Dr. Marena Boctor Nakhla – Laguna Hills

Pelvic organ prolapse (POP) is the descent of one or more organs such as the uterus, bladder, or rectum into the vaginal wall. It is most commonly referred to as herniation. 

Pelvic organ prolapse happens when the pelvic floor muscles are no longer able to support pelvic organs, resulting in a drop of the organs.

Types of prolapse: 

1. Cystocele is when the bladder bulges into the vaginal space. It can also be called anterior wall prolapse.
2. Recotcele happens when the rectum prolapse or herniates into the vaginal space. It can also be known as posterior vaginal prolapse.
3. Uterine prolapse is when the uterus bulges into the vaginal space and can be called anterior wall prolapse.

Now let’s talk about causes for prolapse.

Pelvic Organ Prolapse is mainly caused by pregnancy and vaginal childbirth. Pelvic organ prolapse happens when pelvic floor muscles (PFM) are weak and unable to support the organ. Pelvic floor muscles need to be strong to be able to support the weight of the fetus. After childbirth, pelvic floor muscle starts to fatigue and dysfunction starts to occur.

Prolapse risk factors include:

Laceration, tearing, or stretching can affect the integrity and function of the pelvic floor. Forcep or vacuum-assisted delivery increases the risk of pelvic floor injury.

Grades of pelvic organ prolapse:

Pelvic organ prolapse is rated on a scale of 0-4. Each grade specifies the intensity of the prolapse.

1. Stage 0 is absent or non
2. Stage 1: > 1 cm above hymen
3. Stage 2: 1 cm above or beyond the hymen
4. Stage 3: > 1 cm beyond hymen
5. Stage 4: complete eversion

Symptoms of pelvic organ prolapse 

The most common symptom of all types of vaginal prolapse is the sensation that tissues or structures in the vagina are out of place or feeling that something is coming down. You might also feel pressure or pain in the perineum. Some patients may also feel pelvic or abdominal pain.

Symptoms may be exacerbated with standing or bearing down with bowel movements.

Management of pelvic organ prolapse: 

1. Pelvic floor physical therapy to assess and treat pelvic floor muscle, core strengthening, stabilization exercises, and hip strengthening.
2. Avoid intra-abdominal pressure by managing constipation. Avoid bearing down.
3. Proper lifting mechanics. Always exhale while lifting heavy items.
4. Weight loss. Increased intra-abdominal pressure can increase prolapse.
5. Use of pessary. A pessary is a removable device placed into the vagina to aid in supporting pelvic organs.
6. Loose clothing and supportive garments. Avoid tight and fitted pants as they can increase intra-abdominal pressure.

Dr. Kristen Nelson — Laguna Niguel

Breathing is something we do every day without even thinking about it. It allows our bodies to replenish with oxygen, which is very important for every system. Breathing is also beneficial for mental clarity, better sleep, and reduces stress levels. However, we need to know if we are breathing properly and efficiently. Without proper breathing, we could potentially cause harm to our bodies. 

Proper Breathing Technique 

Even though it seems breathing should be a “no-brainer,” there is a proper way to breathe — called diaphragmatic breathing. Imagine that our bodies are like a balloon. As we inhale, our bellies should be expanding like a balloon, which causes our diaphragm to contract. As we exhale, our bodies should deflate like a balloon when our diaphragm relaxes. If we breathe from our chests, we are not breathing as efficiently and need to recruit our intercostal muscles (the muscles between our ribs) to assist us in breathing. One way to find out if we breathe from our chest or diaphragm is to lie on our back with one hand on our chest and the other on our stomach. Perform your regular breathing pattern and see which hand moves more; this can also be an exercise to teach ourselves how to breathe from our diaphragm.

Breathing and Exercise

When exercising, we sometimes forget to breathe and instead hold our breath. It is important to remember to breathe properly during exercise, especially when performing stressful movements, such as heavy weight lifting. When performing exercises with heavy resistance, individuals might tend to hold their breath which is called the Valsalva maneuver. If you have ever seen YouTube videos of individuals fainting after lifting heavy weights, it is most likely they were holding their breath to be able to perform the lift. Weightlifters faint because of a drop in blood pressure and a lack of oxygen to the brain. Breathing properly will allow for more oxygen and blood flow to our muscles and brain and avoid a drop in blood pressure when performing high resistance activities, which can help mitigate injury (i.e. fainting due to dizziness from holding your breath).

