Dr. Ann Nwabuebo, PT, DPT

Dr. Ann Nwabuebo, PT, DPT Doctor of Physical Therapy. Specializing in pelvic health PT (all genders), pre/post partum rehab,
(6)

Studies show that the majority of people lack knowledge of pelvic floor muscle dysfunction.  As a result they donโ€™t know...
09/17/2022

Studies show that the majority of people lack knowledge of pelvic floor muscle dysfunction. As a result they donโ€™t know how to identify risk factors. ๐Ÿคท๐Ÿพโ€โ™€๏ธ๐Ÿค”
โ €
While pelvic floor training is incredibly effective in treating all types of pelvic floor problems (like pain with s*x, urinary incontinence and constipation).., early detection is ๐Ÿ”‘.
โ €
The ๐˜Š๐˜ฐ๐˜ป๐˜ฆ๐˜ข๐˜ฏ ๐˜—๐˜ฆ๐˜ญ๐˜ท๐˜ช๐˜ค ๐˜‹๐˜บ๐˜ด๐˜ง๐˜ถ๐˜ฏ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜š๐˜ค๐˜ณ๐˜ฆ๐˜ฆ๐˜ฏ๐˜ช๐˜ฏ๐˜จ ๐˜—๐˜ณ๐˜ฐ๐˜ต๐˜ฐ๐˜ค๐˜ฐ๐˜ญ is a great tool ๐Ÿ› ๐Ÿ‘๐Ÿพ I use at community seminars to help people identify if they may have some type of pelvic floor problem.
โ €
So if you wondering whether you might have pelvic floor problems, ๐˜ด๐˜ค๐˜ณ๐˜ฐ๐˜ญ๐˜ญ ๐˜ต๐˜ฉ๐˜ณ๐˜ฐ๐˜ถ๐˜จ๐˜ฉ ๐˜ต๐˜ฐ ๐˜ต๐˜ข๐˜ฌ๐˜ฆ ๐˜ต๐˜ฉ๐˜ช๐˜ด ๐˜ฒ๐˜ถ๐˜ช๐˜ป! ๐Ÿง
โ €
If ๐˜บ๐˜ฐ๐˜ถ ๐˜ค๐˜ฉ๐˜ฆ๐˜ค๐˜ฌ๐˜ฆ๐˜ฅ >3 ๐˜ฐ๐˜ณ ๐˜ฎ๐˜ฐ๐˜ณ๐˜ฆ, ๐—ฝ๐—ฒ๐—น๐˜ƒ๐—ถ๐—ฐ ๐—ณ๐—น๐—ผ๐—ผ๐—ฟ ๐—ฑ๐˜†๐˜€๐—ณ๐˜‚๐—ป๐—ฐ๐˜๐—ถ๐—ผ๐—ป ๐—ถ๐˜€ ๐—น๐—ถ๐—ธ๐—ฒ๐—น๐˜†โ€ฆ, but these symptoms are treatable! ๐Ÿ˜‰
โ €
So reach out to a pelvic floor therapist to get a comprehensive assessment and get started on an individualized treatment plan.

If you are in the Philadelphia area.., DM me to set up a consult!

Studies show that the majority of people lack knowledge of pelvic floor muscle dysfunction.  As a result they donโ€™t know...
09/17/2022

Studies show that the majority of people lack knowledge of pelvic floor muscle dysfunction. As a result they donโ€™t know how to identify risk factors. ๐Ÿคท๐Ÿพโ€โ™€๏ธ๐Ÿค”
โ €
While pelvic floor training is incredibly effective in treating all types of pelvic floor problems (like pain with s*x, urinary incontinence and constipation).., early detection is ๐Ÿ”‘.
โ €
The ๐˜Š๐˜ฐ๐˜ป๐˜ฆ๐˜ข๐˜ฏ ๐˜—๐˜ฆ๐˜ญ๐˜ท๐˜ช๐˜ค ๐˜‹๐˜บ๐˜ด๐˜ง๐˜ถ๐˜ฏ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜š๐˜ค๐˜ณ๐˜ฆ๐˜ฆ๐˜ฏ๐˜ช๐˜ฏ๐˜จ ๐˜—๐˜ณ๐˜ฐ๐˜ต๐˜ฐ๐˜ค๐˜ฐ๐˜ญ is a great tool ๐Ÿ› ๐Ÿ‘๐Ÿพ I use at community seminars to help people identify if they may have some type of pelvic floor problem.
โ €
So if you wondering whether you might have pelvic floor problems, ๐˜ด๐˜ค๐˜ณ๐˜ฐ๐˜ญ๐˜ญ ๐˜ต๐˜ฉ๐˜ณ๐˜ฐ๐˜ถ๐˜จ๐˜ฉ ๐˜ต๐˜ฐ ๐˜ต๐˜ข๐˜ฌ๐˜ฆ ๐˜ต๐˜ฉ๐˜ช๐˜ด ๐˜ฒ๐˜ถ๐˜ช๐˜ป! ๐Ÿง
โ €
If ๐˜บ๐˜ฐ๐˜ถ ๐˜ค๐˜ฉ๐˜ฆ๐˜ค๐˜ฌ๐˜ฆ๐˜ฅ >3 ๐˜ฐ๐˜ณ ๐˜ฎ๐˜ฐ๐˜ณ๐˜ฆ, ๐—ฝ๐—ฒ๐—น๐˜ƒ๐—ถ๐—ฐ ๐—ณ๐—น๐—ผ๐—ผ๐—ฟ ๐—ฑ๐˜†๐˜€๐—ณ๐˜‚๐—ป๐—ฐ๐˜๐—ถ๐—ผ๐—ป ๐—ถ๐˜€ ๐—น๐—ถ๐—ธ๐—ฒ๐—น๐˜†โ€ฆ, but these symptoms are treatable! ๐Ÿ˜‰
โ €
So reach out to a pelvic floor therapist to get a comprehensive assessment and get started on an individualized treatment plan.
If you are in the Philadelphia area.., DM me to set up a consult!

