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  • Plantar Fasciitis in Runners: How Physical Therapy Can Help!!

    Plantar fasciitis (PF) is a common condition found in runners and can significantly impact running ability and performance. In the past PF was defined as a chronic inflammatory pathology which prompted a treatment approach designed to reduce inflammation with things like rest and anti-inflammatory medication. Currently, however, PF is considered to be more similar to a tendinopathy where inflammation is only a small component of the problem and inappropriate load on the soft tissues is the primary issue. Therefore, just resting may not cut it. The good news is that just like tendinopathies, PF can be improved with the help of physical therapy so you can get back to training and setting new PRs ASAP! In general, the plantar fascia can become a source of pain when it is stressed beyond its loading capacity. Everyone’s loading capacity is different and may change with training (or detraining). A marathon runner will have a different capacity than someone who runs 2-3 miles on the weekend. A good rule of thumb with overuse injuries is “most injuries happen from doing too much too fast after doing too little for too long”. Other factors such as muscle flexibility, range of motion, and foot muscle weakness can contribute as well. Physical Therapy Evaluation Your physical therapist will consider your chief complaints, as well as your current performance, goals, and training regimen, and will take you through a thorough assessment and running gait analysis. Goals of the Evaluation Determine what elements are contributing to potential excessive loading/stress of the plantar fascia. Diminish loading forces, in order to alleviate symptoms, allow healing of the soft tissue, while also avoiding a complete stop in training! Consider foot strike patterns. This is an important element because different foot strike patterns place different demands on your feet and load the plantar fascia differently. When running with a forefoot strike the load on the PF is increased compared to a rearfoot strike. This is not a bad thing as the PF can adapt and get stronger to handle this. However, if not given adequate time to adapt, this may contribute to development of PF. As part of rehabilitation, if appropriate, your physical therapist may change your foot strike pattern and cadence to offload the PF and decrease your symptoms and then gradually return you to running even better than before! Can include a change in distance, intensity, duration or frequency of your runs. Implementation of a strength training program can be helpful and will be tailored to your specific needs and impairments. Manual therapy to promote proper joint mechanics and soft tissue length and tension. Improve muscle flexibility and endurance, especially of the calf and foot intrinsic muscles. This will increase the resilience of your feet and legs and get you setting new PRs in no time! Modalities to control inflammation as needed If you’d like to make an appointment to be evaluated by one of our skilled Orthopedic Physical Therapists, please call (212) 353-8693 or email schedule@zionpt.com. Cristina Sabbadin DPT References:1. Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J. 2017;7(1):107–118.2. Chen TL, Agresta CE et al. Ultrasound elastographic assessment of plantar fascia in runners using rearfoot strike and forefoot strike. J Biomech. 2019 May 24; 89:65-71. Schedule an Appointment with Zion Physical Therapy today!

  • How Can Pediatric Physical Therapy Help Children with Core Strength?

