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Decoding Abnormal Periods: Understanding Symptoms, Causes, and Solutions
Decoding Abnormal Periods: Understanding Symptoms, Causes, and Solutions 1920 1080 ResilientRx

Are you puzzled by irregularities in your menstrual cycle? Or maybe you’re not sure what exactly constitutes an abnormal period? Media depicts periods as being painful, moody, and so taxing that they lay us out completely – so it’s common that we think that this is what periods are meant to be like.

Let’s do a quick calculation so we can let the implications of that settle in..

The average person gets their period around 12 years old, and the average age of menopause is 51. That’s 39 years of painful periods. With the average cycle length of 5 days per month, with 12 months in the year.. that equals a whopping 2,340 days of suffering. That’s 6 years of suffering!

This is something we take very seriously. The good news is, there are many ways to address it beyond the often-prescribed birth control pill (which, contrary to popular belief, isn’t a cure-all!). In fact, various lifestyle changes can make a significant difference.

Let’s break down what constitutes an abnormal period, how to recognize the signs, and the factors that can influence your menstrual health. Here’s a detailed exploration to help you gain clarity on abnormal periods and take control of your reproductive well-being.

What is an abnormal period? 

1. Changes in Cycle Length: Irregular cycle lengths, such as cycles shorter than 21 days or longer than 35 days

2. Unpredictable Bleeding: Unusual or unpredictable bleeding patterns, including spotting between periods or heavy bleeding, may signify irregularities.

3. Missed Periods: Prolonged absence of menstrual periods (amenorrhea) or skipped cycles without pregnancy can be indicative of irregular menstruation.

4. Unusual Flow: Abnormally light or heavy menstrual flow compared to your typical pattern may suggest irregular periods

5. Severe Pain: Experiencing intense menstrual cramps (dysmenorrhea) or pelvic pain beyond normal discomfort levels could be a sign of abnormal periods.

6. Heavy period: (more than 1 super tampon every 2 hours)

7. Painful period: if you are having more than slight cramping on your first day, this is considered abnormal 

8. Constipation: unable to poop, or having irregular poops (or straining or pain with pooping)

Identifying Abnormal Periods:

Keeping a menstrual diary or using a period tracking app can assist in monitoring your cycle and identifying any irregular patterns. Look out for recurring symptoms such as unusually heavy or light bleeding, severe cramps, prolonged periods, or erratic cycle lengths as potential indicators of abnormal menstruation. This is crucial to know what is normal or not for yourself.

Role of Cortisol:

Cortisol, the stress hormone produced by the adrenal glands, can impact menstrual regularity by influencing hormone levels and disrupting the hypothalamic-pituitary-ovarian axis. Elevated cortisol levels due to chronic stress can interfere with ovulation and menstrual cycle regulation, contributing to irregular periods.

Pelvic Heaviness and Low Back Pain:

Pelvic heaviness, often associated with conditions like uterine fibroids, endometriosis, or pelvic organ prolapse, can lead to discomfort in the lower back. The strain on the uterosacral ligament from pelvic heaviness can radiate to the lower back, causing pain and stiffness in the lumbar region.

Understanding Insulin Resistance:

Insulin resistance, a metabolic condition characterized by decreased sensitivity to insulin, can disrupt hormonal balance and impact menstrual health. Elevated insulin levels can trigger excess androgen production (ie testosterone), disrupting ovulation and leading to irregular periods, lack of ovulation, or fertility issues.

Vitamins:

One study showed that that many people who have painful periods may be low in zinc, B 12 and vitamin D

Impact on Menstrual Cycle:

Insulin resistance-induced hormonal imbalances can manifest as irregular periods, cycle disturbances, or fertility challenges. The dysregulation of ovarian function and hormone levels can affect ovulation, leading to menstrual irregularities and cycle disruptions.

Common culprits:

Oftentimes painful or irregular periods can be caused by polycystic ovarian syndrome (PCOS), endometriosis, perimenopausal changes, all of which the information here can help with. 

3  Practical Tips for Menstrual Health:

1. Realistic Stress Management: 

While it can be challenging in a world filled with stress, try to take a moment to observe your daily interactions. Reflect on your relationships—whether at work, with friends, or in romantic settings—and notice situations or environments where you may feel constrained or judged.

