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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!

Yoga for Urinary Incontinence is a Thing

By Kasia Gondek PT, DPT, CSCS, certification in Yoga for Pelvic Pain through the Herman and Wallace Pelvic Rehabilitation Institute

When I am working with fitness or physical therapy clients, I often incorporate mindfulness, breathwork, and yoga postures (asanas) into our sessions together to cue pelvic floor muscle awareness. For thousands of years, yoga has been practiced daily as a discipline for the mind, body, and community to restore balance and overall health. Yoga has been shown to be useful in reducing anxiety, perceived stress, and autonomic nervous system imbalances that are risk factors for urinary incontinence. Yoga postures can improve and maintain general lower extremity and core muscle strength, balance, and conditioning, which has been shown to protect against incontinence in older females.¹ An estimated 15 - 40% of females in their 40s to 60s experience some form of urinary incontinence.²

March is Endometriosis Awareness Month.

Today, we explore different exercises someone can do at home to relieve endometriosis pain.

For more information on endometriosis, see our article HERE.

Before we begin exploring gentle movements to relieve pain, we will cover how someone may identify the pain they are having could be endometriosis. The unfortunate truth is that endometriosis can only be confirmed through laparoscopic surgery. Most people go years without getting a diagnosis or proper treatment. One study found that the average delay of diagnosis is 8.5 years!¹ This is for many reasons, including the lack of awareness of the condition, the many bodily systems it involves that complicates the clinical picture, and the absence of noninvasive diagnostic testing to detect endometriosis. Through this, doctors are able to identify the endometrial-like tissue (tissue that is similar to, but not the same as, the lining of the uterus) that can be found throughout the body.

Details: Written by: Heather Jeffcoat, DPT; Published: 07 March 2023; Last Updated: 07 March 2023; 2934 Views

Painful Sex & The Mind Body Connection | Image Courtesy of Jared Rice via Unsplash

Exploring the Mind-Body Connection to Painful Sex

Pain during sex isn’t in your head… but it can ‘get into your head’.

The medical community recently had a major a-ha moment about painful sex. It’s something the women who suffer from it have always known – but the results of a recent study about it could be a game-changer for treatment.

Whether you have a clinical diagnosis like vaginismus or dyspareunia, or you just know that sex hurts, painful sex is a common problem - almost half of all women will experience it at some point in life. More than 20% of premenopausal women say sex is painful; the prevalence is higher in women under 30. For some, it’s difficulty during intercourse; for others, it’s significant pain upon penetration. Still, others may not be able to experience penetration at all.

Helping Women in Need With Our Community in Mind

Details: Written by: Staff; Published: 03 January 2023; Last Updated: 20 January 2023; 24799 Views

Let's Look at the Effects of Pelvic Floor Muscle Strength on Orgasm

Hint: strong pelvic floor muscles = strong orgasm

The world is learning more and more about the pelvic floor and the many ways that it can be treated. At Femina Physical Therapy, we have spoken about pelvic rehab for urinary, bowel, birth, pregnancy, bladder, erectile issues, and many more. But we all know the question that everyone wants answered: Does pelvic floor strength affect orgasm?

Well reader, you came to the right place.

Details: Written by: Heather Jeffcoat, DPT; Published: 05 December 2022; Last Updated: 03 January 2023; 2051 Views

A recent pilot study looked at how resilience affects patients with urinary chronic pelvic pain (UCPP) conditions and chronic overlapping pain conditions (COPCs). Resilience can be defined as the “capacity to adapt successfully to disturbances that threaten a patient's viability, function or development.” (Southwick et al., 2014) Resilience is now an important aspect in the treatment of pain, as it can increase psychosocial well‐being and the quality of life in patients living with chronic pain. (Casale et al., 2019)

Details: Written by: Staff; Published: 28 November 2022; Last Updated: 25 January 2023; 1911 Views

