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

 

Blog Posts by Category

Featured From the Blog:

Announcing Our Newest Location: Claremont

Coming in May, 2021 - Our Newest Location in Claremont, California:

689 W. Foothill Blvd., Suite C
Claremont, California 91711

We are super excited to expand into new areas across the greater Los Angeles region with addition of our new Claremont location. More information including hours of operation, phone number, and such coming soon!

Read more ...

Sexual Assertiveness May Reduce Your Pelvic Pain

Couple kissing
Photo by Victoria Roman on Unsplash

Communicating with your partner about your sexuality may reduce your pelvic pain and increase your sexual function.

A 2016 study by McNicoll et al. suggests that Sexual Assertiveness, or the ability to communicate openly to your partner about your sexual experience, may reduce the pain experienced with provoked vestibulodynia (PVD), increase sexual function, and encourage your partner to communicate you in ways that help boost your sexual health.

How Sexual Assertiveness May Reduce Your Pain

Pelvic pain and pain with sex may come from several different avenues, including vaginismus, vulvodynia, vestibulodynia, endometriosis, or tissue changes caused by menopause. The 2016 study by McNicoll et al. specifically worked with women with provoked vestibulodynia.

Read more ...

Preparing your Pelvic Floor for Childbirth

photo credit by Alexander Krivitskiy on unsplash
photo credit by Alexander Krivitskiy on unsplash

What can a mother do to prepare her pelvic floor for pregnancy and childbirth?

First, you might be asking yourself “what is the pelvic floor”?

The pelvic floor is a group of muscles inside the pelvis that form a hammock from your pubic bone to your tailbone and from sit bone to sit bone on the sides. The function of these muscles are to stabilize your pelvis and spine, support your organs (bowel, bladder and uterus) and maintain continence.  In pregnancy and childbirth, these muscles go through a lot of changes. The goal of this article is to try and achieve optimal pelvic floor function throughout pregnancy and after.

Read more ...
Couple embracing in a pink sunset

Involving your partner in your pelvic floor therapy may improve your outcomes and your relationship.

Here are some ways you can involve your partner in your pelvic floor physical or occupational therapy:

Start Talking About Your Experience.

Both studies and clinical experience have shown that talking to your partner about your sexuality, pelvic floor issues, and sharing the progress you’re making in pelvic floor therapy can improve anxiety, reduce pain levels, and bring more intimacy to your relationship. As you transition to sex with your partner, sexual assertiveness will also help you find activities, angles, and positions that feel pleasurable, not painful to you and your partner.

Read more: How to Involve Your Partner...

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Occupational Therapist Nancy stretching hamstring with yoga strap

Stretching for health

Studies have foune that stretching improves joint range of motion (flexibility), decreases muscle tension, improves circulation, relieves muscle pain, prevents injury, and improves athletic performance (Nakaruma et al., 2015; Avela et al., 1999; Suzuki, 2005). Stretching the legs can allieviate low back, hip, and pelvic pain. 

Here's a New Year's Stretching routine to get started. Please consult with your doctor or a rehabilitation therapist before beginning any exercise routines. 

Tools Needed

  • Yoga strap, dog leash, or robe strap
  • A comfortable place to lay down (yoga mat or blanket)

Read more: Leg Stretching Routine for...

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Therapist Nancy Hoi Wong OTR/L rolling piriformis on foam roller

Here’s a simple foam roller routine to try for a happier pelvic floor this new year.

Foam rolling is a fantastic way to manage pelvic pain by keeping your tissues hydrated with increased blood flow, reducing trigger points in the muscles and fascia, and improving mobility and range of motion. Foam rolling has also been found to increase parasympathetic nervous system response (rest and digest) which is also helpful in chronic pain management (Beardsley, 2015).

I often tell my patients that the pelvic is not an isolated island, in fact it’s at the center of your body and deeply intertwined with many body functions including balance, movement, toileting, and sex. Go ahead and palpate your pelvic bones- you can feel that the muscles to the back, hip, and legs all attach to the pelvis. When there is dysfunction in these muscle groups, pelvic pain, pelvic mal-alignment, and tight pelvic floor muscles can be a result. By keeping these tissues healthy and mobile can help manage your pelvic pain.

Read more: Foam Roller Refresh for a...