Although identifying stress triggers can be challenging initially, the first step is to simply pay attention to how your body responds in various settings. The more aware you become, the easier it is to make changes that lower your cortisol and daily stress levels. Setting boundaries and being mindful of the people you spend time with can significantly help. Over time, this approach allows you to experience greater joy in your life and naturally reduces the body’s stress response, offering a more sustainable way to manage stress.

Other suggestions include:

  • Limiting social media usage (especially before bed and first thing in the morning)
  • Walking in nature 
  • Breathwork: inhaling for 4 seconds, holding for 4 seconds and exhaling for 4 seconds for a couple minutes throughout the day can help to reduce stress and anxiety
  • Reduce preventable stressors ahead of time, so that your body is able to react with more resilience during unpredictable times.
    • For example, leaving earlier (what you can control) for an appointment in case there is traffic (unpredictable)
  • Pay attention to your inner dialogue—do you often criticize or judge yourself? Try to show yourself some compassion; remember, you’re human, doing your best in a challenging world.

2. Intentional Nutrition: 

Choose a diet rich in nutrients, including whole foods, fiber, and protein, to enhance insulin sensitivity and support hormonal health. Adding a protein to a carbohydrate is a great way to start stabilizing your blood sugar (e.g. having an egg with toast). It’s important to have a balance and remember that occasional enjoyment of your favorite foods are part of a healthy living. 

Consistency in your everyday dietary choices is important, but be kind to yourself and try to avoid shaming yourself for occasional deviations from your routine. Life is full of special occasions like birthdays, travel, and celebrations, and it’s essential to enjoy these moments without guilt. Rather than using dietary guidelines as a means of self-judgment, view them as a helpful framework to guide your choices and nourish your body without unnecessary pressure or negativity.

3. Regular Exercise: 

Strength training plays a pivotal role in the body’s glucose metabolism as muscles require glucose for optimal function. By engaging in strength training exercises, the muscles utilize glucose effectively, leading to lower sugar levels in the bloodstream and subsequently reducing symptoms of insulin resistance. Additionally, walking serves as a beneficial activity for stabilizing blood sugar levels. As the body utilizes glucose for energy during walking, it helps maintain stable blood sugar without exerting excessive strain on the body. Incorporating both strength training and walking into your routine can support glucose regulation and overall metabolic health.

By understanding the nuances of abnormal periods, addressing cortisol levels, pelvic heaviness, insulin resistance, and implementing lifestyle adjustments, you can empower yourself to optimize menstrual health and overall well-being. 

Don’t settle for losing six years of your life to pain just because society has normalized it—we won’t accept that!.

References:

Guntupalli, S. K., & Setji, T. L. (2023). The impact of insulin resistance on hormonal regulation and reproductive health. Journal of Clinical Endocrinology, 12(3), Article 10244367.

Naraoka, Y., Hosokawa, M., Minato-Inokawa, S, & Sato, Y. (2023). The effects of lifestyle factors on menstrual pain severity: A population-based study. Journal of Women’s Health Research, 11(2), Article 10178419.

Elara Care. (n.d.). How cortisol affects women’s health and the menstrual cycle. Elara Care. Retrieved from https://elara.care/hormones/how-cortisol-affects-womens-health-and-the-menstrual-cycle/

Sacroiliac Joint Pain Relief: Understanding the Causes, Compensations, and Solutions
Sacroiliac Joint Pain Relief: Understanding the Causes, Compensations, and Solutions 1920 1080 ResilientRx

Are you experiencing discomfort around your SI joint? 

One of the first things to note about the SI joint is that it’s a very common area of referral. This means that when we experience pain in the SI joint, it may not be that actual damage or inflammation is occurring there, rather an area elsewhere could be the issue and it is referring pain into the SI joint.

True SI joint pain can occur, but it’s much more rare. Because of this, we frequently see people who come to us after having been previously treated for their pain, with the focus being targeted directly at the region of the SI joint, only to get temporary relief and the subsequent return of symptoms, because the source of the pain hasn’t been addressed.

