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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:
Hormonal Birth Control and Vulvodynia Part 2: Hormonal Intrauterine Devices (IUD)
Hormonal Birth Control and Vulvodynia - Part 2: Hormonal Intrauterine Devices (IUD)
This article takes a looks at intrauterine devices (IUDs) and it’s potential effect on vulvodynia, or vulvar pain.
Intrauterine devices, also called long-acting reversible contraceptives (LARC), have become more and more popular as a birth control method in the United States due to high efficacy, less side effects and higher continuation compared to other hormonal contraceptive methods1,2,6. They are offered in two forms; hormonal (common brand names are Mirena, Kyleena, Skyla, Liletta) and copper IUDs. For this blog, we will be exploring the effects of the hormonal IUD only. This type of IUD releases progestin into the body which suppresses endometrial cell growth (called proliferation) and thickens the cervical mucus to prevent pregnancy4.
I consider myself to be a case study when it comes to the topic of hormonal birth control and pelvic pain. I have tried several variations of the combo pill, progestin only pill, the Mirena IUD and most recently, the Nuvaring. When taking the combination methods, I definitely noticed the side effects previously mentioned in my last blog post. However, in my early twenties, when I was on the Mirena (hormonal IUD), I didn’t notice any of these side effects.
Read more: Hormonal Birth Control and Vulvodynia Part 2: Hormonal...
Running Mechanics and Pelvic Floor Health: The Impact of Footwear
Did You Know That Proper Footwear Can Improve Your Running Mechanics and Pelvic Floor Health?
How Do My Feet Impact My Pelvic Floor When I Run?
If you are a runner, you tend to look for ways to improve your running. If you’re thinking about starting up or returning to running, it can feel intimidating particularly if you have any symptoms related to pelvic floor dysfunction. This only complicates an exercise that, on the surface, seems fairly straight forward. There are some studies that have looked at how your feet can play a part in your pelvic floor muscle function while you run. And if you are looking to return to running postpartum, read on and also check out this article by one of our pelvic floor physical therapists.
Read more: Running Mechanics and Pelvic Floor Health: The Impact of...
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
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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.
Read more: Diastasis Rectus Abdominis: What, Why, How? | Postpartum...
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- Written by: Heather Jeffcoat, DPT
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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!
Read more: Safely Returning to Activity and Sport | Postpartum...
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- Written by: Staff
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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
Read more: Breast Cancer Surgery and Physical Therapy | Postoperative...
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- Written by: Staff
- 8677 Views
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 orgasm5,6.
Read more: What is IC and What Are The Symptoms? | Interstitial...
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- Written by: Heather Jeffcoat, DPT
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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.
Read more: Endometriosis Laparoscopic Postoperative Care: Steps to...
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- Written by: Staff
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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.
Read more: Mental Health and Sexual Pain: Having Sexual Pain Is Not...
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- Written by: Staff
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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?
Read more: How Chronic Stress Affects Your Sex Life and How To...
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- Written by: Staff
- 5666 Views
Are You Thinking of Returning to Running Postpartum?
There is not a magic time frame as each person recovers differently and the most important thing is to listen to your body.
For healthy uncomplicated pregnancies and deliveries the American College of Obstetricians and Gynecologists (ACOG) recommends women return to low-moderate intensity exercise at six weeks postpartum and eight weeks postpartum for cesarean.
After your OBGYN or midwife has cleared you to return to exercise, if you haven’t started with a Pelvic Floor Physical Therapist yet, now is a good time.
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- Written by: Staff
- 6348 Views
November is Bladder Health Awareness Month.
At Fusion Wellness & Physical Therapy, we take pride in understanding and applying how your whole body affects your pelvic health. In this article, we explore the links between grip strength and urinary incontinence.
A study conducted at the Jeju National University measured grip strength in patients and found statistically significant differences in patients with incontinence, overactive bladder and nocturia4. They found these patients had a weaker grip strength (less than 18kg) using a hand dynamometer.
Read more: Grip Strength and Urinary Incontinence: The Unexpected...
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- Written by: Staff
- 7511 Views
Physical therapy can help women across their lifespan. This includes support with orthopedic considerations related to breastfeeding, as well as other breastfeeding care with clogged milked ducts and noninfectious mastitis.
Symptoms & Causes of Clogged Milk Ducts and Mastitis
Breastfeeding can be a joyous time for some, but unfortunately it can be painful for others. Clogged milk ducts can be extremely uncomfortable and painful. It often arises due to not being able to drain fully, causing a back-up of milk along the mammillary ducts. It can occur when feeding sessions are interrupted or skipped, as well as when mom is under stress. One may experience symptoms such as a painful lump in the breast tissue, pain during breastfeeding that subsides after, and/or decreased milk supply from the blockage. Sometimes if unresolved, it can lead to mastitis, or infection of the breast tissue. Monitor for symptoms such as fever, swelling of breast tissue, redness of breast tissue, and escalation of pain/breast tenderness. If you start to experience these aforementioned symptoms, give your doctor a call as soon as possible.
