- Women's HealthGeneral Page Tier 3BlogYou may have heard a friend talking about her pelvic floor or you’ve seen a pelvic exercise printable on Pinterest. Maybe your doctor mentioned it during a routine exam. But what exactly is the pelvic floor? Where is it, what does it do — or in many cases not do? Your pelvic floor supports several organs and when it is weakened or not functioning properly, it can lead to a number of uncomfortable and inconvenient disorders. If you are one of the millions of women getting up several times in the middle of the night to go to the bathroom, wearing pads every day, having painful sex, feeling heaviness and vaginal bulging, or sprinting to the bathroom, here’s what you need to know. What is the pelvic floor? Your pelvis is a bone, so you may assume the pelvic floor is also made of bone; however, the pelvic floor is an area of muscles that resembles a hammock spanning from the pubic bone to the bottom of the spine. These muscles support and help to control the vagina, uterus, bladder, urethra and rectum. When the pelvic floor weakens, those organs can drop and may have trouble functioning normally. Imagine a trampoline taut and sturdy, holding up and supporting the weight of your body as you jump. The base of the trampoline expands and contracts based on your movement and control. Now, picture the trampoline fibers beginning to wane, the middle sags, the function worsens and control becomes difficult. The pelvic floor can weaken like this. That’s why it’s important to watch for symptoms that, while common, can mean you have a pelvic floor disorder. How do I know my pelvic floor isn’t doing its job? Because the pelvic floor is supporting several different organs, you may experience a variety of symptoms depending on how the structure of the pelvic floor has shifted. Many women will experience incontinence, which is the leaking of urine. Others may have trouble emptying their bladder or bowels. Some are always running to the bathroom, are up going at 3 am or have pain during sex. Often as the pelvic floor weakens, a woman may start to feel a heaviness down below and eventually even a physical bulging of tissue presents itself externally, which is a sign of pelvic organ prolapse. Any and all of these symptoms can happen separately or together. How did this happen? There is often no single cause for pelvic floor disorders, but childbirth, age, hormonal changes, obesity, smoking, constipation and chronic heavy lifting are usually factors. Is there anything I can do? Yes! Talk to your health care provider about all of your symptoms. Don’t be embarrassed; pelvic floor disorders are very common. Chances are you know several other women experiencing the same issues as you, they’re just not talking about it. Solutions can include physical therapy, home exercises, medication or non-invasive surgery. The takeaway is that these inconvenient and uncomfortable changes in your body, though very common, deserve treatment. You don’t have to live with pelvic floor issues. Who can help? As part of a relatively new field of medicine, a urogynecologist is an OB-GYN with additional training and expertise in the evaluation and treatment of conditions that affect the female pelvic organs, as well as the muscles and tissue that support these organs. The Women’s Center for Pelvic Health at Anne Arundel Medical Center has a fellowship-trained team of doctors and nurse practitioners who specialize in the care of female pelvic health disorders. Team members collaborate on care for patients of all ages, from those with minor issues to individuals suffering from complex conditions requiring advanced surgery and care. For each patient, they will conduct a thorough review of medical history, conduct a physical exam, lab studies and advanced imaging and testing to develop individualized treatment plans based on your needs and goals. Author Kay Hoskey, MD, is a urogynecologist with AAMC’s Women’s Center for Pelvic Health. Contact the Women’s Center for Pelvic Health at 443-481-1199 to schedule a consultation to help guide you to the right solutions to meet your needs and health goals. Originally published April 23, 2018. Last updated May 14, 2019.0
- Men's Health, Women's Health, PediatricsGeneral Page Tier 3BlogIf you’re outdoors a lot during the summer, you probably know to watch out for ticks. These insects, especially deer ticks, can transmit Lyme disease and other viruses. While ticks are most active during warmer months, they remain a concern long after Labor Day. Deer ticks can be active as long as the ground isn’t covered with snow, or frozen. Which means a disease-carrying tick can bite you, and infect you, even after the first frost. According to the University of Rhode Island’s TickEncounter Resource Center, deer ticks, also known as blacklegged ticks, start to become active in their adult stage as summer fades away into fall. In the Northeast, there are more adult stage ticks in early October. But ticks can also be an issue in the winter, according to TickEncounter. Ticks that didn’t find a host to latch onto when it was warmer outside can come out from under the snow when the ground thaws, and look for a host then. Not all deer ticks are infected with the bacteria that cause Lyme disease, but it’s still a concern. Since the late 1990s, the number of reported cases of Lyme disease in the U.S. has tripled, researchers say. Lyme disease is rarely fatal but it can be debilitating. Its early symptoms resemble the flu, and a rash sometimes develops around the bite. Preventing ticks Prevention is key. If you’re