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  • 5 Tips to Relieve Plantar Fasciitis

    A great running friend has struggled with plantar fasciitis for years on and off. She eloquently refers to exacerbation of pain as “the Planted Fascists” drilling into her foot. This always makes me laugh thinking of angry politicians banging sharp tools into her foot- clearly not what is happening, but certainly an apt description of this pathology’s pain! If you struggle with this very frustrating, often chronic, foot ailment - here are 5 tips to calm down the ‘Foot Fascists’: Stretch your calf muscles -- All 3 (2 leafs of the gastrocnemius and the soleus) calf muscles contribute to tightness in the posterior lower leg, which then pull on the Achilles tendon which then yanks on the plantar fascia; loose calf = happy foot! Roll your foot on a ball -- the most effective tends to be a frozen golf ball, but anything small and hard to get into the firmest parts of the plantar and relieve knots; if it hurts you’re probably in the right spots! Think about how you sleep: is your foot pointed? If so, try to avoid this! It leads back to tip #1. There are socks that help you avoid doing so, some that provide compression to the medial foot/assist in correct ankle position and others that actually hook/strap so your foot remains more neutral as you sleep. Burn all your thong sandals… kidding, sort of...make sure your footwear has a good supportive arch and that your foot is secure in the shoe. Sandals that only go around your toes and slap when you walk are the worst for plantar problems, followed by very flat shoes, and of course/sadly -- high heels. Seek physical therapy! From soft tissue massage to the plantar surface, to ankle stretching, to hip mobility - PT can assist in changes throughout the kinetic chain to make foot strike and functional mechanics more agreeable for all parts of your body, including the bottom of your feet.

  • Top 5 Warm-Up Exercises for Dancers

    Recommended by an ex-professional dancer & physical therapist! Total honesty- Back in my past life when I was taking dance class twice a day 5-6 times a week and adding to that rehearsals and/or performances I wasn’t in the habit of warming-up properly. Maybe a short barre or a loose mark of the phrases to come in rehearsals or performances and in terms of class...probably hanging out in a center split while chatting with my fellow dancers/friends for 5-10 minutes before start. I had unknowingly led my body down the path of unnecessary pain, fatigue, minor-medium injuries throughout the years. It was only towards the end of my free-lance dancer career in my early thirties that I understood how healthy it was for my body to have the time and attention in the form of specific exercises that targeted my core/hips, so as to properly prepare for the awesomely complex and dynamic routines that dancing entails. After being consistent with this “before routine” my body thanked me during and after a long day of dance. I’d love to share 5 basic core/hip stabilizing exercises with you in the hopes it will help access the sometimes elusive center and turnout more readily and effectively, like it did me. Supine marches- it is important to pull your navel towards your spine and feel the lower abdominals engaging, so as to minimize rotation of the pelvis as your lift/switch legs. Carry over this sensation of activation of the lower abdominal muscles into all barre/center exercises to maintain a strong center. Bridges - your gluteal muscles also help you maintain a stable pelvis. Because dancers are usually in a turned out position, the major gluteal muscles can become a little “lazy”. Help them wake up with this exercise. 2-way Clamshells - this exercise will help you access your hip external and internal rotators. Not only are these muscles the exact one you use when standing in any turned out position they help the hip joint remain stable during any dynamic weight-bearing movement (basically all of dancing). Plank hold - full body engagement of core musculature. Pay attention to how your elbows align with your shoulders and do not sink in your upper body as much as your center. Start slow (10-15 sec holds), focus on proper form and then start adding time. At Zion PT we specialize in dance injury prevention and have helped many dancers recover from injuries and get back to doing what they love best! If you are in need of help or guidance please call (212) 353-8693 to make an appointment with one of our Dance Medicine Physical Therapists!

  • Joint Replacement Survival Guide

    Refer to this chart by Zion Physical Therapy for helpful tips on your joint replacement surgery.

