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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 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
- 4719 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
- 2908 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
- 4410 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
- 3928 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.
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- Written by: Kasia Gondek, PT, DPT, CSCS
- 3416 Views
A very important component of any running program, ranging from a 5 km (3.1 miles) race to an ultra-marathon (anything more than a marathon which is 26.2 miles), is adequate recovery.
Many people neglect this portion of their training because it doesn’t involve getting sweaty or doing high intensity intervals or weights. However, building in a solid recovery routine is crucial to helping your body bounce back after training as quickly as possible. A good recovery routine also helps prevent injury, decreased immune system function, and muscle mass loss. A recovery routine encompasses a cool-down activity, nutrition, and exercises like hatha-based yoga, foam rolling, and/or stretching the major muscle groups used during your workout. Although not discussed here, getting good quality sleep is critical to recovery as well!
My Post-run Recovery Routine:
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- Written by: Staff
- 3504 Views
How do you know if you have lower urinary tract symptoms and an overactive bladder?
Over ¾ of women report that they have experienced one or more Lower Urinary Tract Symptoms (LUTS)1. More than ½ of American women report urinary incontinence (UI), and approximately 17% of women over the age of 18 years report symptoms of overactive bladder (OAB)2, 3. It is also believed that most women underreport their bladder symptoms due to embarrassment and false notions that it is a normal part of aging4, 5, 6.
Lower urinary tract symptoms include incomplete bladder emptying, urine dribbling after you finish urination, persistent drip of urine after completion of urination and/or urinary incontinence. Overactive bladder symptoms consist of urinary urgency (the need to get to a restroom quickly), with or without incontinence, urinary frequency, and frequent nighttime urination (waking more than 1x/night). These symptoms can negatively impact a woman's life. One study found that women with Lower Urinary Tract Symptoms reported several impacts on quality of life including decreased sleep, work productivity, and physical/sexual activity7.
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- Written by: Kasia Gondek, PT, DPT, CSCS
- 3511 Views
Road to Boston Marathon Part 2: Exercising at Home or in the Gym
10 Exercises to Improve Strength, Conditioning, and Balance
Leading up to the Boston Marathon, I have been incorporating these 10 key exercises into my weekly routine (3x/week) to keep my body strong and balanced. Videos of these exercises are posted below. These exercises target the key muscle groups used by runners. These are for educational purposes, not meant to treat medical conditions nor supplement medical advice.
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- Written by: Kasia Gondek, PT, DPT, CSCS
- 4560 Views
Self-Care and Self-Management Strategies to Combat Endometriosis Symptoms During the COVID-19 Pandemic
Since March of 2020, people living with endometriosis symptoms are facing tough challenges and barriers due to the Covid-19 pandemic: canceled surgeries, canceled appointments with family physicians, gynecologists, fertility specialists and/or other allied healthcare providers, postponed in-office assessments and visits, and changes in overall work environment and social activities. This can worsen feelings of isolation, depression, anxiety, hopelessness, and have a negative impact on self-reported pain and disability levels during this time.
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- Written by: Staff
- 4554 Views
Endometriosis and Sexual Function Require a Specialized Approach
Endometriosis is a global disease affecting 5-15% of women during their reproductive years. It is characterized by the presence of endometrial-like tissue outside of the uterus which can trigger a local inflammatory response and can have a significant impact on patients’ quality of life.
One such domain of quality of life that is often affected is the correlation between endometriosis and sexual function. The DSM-V defines sexual dysfunction as a clinically significant disturbance in a person’s ability to respond sexually or to experience pleasure and includes pelvic pain, penetration disorders, lack of sexual interest, and/or arousal and orgasm disorders. Unfortunately, it is common, as approximately 40% of women with endometriosis and chronic pelvic pain suffer from sexual dysfunction.
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- Written by: Kasia Gondek, PT, DPT, CSCS
- 2766 Views
Road to Boston Marathon Part 1
A Tribute to the First Female Runners
On April 18, 2022 I am excited and grateful to be able to run the historic and prestigious Boston Marathon! As a physical therapist at Fusion Wellness /Femina Physical Therapy and avid long-distance runner for over 20 years, I’m excited to share my training journey with you leading up to the race. This race holds a special place in the hearts of long-distance runners because you must run a qualifying race with a qualifying time. Females ages 18-34 must run 3 hours 30 minutes or better, and males ages 18-34 must run 3 hours flat or better.
