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Endometriosis and Pelvic Floor Physical Therapy: A Whole-Person Approach to Pelvic Pain
Endometriosis is a chronic, estrogen-dependent inflammatory disease in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus. These growths, called lesions, are most commonly found around the pelvic organs but can also occur on the bowel, bladder, diaphragm, and other areas throughout the body. The hallmark symptom of endometriosis is pelvic pain, often linked to the menstrual cycle because the lesions respond to hormonal fluctuations. Ho
Joanna Hess
Jun 11
Hypo-ed up? Hypopressives for pelvic floor dysfunction
In a previous season of life, I lived in Qatar and working at a interdisciplinary sports hospital. I loved learning about physiotherapy culture around the world. The Greeks used a wheel, the Tunisians loved rotational patterns, the Australians swore by load progressions, the Scandanavians prescribed eccentric exercises, and the Brazilian/Portuguese/Spanish—they had hypopressive abdominal exercises. Hypopressive exercises were magic exercises that solved low back pain, prol
Joanna Hess
May 19
Vaginal Flatus: Messages from the front
You are feeling strong at the yoga studio or in the bedroom, and suddenly a sound comes from your vagina. What was that? Queef, vaginal wind, vaginal gas, vaginal flatus, fanny fart, garrulitas vulvae, and other terms all describe the involuntary release of odorless gas from the vagina. Occasional vaginal noise from trapped air is natural and normal. While vaginal gas is common, it can still feel embarrassing, isolating, or impact quality of life. Unless vaginal wind has an o
Joanna Hess
May 19
Lace Up or Lie Down? Running Through Pregnancy Safely
Running in ever-tightening spandex while looking out for the next toilet, just in case? Pregnancy is a great equalizer. Not even Cardi B and Kate Middleton could escape the hormonal changes that may cause mood swings, fatigue, nausea, and aches. These symptoms, along with modern culture, often encourage pregnant women to reduce movement and everyday activity. However, research strongly supports that exercise during pregnancy, including recreational running, is beneficial for
Joanna Hess
Apr 8
Mind the Gap (Part 2): How to Exercise with Diastasis Recti, Without Making It Worse
If Part 1 left you thinking, “Great… so what do I actually do ?” you’re not alone. We know more than ever about diastasis recti abdominis (DRA), and at the same time, we are still piecing together the full picture. What we do know is this: You cannot “close the gap” with one magical exercise. You can, however, train your body to manage pressure, generate tension, move well, better input and reorganize . This is what improves function, and often, appearance follows. We
Joanna Hess
Mar 27
Mind the Gap (Part 1): Diastasis Recti Abdominis
As curated social media images expand, stories of going from postpartum body to model abs are everywhere. They are compelling and hopeful. They are also incomplete. They do not reflect most experiences, and they do not answer many of the lingering questions about diastasis recti abdominis. What is diastasis recti abdominis and why do we care? Diastasis recti abdominis (DRA) is a widening between the two sides of the rectus abdominis, often called the six-pack muscle. This sep
Joanna Hess
Mar 24
Battle Wounds: Postpartum Scar Management (C-Section and Perineal Healing)
No one tells you that the pain of childbirth does not always end with that final push. It also does not matter whether you had a vaginal birth or a cesarean birth. If you are among the roughly 10% of people who delivered without tearing, we salute you and your fairy child. For the rest of us, here are practical, evidence-informed strategies for postpartum scar care. For many new parents, scars from delivery heal without intervention. However, in our clinic, we often see hype
Joanna Hess
Mar 24
The Art of Letting Go: Pelvic floor muscle down-training and relaxation
“Just relax” must rank as one of the most infuriating phrases in modern life. Relaxation sounds easy and does not require money or advanced degrees. And yet, when someone kindly tells us to “just relax,” our minds and bodies often ramp up, alerting even the highest achiever that not doing can be harder than doing. The pelvic floor relaxation addressed in this blog post relates to the treatment of overactive pelvic floor muscles . The goal is better described as pelvic floor d
Joanna Hess
Mar 23
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