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

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Featured From the Blog:

Announcing Our Newest Location | Claremont

Now Seeing Patients at Our Newest Location in Claremont, California:

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

Telephone: (909) 788-0585

We are super excited to expand into new areas across the greater Los Angeles region with addition of our new Claremont location. 

Read more ...

Getting Back to Exercise Postpartum

Getting Back to Exercise Postpartum

Exercise has shown to be beneficial in all stages of life.

The postpartum period is a great time to continue a healthy lifestyle or start a new one.

Some of the benefits of postpartum exercise are:

  • Strengthen and tone abdominal muscles
  • Boosts energy
  • May help prevent postpartum depression
  • Promotes better sleep
  • Relieves stress
  • Can help you lose the extra weight that you may have gained during pregnancy
    (ACOG, July 2019).

Even with all these benefits, research shows that most mothers stop participating in exercise programs which leads to increased weight gain and obesity (Minig et al., and O’Toole et al., 2003). There are many adjustments that have to be made when becoming a new mother and the information on the internet regarding postpartum exercise can be misguided and overwhelming. Let's break down what the literature says about guidelines for returning to exercise postpartum.

Read more ...

Birth Prep Services Offered at Femina Physical Therapy

Pregnant belly birth prep services

Pregnancy, labor, and delivery greatly affect the pelvic floor muscles, and our birth prep services using pelvic floor therapy can bring you confidence, strength, and flexibility.

What are the pelvic floor muscles?

The pelvic floor muscles are a group of muscles inside the pelvis that form a hammock connecting the pubic bone to the tailbone. Both men and women have pelvic floor muscles. These muscles play an important part in stabilizing the pelvis and spine, supporting your organs (bowel, bladder and uterus) and toileting. 

The Pelvic Floor and Pregnancy

During pregnancy the pelvic floor muscles are working overtime trying to stabilize and support the growing body of the mother and child. Read our previous blog post about preparing the pelvic floor for childbirth. During a vaginal childbirth, these muscles will utilize their strength and flexibility to help the baby be birthed. Whether or not the baby is born via C-Section or vaginally, the pelvic floor is involved, and this is where our birth prep services come into play.

Read more ...

A recent study by Felde et al. (2020) has echoed earlier connections linking depression and anxiety to higher prevalence of urinary incontinence (UI) in women.

What is urinary incontinence?

Urinary incontinence refers to the loss of urine, out of your control. There is actually more than one kind of urinary incontinence: the two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB).

  • Stress Incontinence: urine leaking with physical activity - sneezing, coughing, laughing, lifting, pushing/pulling, jumping.
  • Urge Incontinence: urine leakage that is coupled with urgency to go- leaking while you’re in line for the toilet, leaking/urgency when you’re parking your car in the driveway, putting the key in the door, fumbling with your pants, etc.
  • Mixed UI: a combination of stress and urge symptoms

Read more: Depression and Incontinence...

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Picture of dripping wet panties

The latest literature review conducted by Mazur-Bialy et al. (2020) shows the most modern methods of pelvic floor physical therapy that can help with urinary incontinence.

Here at Femina PT, we pride ourselves in keeping up with the current best practices and latest techniques. Here’s a breakdown of the latest techniques and how we utilize them at the clinic.

What is urinary incontinence?

Urinary incontinence refers to the involuntary loss of urine, which can range from a few drops (also called light bladder leakage) to complete loss that wets the floor. There is actually more than one kind of urinary incontinence: the two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB).

Read more: The Latest in the Treatment...

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Woman using hypervolt gun

Recent studies have shown evidence vibration therapy is just as effective as massage in reducing muscle soreness after exercise and can also help increase range of motion.

Over the past few years, we’ve been using more vibration and percussive therapy products at the clinic, such as the Hypervolt gun, vibrating foam rollers, and vibrating massage balls. But what’s all the hype about?

Effect on Muscle Soreness

In a 2014 study by Imtiyaz et al., they found that a 5 minute session with a vibration device provided as much relief to muscle soreness as a 15 minute massage session over the same area, as compared to control groups who received neither after a bout of exercise.

Read more: Vibration Therapy | A New...