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Bowl of colorful fruit with whole grain toast

It’s that time of year when many of us are considering a diet change as a New Year’s Resolution. But with all of the wildly different diets out there, don’t let your new diet affect your pelvic floor health negatively.

Avoid Constipation

Constipation can contribute to pelvic pain, risk of prolapse, back pain, and pain with sex, among other issues.

As we’ve written about on this blog before, managing constipation is one of the cornerstones for maintaining pelvic health, especially if you suffer from pelvic pain, prolapse, or pain with sex. Constipation will lead to storage of old stool in the colon, which can contribute to pelvic, abdominal, and back pain. This added pressure can lead to pelvic floor tension and contribute to issues like pelvic pain and pelvic floor spasms. Last, but not least, constipation leads to straining on the toilet, which greatly increases your risk for issues like pelvic organ prolapse (read more about prolapse in this previous post).

Read more: Don’t let your New Year’s...

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mommy tummy

Mommy tummy aka diastasis recti abdominis (DRA) is a prevalent issue.

One in three American moms have DRA that persists greater than a year.

So what is a diastasis recti? It is the stretching of the linea alba, a connective tissue that runs down the midline of the abdomen and connects the abdominal muscles. The stretching happens during pregnancy in almost 100% of mothers to make room for a growing baby. Many of these moms are told this is a normal part of pregnancy, even by their healthcare providers.

DRA is not just about appearance, it is also connected to pelvic floor dysfunctions as well as pelvic and low back pain. In a study by Kari Bo et al., they found that mothers in the US with DRA were also more likely to have the following:

Read more: Mommy Tummy - Not Something...

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Involuntary loss of urine during athletics is more common than you thought

Athletic incontinence is a type of stress incontinence that happens during an athletic event. Stress incontinence is an involuntary loss of urine due to a pressure or force like coughing, sneezing or jumping. When most people think of urinary incontinence they do not usually picture young athletes, however it is surprisingly common.

A study of young, elite athletes found 43% experienced urinary leakage while participating in their sport. The study also investigated which sports had higher incidences of incontinence:

Read more: Pelvic Floor Physical...

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What studies say about returning to running as postpartum exercise

Most of the therapists in our office are moms, and we intimately understand wanting to get back to exercise after delivery. Caution should be taken when returning to running postpartum - we see this clinically and research also shows postpartum movement strategy changes that can increase your risk of injury.

A recent pilot study by Provenzano et al., 2019 compared the biomechanical changes of runners pre-pregnancy (or <14 weeks gestation and postpartum). They found at six weeks postpartum subjects had decreased trunk and pelvic rotation, decreased running speed, with increased step width and stance time compared to pre pregnancy measurements. They also found decreased motion in the hips with increased motion at the knee as a compensation.

Read more: How is your running changed...

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Photo of a middle aged woman with black hair in a blue shirt by Ashwin Vaswani on Unsplash

Pain with sex and pelvic pain may result from treatment of all types of cancer, but particularly gynecologic cancer of the reproductive organs.

Types of Gynecologic Cancer

  • Cervical cancer begins in the cervix, which is the lower, narrow end of the uterus. (The uterus is also called the womb.)
  • Ovarian cancer begins in the ovaries, which are located on each side of the uterus.
  • Uterine cancer begins in the uterus, the pear-shaped organ in a woman’s pelvis where the baby grows when she is pregnant.
  • Vaginal cancer begins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the outside of the body.
  • Vulvar cancer begins in the vulva, the outer part of the female genital organs.
    CDC, 2020

Read more: Pelvic Pain and Pelvic...

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Laxity in Pregnancy is what may be causing you those aches and pains

The Role of the Relaxin Hormone

As discussed previously on the blog, pregnant people undergo some major changes in their bodies, including producing different hormones that play various roles during pregnancy. One hormone that affects the musculoskeletal system in a pregnant person’s body is called relaxin.

Relaxin is a hormone produced by the corpus luteum (an endocrine gland made in the ovary when a follicle has matured and released an egg during ovulation) and the placenta (an organ developed in the uterus during pregnancy that provides oxygen and nutrients to your baby). Relaxin inhibits uterine activity and helps relax the pelvic joints so your hips can widen in preparation for birth. Relaxin peaks during the first trimester. However, relaxin can also contribute to laxity in other areas of the body during pregnancy, not just the pelvis.

