PELVIC-CURIOUS?

SHOULD YOU GET A PELVIC FLOOR ASSESSMENT?

You don’t have to wait for a problem to arise to get a pelvic floor muscle assessment.

Many pelvic floor muscle dysfunctions are preventable. Getting a pelvic floor muscle assessment before problems arise is better to prevent them from ever happening in the first place!

You can be proactive in your health. You do not need to wait for there to be a problem, you do not need a diagnosis to prove “medical necessity”, and you do not need a doctor’s referral to give you permission to get preventative care. You can schedule an appointment with a pelvic floor therapist for the sake of education, information, knowledge, and empowerment.

Preventable pelvic floor dysfunctions include pelvic organ prolapse, stress urinary incontinence, constipation, perineal tearing during childbirth, and more!

Your body, your needs, your therapy. At Studio Rehab, we believe in creating a treatment plan that is specific to you. A preventative pelvic floor muscle assessment will include posture and movement analysis, hip and low back joint mobility and range of motion, lower extremity muscle length and flexibility, strength tests, and pelvic floor muscle assessment to evaluate connective tissue, muscle integrity, strength, endurance, coordination, and function relevant to your personal needs.

Peace, Love, Pilates & Pelvic Floor

Amanda Fitzgerald, Physical Therapist, Pelvic Rehab Practitioner Specialist, Certified Pilates Instructor

KEGEL OR NO?

tO KEGEL OR NOT TO KEGEL? that is the question.

Social media is all the rage with conflicting and contradictory information on if kegels are recommended to help with your pelvic floor issues.

The short answer is— it depends. The long answer is— it depends on what your issue is; if your issue is pelvic pain, pain with sex, recurrent UTIs, painful bladder syndrome, or constipation, then no, kegels are not going to help you and may make your symptoms worse; if your issue is weakness, laxity of connective tissue, leakage of urine with coughing/sneezing/jumping/running, or prevention of pelvic organ prolapse then yes, kegels very well may help you!

Kegels have been described as far back as ancient yoga practice as “mula bandha”, the practice of drawing the root chakra up and in. The root chakra is said to be located at the base of the torso, or the perineum, which is the area between your anus and genitals. Obstetrician Dr Arthur Kegel first described pelvic floor muscle strengthening in publications in 1948 to prevent pelvic organ prolapse and stress urinary incontinence. The field of pelvic floor physical therapy had its roots in the Women’s Health Movement of the 70s with pioneers in the field such as Illinois’ Rhonda Kotarinos (one of my clinical instructors in PT school!) in the late 70s and early 80s who advocated for physical therapy for postpartum women, and in the late 80s and 90s with Washington’s Hollis Herman and Kathy Wallace (creators of the continuing education & Pelvic Rehab Practitioner Certification where I received my specialty!).

Today in 2024, there is “Level A” clinical research to support that pelvic floor muscle strengthening (kegels) can CURE stress urinary incontinence. That is a BIG deal. This means there is strong recommendation with consistent evidence from multiple studies that clinicians should follow. So there is without a doubt a time and place for kegels!

So should you kegel? You can find out from a skilled and experienced pelvic floor physical therapist if it’s appropriate for your individual needs.

Your body, your needs, your therapy. At Studio Rehab, we believe in creating a treatment plan that is specific to you. Assessment will include posture and movement analysis, test and measures, joint mobility and range of motion, muscle length and flexibility, strength tests, and pelvic floor muscle assessment relevant to your issues. Treatments sessions are individualized based on initial evaluation and diagnosis, and may include manual therapy, joint mobilizations, dry needling with electric stimulation, soft tissue mobilizations, cupping, corrective exercises, home exercise program, education, body mechanics, posture, and Pilates reformer and pelvic floor specific interventions.

Dr Amanda Fitzgerald is a Doctor of Physical Therapy, Pelvic Rehab Practitioner Specialist, and Pilates Certified Instructor. Her passion for treating the pelvic floor began with working with postpartum moms taking her Baby & Me Pilates classes in Chicago circa 2006.

Peace, Love, Pilates & Pelvic Floor

Amanda Fitzgerald, Physical Therapist, Pelvic Rehab Practitioner Specialist, Certified Pilates Instructor

CIRCUS MEDICINE

What is Circus Medicine?

It is the specialized field of physical therapy that caters to the unique needs of circus athletes. Circus performers subject their bodies to significant stress. Consequently, injury prevention becomes essential to enjoy a long career. Our circus-specific physical therapy establishes a plan of care and goals individualized based on a diagnosis and assessment of condition specific to your circus needs.

Your body, your needs, your therapy. At Studio Rehab, we believe in creating a treatment plan that is specific to you. Assessment will include posture and movement analysis, test and measures, joint mobility and range of motion, muscle length and flexibility, strength tests, grip, hanging and inversion assessment relevant to your circus discipline. Treatments sessions are individualized based on initial evaluation and diagnosis, and may include manual therapy, joint mobilizations, dry needling with electric stimulation, soft tissue mobilizations, cupping, corrective exercises, home exercise program, education, body mechanics, posture, and Pilates reformer and circus specific interventions.

Dr Amanda Fitzgerald is a Doctor of Physical Therapy, Pelvic Rehab Practitioner Specialist, and Pilates Certified Instructor. Her circus focus has been static trapeze, which she considers Pilates in the air, since 2018. She participates in ongoing continuing education courses in Circus Medicine and has a special interest in helping circus athletes return to sport.

