Asking patients about pain is a major component of an initial evaluation as well as with follow-up treatments. Monitoring changes in pain behavior, the intensity and the location can help gauge treatment success and progress. However, not a lot of people are aware of a major source of pain which is visceral pain. Kevin Hellman, PhD from NorthShore University Health …
Abdominal Wall and Hernia Pain
By: Elizabeth Akincilar, PHRC Cofounder For some of you reading this, October conjures images of autumn leaves, Halloween, and pumpkin spiced…everything. For me, there’s one additional thing that I associate with October. The Annual International Pelvic Pain Society Scientific Meeting. Every October, for the past 13 years, I’ve attended and participated in this meeting. This year, I was pleased …
EVERYTHING Is Connected: What is Visceral Manipulation and How Does it Relate to the Pelvic Floor?
Remember our earlier post on fascia? Simply put, fascia is a continuous sheath of connective tissues that lines everything in our body – the organs, bones, muscles, blood vessels, nerves etc. Healthy fascia is fluid and mobile. It allows everything in the body to slide and glide promoting healthy and balanced movement. Restrictions in fascia can impact the mobility of …
Alternative Treatments for IBS: Can Hypnosis Help Heal Your Gut?
Irritable bowel syndrome (IBS) is considered a functional gastrointestinal disorder. The Rome Foundation defines IBS as when a person has chronic abdominal pain at least one day per week in the last three months combined with at least two of the following: abdominal pain related to having a bowel movement; abdominal pain onset is associated with change in stool frequency; …
Center for Disease Control Opioid Guidelines: notes from #IPPS2018
By: Kim Buonomo, PT, DPT, PHRC Lexington At the International Pelvic Pain Society’s annual meeting I had the great opportunity to listen to two presenters discuss the role of medications in managing pelvic pain. In this blog, I’ll be talking about Dr. Stephen Ziegler PhD, JD from Purdue University’s lecture regarding the opioid epidemic and ways that we can …
Don’t hold your breath! What you do when you poo
By: Kim Buonomo, DPT, Lexington Don’t hold your breath! What do you do when you poo? It sounds like something from Dr. Seuss. It’s a strange question, and some of our patients don’t know how to answer it. Next time you have a bowel movement, try to think about the specifics. How are your feet positioned? Are they flat on …
Managing Life on or after “The Pill”
By: Jandra Mueller, DPT, MS, PHRC Encinitas If you are a female reader of our blog, have experienced painful intercourse, and happened to have come to the Pelvic Health and Rehabilitation Center (PHRC) for treatment, then you are probably familiar with our talk about how systemic birth control like oral contraceptives (OCPs) or “The Pill,” may be the underlying culprit. …
Using Cannabis to Treat Persistent Pelvic Pain
Introduction by Melinda Fontaine, article by guest bloggers Eloise Theisen, AGPCNP-BC and Timothy Byars From Melinda: For years, I have seen my patients using cannabis to treat a variety of conditions. A common complaint is the lack of guidance to do so. Recently, I found a medical professional who is not afraid to make specific recommendations. In fact, cannabis education, …
Part 2 of 2: What is a good pelvic PT session like?
Last week, in Part 1 of What is a good pelvic PT session like, we described what a pelvic floor physical therapy evaluation consists of and how we go about developing an assessment and setting goals to help our patients get better. This week we dive deeper into pelvic floor physical and occupational therapy treatment plans, patient education, and ongoing …
Wait there’s a (secret) society for that?
In the age of social media and WebMD, often times I will have a patient who has gained information from all sorts of sources all over the internet. It takes a lot of effort to weed through the information that the patient has “learned” and separate fact from fiction. One of the best and most rewarding parts of my job …
How Pelvic Floor Physical and Occupational Therapy Can Serve the Transgender/Gender Non-conforming Population: Part 2
By: Elizabeth Akincilar Last week, Shannon Pacella, DPT, taught us how physical and occupational therapy can benefit transgender individuals prior to gender affirming surgery and for those who choose not to undergo gender affirming surgery. You can read her blog here. This week, I present Part two, where I will explain why physical and occupational therapy for transgender individuals after …
How Pelvic Floor Physical and Occupational Therapy Can Serve the Transgender Population: Part 1
By: Shannon Pacella Earlier this summer, Dr. Heidi Wittenberg wrote a blog post enabling medical providers to understand transgender healthcare needs, which you can read here. Following Dr. Wittenberg’s lead, I was fortunate enough to attend an educational course focused on the physical and occupational therapy evaluation and treatment of transgender patients, and I believe it is imperative to convey …
Mindfulness Meditation: Is it actually effective for treating chronic pain?
