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The Femina Physical Therapy Blog

Featuring original articles by our staff about current events and trends

With emphasis on vaginismus, pregnancy and postpartum best practices, treatments for incontinence, and other topics related to the health of your pelvic floor.

Featured From the Blog:

Introducing The Origin Fund - Helping Women in Need

Helping Women in Need With Our Community in Mind

The Origin Fund is dedicated to facilitating access to services that address a person’s physical, emotional and medical needs. Our focus is on individuals with pelvic health dysfunctions, and we are dedicated to improving the biopsychosocial aspects of each person as a whole. Through education, outreach and providing access to these services, we can support individuals on their journey to address their pain and dysfunction—linking patients to our network of referrals that provide these services.

Therapeutic Breast Massage in Lactation (TBML)

Therapeutic Breast Massage in Lactation | Image Courtesy of Mehmet Turgut Kirkgoz via Unsplash

Therapeutic Breast Massage in Lactation Can Help Make Breastfeeding Less Painful

Breastfeeding is widely accepted as the normal standard for providing nutrition to newborns, however, many women who do not reach their breastfeeding goals. US national data stated that breast pain was a commonly reported reason for women weaning less than 1 month postpartum. Within that segment, 29% of women who participated in the study stated that “breastfeeding was too painful” to continue.

In the same study, 24% of women reported “breasts feel(ing) too full or engorged” as another reason to discontinue breastfeeding prior to 1 month postpartum.¹ Currently, The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life. As physical therapists who treat patients with postpartum conditions, we are well positioned to make a big impact on patients with breastfeeding related pain and reduce barriers to continued breastfeeding!

Treating Bloating and Abdominal Distension: a Multi-Disciplinary Team

Why a Multi-Disciplinary Team is Best for Treating Bloating and Abdominal Distension

Bloating, abdominal distension, loose stools, constipation, abdominal or pelvic pain, fatigue, brain fog, weakness, nutritional deficiencies… these symptoms may be caused by a variety of gastrointestinal or pelvic conditions. If you are experiencing any of these symptoms, this article is a good place to start when deciding who to have on your care team, and what treatments can help!

What is Edema, and what causes swelling during pregnancy?

During pregnancy, extra water and salt retention is one of the most common complaints and symptoms that occur during pregnancy– this is called edema. Edema happens as a result of a few different changes that occur in pregnancy: the growth of the baby as they put greater pressure on one of the major blood vessels of the body called the vena cava which is located in the abdomen; hormonal changes that happen during pregnancy such as changes in progesterone, estrogen HCG (human chorionic gonadotropin), and prolactin which can cause increased swelling in the body; increased blood volume (by up to 50% more in pregnancy). Additionally, varicose veins may occur in up to 60% of females, with an increased risk depending on increased age and increased number of pregnancies.1 Edema can cause stiffness in joints, heaviness, and a sensation of warmth in the area that is swollen.

Are You Suffering From Chronic Overlapping Pelvic Pain Conditions? We Can Help!

Part 1: Endometriosis and Vulvodynia

Chronic pelvic pain, sometimes abbreviated to “CPP”, is defined as “pain in the abdomen or pelvis for at least 14 days per month and severe enough to cause functional limitations” by a recent literature review of chronic pelvic pain⁵. The cause of chronic pelvic pain is often multifactorial and can be the result of conditions such as:

endometriosis
Vulvodynia (or vestibulodynia)
interstitial cystitis/bladder pain syndrome
irritable bowel syndrome (IBS)

Details: Written by: Stephany Tritt, PT, DPT; Published: 11 December 2023; Last Updated: 06 March 2024; 2491 Views

Discover the Ways Urinary Incontinence and Weight Are Linked

Today, let's delve into the intricacies of bladder leakage, commonly known as urinary incontinence (UI)

Balancing health and weight involves various factors, both intrinsic and extrinsic, making it a complex aspect of well-being. As a pivotal metric for assessing health, weight is not only a symptom but can also act as a causative factor for various health conditions.

According to the Centers for Disease Control and Prevention (CDC), in 2023, a staggering 41.9% of adults in the U.S. are affected by obesity, accounting for $173 billion in annual healthcare costs. While the implications of being overweight on cardiovascular and mental health are widely known, we explore whether it can also impact pelvic floor health, especially in the context of urinary incontinence.

