January 8, 2018

Pediatric Pelvic Floor Therapy

Posted in Uncategorized tagged , , , , , , , , , , , , , at 4:00 pm by ntfunctionsmart

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Potty training for any family is rarely described as an easy process. Yet when the child also struggles with functional constipation (no signs of abnormalities physically, seems to be of functional cause) and/or encopresis (involuntary defecation) it turns into a frustrating process that is difficult to get a handle on. Other factors and diagnosis that can prolong toilet training are Hirschsprung disease, Crohn’s, Imperforate anus, Celiac disease, slow transit systems, developmental delays, sensory processing disorders, Autism spectrum disorders, etc.

Pelvic Floor Therapy using Biofeedback (surface EMG)/Real Time Ultrasound (RTUS), therapeutic exercises, nutrition advice, and life style modifications can help navigate this difficult process and improve symptoms associated with chronic constipation, encopresis, and chronic laxative use.
Several studies have concluded positive outcomes with Pelvic Physical Therapy interventions.

A study completed by Zivkovic et al in 2012 looked at the use of diaphragmatic breathing exercises and retraining of the pelvic floor in children with dysfunctional voiding. They defined dysfunctional voiding as urinary incontinence, straining, weakened stream, feeling the bladder has not emptied, and increased EMG activity during the discharge of urine. Although this study focuses primarily on urinary issues, it also includes constipation in the treatment and outcomes. Forty-three patients between the ages of 5 and 13 with no neurological disorders were included in the study. The subjects underwent standard urotherapy with included education on normal voiding habits, appropriate fluid intake, keeping a voiding chart, and posture while voiding in addition to pelvic floor muscle retraining and diaphragmatic breathing exercises. Results showed 100% of patients were cured of their constipation, 83% were cured of urinary incontinence, and 66% were cured of nocturnal enuresis.

A recent study by Farahmand et al in 2015 researched the effect of pelvic floor muscle exercise for functional constipation in the pediatric population. Stool with holding and delayed colonic transit are most often the causes for children having difficulty with bowel movements. Behavioral modifications combined with laxatives still left 30% of children symptomatic. Forty children between the ages of 4 and 18 performed pelvic floor muscle exercise sessions at home, two times per day for 8 weeks. The children sat for 5 minutes in a semi-sitting (squatting) position while being supervised by parents. The patients increased the exercise duration 5 minutes per week for the first two weeks and stayed the same over the next six weeks. The results showed 90% of patients reported overall improvement of symptoms. Defecation frequency, fecal consistency and decrease in fecal diameter were all found to be significantly improved. The number of patients with stool withholding, fecal impaction, fecal incontinence, and painful defecation decreased as well.

Children and parents gain confidence and knowledge to take control of stooling and urination issues when they have the right information and tools to do so. Overall, it is important to know toileting problems are common in children and Pediatric Pelvic PT can help your family engage in a plan for success.

Call us with any questions and speak with your health care provider if a family member may be in need of this specialty.

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December 14, 2017

Meditation For Healing

Posted in Mind and Body, Pelvic Health tagged , , , , , , , , , , , , , at 9:40 pm by FunctionSmart

Meditation has many health benefits and can really help you heal from injury, illness or chronic conditions. It doesn’t have to be complicated to get started either. Here is a meditation 101 primer for you, to help you unfreeze, focus, re boot, re-frame and calm your mind.  Use this acronym and the tips below to help start your practice and read on for links to resources.harmony-image

SIMMPLE: this may help you remember elements of a meditation practice: Steps to consider:

Select a place. Sit tall. Sitting tall will help you stay alert. Folded blankets or stacked pillows or a “meditation cushion” can help with support. If you have back pain while sitting, you may lie supine, on your back. If you are lying down, turn your palms up and move your arms out to the side slightly, as in the “corpse pose” at the end of yoga classes, Shavasana. The arm posture will help you to not fall asleep.

Intent: Calming, relaxation, peace, and joy. Interest the mind in calming, relaxation, peace, and joy. Intent: Non -judgmental, beginners mind, noticing thoughts and calmly, gently re-direct to present time. Intent: positive feeling, appreciation.

Mental: scanning, body, skin, pressures supported by the chair and floor, and note sounds, sensations, aromas, mood, moment. Melt away from it all.

Mantra; Your phrase. Choose your mantra for calming your mind, and focus. See the guide at the end of this post.

Pace: your breath, with an easy pulse of airflow in, and a pulse of air flow out. Pure oxygen, Pace 1, 2, and 3 inhale, pace pause, pace 1, 2, 3 exhale, pace pause. Peaceful recharge. Pace the breath as a wheel turns, flowing, circular. Gradually lengthen the inhale, the pause, and the exhale, as you are comfortable.

