Why pelvic health is important for oncology rehabilitation
While the pelvic floor is a mystery to many, it is important to your long-term health and quality of life.
But for those who have received a cancer diagnosis, the type of cancer and treatment regime can affect pelvic floor function.
But first, what is the pelvic floor?
The pelvic floor is a group of muscles, ligaments and tissue that form a sling to support the pelvic organs and spine. These muscles also help with control and coordination of bowel, bladder and sexual function.
Muscle control — the ability to squeeze and relax pelvic floor muscles — is key here.
Pelvic floor muscles contract to prevent bowel and bladder leakage. The muscles also relax to allow the bladder to empty completely when you void, empty the bowel without straining and have intimacy or pelvic exams without pain.
Pelvic floor muscles also support reproduction.
In women, pelvic floor muscles are the muscles that:
- Contract with orgasm.
- Support the uterus.
- Promote circulation of blood and lymphatic fluids
With men, pelvic floor muscles help to:
- Develop and maintain an erection.
- Support the prostate.
- Ejaculate during sex.
- Promote circulation of blood and lymphatic fluids.
- Prevent incontinence, or increased urgency.
Now, put it all together and pelvic floor dysfunction (PFD) describes bowel and bladder disorders, sexual disorders and chronic pelvic pain syndromes that affect the pelvic floor muscles’ inability to contract or relax appropriately.
What are common symptoms of PFD?
Unfortunately, pelvic health issues may go unrecognized and untreated. Indeed, people are often hesitant to share their concerns and, when they finally do, often wait several weeks or months to make an appointment with their doctor.
Common symptoms of PFD may include:
- Urgent or frequent urination or bowel movements. You may feel like you have to go right away or all the time. You may also fear leaving your home so that you can stay close to the bathroom.
- Hesitancy or painful urination. You may also feel you need to ‘force it out’ to go or you might stop and start many times.
- Constipation, or pain during your bowel movements. Up to half of people suffering from long-term constipation may have pelvic health dysfunction.
- Straining or pushing really hard to pass a bowel movement. You may also find yourself changing positions on the toilet.
- Leaking stool or urine (incontinence).
- Feeling pain in your lower back or hips with no other cause.
- Feeling ongoing pain in your pelvic region, genitals, or rectum.
If you’re experiencing any of these symptoms, it can feel as though your quality of life has diminished.
But, there’s no need to accept this as your new normal.
How cancer and the pelvic floor can go hand-in-hand.
Many people with cancer simply aren’t told that treatment side effects can impact their pelvic floor. They may believe that their symptoms are a normal part of aging or are so grateful to be cancer-free that they don’t put two and two together.
Women with gynecological cancers, including uterine (endometrial), ovarian, cervical, vulvar and vaginal cancer, men with prostate and testicular cancer and anyone with bladder, rectal or anal cancer are most at risk for experiencing problems with PFD.
For example, radiation for gynecological cancers, which are located in the pelvic region, may cause fibrosis, a hardening of tissue that may narrow or shorten the vaginal canal. This may cause generalized pelvic pain and pain with intercourse.
Men who have radiation therapy for prostate cancer treatment, or who undergo a prostatectomy (the surgical removal of the prostate), may develop incontinence and/or erectile dysfunction.
Several types of surgery may also affect the pelvic floor, including:
- Tumor debulking to remove as much of a cancerous tumor as possible.
- Hysterectomy to remove the uterus.
- Salpingo-oophorectomy to remove the ovaries and fallopian tubes.
Regardless of what caused your PFD, pelvic health therapy and cancer rehabilitation can help you feel your best.
How can pelvic health therapy help?
A pelvic floor specialist can help to develop a care plan to achieve the right mix of coordination, control and strength in the pelvic floor muscles.
Pelvic health therapy, whether it’s physical therapy or occupational therapy, aims to restore function and reduce pain. A pelvic health therapist will give you an assessment of your muscle function, posture, breathing patterns, strength and flexibility of your spine, hip and abdominals to determine contributing factors of any pelvic health issues.
Every person is different, so pelvic health therapy will look different for everyone. Some interventions you might experience can include:
- Therapeutic manual (or hands-on) therapy.
- Trigger point release: Trigger points are sensitive areas in the muscle or connective tissue that are painful when pressed. Trigger points may cause pain in the pelvic area. Trigger point release is a hands-on technique to relieve chronic pain.
- Dry needling: This form of treatment uses a dry needle - a needle without medicine - to deactivate trigger points in the muscle, help reduce scar tissue and promote healing in the body. Dry needling is not acupuncture.
- Connective or scar tissue mobilization: This form of manual therapy aims to break up fibrosis related to cancer treatment that may be causing stiffness, desensitization or pain. Besides gently breaking up the tissue, this type of hands-on therapy helps to stretch and relax surrounding muscles building essential flexibility.
- Myofascial release: This treatment style helps to lengthen and reduce tension in the connective tissue.