Another Type of Breathing Exercise

Not only is there diaphragmatic breathing, but there are other types of breathing techniques that are beneficial for individuals. One that I find to be helpful is “pursed-lip breathing.” This type of breathing can assist with activities such as lifting and bending. It is a technique to control and slow down our breathing patterns. Start in a relaxed position, such as sitting down in a comfortable chair. Next, start breathing slowly through your nose for a count of two. Then you want to purse your lips like you are blowing out through straw or trying to blow out a candle slowly. This slow exhalation should occur for a count of four. Perform this for a cycle of 5 breaths.

Take Away 

As we go about our daily lives, it is good to stop and check ourselves to see how we are doing with our breathing. Even though many of us have difficulty finding the time to check on our breathing, it only takes a minute to sit in a comfortable spot and focus on our breathing. Our physical and mental health will thank us for taking the time to check in with ourselves.

Jennifer Carman – Laguna Hills

In my 20+ years as a Physical Therapist, I have come across individuals who were displeased with their previous physical therapy experiences. They reported that physical therapy did not work for them, and they did not see any functional improvement. When I inquired about the details of their experience, I realized that although the service they received was called “physical therapy,” it was, in fact, not skilled rehabilitative physical therapy. I responded with, “That was NOT Physical Therapy!”

Physical Therapy ISN’T…

The following is what Physical Therapy IS NOT:

• A quick patient assessment based solely on the treating diagnosis — followed by a cookie-cutter treatment plan for that diagnosis.
• Seeing the treating physical therapist only on the initial evaluation day and never seeing them again during any follow-up visits.
• The only hands-on treatment is placing a pre-treatment hot pack followed by a general massage.
• Unsupervised exercises in the corner table.
• Leaving the PT clinic with more pain and having made no progress.

Physical Therapy produces results when skilled, knowledgeable, individualized evaluation and hands-on treatment occur. We are proud to provide integrative, personalized, excellent, caring physical therapy.

Physical Therapy IS…

The following is what Physical Therapy IS:

• 60-minute evaluation and patient assessment including thorough patient history; evaluating patient posture, strength, range of motion, flexibility, nerve function, gait mechanics, mobility, stability; observation of performance, movement. and specific recreational/vocational activities. The Physical Therapist creates a plan of care, and treatment plan, for each individual to address their specific impairments, dysfunction, and goals — based on what they find.
• Every treatment visit following the initial evaluation consists of one-on-one time with the Physical Therapist, whereby the PT reassesses progress and goals. Treatment includes hands-on manual techniques, passive range of motion, joint mobilization, myofascial release, pain modalities, muscle reeducation and stabilization, balance/ posture/ gait training, movement analysis as needed, and relevant to patient diagnosis and presentation.
• Treatment continues with therapeutic exercises chosen by the PT specifically for the individual patient, based on their goals and presentation. A physical therapy aide trained to instruct and observe proper exercise techniques supervises each exercise session.
• PT treatment frequency and duration vary based on progress; usually, the patient will attend PT 1-3 treatments per week, times 4-8 weeks; as needed and medically necessary.
• Each patient receives an individualized home exercise program to promote healing and functional progress.

Your Physical Therapy experience is our utmost priority. We are committed to your success. If you think you have had a previous unsuccessful Physical Therapy experience and are currently in pain or limited by pain or dysfunction, consider Physical Therapy with us. We accept Direct Access, which means a doctor referral or prescription is not required. 

We hope to see you soon so you can get back to your best life!

Start your journey to recovery today — (949) 597-0007. Don’t forget to join us on our Facebook page.

What comes to your mind when you think of a healthy snack? You probably thought of fruits, yogurt, and cereal bars, right? So it’s time for you to try something new. Smoothies are refreshing, easy to prepare, versatile, and nutritious. Check out Dr. Danielle’s secret smoothie recipes to inspire your next break.

By: Dr. Danielle Fleming

In my opinion, any time is a perfect time to whip up some smoothies (or bowls) for a cooling delicious meal, snack, or dessert.

Smoothies are great in many ways. Yes, they can be cool and refreshing (although I’ve been known to eat them in winter months, too), and they are extremely versatile. You can throw whatever you want in a blender, really! Smoothies can also be helpful for sneaking in plenty of fruits and vegetables and protein, and for gaining or losing weight depending on how you prepare them! They are also easy to meal prep, they’re portable, and they may be easier on your digestive system vs. solid foods. Frozen fruits and veggies are great, and affordable options for your smoothies!

