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

Wait, you're not a PT?

I often get questions from clients regarding how my training as an occupational therapist differs from my physical therapist co-workers here in the office. Today’s blog is a little overview.

What is Occupational Therapy?

Occupational therapy is defined by the American Occupational Therapy Association (AOTA) as “the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community, and other settings” (American Occupational Therapy Association, 2014).

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It’s truly amazing what bodies endure during and following pregnancy. We praise all the new parents that come into the clinic for their resilience not only physically but mentally, taking care of themselves as well as being a caretaker 24/7 whether it’s one child or three children, it really is a super power. It’s so easy to neglect ourselves when you become a new parent; however, this is the time that you can really use our help as rehab therapists. Physical therapy and occupational therapy can help women tremendously throughout pregnancy and during the postpartum period. In this article I will be going through a few of the common diagnoses the therapists see at our clinic during and following pregnancy; however, to understand these common diagnoses it would be better to explain the physical changes that occur and then contribute to patients’ symptoms.

Issues Commonly Experienced During Pregnancy

  • One of the most common complaints reported during pregnancy is Low Back Pain, pain that occurs anywhere between the 12th rib and gluteal fold.
  • 45% of pregnant women report some level of LBP during their pregnancy (33% were considered pregnancy-related low back pain and 50% were pelvic girdle pain).
  • Pelvic Girdle pain, this is defined as pain located below the PSIS (posterior superior iliac spine), in gluteal region, posterior thigh and the groin.
  • Pregnancy-related low back pain is defined as pain along anywhere of the lumbar spine region and above the sacrum.

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Heather Jeffcoat, DPT visits the Great Wall of China

I just returned to Los Angeles after completing an amazing eight day trip to Beijing, China. There I had the opportunity to work with the Chinese Olympic Committee,their rehabilitation staff and athletes. I gave two lectures with hands-on labs to their physiotherapists on Hip Impingement and Cyclist's Syndrome (Pudendal neuralgia in cyclists). Did I talk about the pelvic floor muscles in both lectures? You bet I did! Monica is my awesome Mandarin translator pictured standing next to me below.

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We have moved our East side office to the community of Montrose, just a half mile from our original La Canada location.

This new office is convenient to Glendale, Silver Lake, Atwater Village, Eagle Rock, La Crescenta, Pasadena, Alta Dena, South Pasadena, San Marino, Downtown Los Angeles and more!

We are excited to announce the opening of our newest physical therapy location in Montrose, CA. Right outside of Glendale and La Canada sits our 1,800 square foot office at the connection of the 2 and 210 freeways.

Complete with four treatment rooms and a large gym space including a pilates reformer we are able to support our patients’ needs specializing in pelvic floor, pregnancy and orthopaedic physical therapy. We look forward to having classes, seminars, and course trainings to provide to the community.

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Constipation and pelvic floor disorders often go hand-in-hand for clients with hypertonic (tight) pelvic floor muscles and with associated symptoms like pelvic pain, pain with sex, and urge incontinence. So, let’s get your constipation in control!

The connection between your bowels and your pelvic floor

If you think about what is housed inside of the pelvic bowl, three important systems have to co-exist and share a limited amount of space:

  • Urinary System: the bladder and urethra
  • Reproductive Organs: Uterus, ovaries, fallopian tubes, and vaginal canal
  • GI System: sigmoid colon, rectum

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Don’t let your New Year's workout make you leaky!

Happy New Year!
With new year’s resolutions, a lot of us will be starting new workout routines to shape up. While exercise is a cornerstone of physical health, a little talked about side effect of increased athletic training, particularly for those with female anatomy, is urinary incontinence. A comprehensive literature review published March 2018 in International Urogynecology Journal found that female athletes have an increased the risk for urinary incontinence.

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Urinary Incontinence is common, Pelvic Floor Therapy can help

Urinary incontinence is the loss of bladder control. Urinary incontinence affects up to 1 in 3 women. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB). Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause are contributing factors to urinary incontinence. Urinary incontinence should not be considered a normal part of aging, and it can be treated.

