Host: Dr. Melanie Carminati, PT, DPT, GTS, NCPT Guest: Dr. Juan Salgado, MD Dr. Salgado from San Juan, Puerto Rico, is a distinguished endometriosis specialist renowned for his expertise in obstetrics and gynecology, particularly in minimally invasive surgery. Today, he generously shares his journey and insights into the revolutionary treatment of endometriosis. Dr. Salgado's Journey: From Tradition to Innovation Dr. Salgado embarked on his medical career as an OB-GYN over three decades ago. However, it wasn't until 2009 that a pivotal moment reshaped his approach to endometriosis treatment. Faced with a patient's harrowing experience due to untreated endometriosis, Dr. Salgado recognized the pressing need for change. Determined to evolve, he embraced laparoscopic techniques under the mentorship of pioneering figures. With unwavering dedication, Dr. Salgado mastered advanced laparoscopic procedures, including bowel resections and bladder excisions. His commitment to excellence has revolutionized endometriosis treatment, emphasizing the crucial role of accurate diagnosis through techniques like endometriosis mapping via sonogram. The Power of Endometriosis Mapping via Sonogram Endometriosis mapping via sonogram offers unparalleled accuracy in diagnosing deep endometriosis compared to traditional methods like MRI. Dr. Salgado underscores the importance of training and expertise in interpreting sonogram results accurately. He advocates for the widespread adoption of this technique to optimize surgical planning and ensure comprehensive lesion removal. Advocacy and Collaboration: Spreading Awareness and Expertise Dr. Salgado's vision extends beyond clinical practice. He strives to disseminate endometriosis mapping globally, collaborating with organizations like Endometriosis Puerto Rico and Endo Communities worldwide. Through advocacy efforts, he aims to increase awareness and access to advanced treatments for endometriosis. Empowering Patients: Education and Support In conclusion, Dr. Juan Salgado Morales epitomizes innovation and compassion in endometriosis treatment. His journey illustrates the transformative power of dedication and expertise in improving patient outcomes. As we navigate the complexities of endometriosis, Dr. Salgado's insights serve as a beacon of hope for patients and practitioners alike. We extend our heartfelt gratitude to Dr. Salgado for his invaluable contributions and unwavering commitment to enhancing the lives of those affected by endometriosis. His passion and expertise inspire us all to strive for excellence in healthcare.

Embarking on better pelvic health is crucial for overall well-being. Today, with Dr. Melanie Carminati, a distinguished Doctor of Physical Therapy and founder of Inspira Physical Therapy, we explore endometriosis's impact on pelvic floor anatomy, receiving expert advice on treatments and exercises. Understanding Endometriosis and Its Effects: Dr. Carminati highlights the intricate relationship between endometriosis and pelvic health, revealing that 93.3% of women with endometriosis experience pain. Additionally, 75% exhibit increased tone in their levator ani muscles, emphasizing the prevalence of hypertonic pelvic floor issues among this group. Research Findings and Pelvic Floor Physical Therapy: Systematic reviews confirm that pelvic floor physical therapy reduces pain and improves overall quality of life for individuals with endometriosis. This underscores the transformative impact of targeted physical therapy interventions on managing pelvic pain. Demystifying the Pelvic Floor: Dr. Carminati explains the pelvic floor's anatomy as a three-layered muscle group and its significance in understanding muscle tension, dysfunctions, and treatments. Objective Assessments and Holistic Considerations: She begins with objective assessments, revealing the prevalence of hypertonic pelvic floor muscles and emphasizing the need for tailored interventions. She also considers diaphragm breathing dysfunctions and fascial restrictions for a comprehensive evaluation. Connecting Through Subjective Experiences: Dr. Carminati acknowledges subjective experiences such as dyspareunia, urinary issues, and pain, fostering empathy and encouraging individuals to seek personalized solutions. The Pelvic Floor's Role in the Deep Functional Core: She discusses the pelvic floor's connection to the deep functional core, emphasizing its interplay with the diaphragm and its disruption in dysfunctional pelvic health. Practical Insights into Pelvic Floor Physical Therapy: Dr. Carminati outlines what to expect during therapy, covering communication, sexual function, and physical assessments to tailor treatment plans effectively. Layered Approach to Therapy: She employs a layered approach, combining external observations, palpation, and internal assessments to create tailored treatment plans. Manual Therapy and Osteopathic Techniques: Various manual therapy techniques, including Winback radio frequency therapy, aim to relax hypertonic pelvic floor muscles and restore pelvic health. Osteopathic Techniques for CNS Regulation: Osteopathic techniques like craniosacral therapy aim to regulate the central nervous system, crucial for pain management. Pelvic Floor PT Treatments and Exercise Considerations: Neuromuscular reeducation and exercise, such as diaphragm breathing and Pilates-based core reeducation, are integral components of therapy. Building a Collaborative Support Team: Dr. Carminati advocates for a multidisciplinary team approach to pelvic health, fostering collaboration between healthcare providers and specialists. Validation and Encouragement: She validates individuals' experiences and encourages them to seek supportive healthcare, emphasizing the importance of trust and collaboration in rehabilitation.

