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Wellness Training Packages for Peri and Menopausal Women

Lotus Physical Therapy for Women is now offering personalized wellness training packages for peri and menopausal women in both the Nyack and New Paltz, NY locations. The series will include separate sessions on training for bone and muscle health, posture, balance, cardiovascular fitness and pelvic floor (bladder, uterine, sexual and bowel) health and fitness. The series will consist of 5 separate hourly sessions. Call the contact number for more information and to schedule your appointment. Start learning how to properly care for yourself and set the foundation for feeling great today!!!!

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Frozen Shoulder/Adhesive Capsulitis

Frozen shoulder or adhesive capsulitis is a painful condition of the shoulder. It is prevalent primarily in females between the ages of 40-60. One or both shoulders can become extremely painful with marked reduction in range of motion of the shoulder(s) due to thickening and adherence of the ligaments and capsule of the joint. the exact cause is unclear and can occur after treatment for breast cancer or injury to the shoulder or no apparent injury at all. It appears to be linked to hormonal change and blood sugar levels. This condition often restricts and limits activities of daily living like dressing, grooming, driving, lifting, turning in bed and exercising to name a few. It is often self-limiting but can take a very long time to heal, one to three years, if left untreated. Physical therapy including, myofascial release, joint mobilization, therapeutic modalities and stretching exercises can be very helpful in speeding the healing process. I can relate to those who are suffering from frozen shoulder myself. After an injury to my shoulder 7 months ago, my shoulder became intensely painful, with limited motion and decreased function. Thankfully, I am on the mend with lots of physical therapy and some acupuncture!!! If you are suffering from a frozen shoulder, don’t wait to get treatment. Early intervention can make a world of difference.

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??? A Question I Frequently Get Asked ???

Working in the field of Women’s Health, patients frequently ask me how and why I became interested in doing the type of therapy that I do.

Here is what I tell them…

While in the physical therapy program at Hunter College in New York City, I became interested in orthopedics and very quickly realized that is what I wanted to specialize in.  So I did.  

After I graduated and received my professional license, I began working in the field of orthopedics.  I worked at two of New York City’s prestigious Orthopedic hospitals and a private Orthopedic practice that specialized in treating performing artists.  I then went on to work at a Rehabilitation hospital where I practiced all aspects of Orthopedic physical therapy. I worked with both females and males.  I went on to become a certified Orthopedic specialist in my field.

 Around 10 years into my career, I became interested in orthopedic injuries and illness that were more prevalent in females, since I am a female.   I began taking continuing education courses related to those types of subjects.  One of the courses I took was presented by a host of professionals including MD’s and the founder of the American Physical Therapy Association’s Section on Women’s Health, Elizabeth Noble, physical therapist.  The topics covered ranged from things like prenatal and postpartum exercise and care to post mastectomy care, urinary incontinence and pelvic pain in women.

 I instantly realized I needed to incorporate treatment for these types of conditions into my regular orthopedic practice as there was a great need for it.  It was a found missing puzzle piece for me.   So many females require treatment in these areas and services were lacking.   I became passionate about wanting to treat in the realm of Women’s Health. So, I began taking more and more courses given by the leaders and experts in the field and became the co-founder of a Women’s Health program at the hospital at which I was working at the time.  Within a few years after that, I decided to open my own practice with the emphasis on dedication to treating Women’s Health-related conditions.

Having a strong orthopedic background has helped me to be a better practitioner and look at each patient more comprehensively. In addition to being a physical therapist, I am also a certified yoga instructor and have a background in dance, which enhances my understanding of functional movement in the body.

I love and respect the work that I do. As a female, I find it fulfilling to work with and help other women on a daily basis.  My focus is on treating females but I do treat males who have pelvic floor muscle dysfunction and/or would like orthopedic physical therapy. 

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Lotus Physical Therapy for Women, PLLC is Opening a Second Location!!!!!!! New Paltz, New York

I am pleased to announce that Lotus Physical Therapy for Women, PLLC is about to open a second location in NEW PALTZ, NEW YORK!!! I will be providing the same services and can be reached via the same contact information. The address for the new location is 5 Academy Street, New Paltz, New York 12561. This location will be serving Ulster County, Orange County, Sullivan County, Greene County, Putnam County and Dutchess County, New York. The office is set to open mid-November. For appointments, please call the number provided on the site. Can’t wait to provide Women’s Health Physical Therapy to area!!! Luba Starostiak

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Rehabilitation After Hysterectomy

