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The Staff of Femina Physical Therapy Blogs About Vaginismus, Pregnancy and Postpartum Best Practices, Treatments for Incontinence, and More

Blog Posts by Category

Featured From the Blog:

7 Tips for Returning to Running Postpartum

Running Postpartum | Image Courtesy of Filip Mroz via Unsplash
Running Postpartum | Image Courtesy of Filip Mroz via Unsplash

When Can I Return to Running Postpartum?

There is not a magic time frame as each person recovers differently and the most important thing is to listen to your body.

For healthy uncomplicated pregnancies and deliveries the American College of Obstetricians and Gynecologists (ACOG) recommends women return to low-moderate intensity exercise at six weeks postpartum and eight weeks postpartum for cesarean.

After your OBGYN or midwife has cleared you to return to exercise, if you haven’t started with a Pelvic Floor Physical Therapist yet, now is a good time.

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Getting Back to Exercise Postpartum

Getting Back to Exercise Postpartum

A healthy lifestyle includes getting back to exercise postpartum

Exercise has shown to be beneficial in all stages of life, and the postpartum period is no exception.

Some of the benefits of postpartum exercise are:

  • Strengthen and tone abdominal muscles
  • Boosts energy
  • May help prevent postpartum depression
  • Promotes better sleep
  • Relieves stress
  • Can help you lose the extra weight that you may have gained during pregnancy
    (ACOG, July 2019).

Even with all these benefits, research shows that most mothers stop participating in exercise programs which leads to increased weight gain and obesity (Minig et al., and O’Toole et al., 2003). There are many adjustments that have to be made when becoming a new mother and the information on the internet regarding postpartum exercise can be misguided and overwhelming. Let's break down what the literature says about guidelines for returning to exercise postpartum.

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Pelvic Floor Injury During Childbirth: All About Levator Ani Avulsion

Levator Ani Avulsion - Injury during Childbirth
Image courtesy of Sharon McCutcheon via Unsplash | Levator Ani Avulsion, Injury During Childbirth

Levator Ani Avulsion: Understand your pelvic anatomy to better understand your injury

The pelvic floor is a group of muscles positioned like a hammock along our saddle region.

The group of muscles attach from our pubic bone on the inside and then to our lateral pelvic walls with a bundle of collagen fibers called the levator arch, and attach to the ischial spines (the inside of the sit bones) and tailbone on the back side. During vaginal childbirth, the pubococcygeus muscle, a group of pelvic floor muscles, stretches 3.26 times more than its normal length to make room for the coming baby in the vaginal canal! As you can imagine, this may result in some perineal tearing and/or levator ani avulsion.

Levator ani avulsion occurs when muscle fibers of the puborectalis (the innermost muscle of the pubococcygeus group) are detached from its insertion on the pubic bone. This is somewhat frequently occurring, and about 20% of women experience an avulsion during their first vaginal childbirth. Risk factors include instrumental-assisted delivery (forceps presenting a higher risk than vacuum), older age at vaginal birth, second stage lasting longer than 2 hours, baby weighing over 8 pounds and 13 ounces, and those who had a grade 4 perineal tear.

What does this mean for folks that have this injury?

As bad as it sounds to have an Levator Ani Avulsion, research has shown that it does not necessarily increase perineal pain in postpartum or beyond. However, it does put women at risk for pelvic organ prolapse either early in postpartum or in their later years.

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Endometriosis Laparoscopic Road to Recovery | Image Courtesy of Unsplash

The First 48 Hours After Surgery: 

  • Arrange for a partner, family member, or friend to drive you home and stay with you after your procedure. General anesthesia can cause nausea and vomiting. Having a bag or bin ready for the car ride home is a good idea. 
  • It can also be helpful to have a small pillow or cushion to put between your abdomen and seat belt for the ride home.
  • Each surgery has unique guidelines specific to your case and what was done during surgery. Follow the guidance of your surgeon and pelvic health physical therapist. As this is a general guideline It is always a good idea to speak with your health care team prior to initiating any new exercise or protocol. 
  • Take it easy and rest for the first 24 hours. 
  • Finding a position of comfort: During the initial stage of recovery it is important to find a position that is comfortable to allow your body to rest and recover.

IMG 3762 1

Instructions: 

  • Place pillows under your knees and under your shoulders and arms. Sitting slightly upright with your upper back supported on a wedge or several pillows
  • This position can be helpful as it decreases any abdominal stretching. 