Did You Know That Proper Footwear Can Improve Your Running Mechanics and Pelvic Floor Health?

How Do My Feet Impact My Pelvic Floor When I Run?

If you are a runner, you tend to look for ways to improve your running. If you’re thinking about starting up or returning to running, it can feel intimidating particularly if you have any symptoms related to pelvic floor dysfunction. This only complicates an exercise that, on the surface, seems fairly straight forward. There are some studies that have looked at how your feet can play a part in your pelvic floor muscle function while you run. And if you are looking to return to running postpartum, read on and also check out this article by one of our pelvic floor physical therapists.

Details: Written by: Debbie Dy, PT, DPT; Published: 09 November 2023; Last Updated: 14 November 2023; 3787 Views

Safe Exercise During Pregnancy: ACOG Backed Guidelines — Safe Pregnancy Exercise | Image Courtesy of Lucas Favre via Unsplash

Dr. Debbie Dy, PT, DPT

Orthopedic Clinical Specialist/Pelvic Health Physical Therapist

Once the exciting news of a new pregnancy is shared, it is common to get flooded with misinformation and “advice” from concerned family members regarding the safety of exercise during their pregnancy. Historically, it is common for people to be told to “take it easy” during their pregnancy or spend more time in bed. What we know is that exercise during pregnancy is safe and beneficial for both birthing parent and baby.

ACOG Updated Guidelines on Exercise During Pregnancy

The American College of Obstetrics and Gynecology (ACOG) in 2020 released updated guidelines regarding exercise in pregnancy which states that “exercise is both safe and desirable for birthing people in the absence of obstetric or medical complications or contraindications.” Not only is regular exercise safe for most pregnancies, exercising has immense physical and mental health benefits for not only the birthing person, but for the growing fetus as well. Birthing people who engage in regular exercise during their pregnancies have been shown to have decreased rates of gestational diabetes, hypertension, cesarean births, operative vaginal births and postpartum recovery time. It can also be preventative for the development of depressive disorders in the postpartum period.

Let's Discuss Some Solutions for Chronic Constipation

"Chronic constipation can have detrimental effects to daily life..."

Constipation is an extremely common symptom that has been reported to affect 63 million people in North America.¹ Chronic constipation can have detrimental effects to daily life and is known to increase psychological distress and impair health related quality of life. Most commonly, individuals who are struggling with constipation often intervene with laxative use and dietary changes to increase fiber intake. These interventions fail to improve symptoms in about 50% of patients whom they are prescribed.² If you find that you continue to struggle with constipation, there are many lifestyle changes one can adopt that can have a profound effect on symptoms including decreased frequency, straining, and pain with bowel movements.

Details: Written by: Debbie Dy, PT, DPT; Published: 17 October 2023; Last Updated: 22 October 2023; 4690 Views

Vulvovaginal Moisturizers: Effective Hydration and Relief | Image Courtesy of Averie Woodward via Unsplash

Choosing the Right Vulvovaginal Moisturizer

Assuming you need one, make sure it's got the right ingredient list

There are many reasons why those born with female anatomy may require the use of a vulvovaginal moisturizer throughout their lifetime. As you age, the vaginal and vulvar tissues tend to become drier and less elastic. This change is typically seen around the time one goes through menopause due to the drop in estrogen that occurs. The vulvovaginal tissues are very sensitive to hormonal changes and estrogen is the hormone that controls vaginal lubrication, as well as tissue elasticity and thickness.

Details: Written by: Stephany Tritt, PT, DPT; Published: 10 October 2023; Last Updated: 22 October 2023; 2424 Views

Updated Endometriosis Guidelines | Image Courtesy of Emma Simpson via Unsplash

What Do Updated Endometriosis Guidelines Mean to You?

A variety of treatments are available for endometriosis and its symptoms. They include pharmacological treatments, surgical treatments, acupuncture, electrotherapy, nutritional changes, psychological therapies and of course, pelvic floor physical therapy.

The World Health Organization (WHO) states that Endometriosis affects 190 million (10%) of women of reproductive age worldwide. It occurs when uterine-like tissue (similar to, but not the same as) grows outside of the uterus. Currently there is no known cause or cure, however various treatments exist to manage symptoms. Currently, diagnosis of endometriosis can be delayed up to 8-10 years after initial symptoms onset. This happens for a variety of reasons, including limited access to health care or knowledgeable practitioners, poor awareness of or minimization of symptoms. In addition to the potentially debilitating symptoms of endometriosis, the socioeconomic cost of this disease is comparable to those of other chronic diseases such as diabetes mellitus.