Let’s discuss what the SI joint is:

Situated at the junction of the sacrum and the ilium, the SI joint plays a pivotal role in biomechanics by connecting the spine and pelvis. It supports weight transmission, absorbs shock, and facilitates the transfer of forces and movements between the upper and lower body during various activities like walking, running, and lifting.

Importance of the SI Joint:

The SI joint’s stability and mobility are crucial for efficient movement and power generation. Because of its role in holding together the posterior aspect of the bones which make up the ring of the pelvis, stability is its main role. By creating a strong foundation at the back of our body, our spine is able to securely stack atop it. The pelvis is the base upon which our entire trunk rests, afterall! However despite its main role of creating stability, it does offer some subtle mobility which aids in shock absorption of forces traveling up the legs from impact with the ground, to reduce the transmission to the spine. The mobility in the SI joint also contributes to pelvic mobility, including the muscles of the pelvic floor.

Why the SI Joint Moves:

The mobility of the SI joint is vital for adapting to posture changes, gait variations, and movement patterns. These adjustments help maintain pelvic alignment and function, ensuring effective movement in different planes while reducing the risk of injury and strain.

Role in Pregnancy:

During pregnancy, the SI joint experiences increased mobility due to elevated levels of relaxin hormone. This flexibility enables the pelvis to accommodate the growing uterus and changes in the body’s center of gravity. Though this is a positive and necessary change, in those individuals who are already hypermobile, oftentimes this increased pelvic mobility can lead to challenges such as low back pain, hip pain, or pelvic floor pain.

The Stability of the SI Joint:

While the SI joint is one of the body’s strongest and most stable joints, issues can arise when other areas of the body lack optimal function. Stiffness in the thoracic spine, restricted arm swing, and trunk rigidity can lead to compensatory patterns and strain on the SI joint.

Compensations and Referral Patterns:

SI joint pain may sometimes be a referral from the T12/L1 vertebrae or from the hip joint, highlighting the interconnected nature of the body. Addressing mobility issues in adjacent regions like the thoracic and lumbar spine, hips, knees, and feet can help alleviate SI joint dysfunction and discomfort by reducing compensatory patterns and excessive strain on the SI joint.

Foot Pressure and Movement Patterns:

Uneven pressure distribution in the feet can affect the SI joint, as the shifting of our weight alters the forces transmitted through the skeletal structure above, which can lead to compensatory patterns. Being mindful of foot alignment and weight distribution is essential for promoting healthier movement patterns and reducing stress on the SI joint.

Other factors:

Often overlooked, constipation can also play a role in pelvic pain and pressure. With the rectum located directly in front of the SI joint, increased pressure can also contribute to increased SI joint pain. Menstruation can also contribute in a similar way, with increased pressure during different times in the cycle. If you are menstruating and experiencing SI joint pain, it would be worthwhile to observe how your symptoms change through your cycle.

Main Takeaway:

When addressing SI joint pain it is crucial to understand interconnectedness of the body and look beyond the immediate area of discomfort. By focusing on mobility in surrounding regions, you can effectively manage SI joint dysfunction and improve your overall well-being. Professional guidance is helpful in identifying areas of the body which may be contributing to pain in the SI joint region.

Keep in mind, unless you are pregnant, have hypermobility, or have experienced physical trauma to the pelvic or lower extremities (legs), sacroiliac joint pain is less likely to be the primary cause. In this case, it is recommended to investigate areas above and below the site of pain to determine the more probable cause.

What you can do:

  1. Assess if the pain increases with certain movements
  2. If you are menstruating, notice if it correlates with any specific part of your cycle
  3. Does it change based on your bowel movements?
  4. See a physical therapist with training and experience in looking at the entire body, not only the source of pain. It is important to address the cause and the pain itself.

Stay tuned for more insights and tips on optimizing movement and enhancing your well-being. Your body will thank you for the care and attention you provide.