As I mentioned, feel free to experiment with your smoothie recipes! The ones I have here are just some frameworks for ones I like! I also like to add protein powder to my smoothies (some of my favorites are Nuzest. Truvani, and Orgain).

Keep in mind, to keep the sugars (carbs) from fruits in check, balance with veggies! You can of course do all veggie smoothies, too!

• Acerola Cherry & Peach

  1. 1 frozen acerola cherry puree packet (can be found at grocery stores like Trader Joe’s)
  2. 1 cup frozen peaches
  3. ½ frozen banana (frozen into coins is easier to blend, or fresh + ice cubes)
  4. 1 cup frozen riced cauliflower
  5. 1 scoop protein powder (I like vanilla)
  6. 1 tablespoon flaxseed
  7. Liquid (plant milk, water, etc.) as needed for consistency

• Berry Berry Green

  1. 1 cup frozen blueberries
  2. 1 frozen acai puree packet (or sub with 1 cup frozen raspberries)
  3. ½ cup frozen blackberries
  4. Big handful(s) of dark greens like kale or spinach
  5. 1 scoop of protein powder
  6. 1 tablespoon chia seeds
  7. Liquid as needed for consistency

• Sunny Orange

  1. 1 frozen orange (peel, dice, freeze)
  2. 1 cup frozen papaya (peel, dice, freeze)
  3. ½ cup frozen pineapple
  4. 1-2 cups frozen riced cauliflower
  5. ½ cup frozen sweet potato (steamed, diced, frozen)
  6. 1 tablespoon hemp seeds
  7. Liquid as needed for consistency

• Veg’d Out

  1. Handful spinach (can be chopped, frozen, or fresh)
  2. Handful kale (can be chopped, frozen, or fresh)
  3. 1 teaspoon green spirulina
  4. 1 cup frozen cucumber
  5. 1 cup frozen cauliflower
  6. A scoop of protein powder
  7. 1 tablespoon nut butter (choose raw versions — I like almond butter or Sunbutter)
  8. Liquid as needed for consistency
  9. *If you want some fruit, green apple, banana, or pineapple would go well!

For all of these, just throw in a blender and blast until smooth! 

Comment on some of your favorite smoothie experiments!

Disclaimer — All the information that you find on our blogs and social media pages is for informational purposes only and is not intended to be used as your personal professional diagnosis, or treatment. Come and see us for your excellent, personalized care! https://staging.rauschpt.net/

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Dr. Danielle Fleming, PT, DPT, CSCS, Pn1

daniellef@rauschpt.net 

Dr. Danielle, our “Wellness PT” is a certified nutrition and wellness coach, and promotes a holistic approach to health. Let’s talk! We are here to help. Give us a call at (949) 276-5401 for a complimentary consultation. We would love to meet you.

There’s no prescription needed from a doctor to see us, but we will communicate your progress and treatment to your doctor — if you’d like us too! 

If living a happier and healthier life in 2022 was one of your New Year’s resolutions, this article is for you! Dr. Danielle Fleming has gathered life-hacks shared by the people from the healthiest areas of the world.

By: Dr. Danielle Fleming

History of Blue Zones – Blue Zones

Have you heard people talk about Blue Zone populations? Wondering what and where they are, and what makes them so special?! I have answers!

Blue Zones is a trademarked term – dubbed by Dan Buettner – identifying world regions with the longest-living, healthiest populations. These are the populations with the most centenarians. People here tend to live happier, more fulfilled lives, too. Yay! 

There are five Blue Zones around the world: Okinawa, Japan; Loma Linda, California, USA; Sardinia, Italy; Icaria, Greece; and Nicoya, Costa Rica. Dan and his team found that people in these areas share several common lifestyle factors that contribute to their longevity and health. 

These 9 common factors are:

1. Moving naturally and often 
2. Knowing their purpose in life
3. “Down shifting” i.e. de-stressing activities 
4. 80% rule (stop eating at 80% full and don’t eat late at night)
5. Plant-based diets with minimal meat
6. Light-moderate wine drinking frequently (but not heavy binging)
7. Belonging to any kind of faith-based community
8. Prioritizing family ties
9. Being surrounded by the right people that promote healthy lifestyles

I’m sure many of us want to live long, thriving lives in every aspect (thriving vs surviving). Drawing inspiration from the Blue Zone populations could help us do that, so knowing and implementing these factors is a first step! 

