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By Sabina Kapasi December 25, 2019 Pelvic Health, Prolapse

Pelvic Organ Prolapse

Pelvic organ prolapse, defined as protrusion of the Pelvic organs (uterus, bladder or rectum) into the vagina, is a common but often overlooked problem. Two large epidemiologic studies – the Women’s Health Initiative (WHI) and a Kaiser Permanente study – evaluated the incidence of pelvic organ prolapse among a wide range of women. The WHI, which followed more than 160,000 postmenopausal women ages 50-70, documented pelvic organ prolapse in 41% of women who had not undergone hysterectomy and in 38% of women who had undergone the procedure. Kaiser Permanente’s epidemiology of Prolapse and Incontinence Questionnaire (EPIQ), documented self-reported pelvic organ Prolapse in 7% of 4,458 respondents ages 25 to 84.

Pelvic Organ Prolapse occurs when the pelvic floor muscle (levator ani) weakens and allows the pelvic organs to bulge into the vaginal cavity. In its early stages, the condition often produces no symptoms. As the pelvic floor muscle weakens, prolapse worsens and leads to urinary and fecal symptoms.

Management Options
Surgery is the only definitive therapy for pelvic organ prolapse, but it is often imperfect. That’s because the repair of one vaginal compartment may predispose another compartment to develop prolapse. In addition, the integrity of pelvic floor innervation and muscle strength can affect surgical outcome. This conclusion is supported by the fact that approximately one-third of procedures for pelvic organ prolapse are repeat operations.

Nonsurgical Treatment Options for Pelvic Organ Prolapse are:
Pelvic floor muscle exercises (PFME)
For women who are unable to perform PFME, biofeedback
Space-occupying devices (tampons, pessaries, etc.)
Behavioral modification
Avoidance of heavy lifting Maintenance of a healthy weight
Avoidance of constipation Avoidance of chronic coughing

The Colpexin Sphere
A new intravaginal device, the Colpexin Sphere, offers a unique option for conservative management. The Colpexin Sphere, which became available in the United States in 2006, supports the pelvic floor muscle and facilitates performance of PFME. The device is a medical-grade polycarbonate sphere with a locator string that is fitted above the hymenal ring to support the pelvic floor muscle.

Pelvic Organ Prolapse is a significant clinical issue among women of all ages, and it often results in discomfort, altered lifestyle and urinary incontinence. The Colpexin Sphere, which provides pelvic organ support and facilitates pelvic floor muscle strengthening, is an efficacious and conservative management option that should be considered for women with urinary incontinence and pelvic organ prolapse.

By Sabina Kapasi December 25, 2019 Exercise, Health

Strengthen Your Bones Ladies

Bone is living tissue that is constantly changing and adapting. The good news is that you can improve your bone health at any age. There is a misconception that osteoporosis is a disease of the elderly when actually healthy bone development starts in our youth. Girls who have diets high in dairy and who exercise regularly create bones that are denser and are less likely to develop osteoporosis. Women reach their peak bone mass at about age 21. After that, there is a slow, steady decline that increases with the loss of estrogen surrounding menopause.

Listed Below are 5 helpful tips to improve your bone health:
Trunk Lifts – trunk lifts build strength in your back bones by doing reverse sit-ups; lie on your stomach and lift up your trunk.
Vitamin D3 – a daily dose of Vitamin D3 helps your body absorb calcium. It is also known as the “sunshine vitamin” because we make it when our skin is exposed to sunlight. If you live in the Northeast, however, you cannot depend on getting enough daily sun year-round to make sufficient Vitamin D3; So taking the supplement is encouraged.
Lift Weights – Pump a little iron in addition to your cardio. Strength training with high loads and low repetitions can increase bone mineral density in women.
Increase Your Dairy Intake – Calcium is not produced by our bodies; so we must get it from food or supplements. Calcium is essential for many bodily functions (including heart rate regulations), so if you don’t have enough in your diet, calcium will be taken from your skeleton. If you are allergic to dairy, you should talk to your doctor about good calcium supplements.
Walk More – walking is a weight – bearing activity that increases the bone density in your hips. Gradually build up to walking at a moderate pace for 30 minutes, five days per week. Other wight-bearing exercises include tennis, jogging, volleyball, calisthenics, aerobics, stair-climbing, and dance.
Remember that what you do today strengthens your bones tomorrow.

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 Pelvic Floor

How posture affects the pelvic floor

The way you carry your body all day affects the pelvic floor muscles.
Some tips:
Standing: Keep your knees unlocked, buttocks and abdomen relaxed.
Sitting: Use proper support for the back. An additional cushion under the thighs keeps pressure off the pelvic floor and buttocks.
Lying: Elevate the legs on a pillow or two.

Preventing stress on the pelvic floor
Lifting correctly
As you get ready to lift:
Bend your knees
Gently hold in your stomach muscles
Exhale or breathe out as you lift (Don’t hold your breath!)

Moving out of a chair
Take your bottom with you!
Scoot to the edge of the chair
Tighten the muscles around your vagina
Suck in your lower belly muscles
Push off the chair using your leg and arm muscles as you breathe out

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 Bladder Health

Proper Bladder Habits

Proper bladder habits can aid a great deal in controlling issues such as urinary incontinence, urinary tract infections, and yeast infections. Understanding how to keep your bladder healthy can keep you more active and self-assured as you age. Following are guidelines to keeping and maintaining a healthy bladder.
Drink 80oz of water per day.
voiding should take place no more than 6-8 times in a 24 hour period
Normal voiding intervals should be 2-5 hours apart.
people under the age of 65 should not void during the night.
Each urination stream should last up to 8-10 seconds long.
Avoid bladder irritants such as caffeine, alcohol, acidic juices, certain medications, and nicotine.
** If you decide to drink a cup of coffee or tea, make sure you add 10 ml of water to your daily intake.

By Sabina Kapasi December 25, 2019 Health, His Thearpy

We Recommend Spanx

We recommend Spanx because:
1) It helps to teach you how to maintain a neutral spine position
2) it can help decrease back pain
3) it promotes a pelvic brace posture
4) it can help decrease pelvic pressure and pain
5) it can decrease and prevent disastasis recti post partum
6) it can improve body mechanics and posture by tactile cues and compression
7) it can decrease coccyx or pubic pain
8) Spanx are very affordable

As wonderful as Spanx are to us they are not the only way to prevent the above. You must also strengthen your core and pelvic floor muscles. We are able to help with that. Come to our office for a pelvic floor assessment and we can teach you how to prevent and how to strengthen your core and pelvic floor muscles.

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