Painful Sex, Vaginal Pain: Q & A with a Medical Doctor
Painful sex is a problem for more women than you think. Some women fake sexual pleasure to please their men, but other times, the pain during sex is so agonizing that these women avoid sex at all costs.
When women don’t know why they have painful sex, they are more apt to believe the problem is “all in their head.”
But painful sex is a real problem that’s in the genital area, NOT a woman’s head.
If you suffer from painful sex, it has a name: DYSPAREUNIA, of which vestibular vulvodynia is a possible cause.
Vestibular vulvodynia describes a condition that afflicts many women in varying degrees.
The degree of pain during sex can vary, from minor discomfort to excruciating.
In fact, in severe cases of painful sex, the pain has been described as feeling like a steak knife is being jammed through the vaginal entrance. In severe cases of vestibular vulvodynia, sexual relations are not possible.
I asked an expert a number of questions about vestibular vulvodynia: Adelaide G. Nardone, MD, OB/GYN, Medical Advisor to the Vagisil Women’s Health Center; Providence, Rhode Island.
Just what is VV?
Vulvodynia is a condition of chronic pain and discomfort in the vulvar area. It is considered to be a pain disorder and the exact etiology (cause) is unknown.
It has been associated with a prior history of certain conditions such as chronic yeast infections, allergic reactions, low estrogen levels, trauma or injury to the vulvar area, and even genetic factors and sexual abuse.
Why is it so painful?
While the exact cause of the pain is unknown, there are theories that women with this problem have suffered some type of nerve damage to the sensory nerves in this area, which results in chronic and sometimes debilitating pain.
It may also be possible that they have developed a state of “hypersensitivity” from prior insults such as chronic infections or allergic reactions.
Vulvodynia is also reported in postmenopausal women, so there may be some link to low estrogen levels as well.
Whatever the cause, it is real pain for these women and has real impact on their overall quality of life.
Can VV be so painful, that it outright prevents a woman from having sex?
Vulvodynia is often so painful that it prohibits women from enjoying a healthy sexual relationship.
Many women can no longer engage in any sexual activity because mere contact with that area results in excruciating pain. This has been and continues to be a major quality of life issue for VV sufferers.
Furthermore, many of these women cannot engage in regular exercise, they cannot use tampons, they cannot wear certain clothing, etc.
Many women refrain from openly discussing this delicate issue with others, so they often feel isolated, “different” and may even suffer with depression.
One step in the diagnosis of VV is the “Q-tip” test. This is a simple procedure done in a doctor’s office whereby a Q-tip is gently applied to the vulvar area. This alone is enough to provoke “pain” in these patients.
The doctor may then go onto “mapping” the pain and its intensity. This test also helps to distinguish if the patient has generalized VV or localized VV, which is referred to as vulvar vestibulitis syndrome.
How do patients describe this pain? Men have a difficult time understanding that even a lubricant and painkillers won’t help.
This is a chronic pain disorder with no known cause and no known cure. The pain is described in many ways, but the most common is: a burning pain.
Other descriptions include: stinging, rawness, aching, throbbing and sometimes itching.
Whatever perception of pain women may have from VV, it is certainly not easily remedied.
Is it possible that vestibular pain can be all in a woman’s head, perhaps from past sexual abuse?
The psychological and emotional affects that sexual abuse have on women are varied and far reaching.
There are cases of vulvodynia where a prior history of sexual abuse is notable.
However, sexual abuse is also associated with some aspects of sexual dysfunction such as dyspareunia (painful intercourse) and vaginismus (strong muscular spasms of the pelvic muscles with sex often preventing penetration and vaginal intercourse).
Is VV necessarily something that a woman has always had, since childhood (i.e., first becoming aware of it at age 13 when attempting to insert a tampon); or, can it sometimes just develop when she’s an adult?
VV can occur in women beginning with the teenage years. However, it is more common in women after the third decade of life and more so in the postmenopausal years.
Are there known treatments?
Just as there is no known cause to VV, there is no known cure. Here are some precautions and prevention:
Avoid harsh soaps, detergents, shampoos and chemicals on the vulva area.
