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 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!
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- Written by: Staff
- 2222 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.
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- Written by: Staff
- 9287 Views
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.
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- Written by: Staff
- 2511 Views
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.
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- Written by: Staff
- 2041 Views
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.
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- Written by: Staff
- 3153 Views
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.
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- Written by: Staff
- 3723 Views
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.
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- Written by: Heather Jeffcoat, DPT
- 2435 Views
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.
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- Written by: Heather Jeffcoat, DPT
- 3437 Views
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.
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- Written by: Staff
- 3299 Views
Are You Thinking of Working with a Doula?
Here are some of the benefits
Being a pelvic floor physical therapist, I work with pregnant and postpartum women almost daily. Not having birthed any children yet and currently pregnant, I was curious about the doula process both professionally and personally. So, I attended a wonderful birth doula training program and learned a ton about what working with a doula is all about.
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- Written by: Heather Jeffcoat, DPT
- 2827 Views
Are There Non-Surgical Treatments for Pelvic Organ Prolapse?
That constant heavy feeling in your pelvic area. That embarrassing urine leakage. That bulge ‘down there’.
It took a while, but you found the courage to talk to your doctor about your symptoms. (Good for you!) Now you know your condition has a name – pelvic organ prolapse – and a treatment. But is surgery really the best option?
Research estimates that 50% of all women who give birth will develop pelvic organ prolapse at some point in life; but while pregnancy and childbirth top the list of risk factors, the condition usually develops over time from a combination of factors that can also include anything from frequent strenuous gym workouts to smoking to menopause (and even genetics).
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- Written by: Heather Jeffcoat, DPT
- 3999 Views
The medical community has a new acronym for painful sex - GPPD
New data on self-compassion and emotion regulation that many women who suffer from it may never have considered.
First, let’s take a look at that new name - genito-pelvic pain/penetration disorder (GPPD). That’s a medical mouthful, I know; but it’s actually a helpful attempt to simplify diagnosis by combining two similar disorders under one treatment heading. Dyspareunia is pain with sexual activity; vaginismus is the involuntary contraction of muscles in the pelvic floor that often cause that pain. GPPD recognizes them as essentially the same problem – recurrent or persistent pain in the genital area associated with intercourse. And it’s a common one; the study I’m reviewing in this article says,
Sexual pain is among the most common complaints in women who seek for help in clinical settings.”
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- Written by: Heather Jeffcoat, DPT
- 2642 Views
What are Pelvic Organ Prolapse and Urinary Incontinence?
What is the biggest risk factor for both conditions? And how can you tell if you have them?
Not sure? You’re not alone. In fact, one research study found women actually know more about erectile dysfunction than they do about pelvic organ prolapse! While pharmaceutical company advertising bias may be to blame for part of that equation, one of the largest surveys of pregnant women and new moms ever conducted on the subject (by a team of medical experts in New England) reveals women’s healthcare providers consistently miss their biggest window of opportunity to educate patients about these conditions and offer treatment strategies that work.
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- Written by: Staff
- 4740 Views
Did You Know That There Are Non-Surgical Treatments for Provoked Vulvodynia (PVD)?
Provoked Vulvodynia affects approximately 10% of women
PVD is known as a chronic overlapping pain condition with endometriosis... While there are pharmacologic and surgical options, there are also other more conservative non-surgical treatments for provoked vulvodynia.
Provoked vulvodynia (PVD) is a chronic pain condition characterized by pain in the vulva when provoked by touch such as a tampon, speculum, clothing and/or sexual penetration. This condition affects approximately 10% in young women and can be truly debilitating. The etiology of PVD is complex and includes a combination of biologic and psychological factors. Other factors that may contribute to PVD are neural proliferation (an increase in nerve endings in the area), pelvic floor dysfunction, hormonal imbalances, recurrent infections, inflammation, high urinary oxalate levels and other psychological factors.
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- Written by: Staff
- 2928 Views
May is Osteoporosis Awareness Month.
Did you know that Physical Therapists are an essential member of your interdisciplinary care team?
With life expectancy increasing it is becoming more evident that bone health and fall prevention are key to a good quality of life. Osteoporosis is defined as a decrease in bone mass or a change in the structure of the bone causing the bone to be more fragile.1 If the bone is weak there is a higher chance of a fracture (bone break). The most common areas of fractures are the hip, spine, forearm, and humerus (upper arm bone). Osteoporosis causes more than 8.9 million fractures annually worldwide, affecting predominantly postmenopausal women. The probability of women, at menopause, of having an osteoporotic fracture exceeds that of breast cancer and the likelihood of a fracture is approximately 40%.2
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- Written by: Staff
- 4436 Views
All About the Importance of Pelvic Floor Stretches for Childbirth
**Talk to your physical therapist and healthcare team about specific guidelines for you**
Are you ready for the big day? Have you thought about how you will prep for your upcoming delivery? In this article, we’ll review four pelvic floor stretches for childbirth that may be appropriate, but recommend you consult with your childbirth healthcare professional to confirm if these are right for you.
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- Written by: Staff
- 3962 Views
Let's Talk Pilates for Urinary Incontinence and Low Back Pain
"Physical Therapy is the first line of treatment for any type of urinary incontinence."
Incontinence, or unwanted urinary leakage, is commonly experienced by women, especially during pregnancy and postpartum. Experts often state, and research supports, it occurs in 1 in 3 women. While this may be common, it is not normal, and it is treatable! Physical therapy is the first line of treatment for any type of urinary incontinence. In fact, pelvic floor muscle training for women with stress urinary incontinence is six times more likely to result in a cure or a significant improvement. For all other types, women are twice as likely to report significant improvement or completely resolve their urinary incontinence. As you can imagine, getting help can dramatically improve their quality of life.