Sabina Kapasi, Author at His Therapy

By Sabina Kapasi December 25, 2019 Bladder Health

Bladder Health Tips

Tips To Maintain Good Bladder Habits:

1. Maintain a good fluid intake. Depending on your body size and environment, drink 4-8 cups (8oz each) of fluid per day unless otherwise advised by your doctor. Not enough fluid creates a foul odor and dark colored urine.

2. Limit the amount of caffeine (coffee, soda, chocolate or tea) and citrus foods that you consume, as these foods can be associated with increased sensation of urinary urgency and frequency.

3. Limit the amount of alcohol you drink. Alcohol increases urine production and also makes it difficult for the brain to coordinate bladder control.

4. Avoid constipation by maintaining a balanced diet of dietary fibers.

Practice these habits and enjoy a healthy bladder!

By Sabina Kapasi December 25, 2019 Incontinence

Stress Incontinence

What is stress Incontinence?
Stress incontinence occurs when you are not able to prevent urine from leaking out when the pressure in your abdomen increases with events such as coughing, sneezing, and lifting.
It is caused by a weakening of the pelvic floor muscles (the muscles that keep urine from leaking out) that is contributed to by trauma such as delivering a baby.
Physical Therapists can fix this problem by teaching their patients the following: the function of the pelvic floor muscles, proper bladder habits, exercises specific for the pelvic floor, and through biofeedback and electrical stimulation.

Pelvic Floor Muscle Functions
The pelvic floor has three functions. The pelvic floors main function is to support the surrounding structures and help keep organs such as the uterus, bladder, and rectum inside the body. The second function of the pelvic floor is sphincteric. This helps the tube from which you urinate to open and close when urinating and your rectum to open and close having a bowel movement. The third function of the pelvic floor is sexual. This provides sensation for sexual intercourse.

Proper Bladder Habits
Proper bladder habits include the following: Drink 8-10 glasses of water per day (80 oz.) , Urinate 6-8 times in a 24 hour period, only urinate every 2-5 hours, there should be no nighttime urinating (pay attention to whether or not the urge work you up or something else woke you up and you realized you needed to urinate), each stream should last 8-10 seconds, avoid bladder irritants such as caffeine, alcohol, orange juice, soft drinks, and nicotine.

Exercise
-exercise the muscles supporting your pelvis by performing Kegel exercises 3 times per day with 3 sets of 20 repetitions each time (if this is difficult at first you can build up to it)
-Stretch tight muscles surrounding the area because they can compensate and contribute to even further weakening of the pelvic floor muscles

Biofeedback and Electrical Stimulation
-Biofeedback is a type of treatment that provides visual feedback on how well you are able to contract your pelvic floor muscles
-Electrical stimulation is a means of using a mild electric current to increase the strength of your pelvic floor muscles that is enhanced when you perform the Kegels during treatment