Host: Dr. Melanie Carminati, PT, DPT, GTS, NCPT Guest: Dr. Jeffrey Charles Schildhorn 521 Park Ave. Suite 1, New York, NY 10065 Phone: (212) 980-1375 Email: info@jcsnyc.com On the Know and Do Better Podcast, we bring you expert insights to empower your health decisions. In today's deep dive, we explore critical considerations before surgery, guided by the expertise of Dr. Jeffrey Schildhorn, an esteemed orthopedic surgeon. Uncover the nuances of joint replacements, insights on managing hypermobility and trauma surgeries, and valuable tips for a successful preoperative journey. Meet Dr. Jeffrey Schildhorn Dr. Schildhorn, a distinguished Duke University graduate, brings a unique blend of academic excellence and hands-on experience to orthopedic surgery. His specialization in minimally invasive procedures reflects a commitment to reducing post-surgery downtime and enhancing patient outcomes. Conservative Orthopedic Approach Dr. Schildhorn advocates for a conservative approach in orthopedic medicine, emphasizing alternatives to immediate surgery. This approach prioritizes careful planning, physical therapy, and minimally invasive procedures, aligning to restore normal function without unnecessary intervention. Deciding on Joint Replacements Discover the criteria Dr. Schildhorn uses when considering joint replacements. From advanced arthritis to symptomatic pain hindering daily activities, Dr. Schildhorn sheds light on the factors that guide his recommendations. Gain insights into the nuanced decision-making process, ensuring patients receive the most suitable care. Hypermobility and EDS Considerations For those dealing with hypermobility and Ehlers-Danlos Syndrome (EDS), Dr. Schildhorn’s approach favors physical therapy over surgical intervention. Dive into the reasons behind this preference, emphasizing the crucial role of muscle stabilization in achieving optimal outcomes. Trauma Surgeries vs. Joint Replacements Dr. Schildhorn provides clarity on distinguishing trauma surgeries from joint replacements. Understand the immediate decisions involved in trauma surgeries, often guided by distinct fracture patterns visible in X-rays. This expert insight showcases the precision required in different surgical scenarios. Setting Patients Up for Success Unlock valuable tips for preoperative success, ranging from the importance of preoperative physical therapy to addressing metabolic issues and maintaining a healthy lifestyle. Dr. Schildhorn emphasizes the role of preoperative weight loss in enhancing overall outcomes, providing actionable steps for patients to take charge of their health journey. Decision-Making and Finding the Right Surgeon Explore the intricate decision-making process for surgery, emphasizing the crucial patient-surgeon relationship. Dr. Schildhorn stresses patients' active role in postoperative care, attending appointments, and following instructions for a smoother recovery. As we conclude this comprehensive exploration, thank Dr. Jeffrey Schildhorn for generously sharing his expertise. If you are considering surgery or grappling with questions, contact Dr. Schildhorn for personalized guidance. Stay tuned for more insightful discussions in our next post, and take proactive steps toward a healthier, empowered future!