- Biofeedback, which is commonly used to retrain pelvic floor muscles. This pain-free procedure uses special sensors to monitor pelvic floor muscles as you try to contract and relax them. The sensors provide feedback to you and your therapist about which specific muscles you need to strengthen to gain sensitivity or improve coordination of pelvic floor muscles.
- Pelvic floor exercises. Your therapist will prescribe exercises to enhance coordination, control and function of the pelvic floor and surrounding muscles like the back, abdominals and hips.
Talk to an oncology and pelvic health specialist today.
If you or someone you love has been impacted by cancer that has led to any sort of pelvic health issues, ReVital Cancer Rehabilitation can help.
Our compassionate clinicians are certified in oncology rehabilitation, and uniquely trained to treat pelvic health issues.
To request an appointment to work with one of our clinical team members or ask us questions about treatment, fill out our short online form. A member of our team will connect with you to confirm your visit.
How the ravages of history launched two profound professions
When a doctor recommends occupational therapy (OT), rather than physical therapy (PT), many people don't at first realize there are two kinds of therapies.
It might also not be understood that there's a difference between them, or why a doctor prescribes one over the other.
As therapists, we get this question a lot.
For sure, there's a difference between the therapies and how they're used in healing and recovery. And the story is more interesting than you might imagine…
A short history of modern therapy
Movement and manual therapies can be traced back to ancient Asia, Greece and Rome. Those early practices included massage and hydrotherapy (water therapy).
In the 1920s and ‘30s, Franklin D. Roosevelt found relief with hydrotherapy. FDR receiving physical therapy or exercising with assistance in an indoor pool at Warm Springs, GA, 1928. Courtesy of Franklin D. Roosevelt Presidential Library and Museum.
Fast-forward to modern-day therapy which began in 18th century Sweden with the practice of orthopedics — the medical focus on bones and muscles.
A bit later, Hanrik Ling, developed the Swedish Gymnastic System (also known as the Swedish Movement Cure). His motivation? Having experienced the benefit of improved body movement through his practice of fencing.
At its core, Ling's system emphasized physical conditioning for its ability to improve health and body function. It combined lesser intensive floor-style of gymnastics with manual therapy. Ling's approach brought wide acceptance of his methods.
In 1813, the Swedish government appointed Ling to start the Royal Central Institute of Gymnastics (RCIG).
Ling's system became wider spread as graduates of the RCIG adopted its four core components:
- physical education
- massage, physical therapy, physiotherapy
- dance performance
One more fast-forward to the 1920s. The polio epidemic was raging in the United States, especially among children.
During the epidemic, two schools of thought emerged.
One used the practice of immobilizing the limbs of patients believing limb movement and stretching would impair muscle recovery and cause more deformity.
A second practice re-introduced the Roman practice of hydrotherapy. Here therapists used exercise in heated pools to improve a patient's muscle recovery and movement.
Polio paralysis spurred working with patients to improve balance and regain muscle strength. The benefit of warm water was helpful as well as buoyancy – water supports body weight and reduces stress on the joints.
The practice – active polio therapy – helped grow a population of physical therapy (PT) specialists who became instrumental in treating polio paralysis.
These early PTs developed methods for assessing and strengthening muscles – methods still used today.
This piece of history gave the push to establishing the profession of physical therapy in the U.S.
Turning now to the topic of occupational therapy (OT), its history doesn't stretch back as far as those of physical therapy.
But its roots in America began to grown in the late 1800s. This happened primarily as a way to help individuals with mental illness by engaging them in meaningful tasks. Examples include gardening, painting and arts and crafts creation.
The U.S. military also began recognizing the importance of mental health services for wounded and traumatized soldiers to help them resume daily living.
This marked an entry for OT services in the treatment of individuals with mental and physical needs.
Three movements of thought were significant in the development of OT:
- The consensus that mental health patients should be treated and not put in asylums or prisons.
- The reemergence of the value of manual occupation and vocational skills over mass production.
- The rise of thought that working with your hands to produce items of value can be beneficial to a person’s overall health.
During this time, mental health asylums changed to reflect these new ideas. They were ideas of humane rehabilitation and included craft and recreational activities to help patients return to society through their contributions.
These ideas were foundational for developing OT.
About 1915, a social worker named Eleanor Clark Slagle started the first formal OT education program at John Hopkins University in Baltimore.
Dubbed the "mother of occupational therapy" she trained more than 4,000 therapists and promoted OT within the medical community.
While PT and OT therapies were in their infancy on the two sides of the Atlantic, it was America's entry into the Great War in 1917 where they came together.
To summarize some of the above timeframes, it's worth a look at how it happened.
World War I and its transformation of therapy
World War I transformed medicine and contributed to the development of today's scope of medical care.
The total number of military and civilian casualties in World War I was about 40 million.. and about 23 million wounded military personnel.
With the staggering number of wounded worldwide, orthopedics and therapists rapidly advanced to meet the need.
The course of thought was that society had a moral responsibility to help these soldiers return to a normal and purposeful life. Thus, medical specialties developed to fill this need.
The U.S. military hired a small group of women, calling them "reconstruction aides." In their roles they provided treatment by teaching occupation skills to the wounded.
