Acupuncture, Prism Blog, Scar Reduction, Surgical Recovery, Transgender Wellness

Can You Exercise After Gender Affirming Surgeries?

Exercise can be a great way to increase energy, keep your body strong, and help clear your mind. Treating your body kindly with modified exercise before and after surgery is especially imperative to assist in the healing process. However, it’s important to know how much and what type is okay. Today, we’re breaking down what types of exercise you can incorporate into your recovery routine and how they can help your body feel its best after gender affirming surgery.

Remember that this is just a guide. Only YOU know your body and your limits. While there may be movements that are uncomfortable after surgery, never do anything that causes you pain or causes you to bleed. Know your body’s limits and be sure to take care of it.

Pre-Op:

Prior to your surgery, it’s best to make time for daily exercise. While each person is unique, take time to discover what exercises feel good and prepare your body best for surgery. Since you likely won’t be able to be active for some time after surgery, it’s important to get your exercise in and make it count.

  1. Foam rolling: You can buy these in most stores or online and they can be used to help sore or tight muscles. Use a foam roller daily the week before surgery (or earlier than that) to soothe any tight muscles. Do what feels right for your body, but refer to this article for five beginner-friendly positions. 
  2. Core exercises: Core work can help your posture and strengthen your core. Here are some core moves to incorporate into your exercises before your surgery. 
  3. Stretching: Stretching isn’t just for before or after a workout. Stretching can help with tight muscles, improve flexibility, release tension, and more. Find a stretching routine that works for you
  4. Pelvic floor exercises: Prior to bottom surgery–like vaginoplasty, metoidioplasty, or phalloplasty–pelvic floor exercises can be extremely helpful in preparing the body. One exercise we recommend involves imagining you’re picking up a marble or closing a drawstring purse with your perineum. Pick it up, hold for a moment, then let it go. This exercise can both strengthen and relax your pelvic floor muscles prior to surgery. If you have any pre-existing pain or issues with urination, contact a pelvic physical therapist to discuss what’s best for your body. 

Post-Op:

After your surgery, you may notice your body feels and moves differently. It’s important to be sure to balance out your healing with both rest and movement to help your body in its recovery. Take each move slowly, paying attention to how your body is feeling.

  1. Slow walks: Unless you’re on bed rest (which may be the case for bottom surgery), try going for a slow walk around the block the day after surgery. If you’re on bed rest, start this the day you’re off bed rest. Bring a buddy with you to keep you company and assist you if needed. Rather than going for longer walks, go for shorter walks more often. A good rule of thumb is to aim for three one-block walks every day in the first week, then increase to a few blocks at a time if you’re up to it. Many doctors recommend you keep your walks short, around less than 15 minutes until two or more weeks post-op. 
  2. Ankle exercises: Start with pointing and flexing your toes 20 times every two hours. Then, make circles with your ankles 10 times in each direction to promote circulation and prevent deep vein thrombosis. This is recommended to be done every two hours while lying in bed. Ankle pumps are simply moving your ankle up and down. To do ankle pumps, plantarflex one foot as if pressing down on an imaginary gas pedal. Then, dorsiflex your feet by pulling your toes up toward your shins as if letting off the gas. Repeat with the other foot and alternate sides for 20 repetitions. This is great when you’re on bed rest, such as after phalloplasty, metoidioplasty, or vaginoplasty.
  3. Deep breathing: Not necessarily an exercise, but a great way to check in with yourself and your body. If at any point you need to relax, breathe through discomfort, or put your mind at ease, practice deep breathing through your nose. Let your belly and chest expand all the way from the tops of your shoulders to your pelvic floor, and sideways to expand your ribs. Feel the air fill your lungs and exhale slowly through the mouth. Do this however often you’d like, with a recommendation of two or more minutes, two or more times per day. Yes, this exercise is ok to do after top surgery (mastectomy, chest masculinization, or breast augmentation); you may feel some discomfort but should not feel pain.
  4. Shoulder rolls: With a surgeon’s consent, stand or sit comfortably with your arms relaxed at your sides. In a circular motion, bring your shoulders forward, up, backward, and down. Try to make the circle as large as you can and move both of your shoulders at the same time, doing this 10 times. If you have tightness across your incision or chest, start with smaller circles and increase the size as the tightness decreases. After your series of 10, switch directions and do 10 shoulder rolls in the backward direction. Bring your shoulders backward, up, forward, and down. You may find that the backward direction is a little tighter across your chest than the forward direction. Rest assured knowing that this will get better with practice.
  5. “Chicken wings:” Also called shoulder wings, these are done by placing your hands on your chest or collarbone, wherever is most comfortable. Raise your elbows upwards out to the side, limiting your range of motion as instructed by your healthcare team. Slowly lower your elbows. Do this 10 times, imitating a chicken wing, and then slowly lower your hands back down to your lap. If you feel discomfort while doing this exercise, hold your position and do the deep breathing exercise above. If the discomfort doesn’t go away, don’t raise your elbows any higher. If the discomfort does go away, finish the exercise in a range of motion that’s comfortable for you.
  6. Arm side circles: With a surgeon’s consent, stand with your feet slightly apart to help you balance. Raise each arm, one at a time, out to the side as high as you can. Gently, start making slow, backward circles in the air with your arm. Be sure you’re moving your arm from your shoulder, not your elbow, and keep your elbow straight. Increase the size of the circles until they’re as large as you can comfortably make them, limiting your range of motion as instructed by your healthcare team. Be sure to complete at least 10 full backward circles. If you feel any aching or if your arm is tired, take a break. Continue doing the exercise when you feel better. Slowly lower your arm to your side to rest your arm for a moment. Repeat the exercise at your comfort level, this time making slow, forward circles instead. 
  7. Hand pumps: These can help reduce swelling in the chest and should be done three times a day. Open and close the fists ten times, holding for a few moments in between. 
  8. Other exercises: Three slightly more advanced poses to help with surgical recovery are “happy baby pose,” “child’s pose,” and side bends. You can use a pillow under your knees in child’s pose if it’s uncomfortable. Wait to start these until you have surgeon approval as they require a little more range of motion. 