Let: Let go of your thoughts, your busy rabbit brain, let your mind wander and come back, let your thoughts be without judgment. Leave the concerns of the past, leave concerns of the future, and let yourself be. Let go of the need to move or “do” let go, to be present. Let all be. Continue the mantra, and the breath cycling, flowing.

Enjoy: positive feelings, a positive thought, enjoy gratitude. Enjoy a sense of gratitude for the positive things in your life. Enjoy being, and your mantra, and your breath. Enlist all thoughts of gratitude and appreciation.

The practice of meditation can allow you to slow down and focus on moments during the day, with appreciation. This is when meditation overflows to mindfulness. Mindfulness entails a slowing down sense,  appreciation and being in the moment throughout the day,

The mantra:  A great text is Strength in the Storm, by Easwaren, founder of the Blue Mountain Center of Meditation in Berkeley Ca. Easwaren provides examples of how individuals of various faiths can use a mantra specific to their faith for meditation. He advises half an hour in the morning, and evening if possible for meditation and spiritual reading. Even 5 minutes AM/PM can be a good start. You may use his guide for selecting a mantra or simply make one of your own that’s meaningful to you.

There are many free online-guided meditations that can be useful to guide your practice. Here are some links:

Meditation guides

About Meditation: This is a nice site with free offerings of guided 10 -minute sessions, great for mini breaks, and more extensive options for those who want to study as a free course.

UCSD Mindfulness UCSD hosts mindfulness based stress reduction training classes, and they offer free online guides, such as a body scan, and loving-kindness. Choose a voice you like, and start with a short one to develop the ability to “be” vs. “do”.

Meditation music

Last FM, Free music downloads

Ipnos Apps:  Relax Melodies, apps available for i-phone and Android. I use the combo ocean wave sound, and flute, during yoga, and some meditation session.

Medical effects and benefits of meditation are abundant and there have been many articles in medical literature to describe them. Here are just a few of the benefits: Improved status of those with PTSD, reduced worry and reactivity, improved sleep, improved cortisol levels, reduced signs of cellular-DNA aging with longer telomeres,reduced BP, weight loss, and other benefits as noted in these links:

Health benefits of meditation from ADHD and anxiety to cancer and menopause

Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres.

Meditation benefits for Youth

Meditation is becoming more of a mainstream practice for all of its benefits and ease of performance with simple training. Enjoy creating your own practice, and reap all the benefits that come with regular time for re framing and re booting your body and mind.

About the author:   Maureen is a Board Certified Women’s Health Specialist, Credentialed Clinical Instructor, and Professional Yoga Therapist utilizing Medical Therapeutic Yoga. She is an advocate for resiliency training in human performance, and she utilizes principles of meditation/relaxation and yoga postures as part of her Physical Therapy intervention. You may schedule with her at Function Smart to create your own unique mind -body program for wellness.

November 15, 2017

Pelvic Pain and Nutrition

Posted in Pelvic Health tagged , , , , , , , , at 5:02 pm by FunctionSmart

Pelvic Pain and the Gut; Nutrition Facts!

Maureen and Natalie have 2 conferences they attended recently and we are excited to help you on your healing journey with science:

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There is an explosion of information regarding the “Gut”,and clinicians are helping their clients TURN OFF PAIN by adjusting their nutritional intake. Notice I did not say “DIET: which is restriction based. New approaches guide individuals to gradually add more positive elements to their nutrition profile, and gradually release habits that are pro inflammatory. There are common threads in Pelvic Rehab and as I observe MD, ND, DO, and NP, PT, D.C. and RD directed, “PELVIC HEALTHY” NUTRITION approaches, I see my clients transform. Sleep improves, bowel and bladder function improves, and pelvic pain often reduces or may be eliminated in some cases. It all comes down to science and optimal nutrients that are easily digested, absorbed and assimilated, and excreted. Our PELVIC ORGANS include the bowel, bladder, uterus, and ovaries, and or in males, the prostate and testes. It turns out the best nutrition will help us build and maintain a barrier and insulation of each organ system vs Leaky Gut, or Leaky Vagina or Leaky Bladder. A fun weird fact: The “Vagina Diet” is coming out in 2018 dealing with these issues, from an integrative OBGYN.The synergistic effect of a nutrition –based approach for Pelvic Pain can have a profound, life changing influence on other health factors as well, such as optimizing weight, blood sugar regulation, improved – tissue pliability and appearance, and resistance to illness. But it can take some detective work, and a food/beverage/symptom diary can be illuminating. Reactions can take a few days to occur after ingestion. You are unique and so are your sensitivities and food pleasures that that can help you heal.