The initial 18 aides were trained in the latest European physiotherapy practices at the time. Aides were chosen from civilian women and women from the newly established profession of OT.
Both therapy groups expanded rapidly to help the soldiers with recovery.
Of the original 18 Aides, 16 went on to form the American Women's Physical Therapeutic Association. This later became the American Physical Therapy Association with McMillan as president.
– The U.S. World War One Centennial Commission.
Soldiers recovering from severe wounds learn basket weaving as a form of occupational therapy, led by the World War Reconstruction Aides Assocation. Learning basket weaving (Reeve 000290), National Museum of Health and Medicine.
The work of these aides brought the military to begin seeing disability in terms of capability in function, and not as limitation.
Their successes were many, helping wounded soldiers learn to walk again and freely move about in their environments.
These early therapists gave training in the use of arm prosthetics, adapted home and work spaces and taught crafts and vocational skills for mental diversion and future employment.
The convergence of today's therapies and practitioners
After WWI, occupational and physical therapy continued to advance.
And with their evolutions came recognition for the benefits they each provided.
But sometimes there was division in which to prescribe: occupational therapy vs physical therapy.
What became clear over time, with advances in the professions, is the benefit to individuals when providing therapies in tandem.
Today's occupational and physical therapists work together in the shared goal of improving an individual’s function through movement.
As individual medical treatments, the therapies, when used together, can have profound results.
Because of this they are recognized as separate but symbiotic professions.
Working in a variety of settings
- Outpatient rehabilitation centers
- Home health agencies
- Nursing homes
Training in key disciplines
Using similar therapy techniques
- Soft tissue mobilization
- Functional activities
- Pain relief
Opposites attract, even in medicine
Even with similarities between the two professions, there are also key differences.
Physical therapy focuses on improving movement, flexibility and mobility. This includes improving physical motion required for a task.
Physical therapy has a unique approach to mobility – movement and muscle balance. It uses prescribed treatment techniques to maximize function, capacity and performance.
PTs work with patients before and after surgery to build strength and kick-start healing. Therapy uses movement to reduce pain, recover from an injury and promote balance to reduce the risk of falls.
The occupational therapy profession has a different focus.
That focus is on functional ability – the ability of an individual to do activities, work and tasks that are normally performed in everyday living and occupation.
That focus gives occupational therapy its name.
Occupation is defined as an activity that is meaningful and purposeful to the individual. It can include basic activities such as dressing, bathing or fixing a meal.
It can also include specific activities which are unique to the individual.
For example, you may be a high school teacher, home gardener, pianist or an electrician. Each occupation requires a unique set of activities. If those activities are compromised by illness or injury, OTs can help.
Your therapist will assess your current function and how to improve your ability to perform a task or modify it to help you complete it.
Now that you know more about the differences between OT and PT, should you need therapy you'll be able to spot the differences in what your therapist recommends.
Of course, it all depends on your condition, your needs, and personal goals.
But thanks to a long history of the disciplines, and more than a century of experience since WWI, PTs and OTs are specialists in your care.
Our job is to help get you back to enjoying the activities that matter to you.
If you or someone in your family might benefit from our therapies, request an appointment with us. We're here to help.
Updated on 3/17/23: published at an earlier date and updated with new information.
Sports medicine’s health care specialists on and off the field
You’ve seen them hustling across the football field or crouching beside a player on the sideline whose face is twisted in pain.
They don’t wear the black and white stripes of the referee, but their breed is just as easy to spot. And their presence on the field can be just as critical as a game-changing field goal, free throw or hat trick.
Enter the athletic trainer.
Often sporting khaki pants, a fanny pack and a polo or sports shirt in team colors, athletic trainers are recognizable in how they look and, more importantly, for what they do.
But if in your mind’s eye you picture an NFL or NBA game, it might surprise you to know the diverse places where athletic trainers work and the scope of work.
While most often associated with sports, athletic trainers are vital practitioners of medical care in many settings on and off the playing field, including the workplace and a few places that might surprise you.
Let’s dive in for a deeper look at these health care specialists.
Partners in injury and injury prevention
No matter the type of athletics, athletic trainers are at the center of a sports medical team – individuals trained in athletic health care.
The athletic trainer is generally first on the playing surface when a player goes down. They have precious little time to do an initial assessment to determine the type and severity of injury or medical emergency. In an emergency, they are the ones to signal for the team physicians and medics to come on the playing area.
For those on the sidelines or in the bleachers, whether game time or practice, athletic trainers provide reassurance in times of injury.
After all, injuries happen.
And if you’re an athlete, a weekend warrior or you have a physically demanding job, you may have more chance of injury than someone who’s not as active.
From athletic injury to onsite emergency care
Though it’s not something we like to think about when suiting up for a game or packing the SUV for a tailgate, medical emergencies can and do happen in any setting.
As part of a sports medicine team, an athletic trainer will know first aid, CPR and automated external defibrillator use (AED).
When NFL safety Damar Hamlin suffered cardiac arrest and collapsed on the field, CPR and AED were administered on the spot.