By Sabina Kapasi December 25, 2019 Pain, Pelvic Floor

Pelvic Pain

The pelvis is the area of the body below the abdomen or belly. There are many different organs and structures in the pelvis, including blood vessels, nerves, reproductive structures, bladder and urinary structures, and the bowel and rectum.There are many different causes of pain in the pelvis. In this blog we will attempt to describe possible causes of pelvic pain in men and women. We also look at the treatment options and when to see a doctor. CausesConstipation, endometriosis, fibroids, and STIs can cause pelvic pain.There are many causes of pelvic pain, including: 1. Constipation Constipation can cause pelvic pain, especially if it affects the lower colon. This type of pain tends to go away once a person has a bowel movement. 2. Other intestinal problems A variety of other intestinal conditions can cause pain in the lower abdomen or pelvis. These include: Irritable Bowel Syndrome Ulcerative colitis Divericulitis 3. Endometriosis Endometriosis is when tissue similar to the uterine lining grows outside of the uterus. This tissue can bleed during a person’s menstrual cycle, as well as stick to other organs, causing pain and other symptoms. The location of the pain depends on where the tissue implants. While some people experience symptoms just during menstruation, others have pain at other times during their cycle. 4. Fibroids Fibroids are benign (non-cancerous) growths in the uterus. They can cause pain throughout the pelvis and lower back. Fibroids can also cause rectal or bladder pressure and the feeling of needing to go to the bathroom more often. 5. Pelvic inflammatory disease (PID) PID is an infection that occurs in the female reproductive structures. It is usually due to a sexually transmitted disease. PID causes pelvic or low back pain, menstrual period changes, and unusual vaginal discharge. 6. Ovulation pain Ovulation pain or “mittelschmerz,” is slight to moderate discomfort during the middle part of a menstrual cycle. Ovulation pain can last for a few minutes or up to a few days. The pain may feel like a cramp or be sharp and sudden. It is not indicative of any underlying problem. 7. Scar tissue or adhesions Previous infections or surgical procedures can cause the formation of scar tissue or adhesions in the pelvis. This type of scar tissue can cause chronic pelvic pain. 8. Adenomyosis Adenomyosis is when endometrial tissue grows deep into the uterine muscle. Women with this condition tend to have very heavy periods with severe pelvic pain. 9. Sexually transmitted infections (STIs) Most STIs do not cause any symptoms, but a few can cause pelvic cramping or pain. These include chylmadia and gonorrhea. Without treatment, some STIs can lead to PID, which can also cause pelvic pain. 10. Menstrual cramps Menstrual cramps can cause pelvic pain.Menstrual cramps occur in the lower part of the pelvis and tend to start just before a person’s period and may continue for a few days. Particularly painful cramps could be a sign of an underlying condition, such as endometriosis or adenomyosis, so a person may wish to speak to a doctor about testing. 11. Ectopic pregnancy An ectopic pregnancy is a life-threatening event that requires immediate medical care. An ectopic pregnancy is when a fertilized egg implants into the pelvis or abdomen outside of the uterus. In most cases, an ectopic pregnancy occurs in the fallopian tubes, but it can happen anywhere in the abdomen or pelvis. Pain and cramping occur as it grows, pressing on nearby organs or nerves. 12. Pregnancy loss A pregnancy loss can also cause cramping or pelvic pain. Though some cramping in early pregnancy is normal as the fetus grows, people should report severe or long-lasting pain to a doctor. 13. Appendicitis The appendix is located in the lower abdomen and can cause pelvic or low back pain if it becomes inflamed and presses against the colon. 14. Hernia A hernia is an opening where the internal organs can pass through. If the hernia occurs in a muscle in the lower pelvis, it can lead to pelvic pain. Other symptoms may include a visible bulge at the location of the pain. 15. Muscle spasms in the pelvic floor The pelvis is made up of several muscles that support the bladder, reproductive structures, and bowel. Like other muscles, the pelvic floor muscles can spasm, causing pain and discomfort. 16. Prostate problems A man’s prostate sits low in the pelvis. Inflammation or infection of the prostate can cause pelvic pain. A growth on the prostate, whether benign or cancerous, may also cause pelvic pain or discomfort. 17. Urinary tract infection (UTI) The typical symptoms of a UTI are burning pain during urination and more frequent urges to urinate. Some people also present with pelvic pain or cramping, especially for severe or long-lasting infections. 18. Interstitial cystitis Interstitial cystitis is a chronic bladder problem that causes pain in the lower pelvis, especially when delaying urination. People with interstitial cystitis usually experience frequent and urgent needs to go to the bathroom to urinate. 19. Kidney stones Stones formed in the kidney usually begin to make their way out of the body through the ureters and bladder, which can cause pain in the lower pelvis. This pain can be severe. 20. Ovarian mass A growth on the ovary can cause pelvic pain especially if it is pressing on the local nerves or nearby organs. Possible masses include an ovarian cysts benign ovarian tumor or ovarian cancer. Managing pelvic pain Consult a doctor or pelvic floor therapists if pelvic pain is severe. It is possible to manage the pain and discomfort once a person knows what is causing it. If a person is not sure of the cause or the pain is severe or does not improve, it is best to see a doctor or consult a pelvic floor therapists. In many cases, simple home remedies can help relieve some of the pain. Home remedies to get relief include: taking over-the-counter pain relievers, such as ibuprofen placing a heating pad or placing ice on the pelvis doing light and gentle exercise or stretching, best to be taught by a pelvic floor therapist resting with the legs elevated, which promotes blood flow to the pelvis While pelvic pain is a widespread problem, people should report it to a doctor, particularly if it does not respond to home remedies or is happening regularly. A person should seek medical help immediately if the pain is severe or they experience nausea or vomiting, fever, or loss of consciousness. It is best to contact a doctor or a specialists like a pelvic floor therapists, with any questions or concerns about new or chronic pelvic pain.

By Sabina Kapasi December 25, 2019 Dry Needling

DRY NEEDLING – What is it?

Dry needling is a treatment that involves a very thin needle being pushed through the skin to stimulate a trigger point. Dry needling releases the tight muscle bands associated with trigger points and leads to decreased pain, improved function, and speeds up the recovery process.

Trigger points are irritable, hard “knots” within a muscle that may cause pain over a large area, leading to difficulty performing everyday tasks. When a person has painful muscles and trigger points, it is sometimes called myofascial pain syndrome.

Myofacial Trigger points are a common type of pain. The word myofascial means muscle tissue and the connective tissue in and around it. These trigger points are usually the result of a muscle injury, resulting from repetitive strain. They are painful when pressed on and can create pain in another area as well, which is called referred pain.