Use cotton-lined undergarments and loose-fitting clothing Avoid scented and fragranced sanitary products.
Dr. Nardone received her medical degree from New York Medical College and has been in practice as an OBGYN for more than 20 years.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/siam.pukkato
Birth Control Pills: Blood Clot Risk in Nonsmoking Women?
Women who don’t smoke take birth controls, and so do women who smoke–and they have a higher blood clot risk.
However, nonsmoking women are STILL at an increased risk for a blood clot simply due to the birth control pills.
You’ve often heard that birth control pills raise blood clot risk in women who smoke.
But what about blood clot risk in nonsmoking women who use birth control pills?
I wondered about this and asked Randy Fink, MD, Director of the Center of Excellence for Obstetrics & Gynecology in Miami, FL. I assumed that something inherent in the birth control pills raised blood clot risk for any female, smoking or nonsmoking.
Dr. Fink explains: “Deep vein thrombosis and pulmonary embolus – a blood clot that travels to the lungs – are called thromboembolic events. Consider the rate of blood clots in women who are not on hormonal birth control.
“The common estimate is that it happens in 5 to 10 cases per 100,000 woman-years. {A more recent study even suggests it happens much more frequently: 50 to 100 cases per 100,000 woman-years.}
“On hormonal birth control, a clotting complication is said to occur in 20 to 30 cases per 100,000 woman-years. This is clearly higher than the 5-10 per 100,000 for women not on birth control.
“So, while the increase may seem frightening, the risk of these same clotting complications occurring during pregnancy is 60-96 per 100,000. During the postpartum period, it is 511 per 100,000 woman-years!”
Why is the blood clot risk so much higher postpartum?
“Pregnancy and the postpartum are associated with the classic risk triad for blood clots. First, blood ‘stagnates.’ Pregnancy changes the flexibility of blood vessels by making them swollen.
The pregnant uterus sits on and compresses the giant blood vessel that is the final pipe leading to the heart (the vena cava) from all the smaller veins. Blood therefore tends to pool.
“The swollen vessels sustain temporary damage, which is the second factor: injury to the muscular walls of these vessels. Finally, pregnancy itself is a hypercoagulable state.
There is a natural increase in several clotting factors, and a decrease in function of the systems our bodies use to break down clots.
A good explanation for this is so that the body does not form small clots that decrease the flow of blood (thus oxygen & nutrition) to the placenta & the baby.
“So, while birth control is not without risk (for blood clots), the risk of pregnancy itself is clearly much higher. Thus, hormonal birth control is said to be a safe way to avoid an unintended pregnancy.”
If, despite being a nonsmoker, you’re still concerned about blood clots because you are taking birth control pills, you can significantly lower risk of blood clots by:
1) exercising daily and including sessions of intense exercise several times/week, 2) ensuring your blood pressure is normal, 3) managing stress and 4) eating a plant-based diet.
Creating an environment where the very best of medicine and gentle gynecology are practiced and where patients come first has always been Dr. Fink’s goal.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Top image: Freepik
Painful Sex in Women: Vaginal Trigger Point Therapy May Help
Vaginal trigger point therapy can treat painful sex in women.
Painful sex for women has multiple causes. Sometimes, the pain during sex in women can be relieved by adding a vaginal lubricant, and prolonging foreplay to trigger more natural lubrication.
On the other hand, numerous conditions can cause a woman to experience painful sex.
A woman can have any one of these painful sex conditions, and yet benefit from a therapy called vaginal trigger point.
For this article I asked Randy Fink, MD, Director of the Center of Excellence for Obstetrics & Gynecology in Miami, FL, about just how effective vaginal trigger point therapy is for women who have pain during sex.
Dr. Fink says yes, vaginal trigger point therapy can help reduce pain during sex. He explains:
“Trigger point injections use a type of long-acting local anesthetic, sometimes combined with an anti-inflammatory such as a steroid, to alter the function of the nerves that contribute to certain types of pain syndromes.