Host: Dr. Melanie Carminati, PT, DPT, GTS, NCPT Guest: Dr. Marc Goldstein, MD, DSc (hon), FACS In a recent interview on the Know and Do Better podcast, Dr. Marc Goldstein, a distinguished expert in Reproductive Medicine and Urology, shared valuable insights into the often-overlooked topic of paternal age and its significant role in fertility. This comprehensive guide delves deeper into the lesser-known concerns of older fatherhood and the crucial aspects of male fertility. Paternal Age and Lesser-Known Concerns While the public is generally aware of the impact of maternal age on birth defects, Dr. Goldstein emphasizes that paternal age, significantly beyond 45, plays a pivotal role. Studies reveal a doubling in the incidence of Down syndrome major birth defects, a threefold increase in schizophrenia, and a fivefold rise in autism. Despite being published in reputable journals, these findings are not as widely recognized as their maternal counterparts. Awareness Gap in Paternal Age Concerns Dr. Goldstein attributes the lack of awareness to a significant gap in understanding male fertility issues. Unlike women, who establish lifelong relationships with gynecologists, men often lack the same awareness and proactive healthcare habits. Conditions like testicular cancer, more prevalent than breast cancer, often go unnoticed until later stages, contributing to the overall gap in knowledge. Freezing Sperm and Egg The option of freezing sperm, Dr. Goldstein suggests, is a viable consideration for men. With a successful history spanning over a century, frozen sperm can maintain viability for decades. Like egg freezing, the age at which sperm is frozen influences its success rate. Younger men freezing sperm generally experience higher success when utilizing it later in life. Male Fertility Evaluation Beyond age, critical considerations for male fertility evaluation include a semen analysis, thorough examination, and medical history. At-home semen analysis tests provide a screening option, while medical history, including prior surgeries and conditions like undescended testicles, plays a crucial role. Blood tests, such as FSH and testosterone level assessments, offer insights into sperm production and overall reproductive health. Impact of Medical History Conditions like bilateral hernia operations or undescended testicles significantly impact fertility. The history of testicular cancer and its treatment, including radiotherapy or chemotherapy, can also have lasting effects on male fertility. Vasectomy Reversal and Changing Perspectives Vasectomy, a common contraception choice, can be reversed. Dr. Goldstein highlights changing perspectives on family planning, where couples who pursued reversal due to a change of heart or the loss of a child often experience remarkably high success rates. Advocacy for Fertility Preservation In the context of cancer treatment, fertility preservation efforts are essential. Dr. Goldstein stresses the need for increased awareness among oncologists about discussing fertility preservation options, particularly sperm banking, with male patients facing cancer treatments. Conclusion Understanding the intricate relationship between paternal age and fertility, considering medical history, and advocating for increased awareness are crucial steps toward comprehensive reproductive health. Dr. Goldstein's insights shed light on acknowledging male and female factors in fertility discussions. For personalized medical advice, it's essential to consult with healthcare providers.

Host: Dr. Melanie Carminati, PT, DPT, GTS, NCPT BrooklynPhysicalTherapy.com Guest: Dr. Michael A. Werner, M.D., FACS MazeHealth.com Disclaimer: The medical information in this podcast is for informational purposes only, not individualized medical advice. For personalized care, consult your healthcare provider. About Dr. Michael A. Werner Dr. Michael A. Werner, Founder and Medical Director at Maze Health, is a board-certified urologist who received specialized Fellowship training in male infertility, surgery, and male sexual dysfunction at Boston University Medical Center. His private practice in Midtown Manhattan and Westchester, New York, is limited to two areas of specialization: male infertility and male and female sexual dysfunction. He's a frequent lecturer and author in medical journals and books on these topics. Exploring Men's Health After 70 In this episode, we'll discuss a crucial aspect of men's health after age 70, focusing on sexual health. Our previous podcast episode, "Sex After 70," primarily centered around female sexual health concerns with Dr. Dena Harrison, a gynecologist. However, we received numerous comments asking about men's sexual health and what can be done for men over 70 to maintain a fulfilling sex life. Dr. Werner, could you please share your clinical experience with male patients aged 70 and above? What are some common complaints they come in with in terms of sexual intimacy and sexual function? Dr. Werner explains that as people live longer, sexual issues in older men become more prevalent. The two primary age-related concerns he encounters are erectile dysfunction and difficulties with ejaculation. The discussion delves into the treatment options for these issues, such as penile implants, penile injections, oral medications, and more. Pelvic Pain and its Connection with Erectile Dysfunction The conversation shifts to discussing chronic pelvic pain syndrome in men, which is often not well understood. Dr. Werner elaborates on the different symptoms and their varied manifestations. Dr. Carminati, as a pelvic floor therapist, adds to the discussion by emphasizing the importance of pelvic floor physical therapy and how it can assist in managing pelvic pain and other related issues. Incorporating Radiofrequency Therapy (Winback Tecar): Dr. Carminati shares her experiences with radiofrequency therapy, specifically the Winback Tecar system, which she finds beneficial for treating various pelvic conditions. The therapy is described as a warming sensation, and it explains how it helps facilitate deep tissue work for male pelvic pain patients. Premature Ejaculation and Its Treatment Dr. Werner addresses premature ejaculation, emphasizing that it's not always a psychological issue but can be physical and, in some cases, lifelong. He discusses treatment options, including the use of selective serotonin reuptake inhibitors (SSRIs) to delay ejaculation and topical numbing agents. Addressing Low Libido The conversation then touches on low libido in older men, often related to declining testosterone levels. Dr. Werner highlights the importance of hormone replacement therapy and discusses how it can significantly improve libido in men. The Impact of Prostate Cancer Treatments on Sexual Function When it comes to patients who have undergone prostate cancer treatments, Dr. Werner explains the common effects on sexual function and discusses potential treatments. He highlights the importance of early intervention to address post-treatment erection issues and emphasizes the effectiveness of penile injections in these cases.

