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Femina Physical Therapy blog

The Staff of Femina Physical Therapy Blogs About Vaginismus, Pregnancy and Postpartum Best Practices, Treatments for Incontinence, and More


Featured From the Blog:

Studies Find Connection Between Diet and Sexual Function

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Photo by Louis Hansel @shotsoflouis on Unsplash

A 2019 study by Towe et al., found that certain medical issues including metabolic syndrome, obesity, and eating disorders have an effect on female sexuality. The study also found evidence that incorporating of healthy dietary patterns into everyday life may positively influence female sexuality.

Metabolic Syndrome and Obesity May Cause Female Sexual Dysfunction

According to the Mayo Clinic, Metabolic Syndrome is a “cluster of conditions that increase the risk of heart disease, stroke, and diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. The syndrome increases a person's risk for heart attack and stroke.” Those with Metabolic Syndrome often have apple or pear shaped bodies.

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Studies Show Mindfulness Can Help You Start and Stick with an Exercise Program

Man Meditating on a Dock
Photo by Simon Migaj (Unsplash)

Physical Activity has Psychological and Physical Benefits

Studies have shown that physical activity has many physical and psychological benefits. Staying physically active can increase happiness (Wang et al., 2012), improve health (Lee and Skerrett, 2001), and enhance quality of life (Penedo and Dahn, 2005).

Getting Started with a Problem Can Be Hard but Mindfulness Can Help

Dishman and Buckworth (1996) found that it is common for adults to quit an exercise program within the first 6 months of starting it, which decreases the chance for folks to fully receive the benefits of an exercise program. One factor that has been identified as helping people stick with an exercise program is satisfaction with physical activity.

In 2016 Tsafou et al. (2016) found that a mindfulness practice while you are exercising can increase

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Can Mindfulness Help With Painful Sex? Part 1

Mindfulness Is More Than A Mindset

From bullet journals to hot yoga, and five minute breathing exercises to weekend meditation retreats, mindfulness is the hashtag-goals wellness buzzword of the moment… and rightly so. It’s hard to argue with all the documented health benefits of being fully present in your activities and relationships.

But is mindfulness a magic cure for painful sex? That’s what many of my patients have been told by well-meaning friends, partners, and even medical practitioners and professional counselors. And I’ll tell you what I tell them:

The pain isn’t in your head; it’s in your muscles. It’s in your nervous system. It’s a complex interplay of the two in many cases.

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Photo by Yuris Alhumaydy on Unsplash

A 2018 study by Bartley et al., showed that transvaginal trigger point injections helped reduce chronic pelvic pain, particularly when in conjunction with therapies including pelvic floor physical therapy.

What is Chronic Pelvic Pain and How Common is it?

Chronic pelvic pain affects 1 in 7 women in the United States and can have significant negative affects on quality of life, physical, emotional, and psychological well-being.  While there are various causes for pelvic pain, a common definition of chronic pelvic pain is pain that is noncyclical and occurring for at least 6 months (Bartley et al, 2018).

Chronic pelvic pain can manifest in various ways, including pain with sex, painful bladder, pelvic girdle pain, and pelvic floor muscle spasms, to name a few. Common diagnoses associated with chronic pelvic pain include interstitial cystititis/bladder pain syndrome (IC/BPS), endometriosis, pain with penetration (dyspareunia), and pelvic floor dysfunctions including vaginismus and anismus.  As we’ve stated in previous blog posts, chronic pelvic pain can involve different systems of the body and include various symptoms that are gynecologic, urologic, psychologic, gastroenterologic, and musculoskeletal.

Trigger Points and Chronic Pelvic Pain

What is a trigger point?

According to the Mayo Clinic, “trigger points are areas of tight muscle fibers can form in your muscles after injuries or overuse. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome.” Researchers have recently confirmed that endometriosis is tied to sensitization of pain receptors in the peripheral and central nervous system as well as myofascial dysfunction and pain(Stratton, Khachikyan, Sinaii, Ortiz, & Shah, 2015).

Read more: Chronic Pelvic Pain:...

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Woman singing Photo by Josh Rocklage on Unsplash

Did you know that when you sing you are not only using your vocal chords, but also the lungs, the diaphragm, the abdominal muscles, and also the pelvic floor?

It’s no surprise that the body is all connected, as in it’s one whole unit, but it’s easy to forget that an activity like singing is a dynamic and complex way we use our bodies. In a 2018 literature review, voice researchers Emerich Gordon & Reed refer to this YouTube video by osteopathic practitioner Roger Fiammetti which beautifully shows how the simple act of breathing involves not just the lungs, but the muscular system from the face and neck down to the bottom of our pelvic floor and the perineum, the video also outlines how the body has four diaphragms which help regulate air and fluid pressure throughout the body.