“This is best described for women in one called Myofascial Pelvic Pain Syndrome (MPPS).
“The pain may occur in the pelvis, vagina, vulva, rectum, or bladder, or in more distant referral areas such as the thighs, buttocks, or lower abdomen.
“Commonly associated symptoms include a sense of aching, heaviness, or burning in these areas, sometimes with symptoms of overactive bladder, constipation, or painful sex.
Many experts believe that many, if not most, women with chronic pelvic pain have some degree of MPPS.”
How long do the vaginal trigger point therapy injections last?
“Anywhere from a few hours, to a few months, depending on what is being treated,” says Dr. Fink.
“Injections including local anesthesia and a steroid were studied in women with myofascial pelvic pain, and 72% still had relief at three months.”
Exactly where is the injection made?
“This depends on where the pain actually is. In the case of vulvodynia, they are made in and around the vulva, with specific focus on the pudendal nerve (4 and 8 o’clock positions).”
About how many injections?
“Again, depends, But usually 4-8.”
Is this therapy effective with vestibular vulvodynia?
“Can be. See above.”
Vestibular vulvodynia can cause significant pain during sex, as well as when anything is inserted into a woman’s vaginal orifice, such as a tampon, birth control device or even a swab for a Pap smear.
Additional Causes of Painful Sex for a Woman
• Injury to vagina or vulva from giving birth
• Sexually transmitted disease
• Menopause causing a dry vaginal lining
• Pelvic inflammatory disease
• Ovarian cysts
• Endometriosis
• Uterine fibroids
• Cervical infections
• Vaginal infections
• Vaginismus, which is when the vaginal muscles go into spasm due to a woman’s anxiety over sex or a Pap smear.
Creating an environment where the very best of medicine and gentle gynecology are practiced and where patients come first has always been Dr. Fink’s goal.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik
Can Women with Very Small Breasts Get a Mammogram?
Is a mammogram possible for women with very small breasts?
Very small breasts and the mammogram: If you’re a woman who’s approaching the age at which it would be a wise idea to start getting a mammogram, and — if you just happen to have very small breasts, you might be wondering if it’s even possible to have this procedure done.
After all, perhaps you’ve seen photos or videos of the mammogram procedure, in which a woman’s breast is literally set atop a platform while she stands, and then the equipment is clamped down upon her breast, compressing it, almost like a vice.
How can this be possible if a woman’s breasts are so small that it’d seem that there’s not enough tissue to set atop the platform and then compress?
I had very small breasts, so I know what it’s like to have a mammogram.
Ultimately I chose to have an elective, prophylactic double mastectomy after learning my sister had breast cancer, but up to that point, I’d been very experienced with undergoing mammograms.
It’s not the easiest thing in the world for the technician to position very small breasts for an accurate reading by the machine.
My size was what I called “sub-A,” meaning, I don’t quite fill an A cup.
Thus, there is nothing for the technician to easily grab onto and place atop the platform. However, it can be done.
“Mammograms are meant for women and men of all breast sizes,” says Anjali Malik, MD, a board certified diagnostic radiologist with Washington Radiology in Washington, DC. She interprets mammograms, breast MRIs and ultrasounds, and performs biopsies.
“That’s right, I said men,” continues Dr. Malik. “While the average man has predominantly fatty breast tissue with more pectoralis musculature, they are still eligible for and able to undergo mammography.”
Man undergoing a mammogram.
The procedure will take a little longer than it will for a patient who has larger breasts that can be taken in the hand of the technician and literally placed, like a water balloon, on top of the platform.
More than once, the technician has had to make several adjustments for each of my breasts before finally taking the image.
If you have a very small chest, don’t let that stop you from getting a mammogram. Don’t assume that it can’t be done or that it’s not worth it.
I’ll be honest about something: It’s not comfortable. The impression I got from the technician was that the compression was more pronounced because of the size of my chest.
However, the compression will not injure you or increase the risk of cancer.
It may hurt quite a bit, but it’s harmless and won’t damage your body in any way.