Read more: How Physical Therapy Can Help with Clogged Milk Ducts and...
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- Written by: Staff
- 6199 Views
Third Stage of Childbirth: Delivery of the Placenta
You made it!
Now, at this point you have delivered your baby and your body’s hormones have shifted tremendously! You may feel overwhelming emotions of joy and exhaustion at the same time. Oxytocin, the bonding hormone, rises sharply to compensate for the drastic drop in estrogen and progesterone. You may find yourself shivering, and this is normal immediately post-giving birth and can last up to one hour.
Delivery of the Placenta
Read more: Vaginal Childbirth Positioning Series | Part 3: Delivery...
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- Written by: Staff
- 12292 Views
Upright Labor Positions for the Second Stage of Labor
If you missed part 1 in the vaginal childbirth positioning series, go back and read it here.
Childbirth/labor is quite an experience, and it can be scary waiting for the unknown. Being prepared, knowing, and being familiar with different options and labor positions is the best way to approach childbirth to help decrease as much anxiety should surprises arise.
This article will go over specific labor positions that help progress labor, and prevent perineal trauma.
As mentioned in Part 1: Pre-Birth article, it’s important to keep changing labor positions to help progress, preferably in different upright labor positions. As a reminder, the first stage is all about increasing the pelvic inlet to help guide the baby through the mid pelvis and finally towards the pelvic outlet/vaginal canal.
Read more: Vaginal Childbirth Positioning Series | Part 2: Upright...
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- Written by: Staff
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Positioning for the Pre-Birth Stage of Labor
What to Expect and What to Focus On:
If you have been pregnant for many months now, it is time to get ready for your upcoming birth! Similar to a marathon, we need to train for childbirth to prepare the muscles and body for the big 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 pre-birth stage of labor involves contractions to dilate and open the cervix. Once the cervix 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 how to best support our bodies throughout your childbirth journey.
Positioning for the Stages of Labor
Practicing and knowing different positions during this first stage can be helpful when pain may escalate. Upright positioning such as: walking, standing, rocking back and forth, kneeling over birthing ball, leaning against wall, holding onto partner are just some of the many, many positions that can be helpful.
Read more: Vaginal Childbirth Positioning Series | Part 1: Pre-Birth...
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- Written by: Staff
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Postpartum Pelvic Health Recovery Should Start Day 1.
Here are some tips to help you get your postpartum pelvic health (and general health) back on track:
This article focuses on 5 key techniques you can use to improve postpartum pelvic health. It covers diaphragmatic breathing to activate core muscles and kickstart lymphatic drainage, pelvic floor muscle coordination, posture, and the benefits of a pelvic floor evaluation by a physical therapist to begin improving postpartum pelvic health on day 1. It also provides detailed instructions and references scientific studies to provide further research.
Read more: 5 Things You Can do to Improve Postpartum Pelvic Health
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- Written by: Staff
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Interstitial Cystitis, Multimodal Treatments, and How Pelvic Health Physical Therapy Helps IC
Interstitial cystitis (IC) also known as bladder pain syndrome or painful bladder syndrome, is a debilitating condition that significantly affects the quality of life of patients living with it.
The definition of IC from an international consensus is:
An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable cause" (Hanno et al, 2009).
Interstitial cystitis affects 6-11% of women and 2–5% of men and increases with age from 1.7% under the age of 65 and up to 4.0% in women aged 80 years or older (Clemens et al., 2007 and Lifford et al., 2009). Patients that live with IC report that their quality of life is significantly impacted affecting their psychosocial, work-life, psychological well-being, personal relationships, and general health (Clemens et al., 2007). One important domain that is affected by IC is sexual function. 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 (Peters et al., 2007 and Tincello et al., 2005).
Read more: What is Interstitial Cystitis and How Pelvic Health...
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- Written by: Staff
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Whether you're asking for a friend or for yourself, it's an important question these days.
Practicing social distancing and wearing a mask can make it quite difficult to have intimate relationships.
Through the last year and half, we have learned more about COVID-19 and each and every day new data helps us better understand this virus and how to practice safe sex during COVID.
How is the virus transmitted?
The virus spreads through infected saliva, mucus, or respiratory particles entering the eyes, nose, or mouth. This means it can be transmitted through kissing and close contact. Studies have also detected the virus in feces and in sperm in those infected (Diangeng et al., 2020). It is unknown at this point if the virus can be spread through sperm or feces. Educating yourself can be the key to safe sex during COVID-19.
Read more: Sexual Health Awareness Month | Safe Sex During Covid-19