  • Exercises for Ehlers-Danlos Syndrome (EDS)

    Do you ever feel like you never know where your body is in space? Or you end up sitting like a noodle on the couch and you didn’t even realize you got into that position? Or that your joints are always subluxing or dislocating? These are some of the common symptoms along with pain and chronic tightness that people with hypermobility syndromes combat daily. What is hypermobility and the syndromes that go with it? Hypermobility syndromes such as Ehlers-Danlos Syndrome, Marfan’s Syndrome, Hypermobility Spectrum Disorder or Joint Hypermobility Syndrome can cause instability and weakness in the joints leading to pain and other symptoms listed above. Both stability and strength training can be very beneficial for these individuals in order to increase joint stability, strength as well as reduce pain, fatigue, lack of endurance and improve overall function. Here are some tips for incorporating stability and strength training into your exercise routine! 1. When thinking about exercise you want to work on exercises that will help you improve the foundation of your body- your core, as well as the stability in your joints. The first thing that is important to work on is joint and body proprioception (proprioception is when you know where your body is in space). A good rule of thumb is that anything with a closed kinetic chain (CKC) is safe. A closed kinetic chain exercise is an exercise where you are in contact with a surface such as a wall, table or the floor. Exercises like this would include wall sits or table planks. 2. Next, think about stability. So now we’re thinking about core stability exercises and making sure to engage the deepest parts of your core! You can also use balancing on one leg or unstable surfaces to start to challenge your stability and help to improve your functional stability! 3. Once you have set the foundation with your CKC and core exercises you can begin to strengthen the muscles surrounding the joints in order to create more awareness (proprioception), stability, and strength as well as control! You can do this with body weight exercises which you will progress to weighted exercises such as squats or deadlifts as well as resistance band exercises. 4. Proper form is important within exercises but it is important to note our bodies need to be strong enough to manage many postures throughout the day so we are training our bodies to do that pain free! So while remembering proper form with exercise is important, know there is no perfect posture to maintain after exercise is done. 5. Next work on compound exercises in order to improve overall functionality and strength as well as endurance. Compound exercises can be squats and deadlifts or combining upper and lower body exercises such as a squat to overhead press or a deadlift to a row! 6. The last step is working on power, power is essential to maintaining good bone health and help us absorb and transfer strength and force well throughout our bodies. This can be done by starting with agility ladders and progressing to different jumping activities like forward hops, single leg hops, skater jumps, and finally box jumps or single leg box jumps. 7. Gradual increase in resistance and weights are important! Make sure to pace yourself, hydrate often and take breaks as needed. Building up into exercise is important in how often you exercise as well! Start with exercise once every 3 days and progress to every other or even every day with one or two rest days a week! 8. Consider calling Zion Physical Therapy at (212) 353-8693 to work with one of our very qualified physical therapists who can help you feel safe in your progressions and exercise as well as develop an individualized home exercise program for you! In conclusion, stability and strength training can be very beneficial for individuals with hypermobility syndromes to improve joint stability, reduce pain, improve strength and improve overall function. By incorporating stability exercises, resistance training, proper form, compound exercises, balance and coordination exercises, and progressing gradually, you can create a safe and effective exercise program that meets your individual needs.

  • MomStrong Workout: Baby Edition

    Let’s be realistic. It’s awesome to have childcare available to get to your favorite fitness class, but it’s not always feasible. And we know flexibility and convenience are cornerstones of keeping up with your fitness goals. Here, I share some of my personal explorations of “making it work” with a baby at home. These exercises are what made sense for me, after two months of focused foundational exercises for the core and hips. Feel free to try them, knowing that some moves are more advanced than others. Don’t jump into it if you are having back pain, pelvic pressure, or a diastasis that has not been checked out. Or, we can work on exercises together to build an at-home workout that makes sense for you, as part of our MomStrong program. Suggested Duration: 6-18 minutes (or until baby is over it) 1 min/exercise, 1-3 times through Baby Bird-Dog Side Plank with Rotation Tickle Airplane Abs Baby Sumo Squats Straight Leg Baby Lifts Twisting Baby Lunge Contact Zion Physical Therapy to schedule an appointment online or in person at one of our four convenient locations: Phone: 212-353-8693 Office Email: frontdesk@zionpt.com Online Form: Request Appointment

  • How to Stretch at Your Desk!