Think about which ones you need more of in your life, and actions to take based on that.

Like for me, I am working on surrounding myself (and BEING ONE) with people that promote the lifestyle and goals I am looking for (#9) so I can #levelup and continue to grow.

Additionally, The Blue Zones organization has lead to further research and movements related to promoting health and longevity. For example, my friends gifted me The Blue Zones Kitchen cookbook (I need to utilize it more!), which contains all kinds of healthy recipes based off of the research around what people in the Blue Zones typically eat. My friends made me the Minestrone Soup from Sardinia (enjoyed with red wine) and…BAM!

Let’s point out some of these recipes – you may find some new faves or get the book yourself for more!

Sardinia:

• Minestrone 3 Ways – Minestrone with Fennel and Wild Garlic
  Beans, chickpeas, fava beans, lentils, potatoes, onion, celery, garlic, fennel, pasta, chard, squash, tomatoes
• Cabbage and Sun-Dried Tomato Saute
  Sun-dried tomatoes, cabbage, green onions, sweet onion, EVOO
• Spaghetti with Walnut Pesto
  Walnuts, spaghetti, garlic, parsley, EVOO, salt
• Sardinian-Style Pizza
  Garlic, EVOO, tomatoes, basil, veggie broth, pane carasau bread (or pitas), optional pecorino cheese

Okinawa: 

• Sweet and Spicy Carrot Medley
  Carrots, onion, sesame oil, dashi or veggie broth, chili paste or red pepper flakes, mirin
• Sweet Potato and Onion Hash
  White sweet potatoes, onion, carrots, oil, dashi broth, scallions, soy sauce
• Iced Banapple Tumeric Smoothie
  Banana, apple, turmeric, soy milk, ice
• Savory Rice Porridge
  White rice, miso, dark green leafy greens, dashi broth

Nicoya:

• Veggie Hash with Corn and Onions
  Chayote squash, corn, red or yellow peppers, onion, cilantro, celery, garlic, cilantro coyote, achiote paste
• Fried Green Plantains
  Plantains, veggie oil
• Bean Soup Three Ways – Black Bean and Potato Soup
  Chayote squash, carrot, potatoes, culantro coyote, onion, garlic, veggie stock, black beans
• Horchata:
  Rice, water, cinnamon, nutmeg, sugar

Icaria:

• Winter Potato Salad
  Potatoes, dill, EVOO, red wine vinegar, arugula, spinach, onion, romaine, radish
• Hummus With Parsley
  Chickpeas, garlic, EVOO, red wine vinegar, parsley
• Honey Cookies
  Orange juice, honey, lemon, vanilla, cognac/rum, EVOO, flour, cloves, cinnamon, nutmeg
• Tomato Pasta Soup
  Veggie broth, tomato, tomato sauce, EVOO, orzo/pasta

Loma Linda:

• Longevity Smoothie Bowl
  Almond milk, banana, blue/blackberries, kale, spinach, almond butter, flax, turmeric, cinnamon – toppings!
• Quick Cornbread
  Flax, cornmeal, flour, soy milk, applesauce, oil, maple syrup, vanilla, corn
• Veggie No-Meat Balls
  Chickpeas, garlic, bread crumbs, oregano, basil, spices
• Coconut Chia Pudding
  Coconut cream, coconut milk, agave, lemon zest, chia seeds

Which ones sound good to you?! I know healthy cookies, pizza, and horchata sound YUMMY to me! Share with your buddies and get cooking!

Disclaimer — All the information that you find on our blogs and social media pages is for informational purposes only and is not intended to be used as your personal professional diagnosis, or treatment. Come and see us for your excellent, personalized care! https://staging.rauschpt.net/

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Reference:

History of Blue Zones – Blue Zones

The Blue Zones Kitchen: 100 Recipes to Live to 100 – Dan Buettner 

Dr. Danielle Fleming, PT, DPT, CSCS, Pn1

daniellef@rauschpt.net 

Dr. Danielle, our “Wellness PT” is a certified nutrition and wellness coach, and promotes a holistic approach to health. Let’s talk! We are here to help. Give us a call for a complimentary consultation. We would love to meet you.

Did you know there’s no prescription needed from a doctor to see us – but we will communicate your progress and treatment to your doctor if you’d like us too! 

(949) 276-5401