Read more: Joint Laxity and Pregnancy:...

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There really is an app for everything… even pelvic floor exercises!

And research proves supervised pelvic floor home exercise programs can reduce treatment time and result in significant improvement over in-office therapy alone.

So why don’t all my patients have pelvic floor apps? Especially at the beginning of treatment, those exercises can be difficult enough to squeeze into a daily schedule without the added anxiety of scrolling through hundreds of options to find an affordable and reliable one; and no one wants to base sensitive healthcare decisions on anonymous user reviews.

Wouldn’t it be great if a medical expert could cut through all the clutter?

Read more: There’s An App For That?...

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Woman laying in bed in pain

Endometriosis Affects 1 in 10 Women of Reproductive Age

And yet the delay in diagnosis hovers around 8.5 years (Barbieri, 2017; Ballard, 2006), meaning that, on average a woman will experience 8.6 years of symptoms and disease progression before they are diagnosed with the disease.  

What is Endometriosis?

Endometriosis is a condition where endometrial-like tissue grows outside of the uterus (endometrial tissue is tissue that usually grows inside of the uterus and sheds each month). The most common area for it to grow is in the abdominal cavity, where it can implant on the surface of other structures including the ovariesbladderrectum, and along the walls of the abdomen and pelvis.

Read more: Endometriosis: Why the Delay...

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vaginal mesh is link putting a chain link fence in your vagina - ouch!

“The cure is worse than the disease."

We’ve all heard the cautionary proverb; but to someone desperate for a cure, it’s all too easy to ignore.

Sadly, that’s been the outcome of too many vaginal mesh surgery cases. It’s a popular treatment for stress urinary incontinence, among other conditions; but many of these patients have paid a heavy price. Increasingly, women are opting to have the mesh surgically removed; and some of them are further devastated to learn that one of the most common complications – pelvic pain – can persist long after the mesh is gone.

Read more: Is Vaginal Mesh Surgery...

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glutes in pink pants with rainbow hankerchief tucked into waistband

Pudendal Neuralgia (PN) is a condition that can cause chronic pain or numbness along the course of the pudendal nerve, which is the nerve that innervates the pelvic floor.

What is the pudendal nerve and what does it do?

The pudendal nerve, like other peripheral nerves in your body, is how your brain “connects” with the muscles and tissues of the body- sending and receiving messages between the brain and body like movement and sensation. When nerves get compressed, irritated, or constricted, problems can occur in this “message chain” and you might feel things like pain, numbness, tingling.

Read more: What is Pudendal Neuralgia...

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Red Tomato sliced open to look like a vulva

Persistent genital arousal disorder (PGAD) is a condition that is poorly understood.

It is a rare disorder most commonly seen in those with female anatomy and is characterized persistent sensations of genital arousal in the absence of sexual desire or stimulation. These sensations typically stay after orgasm and are intrusive, unwanted, and can negatively affect quality of life.

The diagnosis itself is not well known among healthcare practitioners yet alone the general public. Those who experience its symptoms can be hesitant to talk about it with their healthcare practitioners even though it may be affecting their quality of life.

Read more: Persistent Genital Arousal...

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Woman with cat Photo by Maria Lupan on Unsplash

September is Healthy Aging Month! In recognition, this blog will talk about Menopause and how it can affect your genitals and sexual function.

What Happens During Menopause?

Menopause marks 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.

Read more: September is Healthy Aging...

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Hot flashes, insomnia, vaginal discomfort and more – hello, menopause!

If you’re experiencing any of those symptoms, your doctor may have recommended some form of menopausal hormone therapy. But is it safe? When should you start? And which therapy is right for you?

Researchers have been trying to answer those questions for decades, often with confusing and even conflicting results. Let’s take a look at the history of estrogen therapy, and how past studies are informing the latest recommendations.

A French physician coined the word ‘menopause’, and advanced the revolutionary idea that the health concerns of aging women deserved medical attention, in the 1800s. Throughout that century, doctors experimented – sometimes on themselves – with various animal hormones. The science was far from perfected; but by the 1890s, women were being treated successfully for symptoms of menopause with a powder or pill made from cow ovaries.

Read more: The History of Estrogen...

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