out hiking at any time of year, stay in the center of trails and avoid areas with thick vegetation and grass. The Centers for Disease Control and Prevention (CDC) also recommends that you use repellent containing 20 percent or more DEET on exposed skin. You should also use products that contain permethrin to treat pants and shoes, or choose outdoor clothing that is pre-treated with permethrin. Know what to look for: Adult deer ticks grow only to about the size of a sesame seed, and have reddish hind bodies with black markings and legs. After you come in from outside, you should take a bath or shower as soon as you can to wash off any ticks before they bite. Wash your clothes in hot water, or dry them on high heat. The CDC also advises people to examine pets after they come inside to make sure they aren’t bringing ticks with them. What to do if You Find a Tick on Your Skin If you do find a tick on your skin, you should take fine-tipped tweezers and grasp onto the insect as close to your skin as possible. Pull the tick upward. Once you remove the body of the tick, it can’t transmit disease. Wash the bite area and your hands. Take special note of whether the tick was engorged, or full of blood. Ticks that look “puffy” are more likely to transmit diseases. You may also want to save the tick in a plastic baggie, in case you need to go to the doctor and identify the type of tick. If you start to notice any of the signs of Lyme disease, including fever, headache, fatigue, or muscle or joint aches, call your doctor. Don’t let a fear of ticks keep you indoors. By taking the proper precautions, you can enjoy being outside all year long. Originally published Sept. 11, 2017. Last updated Sept. 16, 2025.0
- Orthopedics, Physical Therapy, WellnessGeneral Page Tier 3BlogTennis is a great sport that offers a cardiovascular challenge, a test of skill and strategy. Proper tennis warmups and strengthening exercises can help prevent muscle and tendon strains and tears. Below are some tips to help get you tennis ready and help prevent injuries. The warmup Start with a light jog, jump rope, do burpees or do a combination of all three. The point is to get your blood flowing. In five minutes you should feel loose and have your heart pumping. Dynamic warmup The goal of the dynamic warm up is not just to stretch, but to make sure you are able to take your joints their full range. Frankenstein’s Kick – You can do this statically in one position or walk around. Keep your hips and pelvis pointing straight ahead and kick your right foot while reaching out with your left hand, then alternate with your left foot and your right hand. Do this for 30 seconds or go 30 yards. Butt Kicks – The ideal athlete should be able to kick his or her own butt. Stand tall, keep your tail bone tucked and kick your right foot back while reaching back with your left hand to touch it. Now alternate with your left foot kicking back with your right hand reaching back to touch it. Do this for 30 seconds or go 30 yards. Side Shuffles – We move in one direction most of the day: forward. Get in an athletic stance, like someone was going to knock you over. Side shuffle each direction for 30 yards. Keep your body squared and hips forward. Grapevines – This is the same as the side shuffle except you have to open up your hips, bring the push off leg in front of the lead leg, shuffle laterally and then bring the push off leg behind the lead leg. Repeat for 30 yards each way. The stretching Now that your body is warmed up, it is time to stretch. For tennis players and all overhead athletes, due to the repetitive nature of the sport, certain things tend to tighten. Cross body shoulder stretch – Keeping your shoulders low, bring your arm across your chest. Grab onto your elbow with your opposite hand and pull. Hold 20-30 seconds and repeat three times. Now repeat on the other side. Prayer stretch and reverse prayer stretch – Bring your palms together as if you are going to pray. Place your elbows out and feel the stretch of the muscles of your forearm. Now alternate with bringing the back of the palms together. Keep elbows out and hold each stretch for 20 seconds. Repeat twice. Sleeper stretch – Lying on your side, bring your arm that you are laying on out at a 90-degree angle from your body. Now bend your elbow to 90 degrees with your palm facing the direction in which you would arm wrestle someone. Use your top arm and push your hand down towards the floor/bed/mat. You should feel a nice stretch in the back of your shoulder. Hold for 20-30 seconds and repeat three times. Thoracic mobility – A stiff rib cage and thoracic spine can cause your whole shoulder girdle to overstress itself. Lying on your side, keeping your knees together, open up your trunk like a book. Your top arm is going to reach away from the direction that your knees are pointing. Turn your head facing your reach hand, as well. Hold 2-3 seconds, and repeat 10 times. Now try the other side. Rotator cuff strengthening There are many ways to approach rotator cuff strengthening. These are a few of my favorites: Neutral external rotation (NERT) – Using a resistance band, keep your arms by your side with your arms bent at 90 degrees, like you are holding a pizza box. Palms up, thumbs out. Grip the resistance band and pull it apart while keeping your elbows tucked into your rib cage. Squeeze the shoulder blades together. Repeat 15 times. Do 2-3 sets twice a week. Plank and rotate with a band – Hold a plank on your elbows while holding a resistance band with light tension between your hands. Now rotate your body so all your