Emergency treatment lasted 20 minutes before Hamlin could be moved. The quick medical treatment put a spotlight on just how valuable athletic trainers are because of their skills in emergency medicine.
As first on the playing surface to assess the situation, athletic trainers inform the medical team of any life-threatening injury to initiate emergency medical care.
While the on-site response is critical, there’s also a tactical side to athletic training work that’s just as important in times of crisis.
We can put them in a short list of critical need-to-knows that in the face of emergency help the medical response teams stay calm, organized and effective:
- Emergency Action Plan to handle crisis situations
- Emergency phone numbers
- Ambulance access points at venues
- The working condition of onsite emergency equipment, like AEDs
Another thing that’s a must for all athletic trainers: great communication skills.
Athletic trainers are the source of communication between coaches and family when a player is injured. Their job includes reporting on the injury and expectations from the point of injury to next steps toward recovery.
Post-injury. Return to play. Return to work.
Okay, you’ve had an injury (ouch!).
You completed recovery and rehab (hooray!).
What comes next?
The next stage in post-injury progression is your return – return to play (RTP) or return to work.
This happens after your medical care provider is satisfied with your progress and clears you to get back to sports and physical activities. Working with an athletic trainer is essential in getting to this stage.
While an athletic trainer is first on the scene to assess injury, they’ll be in your corner to guide your recovery.
Your athletic trainer will do functional tests and look at your performance stats to gauge your readiness for activity, at what level and at what pace. There may be others in your corner that your trainer will coordinate to help with your full rehabilitation:
- Physical therapist
- Occupational therapist
- Strength and conditioning coach
- Massage therapist
- Sports psychologist
For you as an athlete, and depending on your injury, functional tests can include:
- Cutting drills (lower body injuries)
- Lifting and push-pull exercises (upper body injuries)
Athletic trainers use the stats to pinpoint any deficits remaining post-injury recovery, like limping or weakness, which could hinder you from safely retuning to play.
If testing is clear of any concerns, you’ll get the green light to return to full activity.
If there are areas of concerns, your trainer may plan additional exercises, or modify your activity level to help you improve on the deficits and continue toward full clearance.
Return to play is unique to each athlete and injury. The goal of functional testing and injury recovery is to ensure your safety on the playing field when returning from an injury.
Around the world, athletic trainers are looked to as trusted professionals playing a crucial part in health management and health care.
Multi-skilled and holding advanced certification to help athletes, performers and people across many job settings, athletic trainers bring benefits to health care. If you’ve been sidelined from work, missed out hanging with friends or playing your sport because of injury – or a repeated injury – there’s good news.
Working with an athletic trainer now can help avoid injury later. Put another way, you don’t have to wait until you’re injured to address the issue.
An athletic trainer can identify weaknesses or conditions that may be leading to your injuries and help correct them.
This approach is called prehab – preventive activity to decrease risk of future injury. Two important areas include:
Functional movement screens
Done by an athletic trainer to identify dysfunctional or painful movement patterns.
Exercises are taught to correct movement and any bad habits you may have acquired in compensating for pain. These can be done on their own or as part of a warm-up before activity.
For example, a proper warm-up using dynamic stretching can help increase blood flow to loosen muscles prior to activity, whether it’s working out or warming up before performing a concert or dance routine.
Proper nutrition, hydration and sleep are all needed to keep the body in the right state for exercise. But it takes planning and discipline to adopt the right approach for your body and your activity level.
Your athletic trainer is your partner in injury prevention and can advise you on the right balance of all these things.
Athletic training: beyond the playing field
There’s high regard for the public work that athletic trainers do in helping individuals avoid injury and recover from injury.
Not surprising, then, are the standards that trainers are held to.
Athletic trainers must graduate with a bachelors or master’s degree and pass the Board of Certification Exam (BOC) to work with professional athletes. There’s also regular renewals on the certification to demonstrate continued learning and competence.
All this is to ensure that athletes are healthy and performing at their peak potential.
But think about the word “athlete.”
In a traditional sense – youth and high school programs to college and professional divisions – it conjures a playing field, ice rink, basketball court, you name it.
So this nugget may surprise you:
“Only 2% of all athletic trainers work in professional sports.”
Athletic trainers work in all sorts of job settings and treat a host of individuals beyond traditional sporting venues, such as:
- Doctors’ offices
- Hospitals and emergency rooms
- Urgent Care centers
- Rehabilitation centers
Outside of clinical settings, there are many emerging job settings where athletic trainers are finding new opportunities in public safety, military schools and the armed forces, and in performing arts and aeronautics. There’s a whole program at Boeing called the Industrial Athlete program designed to keep employees who work in physically demanding jobs healthy.
Such specialty industries employ individuals who need certain levels of fitness to do their jobs. They also need training to reduce risk on the job and stay fit for duty.
Add to those, various commercial settings like airlines, warehouses, hotel/resort and theme parks, and an athletic trainer’s scope of practice broadens even more.
For each of these sectors athletic trainers will have specific training to provide medical care based on the unique activities, physical demands and requirements of the employees.