    Here are some effective and fun activities you can do with your 2-5 year old child to strengthen the core. The core muscles are located in the front, back, and side of the trunk, as well as the muscles in the buttock region. Adjust the level of difficulty based on the child’s needs; start easy and gradually progress. Challenge within reason while having fun. Zoo Rescue! *Place a box or bucket in front of the child. This is the “zoo”. *Spread about 8 stuffed animals (or other soft toys) within reaching distance around the child in all directions (in front, to sides, and behind the child). *Choose from a position pictured below for your child to remain in while rescuing the animals. Instructions to Child: “Oh no, all of the animals have escaped from the zoo! Rescue them by bringing them back home to the zoo as quick as you can, before they run away! Rescue 1 animal at a time.” Modification: Use less stuffed animals and/or place animals & zoo closer to child. Progression: Use more stuffed animals and/or place animals & zoo farther away from child. Baby Shark *Have the child lay on their stomach and lift both arms and legs off the ground. Instructions to Child:“Let’s swim and move our arms like baby shark!” or “Lets fly like superman!”. Play the baby shark or superman song, pausing at times.“Move when the music’s on, stop when it’s off!” Modification: Lift opposite arm and leg or lift arms only. Progression: Have the child flutter their arms and legs while keeping them off the ground. Wheelbarrow Walking Wheelbarrow Walking *Start with the child laying on their belly and you hold their legs. *Lift their legs off the ground and have them walk on their hands. *Try having them walk forwards, backwards, to the left and right. Modification: Instead of walking, have them reach out and touch something (i.e. touch favorite stuffed animal), going back and forth trying it with both arms. Progression: You can move your hands down to their ankles for more of a challenge. Crab Walks *Have your child sit down with their buttocks on the ground. *Now have them raise up the buttocks so that only their hands and feet are touching the ground. *Have them walk on their hands and feet backwards and then forwards for the desired time or distance. Instructions to Child: “We are going to walk like crabs!” Modification: Your child may carry objects on their stomach while walking. You may tell your child that they are bringing supplies back to the crab house. Progression: Once your child begins to be accustomed to the movement, your child may try to walk sideways in this position. Bear Crawls *Have the child start on their hands and knees. *Now come off their knees onto just their hands and feet, not letting anything else touch the ground. *The child will move forward by crawling with the opposite hand/foot (i.e. right foot and left hand advance, followed by left foot and right hand). You can play tag and have relay races, whatever your child will have fun with. Modification: Change direction (crawl backwards, side-to-side, etc.), can create a hamstring/calf stretch by keeping hands still and walking feet up towards hands, and then letting the hands walk forward. Progression: Go outside onto soft/uneven surface, practice going up and down hills, play “red light green light” where the child has to abruptly stop and stabilize, holding that position. Concerned about your child’s core strength? Call Zion PT for an assessment of their motor skills, strength, balance, and flexibility. We’re here to help and work with your pediatrician to optimize their function! Call (212) 353-8693 or email schedule@zionpt.com to inquire about pediatric physical therapy at Zion Physical Therapy in the Upper East Side clinic!