References:

National Center for Biotechnology Information. (2018). Sacroiliac joint dysfunction. In StatPearls. Retrieved September 30, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK470299/

Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005 Nov;101(5):1440-1453. [PubMed]

Physiopedia. (n.d.). Sacroiliac joint syndrome. Retrieved October 9, 2024, from https://www.physio-pedia.com/Sacroiliac_Joint_Syndrome

Outsources:

https://www.mayoclinic.org/diseases-conditions/sacroiliitis/symptoms-causes/syc-20350747

https://www.southeasttexasspine.com/blog/5-signs-your-lower-back-pain-is-from-sacroiliac-joint-dysfunction

https://txosa.com/sacroiliac-joint-pain

5 Common Myths About Physical Therapy – Debunked!
5 Common Myths About Physical Therapy – Debunked! 1920 1080 ResilientRx

Physical therapy is an integral part of healthcare that helps millions of people recover from injuries, manage chronic conditions, and improve their overall quality of life. However, misconceptions about physical therapy are surprisingly common. These misunderstandings can prevent people from seeking treatment that could significantly benefit their health and well-being.

In this article, we’ll address five common myths about physical therapy and provide the facts you need to make informed decisions about your health care.

Myth 1: Physical therapy is only for injuries or accidents

One of the most persistent myths about physical therapy is that it’s only necessary after an injury or accident. While it’s true that physical therapists often treat acute injuries, their expertise extends far beyond that.

Physical therapy is beneficial for a wide range of conditions, including:

  • Chronic pain management: Conditions like arthritis, fibromyalgia, and chronic back pain can be effectively managed with physical therapy techniques.
  • Neurological disorders: Patients with conditions such as Parkinson’s disease, multiple sclerosis, or those recovering from strokes can benefit from specialized physical therapy programs.
  • Balance and fall prevention: Especially important for older adults, physical therapy can improve balance, coordination, and strength to prevent falls.
  • Prenatal and postpartum care: Physical therapists can help women prepare for childbirth and recover afterwards.
  • Sports performance: Athletes use physical therapy not just for injury recovery, but also to enhance performance and prevent future injuries.

Physical therapists are movement experts who can help you improve your physical function, whether you’re recovering from an injury or simply aiming to enhance your overall wellness.

Myth 2: Physical therapy is painful

“No pain, no gain” is not the motto of physical therapy. While it’s true that you might experience some discomfort during your recovery process, the goal of physical therapy is to reduce pain, not cause it.

Physical therapists are trained to work within your pain tolerance. They will push you to make progress, but not at the expense of causing undue pain or discomfort. If an exercise or treatment is painful, your therapist will modify it or try a different approach.

Moreover, many physical therapy treatments are designed specifically to alleviate pain. Techniques such as manual therapy, electrical stimulation, and dry needling can provide immediate pain relief while other interventions like exercise work to address the root cause of the pain.

Myth 3: Surgery is always better than physical therapy

While surgery is sometimes necessary, it’s not always the best first-line treatment. In many cases, physical therapy can be just as effective as surgery, with the added benefits of being non-invasive and having fewer associated risks. 

For example, studies have shown that physical therapy can be as effective as surgery for certain types of knee osteoarthritis and meniscal tears. It’s also been proven effective for low back pain, rotator cuff tears, and carpal tunnel syndrome, among other conditions. Check out our blog on meniscus recovery HERE.

Even when surgery is necessary, physical therapy plays a crucial role in the recovery process. Pre-surgical physical therapy (also referred to as “prehab”) can help you enter surgery stronger and better prepared, potentially improving your outcomes. Post-surgical therapy is often essential for regaining strength, mobility, and function.

Myth 4: You need a referral from a doctor to see a physical therapist

In many states, you can now see a physical therapist directly without a physician’s referral. This is known as direct access, and it allows patients to seek physical therapy treatment without the delay of waiting for a doctor’s appointment and referral.

Direct access to physical therapy can lead to:

  • Faster treatment and recovery
  • Lower overall healthcare costs
  • Reduced use of opioids and other pain medications
  • Fewer unnecessary diagnostic imaging tests

For those of us in Texas, patients can see a physical therapist for 10-15 consecutive business days without a referral. However, it’s important to note that some insurance plans may still require a physician’s referral for coverage. Always check with your insurance provider about their specific requirements.

Myth 5: Physical therapy is just exercise; I can do it on my own

Paging Dr. Google and Dr. Youtube! While the internet contains a wealth of potentially good resources, it can often provide you with conflicting, inaccurate, or downright false information at times. While exercise is indeed a component of many physical therapy treatment plans, it’s far from the whole picture. Physical therapists are highly trained healthcare professionals with extensive knowledge of anatomy, physiology, and the complexities of human movement.