“A new mammogram stabilization system from Hologic called the SmartCurveTM is designed to have a curve simulating that of the breast, and offers a more comfortable experience for some women and breast shapes,” says Dr. Malik.
“For women who have physical limitations due to chest, breast or shoulder surgeries; congenital deformities of the rib cage called pectus excavatum or pectus carinatum; or for other physical limitations or some patients who are wheelchair-bound — positioning of the mammograms might be technically challenging, and the images may be suboptimal.
“For these women, a combination of mammogram and ultrasound may be offered for complete annual screening surveillance.”
Dr. Malik is a frequent public speaker and advocate for breast health awareness. She has lectured on the latest advances in breast cancer screening including 3D Mammography™. Follow her on Instagram: @AnjaliMalikMD
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Can Prenatal Vitamins Benefit a Non-Pregnant Woman?
Does a woman need to be pregnant in order to benefit from prenatal vitamins, or is the “prenatal” just a marketing gimmick to get pregnant women to buy them?
Well, I posed these questions to Randy Fink, MD, Director of the Center of Excellence for Obstetrics & Gynecology in Miami, FL.
Dr. Fink explains, “Prenatals can be taken when not pregnant, though they are not formulated for the recommended daily allowances (RDA) as are multivitamins.
“So yes, there is a difference. Is it enough of a difference to matter to most women?
“There is no harm in taking a prenatal vitamin when not pregnant for most women with normal nutrition, but pregnant women should stick with a vitamin called a ‘prenatal.’”
Dr. Fink adds that there should be other considerations when shopping around for supplements. A more expensive supplement is not necessarily superior to a cheaper one.
- Read the ingredients on the back of supplement bottles.
- For example, some supplements contain soy.
- Vitamins targeted at children typically contain artificial color and artificial flavor.
Dr. Fink says that there don’t exist studies that show one product to be superior to another, however.
He explains, “The more important issue is what you tolerate; some vitamins are coated, some have a stool softener, some have an aftertaste.”
Also be alert to the dosage that’s listed on the front of the bottle.
As for the best time to take prenatals?
Dr. Fink says that no data is available to confirm best specific times for taking the supplements.
Nevertheless, he does explain, “A prenatal vitamin can be taken at any time of the day, and either with or without food.
“However, sometimes the vitamin can cause stomach upset. This may be particularly true during the first trimester, when nausea and vomiting are more common.
“Even still, as the baby grows and increases upward pressure on mom’s stomach, mom may be more prone to acid indigestion.”
A pregnant woman, regardless of how far along she is, may still experience disagreement with a supplement.
Dr. Fink advises that if a supplement upsets a pregnant woman’s stomach, she should take it at night.
To reduce risk of heartburn after taking supplements at night, a woman should prop her head up with more than one pillow when she sleeps.
On the other hand, if there is no stomach upset, a pregnant woman may choose to consistently take her prenatal vitamins as part of her morning ritual so that she doesn’t forget.
Lay the vitamins out before bedtime, so that they are ready to take come morning.
Creating an environment where the very best of medicine and gentle gynecology are practiced and where patients come first has always been Dr. Fink’s goal.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/popovartem
Are Hoarding and Obesity Linked? Can Hoarders Self-Treat?
Is there a link between hoarding and obesity?
Seems that most, if not all, hoarders are obese; you may have drawn this conclusion after seeing TLC’s “Hoarders: Buried Alive,” or even mere previews to this reality show.
I’ve also seen hoarders on Animal Planet’s various animal cops shows, and they are all notably overweight.
This isn’t to say I’ve never seen a hoarder who wasn’t obese or overweight, but weight problems sure seem quite common among hoarders.
“We do have some evidence of overweight in our hoarding sample drawn from an internet study,” says Gail Steketee, PhD, Dean and Professor, Dean Emerita and Professor Emerita, Boston University School of Social Work, and co-author of “Stuff: Compulsive Hoarding and the Meaning of Things.”
“However, we know almost nothing about whether these are related to each other (hoarding and obesity), or whether hoarding is related to more general health problems, or both are connected through a third variable we don’t yet understand.”
