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The Femina Physical Therapy Blog

Featuring original articles by our staff about current events and trends

Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.

Featured From the Blog:

Understanding Relaxin: Why It Doesn’t Cause Pain in Pregnancy

Pregnancy is a time of significant physical and hormonal changes, and among the many hormones involved, Relaxin plays a crucial role. However, there’s a common misconception that Relaxin is responsible for pain during pregnancy. Let’s take a closer look at what Relaxin does and why it doesn’t directly cause pain.

What is Relaxin?

Relaxin is a regulatory hormone involved in growth, metabolism, and tissue remodeling after an injury to our bones, ligaments, muscles or tendons (Dehghan 2014). During pregnancy, Relaxin levels begin to increase in the first trimester to help the body prepare for childbirth by relaxing the ligaments in the pelvis and softening the cervix (Aldabe 2012, Daneau 2014). The ligaments of the pelvis will begin to relax around the 10th-12th week of pregnancy (Aldabe 2012). This process allows for greater flexibility in the pelvic area, facilitating delivery and accommodating the growing baby.

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!

Restorative 20 Minute Home Yoga Practice For Chronic Pelvic Pain

Yoga Practice For Chronic Pelvic Pain Can Be a Very Helpful Routine

As stated in my last blog post, yoga can be so beneficial as a pain management tool due to its ability to modulate the sympathetic nervous system3,4 which plays a large role in chronic pain. The exact mechanism of how yoga helps with chronic pain is still being studied, however, it is reasonable to believe the full body relaxation promoted by a yoga practice helps to decrease tension in key muscle groups- including the hips and pelvic floor which are often tight in people with chronic pelvic pain.

Currently, evidence has mostly focused on one hour long practices as an intervention, although there are some studies that report improvements in pain with shorter practices, such as the routine below. As with any mobility/stretching routine, benefits will be seen with more frequent practice, however even twice weekly can help decrease pain.

Details: Written by: Staff; Published: 17 January 2022; Last Updated: 24 June 2024; 2977 Views

Coping with Restless Leg Syndrome | Image Courtesy of Yuris Alhumaydy via Unsplash

Restless Legs Syndrome (or RLS)

Restless legs syndrome (or RLS) is a condition where there are uncontrollable urges to move limbs (mostly in the legs, but sometimes in the arms) that follows a circadian pattern, namely evenings/overnight when resting.

The urges usually come with unpleasant sensations such as tingling, burning, itching, or otherwise pain. Usually, it can be alleviated by movement, but as you can imagine, it can be debilitating and impair sleep, and thus the quality of life. It is common to experience mood swings, anxiety, and depression.

It is estimated that about 3.9-14.3% of the general population suffers from RLS. It is the most common movement disorder in pregnant women. There is either primary (idiopathic) RLS, or secondary (acquired) RLS due to pregnancy, renal pathologies, diabetes, hypertension, and other metabolic conditions. The two most common risk factors for RLS are iron deficiency and kidney disease.

Details: Written by: Staff; Published: 10 January 2022; Last Updated: 24 June 2024; 7566 Views

Postpartum Recovery pt. 2 Diastasis Rectus Abdominis | Image Courtesy of Katherine Hood via Unsplash

What is DRA?

Diastasis rectus abdominis (DRA, sometimes referred to as Diastasis Recti) is a distortion or thinning of the linea alba which is the midline of the abdomen that connects left and right rectus abdominis muscles together.

Although DRA can be found in both genders, it is more commonly found in females, and more common during pregnancy (66-100% of women have DRA during their third trimester) and can persist through their postpartum periods. About 33% of women continue to have a DRA a year postpartum. It can look like a gap in the midline, “doming” in the midline, or it can even appear as a “pooch,” in the lower abdomen.

Why Do We Care?

The abdominal muscles and linea alba assist in trunk movement, posture, lumbopelvic stability, breathing, and abdominal organ support. As you can imagine, it can affect those functions when a DRA is present. As movement specialists, we want to make sure you are engaging the muscles and tensing up the fascia of the linea alba appropriately to help prevent low back pain, pelvic girdle pain, and activity-related injuries.

Details: Written by: Heather Jeffcoat, DPT; Published: 03 January 2022; Last Updated: 24 June 2024; 5554 Views

Safely Returning to Activity and Sport Postpartum

Postpartum Recovery Part 1

Most women get the clearance after their 6 week check-up for sex and exercise, YAY! But, really? How? What does that mean? There are no guidelines on how to return to activity in a safe, leak-free and pain-free manner.