  • Yoga and Osteoporosis

    Current treatments for osteoporosis include pharmaceuticals, nutritional intervention and physical therapy. But what about YOGA?? Yoga as an intervention has excellent accessibility. There is minimal to no cost related and minimal training required. The ‘side effects’ of yoga include improved ROM, improved strength, improved gait, improved posture/balance and decreased anxiety. Ready for some shocking facts?? Currently osteoporosis affects ~200,000,000 individuals worldwide. Per year in the United States, there are over 700,000 spinal fractures and more than 300,00 hip fractures. Of the annually 2 million individuals who experience a hip fracture: 25% will die within a year and an additional 25% will never be discharged home. Roughly $19 billion is spent annually in related health care costs. So what can we do?? Current treatments for osteoporosis include pharmaceuticals, nutritional intervention and physical therapy. Pharmaceutical therapies include: bisphosphonates and serum estrogen receptor manipulators whose common side effects include gastrointestinal distress. Nutrition intervention often includes Vitamin D and calcium supplementation. Physical therapy consists primarily of weight bearing activities and resistance training. Only 28% of women started bone therapy within a year of diagnosis as reported by the Clinical Interventions in Aging. But what about Yoga?? Yoga as an intervention has excellent accessibility. There is minimal to no cost related and minimal training required. The ‘side effects’ of yoga include improved ROM, improved strength, improved gait, improved posture/balance and decreased anxiety. Yoga uses a mixture of 1 – 4 limbs to support body mass against gravity. This translates to upper and lower extremities being utilized as weight bearing support for the body. Since upper extremities do not normally bear load, this use during yoga practice may be classified as high impact for the upper extremities (more research is needed). Generally, there is little to no jumping performed during yoga practice. Jumping results in a higher impact classification. This means that faster paced, advanced asana classes have potential to be classified as a high impact activity. That being said, even low impact, weight bearing exercise has been shown to positively influence bone health. Dr. Loren M. Fishman from Columbia University began researching the correlation between yoga postures and maintaining bone density in individuals with osteopenia or osteoporosis in 2005. A follow-up study was done in 2016 showing that 12 minutes of prescribed yoga regimen actually reversed osteoporotic bone loss. Fishman’s 2016 follow up study included everyone who performed the yoga sequence more than 50% of the prescribed amount of every day. Qualitative evidence indicates improved bone quality. Results showed effective reversal of bone loss of spine and femur, with weaker correlations of positive effects of the hip as indicated by DXA scan. “Poses were chosen specifically to produce torque and bending of the proximal femur, compression of the pelvis and twisting of the lumbar vertebral bodies.” This twisting, bending and compression have been shown to stimulate osteocytes. Osteocytes are the most commonly found cell in mature bone tissue. When performing certain yoga postures, opposing muscle groups must simultaneously engage in order to “hold the pose”. This activity of opposing muscle forces generates activity in osteoblasts and osteocytes which encourages bone density. Yoga is easy to instruct, learn and perform. Please see the following pictures and descriptions for the yoga poses studied by Dr Loren Fishman. Happy practicing! Tree Standing on one leg, place the sole of the opposite foot on either ankle, calf or thigh Avoid placing sole of foot directly over knee joint Palms may press together in front of the chest or reach overhead Triangle Step legs 2 – 3 feet apart Rotate front foot so it is perpendicular to back foot, toes of front foot point forward, both knees are straight Abduct arms to shoulder height Reach front arm forward as opposite hip draws back Front arm reaches down, hand rests on either shin or foot Warrior Two Step feet 2 – 3 feet apart Rotate front foot so it is perpendicular to back foot, toes of front foot point forward, front knee is bent, back is straight Abduct arms to shoulder height, palms face down Shoulders draw down, chest open Lift through the top of the head Side Angle Step feet 2 – 3 feet apart Rotate front foot so it is perpendicular to back foot, toes of front foot point forward, front knee is bent, back is straight Front forearm to thigh, or hand to floor Opposite arm may reach either overhead to sky or in line with head parallel to g Twisted Triangle Step legs 2 – 3 feet apart Toes of both feet point forward Abduct arms to shoulder height Rotate chest so that back arm reaches forward Then reach down towards the floor of front foot Hand may rest on floor or block for support Locust Lay facedown, arms are by sides, palm face down Lift up torso, legs and arms Scoop chin in, while lengthening muscles on the back of neck Gaze is low to avoid excessive extension of neck Bridge Lay on back, soles of the feet on the ground, hip width apart, fingertips are able to touch heels Lift hips into the air while drawing knees together Option to either press palms into ground or to clasp them together under bod Supine Hand to Foot 1 Lay on back, one leg is flat on ground, other leg is in the air Either hold on onto foot with hand or use strap Keep raised leg straight without being fully locked out, keeping muscles engaged Shoulders actively draw to ground Supine Hand to Foot 2 Lay on back, one leg is straight on ground, other leg is abducted from body Either hold on onto foot with hand or use strap Keep abducted leg straight without being fully locked out, keeping muscles engaged Shoulders actively draw to ground Straight Legged Twist Seated on the ground, one leg is straight, opposite leg is bent to chest Keeping both hips on ground, twist to side of bent leg Maintain length in spine Bent Knee Twist Seated on the ground, one leg is bent, ankle of opposite leg is on the outside of thigh with knee to chest Keeping both hips on ground, twist to side of top leg Maintain length in spine Corpse Pose Lay flat on back Arms either palm face up by sides, or place palms on chest and/or stomach Resources Brody, Jane E. (2015) 12 Minutes of Yoga for Bone Health. The New York Times (2015) Fishman, Loren M. (2009) Yoga for Osteoporosis: A Pilot Study. Topics in Geriatric Rehabilitation 25. (2009) 244-250. Lu, Y., Rosner, B., Chang, G., Fishman, L. (2016) Topics in Geriatric Rehabilitation 32. (2016) 81-87. DOI: 10.1097/TGR.00000000000000085 Siris, E., Yu, J., Bognar, K., DeKoven, M., Shrestha, A., Romley, J. (2015) Undertreatment of osteoporosis and the role of the gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage. Clinical Interventions in Aging (2015) 1813 -1839. DOI: http://dx.doi.org.ezproxy.uvm.edu/10.2147/CIA.S83488 Wilcox, S., Hager, R., Lockhart, B., Seeley, M. (2012) Ground Reaction Forces Generated by Twenty Eight Hatha Yoga Postures. International Journal of Exercise. (2012) 114-126. Request an Appointment today!