Remember: If you can’t eat, drink, and/or urinate, or have a fever, chills, an infection, trouble breathing, unusual bleeding, redness, feel unwell, or have a hot feeling in the surgical site, call your doctor or go to the emergency room. Ask your surgeon what signs you should look for regarding post-surgical complications.

Get acupuncture home visits in Berkeley, Oakland, and the greater Bay Area to improve your recovery: www.prismacupuncture.com/appointments

This information is for educational purposes only, please consult a healthcare provider before exercising and always follow your surgeon’s advice.

Four queer patients of color, including masculine of center nonbinary transgender patients and trans men
Prism Blog, Surgical Recovery, Transgender Wellness

Six Steps to More Comfortable Binding: Part One of Six

Guest blog from Sandy Baird DC of Riverstone Chiropractic


According to a Health Impact Study published in the Culture, Health, and Sexuality Journal, 97% of people who wear a binder experience uncomfortable side effects such as neck pain, shoulder pain, back pain, and trouble breathing.

Other than limiting the time you spend in a binder, changing/washing your binder often, and avoiding unsafe compression methods such as duct tape and ACE bandages, there are several steps you an take to decrease the discomforts associated with binding.

This collection of tips comes both from my personal experience wearing binders as well as my clinical experience in treating the musculoskeletal complaints that my clients experience from binding.

  1. Practice daily movement and stretching

Increasing circulation and stretching key muscles in your body can help release some of the tightness that builds up from the daily postural stress associated with binding.

One possible routine would start with five minutes of movement of your choice (walking, dancing, jumping jacks, etc) to increase general blood flow to your muscles.

Then spend 30-60 seconds performing each of the following stretches:

  • Trapezius muscles:
    • From a seated or standing position, tilt your right ear towards your right shoulder, imagining your neck growing long towards the sky before settling into the tilt.
    • This should bring a stretching sensation into your left neck muscles and trap muscles (the chronically tight muscle between your head and your shoulder.
    • If you want more of a stretch, you can reach up with your right hand and gently apply a bit of overpressure, being careful not to crunch your head down, but instead allowing more length in your neck.
  • Pectoralis minor muscle:
    • Find a doorway you can walk through.
    • Bring your right arm up and out to your side like a goalpost
    • Then place your right elbow and right wrist against the doorframe.
    • Your elbow should be level with your shoulder.
    • Slowly lean your torso forward into the door opening while keeping your elbow and wrist in contact with the doorframe.
    • If this stretch creates any pinching sensation in your shoulder, you can alternatively lie atop a foam roller placed vertically along your spine (head and hips supported) and drop your arms out to the sides.
  • Side stretch:
    • Reach your arms overhead if that is available to you, or plant your hands on your hips.
    • On your inhale, reach and lean upwards and over to your left side.
    • If your arms are overhead you may want to grasp your right wrist with your left hand.
    • You should feel a stretch along the right side of your body through your ribcage.
  • Cobra stretch:
    • lying face-down, place your hands under your shoulders with your palms down and fingers pointing forwards.
    • Draw your elbows back and in towards your sides so your shoulders won’t hunch up by your ears.
    • Then press up gently until you feel a generalized stretch through the front of your chest and abdomen.