Hosted by Dr. Melanie Carminati: Chronic pain is a complex condition affecting many globally, often treated with a focus on physical aspects, neglecting psychological factors. Dr. Barbiere, a clinical psychologist with 30+ years of experience, advocates for a holistic approach to chronic pain management. She combines Western and Eastern medical modalities, including acupuncture and herbal medicine, in her practice. Dr. Barbiere's career spans various roles in NYC hospitals, including NYU Lutheran Labor and Delivery and Ortho-Neuro Rehabilitation departments. Currently, she is affiliated with Manhattan Pain Medicine, offering expertise in pain psychology. Her dedication extends to her involvement with the New York State Psychological Association and as an adjunct clinical supervisor for Yeshiva University Ferkauf Graduate School of Psychology. In this blog post, Dr. Barbiere discusses the psychological perspective on pain, emphasizing its impact on emotional and psychological well-being. She highlights the role of the brain in chronic pain and the need to address psychological aspects. Dr. Barbiere employs a dual approach to chronic pain management: the top-down and bottom-up approaches. The top-down approach targets thoughts and behaviors using techniques like cognitive-behavioral therapy (CBT) to modify distorted thoughts related to pain. The bottom-up approach focuses on the body and nervous system, using techniques such as somatic body awareness, mindfulness, meditation, and muscle relaxation to signal safety to the brain. Emotion regulation techniques like mindfulness and meditation are crucial for addressing the emotional aspects of pain while pacing and breaking activities into manageable parts helps prevent pain exacerbation. Dr. Barbiere's insights offer a comprehensive strategy for managing chronic pain by considering both the mind and body. Her expertise underscores the importance of addressing the psychological aspects of pain, providing hope and support for those seeking effective pain management and improved well-being.

In the world of wellness and rehabilitation, Pilates stands out as a transformative and holistic approach to physical well-being. In this enlightening podcast episode, we had the privilege of hosting a roundtable discussion with our team at Inspira Physical Therapy & Pilates in Brooklyn, who are experts in the field. Dr. Melanie Carminati, PT, DPT, GTS, NCPT, founder of Inspira Physical Therapy & Pilates, leads the conversation with her team, each with a unique journey into the world of Pilates. They share insights into the essence of Pilates, its evolution, and its profound impact on the mind and body. Let's dive into the world of Pilates and discover the magic it holds.