This article shares a small window into the immense discipline of athletic training. It’s a discipline that’s grown from its origins of sport athleticism to stretch beyond the sidelines and into patient and employee health care.
Around the world, athletic trainers are looked to as trusted professionals playing a crucial part in health management and health care.
No matter where you encounter them, athletic trainers share the goal of keeping active people safe, well and moving forward.
Click to request an appointment to work with our Athletic Training Services team. If you are am employer interested in worksite safety training, check out our WorkStrategies® Program.
Posted 2/14/2023. | 5 min. read
How we are helping patients access effective pelvic health therapy
Physical therapy (PT) – as an industry – talks a lot about the benefits of PT, sometimes in general terms.
It can help with the management of aches and pain.
It can help you heal from injury.
It can help you regain strength and improve mobility after surgery.
It can even help you avoid surgery – read Reason 3 in this popular blog to learn how.
And while all that’s true, for this blog we’re taking a bit of a departure to talk about a more, well… pressing problem.
Pelvic floor dysfunction.
It can literally feel like pressure – or pain – in your pelvic region, either in the front or the rear of your pelvic area.
This is a condition that’s a growing problem among U.S. adults – about 25 million – women and men.
And it’s been the elephant in the room that, until recently, no one really wanted to talk about. Let alone admit they knew the elephant was there.
But the American physical therapy community is bringing the elephant into the light to drive conversation, education and new ways to access care and treatment of pelvic issues.
Now, there’s no need for a show of hands, but if a belly laugh makes you leak urine, if a bowel movement causes you misery or you’re bounding to the bathroom and hoping to make it, this blog is for you.
Read on to learn more.
What is the pelvic floor and its function?
Like many other body parts, the pelvic floor is a mix of muscles, ligaments and connective tissue that fit together to form and support various organs in the body. In other words, this “floor” is the base of your pelvis and home to important organs.
Picture the bladder, bowel, uterus (women) or prostate (men) within the pelvic area and the pelvic muscles holding them all in place. Now imagine a bowl holding fruit or a hammock holding a peson – that’s what the pelvic floor does.
The support of the pelvic muscles allows us to go to the bathroom without issue. That’s all thanks to the normal function of the muscles tightening and releasing as they should.
But when the pelvic floor muscles are weak (hypotonic) or become too tight (hypertonic) – more about these in a bit – it’s called pelvic floor dysfunction.
That dysfunction can lead to all sorts of uncomfortable or embarrassing things for women and men.
Pelvic dysfunction: women vs. men
Every year millions of women and men experience pelvic floor dysfunction.
In both genders the pelvic floor muscles are attached in two places: the pubic bone (front) and the tail bone (back).
Both genders can share similar symptoms of pain – internal organs, pelvis, hip, groin and tailbone – incontinence, constipation and declining sexual health.
But there are key differences and causes for the dysfunction, too.
Pelvic floor dysfunction: women
- Reproductive health due to muscle strain during pregnancy or prolonged labor
- Painful sex due to the muscles’ inability to relax
- Muscle weakness that causes the pelvic organs to drop through the vagina or rectum
Women who have had multiple births have an increased chance of developing pelvic floor dysfunction.
Often, they may feel like their pelvic floor muscles are too weak or loose – a hypotonic pelvic floor. This means your pelvic floor muscles do not have the strength to properly position and stabilize your pelvis. Because of this you may experience symptoms of incontinence when you cough, sneeze, laugh or exercise.
Alternately, women can have hypertonic pelvic floor muscles. Increased tension in a muscle is created when you hold the muscles tight for a prolonged period of time – like when you have chronic pain. A good example is endometriosis. Symptoms of a hypertonic pelvic floor would be pain with pelvic exams, pain with intercourse and difficulty using a tampon.
Pelvic floor dysfunction: men
- Erectile dysfunction that may be caused by muscle tension
- Extreme workouts or long-term sports due to the core muscles being engaged for long periods
- Testicular pain
- Prior prostate surgery
These are just some of the many factors that can contribute to pelvic floor dysfunction. If you’re experiencing any type of dysfunction of the pelvic region, it’s recommended to seek help.
Can physical therapy help pelvic floor dysfunction?
In a word, yes.
Physical therapy can be an effective and non-invasive, non-surgical way to help with pelvic floor dysfunction.
It may be key in finally finding relief and getting back to a better quality of life. So if you’re one of the more than 25 million U.S. adults whose laughter, coughing or sneezing we referenced at the top of this article – or whose pelvic area is in constant pain – impacts your day-to-day, you may want to talk with one of our pelvic floor therapists.
Of course, depending on what your symptoms are and how long you’ve had them will determine the best type of therapy and its length.
With all the DIY self-help on the internet and apps to download for pretty much anything, you may think there are plenty of ways to find improvement without working with a specialist. Or you may think it too embarrassing to talk about. But the reality is that a pelvic health specialist is trained in how the body functions and can determine the nature of your pelvic floor condition and work with you one-on-one.
You’ll benefit from a professional assessment and a program of therapy and exercises we’ll put together just for you and your needs.