Dry Needling is becoming a popular modality in medical practices, as musculoskeletal complaints are one of the most reported reasons to seek medical attention. Because contractures and trigger points are invisible to X-rays, MRI, CT’s, a Dry Needling Therapist can “feel” with the needle and utilize it as a diagnostic instrument. Contractures deep in the muscles can be felt with the needle via feedback on the quality of the tissues that it is penetrating.

For more information, please call our office to set up a consultation on the phone or set up an initial evaluation in our office. Call His Therapy at 864-534-1780 today!

Have a Blessed Day!

By Sabina Kapasi December 25, 2019 Health

Diaphragmatic Breathing

The diaphragm, a dome like muscle that forms the floor of the rib cage, is the most efficient muscle for breathing and relaxation. The correct use of diaphragmatic breathing can help to quiet brain activity resulting in the relaxation of all the muscles and organs of the body. This is accomplished by slow rhythmic breathing concentrated in the diaphragm rather than the chest.

Learning Diaphragmatic Breathing
Place one hand on your chest and one hand on your abdomen. 
Exhale completely, breathing out through your mouth. Allowing your abdomen and chest to fall. 
Inhale deeply. Breathe in through your nose and mouth while contracting the diaphragm. It will move downward causing your abdomen to rise. Keep your shoulders and chest relaxed during this exercise. 
Remember to breathe slowly. Do not force your breathing.

By Sabina Kapasi December 25, 2019 Pelvic Floor

Do you know what causes the pelvic floor muscles to become weak?

Childbirth
This is the major, but not only, factor that stretches and damages your perineal muscles. If strength is not resorted in these muscles after delivery, they will remain stretched like an old hammock, and continue weakening as you resume your normal activities. Future pregnancies will further weaken these muscles.
Constipation
sustained coughing or sneezing
Heavy lifting
Obesity
Hormones associated with menopause

The good new is that we can help you! Call us today to schedule an appointment with us.

By Sabina Kapasi December 25, 2019 Mothers

Scar Management For Mothers Who Delivered By Cesarean

Following surgery, the incision heals by a process called scar formation. Scar tissue does not stretch easily and may cause adhesions deep in the tissue. Adhesions can restrict movement and cause pain. By massaging the tissue, adhesions and discomfort may be avoided.
Desensitization: (2 weeks after surgery and no scab or seepage from scar) Use a rough wet towel to rub across the scar in all directions. Repeat with dry towel if tolerated. This helps decrease sensitivity of the scar and helps you feel more at ease touching it.
The following is a list of scar massage techniques with the approximate time to start them.
Push and Pull: (after incision is completely healed four weeks) Place two fingers directly on the scar and move it slowly straight up toward ribs. When the skin stops “moving”, continue to hold firm pressure on the scar for one to two minutes. This should be a strong pulling sensation, but should not cause sharp pain. Then push down towards the pubic bone and hold again. Repeat to the left and to the right in similar manner
Skin rolling: (Four weeks after surgery) Pinch the skin on either side of the scar line. Start at either end and move forward rolling and raising the skin as you move. A free scar bulges upwards (try and pinch skin on your arm/ hand and notice the upward bulge). A “stuck” scar dimples inward.
Plucking: (6-8 weeks after surgery). Put your index finger on one side and thumb on the other side of the scar. Try to pick up the scar, separating the underlying tissues. If you can get under the scar, move your fingers slightly from side to side for one to two minutes. Start at either end and work toward the center. If the skin slips out of your fingers, you may not be ready for this stage, but keep trying.
Points of emphasis about scar massage
The more often you effectively massage the scar, the more complete your recovery will be. You can make a difference by helping your scar move more freely. All massage of your scar should be a gentle smooth movement.
Try making the massage a part of your daily routine (while watching television, listening to music, reading).
The benefit is greatest when the skin is worked firmly and just below pain threshold.
You should never feel sharp stabbing pain.
The sensation is one of strong pulling or light burning.
Duration – 5-15 minutes/day.
You may find massage more comfortable immediately after a shower. You may use warm compresses before and after treatment.
The pads of your fingers should “stick” to the skin NOT slide across the skin.
When you massage your scar you may notice one or two directions that feel especially “stuck”. “Stuck” areas of the scar do not remove as freely as other areas. You may feel some resistance when massaging these areas. Spend a little more time holding in those directions if possible to free “stuck” tissue. This should be a gentle “hold” motion, not a forceful movement.

*This section on scar massage has been reproduced with permission from Elizabeth Shelly, PT, Cambridge Physical Therapy, Cambrideg, Massachusetts.