Diaphragmatic breathing exercises can be helpful for nervous system down training, can prevent pneumonia, improve digestion and lymphatic drainage.

image0 3Instructions:

  • Lie on your back. Place a pillow under your knees.
  • Place one hand over the heart and one over the belly button.
  • Inhale through the nose and feel both hands rise with the in-breath. Ribs and belly are expanding, even the back of the body expands into the mat.
  • Exhale gently and slowly, either through pursed lips or the nose. The air is slowly escaping as if you poked a hole in a tire with a needle and the air slowly passes out. The goal is to elongate the exhale, so that it is longer than the inhale.
  • When the breath has been fully exhaled, pause for a second or two before beginning the next breath cycle again, with another inhale. After you have exhaled wait a couple of seconds until you inhale again. Continue breathing for 5-10 minutes. This exercise can be done every hour. 
Don't expect too much of yourself for the first few days.  You will probably be very tired and need lots of naps.  However, be sure to get up and move around as you're able. It is important to get movement especially in your lower extremities to prevent blood clots.  One exercise you can do to help with blood flow and lymphatic drainage are ankle pumps.  

 

Ankle Pumps: 

IMG 3765 1 Instructions:

  • Start by either lying down flat or with your back propped with pillows.
  • Slowly, bring your toes up towards your nose.
  • Next, point your toes down,
  • Pumping up and down for 20 repetitions.
  • This should be repeated 5 times per day

Another great exercise to prevent tightness in the calves from being in bed are calf stretches. 

 Calf Stretches

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Instructions: 

  • This can be done either in standing or long sitting.  Depending on how you are feeling, choose which position will work best for you. 
  • In standing: 
    • Place your hands on the wall and extend one leg straight backward, bending your front leg, until you feel a stretch in the calf of your back leg and hold for 30 seconds. You can also bend your back knee (while keeping your heel on the ground) to feel a stretch in a different calf muscle. 
  • In sitting: 
    • In your bed or on your couch, begin by placing a strap around the middle of your foot. 
    • Slowly pull your foot towards you with the strap until you feel a stretch in your calf.  Hold for 30 seconds. 
  • With both stretches you should feel a gentle stretch in the back of the lower leg.

Post-op care: 

  • You might be instructed not to shower or take a bath for up to 48 hours following a laparoscopy to allow the incision to heal.
  • You may have some light vaginal bleeding. Wear sanitary pads if needed. Do not douche or use tampons.
  • Wear loose, comfortable clothing. For a few weeks, avoid anything that puts pressure on your belly.
  • Hold a pillow over your incisions when you cough or sneeze. This will support your belly and may help to decrease your pain.
***If you are having shoulder pain after the surgery try using a heating pad over the shoulder or abdomen. This happens due to CO2 gas becoming trapped against the diaphragm. (The gas irritates the phrenic nerve leading to referred pain in your shoulder).

After the first 48 hours: 

  • The most important things in the first week after surgery are to keep your stools soft, drink adequate amounts of fluid (at least 64 oz. / day), and eat fiber rich foods.
  • Additional stretches that are helpful for recovery at this time are modified piriformis stretches and supine butterfly stretch   

Modified Figure Four Stretch

IMG 3766 1 Instructions:

  • Lying on your back with your knees bent and your feet flat on the ground.
  • With the assistance of your arms cross lift  one leg and place that ankle on your opposite knee
  • Apply a gentle pressure to your bent knee with your hand. You should feel a gentle stretch in your buttocks. Hold for 30 seconds or 6 slow, deep breaths.

Supine Butterfly Stretch

IMG 3763 1

Instructions:
  • Place the soles of your feet together and let your knees drop toward the floor until you feel a stretch in your inner thighs and hold for 30 seconds, or 6 slow, deep breaths.
  • Make sure you do not feel pain and that it feels like a gentle stretch in your inner thighs. If you feel pain you can slide your heels away from your groin or use pillows underneath your knees. 