Without an assessment, there’s no way of knowing which muscles or body parts you need to focus on. With DIY you’ll be guessing, which could lead to bigger problems.
Working with us, you’ll have the benefit of immediate feedback to adjust your exercise and monitor your progress.
If you’re experiencing pelvic pain or any of the symptoms we’ve highlighted, it’s important to seek medical attention. A physical therapist can provide the necessary treatments to help reduce and eliminate your pain and discomfort.
To request an appointment to work with one of our clinical team members or ask us questions about treatment, fill out our short online form. A member of our team will connect with you to confirm your visit.
Posted 2/13/2023. | 1 min. read
HealthWorks Rehab & Fitness has appointed Colleen Hickey, MHA, M.S., P.T., as the director of its outpatient pelvic health rehabilitation program. Colleen previously served as pelvic health program director in the mid-Atlantic region.
She has more than 30 years of experience in the physical therapy industry, including 10 years in pelvic health therapy. Colleen previously developed and implemented a pelvic health program in central Pennsylvania. The program currently has 63 clinicians in 52 centers.
“Pelvic floor dysfunction negatively impacts the quality of life of millions of Americans, and while conservative care has shown to be effective in treating this condition, access to these services remains limited and therapy is underutilized,” said Colleen. “I’m passionate about pelvic health and honored to take on this leadership role to bring the highest level of pelvic floor therapy to those who need it.”
Originally written on 10/18/2021 by: Joe Zucco, P.T., DPT, FAAOMPT, center manager for Select Physical Therapy. Updated 1/30/2023 to include new data and information. | 5 min. read
For many of us, our smartphones are an indispensable part of our lives.
We use them to stay connected to family and friends, get information in seconds and tap our way through our favorite music, news, social pages, sports stats and recipe sites. We also use them to keep our personal and work appointments organized.
But, with all our tech device touchpoints each day, there’s a very real and painful side effect.
Studies show that we’re spending too much time hunched over our devices, creating tech neck, also called “text neck”.
Fortunately, physical therapy exercises can help you get rid of tech neck pain.
In this blog post, we’ll cover what tech neck is and the side effects of spending too much time on your phone.
We’ve even thrown in a surprising look at the pressure you’re putting on yourself that’s causing tech neck. Then we’ll leave you with five essential exercises to get rid of it.
What is tech neck?
Tech neck is a term used to describe the neck pain that has become increasingly more common due to our overuse of technology.
It’s caused by the strain on the neck from looking down at our phones and tablets for long periods of time.
This strain can cause pain, stiffness and even limited range of motion. And it’s becoming increasingly more common in younger generations due to the amount of time they spend on their devices.
Side effects of spending too much time on your phone
The yearly climb in how many hours US adults – and kids – spend on their mobile phones, feature phones and tablets will reach 4 hours, 35 minutes per day in 2023.
- research from Insider Intelligence
That’s a 2.5% increase since last year! Up from 3 hours, 42 minutes in 2018.
The side effects of spending too much time on your phone can range from mild discomfort to severe pain and stiffness.
The most common side effects include:
- neck and shoulder pain
- poor posture
Other side effects can include numbness and tingling in the arms and hands, as well as blurred vision.
It’s not something we think about often, but the human head is between 10 and 12 pounds.
That’s a bowling ball!
When you lean your head down, the lower the angle, the more pressure and strain that’s put on the head. That can feel like 10 bowling balls.
If you’re experiencing any symptoms of tech neck, physical therapy can help.
5 essential exercises for tech neck
Hunched over, staring at your phone? Your head pushed out in front of your shoulders? This is the starting position for retraction.
When you realize you’re hunched over, pull your chin backward while looking directly forward. You should feel a “double-chin” forming under your jaw.
Repeat this forward/backward exercise 10 times once an hour or two while working or catching up on texts.
Tension in the upper trapezius muscles is common. These muscles span the back of the neck and shoulders, working in tandem to move the head and shoulder blades. The trap stretch can be performed any time you feel tight.
Just 20-30 seconds for each side of the neck to release tension.
To stretch the right side, place your right hand on your waist or lower back, tilt your head to the left while looking back to the right. Place your left hand on top of your head and gently pull toward the left until you feel a comfortable stretch. Don’t overdo it.
Repeat on the other side.
Okay… let’s be honest. This one might look a bit odd if your cubicle mates walk by while you’re doing this stretch.
But the Ah-hhh factor will be worth it!
Lean forward in your chair. Pretend you’re smashing a pillow between your belly and thighs. Place your hands with fingers crossed behind your head.
Do this one every couple hours while sitting at your work space. Who knows? You might convince others to join in.
The next two exercises might be better done at home… curious onlookers and all.
Lie face down on the floor with your arms at your side, hands near the hips.
Keep your neck straight (do not look upward).
Lift your chin, arms and knees slightly off the floor.
Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
Lie face down on the floor with your arms reaching upward and slightly outward from your head.
Keep your neck straight and lift your chin, arms and knees off the ground.
Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
With the overhead arm position, this exercise emphasizes the lower trapezius muscle between your shoulder blades. The prone scaption can be performed 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.
Strengthening your neck posture
In addition to the exercises listed above, it’s important to pay attention to your posture while using your phone or tablet.
Keep your chin parallel to the ground, and make sure your neck is in line with your spine. This will help reduce the strain on your neck and reduce tech neck pain.
Tech or text neck and how to avoid it
If you’re looking to avoid tech neck pain in the future, the best way is to limit your use of technology.
Set limits on how much screen time you spend on your phone or have your apps running.
Take regular breaks from looking at your screen.
You can also invest in a stand for your phone or tablet that angles the screen toward you, so you don’t have to look down as much.
And now, armed with these exercises, stay active and stretch regularly to keep your neck and shoulder muscles flexible to reduce the strain on your neck. Save the bowling balls for when you go bowling.
If you’re experiencing neck pain, it’s important to seek medical attention. A physical therapist can provide the necessary treatments to help reduce and eliminate pain. Request an appointment to work with one of our movement experts near you.
Posted 1/12/2023 | 4 min. read
You may think about physical therapy as a way to get back on your feet after an injury or regain strength after surgery.
And you would be right.
A typical idea of what physical therapy looks like might include a room with padded tables, balance balls and exercise equipment. These are traditional items well-known to those working through movement issues with the professional help and guidance of a physical therapist.
Treatments using these items are pretty standard for improving strength and restoring movement.
But did you know there are other types of treatments – and equipment – that while maybe not be as common are also effective in improving movement?
As a movement expert, your physical therapist can evaluate the type of treatment or treatments that can benefit your condition. Chances are, there may be a mix of traditional and not-so-traditional treatments to:
- Increase your range of motion
- Decrease pain and discomfort
- Build endurance
- Lower or avoid the need for medication
- Recover quality of life
Depending on your condition or diagnosis, the success of some less familiar physical therapy treatments can make them a consideration for your care plan.
Cupping treats muscle and soft tissue dysfunction, like spasms, swelling and pain.
This manual technique uses small silicone “cups” or “domes” (sometimes glass) pressed against the flesh to create suction.
The technique stimulates blood flow as the suction pulls the skin upward into the cup. This expands tiny blood vessels under the skin to increase blood flow, turning the cupped area a reddish or pink color.
Cupping has been around for thousands of years, but is one of the lesser known techniques employed to ease:
- Back and neck pain
- Headache relief
Much different than cupping, which targets broader areas of the body, dry needling is a micro treatment.
As the name implies, dry needling uses thin needles inserted into the skin at precise points in the muscle where there is pain or sensitivity. These points in the muscle, when touched or stimulated, can trigger pain, which is why this treatment is also known as “trigger point dry needling.” There is no medication delivered through the needle, like with a vaccine, which is why it’s called a dry needle.
When inserted into the skin, the needle shuts down the trigger point, easing or eliminating the pain.
Though it uses needles, this alternative method of pain relief is not acupuncture, a common misconception.
Dry needling is a technique for stimulating and releasing trigger points, while acupuncture is a practice that’s focused on restoring energy flow in the body.
In the dry needle procedure, the length of the needle will depend on the area of the body being treated. Most people feel little or no pain, and the procedure lasts about 15 minutes.
If appropriate for your type of pain, our therapists will create a treatment plan that includes dry needling along with other therapies.
Dry needling is not a service provided in every state. Find a location near you that provides dry needling services.
Instrument-assisted soft tissue mobilization (IASTM)
Ever had a deep tissue massage? That firm pressure targeting a deep ache or an area of chronic pain?
Well, IASTM is a technique that gets deep into the tissues, including the muscles.
Similar to deep tissue massage, soft tissue mobilization works like standard massage, but using specialized instruments. Used quite often in physical therapy, it allows for more direct treatment than just using the hands.
IASTM produces good results for large muscle groups as well as smaller, targeted areas.
Angle and pressure in using the instruments help your therapist work on a specific layer of soft tissue during treatment. Often, these are areas where prior injury or long-term overuse has contributed to a build-up of scar tissue that IASTM can help break down.
IASTM is a good choice for many who have soft tissue pain or injury contributing to movement restriction, including:
- Arthritis sufferers
- Workers who perform long-term repetitive tasks or whose job has them on their feet a lot
Read more to find out if you’d be a candidate for IASTM.
To request a consultation for any of our specialty services or ask us questions regarding treatment, fill out our short online form. A member of our team will connect with you directly.
If you’d rather speak with someone personally, call our toll-free scheduling line at (800) 779-6682.
Posted 12/8/2022 | 4 min. read
If you’ve never been to a physical therapist, you may not know some of it’s surprising benefits.
And if you have needed physical therapy (also known as PT) at some point, this article may still hold some surprising considerations.
But first things first. Like the not so subtle calendar to the right.
Yes, it’s that time again, when the old year is about ready to phase into a new one. For many of our readers, the little red circle at the end of the month sounds the alarm for just-oh-how-much still needs to get done.
