Connect Physical Therapy: It's time to Own Your Body
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Read about insights and research updates in
​orthopedic and pelvic physical therapy.

Exercising Safely While Pregnant

2/26/2018

 
Written by Mary Ann White, PTA

​Are you wondering how exercise can help you during pregnancy or what kinds of exercises are safe? Exercise is appropriate for most healthy women with uncomplicated pregnancies. ​
exercise during pregnancy
​Maintaining a regular exercise program during pregnancy can help you stay fit, reduce some of the common discomforts of pregnancy and make it easier to get back in shape after the baby is born. ​

​Exercise:
  • Improves posture
  • Eases constipation
  • May decrease your risk of gestational diabetes, preeclampsia and C-section
  • Makes it easier to lose weight and get back in shape after the baby is born
  • Reduces fatigue
  • Relieves stress
  • Build stamina for labor and delivery
  • Promotes healthy weight gain during pregnancy
  • Improves your overall fitness
Staying safe while you exercise is a top concern. Walking, swimming, stationary biking, low-impact aerobics and pregnancy workout classes are appropriate during pregnancy.  Remember to progress slowly and follow the guidelines below. 
Picture
Workout at a moderate intensity
  • Use the Borg Rating of Perceived Exertion Scale and keep the intensity of aerobic exercise between levels 12–14 (somewhat hard).
  • Strength training exercises should be performed with moderate resistance (about 50% of what you can safely lift one time) or less.
​
Stay hydrated and avoid working out in hot, humid conditions
  •  Drink plenty of water
  •  Wear loose fitting clothing
  •  Workout in an air conditioned or temperature controlled environment
If you have gestational diabetes
  • Exercise about an hour after a meal to keep your blood glucose level stable.
  • If your blood glucose levels drop below 100 mg/dL during or after exercise, consume 15-20 grams of fast acting carbohydrate every 15 minutes until blood glucose is above 100 mg/dL
  • Postpone exercise if your blood glucose level is above 240 mg/dL or you are sick
  • Exercise at the same time each day, if possible
  • Have a bedtime snack to keep blood glucose stable overnight
  • If you are on insulin or medication, check with your physician about the proper timing of exercise and medication

Avoid activities that put you at risk for falling, injury or other complications
  • Contact sports like ice hockey, boxing, soccer, basketball
  • Activities with a high risk of falling like surfing, skiing, off-road cycling, gymnastics
  • Hot yoga and hot Pilates
  • Avoid exercising in a supine position (on your back) after the 1st trimester
  • Avoid prolonged standing

Stop exercising and consult your physician if you experience:
  • Vaginal bleeding or leakage of amniotic fluid
  • Regular painful contractions
  • Shortness of breath before physical activity
  • Dizziness or sudden headache
  • Chest pain
  • Muscle weakness that affects your balance
  • Calf pain or swelling

For more information, see:
  • Physical Activity/Exercise and Diabetes:  A Position Statement of the American Diabetes Association (2016)
  • The American College of Obstetricians and Gynecologists Committee Opinion:  Physical Activity and Exercise During Pregnancy and the Postpartum Period (number 650. December 2015)

Theresa's story: a case study on bowel incontinence

2/7/2018

 
Written by Becca Ironside, PT. Becca is also a published Author of Fiction.

​Theresa came to Connect Physical Therapy in late fall of 2017. She looked like she had it all – dark, glossy hair, olive skin and a neckline without wrinkles that belied her age of 57. Theresa has two children, is married to a man from Ireland and is gainfully employed by the State of New Jersey in Trenton. Theresa has an unmistakable air of confidence. This was surprising, given her reason for seeking help in our office for Pelvic Floor Physical Therapy.

During her first visit, Theresa confided that she had recently begun to experience fecal incontinence. It had come out of the blue, she said. A few months back, Theresa noticed severe urgency with bowel movements. She would feel spasms within her rectum and there was no warning before she would have to defecate. There were times when she could not make it to the toilet in time, and so she was forced to wear disposable pull-ups to manage her “accidents”. She had to plan her commute to work, stopping at least once in the cleanest of public bathrooms she could find, because she could not wait during traffic. Theresa’s problem was worsening. She could no longer go to social outings without scoping out for the nearest restroom. The humiliation was awful, she said.

