Monday, February 24, 2014

Ladies, Listen Up, Do Your Kegels!

I used to think kegels were for women with 5+ kids.  An up close and personal journey has taught me that, nope, they are for women just like me! I am a physical therapist recently moved from Orlando, FL to New York for my husband’s job transfer, and decided to venture into the “pelvic floor world” of therapy. I am a very active person, I go to the gym 4-5x a week with a variety of cardio and weights, and had an uncomplicated vaginal delivery two years ago.  

 As part of training for my new pelvic floor concentration, I used biofeedback equipment to test my kegel strength and coordination. While I wasn’t expecting high scores, I was shocked to see my poor attempt at a kegel looked more like a muscle twitch on the biofeedback graph.  And to top it off, I used every muscle in my lower body to get a whopping score of 9! Just to give you a frame of reference, that is about 25% of the normal value for women. I have since devoted 20 minutes a day to kegeling and am happy to say my scores are climbing quickly and are now around 25.

I should point out that I had absolutely no symptoms of incontinence, and therefore if not a PT would have never sought out pelvic floor therapy. I am very fortunate to have discovered my weakness prior to symptoms, because with my 2nd pregnancy in progress and such poor pelvic floor strength, I would say incontinence was in my near future! I have since started telling all of my family and friends to do their kegels! And with talking about kegels I have found that a lot of women had the same ideas that I did. “Those are for my grandmother!” “That just comes with pregnancy” “Incontinence runs in my family.” And my favorite one from my mom: “You’re a physical therapist, so why are you teaching people to kegel? And how exactly are you doing this?”

I use my personal story as an example of why women should be proactive about their health. Let’s stop dismissing incontinence as just one of the effects of pregnancy or age, it doesn’t have to be! Your pelvic floor muscles are just like any other muscle; they need attention, time and consistency. And, yes, physical therapists treat pelvic floor muscles just like any other muscle in your body. If you’re a numbers person like me, call our office and schedule an appointment with one of our pelvic floor therapist and get your baseline scores and set goals for yourself. Or just start kegeling! You can start with quick contractions x 20 reps and endurance contractions up to 10sec x 10 reps and repeat this 5-10x a day. You can do it on your commute to work, while you watch TV, shower or at the gym.
 A quick summary:
 What is a Kegel?
·       A contraction of the pelvic floor muscles
 Purpose of the Pelvic Floor
1.    Support- acts as a sling or “hammock” to the bladder, uterus, intestines
2.    Sexual function
 Importance of a strong Pelvic Floor
1.    Supports healthy pregnancy, successful birth and minimizes postpartum complications
2.    Increased sexual pleasure
3.    Minimizing problems with urinary incontinence
4.    Decreasing risk for prolapse

Candice Amat, PT, DPT

Friday, February 7, 2014

PREGNANCY: The Joy of Giving Birth!!

I started to write this blog the last week of work before going on maternity leave and then nature intervened --- so I finish this blog staring at the face of my second child quietly sleeping in her crib.

When I went through my first pregnancy I was determined NOT to be a victim to pregnancy related musculoskeletal problems, which we treat at our practice. There is nothing more moving than to see someone pregnant and suffering with sciatica, low back, pubic bone or neck pain or an inability to walk pain free… not because they are weak but mainly because they feel it is normal.

Pregnancy is a joyous moment and every pound that one gains (trust me I know I gained more weight with my second) is towards growth of a child they bear. So I put myself on an exercise regimen contrary to the popular ones like viz. yoga and Pilates. Instead I put myself on functional strength and balance exercises to help me cope with the changes happening to my body. After a successful pain free first pregnancy I devised P3: PLAN PREVENT PREPARE! And launched the program in 2012, the program is based on the science of movement, biomechanics and exercise.

So as I went about caring for my newborn and being a full time PT – I got back to my old weight and went about my business. Then in late spring last year --- I was pregnant again. This time I put myself on the P3 program like I had advised all my patients for the past two years. With pregnancy number two I was much bigger and gained 10 pounds mostly all in my belly. I am five feet tall and weigh 104 pounds –so walking around with a belly girth of 44 inches and working as a PT ---was no joke! Most colleagues and friends who compared me to my first pregnancy were shocked.

But let me be a testament to myself and all the other pregnant women out there who embraced the P3 method --- I had no back pain and no sciatica. Although I did have three groin spasms that I needed to stretch out -- all of my own doing trying to sprint walk across Broadway at 35 weeks to make a light (silly in retrospect).

So yes I did have a joyous birth experience --- where I could rely on my body – those strong core muscles that held the baby in place, those sling pelvic floor muscles that provided a hammock, those gluts and oblique’s that prevented me from waddling, those scapula stabilizers that allowed me to be a manual therapist. The list is endless....

So to all the women out there ---pregnancy does not have to hurt your muscles and joints. There are ways to turn in bed, walk, maintain good posture, sit on a toilet, dress and choose footwear --- so that you can have a joyous birth

Come visit us --- we can show you how!!!

Renuka Pinto, MPT, PGDR, CSCS, CES

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