Kegel and Transverse Abdominus Co-Contraction

IMG 3768 1Instructions: 

  • While lying on your back with your legs straight or supported (pillow under your knees) start to bring your focus to your breath
  • Inhale pelvic floor lengthens (use visual cues ie. sit bones spreading apart, pelvic bowl expanding) 
  • Exhale pelvic floor contracts (use visual cues 
  • It is important to reconnect to your core and progress to using this activation when getting out bed, out of a chair and bending of lifting (depending on your surgery you may be told to avoid bending or lifting for up to 8 weeks after surgery)

Post-op care: 

  • Start taking short walks. Listen to your body, feeling for any increased pain or fatigue. If so, adjust your time so that you feel good after your walks. Start with walks in and around your house and progress to slow paced walks without inclines around your neighborhood. 
  • Speak to your surgeon for your specific guidelines regarding return to intercourse, tub bathing, swimming, lifting  (the length of restriction will depend upon the surgery you are undergoing). 
  • Typically you can begin core strength training 6 weeks after the surgery but talk to your surgeon beforehand. Begin slowly under the guidance of your pelvic health therapist making sure you are engaging the muscles in the correct order and without compensations. 

Some things to look out for and call your surgeons office if you have: 

  • Heavy bleeding from your vagina or incision sites
  • Redness, swelling or pus at the incision sites
  • An upset stomach or vomiting after the first day
  • A fever higher than 101°F (taken by mouth)
  • Severe pain that doesn’t get better with pain medicine

If you need additional post-surgical support, call our offices and make an appointment today.

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Mental Health & Sexual Pain | Image Courtesy of Anthony Tran via Unsplash

Having sexual pain or dysfunction is not “in your head”. We have seen that experiencing sexual pain CAN affect your mental health, and pre-existing mental health conditions can amplify sexual dysfunction. This article will review the research related to these, but in reading, know that we believe your pain is real and should be addressed from all relevant contributing factors.

A very large range, about 7-46% of Americans may experience painful sex. For some, it may be a one-time painful experience, and for others, it may be every single time. This can have a huge effect on mental health and overall quality of life. There may be an underlying reason for the pain, such as dermatological issues, perineal trauma from childbirth, chronic UTI or yeast infections, hormonal deficiencies, endometriosis, high pelvic floor muscle tone, etc. Unfortunately, whatever the cause may be, this can cause a cascade of events, and greatly affect our mental health. One study of older women (aged 50-99) suggested that sexual health is linked more strongly to mental health than to physical function, stress, or age itself. However, the reverse of this is also possible, as those with mental health disorders may be at increased risk for sexual dysfunction disorders. According to Basson & Gilks, psychiatric disease is the most important risk factor for sexual health disorders. More recent research highlights the high possibility that there is an underlying vulnerability to both psychiatric disease and sexual dysfunction.

Read more: Mental Health and Sexual...

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Chronic Stress & Your Sex Life | Image Courtesy of Engin Akyurt via Unsplash

You may have heard that chronic stress takes a toll on your body. But did you know that chronic stress also has a negative effect on your sex life?

What is chronic stress?

Chronic psychosocial stress is defined as either a major life event that takes place over a long period of time (ie. death of a family member) or small stressors that are constant and often accumulate (ie. traffic, financial worries, work deadlines).1,2 A study by Allen Kanner, Ph.D, published in the National Library of Medicine, found that these small stressors can have more of a negative effect on health than the more severe but less common stressors.1

How does chronic stress inhibit sexual arousal?

Chronic stress can inhibit sexual arousal by affecting hormones and emotional wellbeing and leading to cognitive changes. Stress can raise a hormone called cortisol. When cortisol levels are high there is a decrease in two important sex hormones: testosterone and estradiol. These hormones are important for genital arousal in women.3,4,5 Increased blood pressure is also commonly linked to increased stress which can decrease blood flow throughout the body.6 This could in turn inhibit blood flow to the genitals which may interfere with genital arousal. The emotional and cognitive changes that happen with chronic stress can distract a person from sexual cues towards the stressors, impacting sexual arousal.7

Read more: Chronic Stress: How It...

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Grip Strength & Incontinence | Image Licensed by Securecat under Creative Commons BY-SA 2.0

November is Bladder Health Awareness Month.

At Fusion Wellness & Physical Therapy, we take pride in understanding and applying how your whole body affects your pelvic health. In this article, we explore how urinary incontinence and other bladder issues are correlated with grip strength.

A study conducted at the Jeju National University measured grip strength in patients and found statistically significant differences in patients with incontinence, overactive bladder and nocturia4. They found these patients had a weaker grip strength (less than 18kg) using a hand dynamometer. 