07/10/2022

If you are or know anyone is pregnant or newly postpartum.., you have to check out a project I was involved with called ..
Nikeโ€™s (M)ove Like A Mother Program! ๐Ÿ’ช๐Ÿพ

Itโ€™s the 1st of itโ€™s kind! Itโ€™s got โ€ฆ

๐Ÿ‘‰๐Ÿพa series of 24 workouts (focused on various stages during pregnancy & postpartum)
๐Ÿ‘‰๐Ÿพexpert led tutorial videos (including mine ๐Ÿ˜‰)
๐Ÿ‘‰๐Ÿพand several editorial articles I contributed to..

โ€ฆ..and itโ€™s all FREE!!!๐Ÿ‘๐Ÿผ๐Ÿค—๐ŸŽ‰

The program lives in in the Nike Training Club app that you can easily download from your App store.

Iโ€™m really proud to have been a contributor to the program โ˜บ๏ธalong with a stellar team of health care providers and fitness professionals.
๐Ÿ…

Over the next few posts, Iโ€™ll share some highlights .., but first check out the promo video๐Ÿ‘Œ๐Ÿฝ

If you are experiencing any discomfort, pain or urinary symptoms with tucking, try these 10 healthy tucking tips to see ...
07/04/2022

If you are experiencing any discomfort, pain or urinary symptoms with tucking, try these 10 healthy tucking tips to see if it helps.

Tucking is a term used to describe the act of flattening the external genitalia for a smoother outward appearance.People...
06/25/2022

Tucking is a term used to describe the act of flattening the external genitalia for a smoother outward appearance.

People tuck to feel more comfortable with their appearance, reduce dysphoria or affirm their gender ๐Ÿฅฐโค๏ธ๐ŸŒˆ๐Ÿณ๏ธโ€โšง๏ธ

Tucking may be mildly uncomfortable (when you first get started), however it should not be painful or cause any health concerns.

Common side effects can include chronic urinary tract infections or problems urinating due to the placement and compression of the urethra (where p*e comes out) close to the a**s. Prolonged tucking can also lead to symptoms like prostatitis or cystitis from the increased pressure on the tissues around the external ge****ls. As the pelvic floor muscles guard in response to the tissues being irritated around themโ€ฆ, pelvic floor dysfunction or chronic pelvic pain can result๐Ÿ˜ฃ.

Affirming pelvic health therapists ๐ŸŒˆโค๏ธcan help treat these different concerns by finding techniques to allow affirmative practices while decreasing the unwanted side effects.

In the next post, letโ€™s go through some simple self care tips I give my patients to try.

Reinforcing healthy chest binding practices allows my clients and patients to have less health complications in the long...
06/11/2022

Reinforcing healthy chest binding practices allows my clients and patients to have less health complications in the long run.

Here are 10 helpful binding tips to consider when binding๐Ÿ‘๐Ÿพโ€ฆ

โœ”๏ธTry to take your binder off as much as possible during times where itโ€™s less important to bind. Also consider taking a few days off from binding.

โœ”๏ธ Take your binder off before you sleep. Give your body rest while you rest. ๐Ÿ˜ด๐Ÿ’ค๐Ÿ›

โœ”๏ธ Work out using a less compressive garment. ๐Ÿ‹๐Ÿฝโ€โ™‚๏ธSports bras are designed to move with you as you workout, while a binder can make movement and even breathing more difficult. So consider wearing a sports bra with a baggy shirt, or a binder that is a size larger.

โœ”๏ธ Ideally, wear a binder that is commercially made that has a chest compressing fabric.

โœ”๏ธBe sure to use the sizing guidelines to find your ideal size.

โœ”๏ธAvoid use of duct tape, saran wrap or ace bandages to bind your chest. Ace bandages in particular are designed to constrict, ๐Ÿ˜ฃso as you breathe, they get tighter which can hurt.

โœ”๏ธ Stay hydrated!๐Ÿ’ฆ๐Ÿ’ง

โœ”๏ธ Stretch your chest, ribcage and back and work on breathing ๐Ÿ˜ฎโ€๐Ÿ’จ๐Ÿซand postural re-education anytime you are out of your binder.

โœ”๏ธ Keep your binder clean, and be sure to first check with your binder manufacturerโ€™s website to see if they have recommendations for how best to wash your specific garment. ๐Ÿงบ๐Ÿงฝ๐Ÿงผ

โœ”๏ธIf you are feeling any nagging pain , donโ€™t ignore it. Stop binding ๐Ÿšซ for some time and ask for help from your health care team.