Nicqueva Haughton was featured on our Endometriosis Fundraiser expert panel discussion speaking on stage during the live event as a patient advocate about her experience with endometriosis. She has many words of wisdom and encouragement to give individuals who have endometriosis and are either at the beginning of getting help or have been going through it for some time. This blog post was written based on the Know & Do Better podcast episode, The Patient Perspective: Nicqueva Haughton's Journey & Triumph with Endometriosis.  Living with endometriosis can be a challenging and often misunderstood experience. In this blog post, we will explore the personal journey of Nicqueva Haughton, who battled endometriosis from an early age, endured excruciating pain, and eventually underwent a hysterectomy. Despite the hardships faced, there is hope, resilience, and a message of empowerment for others navigating this condition. Nicqueva Haughton experienced endometriosis symptoms soon after her first period at age 12. The pain gradually worsened over the years, causing her to miss school and endure debilitating cramps that were far beyond what was considered normal. Due to her young age, Nicqueva did not see an OBGYN until she was 18 years old, prompted by her mother's concern. The doctor discovered grapefruit-sized masses during an ultrasound, leading to a surgical procedure that resulted in the removal of her left ovary. The diagnosis of endometriosis was given, accompanied by the devastating news that she might never bear children. At the time of diagnosis, endometriosis specialists were scarce, and Nicqueva’s doctor did the best with the limited information available. Despite the surgery providing temporary relief, the pain eventually returned, leaving her to explore various procedures and treatments.  Contrary to the doctor's initial prognosis, Nicqueva defied expectations and became a mother of three. Unexpectedly conceiving her first child at a young age, followed by subsequent pregnancies, brought immense joy and gratitude to Nicqueva. Years later, after enduring chronic pain and its impact on her personal and professional life, Nicqueva decided to pursue a hysterectomy. She described the struggle of being heard and understood by medical professionals, advocating for her health and well-being. The surgery revealed that endometriosis had spread to her bowels and bladder, underscoring the severity of the condition. Nicqueva shares her initial apprehension about her identity and femininity after the hysterectomy. However, she emphasizes the significant improvement in her quality of life, highlighting her newfound ability to participate in activities without constant pain and worry. Living with endometriosis is a challenging journey, marked by pain, uncertainty, and often delayed diagnosis. This blog post aims to shed light on one person's experience, highlighting the importance of self-advocacy and the significance of finding the proper medical support. Through Nicqueva Haughton’s story, she hopes to instill encouragement for others facing endometriosis, emphasizing that there are paths to motherhood and fulfilling life despite the challenges posed by this condition. Internet Resources for Endometriosis Nancy’s Nook EndoFound Internet Resources for Mental Health CDC.gov Mental Health First Aid

Are you struggling to conceive and considering fertility treatments? We delve into the world of fertility treatments on the Know & Do Better Podcast with Dr. Edward J. Nejat, the practice director of Generation Next Fertility in New York City. Dr. Job is an esteemed fertility specialist and reproductive endocrinologist, known for his patient-centric approach and expertise in various fertility treatments. In this blog post, we will explore the basics of fertility treatments and the role of different practitioners in the process. When a patient visits Generation Next Fertility, the initial step is to establish their goals and aspirations regarding family planning. Dr. Nejat emphasizes the importance of understanding the patient's desired number of children and long-term family planning goals. This information plays a crucial role in customizing the treatment approach to ensure the best possible outcomes. Dr. Nejat recognizes the vulnerability and emotional challenges that patients face when seeking fertility treatments. At Generation Next Fertility, the focus is on creating a supportive and compassionate environment. The initial consultation serves as an opportunity to establish rapport, actively listen to the patient's concerns, and provide guidance throughout the fertility journey. The clinic aims to be more than just a healthcare provider but also a partner for patients on their path to parenthood. Fertility treatments involve a multidisciplinary approach, requiring the expertise of various professionals. At Generation Next Fertility, a team of approximately 75 staff members, including clinical assistants, laboratory technicians, stenographers, and finance specialists, work together to provide comprehensive care. Each team member plays a vital role in ensuring patients receive the highest quality care and support. Dr. Nejat explains that fertility treatment options vary depending on individual patient needs. The initial evaluation typically involves a vaginal ultrasound and blood tests to assess hormone levels, infectious diseases, and genetic factors. Additional tests, such as hysterosalpingograms (HSG) to check fallopian tube patency, may be recommended if necessary. One common treatment approach is intrauterine insemination (IUI) involves monitoring the female partner's natural cycle and inducing ovulation through medication. This is followed by the introduction of concentrated sperm into the uterus, either from the male partner or a donor. For patients requiring more advanced intervention, in vitro fertilization (IVF) is often recommended. IVF involves stimulating the ovaries with medications to produce multiple eggs, retrieving the eggs, fertilizing them in the laboratory, and transferring the resulting embryos back into the uterus. Dr. Nejat emphasizes the importance of tailoring treatment plans to meet individual patient needs. For patients with diminished ovarian reserve or previous unsuccessful IVF cycles, Generation Next Fertility specializes in mild stimulation protocols. These protocols involve lower medication doses to retrieve a similar number of higher-quality eggs, improving the chances of success. Fertility treatments can provide hope and a path to parenthood for individuals and couples struggling with infertility. With Dr. Edward J. Nejat and the dedicated team at Generation Next Fertility, patients receive personalized care, guidance, and support throughout their fertility journey through understanding patient goals, fostering strong patient-doctor relationships, and utilizing a collaborative approach.