I have never seen a hoarder who looked like a gym rat, and this includes the few I’ve seen on TV who would not be classified as overweight.
Despite not being obese or overweight, the smaller hoarder nevertheless appears to be in dismal physical condition.
Do you wonder what percentage of hoarders, obese or not, work out?
It would be interesting to know how effective an exercise program would be in treating this compulsive behavior.
Another issue that I have wondered about is whether or not such an individual can treat the condition on his own, that is, become so sick of it one day that he or she decides to do something about it — without any intervention.
I’ve read about people with anorexia nervosa and bulimia who treated their conditions successfully without intervention.
There are also former drug users who one day awakened to realize that they couldn’t keep going on like that, and outright quit drugs cold turkey.
Can a person quit collecting junk, garbage and used items cold turkey, or at least employ a taper-down strategy (gradually discarding the clutter) of self-treatment?
Dr. Steketee explains, “I’m sure it is possible but it seems to be pretty rare. Of course, people who fix their own problems are not featured on TV, as there is nothing to show, and they don’t show up in our treatment clinics because they don’t need us, so we wouldn’t meet these people in the course of our work.
“It’s important to consider what we are not seeing and whether it might be there, but simply unknown to us.”
So if there are people out there who used to be hoarders, especially if they’ve always lived alone, it’s quite possible that at some point, a rude awakening inspired them to do away with all the clutter, whether it was over a short period of time or a longer timeline.
As for the obesity issue being linked to hoarding, more research is needed.
Dr. Steketee has conducted research not only in the assessment and treatment of hoarding disorder, but also cognitive and behavioral treatments for anxiety disorders, obsessive compulsive disorder and body dysmorphic disorder.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
Can Anxiety Lead to Gum Disease?
The link between anxiety and stress to gum (periodontal) disease is nothing to ignore.
Watch that anxiety: It can cause bad gums. Even the stress of loneliness can cause gum (periodontal) disease, says a study.
The study, though, doesn’t provide a conclusive, definitive relationship between stress, anxiety and gum disease.
However, study author Daiane Peruzzo, PhD, says: “More research is needed to determine the definitive relationship between stress and periodontal diseases. However, patients who minimize stress may be at less risk for periodontal diseases.”
How is it that stress and gum disease can be connected?
The suspect is cortisol, the “stress” hormone that promotes fat storage in the belly.
Another way to look at this, though, is a secondary effect of stress and anxiety on the gums.
People suffering from chronic anxiety are more apt to do things that are harmful to the gums, such as smoke, drink and neglect good oral hygiene.
“Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep, and maintaining a positive mental attitude,” says Preston D. Miller, Jr., DDS, and President of the American Academy of Periodontology.
In short, the link between periodontal problems and chronic stress may not necessarily be causative, but rather, associative.
Stressed out people often do not exercise regularly. Exercise has a suppressive effect on cortisol production.
When we are under emotional stress, cortisol levels increase.
This is part of the body’s “fight or flee” response to an environmental stressor.
This physiological reaction is designed to help us deal with perceived threats or stressors by preparing the body for immediate action.
Cortisol, a hormone produced by the adrenal glands, increases glucose availability for energy, enhancing the brain’s use of glucose, and curbing non-essential functions that might be detrimental during a crisis.
This response is beneficial in short-term stressful situations; however, prolonged or chronic stress can lead to consistently high levels of cortisol.
Over time, elevated cortisol can negatively affect various aspects of health, including immune function, metabolism and mood, potentially leading to conditions such as hypertension, weight gain and anxiety disorders.
Problem is, modern-day men and women don’t fight or flee when faced with anxiety, because the source of stress or anxiety is not something that a person can readily physically fight off, such as one’s boss at the workplace; being trapped in rush-hour traffic; waiting endlessly in a slow-moving line; etc.
Nor can someone flee from the workplace in a blaze of physical prowess, like ancient man did when faced with the stress of a wild predatory animal or impending thunderstorm.
So what we have here are chronically elevated levels of cortisol.