A recent statistical study reported that in the USA alone, approximately 600,000 hysterectomies are performed annually.  Hysterectomies are performed for various reasons such as cancer, endometriosis, excessive bleeding and tumors.  The procedures can be carried out abdominally through an open incision, trans-vaginally, laparoscopically and more recently, robotically guided.  The scope of the percentage of reproductive organ removal varies from removing just the uterus to complete hysterectomy where uterus, cervix, ovaries and even a portion of the vaginal canal are excised.  Pelvic organs (uterus, ovaries, bladder and bowel) contact each other inside of the body by proximity and connective tissue attachments.  This type of surgery can disrupt the natural function and stability of both internal organs as well as that of the pelvis and spine.  Hysterectomy has been linked to incontinence, surrounding organ prolapse, back pain, abdominal weakness, to name a few.  After having a hysterectomy, whether partial or complete, it is helpful to have guidance in learning how to restore function to abdominal and spinal muscles as well as strengthen pelvic floor muscles to provide internal stability to remaining organs.  Learning proper body mechanics for mobility and exercise can be extremely helpful.  Seeking guidance from a Physical Therapist who is an expert and specialized in Women’s Health, can help decrease pain and restore lost function and potentially further problems down the road.

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Exercise and Menopause

Avoiding a sedentary lifestyle through exercise can help reduce some of the negative effects associated with menopause.  The decrease in hormone production during this time, especially estrogen, can lead to a host of changes in the body.  Women often experience weight gain, loss of muscle mass and strength as well as a decrease in bone mineral density which may lead to osteopenia or osteoporosis.  Depression and fatigue are also commonly reported and experienced.  Weight gain can lead to obesity if unchecked.  Obesity has been shown to increase the risk for cardiovascular disease and diabetes.  Osteoporosis can lead to fractures in the wrist, thigh bones and/or spine.  These potential problems can be addressed by avoiding a sedentary lifestyle.  Adding 30 minutes per day of exercise on most days, including weight-bearing exercises and resistive exercises have been shown to increase bone density, decrease the risk for diabetes and cardiovascular disease, control excessive weight gain

and diminish depression.  Weight bearing exercise could simply be brisk walking for weight-bearing to the lower extremities and pelvis.  Weight bearing can also be done in the form of exercise on hands and knees if possible, like gentle yoga.  This would help with weight-bearing to the upper extremities and upper spine.  Exercising with resistance bands or weights strengthens both muscle and bone.   A 2016 study by Kai, Nagamatsu, Kitabatake and Sensui in the journal Menopause showed that gentle 10-minute nightly stretching, for example, before bed-time could also help diminish symptoms such as hot flashes and feelings of depression.  So a combination of aerobic-type exercise along with resistance training as well as stretching all prove to be beneficial as women transition through their menopausal and post-menopausal phases of life.  It is always best to be guided by a professional, like a physical therapist whose training and expertise is in Women’s Health for best out-comes and avoidance of injury.

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Exercise and Pregnancy

Frequently, I am asked by pregnant clients, “What exercise is okay for me to do?”

Excellent question!!!

Very often during pregnancy, women want to begin exercise programs to ensure the health of their developing babies as well as themselves.  On first consideration, this sounds like and often is a good idea and recommended.

So, how to answer this question?

Before answering, there are some important considerations that need to be kept in mind.

My first response is, “What kinds of pre-pregnancy exercise have you been engaging in up until the present?”  This clues me in to how active they have been and currently are.  It also tells me what types of exercise they enjoy and are more likely to continue if deemed safe.

In accordance with the ACOG’s (American Congress of Obstetricians and Gynecologists) guidelines:

– 30 minutes/day on most days is recommended.

– Recreational and competitive athletes with uncomplicated pregnancies can remain active during pregnancy and should modify their usual exercise routines as medically indicated.  The information on strenuous exercise is scarce; however, women who engage in such activities require close medical supervision.

–  Previously inactive women and those with medical or obstetric complications should be evaluated before recommendations for physical activity during pregnancy are made.

–  A physically active woman with a history of or risk for preterm labor or fetal growth restriction should be advised to reduce her activity in the second and third trimesters.

Keeping these guidelines in mind, a customized exercise program can be formulated to meet the health and recreational requirements of the client.  Some women are professionally athletic, some are recreationally athletic at a very high and competitive level, some exercise 2-3 times per week at a gym and others take dance and or yoga classes one to several times per week.  Others still, are sedentary.  The range of how and how often women move their bodies is highly variable.

In general, if a woman is regularly active prior to pregnancy, she may continue at the same level unless:

–  It is extremely strenuous with or without twisting.

–  Involves high impact like jumping and or bouncing.

–  High altitude sports.

–  Heavy weight lifting.

–  Board and platform diving.

–  Competitive events.

–  Contact sports.

–  Scuba diving.