Daphne Javitch is a Health Educator and Founder of Doing Well, who overcame lifelong symptoms of stage four endometriosis through diet and lifestyle. Her approach to health is founded in nutrition but emphasizes holistic well-being, including sleep, stress management, exercise, AIS connection and purpose, and routine building. Daphne's endometriosis symptoms started when she was 13 years old, and they became more debilitating as she grew older. At the age of 34, she was diagnosed with endometriosis and was advised to go on birth control immediately. Instead, she chose to address her condition holistically with the help of a health coach. Daphne was consistent and rigorous in her approach, and some of her symptoms went into remission within six months. She went from taking 12 Advil a day on the worst day of her period to just one Advil for her entire cycle. This awakened an innate feeling within her and propelled her life and profession in a new direction.  Daphne believes that consistency, repetition, and creating a routine play a vital role in improving health. She understands that people have a lot of information, but they are missing the how. Being consistent with small adjustments has a cumulative effect and is more impactful than extreme measures that lead to extreme failure. “Living a healthy life is not just about exercising, it's about finding ways to support your body, especially if you're dealing with chronic pain, chronic conditions, injury, or disabilities. While we have the potential to heal ourselves internally, we also live in a very unnatural modern world that exposes us to toxic burdens. Even if we do everything perfectly, we can still experience health challenges.” – Daphne When asked what someone could do to lead a more uplifting, energized life with a healthful routine, her response was simple: start drinking a liter of water before noon. This not only ensures hydration but also helps people keep track of how much water they're drinking, which can be difficult to gauge without measurement. Drinking water in the morning is also supportive of intermittent fasting practices and helps give the body an internal rinse after a night's sleep. As for words of encouragement, Daphne advises people to focus on the return, especially when things don't go as planned. Life is full of unexpected interruptions, but it's important to find joy, excitement, and spontaneity, which can be healing in their own right. In summary, Daphne's journey with endometriosis taught her the importance of a holistic approach to health, emphasizing nutrition, sleep, stress management, exercise, AIS connection, purpose, and routine building. Her story is a testament to the power of consistency and the innate healing power that we all possess. Follow her along on her journey. At Inspira Physical Therapy in Brooklyn, NY, we use different holistic osteopathic techniques like Craniosacral Therapy and visceral manipulation. Learn more and book an appointment today.

On March 21, 2023, Inspira Physical Therapy & Pilates hosted the Endometriosis Fundraiser in Brooklyn, NY. 80+ people within the community including those with endometriosis and their loved ones and providers were in attendance. Below The Belt film documentary was played before the expert panel discussion. Panelists: Dr. Melanie Carminati, PT, DPT, GTS, NCPT - Pelvic Floor Physical Therapist Dr. Michael L. Lewis, MD - Endometriosis Surgeon Dr. Murray Orbuch, MD - Gastroenterologist Dr. Jason Siefferman, MD - Pain Physiatrist Dr. Masahide D. Kanayama, MD - Endometriosis Surgeon Nicqueva Haughton- Person with Endometriosis & Patient Advocate

Shannon Cohn, Documentary Producer, and Director has been broadcasted on PBS, Nat Geo, and Discovery Channel. Before becoming a filmmaker, she practiced international law and was part of the legal team who prosecuted Enron. Endometriosis is a disease where endometrial-like tissue forms outside of the uterus in other different parts of the body. Some of the symptoms include pelvic and abdominal pain, bloating, gastrointestinal issues, infertility, and many other symptoms and diagnoses. Shannon Cohn describes that all of the work comes from a personal place. She has endometriosis and has two young daughters with a seven-time increased risk of having the disease. At 16, Shannon experienced her first symptoms similar to GI symptoms. She did not hear the word endometriosis until 13 years later when at 29 years old she had ovarian cyst surgery and her doctor offhandedly made the diagnosis after in the post-op. Shannon felt terrified of the stats about how it affects fertility as it was part of her own personal wish to have children. She went back to her OB-GYN with complex questions and although she was a great obstetrician to her, she wasn’t well-equipped to answer in-depth about the retraces and nor was she qualified to treat Endometriosis. Billions of dollars in the US each year are due to lost productivity, medical costs, and all of the things that physically the disease puts on. Why are people not recognizing it? It feels almost criminal. It could change the lives of so many people to get them the care they need sooner and improve their quality of life. Below the Belt is geared more towards highlighting social justice issues surrounding the diagnosis and as the name implies below the belt, implies that unfair treatment. Shannon wanted to make a film and tell a story of the disease and people highlighted who live with it to bring the story to mainstream audiences by making the content digestible and personal. “One way to do that is to highlight the social justice issues that this disease does raise. I say it’s a perfect, awful storm of so many things like stigma and taboo. Historically with menstrual health or women’s health conditions below the waist, below the belt, so to speak, is the gender bias in medicine, racial bias in medicine, which compounds the issue and informed consent.” Shannon speaks about a nurse at UCLA going to E.R., and the doctors weren’t taking her seriously. She could feel like she wasn’t being believed. So she started taking her boyfriend, who was a computer programmer, appointments with her to the E.R. with her because she found a market difference, that if he were there, they would listen to her more, and sometimes she would even let him speak for her on a health condition that was affecting her body. She happens to be an African-American woman and her boyfriend at the time was a white man. Shannon decided to examine that and shine a light on it to say that this is happening. “But it’s not just one thing. We have to change national discourse or international discourse around the disease, break the taboos, talking about menstruation periods, endometriosis, and related conditions that historically have been, you know, wrapped in like a silence, basically, or whispered about that needs to change.” And it is changing. It all starts with awareness and shining a light on the issues so that people understand these are issues because it is holding back progress. When people understand and are aware of them, then we can all start working to change.