  • Developmental Coordination Disorder

    Developmental Coordination Disorder (DCD) is a motor skill disorder that affects parts of the brain that learns and remembers motions. It is not related to intelligence. DCD affects approximately 5-6% of school-aged kids, with slightly more boys being diagnosed than girls. The exact cause is unknown. Research shows that it may be connected to low and premature birth weight. DCD results in difficulties with coordination, balance, body awareness, and movement skills like riding a bike, jumping jacks, running, jumping, skipping, kicking, throwing, catching, and playing sports. Kids tend to have a hard time imitating and learning new skills even with many repetitions and keeping up with peers their age. With inactivity, children are at higher risk of having heart disease, overweight, poor fitness, and self-esteem/social/emotional problems. While DCD continues throughout life, the good news is that PT can help kids and teens improve their coordination, balance, strength, school and daily activities by learning to use new movement strategies. Here are some exercises you can try at home to work on coordination and balance: STAND LIKE A FLAMINGO: KICK A BALL: SQUAT: JUMP OVER HURDLES/OBJECTS: WALK THE “TIGHTROPE”: FORWARD AND BACKWARDS SIDESTEPS Make An Obstacle Course: (Use cones, pillows, and boxes to step on objects, to step over, and step around) Want to learn more? Check out this website: https://www.choosept.com/guide/physical-therapy-guide-developmental-coordination-disorder Does your child have a developmental coordination disorder? Call Zion PT at (212) 353-8693 or email schedule@zionpt.com to get assessed and treated!

  • Spina Bifida

    What Is Spina Bifida? Spina bifida occurs before birth when the neural tube (what later becomes the spinal cord) does not fully close during the first month of pregnancy. As a result, there is a malformation of the bones protecting the spinal cord and damage anywhere along the spinal cord and surrounding nerves. Surgery is typically required shortly after birth. About 1,500 babies in the US are diagnosed with the condition per year. It can cause physical, cognitive, and sensory impairments. How Can Physical Therapy Help? PT is important in helping children move, reach developmental milestones, and prevent or decrease long-term complications. Treatment will be tailored to meet the patient’s specific needs and goals. Activities may include walking training (with or without assistive devices), treadmill training, stretching, and exercises for strength, balance, and coordination. Recommendations for equipment to maximize function may include orthotics, crutches, walkers, standers, or wheelchairs. Furthermore, PTs at Zion PT work closely with your child’s pediatrician and can help determine if the patient could benefit from other health care services. Interested in learning more? For more information, you can go to https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-spina-bifida To schedule an evaluation with a pediatric Physical Therapist, call (212) 353-8693 or email schedule@zionpt.com.

  • Juvenile Arthritis

    Let’s talk about Juvenile Arthritis Awareness. That’s right, juvenile! When most people hear about arthritis, they probably don’t first think of kids but did you know that approximately 300,000 children in the US have some type of arthritis? Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory autoimmune disorder that occurs before age 16. The mean age of onset is 1-3 years old and it affects twice as many girls as boys. With JIA, the body’s immune system attacks its own tissues making them irritated and inflamed, causing them to thicken and grow abnormally. It eventually causes damage to the bone and cartilage (padding) of the joint and surrounding tissues. COMMON SYMPTOMS: Many have periods without symptoms (remission) and periods of worsening symptoms (flareups). Joint pain, stiffness, swelling. Pain is more severe in the morning or after naps. Pain is common in knees, hands, and feet. Decreased range of motion. Limp, due to pain in the lower body. Joint deformities, abnormal growth. Muscle aches Extreme fatigue. DIAGNOSIS: Patient and family history, symptoms, number of joints involved, lab tests, sometimes imaging. CAUSE: Largely unknown. It may be due to environmental triggers, viral or bacterial infections, or genetic predisposition. Most experts believe it’s due to an overly active immune system. TREATMENT: The goal is to stop or slow the progression of inflammation, relieve symptoms, improve function, and prevent more joint damage. PT: Focuses on gentle range of motion, physical activity, stretching, joint protection, muscle relaxation, hot/cold packs, and may use a splint or orthotic to maintain normal bone and joint growth. During a flare-up, rest and reduce symptoms. Treatment includes icing and performing a type of muscle strengthening called isometric contractions. During periods of remission, stay active and involved in sports and activities with peers. This will help maintain range of motion, build and maintain strength, and can help decrease symptoms. Top Physical Activities: Swimming, cycling, yoga, and tai chi. Swimming is great because it is low impact and does not require repetitive stress to load-bearing joints. Kids Yoga Poses: Medication for pain control, joint preparation for mobility, and treatment assist normal growth of a child. Want to learn more? Check out this website: https://www.arthritis.org/juvenile-arthritis Does your child have juvenile arthritis? Call Zion PT at (212) 353-8693 or email schedule@zionpt.com and we’ll start with an assessment, then treatment to help regain function, mobility, and decrease pain.