–  Exercise in hot, humid conditions.

There are also other activities that may become unsafe like horseback riding, Alpine skiing, exercises performed on your back, ice skating and volley ball.

Due to modern cultural pressures, often women feel they must exercise excessively during pregnancy in order to maintain their “figures.”

It is important to reinforce the benefits of exercise during pregnancy for purposes of health including:

–  Increase or maintenance of aerobic exercise.

–  Increase cardiac reserve.

–  Improve muscle tone.

–  Promote good sleep.

–  Prevent low back pain.

–  Reduce gestational diabetes.

–  Improve psychological aspects.

–  Easier labor and delivery.

–  Faster recovery from labor.

Education on the maintenance of health and the acceptance of the NORMAL changes that occur to a mother’s body during pregnancy should be reinforced.

Pregnancy can be a time of nescience.  There can be insecurity based on fear of the unknown.  An educational and supportive birth community can help ease insecurity and provide mom with the confidence she needs to fully experience and enjoy her pregnancy.

I am always delighted when client asks the question about exercise during pregnancy.  I am pleased to demystify any misconceptions about entering into or continuing on with exercise and movement.  I recommend that any pregnant woman who is unsure of what type of exercise to engage in consult with an appropriate professional healthcare practitioner who is an expert in Women’s Health and pregnancy for guidance.   Keep moving for health!!!

June 7, 2017

A Topic Few Wish to Discuss   

So often, I hear women complaining to me about experiencing the symptoms of vaginal itching.  They are stumped and frustrated by this symptom, asking what causes it and how can they eliminate it.

Vaginal “itching” can have many causative factors.  Itching can result from dryness of the skin.  This can happen as a consequence to hormonal change during menopause or even pregnancy.  It can be a sign of nerve irritation.  The pudendal nerve is one of the major nerves that course through the pelvis.  This nerve provides sensation to the vulvar and anal regions.  If the nerve is inflamed, it can cause the sensation of pain or itching or both to those areas.  Vaginal infections, such as yeast and or bacterial can also create an itching sensation.

What can you do?   See your healthcare provider to help determine the cause.  For dry skin, provided you are not allergic to any of these,  a natural emollient,  such as coconut, almond, olive oil or aloe vera can be applied topically to the area to moisturize and sooth the skin. Just as the skin on your face, arms, legs and other body parts can become dry and irritated, your vulvovaginal tissues can as well.    If your MD or other appropriate healthcare provider agree, topical hormonal creams, can also be applied as directed to help with hormone balance to the effected tissues. With nerve irritation and any associated pelvic muscle tension or spasm, physical therapy can be helpful to provide relief from inflammation via various modalities, manual techniques and gentle exercises.  Medications can also be prescribed by your healthcare provider to diminish the nerve pain.  If there is an active infection, it needs to be diagnosed and treated with the appropriate medication and possibly diet modification.

If you are experiencing this type of symptom, don’t hesitate to discuss it with your healthcare provider as there are many ways to address and treat the problem.  Why suffer in silence?

02/13/2017

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​A Topic Few Wish to Discuss​

So often, I hear women complaining to me about experiencing the symptoms of vaginal itching.  They are stumped and frustrated by this symptom, asking what causes it and how can they eliminate it.

Vaginal “itching” can have many causative factors.  Itching can result from dryness of the skin.  This can happen as a consequence to hormonal change during menopause or even pregnancy.  It can be a sign of nerve irritation.  The pudendal nerve is one of the major nerves that course through the pelvis.  This nerve provides sensation to the vulvar and anal regions.  If the nerve is inflamed, it can cause the sensation of pain or itching or both to those areas.  Vaginal infections, such as yeast and or bacterial can also create an itching sensation.

What can you do?   See your healthcare provider to help determine the cause.  For dry skin, provided you are not allergic to any of these,  a natural emollient,  such as coconut, almond, olive oil or aloe vera can be applied topically to the area to moisturize and sooth the skin. Just as the skin on your face, arms, legs and other body parts can become dry and irritated, your vulvovaginal tissues can as well.    If your MD or other appropriate healthcare provider agree, topical hormonal creams, can also be applied as directed to help with hormone balance to the effected tissues. With nerve irritation and any associated pelvic muscle tension or spasm, physical therapy can be helpful to provide relief from inflammation via various modalities, manual techniques and gentle exercises.  Medications can also be prescribed by your healthcare provider to diminish the nerve pain.  If there is an active infection, it needs to be diagnosed and treated with the appropriate medication and possibly diet modification.

If you are experiencing this type of symptom, don’t hesitate to discuss it with your healthcare provider as there are many ways to address and treat the problem.  Why suffer in silence?

02/13/2017