Updates to the IC and Bladder Pain Syndrome Treatment Guidelines | Image Courtesy of Jonathan Borba via Unsplash

November is Bladder Health awareness month and we would like to discuss with our readers a significant update to the research regarding Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS). In May 2022, the American Urological Association (AUA) released updated clinical guidelines for the diagnosis and treatment of IC/BPS. The purpose of the bladder pain syndrome treatment guideline is to provide a “clinical framework” for best practice regarding the management of patients who experience this. That includes what should and shouldn’t be done for patients, and how to avoid unnecessary or harmful interventions. The previous bladder pain syndrome treatment guidelines were released 8 years ago, in 2014.

What is Interstitial Cystitis / Bladder Pain Syndrome anyways?

Muscles And Potty Training, What's the Connection?

Red flags to spot once your child starts potty training, how to prevent poor habits from forming, and when to see a pelvic floor physical therapist

Believe it or not children can show signs of a pelvic floor dysfunction like adults AND show similar signs and symptoms. Pelvic floor physical therapy is for anyone with a human body… these are the muscles that hold up our organs and prevent them from falling out (literally)! Pelvic floor dysfunctions can occur when the muscles of the pelvic floor have lost the ability to properly contact or fully relax.

Symptoms in children tend to become noticeable once potty training begins and have the potential to linger into their teens/ adulthood if gone untreated. It is important to pay attention to behaviors and poor habits that could indicate your child is having a tough time on the toilet.

Details: Written by: Staff; Published: 20 November 2022; Last Updated: 21 April 2023; 2273 Views

More About Urinary Incontinence and Physical Therapy

Urinary Incontinence Under the Radar: Part 2

Welcome back for Part 2! November is Bladder Health Awareness month, and Femina PT would like to shine light on something that tends to go understated, unaddressed, brushed off as “normal”: urinary incontinence. In this blog series we’ve been addressing the various effects that urinary incontinence has on an individual’s life, and how conservative physical therapy treatment can help combat them. If you missed last week’s article, you can find it here.

Last week, we went over a lot of statistics. Urinary incontinence is without a doubt a healthcare crisis and places an enormous burden on the individual and their family members. Urinary incontinence, and the related sequelae, is expensive, isolating, and poses the risk of delirium, falls, pressure ulcers, and abuse.

Treatment Options for Tarlov Cyst: Physical Therapy

This article will go over what a Tarlov cyst is, what symptoms can arise from having a Tarlov cyst, how it is diagnosed, and common conservative and surgical treatments.

What is a Tarlov Cyst?

Tarlov cysts are sacral perineural cysts that consist of cerebrospinal fluid (CSF) close to the dorsal root ganglion on our sacral spine (the triangle shaped bone that connects to our tailbone). Tarlov cysts are often incidental findings on MRI’s, meaning most people with no symptoms may have Tarlov cyst(s). Paulsen, et al, looked at 500 MRIs of the lumbosacral spine and found an incidental rate of 4.6%; of which 20% were symptomatic. Approximately 1% of the cysts are large enough to cause compression, thus requiring prompt treatment.

Yes, Physical Therapy for Urinary Incontinence is a Thing

Urinary Incontinence Under the Radar: Part 1

November is Bladder Health Awareness month, and Femina PT would like to shine light on something that tends to go understated, unaddressed, brushed off as “normal”: urinary incontinence. This blog series focuses on the various effects that urinary incontinence (or UI) leaves on an individual’s life, and how conservative physical therapy treatment can help combat them. Lucky for you, reader, we love to talk about it.

The story goes like this - urinary incontinence is thought to be something expected with getting older, or something that occurs during pregnancy or as a result of delivery. Because of the embarrassment and shame that surrounds such issues, patients often don’t share these problems with their provider. Or worse, if they do share, they may be dismissed as their symptoms being a normal consequence of their stage of life. There is also a lack of awareness for conservative treatments such as pelvic floor physical therapy for these issues. Patients may fear surgery, medication, routine visits, and avoid talking about it all together. However, pelvic floor physical therapy for urinary incontinence can save patients time, money, and psychological distress. The numbers speak for themselves. Up to 45% of adults with bladder control problems fail to seek care.