  • Autism Spectrum Disorder (ASD)

    *WHAT: Autism spectrum disorder (ASD) is a developmental disability that involves developmental delays, as well as social, communication, and behavior impairments. It’s a spectrum because the signs, which can begin as early as childhood, can range from mild to severe. *CAUSE: All aren’t known but the following may increase the likelihood of someone developing ASD: environmental, genetic, and biological factors. *SYMPTOMS: Research shows that individuals with ASD may have impaired motor skills including limited coordination and postural control. They can have more difficulty with planning and executing certain motor skills and learning through imitation. Two core signs include challenge in social communication and interaction as well as restrictive and repetitive patterns of behavior. *TREATMENT: The good news is that research shows that PT can help those with ASD to improve development and skills. There is no “standard” treatment that exists for kids with ASD as treatment is based on each individual child’s impairments and functional limitations. Researchers found that combining PT with fun activities has great benefits. Fun activities like dancing to music and yoga, along with specific PT exercises prescribed by a skilled pediatric PT can help with physical, social, and cognitive abilities. Get Moving With Some Yoga Poses: Turn On Some Favorite Tunes And Have A Dance Party: Interested in learning more about autism spectrum disorder? The Zion PT team of physical therapists are here to help and can set you up with an evaluation. Call (212) 353-8693, or email schedule@zionpt.com and check out this website for more info: https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-autism-spectrum-disorder

  • Cerebal Palsy (CP) Awareness

    *WHAT: CP is caused by an injury to the brain (by infection, stroke, trauma, or loss of oxygen) that occurs before, during, or up to two years after birth. No further damage happens after the initial injury but activities such as walking, standing, reaching, sitting, crawling affected by CP can become more difficult as the child grows. *SYMPTOMS: There are different types of CP with symptoms that can appear as soon as a few months old. They include inability to hold head up, difficulty reaching, rolling, sitting, crawling, or walking, tight muscles, muscle weakness which could present as “floppy” muscles in trunk and neck, moving slower compared to other children, lack of coordination, slower than normal growth, trouble speaking, and learning disorders (with normal intelligence). *TREATMENT: Physical Therapy to improve strength, flexibility, positioning, play, self-calming, pain management, and energy conservation. A PT may also recommend braces/equipment to maximize function and health. Kids with CP are especially at risk for not getting enough physical activity, so an individualized exercise program will be designed for the child. If your child has CP, participating in sports are beneficial including swimming, basketball, cycling, bowling, volleyball, and tennis. Engaging in social events with peers is also recommended. *HOME EXERCISES: Here are some exercise ideas to get your child started in a variety of positions including standing, sitting to/from standing, and walking: Sit to stands from step stool: Standing balance at low table while playing with toys: Push cart to work on walking: Kick ball with support (if needed) to work on balance and kicking: Interested in learning more or having your child evaluated by a pediatric PT? Call Zion PT at (212) 353-8693 or email frontdesk@zionpt.com for an assessment and check out this website: https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-cerebral-palsy-2

  • 8 Things You Should Know about Trigger Point Dry Needling (Intramuscular Manual Therapy - TPDN)