Types & Frequency of Incontinence

In the United States, 51% of women live with urinary incontinence1. Urinary incontinence is the involuntary loss of urine which can be mild (a few drops) to a complete inability to control the bladder. There can be different triggers that may

Read more: Grip Strength and Urinary...

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Clogged milk ducts during breastfeeding | Image courtesy of Timothy Meinberg via Unsplash

Physical therapy can help women across their lifespan. This includes support with orthopedic considerations related to breastfeeding, as well as other breastfeeding care with clogged milked ducts and noninfectious mastitis.

Symptoms & Causes of Clogged Milk Ducts and Mastitis

Breastfeeding can be a joyous time for some, but unfortunately it can be painful for others. Clogged milk ducts can be extremely uncomfortable and painful. It often arises due to not being able to drain fully, causing a back-up of milk along the mammillary ducts. It can occur when feeding sessions are interrupted or skipped, as well as when mom is under stress. One may experience symptoms such as a painful lump in the breast tissue, pain during breastfeeding that subsides after, and/or decreased milk supply from the blockage. Sometimes if unresolved, it can lead to mastitis, or infection of the breast tissue. Monitor for symptoms such as fever, swelling of breast tissue, redness of breast tissue, and escalation of pain/breast tenderness. If you start to experience these aforementioned symptoms, give your doctor a call as soon as possible.

Treatment Options for Clogged Milk Ducts

Home treatments to help with clogged milk ducts include:

  • switching breasts more frequently
  • massaging the breast while feeding or pumping
  • applying and hot compress/towel on the breast before feeding

In office physical therapy treatments for clogged milk ducts include:

  • Postural re-eduation/ergonomic positioning for optimal breastfeeding positions
  • Many folks experience mid back and upper back pain from the many hours of breastfeeding. Physical therapists are trained to brainstorm the best positions for your specific needs and optimize breast milk flow
  • Modalities such as therapeutic ultrasound
  • Research has shown that applying heat through soundwaves can help bring blood flow to the area and reduce inflammation to help unclog the duct (Markowski, 2019)
  • Manual therapy addressing cervical spine, mid back and shoulder complex
  • We are connected through soft tissue and fascia head to toe; working on the neck or shoulder can help open up the breast tissue for more optimal fluid movement has been shown to improve clogged milk ducts

Physical therapy for clogged milk ducts:

Physical therapists can help with optimal breastfeeding positions, manual therapy and apply therapeutic ultrasound to improve clogged milk ducts and prevent the onset of mastitis. Usually 3-5 physical therapy sessions that include therapeutic ultrasound can make a significant improvement in symptoms. Any questions? Call our office to schedule an appointment with a licensed physical therapist at our offices today. Link to: https://feminapt.com/about-us/schedule-an-appointment

References:

Markowski Cucchiara M. Standard of Care: Physical Therapy Treatment of Clogged Milk Ducts. Department of Rehabilitation Services: Brigham and Women’s Hospital. 2019. https://www.brighamandwomens.org/assets/BWH/patients-and-families/rehabilitation-services/pdfs/physical-therapy-treatment-of-blocked-milk-ducts.pdf

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Delivery of the Placenta | Image Courtesy of João Paulo de Souza Oliveira via Unsplash

Third Stage of Childbirth: Delivery of the Placenta

You made it!

Now, at this point you have delivered your baby and your body’s hormones have shifted tremendously! You may feel overwhelming emotions of joy and exhaustion at the same time. Oxytocin, the bonding hormone, rises sharply to compensate for the drastic drop in estrogen and progesterone. You may find yourself shivering, and this is normal immediately post-giving birth and can last up to one hour.

Delivery of the Placenta

The third stage of childbirth involves the delivery of the placenta. Oxytocin also helps with the delivery of the placenta, as it helps separate from the uterus. Depending on your birth plan, your team may help with delivery of the placenta with medications, gentle fundal massage, and gentle tugging of the cord. This will likely be in a position with you lying on your back. Or, you may continue to spontaneously deliver in any position that you feel comfortable, whether that is an upright position, hands and knees position, or even lying on your back. The placenta may come out on its own, or you may feel the urge to push again. The key is to choose a comfortable, yet appropriate position for you.

Read more: Vaginal Childbirth...

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Upright Labor Positions | Vaginal Childbirth Positioning Series | Image Courtesy of Jimmy Conover via Unsplash

Upright Labor Positions for the Second Stage of Labor

If you missed part 1 in the vaginal childbirth positioning series, go back and read it here.