Physical Therapy Can Mitigate the Effects of Cancer on Sexual Function

Sexuality can be a big part of who we are as individuals. Sexual function can be defined as “specific physical, physiological, neurological and emotional behaviors expressed by an individual response”.⁵ Sexual function and cancer can have an important and detrimental relationship. There are certain cancers that can unfortunately affect our sexual health, including cervical, ovarian, bladder, kidney, colorectal and breast cancer to name a few.

Some cancer treatments can cause unwanted side effects that affect our sexual health such as decreased sexual arousal or desire, vaginal stenosis (narrowing of the vaginal canal), dyspareunia (painful sexual intercourse), and bladder/bowel dysfunction. This can affect our relationships with ourselves and with our partners, and reduce quality of life.

Details: Written by: Staff; Published: 27 October 2022; Last Updated: 01 December 2022; 3219 Views

Labor Positions for Vaginal Birth | Image Courtesy of FreeStocks via Unsplash

What Are Some of the Best Labor Positions For Vaginal Birth?

Read on to find out why not all labor positions are created equal

If you have been pregnant for many months now, it is most likely time to get ready for the upcoming birth! Similar to a marathon, we need to train for childbirth to prepare the muscles and body for the upcoming event. For this reason, it is a good idea to start practicing being in different positions either with movement or holding a position for a long time. The first stage of labor involves contractions to dilate and open the cervix. Once the c

ervix is fully dilated, the second stage includes the passive and active phases of the baby crowning and coming out of the vaginal canal. The third stage involves the delivery of the placenta. We will go over each stage and how to best support our bodies throughout the childbirth journey.

Learn About Pelvic Floor Physical Therapy as Treatment for Levator Ani Avulsion

The pelvic floor is a group of muscles positioned like a hammock along our saddle region. The group of muscles attach from our pubic bone on the inside and then to our lateral walls with a bundle of collagen fibers called the levator arch, and attach to the ischial spines and tailbone on the back side.

During vaginal childbirth, the pubococcygeus muscle, a group of pelvic floor muscles, stretches 3.26 times more than its normal length to make room for the coming baby in the vaginal canal! As you can imagine, this can result in some perineal tearing and/or levator ani avulsion. Levator ani avulsion occurs when muscle fibers of the puborectalis (the most innermost muscle of the pubococcygeus group) are detached from its insertion on the pubic bone. About 20% of women experience an avulsion during their first vaginal childbirth. Risk factors include instrumental-assisted delivery (forceps higher risk than vacuum), older age at vaginal birth, second stage lasting longer than 2 hours, baby weighing over 8 pounds and 13 ounces, and those who underwent a grade 4 perineal tear.

Period Action Day: Helping Provide Menstrual Products to Those in Need

Millions of women across the United States are suffering the consequesces of not being able to afford period products. We believe that menstrual hygeine is a matter of human rights, not a prividlege.

Details: Written by: Heather Jeffcoat, DPT; Published: 26 September 2022; Last Updated: 04 November 2022; 3509 Views

Deep Infiltrating Endometriosis and Sexual Function

What is Endometriosis and Deep Infiltrating Endometriosis?

Endometriosis is a benign condition where endometrial tissue (the lining of the inside of the uterus) grows outside of the uterus.

About 5-10% of reproductive aged persons with female-associated genitalia have endometriosis. Symptoms can range from no symptoms to debilitating pelvic pain with dysmenorrhea, pain with periods, abdominal pain, genital pain, bladder dysfunction, bowel dysfunction and possibly other symptoms. In addition, endometriosis is known to also affect sexual quality of life. Pain with sex is called dyspareunia; while deep infiltrating endometriosis is a more severe form of endometriosis.