REFERENCES: healthybinding.com, pointofpride.org

Chest binding is the use of compression garments to make oneโ€™s chest appear flatter.  This can be a significantly affirm...
06/08/2022

Chest binding is the use of compression garments to make oneโ€™s chest appear flatter. This can be a significantly affirming practice particularly for trans and non-binary peopleโค๏ธ๐ŸŒˆ

Other benefits were noted in a study published in the medical journal Culture, Health & Sexuality included;
โœ”๏ธ Increased self-esteem
โœ”๏ธ Minimized gender dysphoria โ€” a conflict between a personโ€™s physical gender and the gender with which they identify
โœ”๏ธ Decreased anxiety and depression and
โœ”๏ธ Improved sense of autonomous control of the body

The downside of binding is it can also be associated with chronic pain and postural problems. In a 2017 study that included 1800 people who bind; 97% reported experiencing 1 negative health outcome associated with binding like back pain, overheating, chest pain and shortness of breath. 82% of them also believed it was important to have a conversation with their health care provider ๐Ÿ‘ฉ๐Ÿพโ€โš•๏ธabout their binding habits.

People who bind shouldnโ€™t feel like they have to choose between feeling confident in their own bodies and physical pain or discomfort. ๐Ÿ˜”

This is where gender affirming PT/ OT can help! ๐Ÿ˜Š๐Ÿ™†๐Ÿพโ€โ™€๏ธTreatment options can include:

๐Ÿ”… Exercises to improve mobility of the ribcage, spine & shoulders
๐Ÿ”… Breathing & relaxation exercises
๐Ÿ”… Strength training: core & upper back muscles
๐Ÿ”… Education on safe binding practices

In the next post letโ€™s get it into some specific exercises๐Ÿ‘๐Ÿพ

According to the Center for American Progress (CAP), nearly 50%of transgender people โ€” and 68%of transgender people of c...
06/07/2022

According to the Center for American Progress (CAP), nearly 50%of transgender people โ€” and 68%of transgender people of color โ€” reported having experienced mistreatment by a medical provider, including being refused care.๐Ÿšซ

Societal stigmas, discrimination (and other factors) prevent trans & gender diverse people from seeking necessary medical care with 28% reporting having postponed or not gotten necessary medical care for fear of mistreatment.

These barriers make it hard to be open and honest with a providerโ€”and as we celebrate Pride ๐ŸŒˆthis month (and every month) - highlighting the specific needs of the LGBTQIA+ community is so needed.

As a PT serving this community, those unique needs can include (but not limited to):
๐Ÿ”…Tissue preparation Pre-Gender affirming surgery
๐Ÿ”…Post gender affirming surgery rehab
๐Ÿ”…Pain from surgical scars
๐Ÿ”…Pain or difficulty with vaginal pe*******on
๐Ÿ”…Inability to achieve vaginal pe*******on
๐Ÿ”…Difficulty or inability to achieve or**sm
๐Ÿ”…Urinary problems including incontinence
๐Ÿ”…Pain or postural problems associated with chest binding
๐Ÿ”†Pain associated with tucking or packing
๐Ÿ”…Pelvic pain
๐Ÿ”…Pudendal Neuralgia (pelvic nerve pain)
๐Ÿ”…Constipation

Letโ€™s talk about some of these topics over the next several posts and how patient-centered, affirming and evidence-based PT can significantly help. ๐Ÿคฒ๐Ÿพ

Iโ€™m so excited to share that I sat down with  to speak on the   the pelvic floor. ๐Ÿค—I got the chance to share my own pelv...
04/07/2022

Iโ€™m so excited to share that I sat down with to speak on the the pelvic floor. ๐Ÿค—

I got the chance to share my own pelvic floor journey and to educate athletes and people who are pre- and postpartum on how to be mindful of and proactive about their pelvic floor.

My hope is that together we can reduce the stigma around pelvic floor dysfunctions. Thank you again to the Nike trained podcast team for inviting me โค๏ธ

Hope you enjoy ii! ๐Ÿ‘๐ŸพLink in bio โฌ†๏ธ

This week I worked with a high school basketball player, a triathlete, a competitive weight lifter, a dancer and a socce...
03/03/2022

This week I worked with a high school basketball player, a triathlete, a competitive weight lifter, a dancer and a soccer player. Athletes across ages and genders but one thing in common - their pelvic pain has sidelined them from returning to their sport of choice ๐Ÿ˜ž

Just like any other injury to the body, creating an effective pelvic pain rehab plan to return you back to the sport that brings you joy should be a priority.

Working through these 3 key rehab phases really helps my patients feel focused on the plan towards their goals. So I hope you find this helpful.

๐Ÿชœ๐Ÿ”†STAGE 1: Reduce pain and Improve mobility
This can include manual (hands-on therapy) in and around the pelvic floor/ spine/ abdomen etc; breathing exercises; mobility/ stretching exercises; alignment and postural re-education work.

Goal: Improve blood flow, calm down the nervous system, relax and gently stretch those stiffened pelvic floor muscles and the muscles that surround it.

