Newsletter & Blog

Helping Reflux with Physical Therapy and Dietary Changes

‬There are 2 types of reflux that patients suffer from. Laryngopharyngeal reflux (or LPR) is when stomach acid comes up into the throat. A common treatment for this is a proton pump inhibitor oral medication. Gastroesophageal reflux or GERD involves a backup of stomach acid into the lower esophagus. We treat GERD and LPR via visceral manipulation, spinal joint mobilization, corrective breathing pattern techniques, and other advanced manual therapies. Here we are performing a manual release technique of the lesser curvature of the stomach. This patient has decreased mobility and motilit[...]

Retraining the Pelvic Floor Muscles in a Post-Partum Patient who is Training as a Pilates Instructor

Here we are using Rehabilitative Real-Time Ultrasound to help our patient downtrain the dominant use of her transversus abdominus muscle (a lower abdominal muscle). Many people who perform Pilates learn to overuse their lower abdominals instead of utilizing their pelvic floor muscles. The overuse of abdominal muscles during a pelvic floor contraction can create a downward force on the bladder. This is counterproductive because the pelvic floor contraction is to gain support of the bladder in an elevation pattern. The pelvic floor needs to contract in an “elevator fashion” upwards or cranially [...]

Pelvic Physical Therapy for the Transgender Patient

Our practice has been helping the transgender patient overcome pelvic pain and other symptoms they have due to transitioning surgeries. Dr. Morrison was the first physical therapist in the US to lecture nationally on the topic of physical therapy for the male to female transgender patient. She presented the surgeries they undergo, the overall costs, healing process, medications, post-operative pelvic pain issues, and how best to provide comprehensive care at the American Physical Therapy Association Meeting in 2012. Her audience included pelvic floor physical therapists predominantly. She also[...]

Sacrotuberous Ligament Release to Help Prepare for Labor and Delivery

The sacrotuberous ligament is a structure that is under-recognized as important to assess and treat during pregnancy. The ligament runs from the sacrum to the ischial tuberosity and has connections into the tailbone and hamstrings muscles via connective tissue. It crosses posterior to the sacrospinous ligament creating an "x" or "t" depending on orientation.When taut the sacrotuberous ligament can cause the pelvis to become posteriorly rotated, cause tension in the same side pelvic floor muscles, inhibit needed coccyx or tailbone mobility for birth, be a source low back pain, and delay or prev[...]

Patient with Pelvic Pain and Constipation Presents with Possible Fracture

Our elderly patient, who is an avid bike rider in NYC, reported having a bike crash and got up to continue riding a few days ago. Instead of starting treatment to help her with her chronic constipation via pelvic rehab as planned, we put on our athletic training hats and proceeded to evaluate this contusion. We held off on sEMG biofeedback, visceral mobilization, intestinal massage, and pelvic floor muscle rehab to assess her limb. Ruling out a possible fracture began: Fractures present with deformity, swelling, black and blue (ecchymosis), and pain. She was fully weight bearing and not antalg[...]

Sacroiliac Joint Taping

Patients with unabating or chronic low back pain sometimes have sacroiliac joint misalignment. This patient has been dealing with a pelvic organ prolapse since delivery of her daughter 5 years ago and has been seeing another PT for her chronic low back pain. She comes to us from out of state for our expertise. Her evaluation revealed a sacral torsion or rotation (misalignment) to the left, pelvic floor muscle weakness, Grade 2+ cystocele, anterior innominate rotation right sided, generalized weakness/deconditioned and true hypermobility syndrome. We have used manual therapy techniques to i[...]

Diastasis Rectus Abdominus in Men with Concurrent Umbilical Hernia

Rectus Abdominus Diastasis (RAD) is a separation of the linea alba, greater than 2 centimeters is considered abnormal. The linea alba is a thick connective tissue that connects the two rectus abdominus muscles together, down the center. With RAD a separation of the abdominal wall occurs because of stretch or sealing of the linea alba. Diastasis rectus abdominus is commonly seen in women during and after pregnancy, in overly fit men and women who focus on excessive abdominal strengthening, and in adults who are overweight with abdominal central obesity. In this image we are evaluating a 40 [...]

Round Ligament Pain in Pregnancy

Pregnant women may complain of lower abdominal, pelvic, groin, hip, or pubic pain. A common cause of this may very well be the stretch sensation of the round ligament which can provoke pain in these areas. The round ligaments are two of the suspensory ligaments of the uterus (there's one on each side). It originates at the lateral wall of the uterus on either side, passes through the inguinal canal, and inserts into the mons and pubic symphysis. As the baby and uterus grows and lengthens so must the suspensory ligaments. The round ligament is initially about 2 inches in length and can stretch [...]

Using Rapid Release Technology To Treat Chronic Pelvic Pain

We sometimes use this device to apply mild heat and vibration to help relax the muscles. Using small strokes at high frequency this device can induce relaxation of the painful muscle rapidly. It has several different treatment "heads" designed for either treating bony contours, myofascial trigger points, or larger muscle bellies. In this image we are utilizing the Rapid Release on the hip adductors. This is a large inner thigh muscle group comprised of 5 muscles: the pectineus, adductor magnus, brevity, longus, and gracilis. There is a shared connection with the obturator externus. Thi[...]

Dr. Morrison Lectures on Labor & Delivery

In this photograph Dr. Morrison is giving an in-house lecture to the staff, and community childbirth practitioners, on manual physical therapy for improving pelvic alignment and mobility for labor and delivery. Addressing imbalanced pelvic joints, pelvic and uterine ligaments, hip and lumbopelvic muscles can help improve pelvic balance and allow for the baby to move to an optimal position for successful vaginal delivery. We evaluate to see which combination of techniques - massage, joint mobilization, muscle energy techniques, strain/counterstrain, positional releases, neuromuscular re-educati[...]