Running to the bathroom, AGAIN!

By Stephanie Stamas

wIgeXGtyiplkxTRIYk3iXG0tC50oA-t6qfUc-H046c0l4liGbEURRiN0ZNe-YyAbK-gNoWyz02uW_OqrTeCmAQkeFh-fxbYm7jCd6rNHMLAIlLGaq4Fkf2lYG5A-an68EFe7Yo7UPxSq00CTdohw5UnNRi-8nE1tmwB4B_OS5tJm_Dbb7CmY0Upj7C55-7guNYLvJxKH-Of2GhbPRyNuZhua4_sXThe Pelvic Health 101 series is back again! At our next class, on Tuesday, March 24, we are discussing urinary dysfunction. Urinary dysfunction is NOT something only post-partum women experience. If you are someone who swears you have a small bladder, leak a little when you sneeze, cough or laugh, get up multiple times a night to urinate, go to the bathroom ‘just in case’ or have to plan an escape route at every party to find the closest bathroom – then this lecture IS FOR YOU!

We will be discussing how urinary dysfunction in women AND MEN can be closely related to pelvic floor muscle issues, what normal looks like (most people have no clue) and what you can do to retrain your bladder back to health. Medical conditions affecting the bladder, such as chronic UTIs, overactive bladder syndrome, interstitial cystitis (IC) and prostatitis will also be discussed. These classes are FREE and are selling out like a New York cronut. Reserve your spot here.

All seminars will be held at Beyond Basics Physical Therapy in New York City and start at 7pm. A free “Healing Pelvic and Abdominal Pain” DVD will be given to first time guests, and $20 voucher for Beyond Basics Physical Therapy products will be given to individuals attending five seminars. Space is limited, so reserve your spot today!


How can I manage my endometriosis-related pain?

Whether you are newly diagnosed or have been living with endometriosis for many years, you may find yourself asking, “Is there anything else I can do to help with the pain?” While there are many medical and surgical options available, a lot of women are not fully satisfied with their pain reduction. In honor of Endometriosis Awareness Month, and every month, we’re here to help.

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Endometriosis is the name given to a condition in which endometrial tissue (the lining of your uterus) grows in places outside of the uterus. The growth of endometrial tissue outside of the uterus can cause areas of restricted or “stuck” tissue called adhesions. Adhesions and scar tissue from surgeries to treat endometriosis, as well as endometrial implants themselves, can cause constipation, painful sex, and severe pain, which worsens during your period. Pain or irritation from endometrial implants on a pelvic organ may refer or appear in muscles that are innervated by the same spinal level as the irritated organ. This is known as the viscerosomatic reflex and can result in muscle spasms and trigger points, which may seem completely unrelated to endometriosis. Scientists still do not agree on a definitive cause of endometriosis; however, scientists have recently published many studies about steps individuals can take to help with their endometrial pain.

Getting in daily exercise has been shown to be helpful in alleviating and preventing many health conditions. The benefits of exercise on endometriosis-related pain have been reviewed in an article by Bonocher(2) and colleagues. The authors of this review found that exercise may indeed have a preventative effect on the development of endometriosis in women who exercised between two and four hours a week.

The same article also suggests exercise may help women who are already suffering from endometriosis-related pain. The pain caused by endometriosis is thought to occur because of inflammation caused by endometrial implants outside of the uterus. Exercise had been shown in repeated studies to increase anti-inflammatory chemicals in the blood and therefore reduce pain caused by inflammatory processes.

In a study by Zahra Rakhshaee(4), published in 2011, yoga was found to ease painful periods and may be helpful in managing the symptoms of endometriosis. In this study, a yoga routine consisting of daily 20-minute sessions had a significant effect in reducing pain in the study participants.

Acupuncture is an ancient Chinese healing practice and can be used to treat many conditions. In a review by Leong in 2014 (3), acupuncture reduced painful periods in 92% of study participants. The review also cited an article in which 73% of participants reported an improvement in their symptoms versus 42% receiving a placebo (fake) treatment.