๐Ÿชœ๐Ÿ”†STAGE 2: Strength train
Work on lengthening AND strengthening the muscles around the spine, pelvis, legs. Add some resistance with body weight, dumbbells/ kettlebells or resistance bands.

Goal: Change how the nervous system responds to those muscles contracting and relaxing. Start to incorporate modifications of your sport of choice e.g do some weightlifting at 25-50% of where you were when you were at your best etc

๐Ÿชœ๐Ÿ”†STAGE 3: Challenge your body!
Start to add more load i.e heavier weights or resistance. Add more reps, more impact. Use the principles you learned from Stage 1 and apply them here while you train. Stick with the general rule of thumb and limit your increase in resistance work (eg dumbbell training) to 10% at a time. Take 1-2 days to recover and monitor how your pelvic floor responds after each progressively harder routine.

Goal: To steadily, safely and mindfully challenge your body with heavier resistance exercise, until you are back to the sport you love.

Contd in comments โ€ฆ

The vagus nerve is the main parasympathetic nerve of the body.  When we feel calm, the vagus nerve keeps out heart rate ...
02/27/2022

The vagus nerve is the main parasympathetic nerve of the body. When we feel calm, the vagus nerve keeps out heart rate down and digestive system working. It runs from the neck, through the chest and down into the digestive tract.

When we are stressed or anxious (and feeling more of those chronic pelvic pain symptoms) pain๐Ÿ˜–this nerve works hard to try and calm things down. ๐Ÿ˜Š

Here are some simple tips to try and help it out.

๐Ÿ”…Sing or read out loud: The vibration from the vocalization helps stimulate the vagus nerve. You can also take long, slow exhalations making โ€œhmmmโ€ or โ€œomโ€ sounds.

๐Ÿ”…Ear pulls: ๐Ÿ‘‚ This provides indirect input input to your nervous system to create a calming response. This can also be helpful if you have tension headaches or TMJ.

๐Ÿ”…Laugh out Loud: ๐Ÿ˜‚ Our nervous system doesnโ€™t know the difference between real and fake laughter. They both have the same effect of helping us feel happier and more relaxed.

๐Ÿ”…Diaphragmatic breathing: ๐Ÿ˜ฎโ€๐Ÿ’จFind a comfortable position. Inhale for 2 secs and exhale for 4 secs. Repeat for 2 mins.

๐Ÿ”…Yawn: ๐ŸฅฑDo this from time to time voluntarily. This will help your body feel calmer.

๐Ÿ”…Be conscious of your diet: ๐Ÿฅ•Limiting foods like artificial sugar, processed foods and dairy โŒ can help reduce gut inflammation and bloating and relieve some of the pressure around the vagus nerve.

Super grateful to partner with Maisonette] in supporting our prenatal/ postpartum community. Be sure to check them out a...
02/16/2022

Super grateful to partner with Maisonette] in supporting our prenatal/ postpartum community. Be sure to check them out along with my recent blog post:)

Repost from Maisonette]
โ€ข
Are you trying to figure out what is and isnโ€™t normal for your pelvic health after childbirth? Pelvic Health Specialist, Dr. Ann Nwabuebo of , offers insights on key things every postpartum parent should know about their pelvic health now on Le Scoop at the link in bio.

Illustration by

Filled with gratitude ๐Ÿ™๐Ÿพ for clients who allow me the opportunity to walk with them for a part of their healing journey....
01/18/2022

Filled with gratitude ๐Ÿ™๐Ÿพ for clients who allow me the opportunity to walk with them for a part of their healing journey. ๐Ÿ™๐Ÿพโค๏ธโœจ

01/03/2022

Happy New Year friends ๐ŸŽŠ๐ŸŽ†๐ŸŽˆ May the new year bless you with joy, health, and so much happiness. ๐ŸŽ‰๐ŸŽŠโค๏ธ

So I did a thing!.. ๐Ÿ˜‰Just published  !  โ€œEach Womanโ€™s Menopause: An Evidence Based Resourceโ€Really proud to have joined ...
12/13/2021

So I did a thing!.. ๐Ÿ˜‰

Just published !

โ€œEach Womanโ€™s Menopause: An Evidence Based Resourceโ€

Really proud to have joined a team of incredible clinicians and Lucia Miller, MPT,WCS to co-author a chapter that covers an interdisciplinary approach in treating symptoms associated with menopause.

This book offers a diverse world ๐ŸŒŽ picture on menopause using global data about this important life transition.

Writing my chapter, I thought a lot about my mother, her experience and cultural expectations ๐Ÿ‡ณ๐Ÿ‡ฌ while going through โ€œthe changeโ€.

I wondered how different her experience would have been had she received the medical guidance the way this resource offers it. My hope is that the international reach of this book will offer that to many others.

So grateful to our editor for doing me the honor in allowing me to be a part of this amazing project. ๐Ÿ™๐Ÿพโค๏ธ๐Ÿฅฐ

Scroll through to check out one of my favorite excerpts from the bookโ€™s preface.