weight is through one elbow. Extend the free hand towards the ceiling while pulling the band. Rotate and repeat 10 reps to each side. Do two sets at least once a week. The reverse throw – Set a band or a pulley system to waist height and stand centered to it. Grab onto the band with your throwing arm and cock your arm back as if you were to throw a football. You should be able to do 20 reps. Repeat for three sets and alternate arms. ABC plank – Plank on a Swiss ball with elbows on the ball. Now draw the whole alphabet with the ball, keeping a tight plank. Do one set with capital letters and one set with lower-case letters at least once a week. Other general upper body strengthening to help the shoulder girdle that should be part of any strengthening program include: Pushups Dips Pull ups Rows Knee stability The knee needs balance between all the muscle behind the knee, above the knee, and below the knee. Knee range of motion – Make sure you have full range of both knees. Can they bend all the way equally, and can they not only extend, but hyperextend equally? If not, stretch them or make an appointment with your physical therapist to figure out why. Squat – Feet should be shoulder width apart. Keep your knees behind your toes and squat down. You can add resistance with a barbell, kettle bell, dumbbell, etc. Find a trainer to make sure your form looks good. Single-leg dead lift – Stand tall holding a dumbbell or kettle bell. Hinge forward with one leg kicking back. Bring the weight down towards the floor keeping the three curves of the back. Allow the stance leg’s knee to bend. Now bring it back to position one. It is okay to do a standard dead lift with a barbell, as well. Form is everything when trying to prevent injuries in this exercise. Overhead reverse lunge – Holding a weight over your head with your right hand, step back with your left leg and sit in a lunge with the left knee close, but not touching the ground. Return to start. Repeat 8-10 times for two sets and switch legs. Side plank clams and hip abduction – Holding a side plank, try 20 reps of clams. The top leg should be bent at 90 degrees. Open the hips just enough before your trunk starts to rotate. For hip abduction, return to the side plank position. Keeping the hips and toes pointing forward, lift your top leg away from the bottom leg, leading with the heel. Repeat 20. The leg exercises not only give you the strength needed to compete, but also improve the power of your swing. Proprioception Proprioception is your body’s ability to perceive its position in space. Simply balancing and standing on one leg can challenge your proprioception. Exercises like yoga and the practice of martial arts help you develop the balance, strength and skill to master your body awareness. At a gym or at home use a Bosu ball or wobble board with your exercise routine to help you challenge your proprioception and improve your core activation. Simply standing on a BOSU while doing arm curls can help improve proprioception. Stand-up paddleboarding is also a great way to challenge your balance, proprioception and core strength for tennis players looking for a way to cross train. Plyometrics Plyometrics is a type of activity that involves explosion and using a muscle in a way that creates a quick stretch and response. Jumping rope – Keeping your body relatively stiff, jump rope. Variations include single leg, alternating skips and side-to-side jumping. Box jumps – Finding a box at an appropriate height for your level of skill is important. This is an explosive exercise. Keeping your legs parallel, hop up on to the box, landing as softly as possible. Then step down. The point is to explode and react with strong stability. Do reps of five for a set of five. Depth jumps – It is also important to learn how to react quickly with plyometrics. Set up two boxes at difference heights or a box and a hurdle. Start at the higher box and jump down. Now explode as fast as you can onto the second box. The cue is “attack the ground.” Again, repeat for five reps for a set of five. Other activities that can help you train plyometrics include basketball, high-intensity interval training (HIIT) classes and wind sprints. If you’d like help developing a training routine specific for your needs or help recovering from a sports injury, AAMG Physical Therapy can help. Call 443-481-1140 for an appointment or more information. Author Dat Quach, PT, is a senior physical therapist at AAMG Physical Therapy and supervisor at the Bowie Pavilion clinic. To reach his practice, call 443-481-1140. Originally published June 6, 2017. Last updated June 11, 2018.0
- Pediatrics, WellnessGeneral Page Tier 3BlogSummer’s here which means it’s a great time for kids to get outside and play, but the heat can also take a serious toll on little bodies when we aren’t careful. Heat exhaustion is one of the most common conditions kids experience in the summer. A child’s body surface makes up a greater proportion of their overall weight than an adult’s, which puts them at greater risk of dehydration and heat exhaustion. Symptoms of Heat Exhaustion Severe thirst Nausea Fast and shallow breathing Headaches Muscle pain Cool, clammy skin If your child is experiencing these symptoms you should immediately bring them to a cooler place, remove any excess clothing, encourage them to drink cool fluids and call your doctor for advice. You can prevent heat exhaustion by being proactive about keeping your child hydrated. Make sure they drink cool water early and often. If they’re going out to play or to a sports practice make sure they’re