Pelvic Pain Dr. Tayyab Ahmad is a Doctor of Physical Medicine and Rehabilitation who was born and raised in New York. She is Board Certified in Physical Medicine and Rehabilitation from the New York College of Osteopathic Medicine and is also a fellow of the Academy of Physical Medicine and Rehabilitation and a member of the International Pelvic Pain Society. Dr. Ahmed is a contributing author to a textbook that is considered a staple during every physiotherapist training. Pelvic pain is classically defined as pain anywhere between the belly buttons and the knee because there are a lot of joints in between those two areas. We're seeing men and women classically. We thought pelvic pain was mostly a female dysfunction – however, everyone has a pelvic floor and it does not discriminate. So we see both people from all genders inclusive of pelvic. With men, it's a lot of penile pain and testicular pain, and pain with sitting. This region does not discriminate. Both men and women can experience pelvic pain. But, the causes of pelvic pain depend on the situation for men. A lot of the common causes or diagnosis is that people will have bacterial prostatitis, prostatitis, they might have true infections. There are also patients who don't have true infections but have an inflammation of their prostate. There's a handful that has chronic constipation, whether it's related to IBS, or inflammatory bowel disease. If a patient has anything going on with their GI tract, they can have pelvic floor dysfunction, thus causing pelvic pain. Women, it's different. There's a lot of endometriosis. One of the biggest causes of pelvic pain is not just a gynecologic condition, but a total body inflammatory disease that affects multi-system. We do see some people postpartum or during their pregnancy who have pain during the pregnancy and then resulting pain that happens after the pregnancy. We cannot exclude mental health like anxiety and depression and see that pelvic floor dysfunction is in the setting of mental health dysfunction. When we get to the actual assessment of the pelvic floor, many times what we're seeing is hypotonia sitting on the pelvic floor. For patients who we think of as having a hypertonic pelvic floor, we'll order an MRI pelvis, and try to see if I'm looking about a hernia or sports hernia. Vaginismus, are involuntary contractions of the muscles due to anything entering the vagina. The muscles tighten in a response to trauma as a protective mechanism, even if there's not necessarily tissue damage, but because of the emotional component of it. A lot of the different causes and getting to the bottom of what the causes are is really what helps figure out how to treat it. Getting to the root cause so that patients may stop experiencing symptoms is crucial. It's so important that if you may even think something is wrong or have gone through many appointments, don't give up. The fact that you're investing time means that there are people just like you looking for answers and they're out there.

On the Know & Do Better, we feature specialists in a variety of fields such as gastroenterology, Pain Physiatry, psychology and more. We believe in the importance of community and how we can now surround ourselves with our loved ones such as before the virus. At Inspira Physical Therapy, we cultivate community through our local and public outreach. We create educational content such as instructional videos, lectures, workshops, and the Know & Do Better podcast.  Spreading information is important to the business as it provides resources to our local community. We are excited to host the Endometriosis Fundraiser, on March 21st at 7 p.m. at Littlefield NYC. It will feature a Below The Belt film screening with a post-screening expert panel discussion. All funds will be donated to Endometriosis Research Center to pay it forward that much more. In 2022, we featured Dr. Lora Liu, an endometriosis surgeon, and we spoke about endometriosis and common questions that my patients ask. Endometriosis is a condition that we see in some of the patients who come to Inspira because we provide pelvic floor physical therapy in addition to complex orthopedic physical therapy. “I hope we can take this information communicated in the documentary and inform a bunch of people in the community in our local community of Park Slope, Brooklyn, and then have that kind of ripple effect where that many more people are informed.” - Dr. Melanie Carminati, Know & Do Better Podcast Donate/Book Tickets: EndometriosisFundraiser.com You may connect with your local community through: MeetUpEventbriteFacebook groups Have a happy and healthy new year!