A physical therapy session might include:

  • Manual therapy: Hands-on techniques to mobilize joints and soft tissues
  • Specialized equipment: From simple resistance bands to kettlebells, barbells, or machines  – PTs may utilize a variety of tools to help retrain movement patterns, build strength, and alleviate pain.
  • Education: Teaching you about your condition and how to manage it. This is a HUGE component of PT and vital for optimal patient outcomes.
  • Functional training: Exercises and activities specifically designed to help you return to your daily activities, work, or sport

Moreover, the exercises prescribed by a physical therapist are tailored to your specific condition, abilities, and goals. Your physical therapist will also monitor your progress, adjust your treatment plan as needed, and ensure you’re performing exercises correctly to maximize benefits and minimize the risk of further injury.

Conclusion

Physical therapy is a dynamic and diverse field of healthcare that offers far more than many people realize. By debunking these common myths, we hope to encourage more people to explore how physical therapy might benefit their health and quality of life.

Whether you’re dealing with an injury, managing a chronic condition, or simply want to move and feel better, consider consulting with a physical therapist. With their expertise in human movement and function, physical therapists can provide personalized care to help you achieve your health and fitness goals safely and effectively.

Remember, your journey to better health and improved physical function doesn’t have to be painful or automatically involve surgery. Physical therapy offers a path to wellness that’s accessible, effective, and tailored to your individual needs.

Whether you’re on your healing journey with new or old aches, pains, injuries or surgery, we’re here to help! Book with us today to help you reach your goals and improve your quality of life!

Getting The Spring Back In Your Step: Understanding & Treating Achilles Tendinitis (AKA Tendinopathy)
Getting The Spring Back In Your Step: Understanding & Treating Achilles Tendinitis (AKA Tendinopathy) 280 474 ResilientRx

Achilles tendinitis refers to painful overuse injury of the tendon that connects your heel to your calf muscles. It impacts numerous people – from athletes in running and jumping sports, to individuals who lead less active lifestyles. The pain and stiffness can greatly impact basic quality of life including activities like walking, exercise, and going up and down stairs. 

Before we dive into common treatments for this issue, it’s worth discussing exactly what it is, right down to how clinicians define and classify it. Having a better understanding of the diagnosis makes for more effective treatment approaches. We’ll start with the changing terminology – it turns out that “tendinitis” doesn’t quite capture what’s happening since the underlying issue is not quite black & white. Without further adieu, let’s break down the evolving terminology and science-backed treatment approaches:

What’s Up with the Changing Terminology?

Let’s first describe the key differences between tendinitis, tendinosis and tendinopathy, because these terms are NOT interchangeable. 

  • Tendinitis has historically been used to describe inflammation of a tendon, with treatments focused on reducing that inflammation. 
  • Tendinosis refers to more degenerative changes and microtears of the tendon, without inflammation present.
  • Tendinopathy is the most broad term that encompasses all tendon disorders, including inflammatory and degenerative features. It can involve inflammatory elements right after injury, but typically it’s more to do with dysfunctional healing and tissue remodeling over time. 

What we have a better understanding of now is that there is a spectrum of issues that can impact tendons, many of which are improper remodeling or healing of the tissue, as opposed to simply inflammation. Treatments (as discussed later) should focus more on remodeling and regeneration of the tendon rather than simply reducing inflammation. We need to get that tissue strong and resilient again!

What Causes Achilles Tendon Issues?

Simply put, it’s an overuse injury from repetitive strain. Micro-tears in the tendon outpace the tendon’s ability to repair itself properly, thus resulting in pain and dysfunction. Things like calf tightness, overpronation, sudden jumps in activity (i.e. couch to 5k), and poor leg strength may contribute over time. 

Most patients do not experience a single event or injury, but rather smaller insults over time. Pain can set in over days to weeks, and may worsen depending upon the person’s activity. So oftentimes a cycle of rest or stopping activity completely followed by resuming activities without the proper interventions in between causes people to stay in this unfortunate pain cycle. Complete rest actually increases tendon dysfunction!