Between 6 and 31% of postpartum women experience urinary incontinence. In addition, 66% of those who experience urinary incontinence during pregnancy and/or their first 3 months of postpartum continued to experience incontinence even at 12 years after birth! As you can see, it may be common, but it is certainly not normal!

Details: Written by: Staff; Published: 21 December 2021; Last Updated: 28 March 2022; 6066 Views

Breast Cancer Surgery and Physical Therapy - An Overview

There are an estimated 2 million breast cancer survivors in the United States and it is the most common form of cancer among women.^{2, 3}Following breast cancer surgery many patients experience neck, arm, and shoulder impairments. The most common complaints after surgery are restrictions in shoulder range of motion, pain, or a change in sensations of the arm and lymphedema.¹

Common Side Effects After Breast Cancer Surgery

Restricted Arm Mobility

Women that experience restrictions in arm mobility following surgery report a lower quality of life and higher psychological distress.⁶ It is estimated that anywhere between 3.8–73% of women will have restricted arm motion following surgery.¹⁰

Details: Written by: Staff; Published: 08 December 2021; Last Updated: 29 November 2022; 9999 Views

what is IC Interstitial Cystitis | IC & Symptoms | Image Courtesy of Marek Piwnicki via Unsplash — Interstitial Cystitis | IC & Symptoms | Image Courtesy of Marek Piwnicki via Unsplash

What is IC or Interstitial cystitis?

IC is also known as bladder pain syndrome or painful bladder syndrome and is a debilitating condition that significantly affects the quality of life of patients living with it.

Many patients with IC have other overlapping pain conditions such as Dyspareunia (pain with intercourse). 88% of patients with IC had at least one symptoms of sexual dysfunction (lack of sexual interest, can’t relax and enjoy sex, difficulty becoming sexually aroused and difficulty reaching orgasm)¹. Women with IC rated their sexual dysfunction as moderate to severe when compared to controls and reported increased pain with intercourse, decreased desire and decreased frequency of orgasm^5,6.

Details: Written by: Heather Jeffcoat, DPT; Published: 22 November 2021; Last Updated: 06 January 2022; 18236 Views

Endometriosis Laparoscopic Road to Recovery | Image Courtesy of Unsplash

Postoperative Care for Endometriosis Laparoscopic Procedures

Recovering from an endometriosis laparoscopic procedure requires proper care for a full and timely recovery. During this time there are some important steps to follow in order for everything to go smoothly. Here is a guide that will help ensure that you return to full health as soon as possible.

The First 48 Hours After Endometriosis Laparoscopic Surgery:

Arrange for a partner, family member, or friend to drive you home and stay with you after your procedure. General anesthesia can cause nausea and vomiting. Having a bag or bin ready for the car ride home is a good idea.
It can also be helpful to have a small pillow or cushion to put between your abdomen and seat belt for the ride home.
Each surgery has unique guidelines specific to your case and what was done during surgery. Follow the guidance of your surgeon and pelvic health physical therapist. As this is a general guideline It is always a good idea to speak with your health care team prior to initiating any new exercise or protocol.
Take it easy and rest for the first 24 hours.
Finding a position of comfort: During the initial stage of recovery it is important to find a position that is comfortable to allow your body to rest and recover.

Details: Written by: Staff; Published: 20 November 2021; Last Updated: 06 January 2022; 9403 Views

Mental Health and Sexual Pain | Image Courtesy of Anthony Tran via Unsplash — Mental Health & Sexual Pain | Image Courtesy of Anthony Tran via Unsplash

Mental Health and Sexual Pain: Sexual Dysfunction is Not “In Your Head”.

We have seen that experiencing sexual pain CAN affect your mental health, and pre-existing mental health conditions can amplify sexual dysfunction.

This article will review the research related to these, but in reading, know that we believe your pain is real and should be addressed from all relevant contributing factors.

A very large range, about 7-46% of Americans may experience painful sex. For some, it may be a one-time painful experience, and for others, it may be every single time. This can have a huge effect on mental health and overall quality of life.

Details: Written by: Staff; Published: 16 November 2021; Last Updated: 23 February 2022; 8781 Views

You may have heard that chronic stress takes a toll on your body. But did you know how chronic stress affects your sex life?

What is chronic stress?

Chronic psychosocial stress is defined as either a major life event that takes place over a long period of time (ie. death of a family member) or small stressors that are constant and often accumulate (ie. traffic, financial worries, work deadlines).^1,2 A study by Allen Kanner, Ph.D, published in the National Library of Medicine, found that these small stressors can have more of a negative effect on health than the more severe but less common stressors.¹

How does chronic stress inhibit sexual arousal?

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