    During the time COVID-19 pandemic, you may be sitting more on your couch or having to figure out working from a home desk, and your neck, hips, back and wrists may be sore, tight or painful. Following are eight stretches that are easy to incorporate into your day to manage symptoms or to simply feel a little less creaky throughout your day. You can do them as often as feels good to your body, but we recommend holding each stretch for 20-30 seconds and performing them 2-3 times, 2-4 times a day. Prayer hands: palms together, pushing in Reverse prayer hands: backs of hands together, pushing in Chair pigeon: outside of leg hip height or lower, engage core, lengthen spine Cat cow desk: arch back while looking up, then tuck chin to chest, pulling shoulders forward Neck stretch holding chair: bring ear to shoulder, opposite arm holds on to seat of chair Seated spinal twist: keeping hips and legs forward, twist from the back, looking over shoulder Standing quadriceps stretch with overhead reach: grab onto foot and kick back into hand as opposite hand reaches for the ceiling Forward fold: reach for toes, alternating bending and straightening knees Happy stretching!

  • Running Strong through the Trimesters: A Therapist’s Perspective

    I run to feel good, both physically and mentally; therefore, I needed running even more during pregnancy. But running while my body was (and still is) constantly changing presents some new challenges. Here’s a guide of some helpful tips to avoid running into any problems. SAFETY FIRST Take it Slow Let’s start with the usual disclaimer: make sure you are cleared by your doctor (obstetrician/midwife/gynecologist) before beginning an exercise program. There are a number of medical and obstetric conditions that may make exercise unsafe during pregnancy. With that out of the way, the current guideline for exercise during pregnancy calls for about 30 minutes of moderate intensity exercise, most days of the week (as per the American College of Obstetricians and Gynecologists). Fortunately, running is an activity that allows you to moderate the effort you put forth. You may be a seasoned runner, aware of how hard you feel you’re working and able to regulate on your own. Or, your doctor might want you to wear a heart rate monitor and stay within a certain range. As for me and my slightly competitive nature, I needed additional external factors to slow me down. I ran with my dog so that his incessant need to stop and smell the roses would force me to take rest breaks, or I chose a running partner who was slower than my current pace (shown below at 34 weeks gestation, with my 60 year old dad). Staying out of the red zone is important because your blood volume is increasing tremendously (from 30-50% as early as 16 weeks gestation), causing your heart rate to be higher than normal even at rest. And if you’re like me, your iron stores haven’t necessarily caught up with the increased red blood cells, so your risk of anemia is increased. Add to that your difficulty breathing now that your rib cage has expanded and your diaphragm is less efficient (it’s stretched out and contracting against more resistance), and you’re likely to find yourself short of breath way earlier than usual. So, go for your run, but be prepared to slow down and incorporate intervals of walking. Don’t Overheat If you’re in warmer climates or it’s summertime in the city, be especially cautious to not overheat, which could be harmful for your developing baby. I usually like to get a tan while I run, but soon I found more comfort in taking routes that were shady instead of sunny. The thought of carrying a water bottle with the weight I had already gained seemed preposterous, so I memorized all the water fountains along the route as well. If you have retained fluid during your pregnancy, and have found that your hands or feet are swollen on the regular, keep this in mind. Dehydration will come on sooner (especially if you skipped your normal glass of water pre-run so that you could last a little longer without a bathroom break.) By my third trimester, during the heat of the summer, I kept all my runs close to home, sometimes just circling the park next to my apartment, just in case. PREVENTION Do Your Kegels It was early on in the second trimester that pressure built on the pelvic floor and the pelvis started to stretch and change, which meant leakage, first with sneezing and then with running. I had to up my kegel game immediately. I ran with a liner at first, but I caution you that you must change out of your running clothes pretty immediately after your workout, as UTI risk is higher during