11/06/2021
It was really awesome getting interviewed as a member of the MossRehab (Tabor Road) Philadelphia team.  Check out the ar...
11/05/2021

It was really awesome getting interviewed as a member of the MossRehab (Tabor Road) Philadelphia team. Check out the article ๐Ÿ˜‰

10/28/2021

These are devices I recommend to my patients on a daily basis. Accessibility to them is what allows them to progress so much farther and faster in their care. Please show some support and sign the petition today.๐Ÿ™๐Ÿพ

๐Ÿ”…Donโ€™t think. Just run!๐Ÿ”…This was her affirmation going into her 1st race.Less than a week ago I got this lovely text fro...
10/20/2021

๐Ÿ”…Donโ€™t think. Just run!๐Ÿ”…

This was her affirmation going into her 1st race.

Less than a week ago I got this lovely text from an old patient of mine. Itโ€™s been a year since our last session. Her hip pain plus a global pandemic had side lined her from running her first marathon 2 yrs ago. After we worked together for a few months, I moved, but we checked in periodically as she continued working with a new PT.

She finally ran her race to celebrate her 5th decade of life and absolutely crushed it!! ๐Ÿƒโ€โ™€๏ธ ๐Ÿฅ‡ So honored to have played a role in her healing.

Gentle reminder .. no matter what your race is..donโ€™t give up โค๏ธ

As the World honors today as World Mental Health Day.., itโ€™s worth acknowledging that people with chronic pelvic pain (C...
10/10/2021

As the World honors today as World Mental Health Day.., itโ€™s worth acknowledging that people with chronic pelvic pain (CPP) suffer from mental health conditions at a much higher rate compared to their p*ers.

A 2019 study showed that 50% of cisgendered women with CPP had moderate to severe anxiety and more than 25% had moderate to severe depression. Other studies have shown that men and p***s owners with CPP have a higher prevalence of anxiety/panic disorder/symptoms that those without CPP.

If you are a CPP sufferer, you are not alone. Your health care providers must acknowledge and support your mental health and wellness, no matter what their specialty might be. Caring for your mind and body go hand in hand in finding long term solutions in your healing journey.โœจโœจ

Conditions that can cause Chronic Pelvic Pain (CPP) can come from the reproductive organs, bladder, bowels, the pelvic v...
10/10/2021

Conditions that can cause Chronic Pelvic Pain (CPP) can come from the reproductive organs, bladder, bowels, the pelvic veins, nerves and the muscles/ joints around the spine and pelvis. Examples areโ€ฆ

โ›”๏ธ Menstrual cramps
โ›”๏ธ Interstitial Cystitis/ Painful Bladder Syndrome
โ›”๏ธ Nonbacterial protatitis
โ›”๏ธ Pudendal nerve entrapment
โ›”๏ธ Testicular torsion
โ›”๏ธ Endometriosis
โ›”๏ธ Post vasectomy pain
โ›”๏ธ Uterine fibroids
โ›”๏ธ Pelvic inflammatory disease
โ›”๏ธ Irritable Bowel Syndrome
โ›”๏ธ Diverticulitis
โ›”๏ธ Low back and hip pain
โ›”๏ธ Fibromyalgia
โ›”๏ธ Pelvic surgery/ Injury
etc

With different specialists involved to find the primary driver of the pain (like a gynecologist, urologist, pain management specialist, colore**al doctor, gastroenterologist ๐Ÿ‘ฉ๐Ÿพโ€โš•๏ธ etc).., what tends to stay consistent across these diagnoses is the state of the pelvic floor muscles, the surrounding tissues AND the nervous system ๐Ÿง  . Everything ends up working really hard ๐Ÿ˜ฃ๐Ÿ˜–๐Ÿ˜ฉ to protect you which in turn causes a vicious cycle of pain.

This is where having a pelvic floor PT involved in your care is key. Learning tips and tricks on how to reduce this tension to break this cycle can give long term solutions with holistic healing.

A diagnosis of Chronic Pelvic Pain (CPP) is made after 3-6 months of pelvic pain (i.e the lower abdomen, p***s, testicle...
09/26/2021

A diagnosis of Chronic Pelvic Pain (CPP) is made after 3-6 months of pelvic pain (i.e the lower abdomen, p***s, testicles, v***a, re**um, perineum etc).

Diagnosing and treating CPP can be very tricky ๐Ÿค”as the causes could stem from the bladder, the reproductive organs, the gastrointestinal system, or the nerves/ muscles of the spine, pelvis and the abdomen.

An estimated 50% of cases of CPP remain undiagnosed and it can 5-7 yrs for someone to be diagnosed. This delay can be for a variety of reasons..

โ›”๏ธ Imaging and lab findings are typically inconclusive.
โ›”๏ธ CPP is a diagnosis made by ruling out others. So the process can take time.
โ›”๏ธ Inadequate care from getting misdiagnosed.
โ›”๏ธ The sensitivity and cultural taboo of discussing topics related to pelvic pain.

Over the next few posts let's talk about the different types of CPP, their causes and considerations to make when treating it.