By Elizabeth Akincilar Mindfulness meditation. Even if you’re not exactly sure what it is, I’m going to bet you’ve heard of it. It has gotten a lot of attention recently. It’s everywhere. It’s not like the mediation of 20 years ago. Back then meditation was considered “alternative” or “fringe” that few people practiced, especially in western countries. Now, mindfulness has …
Sex Therapy and CBT for Pain with Sex
In 2012, The Journal of Sexual Medicine published an article, What we don’t talk about when we don’t talk about sex: results of a national survey of U.S. obstetrician/gynecologists. The results from the survey revealed that though Ob/gyns routinely (63%) assess their patients’ sexual activities, only 40% of them ask their female patients about sexual problems. Sexual problems may include …
The Pelvic Health and Rehabilitation Center Turns 12!
By: Stephanie Prendergast On July 17th, 2006, Liz and Stephanie opened the doors to the Pelvic Health and Rehabilitation Center in San Francisco. Their mission was to improve the quality of life of their patients and to contribute to the dynamic growth of their employees and students. They aspired to educate the community and medical professionals about pelvic …
Putting down the prescription pad: The opioid epidemic and pelvic pain
It should be a surprise to no one that we are in the middle of a serious, nationwide opioid epidemic. And to top that off, a crisis on opioid overdose. Did you know that on average 115 Americans die each day from opioid overdose?2 In October 2017, President Trump declared the opioid crisis a public health emergency and has since …
Antenatal and Postpartum Pelvic Floor Physical and Occupational Therapy as Standard of Care
By Dr. Ann Croghan, PT, DPT, CLC, and CAPP-OB trained with introduction by Stephanie Prendergast, MPT A few months ago I shared a link to an article I was interviewed for in Men’s Health Magazine about postpartum sex on our PHRC Facebook Page. I was disappointed there was not better coverage about postpartum pelvic floor physical and occupational …
Vulvodynia, Vestibulodynia, and Vaginismus: what’s the difference and why does it matter?
By Stephanie Prendergast, PHRC Cofounder As many as 28% of women experience painful sex at some point during their reproductive years and that sucks. Knowledge is power and May is Pelvic Pain Awareness Month so we want to provide women with useful information about the three most common diagnoses associated with painful sex: vulvodynia, vaginismus, and vesitbulodynia. Differentiating …
Posture Revisited: Sitting and the Pelvic Floor
Photo via Joe Loong via Flickr In previous entries, Britt beautifully took us through all things posture (Posture and the Pelvis Part One and Part Deux). Here are some important takeaways from her posts to consider as we explore how sitting may affect your pelvic floor: The diaphragm, trunk (back extensors, transversus abdominis, obliques, etc.) and pelvic floor muscles are …
Vaginismus: Real Answers for Sexual Pain
Vag·i·nis·mus /ˌvajəˈnizməs/ Noun noun: vaginismus painful spasmodic contraction of the vagina in response to physical contact or pressure (especially in sexual intercourse). What is vaginismus? Above is the definition that comes up when you google vaginismus. You may have seen blogs or posts on social media about vaginismus or painful sex or may have experienced it …
The Blunt Truth About Medicinal Marijuana and Pelvic Pain: Part 2
By Shannon Pacella, DPT, PHRC Lexington First things first: if you haven’t already read the Part 1 to this post, please do so first! There are a few updates since my first post regarding laws and legislature for marijuana (cannabis) use throughout the United States. Updates Currently, 29 states plus Washington, D.C. have legalized the use of medicinal marijuana, …