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Anatomical drawing of pelvis

Acute pelvic fractures can be traumatic

A 2014 study by Harvey-Kelly et al. points to the fact that the long term consequences of this injury can include sexual dysfunction and pelvic pain for both males and females.

Pelvic fractures occur most commonly with a high-energy trauma. The most common ways people fracture their pelvis include motor vehicle (57%), pedestrians hit by car (18%), motorcycle crushes (9%), falls from a height (9%), and crush injuries (5%) (Harvey-Kelly, 2014).

Chronic Issues After Pelvic Fracture

Thanks to advancements in critical care medicine and acute trauma care, the mortality rate for those who have had a pelvic fracture has been reduced over the years. However, pelvic fracture survivors often report chronic issues including chronic pain, chronic pelvic pain, changes in gait, issues with bowel and bladder, and sexual dysfunction. This is because the muscles, bones, nerves, and blood vessels, are often all implicated in these injuries, and the pelvis contains the organs of the urinary, bowel, and sexual function systems. Therefore, the subsequent rehabilitation of all these systems is more complicated than, say, a fracture of your ulna or radius in your forearm.

Read more: Sexual Dysfunction After...

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Woman crouching next to bed holding on to stomach

How do histamines effect Interstitial Cystitis?

Newly published research by Grundy et al. (2019) shows a more direct connection between histamines and interstitial cystitis (Painful Bladder Syndrome or Bladder Pain Syndrome).

In this study, to be published in the upcoming February 2021 issue of The American Journal of Physiology: Renal Physiology, Grundy et al. show correlation that histamines in the body lead to changes in the sensory nerves of the bladder, particularly hypersensitivity during bladder distension, or when the bladder is filling or full.

The study determined that certain sensory nerves in the bladder can become more sensitive when histamines are present. This activation occurs in the bladder membrane, the detrusor muscles, as well as the afferent nerves of the bladder.

Read more: Histamines and Interstitial...

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Sciatic nerve pain can be uncomfortable and may affect your quality of life and your activities.

Flares in sciatic pain can be debilitating. Often times the lower back and hips can contribute to sciatic pain. Try these yoga stretches for some relief.

This article is for informational purposes only and should not be considered medical advice. Please consult with your doctor or a physical therapist for an individualized session and exercises.

Here are some stretches you can do at home, at the gym, or at the park to keep your sciatic nerve pain at bay and enjoy your day pain-free.

Read more: Yoga for Sciatica

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Photo by Matteo Vistocco on Unsplash

Dealing with tension headaches? Try these yoga poses.

Headaches can be caused by tension in the jaw, face, neck, shoulders, and back.

Headaches can be caused by tight and restricted neck muscles, and a seated neck release will stretch the scalene muscles on the neck. Sometimes headaches are caused by back pain that’s radiating up the spine.

Try these simple poses to release tension that may be givign you a headache.

Read more: Yoga to Relieve Your Headache

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woman with red laser beams around her

A Breakdown of common Energy Based Devices Marketed for your Vagina

Risks and Possible Benefits

*This article is intended NOT intended to be used as medical advice. Please talk to your doctor about what treatments may be right for you.*

In the past decade, nonsurgical devices using radio-frequencies, lasers, and infrared light have been marketed as non-invasive treatments for “vaginal rejuvenation.” However, there has been conflicting opinion among the medical community as to what the lasers have evidence of treating. The rampant use of the lasers to treat conditions they have not been approved to treat has also caused the Food and Drug Administration to warn the public about these devices in 2018.

Read more: Lasers... And My Vagina?

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We wanted to share this article that we found published by the New England Journal of Medicine. We all have a lot of ongoing questions about the ongoing COVID-19 pandemic, and this is a great resource that answers nearly every question we’ve had regarding testing, vaccines and more.

Covid-19 Vaccine — Frequently Asked Questions

Image courtesy of NEJM

A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.


Read more: New England Journal of...

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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 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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Couple kissing

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: Sexual Assertiveness May...

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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: Preparing your Pelvic Floor...

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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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What They Say About Us

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    • Testimonial by S.H., age 24

      I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be. It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally...

      Read more Testimonial by S.H., age 24

  • 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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