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- Written by: Staff
- 3026 Views
Postpartum Recovery Series Part 5
Managing Urinary Incontinence After Childbirth
Urinary incontinence is the unwanted leakage of urine, also known as accidental bladder leakage. There are a few main types. Stress urinary incontinence is leakage associated with activities, such as lifting, exercising, coughing, sneezing, or laughing. Urge urinary incontinence is leakage associated with the urge and people often experience leaking on the way to the toilet. There is also mixed incontinence which is a combination of the two types. Continence is managed by the complex interaction of bladder physiology, central nervous system, and the pelvic floor muscles. When there is dysfunction in any part of the three systems, incontinence may occur.
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- Written by: Staff
- 3937 Views
Did You Know Physical Therapy Can Help Endometriosis?
What is the link between endometriosis and painful sex?
Endometriosis is a global disease affecting 5-15% of women during their reproductive years. It is characterized by the presence of endometrial-like tissue outside of the uterus which can trigger a local inflammatory response and can have a significant impact on patients’ quality of life.
Sexual Function
One such domain of quality of life that is often affected is sexual function. The DSM-V1 defines sexual dysfunction as a clinically siginifcant disturbance in a person’s ability to respond sexually or to experience pleasure and includes: pelvic pain, penetration disorders, lack of sexual interest and/or arousal and orgasm disorders. Unfortunately, it is common, as approximately 40% of women with endometriosis and chronic pelvic pain suffer from sexual dysfunction.
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- Written by: Staff
- 5133 Views
What's the Link Between Endometriosis and Central Sensitization?
Endometriosis affects roughly about 10% of reproductive-age women, and is characterized by endometrial-like lesions that grow outside of the endometrium (the lining of the uterine wall). Women with endometriosis have symptoms such as: chronic pelvic pain, dysmenorrhea, abdominal pain, infertility, constipation, interstitial cystitis/painful bladder syndrome, and more.
Often endometriosis is treated through hormonal management and/or surgically. However, 18-27% of patients with endometriosis treated via hormonal medications reported no relief from symptoms. About 20% of patients with endometriosis treated through surgical excision or ablation continued to experience chronic pelvic pain and other endometriosis symptoms. Moreover, 70 to 80% of women with chronic pelvic pain with confirmed endometriosis lesions do not have lesions in the areas where they experience symptoms.
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- Written by: Staff
- 2987 Views
What causes incontinence during pregnancy?
There are many causes for incontinence during pregnancy and postpartum. Some of the proposed factors are:
- hormonal changes,
- pelvic floor muscle and connective tissue modifications,
- bladder neck widening (due to the weight of both the uterus and the growing fetus),
- anatomical injuries during delivery.1, 2
A hormone called relaxin is produced during pregnancy to help soften the muscles and ligaments in preparation for delivery. As the uterus and baby grow throughout pregnancy more load is placed on the pelvic floor muscles causing the pelvic floor muscles to become weaker.3 Also constipation, which is commonly seen in pregnancy, puts an additional load on the pelvic floor.4 Furthermore, the pelvic floor has additional strain placed on it during labor; the pelvic floor muscle is stretched five times its original length.5
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- Written by: Staff
- 5230 Views
What Are The Connections Between Endometriosis and Sleep?
March is Endometriosis Awareness Month.
The endometrium is the lining of the uterus. When there is tissue similar to the endometrial lining that is growing outside of the uterus, it is called endometriosis. Endometrial lesions can be on the ovaries, vaginal walls, bladder, colon, and more. Endometriosis affects up to 10% of the general population and can be quite debilitating as common symptoms include dysmenorrhea, dyspareunia (pain with sex), infertility, bloating, gastrointestinal symptoms, and chronic pelvic pain.
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- Written by: Staff
- 4363 Views
Pelvic Floor Rehabilitation for Prolapse Surgeries
Including both Pre and Post Operative Situations
Suffering from symptoms of pelvic heaviness? Experiencing a feeling that there is a bulge down there or something is falling out of your vagina? Have trouble having a bowel movement or experiencing incontinence? These are all common symptoms of pelvic organ prolapse (POP). Unfortunately, 2-48% of women may experience symptoms of POP.
Pelvic Floor Rehabilitation Treatment Options
There are treatment options such as pelvic floor rehabilitation through physical therapy techniques including lifestyle modifications such as managing intraabdominal pressure, promoting healthy bowel/bladder habits, as well as physical therapy, manual therapy, and strengthening exercises to decrease pelvic heaviness.