Many circus activities involve lifting, supporting, or hanging from apparatus overhead. Maintaining strong and stable shoulders helps reduce the risk of overuse injuries and strains during these overhead movements. By prioritizing joint health, circus athletes can extend their careers and continue to enjoy the art form without being hindered by chronic joint problems or early retirement due to injuries. Preventing these injuries involves a comprehensive approach, including proper warm-up, strengthening exercises, technique refinement, and regular monitoring of shoulder health by healthcare professionals.

Early intervention and rehabilitation are crucial for circus athletes to maintain optimal shoulder function and prevent long-term issues. Targeted strength training for the rotator cuff muscles is crucial for circus athletes to enhance shoulder stability and prevent injuries. Incorporating rotator cuff strength training and scapular stabilization into a well-rounded workout routine can contribute to improved shoulder stability and reduced risk of injuries for circus athletes.

Maintaining proper technique is essential for both the artistic and safety aspects of circus performances. Consistent training, attention to detail, and ongoing refinement of technique contribute to successful and captivating circus acts. Regular attention to movement patterns, technique refinement, and targeted corrective exercises contribute to injury prevention and safer return to aerial after injury.

Peace, Love, Pilates & Circus,

Amanda Fitzgerald, Physical Therapist, Pelvic Rehab Practitioner Specialist, Certified Pilates Instructor, Recreational Trapeze Artist

baby & me pilates

The Postpartum experience is really something.

While babies are adapting to life outside the womb, parents are adapting to their postpartum realities. Juggling the baby’s feeding and sleeping schedule with their own daily routines makes it a challenge to find any time to set aside for much of anything self care, including exercise or making new friends. Enter Baby & Me Pilates!

Baby & Me Pilates is so much more than a group fitness class, it’s also community, a play date, and a parent/baby bonding experience. First of all, you bring your baby with you! So no barriers with the need to find childcare. The Pilates class is led by myself, Dr Amanda Fitzgerald, a Physical Therapist, Pelvic Rehab Practitioner Specialist, and Certified Pilates Instructor, in the beautiful healing space of Spyre Center in New Orlean’s Lower Garden District. Each class is meant to give you a safe Pilates workout in consideration of postpartum healing. This doesn’t mean it’s easy, Pilates is never easy when done intentionally! Every Pilates class promises spinal mobility in every plane of movement, core and pelvic floor activation, balance training, breathwork, flexibility, and strengthening. We intersperse the class with songs, involving babies as resistance or adoration, and end every class with the best dang bubbles you’ve ever seen. My favorite part of this class, after the babies of course, is seeing friendships form. The crowd often flows out to the Well Cafe for lunch and then poolside for a relaxing hang out.

What do babies even do in Baby & Me Pilates? Well the answer is, Babies Rule! They often are very interested in the group setting and are remarkably calm. They are involved with the songs we sing and smile and giggle. They always love when we involve then with movement such as riding along during bridges, squats, lunges, airplane or flying baby. When the crowd gets fussy, we pick them up! If babies are super chill, we may get as much exercise in for mom as we can! Every class is different.

Bring me your babies!

Peace, Love, Pilates & Pelvic Floor,

Amanda Fitzgerald, Physical Therapist, Pelvic Rehab Practioner Specialist, and Certified Pilates Instructor

Pilates for the pelvic floor

You’ve heard that Pilates builds your core. But did you hear it can also strengthen your pelvic floor?

Pilates is one of the few exercise genres that includes cues for the pelvic floor as part of the core. The fundamentals of Pilates are breath, concentration, control, precision, and flow. The pelvic floor muscles do not activate themselves, it doesn’t just happen, you have to put it there! Similar to activating the abdominals during Pilates, it’s intentional, it doesn’t just do itself!

Let’s dig deeper into the Pilates fundamental of breath. With restful breathing the diaphragm muscle pulls downward on an inhale bringing air into the lungs, and an exhale is passive recoil of the lungs. With a forceful exhale, however, THAT is an action of the abdominals. Every movement in Pilates that is connected to breath is an opportunity to activate the abdominals, so why not the pelvic floor too?! The pelvic floor muscles, the levator ani, have fascial connections that brace against the abdominals. If you place your hands just inside your hipbones, you can feel your abdominals tension when you do an isolated pelvic floor muscle contraction or with a cough. This is a timely opportunity to activate your pelvic floor along with your abdominals during Pilates practice, with that forceful exhale. The air is leaving your body, so there is less resistance to the squeeze and lift of your pelvic floor compared to an inhale when your lungs are bringing in incoming pounds of pressure downward. Blow like you are blowing a balloon up with air to get the most of the forceful exhale and abdominal activation. If you’ve been doing Pilates for a while, you know Pilates breathing can be heard! Make some noise!

The other fundamentals of Pilates also have pelvic floor considerations. With concentration the activation is intentional and quality, with control and precision the effort, power and coordination of the muscles is specific, and with flow there is the opportunity for concentric and eccentric activation with the rhythm of the movement and breath so that there need not be excessive tension and creation of unnecessary overactivity.

You like evidence based practice? Me too. 12 weeks of 2x/week pilates mat class decreased urine leakage in participants with continued improvement at 6 month follow up (Hein et al 2020). Overall whole-body strength is not associated with stronger pelvic floor muscles in powerlifters (Skaug et al 2023). See? Even heavy powerlifters don’t just get a stronger pelivc floor just because they lift heavy. You have to put there!

The caveat here is can you correctly activate your pelvic floor? If you are not sure, I suggest you see a Pelvic Specialist and confirm you are doing it right.

Peace, Love, Pilates & Pelvic Floor,

Amanda Fitzgerald, Physical Therapist, Pelvic Rehab Practioner Specialist, and Certified Pilates Instructor