Recognize:Power packed nutrition for health:

  1. Cooked vegetables
  2. “Good fats” Omega 3 as found in Salmon, Sardines, and more
  3. Berries and cherries
  4. Lean protein
  5. Nuts and seeds
  6. Yogurt ,* or other source of probiotics

Reduce/trial, and if reactive: gradually eliminate

  1. Refined carbs: they spike sugar and increase inflammation
  2. Gluten, Dairy, Soy: most common food allergens
  3. Alcohol: limit to a few oz., but not daily
  4. Processed meats
  5. Fried foods
  6. Cold beverages such as iced smoothies, milk shakes, icy raw veggies drinks

Also hormone influences can be associated with pelvic pain so if there is a concern check your labs with your health care provider. Studies are demonstrating that a combination of medication and probiotics helps reduce recurrent bacterial vaginosis. In those with Interstitial Cystitis/Painful Bladder Syndrome, attendees of the San Diego Support group have had some success following NIH guidelines :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153925/

https://www.ichelp.org/

https://www.niddk.nih.gov/health-information/urologic-diseases/interstitial-cystitis-painful-bladder-syndrom

And last but not least, the GUT BIOME is being identified as a perpetrator in chronic health conditions including pain and anxiety. Here is a link from a local Dietician Donna Wolf who halted her fibromyalgia with nutrition and self care:

http://healthydirectionsforyou.com/leaky-gut-what-it-is-why-its-significant/

Consider what new items to add for health and what you may need to taper or even eliminate. Consult Your Pelvic PT specialist for more information, such as the myofasical basis of pelvic pain, as well. Power On!

Enjoy this THANKSGIVING MONTH and sample a new healthy treat, let us know. This is from S.F. based Seed and Salt:

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October 21, 2017

Mind Body Skills: The Pelvic Floor

Posted in Mind and Body, Pelvic Health tagged , , , , , at 12:59 am by 1wcspt

rock stack beach image Your pelvic health, is it “balanced”?

I am speaking this week at the Academy of integrative Health and Medicine AIHM17# , on The Secret World of Pelvic Physical Therapy. Some “secrets” I will divulge include:

1.Kegel Power (Pelvic Muscle Strength) does not always =bladder control, or continence.

2.A “Short Pelvic Floor” is a common condition, and it is too tight to function well! It may be associated with pelvic pain, bladder leakage or pain, constipation or bowel leaks,  pelvic pain with rest and play activities, and/or sexual problems.

3. Sexual  function may be improved with pelvic physical therapy!

4. Mind-Body Skills such as Medical Therapeutic Yoga, Meditation and Mindfulness Training can help improve quality of life, reduce pain, and provide a drug free “re-set”, all helping your Pelvic Floor with improved function. Respiratory exercises and daily health care routines established in therapy can enhance your well being.

Many people are shy about pelvic problems, and so are many medical professionals, so if you have a pelvic health concern, talk with your health care provider regarding conservative care with Physical Therapy.

Meditation, mindfulness training requires “practice”, I suggest my clients start with a comfortable position for 10 min per day, 3 x a week. Results are “dose related”.

https://health.ucsd.edu/specialties/mindfulness/programs/mbsr/Page

Pelvic PT for men and women; details:

http://www.womenshealthapta.org/patients/

 

 

 

September 8, 2017

What is Pelvic Physical Therapy?

Posted in Uncategorized tagged , , , , , , , , , , , , at 12:45 am by dptrose

What is pelvic physical therapy?

Pelvic physical therapy is a specialization within physical therapy that addresses musculoskeletal dysfunction of the muscles of the pelvic floor as well as the muscles stabilizing the hips and core. Dysfunction in these muscles can lead to urinary or fecal incontinence, constipation, pelvic pain (including pain with sexual activity), difficulty reaching orgasm and even erectile dysfunction.

Who can benefit from pelvic physical therapy?

Men, women and children can all benefit from pelvic physical therapy. Some common diagnoses include:

  • Children with constipation, bed wetting, soiling of urine/feces during the day.
  • Women with pelvic pain, urinary incontinence, prolapse and post-partum.
  • Men with pelvic pain (including testicular and penile pain), erectile dysfunction, and urinary incontinence post-prostatectomy.

Who can practice as a pelvic physical therapist?

A physical therapist who completes post-graduate advanced education on the evaluation and treatment of pelvic floor dysfunction. These physical therapists often have additional post-graduate education on other systems including orthopedic, gastrointestinal, pediatric, reproduction/sexual health and are experts in treating musculoskeletal conditions of the pelvis.

March 16, 2010

A New Resource for Pelvic Floor Physical Therapy

Posted in Uncategorized tagged , , , , at 11:00 pm by FunctionSmart

This site is currently being constructed to serve as a resource for physicians, therapists and patients seeking more information about treatment options for a variety of pelvic floor dysfunctions.  The site will be managed by San Diego Pelvic Floor specialist Renee Cinco, PT of FunctionSmart Physical Therapy.  We will feature articles from experts both local and national to provide an online resource for men and women seeking options for care.  Many men and women suffer in silence with symptoms of incontinence, pelvic pain, painful intercourse, chronic constipation and much more.  We feel it’s time to break the silence.  Thank you for visiting.