The physical exertion required in a “flight or flee” response is intense enough to subdue the cortisol.
But again, industrialized man does not fight or flee from stress; he remains immobile! (trapped in office cubicle, car, crowded elevator, board meeting, doctor’s waiting room, etc.)
Over time, the elevated cortisol can damage the gums.
So what can we do about this elevated cortisol?
Hit the gym! Intense exercise fights against elevated levels of cortisol, and like Dr. Miller says, exercise is one way to help stave off gum disease.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik
Source: sciencedaily.com/releases/2007/08/070808132009.htm
Why Do Depressed People Want to Get Off Antidepressants ?
Some people know their depression will come back–or take that chance, anyways–if they stop taking their antidepressant.
So why would they want to do this and take that risk?
Many people are curious why someone with a disabling depression, that’s actually subdued by a drug, would THEN want to quit the antidepressant.
An obvious answer might be the side effects.
But there are those who quit their antidepressants despite having zero side effects.
So then, what compels a depressed person to stop taking a medication that helps elevate their mood?
“Unfortunately, no ones wishes to have any illness, let alone a mental illness,” says Rupali Chadha, MD, former chief of medical staff at Metropolitan State Hospital in Norwalk, CA.
“If you have one major depressive episode, you can try to taper off antidepressants,” continues Dr. Chadha.
But for two serious episodes, especially if hospitalization is required, she says, “It is recommended to stay on medication for life.
“Oftentimes, people do not want to be labeled having a mental illness.”
This then begs the question: What about people who can easily conceal their diagnosis and easily hide the fact that they have a little orange bottle of Effexor, Cymbalta or Zoloft in a bedroom drawer?
For some individuals, it may come down to personal knowledge, even if hiding the diagnosis and prescription from family, friends and coworkers is as easy as 2 + 2.
It’s that knowledge of, “I have a psychiatric condition.”
It helps to think of depression — the antithesis of happiness — as a HUMAN condition.
It just so happens that it can be treated by a drug that’s prescribed by a doctor — who isn’t always a psychiatrist.
Antidepressants are also commonly prescribed for depression by primary care or family physicians.
Your medical records will likely say “depression” rather than “mental illness.”
Nevertheless, some people can’t get past the stigma of having a “mental issue” (even if it’s a secret) and thus, quit their antidepressant.
Dr. Chadha also points out, “Other times, people experience side effects, and for whatever reason they are not communicated to the doctor (to adjust or change the medicine) — or rarely, there is no other alternative that works.
“Sexual side effects in particular, like erectile dysfunction in men and anorgasmia in women, are a big deterrent.
“The good news is not all antidepressants cause this in all people. An open dialogue and regular contact with one’s doctor (MD) can help.”
How to Make Sense of Quitting an Antidepressant
My mother has been on an antidepressant for some years now (no side effects), and there’d been occasions that she announced wanting to quit, that she feels great.
Her depression seemingly arose from underactive thyroid, but over time, it’s been clear that in addition to the thyroid medication, she absolutely needs the Effexor (previously she’d been on Cymbalta).
We’ve told her, “The reason you feel great is because of the Effexor!”
See the Situation for What It Really Is
You’re taking a tiny pill for the rest of your life. This is common for Americans.
If you don’t have to inject yourself with a syringe full of insulin for diabetes, remind yourself of that, as there are diabetics who’d love to trade places with you.
My mother has stopped her antidepressant more than once… and it wasn’t pretty.
If your antidepressant has side effects, then ask your doctor to work with you on a solution.
In addition to general psychiatry, Dr. Chadha is also a forensic psychiatrist who treats the brain conditions of the criminally insane and serves as an expert witness in trials. She has a passion for fitness plus how the body, mind and spirit come together to build a healthy individual.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Plantar Fasciitis: Stretching vs. Shockwave Therapy
Have plantar fasciitis? Which is better: stretching or shockwave therapy?
“Both therapies can be very effective and often, it’s best to do them both in tandem,” says Dr. Velimir Petkov, DPM, surgeon and sports medicine specialist of the foot with Premier Podiatry in Clifton, NJ.