๐Ÿ”† Patient Overview:My patient was a 35 yr old, self referred to me.ย  They had pelvic surgery over 6 wks ago after a recu...
09/02/2021

๐Ÿ”† Patient Overview:

My patient was a 35 yr old, self referred to me.ย  They had pelvic surgery over 6 wks ago after a recurrence of ovarian cancer, and they were experiencing severe pelvic pain. Bowel movements, sitting or standing for any length of time resulted in days of debilitating pelvic pain.ย  They were open about their underlying diagnosis of medical PTSD, and their ongoing work with mental health providers.ย ย 

ย ๐Ÿ”† Initial Examination:

* They relied on the use of a wheelchair and a friend to help them get around
* Standing posture was hunched forward and in a guarded position due to the pain
* Very restricted and painful abdominal scars from prior surgeries and procedures
* Internal pelvic floor muscle evaluation wasnโ€™t appropriate considering the severity of their symptoms.

๐Ÿ”† Treatment:

* PT 1x/wk with a focus initially on relaxation based work, breath and visualization work.
* Gentle hands on work (craniosacral therapy, myofascial release, myofascial unwinding, visceral manipulation) was slowly introduced with lots of patient education to ensure ongoing informed consent.
* Consistent communication with their primary care physician/ oncologist was maintained to explore pain mgmt options that would give more localized pelvic pain relief.
* Consistent communication with their mental health provider to help with the processing of emotional releases during/ after various sessions.
* After 4 months of PT, consent was provided for external pelvic work only.ย ย 
* After 8 months, consent was provided for gentle internal re**al work only.ย 

๐Ÿ”† Outcome
After weekly apts for 1 yr, the patient was able to walk without any kind of assistive device.ย  They had significantly cut down on their pain medication, pain with bowel movements had decreased and they started swimming anywhere from 3-5x/wk as part of their self care routine.

This patient worked, and continues to work through a lot of trauma โค๏ธโ€๐Ÿฉน. What I will always remember about them though is the majestic unraveling as they found that beautiful reconnection with their body. โœจโœจโค๏ธ

It was one of the greatest honors of my career to work with this human.๐Ÿ™๐Ÿพโค๏ธ

๐Ÿ”† Patient Overview:My patient was a 35 yr old, self referred to me.ย  They had pelvic surgery over 6 wks ago after a recu...
09/02/2021

๐Ÿ”† Patient Overview:

My patient was a 35 yr old, self referred to me.ย  They had pelvic surgery over 6 wks ago after a recurrence of ovarian cancer, and they were experiencing severe pelvic pain. Bowel movements, sitting or standing for any length of time resulted in days of debilitating pelvic pain.ย  They were open about their underlying diagnosis of medical PTSD, and their ongoing work with mental health providers.ย ย 

ย ๐Ÿ”† Initial Examination:

* They relied on the use of a wheelchair and a friend to help them get around
* Standing posture was hunched forward and in a guarded position due to the pain
* Very restricted and painful abdominal scars from prior surgeries and procedures
* Internal pelvic floor muscle evaluation wasnโ€™t appropriate considering the severity of their symptoms.

๐Ÿ”† Treatment:

* PT 1x/wk with a focus initially on relaxation based work, breath and visualization work.
* Gentle hands on work (craniosacral therapy, myofascial release, myofascial unwinding, visceral manipulation) was slowly introduced with lots of patient education to ensure ongoing informed consent.
* Consistent communication with their primary care physician/ oncologist was maintained to explore pain mgmt options that would give more localized pelvic pain relief.
* Consistent communication with their mental health provider to help with the processing of emotional releases during/ after various sessions.
* After 4 months of PT, consent was provided for external pelvic work only.ย ย 
* After 8 months, consent was provided for gentle internal re**al work only.ย 
(Contd in comments)

Not all PTโ€™s/ Rehab professionals are able to offer trauma informed care.  As you prepare to work with one.., or you loo...
09/01/2021

Not all PTโ€™s/ Rehab professionals are able to offer trauma informed care. As you prepare to work with one.., or you look to find the right fit.., here are a few tips to consider.

๐Ÿ”† Interview potential providers.
Thereโ€™s value in seeking out the right provider to work with. Most providers offer brief introductory calls where they can give you a general sense of their approach in working with folks with a history of trauma.

๐Ÿ”† Consider investing in your health.
Making that out of pocket financial investment in your health, can be a really tough decision to make. To widen your options, consider looking outside of your insurance network plan.

๐Ÿ”†Ask for payment flexibility
The worst thing they could say is no. ๐Ÿคท๐Ÿพโ€โ™€๏ธ if you find an out of network provider that feels like the right fit โ€ฆ., ask if they offer a sliding scale or a package that accommodates your budget. The typical recommendation I make working with clients is to frontload the sessions and taper off the frequency of visits as they transition to self-care work.

๐Ÿ”†Find support
1-on-1 mental health services, trusted friends and family or reputable support groups. Stay connected with people that can surround you with hope while you go through this work.

Not all PTโ€™s/ Rehab professionals are able to offer trauma informed care.  As you prepare to work with one.., or you loo...
09/01/2021

Not all PTโ€™s/ Rehab professionals are able to offer trauma informed care. As you prepare to work with one.., or you look to find the right fit.., here are a few tips to consider.

๐Ÿ”† Interview potential providers.
Thereโ€™s value in seeking out the right provider to work with. Most providers offer brief introductory calls where they can give you a general sense of their approach in working with folks with a history of trauma.