In fact, look at the structural similarities of the vocal chords and the pelvic floor:

Read more: How Singing Could Help Heal...

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You feel it coming, but you can’t stop it; that twitch in your pelvic floor perfectly timed to your sudden cough or sneeze, or the confirmation you’ve pushed that pigeon pose a little too far. Stress Urinary Incontinence (SUI) – involuntary leakage that occurs with increases in intra-abdominal pressure – is one of the more frustrating and embarrassing hallmarks of womanhood, the inescapable tradeoff for motherhood or a satisfying workout.

Read more: Stress Urinary Incontinence...

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A couple laughing with arms around each other.

Studies have shown that mindfulness can improve your sex life by increasing arousal, reducing sexual pain, lowering judgement, improving relationship satisfaction, and improving self esteem. Those of you who have had sessions with me in the clinic have most definitely practiced some forms of mindfulneses meditation with me, as it helps one increase connection between the brain and body, reduce anxiety, and downregulate the nervous system.

What is Mindfulness?

Mindfulness can be defined as an open or a receptive attention to and awareness of what is taking place, both internally and externally, in the present moment (Barnes et al., 2007).

Read more: Mindfulness Can Improve Your...

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three people riding bike near trees during daytime

Cycling has become an increasingly popular mode of exercise and transportation, and before COVID-19 cycling classes were very popular.

Now with many cities under shelter in place ordinances, folks are dusting off their bicycles and riding the streets for exercise.

There are many health benefits to cycling, including improved cardiovascular health, better weight control, and decreased risk of breast cancer in women (Greenberg, 2019).

Despite all these amazing health benefits (I, myself am an avid bicyclist), you can ask almost anyone who has ridden a bike- the seats can get kind of uncomfortable after prolonged periods of time. And for some, issues worse than discomfort can arise: genital numbness, genital pain, nerve conduction issues, and sexual dysfunction. Through the years there has been some research that has linked bicycle riding, genital pain and genital numbness, and sexual dysfunction in both sexes. In fact, we’ve explored how rider/seat positioning on your bicycle can exacerbate nerve and orthopedic issues in past blogs.

Read more: Is riding your bike giving...

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Hetero Couple in Bed

It's no surprise that if you recently had hip surgery, or have an ongoing hip issue- that your sex life could suffer. Read on for some recommendations. 

What is Femoroacetabular impingement (FAI) syndrome?

Femoroacetabular impingement (FAI) syndrome is a disorder of the hip that typically affects young adults. It is the result of an abnormal contact between the greater trochanter of the femur (thigh bone) and the acetabulum (the socket).

FAI is one of the most common reasons why people undergo arthroscopic surgery on their hips, but many people are treated via conservative pathways (PT, rehabilitative exercise, joint injections). The symptoms of FAI syndrome include motion- or position-related hip and/or groin pain. Pain may also be felt in the back, buttock or thigh. In addition to pain, patients may also describe clicking, catching, locking, stiffness, restricted range of motion or giving way. (Griffin et al., 2016). 

Read more: Sex and Your Hip...

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Photo by Toa Heftiba on Unsplash

Manual Therapy Skills are an Often Overlooked Aspect of Physical Therapy

In is well documented in journals such as the International Urogynecology Journal and Harvard Medical School that patients see positive outcomes when they receive treatment with trained pelvic floor therapists. One of the most valued skills of a trained pelvic floor therapist is their manual therapy skills.

Read more: Benefits of Manual Therapy...

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Photo by Kelly Sikkema on Unsplash

Many women experience lower libido, vaginal dryness, sore muscles, and tender skin in the genital area after childbirth.

These issues can make sex uncomfortable, or even unappealing.  

Many women are not comfortable bringing up their sex lives to their doctors and midwives, thinking that it “will get better with time.” However, if you find your sexual health impacted for more than a few months after childbirth, you might start to wonder when you’ll be feeling back to normal.

Read more: Common Postpartum Issues...

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Do you really know what happens to your hormones during pregnancy? Do you know what hormones are in play, during pregnancy?

Well, let’s go through some of the hormones and their functions during pregnancy, so you can have a better understanding of what is occurring in your body. 

Read more: What's Happening To Your...