    1. Dry needling can help reduce local and referred pain and soreness If you're comfortable with needles that don't involve much, if any, pain, you might consider this therapeutic technique if your physical therapist recommends it. A specially trained physical therapist uses a thin needle to release muscle tightness, ease tendonitis and inflammation, and/or promote healing or muscle activation. 2. How does dry needling work with chronic muscle tightness? It stimulates a trigger point in a skeletal muscle. You might call it a knot, and it can cause more widespread pain than just the muscle in which it's found. Another name for a trigger point is myofascial pain syndrome. A tight band of skeletal muscle inside a larger muscle group, a trigger point can be tender when you touch it and may cause pain in other areas of your body. As part of a larger treatment plan, your therapist is using dry needling to try to release the trigger point, relieving pain and/or improving your movement. A twitch can occur when the needle goes into the trigger point, and may be a sign that the therapy is working and reducing muscle tension. 3. What is a typical Session that uses Dry Needling like? At Zion Physical Therapy, you can expect to get treated with Dry Needles for up to 5-10 minutes. Once completed you can expect to do light stretching and then follow up with some exercise to utilize the muscles fibers that just were “freed from the knots” to work normally again. This should help your muscles have better memory of working normally again, leading to less pain when you leave the office that stays lowered. 4. Therapeutic dry needling promotes healing. The technique also can help with muscular issues that don't involve trigger points such as rotator cuff damage. The needle creates a tiny lesion in the tissue, promoting blood flow and healing to the area. 5. Dry needling is different from acupuncture. Dry Needling is NOT acupuncture. The two philosophies are quite different. Therapeutic Dry Needling is based on Western medicine. Acupuncture is based in Chinese medicine and focuses on balancing the flow of energy in the body or Chi. 6. No liquid is involved. The needle itself produces release in the trigger point. There's no solution injected into the muscle. The needle is also not dipped in any solution. 7. Physical Therapists are trained and allowed to administer Dry Needling to patients. As part of their entry-level education, physical therapists are well versed in anatomy and therapeutic treatment of the body. Physical Therapists have taken Gross Anatomy where they learned the depth and three dimensional anatomy required to administer Dry Needling effectively and safely. Physical therapists who perform dry needling are required to supplement that knowledge by obtaining specific postgraduate education and training. 8. Dry Needling does not cost extra! It will be included as part of your session with us at Zion Physical Therapy. Learn more about Trigger Point Dry Needling If you have any questions about whether Trigger Point Dry Needling is right for you, please reach out to Zion Physical Therapy at (212) 353-8693 or email schedule@zionpt.com.

  • The Female Pelvic Floor Adapted from Herman and Wallace Institute

    The pelvic floor consists of several layers of muscles that cover the bottom of the pelvic cavity. These muscles have several distinct roles: 1. To support the pelvic organs, the bladder, uterus and colon within the pelvis. 2. To assist in stopping and starting the flow of urine or the passage of gas or stool. 3. To aid in sexual appreciation. How to Locate the Pelvic Floor Muscles: The Urine Stop Test At the midstream of your urine flow, squeeze the pelvic floor muscles. You should feel the sensation of the openings close and the muscles pulling up and into the pelvic cavity. If you have strong muscles you will slow or stop the stream of urine. Try to stop or slow the flow of urine without tensing the muscles of your legs, buttocks. Do this only to locate the muscles, NOT AS A DAILY EXERCISE!!!! Feeling the Muscle You can insert 1 or 2 fingers into the vagina to feel the contraction and lifting of the muscles. You should feel the opening of the vagina tighten around your finger. Place a fingertip on the anal opening. Contract and lift the muscles as though you were holding back gas or a bowel movement. You will feel your anal opening tighten. Watching the Muscle Contract Begin by lying on a flat surface. Position yourself with your knees apart and bent with your head elevated and supported on several pillows. Use a mirror to look at the anal and vaginal openings and the perineal body (the area between the two openings). Contract or tighten the muscles around the openings and watch for a lifting of the perineal body and closure of the openings. If you see a bulge or feel tissues coming out of your openings, this is an incorrect contraction and you should notify your health care provider for more instructions. Phone: 212-353-8693 • Fax: 347-507-5510 • Office Email: frontdesk@zionpt.com

  • How Diet Can Affect Your Bladder

    There are many foods, fluids, and habits that can irritate the bladder. This handout has suggestions for ways you might be able to change your habits to better control your bladder and suggestions for maintaining a healthy amount of fluid intake. Although there is no particular "diet" that can cure bladder control, there are certain dietary suggestions you can use to help control the problem. There are 2 points to consider when evaluating how your habits and diet may affect your bladder; 1. Foods and Fluids that that can irritate the bladder Some foods and beverages are thought to contribute to bladder leakage and irritability. However their effect on the bladder is not completely understood and you may want to see if eliminating one or all of these items improves your bladder control. If you are unable to give them up completely, it is recommended that you use the following items in moderation: Foods with acidic properties: Alcoholic beverages Tomato based products Vinegar Coffee (regular and decaf) Tea (regular and decaf) Curry Spicy foods Caffeinated beverages Carbonated beverages Cola Milk Food colorings and flavorings Artificial sweeteners Chocolate Substitutions for Bladder Irritants Although water is always the best beverage choice, grape and apple juice are thirst quenchers and are not as irritating to the bladder. Low acid fruits: pears, apricots, papaya, watermelon For coffee drinkers: KAVA® Postum® Pero® Kaffree Roma® For tea drinkers: Non-citrus herbal Sun brewed tea 2. Drinking enough and the right kinds of fluids Many people with bladder control issues decrease their intake of liquids in hope that they will need to urinate less frequently or have less urinary leakage. You should not restrict fluids to control your bladder. While a decrease in liquid intake does result in a decrease in the volume of urine, the smaller amount of urine may be more highly concentrated. Highly concentrated, dark yellow urine is irritating to the bladder surface and may actually cause you to go to the bathroom more frequently. It also encourages the growth of bacteria, which may lead to infections resulting in incontinence. © Herman and Wallace | Pelvic Rehabilitation Institute