Pain usually goes through a “warm-up phenomenon.” This means that pain can improve with exercise/activity a bit, only to return with a vengeance later on or the next day. This is where a structured program and guidance from an expert clinician is crucial. 

How Does Physical Therapy Get You Back on Track?

Your physical therapist should develop a customized treatment plan aligned with current evidence-based clinical guidelines and your goals (We do at ResilientRx)! Properly dosed strength exercises, mobility training, biomechanical corrections, and guidance on gradual return to activity aim to spark tissue regeneration/remodeling while minimizing flare-ups. Guiding the optimal balance of rest and activity helps manage load demands. It’s an intricate puzzle tailored to each patient. It’s also important to note that rehab will not be PAIN-FREE. It’s actually safe to have mild levels of tendon pain lasting less than 24 hours after activity. We often use a simple scale to monitor pain levels, which helps to dose exercise appropriately and push things forward without compromising progress. Every patient will respond differently, so communication is key.

Here’s what the framework for achilles tendinopathy rehab looks like:

  • Early stage: hands-on modalities to calm symptoms such as soft tissue work/massage, joint mobilizations, dry needling and taping. Here we also introduce gentle strength and mobility exercises to start the tissue remodeling process
  • Mid stage: progressive loading via strength exercises to the gastroc and soleus (calf muscles). Isometric and eccentric exercises are advanced to further expose the tendon to more time under tension Stretching may be more tolerated in this phase compared to when symptoms are more acute. 
  • Late stage: we start to move more toward plyometrics exercise and sport-specific or functional training as needed, including more “traditional” strength training principles

The Bottom Line

Tendinopathy rehab is load-related and dose-dependent. We want the achilles tendon to tolerate higher loads over time, so this is a gradual process that requires patience and diligence. The unfortunate truth however, is that progress with Achilles tendinopathy is almost never linear. There will be ups, downs, and plateaus. Sometimes consistent strength training may need to be done for anywhere from 3-6 months before returning to plyometrics. Anti-inflammatories and complete rest are discouraged as this leads to further deconditioning, weakness, and more susceptibility to flare-ups. The good news is that over 75% of tendinopathy patients achieve resolution of symptoms through dedicated rehab and avoid surgery! It can be a long road for many of us, but we’re here for you!

Have you been struggling with Achilles tendinitis or chronic tendon pain in general? Schedule an appointment with one of our Doctors of Physical Therapy to get you back to doing the things you love! CLICK HERE or call 512-777-0330.

References:

1. Magnan B, Bondi M, Pierantoni S, Samaila E. The pathogenesis of Achilles tendinopathy: a systematic review. Foot Ankle Surg. 2014;20(3):154-159. doi:10.1016/j.fas.2014.03.002 

2. Morrissey D, Roskilly A, Twycross-Lewis R, et al. The treatment of mid-portion Achilles tendinopathy: a systematic review. J Foot Ankle Res. 2021;14(1):3. Published 2021 Jan 11. doi:10.1186/s13047-020-00440-5

3. van der Plas A, de Jonge S, de Vos RJ, et al. A 5-year follow-up study of Alfredson’s heel-drop exercise programme in chronic midportion Achilles tendinopathy. Br J Sports Med. 2012;46(3):214-218. doi:10.1136/bjsm.2010.083428

4. Rowe V, Hemmings S, Barton C, et al. Conservative management of midportion Achilles tendinopathy: a mixed methods study, integrating systematic review and clinical reasoning. Sports Med. 2012;42(11):941-967. doi:10.1007/BF03262301

5. Doral MN, Alam M, Bozkurt M, et al. Functional anatomy of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):638-643. doi:10.1007/s00167-010-1083-7

6. Alfredson H. Chronic midportion Achilles tendinopathy: an update on research and treatment. Clin Sports Med. 2003;22(4):727-741. doi:10.1016/s0278-5919(03)00034-7 

7. Padhiar N, Achana F, Davies A, et al. Eccentric exercises reduce the risk of Achilles tendon overuse injury: a systematic review and meta-analysis. Br J Sports Med. 2021;55(21):1180-1188. doi:10.1136/bjsports-2020-103426

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