fully hydrated before leaving and then make sure they take regular breaks to drink – even if they aren’t thirsty. Heat exhaustion starts slowly but if it’s not identified and treated quickly it can progress into heat stroke. Symptoms of Heat Stroke Pounding headache Dizziness and light-headedness Red, hot, dry skin Cramps or muscle weakness Rapid, shallow breathing Nausea, vomiting Confusion Unconsciousness Heat stroke is very serious and is considered a medical emergency. If you think someone has heat stroke, call 911 immediately. While you wait for medics to arrive you can try and cool the person down by moving them to a shady or cool area, fanning them and cooling down their skin with water. Author By David Afzal, DO, a family medicine physician with Anne Arundel Medical Group (AAMG) Waugh Chapel Family Medicine. To find an AAMG doctor in your area, visit MyAAMG.org. Originally published May 29, 2015. Last updated July 6, 2020.0
- OrthopedicsGeneral Page Tier 3BlogMike Upton, 75, is an avid spinner. It was during a class he noticed numbness in his left leg. “I felt like my leg was going to give out when getting on my bike,” Mike said. He would occasionally have this sensation for nearly a year before it got progressively worse. He began experiencing balance issues and muscle weakness in his thigh. “I lacked strength in my leg to go up and down stairs and I became increasingly worried about this.” Concerned these were symptoms of complication from a previous hip replacement, Mike saw his hip surgeon who referred him for an MRI scan of his lower back. The results were negative. Still concerned, Mike went to his primary care doctor who suggested spinal steroid injections. The injections did not help and Mike continued to experience numbness. His doctor then referred him to Alessandro Speciale, MD, an orthopedic surgeon specializing in the spine and spine disorders at Anne Arundel Medical Center (AAMC). Dr. Speciale ordered an MRI of Mike’s neck and thoracic spine, the longest region of the spine running from the base of the neck down to the abdomen. The images showed that Mike had a dangerous herniated disk in the middle of his back. Working as a team “We describe to patients that spinal disks look like jelly doughnuts and, when a disk herniates, it’s like the jelly squirting out of the doughnut and hitting a nerve,” Dr. Speciale explained. “By the time of Mike’s surgery, the herniated disk had become calcified. So, in this case, you had what looked like a piece of bone poking into the spinal canal, blocking spinal fluid from getting through. This was damaging Mike’s spinal cord.” Mike’s surgery would be high risk, with a 75 percent likelihood of success. Dr. Speciale knew he had to bring together a multidisciplinary team. He requested the help of AAMC Thoracic Surgeon Stephen Cattaneo, MD, and Neurosurgeon Timothy Burke. “This case was special in its complexity and inherent risk of paralysis or worsening of other neurologic symptoms,” explained Dr. Cattaneo. “Dr. Speciale was very concerned that removing the disk could compromise the spinal cord, so he involved Dr. Burke and me for expertise in our respective areas.” Each doctor sat down with Mike and explained what their roles would be during the surgery. “My wife and I felt confident with what they told us and how they explained the procedure step by step, so we decided to get it done,” Mike said. Just two weeks after his diagnosis, Mike was in the operating room. Looking back, he describes the ordeal as a flash. “I went from being a candidate that didn’t require surgery to needing to get in there quickly,” he said. “I was very impressed with the speed at which all the doctors saw me and the time each took to walk me through the procedure and their respective roles…this was all very impressive.” Preventing paralysis Mike’s surgery took nearly 10 hours. When waking up in intensive care, Mike said the first thought that crossed his mind was his ability to move. “I wiggled my toes first and made sure my legs could move,” he said. Once he came into consciousness, Dr. Speciale, Dr. Cattaneo and Dr. Burke each congratulated him on a successful surgery. The doctors explained to Mike they had removed part of his rib to turn it in to a substitute disk out of his own bone. They explained that there was no damage to the spinal cord. “This was a really rare disk herniation and probably one of the highest-risk procedures,” said Dr. Burke. “Dr. Speciale, Dr. Cattaneo and I worked side by side to remove bone from the spinal cord without damaging it. The procedure goes to show the importance of teamwork to do cases like these successfully. At AAMC, we have a unique advantage of having great teams available for our patients.” READ MORE: 5 tips to prepare for home life after joint replacement or spine surgery Regaining strength After his surgery on Monday, Mike was discharged from the hospital Friday afternoon. He walked out with the help of a cane. From the very beginning, he noticed renewed strength and balance. To further improve, he completed six weeks of physical therapy. Now, he is slowly getting back into his spinning routine. “I know this could have been more serious, so I’m very grateful to the doctors and the team at AAMC,” Mike said. Authors Alessandro Speciale, MD, is an orthopedic surgeon specializing in the spine and spine disorders at Anne Arundel Medical Center (AAMC). Stephen Cattaneo, MD, is a thoracic surgeon and medical director of Thoracic Oncology at AAMC. Timothy Burke, MD, is a neurosurgeon at AAMC.0
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