Look out for next week’s post for tip #2!

The stretches, self-muscle work, and strengthening exercises are from my full core and glutes strengthening program available for purchase at www.engineeringyourbody.com. And if you are interested in exploring muscle-work or joint adjusting to alleviate your muscle and joint pain, you can find out more about my practice at www.riverstonechiropractic.com.

In happiness and health,

Dr. Sandy Baird, DC

Oakland Chiropractor Sandy Baird

 


Bio:
I’m Dr. Sandy Baird, DC. I’ve been providing bodywork in the Bay Area for over ten years now. First as a massage therapist, and now as a doctor who combines soft tissue work with joint adjusting. I feel that it’s important for queers to have a safe space to have their bodies worked on. Many of us already shoulder a lot of extra stress and tension from being constantly judged, worrying about what bathrooms we should use, and having to actively resist and fight back for our rights as our new state of “normal”.


References:
Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study: https://www.tandfonline.com/doi/full/10.1080/13691058.2016.1191675

 


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

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Sandy Baird DC of Riverstone Chiropractic
Prism Blog

Featured on RiverstoneChiropractic.com: Acupuncture and Post-Surgical Care

Hi everyone! I’m so excited to share my newest article, which was featured on riverstonechiropractic.com (my favorite—and LGBTQ-focused!—chiropractor). Click to read more.

“In Chinese medicine, surgery is considered to block the flow of the meridians (similar to nerve and blood vessel damage in Western medicine). Improperly healed scars and old scar tissue can have the same effect, potentially causing pain, sensation loss, decreased circulation, and even impaired internal organ function depending on the depth of the scar tissue. Acupuncture as soon as possible after surgery helps to promote healing, reduce pain, swelling, and bruising, and prevent scar tissue from forming. Once the bandages are removed, scars can be worked on directly to prevent adhesions and reduce the appearance of scars. Cupping massage is also used to treat surgical scarring and adhesions to underlying tissues, and moxa can be used for post-surgical pain as well as reducing scars…

Surgical scars that are at least two weeks old can be worked on with acupuncture. Such treatments not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to less noticeable scars and a reduction in keloiding. Scars may not only be cosmetically undesirable, but may also have an impact on health…”

Click to read more.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

Scar reduction therapy
Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Neuropathy, Prism Blog, Scar Reduction, Surgical Recovery, Transgender Wellness

Acupuncture for Scar Treatment

Why Should We Treat Scars?
Scars may not only be cosmetically undesirable, but may also have an impact on the health of the individual. This is especially true for very large scars; scars with abnormal coloration, lumpiness, numbness, tingling, itchiness, heat or cold sensations, achiness or pain, tenderness to touch, and muscle restriction.
Such scars and associated adhesions can indicate or lead to nerve and blood vessel damage, decreased range of motion and muscle strength, increased likelihood of future injury, and chronic pain (especially pins and needles, tingling, and numbness). Scars are especially notable on the torso, where underlying adhesions can impair bowel function, chronic pelvic pain or infertility, depending on the site of the scar.
In Chinese medicine, significant scars are considered to block the flow of the meridians, (similar to the nerve and blood vessel damage pointed to by Western medicine) causing not only pain and decreased circulation, but also potentially impaired internal organ function depending on the meridian affected.

Scar Treatment with Acupuncture and Herbs
Scars that are at least two weeks old can be treated with acupuncture and herbal medicine.
A 2014 study used local acupuncture (“surrounding the dragon“: using needles directly around and through the scar) with distal points (4 gates and ST36). After eight treatments in 5 weeks the scar pain had reduced from a 7/10 to a 1-2/10. Such treatments can not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to flatter, smaller, less noticeable scars and a reduction of keloiding.
Moxibustion (a gentle warming treatment achieved by burning dried mugwort), may also be used. Small amounts of moxa may be burned directly on the skin -with a sesame oil cream as a medium to prevent burns- around the scar, or a stick of rolled moxa may be burned above the site to warm the area. Both methods are pleasant and effective.
Topical herbs can also be very beneficial for scar healing. It is generally best to apply your liniment of choice over the affected area before bed and cover with a tshirt (or other clean soft article of clothing depending on the site of the scar), so that it has plenty of time to soak in without washing or sweating which would interfere with product absorption during the day.