Childbirth/labor is quite an experience, and it can be scary waiting for the unknown. Being prepared, knowing, and being familiar with different options and labor positions is the best way to approach childbirth to help decrease as much anxiety should surprises arise.

This article will go over specific labor positions that help progress labor, and prevent perineal trauma.

As mentioned in Part 1: Pre-Birth article, it’s important to keep changing labor positions to help progress, preferably in different upright labor positions. As a reminder, the first stage is all about increasing the pelvic inlet to help guide the baby through the mid pelvis and finally towards the pelvic outlet/vaginal canal.

Read more: Vaginal Childbirth...

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Pre-Birth Stage of Labor

Positioning for the Pre-Birth Stage of Labor

What to Expect and What to Focus On:

If you have been pregnant for many months now, it is time to get ready for your upcoming birth! Similar to a marathon, we need to train for childbirth to prepare the muscles and body for the big event. For this reason, it is a good idea to start practicing being in different positions either with movement or holding a position for a long time. The pre-birth stage of labor involves contractions to dilate and open the cervix. Once the cervix is fully dilated, the second stage includes the passive and active phases of the baby crowning and coming out of the vaginal canal. The third stage involves the delivery of the placenta. We will go over how to best support our bodies throughout your childbirth journey.

Positioning for the Stages of Labor

Practicing and knowing different positions during this first stage can be helpful when pain may escalate. Upright positioning such as: walking, standing, rocking back and forth, kneeling over birthing ball, leaning against wall, holding onto partner are just some of the many, many positions that can be helpful.

Read more: Vaginal Childbirth...

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postpartum pelvic health

Postpartum recovery should start Day 1.

Here are some tips to help you get your postpartum pelvic health (and general health) back on track:

This article focuses on 5 key techniques you can use to improve postpartum pelvic health. It covers diaphragmatic breathing to activate core muscles and kickstart lymphatic drainage, pelvic floor muscle coordination, posture, and the benefits of a pelvic floor evaluation by a physical therapist to begin improving postpartum pelvic health on day 1. It also provides detailed instructions and references scientific studies to provide further research.

1. Breathing With Intention

One of the most important recovery tools for postpartum pelvic health is one that we do all day, but are you doing it with intention? Diaphragmatic breathing can help you tap into your deep core muscles and assist in the healing process. When you focus your attention on breathing into the abdomen you activate the muscles of the core (diaphragm, intercostals, transverse abdominis, and the pelvic floor muscles). This breathing technique also helps to assist the pelvic floor muscles in another important job, lymphatic drainage. This can help eliminate excess waste and inflammation to help with healing. This is a great exercise to begin right after birth, when given the OK by your medical provider.

Additional benefits of diaphragmatic breathing were seen in the study by Fiskin et al., 2018, which concluded improved psychological state and increased mother-baby attachment. Not only are you reaping the benefits but so is the baby!

Read more: 5 Things you can do to...

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Image Courtesy of Ava Sol via Unsplash | Physical Therapy Helps IC

Interstitial Cystitis, Multimodal Treatments, and How Pelvic Health Physical Therapy Helps IC

Interstitial cystitis (IC) also known as bladder pain syndrome or painful bladder syndrome, is a debilitating condition that significantly affects the quality of life of patients living with it.

The definition of IC from an international consensus is:

An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable cause" (Hanno et al, 2009).

Read more: What is Interstitial...

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Safe Sex During Covid | Image Courtesy of Jasmin Chew via Unsplash

Whether you're asking for a friend or for yourself, it's an important question these days.

Practicing social distancing and wearing a mask can make it quite difficult to have intimate relationships.

Through the last year and half, we have learned more about COVID-19 and each and every day new data helps us better understand this virus and how to practice safe sex during COVID.

How is the virus transmitted?

The virus spreads through infected saliva, mucus, or respiratory particles entering the eyes, nose, or mouth. This means it can be transmitted through kissing and close contact. Studies have also detected the virus in feces and in sperm in those infected (Diangeng et al., 2020). It is unknown at this point if the virus can be spread through sperm or feces. Educating yourself can be the key to safe sex during COVID-19.

Read more: Sexual Health Awareness...

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Urinary Incontinence and Depression

A recent study connects anxiety, urinary incontinence and depression in women

What is urinary incontinence?