What is babywearing?

Babywearing is the practice of transporting a baby or child in a sling or carrier that is worn on the body - a practice that has existed for generations, and has been observed across many different cultures.

What are the benefits of babywearing?

In the first few months of an infant's life, it is required of caregivers to perform many hours of carrying, a task that may be daunting if there are other children in their household that need caring for, or other responsibilities within the home that need tending to. Of course babywearing allows caregivers to be physically close to the baby while remaining hands free, but not only this, babywearing has also been shown to have emotional, physical and psychological benefits for both infant and mother. For the infant, maternal carrying of the offspring has been shown to trigger a calming response demonstrated by central, motor and cardiac signals in distressed infants.¹ There is also research to support that can improve length and success of breastfeeding, improve infant temperature regulation, and sleep apnea.

Details: Written by: Kasia Gondek, PT, DPT, CLT, CSCS; Published: 26 September 2023; Last Updated: 19 October 2023; 2545 Views

Underreported Pregnancy Related Lumbopelvic Pain:

A common condition that most healthcare providers are missing and how physical therapy can help

Being pregnant comes with lots of changes to an expecting mother’s body. Hormonal and physical changes to the body, as well as vascular and neural factors can cause pregnancy-related lumbopelvic pain (PLPP). About 63% of pregnant women in the U.S. experience it at some point during gestation. A recent survey study involving 538 pregnant women with pregnancy-related lumbar and pelvic pain (henceforth termed lumbopelvic pain) found that only 43% reported it, and of those, only 22% received any treatment!¹ Physical therapy through the use of manual treatments, therapeutic exercises, muscle re-education, and functional activity training (lifting mechanics, proper sitting and standing posture) have been proven effective at reducing pregnancy-related lumbopelvic pain and improving quality of life.^2,3,4 Pregnancy-related lumbopelvic pain can interfere with quality of life, physical function, inability to perform daily activities, sleep disturbances, and can contribute to mood disorders such as anxiety and depression.^1,2

Learn about low intensity shockwave therapy for painful intercourse (dyspareunia)

Our team at Femina Physical Therapy is committed to providing the highest level of evidence-based care. That is why we are conducting a research study to determine the effectiveness of low intensity shockwave therapy for painful intercourse, or dyspareunia as it is known clinically. We are searching for volunteers to participate in this high quality study. Those who qualify to participate will receive a reduced rate on all visits related to the study!

What's the Link Between Urinary Incontinence and Postpartum Depression?

Postpartum Depression is a medical illness that negatively affects how you feel, the way you think, and how you act.

It typically arises due to a combination of hormonal changes, psychological adjustment to motherhood, and fatigue. Postpartum depression is said to affect between 5-20% of mothers depending on variable socioeconomic factors. Many people associate urinary incontinence as a common postpartum symptom. Prevalence of postpartum urinary incontinence figures vary due to diverse study formats, however it is predicted that bladder leakage is experienced in a quarter to half of all postpartum women.

In recent years, studies have concluded there is a strong link between both postpartum depression and urinary incontinence postpartum.

Why a Multi-Disciplinary Team is Best for Treating Bloating and Abdominal Distension

4 Exercises to Increase Low Back Strength

Julia Connolly, PT, DPT

Rest does not always = recovery. Strengthening the muscles of your lower back to increase low back strength, gain coordination, and increase aerobic endurance will improve your capacity to move throughout your day. Globally, low back pain is the leading cause for years lived with disability.¹ Getting your body moving with better biomechanical strategies, and staying active are important ways to maintain your level of function.

Details: Written by: Staff; Published: 08 June 2023; Last Updated: 22 June 2023; 2691 Views

Scoliosis and Pelvic Floor Health | Image Courtesy of Joyce McCown of Moon Shadow Press via Unsplash

Learn About the Link Between Scoliosis and Pelvic Floor Health

Scoliosis is a 3D curvature of the spine.

If you recall from part 1, scoliosis is a 3D curvature of the spine. Some people get it in early childhood or adolescence, and others get it as an adult. This can lead to low back pain, breathing difficulties, and ... affect the function of the pelvic floor muscles!

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