Hot Topics in Physical Therapy: Caring for the Perimenopausal Patient

My journey towards becoming a pelvic health PT began with my own path towards motherhood.  I got pregnant and got curious about preventing injury in myself both during and after delivery.  Over time, I began to collect skills to serve pregnant and post-partum people at the clinic, and it became an area of specialty.  Those skills expanded to include persons without children with pelvic pain, constipation, erectile dysfunction, etc. but the vast majority of my patients in this space were under 40.  Then something interesting happened…I got older, and so did my clients.   One of the gifts of being a physical therapist is forming relationships with people in your community, and serving as a care provider for them intermittently throughout their lifetime.  I noticed that the people I once cared for in the early days of parenthood were now corralling teenagers.  There was a group of clients returning to the office in their 40s and 50s with new symptoms and new concerns.  They were people entering the phase of life described as perimenopause, and they had questions.  As it happens, so did I.   If menopause describes the phase of life when one no longer menstruates, perimenopause is the time that […]

ABDOMINAL WALL MECHANICS AND PT

Have you noticed an increased bulge in your lower abdomen?  You know the one…the lower belly pooch that won’t go away regardless of your eating or exercise habits?  You’re not alone!  We at Thrive are here to help explain why you’re seeing what you’re seeing, and how we can help. The lower abdominal belly bulge is common amongst all persons regardless of gender or age, and is a sign of muscle coordination issues in the abdominal wall.  For the purposes of this blog, we are going to use toileting mechanics to illuminate common and treatable abdominal muscle dysfunction that contributes to this belly bulge.  Ultimately, bowel and bladder habits tell us a lot about pelvic floor muscles, the abdominal wall, and diaphragm function. For example, in order to eliminate liquid or solid waste, there needs to be a slight increase in abdominal pressure prior to evacuation.  This pressure signals to the pelvic floor that it should relax and allow the passage of stool from the rectum or urine from the bladder. This cycle should be fluid.   Ideally, one experiences a sensation that suggests that the bowel or bladder needs to empty, goes to the toilet, and easily eliminates waste.  It’s like turning on […]

SCHROTH THREE DIMENSIONAL SCOLIOSIS THERAPY

The physical therapy goals in the conservative management of scoliosis include halting curve progression and preventing surgery, addressing spinal pain syndromes, managing respiratory dysfunction, improving aesthetics and body image. In addition to Schroth physical therapists employ an array of manual techniques including joint mobilization, myofascial release, soft tissue mobilization, crainosacral therapy, visceral mobilization and neuromuscular stretching techniques.

STAY IN THE GAME: KNEE PAIN WITH RUNNING

Knee pain is one of the most common symptoms with running and accounts for about half of running-related injuries. If you are a runner who is experiencing knee symptoms or you are a runner who wants to prevent future injuries, there are several ways you can reduce impact or load on the knee joint. One of the most common causes of movement impairment in running is lack of control or strength of the hip extensors, which can ultimately lead to knee pain.

STAY IN THE GAME: ADDRESSING HIP PAIN WITH PHYSICAL THERAPY

Even with ligamentous and muscular support in place, the hip is a common area that is susceptible to pain and irritation. While there is no singular explanation for hip pain aside from direct trauma, we can point to a myriad of different causes associated with pain, such as faulty movement patterns, imbalances within the body due to underlying muscle weaknesses, or abnormal joint motion within the hip or neighboring areas of the body, such as the low back.

WHAT IS THE PELVIC FLOOR, HOW IS IT ADDRESSED IN PHYSICAL THERAPY, AND WHY YOU SHOULD CARE?

Given what we now know of the role of the pelvic floor muscle network, it would make sense that dysfunction could vary widely in presentation and that the avenues for treatment equally as numerous. Direct dysfunction of these muscles can contribute to loss of bowel/bladder control, constipation, urinary and bowel urgency/frequency, pelvic pain, diminished sexual appreciation or pain with intercourse, pelvic organ prolapse, and lumbo-pelvic-hip control issues.

LET’S GET TECHNICAL: DRIVER TESTING, WHAT IS IT, AND HOW CAN IT HELP ME?

Habitual postures can also lead to muscle imbalances. A person may be sitting at their desk all day slouching forwards, which can lead to tight hip flexors and lengthened/weak glute muscles. Tight hip flexors can lead to a lack of hip extension range of motion, thus driving an issue at the back. Because the body likes to find ways around restrictions, this person might compensate with excessive mobility at the low back joints to make up for that lack of hip mobility. Over time, changes in these tissues structures can ultimately become a source of pain.

TAKE CONTROL OF YOUR HEALTH: PHYSICAL THERAPY AND PARKINSON’S DISEASE

There are numerous Parkinson’s research groups that are dedicated to improving the lives of individuals with PD. Regardless of which Parkinson’s research group that you follow, be it the LSVT BIG group, the POWER group, etc., much of the research on Parkinson’s Disease points to the same conclusion: a target-specific exercise program may be essential in delaying the progression and deterioration of function that may develop with PD. Early intervention is one of the key components to promoting a long and healthy lifestyle.

HEALTHY WORK FROM HOME HABITS

With COVID-19 drastically changing the lives of millions, Americans everywhere had to make a quick transition to the “work from home” lifestyle. Many New Yorkers were not given much notice for this change, leading to apartments all over the city being converted to Work From Home (WFH) spaces. There are both positives and negatives in regards to WFH, when it comes to our health. And since it’s seems like the transition to a home office environment is here to stay for a while, we thought it would be a good idea to share a little practical advice.POSITIVESBeing able to take breaks to stretch No longer being in the office allows for people to more readily insert stretching breaks throughout their days (without feeling judged from co-workers). Patients often tell PTs that they only feel comfortable stretching when heading to the bathroom or behind closed doors in an office setting. Being in the privacy of your own home, allows you to stretch whenever and wherever you’d like!Changing to different areas Another benefit of working from home is being able to alter your workstation as often as you like. This is in contrast to being in one chair and desk all day […]

PHYSICAL THERAPY’S ROLE IN PREPARATION FOR LABOR

The genesis for this blog occurred after I attended a birthing preparation course taught by Ashley Brichter at Birth Smarter. This organization has virtual and in person childbirth education classes for expectant parents and professionals. Despite being 5 years removed from having children myself, I found the educational review helpful for my professional practice. It reminded me that understanding the anatomy of a vaginal childbirth can gift the expectant parent with tools to improve the birthing experience.