Gentle disclaimer to all of our listeners: All medical information mentioned in this podcast is purely informational. It is not individualized medical advice. Please follow up with your physician or medical practitioner for individualized care specific to your needs. Thank you. Gareth Ziyambi is a physiotherapist and owner of A to Z Elite Health and Performance in London, UK. He's also the team physio for the UK Olympic Diving Team and has participated in several world championships and Olympic Games, including Tokyo 2020. Gareth is an executive member of Winback International Academy Committee. This blog post refers to the Know & Do Better Podcast. What is Tecartherapy? Where did it come from? The earliest forms of research date back to 1890, scientists were able to ascertain that there were low-frequency, medium-frequency, and high-frequency currents and which parts of the body those would actually have an effect on. We started to investigate the effects of high-frequency currents and to see what frequencies, in particular, would interact well with the human body, Tecartherapy, and its current form were really developed in the late nineties in Italy. Microbiology of Radiofrequencies Radiofrequency current is used quite widely, especially for those with chronic pain and they use radiofrequency ablation, for instance, to calm the nerves down. It's used in microbiology when they're trying to introduce substances into cells, for example, they have the cell in that in a fluid and then they have the current going through it to just increase the rate at which they can get things in, and out of the cell. Radiofrequency currents in particular interact with the cell on a cellular level. The modalities really work around the cell but nothing really works on the actual cell itself which makes it more permeable, increasing the nutrients that are going in and out of the cell. What Does It Feel Like? In most instances at Inspira Physical Therapy, we use it for complex orthopedic cases and pelvic floor therapy. It is warm, with no sting, or burn. It feels enjoyable for those who experience pain traditionally if there's any hypertonic muscle in the pelvic floor, just gentle palpation sometimes if it's the first or first few sessions for pelvic floor physical therapy, it takes time because the whole area becomes hypersensitive to touch. If you are interested in Winback Tecartherapy, Inspira Physical Therapy in Park Slope, Brooklyn performing this in our 1-hour sessions. Book a free phone consultation today! Questions about Winback Therapy: hello@winback.us

This episode discusses how the human body can react to pain and how experts can remedy by finding the source.

In this episode, we discuss SIBO (small intestinal bacterial overgrowth), the importance of a balanced microbiome, and visceral manipulation. Follow Dr. Elena A. Ivanina: @gut_love

Trigger Warning: Eating disorders will be discussed in detail. In this episode, we talk about anorexia, bulimia, and binge eating and how individuals' perspective on their environment influence their behavior.

Dr. Lora Liu, is a board-certified, minimally invasive gynecologic surgeon who specializes in the management of difficult gynecological surgeries, including severe, endometrial losses, difficult hysterectomy, large fibroid removal, and other complex gynecological conditions. The average time that it takes to get diagnosed with Endometriosis is ten years. That's ten years that women are going from doctor to doctor. Unfortunately, the only way to diagnose and treat is going to be with a laparoscopy. A lot of the most common symptoms are very painful and heavy periods that affect your life such as calling out sick for work because you're in so much pain that you can't even get to work. Other symptoms include painful sex, especially with deep contact, a lot of bowel dysfunction, and bladder dysfunction, especially around the time of your period.

For this podcast, we ask 7 Pilates Instructors in NYC answering the same three questions: 1. What is Pilates? 2. In your experience, how can Pilates be a transformative practice?  3. Where do you envision Pilates going in the next 10 years?   Featured Guests:  1. Simona Di Tucci, EHPilates - Simona@pilatesbysimona.com   2. Tracie Matthews, Intuitive Motion Pilates - tracie@intuitivemotionpilates.com   3. Gail Giovanniello, Mind Your Body NYC - gail@mindyourbodyfitness.com   4. Margi Douglass, Pilates Garage - margidouglass@gmail.com   5. Blossom Leilani Crawford, Bridge Pilates - Info@bridgepilates.com   6. Celine Syslo, Annex Pilates - Celine.syslo@gmail.com   7. Ellie Kusner - elliekusner@gmail.com