.

I hope you find the takeaways that I did.

For more info or to read the article directly click  HERE

To purchase or for more info on Pelvic Track App click HERE

Pelvic physical therapy is an effective non invasive treatment for Pelvic Organ Prolapse vs “high risk” transvaginal mesh surgery

The FDA recently deemed use of transvaginal mesh surgery to be “high risk” to repair pelvic organ prolapse.  See news link below:

http://www.philly.com/philly/health/womenshealth/HealthDay687309_20140429_FDA_Moves_Female_Incontinence_Device_to__High_Risk__Status.html

Pelvic physical therapy is a more effective and non invasive option.

In a 2014 study of 800 women with pelvic floor dysfunction (which includes pelvic organ prolapse) by University of Missouri, researchers found that ” incontinence, constipation, and/or pain improve by 80% with pelvic physical therapy”. Research shows that pelvic physical therapy plus a prescribed home exercise program works better than just engaging in one option.

Pelvic physical therapy teaches patients with pelvic organ prolapse how to build up the “floor” or muscular base of the pelvis. The pelvic floor muscles provide the main support for all pelvic organs. Kegels alone are not the only treatment option. If there is tension in the pelvic floor muscles, they need to to be released via manual therapies or risk further dysfunction. Sitting posture and good voiding habits are addressed, exercises are prescribed and body awareness improved.

EMH Physical Therapy has been providing successful pelvic physical therapy for 18 years in NYC. We have helped thousands of women return to better function. Call us today to get your prescription for pelvic health.

Evelyn Hecht PT receives award for 20 years as member of HSS Rehab Network

Evelyn-Hecht individual-HSS-Annual-Meeting

Evelyn Hecht, PT receives an award from Hospital for Special Surgery on February 25, 2014.

Her company, EMH Physical Therapy was recognized for 20 years of excellence as a Charter Member of the HSS Rehabilitation Network

Women’s Pelvic Health

Women's Pelvic Health

 

 

Check out this link ( link) to see Evelyn’s interview on physical therapy for women’s pelvic health in the Los Angeles Times. The app, Pelvic Track, is now available on the Apple store.