๐Ÿ”† Consider investing in your health.
Making that out of pocket financial investment in your health, can be a really tough decision to make. To widen your options, consider looking outside of your insurance network plan.

๐Ÿ”†Ask about payment flexibility
The worst the provider could say is no. ๐Ÿคท๐Ÿพโ€โ™€๏ธ if you find an out of network provider that feels like the right fit โ€ฆ., ask if they offer a sliding scale or a package that accommodates your budget.

๐Ÿ”†Find support
1-on-1 mental health services, trusted friends and family or reputable support groups. Stay connected with people that can surround you with hope while you go through this work.

This was part of a beautiful note โค๏ธ that an old patient shared with me recently that speaks to the heart of what trauma...
08/27/2021

This was part of a beautiful note โค๏ธ that an old patient shared with me recently that speaks to the heart of what trauma informed care from a PT or rehab professional can look like.

This care cannot take the place of working with a mental health provider.

However, what we can be, is an important part of your health care โ€˜teamโ€™ giving you safe, compassionate care โœจto heal those connections between your body, mind and spirit.

There are tons of great books out there that help us understand more about how trauma affects the body.  Others that exp...
08/24/2021

There are tons of great books out there that help us understand more about how trauma affects the body. Others that explain why pain can persist long after the trauma has gone, and some that share powerful individual stories of healing trauma.

Here are some of my favorites:

๐Ÿ”† The Body Keeps the Score by Dr. Bessel van der Kolk
๐Ÿ”† The Body Remembers by Babette Rothschild.
๐Ÿ”† Whatโ€™s in Your Web? By Phil Tavolacci (I wrote a chapter in this book so Iโ€™m slightly biased ๐Ÿ˜œ)
๐Ÿ”† Waking the Tiger: Healing Trauma by Peter Levine
๐Ÿ”† The Trauma Spectrum, by Robert Scaer
๐Ÿ”† The Body Bears the Burden, by Robert Scaer
๐Ÿ”† Healing Ancient Wounds by John Barnes
๐Ÿ”† ๐Ÿ”† Explain Pain by David Butler, Lorimer Moseley
๐Ÿ”† Why Pelvic Pain Hurts - Neuroscience Education for Patients with Pelvic Pain by Adriaan Louw, Sandra Hilton & Carolyn Vandyken

What are some of yours ? ๐Ÿค“

When it comes to self healing a body that has experienced trauma, reintroducing movement (of any kind) OR rehab that inc...
08/18/2021

When it comes to self healing a body that has experienced trauma, reintroducing movement (of any kind) OR rehab that includes touchโ€ฆ, might be scary.

Where do you start? What if it hurts? How do you process the emotions if they come up? ๐Ÿ˜ซ

A trauma-informed PT/OT (or rehab specialist) can be an excellent guide. However, if you are not ready or unable to work with one.., here are a few things that you can keep in mind. ๐Ÿ’ก

๐Ÿ”†1. Choose a physical space that feels safe
Is it your bedroom or out in nature? Wherever it is, be intentional about setting some time to do a simple movement routine there.

๐Ÿ”†2. Choose movement that will bring you joy!
When your movement practice brings you joy, there is a greater chance that it can become a more consistent part of your routine.

๐Ÿ”†3. Feel safe with how you position your body:
It could be as simple as lying on your back or on your side to do some gentle movement. All options are available, even if you need to make transitions midway.

๐Ÿ”†4. Move another body part, if one hurts too much:
If you experience pelvic pain (as an example) and it feels too intense to move itโ€ฆ, then move other body parts. The mobility work can carry over to the painful parts of you, as you ultimately work towards regaining mobility throughout your body.

๐Ÿ”†5. Feel safe in how much or how little you choose to move:
The range of motion that you move your body in should not be forced. Let it be easy, and you will find that with time you can nudge things a little more.

As Iโ€™ve worked with patients and clients over the years move through this initial phase of re-introducing early movement, we discuss the possibility of emotions coming up to the surface. This can be incredibly healing as the mind, body and spirit communicate to heal trauma. โœจ I always encourage my patients and clients to get the support of a mental health provider to help process these emotions. If this comes up for you, know that you are not alone.

โ€œJust breathe!โ€  ๐Ÿง˜๐Ÿพโ€โ™€๏ธ Sounds so easy right?   When it comes to re-introducing movement into a body that has experienced...
08/15/2021

โ€œJust breathe!โ€ ๐Ÿง˜๐Ÿพโ€โ™€๏ธ Sounds so easy right? When it comes to re-introducing movement into a body that has experienced trauma, being very intentional about calming down the nervous system is where it starts. When faced with danger, that โ€˜fight, flight or freeze responseโ€™ describes our natural impulse to defend ourselves or run until itโ€™s safe ๐Ÿ˜ฃ. The challenge is that when you are experiencing persistent pain of any kind, that nervous system impulse is still heightened and the tension in the tissues remains.

Retraining ourselves on how to breath efficiently is the very first step in quietening down the nervous system, reconnecting with our body and reintroducing movement that feels gentle and safe.

