By Kim Buonomo, DPT, PHRC Lexington
We are all getting used to a new idea of normal since COVID-19 became more prevalent. Over the past few months, I’ve noticed a few things that I wanted to share. We are doing our parts at PHRC to stay safe and protect ourselves and each other by wearing masks. Below I share some tips!
- Don’t clench your jaw
I’ve noticed that when I’m in a mask, I’m a little more stressed. I tend to find that I’m breathing through my nose the majority of the time and trying to keep my mouth shut (hard for a girl who loves to talk). As a result of this clenching, I find my cheeks getting sore and feeling tight as the day progresses and eventually my jaw feels like it’s sutured shut. There should be a little space between your top and bottom rows of teeth when your mouth is at rest, and you should be able to breathe comfortably. Not to mention, the mouth and throat are linked to the pelvic floor. When you tighten the upper part of your body, it can sometimes lead to tightening of the lower part of your body, including your pelvic floor muscles. Awareness has been key for me, and a practice of body scanning has been helpful for me to be aware of the tension in my body. You can find a great longer body scan from Calm here (30 minutes), and a 3 minute one from Massachusetts General Hospital here.
- Drink plenty of water
When wearing a mask, you can’t eat or drink without making the conscious decision to take the mask off. On one hand, this is good because it limits needless exposure, but on the other hand, it makes it much more difficult to take small sips of water throughout the day. The general guideline for water intake is that you should drink half of your body weight in ounces of water per day. So for someone who weighs 200 lbs, they should drink 100 oz of water per day. There are many factors that can affect this number including climate/temperature, physical activity levels, food intake and body type. If you’re the person who sweats a lot, you may need to replenish your water more frequently. If you tend to eat lots of fruits that are high in water like watermelon, you may get some of those ounces from the foods you eat. A tip that has helped me is to actually drink out of a mason jar. I like drinking from a wide mouth glass (some people prefer straws and that’s fine too!), drinking from glass instead of plastic is better for the environment and better for your body, as there are no chemicals that can leak from the plastic, and I like that there are measurements right on the side of the glass. I know that with my mason jar, I need to refill it three times throughout the day to hit my goal. Drinking plenty of water also helps to regulate bowel and bladder function.
- Brush your teeth
It’s tempting to let oral hygiene fall by the wayside when you’re wearing a mask all the time. No one sees your teeth or can smell your breath! That said, it’s still incredibly important for overall health and hygiene, as well as avoiding mask stank. Bringing a toothbrush into the office for after lunch may be a good idea. No one wants to be breathing in the smell of their lunch for the whole rest of the day.
- Smile anyway!
One of our therapists, Maryssa Steffen, gave an excellent presentation on a polyvagal based approach to mindfulness-based movement. One of the take-aways was that our physiological state is manipulated by social engagement, and mindful focused attention. This influences the neural regulation of the autonomic system and can influence our physiological functions. A key factor is that cues of safety are embedded in positive social engagement behaviors including welcoming gestures, a prosodic or melodic voice, and endearing facial expressions. All this to say: who doesn’t find themselves smiling and in a better mood when someone smiles at them or gives a friendly wave? COVID has been hard because we are being told to stay away from one another as much as possible and that can make us become less endearing in our portrayal of ourselves to the outside world. I definitely am giving off a few more “don’t talk to me” vibes than usual when I’m in situations where I feel less comfortable such as at the grocery store. That said, I’m going to quote the great Tyra Banks and talk about smizing. You can see in someone’s eyes when they have a genuine smile on their face and the small wrinkles that form around the eyes when smiling can create positive social cues. We all need some of those right now! Not to mention that there is research to support that smiling improves your mood as well. 😀
Who would you rather talk to?
- Use tools to avoid ear strain
Wearing a tight mask all the time can make your ears sore. Getting a mask that fits well is ideal, but it seems that most masks I’ve seen are one size fits all. I’ve seen several DIY options for strategies to decrease ear strain including different kinds of headbands with buttons on the sides to hook the mask onto. My mom’s friend knitted me this awesome tool. It’s a small band that goes around the back of my head and has a button on either side where you can hook the mask.
My ears thank you!
- Avoid glasses fog
Make sure your mask fits well, especially at the bridge of your nose. This will prevent the air you exhale from wafting out of the front of your mask and creating condensation on your glasses. I’ve also heard that putting a small bit of tissue under the nose of the mask can trap some of that moisture, but I didn’t have great success when I tried this myself. On long days, I’ve been opting for my contacts to avoid the problem entirely.
What other things bug you about wearing a mask and what are your best tips for coping with it? Please share in the comments below, and stay safe and healthy!
Speaking of Masks…..
Morgan Conner of PHRC Los Gatos took to the sewing machine and kindly sewed the entire PHRC team masks in our colors, shown above! Morgan made these cotton masks with two layers of no-stretch fabric with stretchy fabric straps that can either be tied around the back of the head or behind the ears! They have a pocket between the layers where you can insert an extra filter and the sides are lined with elastic to keep the mask against your face. They also have room for a pipe cleaner at the top that can be used to tighten the mask around the nose! And finally, they are also machine washable! We are giving away two of these masks on Instagram, head on over to @pelvichealth to enter to win!
Reference:
Feature image: https://pixabay.com/vectors/virus-mask-coronavirus-disease-4999857/
________________________________________________________________________________________________________________________________________________________________
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. The cost for this service is $85.00 per 30 minutes. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at 510-922-1417.
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.