By Sabina Kapasi December 25, 2019 Exercise, Pregnancy

Exercises After Childbirth

It is very important to begin exercising the pelvic floor as soon as you can after delivery. It is important to give yourself time to heal after your delivery before you begin exercising. Ask your doctor or your Physical Therapist if there are any particular exercises they would recommend for you to do following delivery.
Start these exercises 24-48 hours after delivery if you are physically able and have the approval of your Physician to exercise. Only do the exercises that your physician or physical therapist approves of.
It is important that if you experience sharp pain to discontinue the exercises and let your physician or your physical therapist know right away.
Do these exercises 3-5 times and do them 2-3 times per day as tolerated. Remember it is the quality of the exercises that matter not how many you can do.

By Sabina Kapasi December 25, 2019 Physical Therapy, Pregnancy

Preventing Diastasis Recti

The Pelvic Brace is one of the activities you can do to prevent diastasis recti and also make your core stronger.
How to do the pelvic brace?
*if you go to our facebook page we actually just did a video on it so you can have a visual.
The pelvic brace combines a pelvic floor contraction with a contraction of the lower abdominal muscles. Together these muscles create an internal girdle to support your bladder and pelvic organs. To exercise the lower abdominal muscles (near the pubic bone) draw in your belly muscles as if you were trying to zip up a pair of pants that are too tight. This brings your belly button towards your spine without moving or tilting your pelvis. Most people find it easier to tighten the abdominals while they are exhaling or blowing out.
Begin lying down with your knees bent and, take a diaphragmatic (belly) breath.
As you breathe out, tighten and lift your pelvic floor muscles and keep holding them while you tighten the lower abdominals (bring your belly button towards your spine).
Hold the brace without straining for____ seconds. Repeat___times.
Advancing the pelvic brace
If any of these exercises are difficult you may need additional exercises to strengthen your leg and trunk muscles.

The pelvic brace and cough
Practice using the pelvic floor during a cough. Breathe in, as you prepare to cough, bring your hand to your mouth and do the pelvic brace. Hold the muscle and cough. Now relax and brace. If coughing is too much strain on your muscles try this activity while clearing your throat. Repeat___times.

The pelvic brace and lifting
Practicing using the pelvic brace during lifting. Place a lightweight object of __lbs. on a table or the floor. Place your feet shoulder width apart and keep your back straight. Bend your knees to reach the object, do the pelvic brace and lift. Repeat___times.

The pelvic brace and sit to stand
Practice using the pelvic brace while coming to stand. Breathe in as you prepare to stand do the pelvic brace. Hold the muscles and stand up. Be sure your therapist has shown you the proper technique. Repeat ___times.

By Sabina Kapasi December 25, 2019 Health, Pelvic Floor, Pelvic Health

Take Care Of Your Pelvic Floor

What Are Pelvic Floor Muscles?
Pelvic floor muscles are the collection of skeletal muscles covering the bottom edge of the abdominal cavity. They run from the pubic bone in the front to the coccyx (tail bone) in the back and attach to both sides of the pelvis. They form a “sling” at the base of the pelvic bowl and help to hold up the organs of that area, which include the bladder, uterus and the rectum.

What Do They Do?
Pelvic floor muscles have three main functions: supportive, sphincteric, and sexual. Strong pelvic floor muscles help to hold the pelvic organs in place against the pull of gravity. They also help you maintain control of your bladder and bowels by lifting the urethra and rectum to keep them closed. Finally, pelvic floor muscles play a role in sexual function by enabling the vagina to be lifted in tighter, thus increasing sensation, during intercourse. They can become weak or injured in different ways including birthing injuries or neurological dysfunction.

How Can I Keep Mine Strong?
You can strengthen pelvic floor muscles by routinely performing some exercises that target them. You should pull the muscles “up and in,” meaning if you had an object inserted into your vagina you would be pulling it into your body with these contractions. You can tell if you are using the correct muscles because the sensation of contraction the pelvic floor muscles is the same as when you stop your urine flow (however, this is NOT part of the exercise program, do not routinely stop your urine flow). Perform these contractions, being careful not to
substitute” with contraction of your abdominal, buttocks, or hip muscles. Try to contract the muscles as strongly as you can for as long as you can hold the contraction. Do as many of these “strong holds” as you can. Another exercise involves contractions of the same muscles, but in quick succession and as many as you can. A good format to begin with is:

Strong Hold: Quick Hold:
5 repetitions of 10 second holds 15 repetitions of 1-2 second holds

Rules to go by
Water intake should be 8-10 10 oz. glasses per day
You should void only 6-8 times in a 24 -hour period.
You should be able to go 2-5 hours between voids.
You should be able to count 8-10 seconds during the urine stream.
If you are younger than 65, you should not need to void in the middle of the night
Avoid bladder irritants such as caffeine, alcohol, acidic juices, sodas, and nicotine

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Author: Sabina Kapasi