Urinary incontinence refers to the loss of urine, out of your control. There is actually more than one kind of urinary incontinence: the two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB).

  • Stress Incontinence: urine leaking with physical activity - sneezing, coughing, laughing, lifting, pushing/pulling, jumping.
  • Urge Incontinence: urine leakage that is coupled with urgency to go- leaking while you’re in line for the toilet, leaking/urgency when you’re parking your car in the driveway, putting the key in the door, fumbling with your pants, etc.
  • Mixed UI: a combination of stress and urge symptoms

Read more: Urinary Incontinence and...

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Pregnant belly birth prep services

Pregnancy, labor, and delivery greatly affect the pelvic floor muscles, and our birth prep services using pelvic floor therapy can bring you confidence, strength, and flexibility.

What are the pelvic floor muscles?

The pelvic floor muscles are a group of muscles inside the pelvis that form a hammock connecting the pubic bone to the tailbone. Both men and women have pelvic floor muscles. These muscles play an important part in stabilizing the pelvis and spine, supporting your organs (bowel, bladder and uterus) and toileting.

The Pelvic Floor and Pregnancy

During pregnancy the pelvic floor muscles are working overtime trying to stabilize and support the growing body of the mother and child. Read our previous blog post about preparing the pelvic floor for childbirth. During a vaginal childbirth, these muscles will utilize their strength and flexibility to help the baby be birthed. Whether or not the baby is born via C-Section or vaginally, the pelvic floor is involved, and this is where our birth prep services come into play.

Read more: Birth Prep Services Offered...

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Picture of dripping wet panties

The latest literature review conducted by Mazur-Bialy et al. (2020) shows the most modern methods of pelvic floor physical therapy that can help with urinary incontinence.

Here at Femina PT, we pride ourselves in keeping up with the current best practices and latest techniques. Here’s a breakdown of the latest techniques and how we utilize them at the clinic.

What is urinary incontinence?

Urinary incontinence refers to the involuntary loss of urine, which can range from a few drops (also called light bladder leakage) to complete loss that wets the floor. There is actually more than one kind of urinary incontinence: the two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB).

Read more: The Latest in the Treatment...

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Woman using hypervolt gun

Recent studies have shown evidence vibration therapy is just as effective as massage in reducing muscle soreness after exercise and can also help increase range of motion.

Over the past few years, we’ve been using more vibration and percussive therapy products at the clinic, such as the Hypervolt gun, vibrating foam rollers, and vibrating massage balls. But what’s all the hype about?

Effect on Muscle Soreness

In a 2014 study by Imtiyaz et al., they found that a 5 minute session with a vibration device provided as much relief to muscle soreness as a 15 minute massage session over the same area, as compared to control groups who received neither after a bout of exercise.

Read more: Vibration Therapy | A New...

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Anatomical drawing of pelvis depicting sexual dysfunction after pelvic fracture

Sexual Dysfunction After Pelvic Fracture Can be Traumatic

A 2014 study by Harvey-Kelly et al. points to the fact that the long term consequences of this injury can include sexual dysfunction and pelvic pain for both males and females.

Pelvic fractures occur most commonly with a high-energy trauma. The most common ways people fracture their pelvis include motor vehicle (57%), pedestrians hit by car (18%), motorcycle crushes (9%), falls from a height (9%), and crush injuries (5%) (Harvey-Kelly, 2014).

Chronic Issues After Pelvic Fracture

Thanks to advancements in critical care medicine and acute trauma care, the mortality rate for those who have had a pelvic fracture has been reduced over the years. However, pelvic fracture survivors often report chronic issues including chronic pain, chronic pelvic pain, changes in gait, issues with bowel and bladder, and sexual dysfunction. This is because the muscles, bones, nerves, and blood vessels, are often all implicated in these injuries, and the pelvis contains the organs of the urinary, bowel, and sexual function systems. Therefore, the subsequent rehabilitation of all these systems is more complicated than, say, a fracture of your ulna or radius in your forearm.

Read more: Sexual Dysfunction After...

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** This information is for educational purposes only **

What They Say About Us

  • Testimonials

    • Testimonial by S.H., age 24

      I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be. It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally...

      Read more Testimonial by S.H., age 24

  • Testimonials

    • Testimonial by M.M.

      A personal journey and testimonial from one of my patients: My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that...

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