There are many variations of breathing exercises, but this is a simple routine you can try:

๐Ÿ”†Find a space and position that feels comfortable to you.
๐Ÿ”† Place a hand on your abdomen or lower ribs and the other on your chest.
๐Ÿ”† Inhale for a count of 4, and let your abdomen/ lower ribs expand.
๐Ÿ”† Exhale for a count of 4 and let your abdomen relax back down.
๐Ÿ”† Repeat for 6-8 reps

If you notice a lot of movement in your chest with your breath, try to redirect that to your other hand.

Do you have any go-to breathwork routines that help to calm down your nervous system?

โ€œJust breathe!โ€  ๐Ÿง˜๐Ÿพโ€โ™€๏ธ Sounds so easy right?   When it comes to re-introducing movement into a body that has experienced...
08/15/2021

โ€œJust breathe!โ€ ๐Ÿง˜๐Ÿพโ€โ™€๏ธ Sounds so easy right?

When it comes to re-introducing movement into a body that has experienced trauma, being very intentional about calming down the nervous system is where it starts. When faced with danger, that โ€˜fight, flight or freeze responseโ€™ describes our natural impulse to defend ourselves or run until itโ€™s safe ๐Ÿ˜ฃ. The challenge is that when you are experiencing persistent pain of any kind, that nervous system impulse is still heightened and the tension in the tissues remains.

Retraining ourselves on how to breath efficiently is the very first step in quietening down the nervous system, reconnecting with our body and reintroducing movement that feels gentle and safe.

There are many variations of breathing exercises, but this is a simple routine you can try:

๐Ÿ”†Find a space and position that feels comfortable to you.
๐Ÿ”† Place a hand on your abdomen or lower ribs and the other on your chest.
๐Ÿ”† Inhale for a count of 4, and let your abdomen/ lower ribs expand.
๐Ÿ”† Exhale for a count of 4 and let your abdomen relax back down.
๐Ÿ”† Repeat for 6-8 reps

If you notice a lot of movement in your chest with your breath, try to redirect that to your other hand.

Do you have any go-to breathwork routines that help to calm down your nervous system?

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There's a misconception out there that strengthening your core/deep core during pregnancy isn't possible. On the contrary! Breathing exercises, like this one from Dr. Ann Udofia, PT, DPT, is one way to continue engaging those muscles as your baby grows in utero. Perform these standing or sitting against a wall for more total-body feedback as you aim to inhale throughout your entire diaphragm (think: 360 degrees).

https://bit.ly/39S8mTM
My sessions with Ann were always the highlight of my week. She is warm, respectful, kind and professional. She blends western medicine well with a mind-body approach which I appreciated so much.
Had some really bad neck spasms and the 1hr sessions of MFR, trigger point therapy and the craniosacral therapy work Ann did was extremely helpful in getting rid of the pain.
Highly recommend her!
I went to see Ann after a shoulder injury. With the nature of my work and lots of travel, I could only commit to a few sessions.., but that was all it took! With the full hour of purely hands-on work and her going into depth about all the exercises I could do at work, home, hotels and plane rides.., I felt really confident with how to take care of myself.
She even went over and beyond to research a therapist I could work with while out of the country. My shoulder is fully recovered and Iโ€™m really grateful for her skill and expertise.
Ann worked with me through my 2nd pregnancy helping me manage some back and pelvic pain. Not only were the treatments very effective, She helped teach my husband and I some simple stretches and techniques to help prepare my body for labor and delivery, which was really empowering!
I knew about the work she did with postpartum women. So after my baby was born and I was cleared for exercise, I went back to Ann. She treated my scar tissue, and helped me learn how to improve my core and pelvic floor strength allowing my recovery to be much faster than my first.
She is a kind and compassionate professional. I canโ€™t say enough good things about her!
My orthopedic surgeon referred me to Ann due to some shoulder, back and neck pain I was having well after having surgery. Ann was not only extremely knowledgeable about my injury and how to effectively treat me, but she worked closely with my surgeon to make sure my recovery stayed on track.

She went over and beyond to make sure I had the tools needed to return to my busy work schedule in my field of aeronautics and high tech. Would highly recommend her to anyone!
I reached out to Ann after I fractured my ankle in a bad fall. My in network PT had highly recommended her cause although I was doing better, I was still having some discomfort around my scar, my range of motion wasnโ€™t full and I was starting to have some pain higher up in my hip and low back from all the compensations.
After only a few sessions of myofascial release where we worked intensely into my scar tissue, legs, hips and back - I was walking normally again, got back to the gym, and just started running. Very impressed with the level of expertise she has and how well they worked with my in network PT to make sure I had everything I needed for a full recovery. Very grateful for how much she helped me.
Iโ€™ve injured my back quite a bit from playing basketball. Iโ€™ve worked with different Physical therapists over the years, but I found the work with Ann gave more lasting relief. This was because she found lots of other muscles that were overcompensating and treated that as well. Most importantly, she was very clear on exercises I should be doing at home and before/ after basketball to limit my chances of getting injured again.
Had some pelvic pain and was having a hard time finding the right physical therapist to help. Ann was compassionate and very knowledgeable about my diagnosis and made me feel at ease right away. Her hands on approach using myofascial release and visceral mobilization has been the most effective approach by far and Iโ€™m finally seeing the long term results I wanted. I canโ€™t recommend her enough.
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