Physical therapy treatment can be helpful in treating many of the issues associated with endometriosis. In a study by Wurn in 2011 (5), physical therapy was shown to have a significant effect on reducing pain and improving sexual function in women who have endometriosis. Physical therapists are trained healthcare practitioners who can guide you in strengthening and stretching programs to help ease your pain, apply hands-on techniques to restore mobility lost due to endometriosis and other conditions, as well as guide you through lifestyle modifications you can make to ease your pain and other pelvic floor symptoms.

Physical therapy can also be helpful to mobilize and “free up” tissues that have become stuck as a result of adhesions caused by endometriosis. A physical therapist can use his or her hands to loosen adhesions to allow the organs of your abdominal cavity to move more freely, and thus reduce pain, improve issues with constipation and even make sexual intercourse more comfortable. (Arung, 2011)

If one or all of these methods of pain management strategies sounds like they will work for you, Beyond Basics Physical Therapy can help guide you. We have an excellent team of physical therapy practitioners who are experts in the field of pelvic health, who do hands on work, who can develop an appropriate exercise plan tailored to your needs, and can guide you through other lifestyle modifications to help reduce your pain. We also partner with acupuncture and yoga professionals who offer services on site at our Midtown clinic. We hope to see you soon as you begin your journey of healing.

1.) Arung W, Meurisse M, Detry O. Pathology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011: 17(41) 4545-53

2.) Bonocher C, Montenegrow M, Rosa e Silva, et al. Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology. 2014, 12:(4)

3.) Leong F. Complementary and alternative medications for chronic pelvic pain. Obstetrics and Gynecology Clinics of North America. 2014, 41:(3): 503-10

4.) Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish) in women with primary dysmenorrhea: A randomized clinical trial. Journal of Pediatric Adolescent Gynecology. 2011;24(4):192-6

5.) Wurn B, Wurn L, Patterson K. Decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual therapy: results from two independent studies. 2011;3(4)

The School of Pelvic Health is BACK!

Yes, you read that right: We’re doing another semester of our very successful School of Pelvic Health! Starting on March 17th, our own Stephanie Stamas, PT, DPT, will lead you through seven weeks of FREE classes related to pelvic health. These include but are not limited to a review of pelvic floor anatomy (March 17, “Something’s Wrong With My What?”), sexuality and pelvic health (April 7, “Pain & Sexuality: Is it all in my head?”), and much, much more. See the flyer below for more classes (click to enlarge).

At each session, snacks and beverages will be provided, and a $20 voucher for BBPT products will be given to individuals who attend five or more classes. First-time participants will get a FREE copy of Amy’s new DVD, Healing Pelvic and Abdominal Pain.

If you’re interested in attending our School of Pelvic Health classes, you MUST sign up by RSVPing at this link. Spaces fill up quickly, so be sure to do it soon!

If you have any questions, please feel free to give us a call in the office at 212.354.2622. We look forward to seeing you there!


Anti-Anxiety Medication and Chronic Pain

In his new book Touch: The Science of Hand, Heart, and Mind, author David Linden explores the way the brain, the skin, and the nerves interact to create pleasure and pain. In this interview with NPR, Linden discusses the way anti-anxiety medication can affect chronic pain, in that the former can partially reduce the latter.

Linden says:

“So it turns out that the emotional pain centers are richly interconnected with regions of our brain having to do with cognition and anxiety and anticipation. So this is why many people who suffer from chronic pain can get partial relief from anti-anxiety medication. It’s not that the anti-anxiety medication directly affects pain-perception — what it does is it breaks this horrible positive feedback loop between anxiety and chronic pain.”

In many cases, Linden says, anxiety can trigger more chronic pain. So if you have less anxiety, he suggests, maybe you can have less pain as well.

What do you think? Have you ever been prescribed anti-anxiety medication for chronic pain? If so, how did it work for you?