  • What to Expect After Bladder Surgery

    These simple instructions were designed to help answer common questions about your postoperative recovery as well as guide you back to your previous level of activity. Check with your physician prior to beginning this program. WHAT DO I NEED TO AVOID? It is very important that you avoid anything that will stress or strain your incision. Every day activities like lifting groceries and toileting can cause problems. They can put undue stress on your bladder repair and potentially weaken it. Try not to strain (hold your breath and bear down) while having a bowel movement and avoid constipation. If you need to cough or sneeze, you should place a pillow or your hands over your lower abdomen and support it as best you can to counteract the intra-abdominal pressure. WHAT CAN I LIFT? It is recommended that you do not lift anything over 10 pounds in the first 6 weeks after surgery. After 6 weeks, you may gradually increase the weight of objects you lift. Never lift anything you feel you cannot easily handle. Technique is important. Do your pelvic brace by contracting your pelvic floor and lower abdominal muscles together as you begin to lift heavier objects. It is extremely important to use proper body mechanics when lifting. Be sure your back is straight and your knees are bent. When you lift even a light object, keep it close to your center of gravity (near your belly button) and lift with your legs not your back. WHEN CAN I EXERCISE? Once you get home you should climb stairs only as necessary to get to your bedroom or bathroom. A gentle-walking program will gradually build up your endurance and can be initiated for short distances (around the house) in the first week. Remain at low level, gentle walking until your recheck appointment when your doctor can see if you are healed and ready for more vigorous activity. Consult with your physician about when it is OK to begin a pelvic floor exercise program. Pelvic floor muscle exercises, also known as Kegel exercises, help strengthen and support your bladder repair. If you have difficulty learning how to contract these muscles you may need extra help to relearn how to use the muscles and to start strengthening them. At this time, you should consult your therapist to instruct you in proper abdominal muscle training, lifting and postural exercises. This will ensure that the correct muscles are functioning. 1 WHEN CAN I BE SEXUALLY ACTIVE? It is not recommended that anything be placed in the vagina for 4 to 6 weeks post surgery. This includes tampons and douching. When you resume penetration or intercourse, it may be uncomfortable and you may need to use plenty of lubricant. Go slowly to allow the tissues to stretch gradually. If pain persists, massaging the scar may help. Discuss any problems with your physician. POSTURAL CONSIDERATIONS It is common to maintain a more bent or flexed posture after any kind of abdominal surgery. It is important to do some gentle exercises and to stand up straight to avoid poor posture becoming a habit. General Posture Exercise 1. Stand against a wall with your knees slightly bent. 2. Place your arms in a “hold up” position or in the shape of a goal post. 3. Perform a pelvic brace by contracting your pelvic floor and lower abdominal muscles together. 4. In this position slide your hands up toward the ceiling being careful not to let your arms come away from the wall. 5. Repeat this exercise 3-5 times at least 2-3 times a day. WHEN CAN I EXERCISE MORE VIGOROUSLY? If you participate in running or jumping sports, avoid returning to those sports until at least 12 weeks after surgery. This may be difficult to do because you feel ready to return to your previous level of exercise however your bladder may not be as ready as you are. Return gradually doing 30%-50% of what you did prior to surgery. For example, if you ran 3 miles per day before surgery, start out with no more than 1 mile. If you feel any discomfort, pain or pressure in the lower abdomen, stop exercising immediately! If you have any questions about your postoperative recovery please call your physician or therapist.

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