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Photo by Le Minh Phuong on Unsplash

As many places in the United States and around the globe are beginning to navigate new realities and daily routines in light of COVID-19, there is undoubtedly a lot of stress, anxiety, and helplessness affecting not only individuals, but our entire global community.

I myself am writing to you on day 7 of a 14 day quarantine and the Los Angeles community is preparing to abide by a “stay at home” ordinance with no definite end date at the time of this blog.

As various studies have shown, mindfulness meditation is an indispensable tool to help soothe stress and anxiety, reduce chronic pain, as well as keep your brain well resourced and healthy. In fact, this study by S. Lazar in 2005 showed that those with a steady, long term meditation practices have more brain matter than those who did not.

Read more: Ways to Keep Calm: Using...

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Photo by Mark Hang Fung So on Unsplash


Today is another blog post to help you connect with resources to help manage the feelings of stress, anxiety, and helplessness in light of COVID 19 and the ways in which our global community is facing this challenge together. 

What are Tai Chi and Qi Gong?

Tai Chi and Qi Gong are both ancient Chinese practices which involve slow, mindful movements, meditation, and breathing exercises. Both schools of martial art are low impact and designed to increase circulation, balance, and alignment. In Traditional Chinese Medicine, these practice are also thought to restore energy, otherwise known as chi or qi (pronounced "chee").

Read more: Simple Tai Chi and Qi Gong...

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Addressing COVID-19 (Coronavirus) Concerns:

Here at Femina Physical Therapy, we are following COVID-19 along with the rest of the world. Our offices have always followed Universal Precautions and follow CDC infection control guidelines. LA Mayor Garcetti's Executive Order specifically lists Physical Therapy as EXEMPT from the order, allowing our offices to remain open at this time. In order to reduce patient and therapist risks, we have a number of policies in place to redue exposure. Related to COVID-19 per CDC’s website, “Everyone should wear a cloth face cover when they have to go out public" and to "Cover your mouth and nose with a cloth face cover when around others". Additionally Los Angeles County and the City of Glendale (where our Montrose office is located) mandates people have face masks going in to essential businesses.

In addition, CDC also recommends following everyday preventive actions, such as washing your hands, covering your cough, and staying home when you are sick.”

Read more: Addressing COVID-19 Concerns

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Photo by Luis Quintero on Unsplash

Many people start like to start the new year off with exercise regimens and plans to lose weight.

Unfortunately, often times women who start exercise programs to lose weight also lose their ability to control of their bladders and experience urine leakage during physical activity, otherwise known as stress urinary incontinence (SUI).

So what makes certain exercises more leak-prone? Which exercises put less stress on your pelvic floor? Read on to find out.

Read more: Get Fit Without Leaking!

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Photo by Sharon McCutcheon on Unsplash

Pelvic pain during the postpartum period is common, even for those who had a “perfect and easy” pregnancy, labor and delivery. Often times, healthcare providers will tell women that the pain “will get better with time,” however it's important to advocate for yourself and seek out care if you feel like you need it. Read my previous article about advocating for your postpartum care here.

Common types of postpartum pelvic pain and what you can do at home:

Vaginal Dryness

After delivery, your estrogen levels drop and progesterone levels stay high, especially if your are breastfeeding.

What you can do:

A simple solution can be drinking more water and using a water-based lubricant, read my previous blog on choosing the right lubricant for you.

Read more: Postpartum Pelvic Pain and...

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Pain at the pubic bone is also known as pubic symphysis pain

It is a common ailment experienced during pregnancy

In fact, in a study by Mogren (2006), 50% of pregnant women have some type of pelvic girdle pain prior to 20 weeks gestation. The pain can make daily activities like working, walking, and doing chores, painful if not impossible, and can can also negatively affect quality of life and sexual life during pregnancy (Mogren, 2006).

Read more: What to do if You Have Pubic...

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Optimizing Your Pelvic Floor Health is No Longer a Secret

As pelvic floor physical therapy gains acceptance amongst an ever widening audience, popular websites such as Next Avenue are providing much needed exposure to their readers.

In a recent article entitled "Could Your Symptoms Point to a Pelvic Floor Disorder?", author Brette Sember quotes Heather Jeffcoat as part of this wide ranging discussion of pelvic floor treatments:

Read more: NextAvenue.com: Could Your...

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As Featured In

ABC News
Shape Magazine
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What They Say About Us

  • Testimonials

    • Testimonial by R.D., age 38

      "I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and...

      Read more Testimonial by R.D., age 38

  • Testimonials

    • Testimonial by R.M., Age 40

      I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor...

      Read more Testimonial by R.M., Age 40