A new article published in September, 2018 by Lamerton, Torquati, & Brown found that being overweight (BMI 25-30) increased risk of urinary incontinence for young and middle aged by 35% and obesity (BMI ≥30) almost doubles the risk at 95%.

The findings of this study are important because those with urinary incontinence when young and middle aged adults are more likely to have worse symptoms when they are older. Another reason why the study is important is that weight, relative to factors like genetics, is a risk factor that can be controlled with diet and exercise.

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A 101 on the credentials, training, and skills of pelvic floor therapists

Two recently published articles, in the International Urogynecology Journal and in Neurourology and Urodynamics talk about the positive outcomes of treatment with trained pelvic floor therapists. Today is a basic rundown of what kinds of credentials, training, and skills pelvic floor therapists have to offer you.

Credentials

Pelvic floor therapists are often physical therapists (PT) or occupational therapists (OT). Both of these disciplines require academically rigorous coursework that covers topics from anatomy and kinesiology, to neuroscience, and the evaluation, treatment, and management of common diagnoses. They are also trained in a medical system, and are aware of "red flags" in signs and symptoms that patients may present with. These "red flags" will typically require additional medical referral to rule in or out (i.e. suspected masses, infection, etc).

You will often find a jumble of letters after your pelvic floor therapist’s name. Here is a breakdown of what those letters mean:

PT, MPT, MSPT, or DPT: These letters represent the degree that your physical therapist earned. For many years, physical therapists earned a bachelor's degree prior to becoming licensed. Later, schools transitioned to master's degree programs. The letters MPT or MSPT indicates a master's degree in physical therapy. Most programs today now train therapists for a DPT degree, which stands for doctorate of physical therapy.

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Menopause is a period of life transition for many of us. Today we will review what menopause is and how symptoms can negatively affect pelvic health, including bowel, bladder and sexual function.

What Happens During Menopause?

Menopause is an important life transition for those with female anatomy, marking the end of the regular menstrual cycle and the transition to life beyond the reproductive period.

Babies born with female anatomy have a set number of eggs which are stored in their ovaries. The ovaries make the hormones estrogen and progesterone, which control monthly periods and ovulation. Menopause happens when ovaries no longer regularly release an egg every month and menstruation stops.

The age menopause starts can vary, but usually it is after the age of 40. Some people can go through menopause early, usually after a hysterectomy, damage to the ovaries, and sometimes from chemotherapy.

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Painful periods are common.

According to the American College of Obstetricians and Gynecologists, more than half of those who have periods suffer from “dysmenorrhea” (pain associated with their cycles) 1-2 days each month.

What causes the pain?

There are two main causes of the pain associated with menstruation:

  • Primary dysmenorrhea is pain caused by the related to menstruation and starts shortly before or after bleeding begins
  • Secondary dysmenorrhea is period pain that is tied to another condition, usually endometriosis or fibroids

Although period pain is a commonly shared experience, your pain shouldn’t be keeping you from doing things like resting comfortably, going to school, going to work, or being active.

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Tightly Wound recently released on Iris!

Tightly Wound has been released, watch it today and share it with your loved ones and anyone else who may need more education on vaginismus and pain with sex.

Tightly Wound is a 15-minute animated short by Shelby Hadden. Our very own Heather Jeffcoat, DPT is one of the producers of film. Check out the video here.

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Pilates Can Strengthen the Pelvic Floor

A modified Pilates program can be a fantastic way to improve the strength of the pelvic floor muscles. A 2018 study by Lausen et al.  had clients attend weekly one-hour Pilates classes over the course of six weeks. These classes used a type of Modified Pilates which consisted of Pilates exercises which had been modified and led by a physical therapist to specifically target the pelvic floor for the management of urinary incontinence. Those who attended the Pilates classes reported less leakage, improved self-esteem, decreased social embarrassment and lower impact of incontinence. Some of the women also reported improvement in their personal relationships after attending the classes.

In another 2011 study by Phrompaet et al., researchers found Pilates to be an effective treatment for instability in the low back and

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What They Say About Us

  • Testimonials

    • Testimonial by A.B.

      Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the...

      Read more Testimonial by A.B.

  • Testimonials

    • Testimonial by T.H.

      I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse.  I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing...

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