PT In-Service: Alignment and Core Exercises

By Amy Stein

Our famous Dania Kafka, who is an amazing physical therapist and Pilates instructor, recently discussed alignment, posture and core exercises correctly at our latest PT In-Service. She helped us with proper cueing because we don’t want pelvic pain patients to utilize the pelvic floor muscles, or limit their use, with any core stabilization exercises. We went over how to gently engage the transverse abdominus, which is one of the core muscles and helps with pelvic and trunk stability. If this muscle is weak and the patient is overusing their pelvic floor, they can end up with pelvic pain. Core and trunk muscle imbalances can be one of many reasons a patient ends up with pelvic pain and/or pelvic weakness. Therefore, it is important to have a strong and balanced core. Dania proceeded to lead us through a series of transverse abdominus exercises that were adapted by Shirley Sahrmann, PT, and we incorporated diaphragmatic breathing with each exercise. We practiced neutral spine versus posterior pelvic tilt to compare the difference, and discussed with which populations we would use which position.

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With any pain condition, if there are active trigger points, tightened and/or shortened tissue, you need to address these impairments prior to strengthening these muscles. Otherwise you can exacerbate trigger points and continue to shorten tissues. It is essential to make sure these conditions are resolved prior to starting a core exercise to that specific area.

With regard to pelvic floor weakness, including incontinence and post surgical weakness (prostatectomy, prolapse, etc.), it is important to strengthen the pelvic floor muscles correctly and the transverse abdominus correctly, as well as the rest of the core muscles.

Monitoring each patient with each exercise, is essential for their recovery, in order not to worsen any condition. Starting slow and in a controlled environment is key.

If you have any questions with regard to Pilates and core exercises and when to introduce them for pelvic pain, or pelvic weakness, feel free to call us and ask for any of our PTs. Or, attend our upcoming Pelvic Health 101 this spring!

South of Your Border: Straight Answers About Pelvic Health

We love finding pelvic health educational events all across the country and the world, so we’re excited to share the upcoming “South of Your Border: Straight Answers About Pelvic Health” event happening at the Banner Health Center in Surprise, Arizona (13995 W. Statler Blvd.) on February 12. The event is free, and will take place from 6:30pm to 7:30pm. Advance registration is required, which you can do via phone at (602) 230-CARE (2273) or online.

At this event, Dr. Leszek Grabowski,  will discuss female pelvic health, with the range of topics including incontinence, fibroids, menopause, and much more. Dr. Grabowski specializes in obstetrics and gynecology, specifically the screening and treatment of gynecologic conditions. In addition to this discussion, there will also be a Q&A, chances to win door prizes, refreshments, and a gift for all those in attendance.

painting_sizedforwebThe Banner Health Center is a part of Spirit of Women, “a coalition of American hospitals committed to making good health easier for women and their families.” There are Spirit of Women hospitals located throughout Arizona and Colorado, and the coalition sponsors health-related informative events throughout the year. Not only that, but Spirit of Women also “provides opportunities for women and their families to learn more about their health, get regular updates and be part of a community focused on well-being.” We fully support this endeavor!

If you are in or near Surprise on February 12 and are interested in learning more about female pelvic health, we encourage you to attend this event, not to mention other Spirit of Women events throughout the year.

Jennifer Aniston, Cake, and Chronic Pain

In the new film Cake, coming out nationwide on Friday, Jennifer Aniston portrays Claire, a woman suffering from chronic pain, who finds herself learning how to deal with the suicide of a member in her chronic pain support group. While Aniston has received rave reviews for her performance, we’re curious to see the film ourselves. How is chronic pain portrayed? It is one of the first times chronic pain has ever been the subject of a narrative film, let alone one starring a major actress like Aniston.

So far, it seems many with chronic pain have reached out to the actress to say thank you for giving voice to pain that is often dismissed as “not real,”or “easily fixable,” as Aniston says in today’s TODAY show interview with Robin Roberts. Directed by Daniel Barnes, the film debuted at the Toronto International Film Festival in 2014 to a standing ovation.

Will you be going to see Cake? When you see it, let us know what you think in the comments! The trailer is below for you to view, as well.

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