Isa Herrera, MSPT,CSCS owns and operates Renew Physical Therapy, a leading healing center in New York City. She has dedicated her career to helping women find relief from conditions such as dyspareunia, incontinence, pelvic pain, prolapse and pre and post-natal complications. Ms Herrera's approach to healing is holistic, utilizing techniques that tie together mindful-painful body components. Ms Herrera’s passion for women’s health and healing began after working for many years with pregnant women, who many times suffered from sexual pain and other problems after the birth of their children. Herrera's experience with her patients lead to the development of her treatment protocols and therapeutic methods, which fuse together many types of exercises, self-care practice and relaxation techniques. Her women’s health program is called “The Renew Program For WomenTM”. Ms. Herrera’s philosophy is, “With the proper amount of training and encouragement, women can be helped to control their pain or condition, get their bodies back and return to the lifestyles they desire.”

She is currently working on her second book "End Female Pain, a Woman’s Manual" which will be completed in 2009. In this unique book, Ms. Herrera shares her trade secrets to getting on the right track to a pain-free, enjoyable and wonderful sex life. Ms Herrera holds a Masters in Physical Therapy from Hunter College and a BA in Psychology and Biology from Fordham University.

Below is a response from Isa to one member's question about sexual pain after birth. Feel free to ask Isa your question this week and look for her new book "End Female Pain" coming soon.

More information on Isa and her book can be found at: "">

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Dear Lisa,

Kegels will help with your feelings of urgency but you should also have your pelvic floor muscles checked out for trigger points, spasms, and scar tissue. Many times the urgency is really related more to trigger points in the pelvic floor muscles. These trigger points need to be eliminated, so that you can normalize the tone of the muscles, and then combine it with an excellent program of kegel/reverse kegels to get the results you desire.. In addition, you should be educated as to possible behavioral modifications and bladder re-training. This total program and type of approach will do more than just doing kegels.

You have to be careful that you may not be doing the kegels correctly, or that the number of seconds could be off, which would potentially not get you results. You should also consider a Maya massage or seeing a an expert in visceral manipulation to put your uterus and bladder back into position. I specialize in both Maya and visceral work and have re-aligned the organs and helped women jump start their kegel programs. You can get your body back, you just have to have the right tools and be absolutely dedicated to yourself.

In addition to kegels, ou should also incorporate core and hip stabilization in order balance the kegel work and make it more effective.

In terms of UHC, give my front office a call and they can provide you with all of our various options to get you access to our great care. We participate with many variations of UHC. I have a great team and all are very skilled in treating conditions such as yours.

In terms of OB/GYNs, I highly recommend Dr. Jacques Moritz, who is at St. Likes Roosevelt here in NYC.



Lisa Taylor said:
Here's a fun topic/question (ha!)...Following the (vaginal) birth of my two children (one in '05 and one in '08), I have found that it seems much more urgent whenever I feel the urge to use the restroom. My OB/GYN tells me I have poor vaginal floor muscle tone and has recommended kegels, but I feel like perhaps something more is called for (I'm terrible about doing kegels, though I do try). I'm not sure if my situation really counts as "incontinence" since I haven't had "accidents" at all, but it seems perhaps at the age of only 35 I'm well on my way at this rate. Any tips you have to remedy this situation would be greatly appreciated!

Another question: I live in NYC so when I saw that you are located here, I started to wonder if you are a) in the UnitedHealth network and if so, b) I need to check my plan to see if I'd need a referral for PT, but if I do, are there certain OB/GYNs who would refer me to you or whom you'd recommend? I'm looking for a new OB/GYN.

Thank you!
Dear Jill,

You must seek help from a physical therapist who specializes in post-partum pelvic rehab. I would suggest going to your OB-GYN or midwife, and tell them what is going on. They should be able to refer you somewhere so you can get a complete pelvic exam. If you can't find anyone, write my office at, let us know what city you are in and I can try to find you a specialist in your area.

In the meantime, do your kegel exercises laying down on your back. If you are not bleeding, do your kegels laying down with a couple of pillows underneath your butt and lower back as in this photo:

You also need to immediately test yourself for Diastasis Recti. Go to and click on "self help tips" There you will find a free handout on Diastasis testing and basic correction. If you have a Diastasis abdominal separation, there is going to be a lack of support in the pelvic floor for the bladder and other organs, so you need to address both issues simultaneously.

Also avoid lifting anything heavier than the baby, and give yourself some time to heal. Best of luck.



Jill Fremont said:
Dear Isa,

I had a baby about 8 weeks ago and have absolutely no bladder control. When I try to exercise my kegel muscle again, I really can't say that I even feel it. I am unable to stop urine from leaking out. Do you know how I can begin the healing process? I do not want to have issues forever. Thanks.
Dear Isa - I am so grateful to have found you... wish you were near me. I am so frustrated with my situation. I am 10 1/2 weeks postpartum. I had a home birth planned, but as I neared and surpassed my due date, I became increasingly uncomfortable with delivering at home, or rather, I am assuming so because every time I went into labor, I would suddenly stop. I planned using hypnobirthing as my primary method. At 42 weeks, my husband and I decided we needed to go to a hospital because I felt like something was not right. I was not in labor. After arriving and settling in for monitoring, I went into labor, however. I had a drug free, natural birth and tried my best to apply the hypnobirthing techniques, but the pain was so tremendously intense in my deep, lower pubic area, I trembled. I felt like I would pass out. The other pain I was feeling felt like the labor pains I had become accustomed to, while this additional pain was enough to drive me insane. There was no way I would be able to think of THAT pain as a surge. Another note about that pain - in the weeks preceding delivery, I would go into labor and would feel those additional pains and thought I was having severe gas pains. I still breathed deeply and managed to do as much as I could during labor. I delivered a healthy baby girl 8.5 hours later. I am wondering now if the problems I am having now are related to that pain I was feeling in labor. I am having pelvic floor issues, which I know are normal - incontinence and such and some prolapse. However, I am having persistent and sometimes severe pubic symphisis pain. Of course, it intensifies with walking, riding in the car, turning over in bed, etc., but it is always throbbing. Sometimes, I can barely walk. I started my period ( I assume) more than a month ago. After about a week, it ended. A week later, it began again, (but it seemed to be related to my going on a moderate walk). Then, now, a week later, I lifted my baby in her carrier and felt a sharp pain in the same area I felt during labor, and noticed I had started bleeding again a little later. I can't help but wonder if I tore something or ruptured something during delivery. When I have spoken to my doctor about it, she blows it off with calling it normal. But, I am not convinced it is terribly normal. Plus, she only became my doctor because she delivered my baby and I feel like she is not interested in developing a doctor/patient relationship with me since I "dropped in" on her to have a baby. - In other words, she doesn't seem to respect me and is only doing what she is obligated to do - no sympathy. I am the ignorant/risk taking girl who had the audacity to think I could have my baby at home...
Thank you for any help you can send my way regarding this. I feel frustrated and lost!

Sincerely, Chelle Simmons
Isa, thank you for your suggestions! I forgot about that wonderful modified side-lying position.



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