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BLOG

Read about insights and research updates in
​orthopedic and pelvic physical therapy.

What the research says: mindfulness for bowel health

6/12/2019

 
Recent studies support the benefits of mindfulness for bowel health. A 2014 study of 53 patients reported that mindfulness-based stress reduction (MBSR) “had a significant positive impact on the quality of life…” on people diagnosed with ulcerative colitis compared to a control group (1).

Another study the same year examined 24 people with irritable bowel syndrome (IBS) and compared them to a control group. Authors concluded that mindfulness-based therapy was more effective than cognitive behavioral therapy (CBT) to decrease symptoms in those with IBS at a 2-month follow-up. (2)
(1) Jedel, S., Hoffman, A., Merriman, P., Swanson, B., Voigt, R., Rajan, K. B., & Keshavarzian, A. (2014). A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis. Digestion, 89(2), 142-155.

(2) Zomorodi, S., Abdi, S., & Tabatabaee, S. K. R. (2014). Comparison of long-term effects of cognitive-behavioral therapy versus mindfulness-based therapy on reduction of symptoms among patients suffering from irritable bowel syndrome. Gastroenterology and Hepatology from bed to bench, 7(2), 118.

Nutrition strategies to relieve pelvic and chronic pain

6/12/2019

 
strategies for pelvic and chronic relief
By Karen Bruno, PT, DPT 

​Proper nutrition and knowing what you should eat and what you should avoid can assist to reduce the contributors to pelvic pain and chronic pain. This is done by addressing inflammation.  ​
Is what you are eating contributing to your pain? Can the choice of food you eat actually help to relieve pain? Can nutritional interventions ease your pain? The answer is that nutritional interventions are often effective in reversing chronic pain. Simple dietary changes that remove inflammatory foods and replace it with better choices can help to reverse chronic pain conditions. Pain conditions are often due to an imbalance in the body’s chemistry. This can be due to many factors, such as a lack of nutrients in your diet, stress overload, lack of exercise, increased inflammation, insulin resistance and environmental factors. Nutritional interventions can be one element for shifting the chronic pain response.

In the links below, Joe Tatta, PT, DPT,  addresses components of various anti-inflammatory diets and their benefits. Dr. Tatta is a physical therapist and Founder of the Integrative Pain Science Institute, an education company that supports practitioners as they explore integrative models for pain. In these blogs, there is a review of the current literature of the types of foods and diet that can ease the pain associated with various health conditions. 
  • https://www.integrativepainscienceinstitute.com/?s=diet+part+1
  • https://www.integrativepainscienceinstitute.com/diet-best-pain-part-two/
  • https://www.integrativepainscienceinstitute.com/fibromyalgia-research-new-hope/

The Basics:
  1. Eat clean food. This means food that is unprocessed. Eat meats and poultry that are organic when possible, and fish that is wild caught. Eat plenty of fresh vegetables and fruits, and consume grains that are in their purest form. 
  2. Avoid the trap of “organic” and “gluten- free”. Creative marketing is trying to convince us that these foods are healthy. Check the ingredient list. These often consist of low quality, highly processed ingredients. Also. beware of “natural flavors”. That can be a way to hide MSG, yeast, sugar and non-vegetarian based products. Look at the nutrition facts label for additional information.
  3. Natural fats and oils are good for you. These include olive oil, ghee, butter, coconut oil and avocados/avocado oil. 
  4. Some people benefit from the reduction or elimination of dairy milk products from their diet. This may only be needed as a temporary change. Great substitutes include butter, milk and cheese made from nuts and seeds. Once again, make them yourself to avoid the highly processed, less nutritional commercial items. It is very easy and there are plenty of recipes on the internet. The recipes can often be found by looking up the vegan and/or paleo versions of a recipe. 
  5. Eat whole grains and legumes. Whole grains include quinoa, brown rice, buckwheat, millet, barley and whole wheat. Consider using sprouted wheat flour or any other sprouted grain when you bake and cook. Sprouted grains are easy to digest, contain more fiber, and have more available nutrients. Ezekial 4.9 bread is an easily digestible sprouted grain bread and can be easily found in grocery stores, health food stores and Trader Joe’s. Trader Joe’s aldo has a few varieties of sprouted grain bread. Also, consider sprouting legumes to receive similar benefits. Check out these links for tips to sprout your legumes or just do a Google search.

    For more on this, visit Sprout People.

    Avoid refined and highly processed grains. If you do go “gluten-free,” be aware to avoid the refined and highly processed grain substitutes.  
  6. Use natural sweeteners like stevia, which is an herb, monk fruit, raw honey, date sugar and maple syrup. Avoid refined sugars and artificial sweeteners. 
  7. Drink hydrating liquids like water, broths, fresh juices and herbal teas. Carbonated beverages, alcohol and caffeine are bladder irritants that can trigger inflammation. 
  8. For the more sensitive beings, (and we know who we are), it may be beneficial to avoid one or more of the following: eggs, peanuts, corn and alcohol.
  9. Enjoy liberally seasoning your food with plenty of herbs and spices to enhance the flavors. 

These are some general guidelines. There is not a “one-size fits all” eating plan as you are unique and complex. Start by making a few changes in your diet and notice how you feel. For example, you can eliminate sugar and processed foods.  Making limited changes will assist in recognizing how those particular foods impact you. Is there a relationship between food and pain? Going slowly and changing one or two things at a time is recommended so that you can identify whether a particular modification had an effect. 
What happens if you eat a dessert or two, have some alcohol or coffee,  or eat some other food that is generally considered inflammation provoking?  By all means - enjoy it and savor the experience! There will be more on that in an upcoming blog. Resume the low inflammation regimen when you can and just move forward. 