​“After I married my husband, who is from the outskirts of Donegal, Ireland, I traveled overseas to meet his family,” Theresa explained. “They live very simply, these people. They wear the same clothing most days, drive old cars with manual transmissions, and do not have the same access to healthcare that we do.”
bowel incontinence
Theresa had gone to see a gastroenterologist for her new bowel problem. The GI doctor had ordered a colonoscopy, but it had revealed nothing. “My husband’s family in Ireland would not be able to get a colonoscopy as quickly as I did. They would have to stand in a queue. Even if they had the kind of medical emergency that I seem to be having.”

Theresa had gone for second opinions, seen several specialists, but there was no explanation for her fecal incontinence.​
“I am so fortunate to live in America,” Theresa continued. “My Irish in-laws call me ‘A spoiled Yank’. I used to love it when they referred to me that way. I have everything a person could want. Except that now I am terrified of being in public and have to wear adult diapers. I do not feel like a spoiled Yank anymore.”

I knew that Theresa was at the end of her tether. She had tried prescription medication, daily Imodium, altering her diet and kept her legs tightly crossed at all times to avoid what still happened. I explained to her what Pelvic Floor Physical Therapy was all about. That in this type of clinic, we would do an internal examination to discern if the muscles of her perineum might be driving the fecal incontinence.

“I have been through so much already. If you have to do an internal examination, so be it,” Theresa declared. After an exam of the musculature of Theresa’s pelvic floor, it felt as though her muscles were in moderate to severe spasm. These muscles control urination and defecation; they were firing so rapidly that she could not contain feces within her colon, and worked incessantly to force it out. The function of the large intestine is to pull water out of our foodstuffs and allow feces to become solid. This was not happening in Theresa’s case, because the food was not in her colon for enough time, and her stool was unformed and messy. This explained her chronic diarrhea.

The treatment plan for Theresa included deep breathing, relaxation of her pelvic floor muscles and some natural over-the-counter additives to bulk up her stool. “This sounds counter-intuitive to me,” Theresa said at first. “If I relax the muscles, then won’t more feces escape unplanned?” I smiled at her and explained that if she wanted to try something new, she would have to trust me.

It took almost three months of once-weekly treatment in our clinic, with a really good home program, for Theresa’s symptoms to subside. But subside, they did. She now has solid bowel movements twice daily and can control them wonderfully. Gone are the pull-ups and the fear of accidents. Her commute to work and social life have been restored to normalcy.

“I cannot believe how this treatment has helped me! I wonder if this would be available to my relatives in Ireland? I hope so. But at any rate, I feel like a ‘spoiled Yank’ once more,” Theresa remarked. Pelvic Floor Physical Therapy is gaining rank, accessibility and respect all over the world. It likely is available to her in-laws in Donegal, Ireland. The trick is to find ways to talk about these issues and overcome the embarrassment surrounding words like rectum, feces, and stool.

This is what we do, as pelvic floor physical therapists. One client at a time. For spoiled Yanks, people from Ireland and every other continent, men and women, young and older, there is help. We live in a time when anything is possible.
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  • Home
  • About
    • Michelle Dela Rosa, PT, DPT, PRPC
    • Karen A. Bruno, PT, DPT, PCES
    • Bryn Zolty, PT, DPT, PRPC, BCB-PMD, PCES
    • Katelyn (Kate) R. Sheehan, PT, DPT, ATC, PCES
    • Jennifer Watt, PT, DPT
    • Shraddha Wagh PT, DPT
    • Rosalind Cox-Larrieux, PT, MPT, PRPC
    • Giselle Oriendo, PT, CLT
    • Becca Ironside, PT, MSPT
    • Marzena Bard, PTA, CYT, PCES
    • Donna Zamost, PTA, PCES
  • Services
  • New Patients
  • Existing patients
    • Patient Cheat Sheet
    • Pelvic Floor Relaxation
    • Core Strengthening
    • Hip Strengthening
    • Pelvic Correctives
  • Videos
    • Female pelvic pain
    • Male pelvic health
    • Meditation
    • Back pain
    • Pregnancy & postpartum
    • Yoga
  • Ask us
  • Blog
  • Location