pregnancy. I recommend a pretty solid kegel routine as soon as you become pregnant (some apps even let you track your sets and reps), but make sure that you’re holding the kegel for 5-10 seconds at a time for improved endurance. I would try to focus on my pelvic floor contraction during the first half mile for good strengthening practice under running conditions and was able to get rid of my leakage in about one month. If you need more help on this front or aren’t sure you’re doing them correctly, check in with us. Strengthening Rules Still Apply Logically, it’s fair to say that your joints now think that you’re going out for your usual jog while wearing a weighted vest. This is not something most people do voluntarily to enhance their training, and for good reason. An increase in one pound of body weight multiples by 3-4 times that amount when you are running, and it will take its toll on your joints. So strengthening is even more important now than it was even before. Keep up your squats and lunges throughout the pregnancy to ensure support for the knees and hips as you gain weight. I chose to stick with my usual HIIT classes (high intensity interval training) with the support of some solid teachers (check out the great team below) and a number of modifications to make it a MIIT class (moderate intensity interval training). Recover Well, Stretch With Caution Recovery is more important for the same reason, mostly by means of rest and refueling. If you were an avid stretcher or just love to feel flexible, this is where you might need to hold back. With your ligaments being looser than ever, stretch with caution as it’s easier now to “over-stretch.” Keep it gentle with a minimal intensity stretch instead of moderate. I had to change my usual runner’s lunge stretch for my hip flexors to more conservative quad stretches, since it started to make me feel a little unstable (more on that later). GEAR Invest in a New Sports Bra First trimester feels a bit like all the other runs you’ve done while at peak-PMS. Mostly your boobs hurt and you feel bloated. Over the course of the pregnancy, you may need to invest in a new sports bra, the same as you will with your other bras to accommodate the change in size. Mostly, my bras made it feel hard to breathe because they were too tight against my expanding rib cage (which can widen up to 3-4 inches over the pregnancy). I ended up doubling up on some older, looser sports bras to stay supported and comfortable at the same time. Consider an SI Belt If you have a history of sacroiliac (SI) joint pain or low back pain, are feeling excessive movement in your pelvis while running, or are dealing with some SI joint, or sciatica symptoms now that you’re pregnant, consider wearing an SI belt (with extender strap) while running to decrease shear forces on your pelvis. I love the Serola belt and keep one in my office in case you want to do a trial run before you purchase. Just make sure to read the instructions to make sure you’re wearing it at just the right level. Check Your Shoes My old posterior tibialis tendonitis (an inflammation of the tendon that runs along the inside of the ankle) said hello during second trimester. Since the ligaments of your feet are also stretching, your lower leg muscles will be working overtime to stabilize your ankle as your foot hits the ground. If you notice your feet are expanding or you start to feel pain in the arches of your feet, considering switching out your neutral or minimal shoe to a stability shoe for some more extrinsic support. I threw my old orthotics into my running sneakers and it remedied the situation immediately. Couple that with a shortened stride to reduce joint loading and you should be on your way to safely running in trimester three. Suffice it to say that being a good body-listener becomes more important than ever, especially since you’re listening for two. If you’ve been cleared to exercise but just want a little more guidance, if you are struggling with feelings of heaviness or incontinence, or if you are having any pain, don’t hesitate to reach out. Zion’s physical therapists specialize in treating both prenatal clients AND orthopedic cases, so rest assured that we can put the pieces together in a way that works for you and helps you keep exercising safely throughout your pregnancy. Request an Appointment!

  • 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!

  • 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!

  • 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

  • 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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