“In my heel pain patients, I often tend to combine therapies – such as cortisone injections, strappings, physical therapy and custom orthotics in order to tackle the problem and relieve the pain as quick as possible.
“I reserve shockwave therapy as well as PRP injections (platelet rich plasma therapy) for patients who have more chronic injuries and those who fail to respond to the more conservative methods of treatment.
“But, if I could do them all, and the financial aspect was not a constraint, I would completely recommend that therapies be used in tandem.
“This way you can achieve results that are delivered faster and are long-lasting.”
Though stretching as the only therapy may help resolve plantar fasciitis for some patients, and others may find success with only shockwave therapy, BOTH therapies together should have a synergistic effect.
Stretching As the Foundation
A regular regimen of stretching the plantar fascia, Achilles tendon and calf will help prevent plantar fasciitis, as well as give a boost to recovery so that more invasive treatment is never necessary.
An acute case of plantar fasciitis will probably benefit more from ice, avoiding the offending activity, simple exercises such as trying to pick up a sock with your toes, and stretching.
Shutterstock/Alila Medical Media
One stretch for plantar fasciitis should be performed as follows, says the American Academy of Orthopaedic Surgeons:
In a seated position, cross affected foot over knee of other leg. Grasp toes of painful foot; bring ankle up and toes up.
Place thumb along plantar fascia (underside of foot); rub on it to stretch it.
The stretch is held for 10 seconds, and repeated 10-20 times.
Stretching sessions should include before exiting your bed in the morning, and after sitting for long periods.
Dr. Petkov diagnoses and treats numerous ailments related to the lower extremities, and has special interests in sports medicine, wound care and the most advanced minimally invasive procedures for plantar fasciitis and Achilles tendonitis.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/catinsyrup
Source: sciencedaily.com/releases/2010/11/101104101657.htm
How to Strengthen Your Wrists
You can have strong wrists and still sprain them, but stronger wrists are less likely to be severely sprained. Here’s how to make your wrists stronger.
Plus, a strong wrist will recover better from a sprain.
Here’s something you should know: There is no such thing as strengthening only the wrist.
To strengthen this joint area, you must work the forearms.
This can be done in a variety of ways.
Anyone, even “out of shape” people, can benefit from the following exercises.
How to Strengthen the Forearms
Wrist rolls with a dumbbell. Sit at the edge of a bench, light dumbbell in hand, palm facing ceiling.
Shutterstock/Philip Date
Let the dumbbell roll toward your fingertips, then bring it back to the palms. Keep doing this till you can’t any longer.
If this is too difficult, or, another option, is to keep the dumbbell fixed in place, and simply bend your wrist up and down.
How much weight to use will very from one person to the next.
Reverse hand position and bend the wrist up and down while holding the weight.
Another option is wrist rolls with a bar.
Farmer’s walks. Walk around for three minutes holding dumbbells with your arms straight at your sides.
Men can start out with 20 pound dumbbells, while women can start out with 10 pounders. The prolonged hold on the weights will strengthen the forearms and wrists.
If after about three minutes you don’t feel much fatigue in your wrists, then use heavier weight next time. The weights can also be plates or kettlebells.
If you do sprain your wrist, a wrist brace (as shown below) will help it heal.
Shutterstock/belushi
My first sprain (from volleyball) healed quickly. My second one (volleyball), which was worse, was not healing despite icing and immobilization from a brace.
It really hurt at the slightest rotary motion, as in proceeding to turn on the ignition of my car. I had to do that with my left hand.
I went to a doctor and she told me that the problem was that I wasn’t moving it. Yes…that I WASN’T.
It was time to end the complete immobilization and gradually work back into moving the joint.
I moved it to the left several times, then the right several times.
Up several times, then down several times … several sessions like this throughout the day.
Voila, the first day I noticed a marked improvement. Within several days my wrist was practically back to normal.
Additional exercises for strengthening your wrist include the deadlift, any pulling movements such as with weight machines in which you pull the handles towards your chest, and using hand grips.
