Excel PT: Pelvic Floor and Back Pain

THE NEWSLETTER ABOUT YOUR HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter

PELVIC FLOOR: THE FLOOR OF THE CORE AND LOWER BACK

Decreased functioning of the pelvic floor muscles is associated with the development of low back pain. When patient-specific pelvic floor exercises are integrated into the treatment of low back pain, patients achieve decreased pain and improved activity participation compared to those patients whose treatment omitted pelvic floor exercises (Bhatnager & Sahu, 2017) .

By Ashley Long, PT, DPT

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INSIDE : • The Floor Of The Core And Lower Back

• Exercise Of The Month • Featured PT

• We Provide Personal Care For Personal Issues

www.excelphysicaltherapy.com

THE NEWSLETTER ABOUT YOUR HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter

PELVIC FLOOR: THE FLOOR OF THE CORE AND LOWER BACK INSIDE : • We Provide Personal Care For Personal Issues • Featured PT (continued from outside)

• Exercise Of The Month • Patient Success Spotlight

The pelvic floor forms the base of our “core”, a system that supports both our breathing and posture. When we think about the “core”, more often than not, only the abdominal area comes to mind. However, the core extends from the SIT bones to the mid torso, where the diaphragm, (the primary muscle of breathing) and transverse abdominis,

floor will not address the issue and could reinforce imbalances that already exist. Rather, the length, strength, and coordination of the pelvic floor must be assessed as part of a comprehensive plan in the treatment of low back pain. Understanding the role of breathing mechanics, pelvic floor function, and the core as a whole is essential in moving more efficiently and pain-free. So how do we get started in the treatment of low back pain while also considering the role of the pelvic floor? At Excel Physical Therapy, we evaluate and treat patients considering all the pieces of the puzzle that could play a role into their pain experience. Patients receive hands-on, one-on-one care from a licensed physical therapist, who will remain with you throughout your entire treatment. At several of our locations, physical therapists have received specialized training in the treatment of pelvic floor dysfunction and are able to evaluate and design a treatment plan individualized to each patient. If you or a loved one could benefit from Pelvic Floor therapy, feel free to contact one of our Pelvic Floor therapists to learn more about how to improve movement, reduce pain and achieve your recovery goals. Sources: Bhatnager,G.,&Sahu,M. (2017).Comparisonof pelvic floor exercises and conventional regimen in patientswith chronic low backpain. IndianJournalofPhysicalTherapyandOccupationalTherapy,11,38-42.

By Ashley Long, PT, DPT

(a deep abdominal muscle), attach (Key,2013) . Pelvic floor musculature has the following functions as the “floor of the core”: 1) maintain bowel and bladder control, 2) support pelvic organs, 3) sexual functioning, and 4) provide stability to the spine with pressure changes during movement and actions such as coughing or sneezing. If the pelvic floor is not contracting in coordination with our breathing, it is unable to provide optimal support to the low back. In turn, the body develops compensatory movement patterns where more superficial muscles become overactive, firing too early and too often. Due to over-activity, the trunk becomes stiffer, muscle tension develops, and breath holding occurs, all of which lead to changes in posture and movement. These changes in posture and movement can lead to the development of low back pain. However, simply strengthening the pelvic

Key,J. (2013). ‘Thecore’:Understanding it,and retraining its function.JournalofBodywork&MovementTherapies,17,541-559.

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Samantha Fazio , PT, DPT (WASHINGTON SQUARE) FEATURED PT

We Provide Personal Care For Personal Issues

This month’s featured PT is Samantha Fazio, PT, DPT from our Washington Square, Philadelphia location. Samantha finds it extremely rewarding to work with her pelvic floor patients, specifically those who have been having pelvic pain or bowel/bladder issues for a long time and enjoys helping them return to their normal activities without any limitations! Learn more about Samantha:

1. How did you decide to become a physical therapist and what motivates you to work with patients? After having several orthopedic surgeries, I realized that physical therapists are afforded quality time with their patients that is not only different from other healthcare providers, but also allows for a different type of patient-clinician relationship. I love getting to know my patients and learning what is important to them. I think it’s imperative that a person’s rehabilitation is tailored toward their individual goals. After expanding my practice to include patients with pelvic health related conditions, I am motivated more than ever to return my patients back to the most basic activities of daily living that can really impact someone’s quality of life. Men and women with pelvic floor-related conditions are a significantly under-served population, so I’m also motivated by bringing awareness about pelvic floor physical therapy to someone who might not have thought that they can be helped! 2. In your words, what makes Excel Physical Therapy different from other physical therapy clinics? Excel is different because our first focus is about quality of patient care before profit. We love working with people and want to deliver the best care we can, so we don’t load our schedules to a level that we can’t provide that for our patients. We strive to optimize care in each session, but also across the whole plan of care to get you better faster! 3. What was your most memorable patient experience? Working with pelvic floor patients is extremely rewarding! Most women I work with have been having pelvic pain or bowel/bladder issues for a long time and have not had relief. One patient sticks out in particular as she was experiencing urine incontinence for over 10 years after giving birth to 3 children. She was unable to last through a whole workout class without losing her bladder, which was embarrassing and uncomfortable. After 2 months, she had returned to all fitness activities including running without needing to wear a pad! It was especially memorable because she worked so hard and was willing to do anything I threw at her! 4. If you could be any animal, what would it be and why? A bird! I’d love to be able to ride the wind and fly wherever I want. 5. If you could describe yourself in one word what would it be and why? Fun! I like to make people laugh and you can bet I’ll try if you’re my patient. When a patient is discharged, I’ll sing a farewell song. I try to keep the energy fun and upbeat! 6. What do you like to do in your off time, outside the clinic? I love to eat! I love food and trying new restaurants. I also love to cook and learn new recipes! This summer, I learned to cook pasta in Italy and it was a dream come true!

Understanding Incontinence In Women Urinary incontinence has a reputation of being something which only affects the senior population, however, many young people also suffer from urinary incontinence. While more women than men are affected, men can also have urinary problems too, especially after prostate surgery. Fortunately, there are many treatments available for urinary incontinence. Behavioral treatment. Some people with urinary incontinence may get relief by making simple lifestyle changes. If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your physical therapist may tell you to limit how much you drink. If you have urge incontinence, in which you get the sudden urge to urinate and can’t always make it to the bathroom in time, your physical therapist may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse. Exercises to strengthen the pelvic floor muscles, known as kegels, can sometimes help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly. For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops. Devices and absorbent products. Protective pads and panty liners can help to avoid embarrassing situations. A pessary, a plastic device inserted into the vagina, may help prevent urine leakage by supporting the neck of the bladder and is most useful for stress incontinence. Mild to moderate cases of incontinence can be cured or greatly improved by behavioral or exercise therapy. Physical Therapists can also teach you habits and techniques to reduce urgency and urge incontinence (leaking with a strong urge on the way to the bathroom). Contact us today if you experience even periodic incontinence to learn more about therapies which can help!

www.excelphysicaltherapy.com

CALL US TODAY IF YOU ARE IN PAIN

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Patient Success Spotlight

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“I looked forward to each session...” “I was suffering on and off for over a year and seeing one specialist after another. I was finally diagnosed with high-tone pelvic floor dysfunction. My doctoradvised theonly true treatment for thiswaspelvicfloorphysical therapy. I had been in constant pain for the last six weeks, sometimes very severe, when I was referred to Dana Van Der Kieft at Excel Physical Therapy. I was apprehensive as this was all new to me and I had no idea what to expect, but Dana put me at ease right from the start of our consultation. She took the time to listen to my history to truly understand what I was feeling and from there came up with a treatment plan that best fit my needs. She made me feel very comfortable as she was a constant professional and always thoroughly explained what she was going to do before she did it. After our first session, she eased my pain greatly and I remember feeling such relief for the first time in weeks! I looked forward to each session after as she taught me the tools I needed to manage this condition with friendliness, compassion and warmth, and after one month of pelvic floor physical therapy with Dana, I can officially say I am pain-free!” - G.M. (Glen Mills Patient) Try this exercise if you are experiencing back pain EXERCISE OF THE MONTH PELVIC TILTS Lie on your back with your arms across your chest. Bend your knees up so that your feet are flat. Rotate your hips by slightly lifting your lower back off the surface. Rotate your hips by gently pushing your lower back downward. Repeat 10 times. Loosens Back www.simpleset.net

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