What you choose to eat has an influence on your overall health and resolving pain. Nutrition and diet affect both the physical and psychological processes that impact chronic pain, and good nutrition can be a pivotal component to attain and sustain optimal function and quality of life.  

Making delicious and nutritious meals and desserts can be simple. Here is a simple 3 ingredient treat to get you started.

Blueberry Banana Muffins
Ingredients: 
  • 5 very ripe bananas
  • 1 cup nut butter
  • 1.5 cups of blueberries
Preparation: 
  • Preheat oven to 350 degrees.
  • In a bowl, mash the bananas with a fork. Add the nut butter and mix until combined.
  • Add the blueberries and mix well. 
  • Use muffin cups or prepare the muffin tin by rubbing/spraying it with oil.
  • Add the batter to the muffin tin.
  • Bake for 18-20 minutes.
  • Let the muffins cool. Enjoy!
  • Makes 12 muffins. ​

For reference, check out the Integrative Pain Science Institute.

Q&A for men: second edition

6/4/2019

 
Q&A for men by Becca Ironside

While drawing from her clinical experience, Becca Ironside, PT answers specific questions from men about their urinary, bowel, and sexual concerns.

​This is Connect PT's second edition of the Question and Answer series.

​Question from Marc: I have premature ejaculation. It has been part of my life since I was sexually active at 16 years old and I am now 33. Is this something that can be helped by pelvic floor physical therapy?

Answer from Becca: Marc, I would imagine that you may have been treated by psychotherapists for your issue. In the last century, many specialists have placed premature ejaculation into the category of a problem of the brain. However, pelvic floor physical therapists now treat your particular diagnosis in an entirely different manner. What we have discovered in treating men like you, is that those who experience early climax often have tight musculature in their saddle muscles (the muscles of your body that would be in contact with the saddle of a horse, were you seated upon one). In the ideal situation of arousal, these saddle muscles should expand and allow blood to flow into the penis and testicles. This blood should be retained in this saddle area to allow for an adequate time span during arousal and penetrative sex before ejaculation. In the case of premature ejaculation, the muscles of this saddle region are taut and cannot allow accumulation of blood to pool in the testicles and penis, which then creates an emergency expulsion of the seminal fluid from the penis.

This condition of premature ejaculation is treated in pelvic floor physical therapy. We assist men in reaching longer time durations of their erections by teaching them to lengthen their pelvic floor (saddle) muscles. We also instruct patients and their partners to increase the time of arousal and defer climax, thereby encouraging the blood flow necessary to prolong the sexual experience. In answer to your question, Marc, you can find help with a pelvic floor physical therapist.​

Question from Steve: I suffer from chronic constipation. While that is terrible by itself, I also find that I cannot get fully hard during sex when I am constipated. Am I imagining this, or is there a correlation between constipation and erectile dysfunction?

Answer from Becca: Steve, I wish that more of our patients made this connection between the bowel and sexual function. The organs that sit within the relatively small cavern of the bony pelvis in men are the bladder, prostate, and the end of the colon (rectum). These organs are crammed into a very tight space. Which means that when one of these organ systems is a little bit off, the other systems invariably feel askew as well!

When the bowel is impacted with stool, as it is with constipation, this organ presses on the prostate and then the bladder. Also, the pressure on the perineum (the saddle region we discussed in Marc’s case), is created by too much fecal matter accumulating in the bowel. This excess pressure inhibits a full sexual response and limits full erections in men. The long-term discomfort associated in prolonged constipation can also distance a man from wanting to engage in sex.
​

The solution: pelvic floor physical therapists treat bowel dysfunction. We educate our patients in how to improve bowel regularity with stretches, exercise and lengthening of the pelvic floor muscles. What we find in treating patients like Steve is that when regular bowel movements are achieved, more satisfactory sex follows!

Question from Chen: I have trouble urinating from time to time. Sometimes, I think I am done peeing, I pull up my pants, and then I dribble urine. I am only 25 years old. Why is this happening and what can help?

Answer from Becca: Chen, I wish that you would start an online social media feed about your problem! Because it is so common and so very easily addressed. Many men come to pelvic floor physical therapy with complaints of leaking after peeing, or what we refer to in our line of work as “the post-void dribble.” Guys think there is something terribly wrong when this occurs, and because they won’t talk about it, they don’t know that many other guys have exactly the same problem!
​

Many men stand up to pee in urinals. This is the cultural norm in our society. But for men with tight pelvic floor muscles, or even men with moderate anxiety in a public restroom, the bladder cannot completely empty when a guy is in a standing position or when there are other men around him. What happens in this case is that the bladder cannot fully relax and the urine within it will not completely drain from the pelvis. Many guys shake their penises to try to get excess pee out of it. But this technique doesn’t always work to sufficiently drain the bladder. Hence, the dribble occurs after you think you are done peeing, Chen, and so many other men like you leave the bathroom to return to the tavern or sports arena, because they never allowed their bladders to fully empty.

​Here is what a pelvic floor physical therapist may tell you, Chen.


  1. Sit down when you pee. Go into a stall and don’t worry about what your friends think. This will allow your bladder to fully relax and empty, which might prevent the post-void dribble entirely.
  2. Instead of shaking your penis when you think you are done peeing, take your fingers and press up into the space between your anus and your scrotum. Swipe your fingers towards the front of your penis. This will get that lingering pee out before you pull your pants back up.
  3. Don’t wear tight pants or boxer briefs. If you have this condition, skinny jeans may not be for you. This type of clothing creates tension in the pelvic floor and prevents the penis from fully draining pee.
  4. While these suggestions sound ridiculous, they are extremely effective. Moreover, wouldn’t you rather get back to your game? Because you will get back to that game, and you won’t leak urine anymore!​
Finally, for Chen and the vast number of guys like him, view this PDF for the technique on how to avoid the post-void dribble.
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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