Which Topical Should You Choose?
  • Prism’s Scar Oil has frankincense and other essential oils that break up scar tissue in a tamanu oil base, a great oil for reducing the appearance of scars, including keloids.
  • Zheng Gu Shui is beneficial for deep scars that may have adhesions to underlying tissues (for example surgical scars). They can improve local circulation, healing of the scar and the area that was injured, and reduce associated pain. It is better for healing and restoring health to the area than for cosmetic scar reduction.
  • Wan Hua Oil prevents scarring, increases blood circulation, reduces swelling, and helps regenerate damaged tissues. Once the wound closes, massage the oil directly over the scar daily to prevent scarring and promote healing. This option is best to prevent cosmetic scars from surgery. It is also effective for scars from burns.
  • Aloe aids scar healing and reduces infection and swelling. If used during the healing process it can reduce the formation of scars. Be sure to use 100% aloe (fresh is best), not aloe with alcohol or other additives that can dry and irritate the area.
  • Ching Wan Hung oil promotes healing and new tissue growth, reduces scarring, and prevents infection. It is especially effective for scars from burns.
  • You can also use castor oil compresses, to break up deeper scar tissue and adhesions, but I don’t recommend this for new scars that are still healing (or any open wounds).

Note: Many people recommend the usage of Vitamin E on scars, but newer research shows that Vitamin E does not help reduce the appearance of scars, and in the case of surgical scars can actually make scars more visible due to the development of irritation or contact dermatitis.


Providers: read more about acupuncture scar treatments from Skya Abbate, DOM.

Additionally, my colleague, Dena Gold LAc, suggests a Japanese style version of surrounding the dragon that involved needling slightly outside the scar, towards and under under the scar superficially enough that the needle falls rather than roots. Dena also suggests checking the fire points of the channel the scar intersects and if they are tender, needle the metal and water points of that channel before treating the scar directly.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

 

A transgender man binding and looking into the distance
Prism Blog, Transgender Wellness

Chest Binding Safely: Save Your Back!

Interested in binding, or already binding? Here are some very important health tips that you need to know!:

  • Do NOT use an ace bandage or similar homemade device for binding. Wrapping around your chest several times can result in dangerously tight binding that cuts off circulation, breathing, tissue damage, and skin irritation. If you want to make a binder, cut off the top of some control top pantyhose and sew on some straps. This is much safer and still just as cheap!
  • NEVER sleep in a binder (unless you are in a place where it is unsafe for you to sleep without it). Don’t leave your binder on for more than 8 hours at a time. Your body needs time to stretch and breathe. Think about those pictures of women who wore corsets daily and how it changed the shape of their abdominal organs permanently. This can happen so a lesser extent with binding too and tissue damage caused by constant binding can make top surgery more difficult!
  • Wear the right size binder. Don’t wear a smaller size thinking it will be more effective, it won’t flatten your chest more effectively, it’ll just cause more damage to your ribs and make breathing more difficult.
  • If you wear a binder frequently, make sure its made of breathable fabric (not neoprene), or wear a tank top or apply cornstarch underneath it to prevent chafing and breaking out.
  • If possible, take a “day off” at least once a week. Wearing even a tight sports bra once a week instead of a binder can help take some of the pressure off of your ribs.
  • Go braless or wear a loose bra as much as possible. Actually bouncing your chest can help restore circulation and prevent tissue damage. Take your binder off as soon as you can, and spend a few minutes either jumping or just manually moving your chest. This can help prevent issues like breast cancer and tissue damage (and is even recommended for people who wear underwire bras regularly).
  • Binding can change breast tissue, potentially increasing chances of breast cancer. It is important to do regular self exams so you recognize any changes in your body right away. The most important thing is to notice what lumps are normal for you and which are abnormal, immovable, and/or don’t go away.
  • Give yourself chest massages (or get a loved one to do it for you!) to work out any tightness that wearing a binder causes. Pay special attention to the sides of your ribs, collar bone area, shoulders, and use a tennis ball (or two tennis balls taped together) on a wall or the floor to get the knots out of your back and between your scapula.
  • Buy at least two binders so that you can alternate between them. If you give them a day off to regain their shape they’ll last longer! Wash them in special detergent that keeps them stretchy too: you can find soaps for medical braces, swimsuits, or nylons that all work well for this.
  • If you are younger than 20, your body is still growing and changing and this makes binder safety even more important. Don’t wear a binder more than 3-4 times  a week. At younger ages you are more likely to cause dangerous changes to your ribcage and chest tissue by binding more frequently.

Resources for Buying a Binder:
This site has information on fitting, buying, and wearing binders
Low cost binders
T Kingdom
Underworks
Underworks swim binder
Binder reviews

Binder Alternatives:
Frog Bra Substitutes
Qwear sports bras


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.