But give us a few minutes and we’ll give you five reasons for the importance – and benefits – of fitting physical therapy into your end-of-the-year routine to jump start your healthy new year.
Take a minute to assess this past year.
If there’s one fact that we share it’s that we all got older.
Now, we’re not asking you to share your age, but just think about how you’re feeling overall.
Tired? A bit run-down?
Less energy, perhaps, or maybe just not feeling as healthy as you did at the beginning of the year.
As we age, we lose muscle mass and endurance. You may notice new aches and pains or popping – crunchy – noises in your joints. Physical therapy can address all these conditions, and our therapists (aka movement experts) can help with joint pain, arthritis, balance issues and teaching you how to make simple adjustments to your everyday movements to feel better and help prevent aches or an injury.
Physical therapy can be a great way to give your body a tune-up and move more easily.
It’s a big enough reason that there are organizations dedicated to its study. A 2022 “Stress in America” study shows the worsening effects of stress in the U.S. The end-of-the-year holidays can increase stress and anxiety.
Many of our patients come to us with tension in the neck, shoulders and back. These are three main areas where stress can set in and have you feeling unwell.
Physical therapy, especially manual (hands-on) therapy and instrument-guided soft tissue mobilization therapy, can help relieve stress by relaxing muscles and pinpointing treatment to the connective tissue around the muscles.
Our therapists can also give tips for exercise and simple stretches that can do wonders for reducing stress.
Never heard about prehab?
Well, then this may just surprise you. If you’re headed for surgery in the New Year, pre-surgical physical therapy can be a helpful way to prepare now (the “pre”), and help you recover more quickly afterward (the “rehab”).
We see many good results using this approach with joint replacement surgery. So good, that we wrote a blog that includes the benefits of medical rehabilitation when combining physical therapy before and after surgery.
Post-operative studies show prehab leads to better outcomes, including:
- Fewer days in the hospital
- More stamina for physical exercise after discharge
- Getting familiar with therapy equipment – before surgery – that will be used in your rehabilitation
Injury prevention is often a less talked about benefit of physical therapy.
But we place just as much value on learning how to help prevent injury as on how to recover from injury.
Depending on where you live, the change in weather can mean more cold, snow and ice. And that can mean more slips, trips and falls.
But slips, trips and falls can happen in the home too, especially if you’re at a higher risk for falling due to balance issues, like vertigo or dizziness. Or maybe you need help learning to use a new assistive device safely, like a walker.
Physical therapists are familiar with body anatomy and how the body moves – it’s why we call them movement experts.
Their knowledge of a wide range of body parts makes them an excellent source for helping you learn exercises to strengthen and stabilize your muscles. These exercises are meant to help you stay safe and reduce the risk of falling.
For an athlete, sports injury prevention is important, and physical therapy can help with that too. Our physical therapists understand the risks in playing a sport and ways to reduce the most common types of injuries, like stress fractures, ACL tears and concussion.
End-of-year insurance benefits.
For those with a Flexible Spending Account (FSA), this is money that needs to be spent by December 31 each year.
If you haven’t finished your full course of physical therapy sessions (usually between 6 and 10), don’t put it off. This is a great way to focus on your wellbeing during this busy time of year.
Flexible Spending Account (FSA) and Health Saving Account (HSA) monies can be used for physical therapy and co-pays. If you haven’t already been applying your funds toward co-pays, December is the time to start. If you’re unsure about your insurance billing, we can help answer your questions.
And a final bonus benefit!
If you have a spending account balance remaining, you might consider using it to buy products that you use in our centers for your home exercise sessions. Check out the items we have on selectmedical.performancehealth.com and stay healthy and strong into the New Year.
Posted 11/18/2022 | 4 min. read
Why successful medical rehabilitation should have both
Bad knees, bad hips, bad back.
These are just a few common complaints that bring people to physical therapy (PT) in search of relief.
Feeling off balance?
Sprains and strains?
Pain in the neck?
More reasons why more than one million patients sought help through our outpatient physical therapy centers in 2021.
But the past two years, coming out of the pandemic, have brought a renewed focus to in-home care delivery throughout the industry, like physical therapy treatment.
While in-home physical therapy isn’t new – our centers have offered it since 2010 – some newer ways to receive it are growing in popularity.
Take virtual physical therapy, or telerehab, for example.
Its biggest benefit is convenience. Stay in your home and do sessions on your own from your computer or smartphone. If you’re technology savvy, a virtual care delivery model might be appealing.
Recovering from an illness or injury at home? Some level of in-home care delivery can be beneficial in getting you back on your feet again.
But so can in-person rehabilitation at a physical therapy center.
In-center you’ll have the benefit of one-on-one time with clinical specialists who can assess your movement and progress. If you’re new to physical therapy, this is an important consideration. You’ll need feedback to help you become aware of proper body movement, posture and form in doing exercises.
With decades in providing outpatient physical therapy, we look at each patient as an individual. Our treatment of them is also as an individual, which means the best treatment isn’t a this-or-that way; in-center or in-home.
It’s both, one after the other.
Curious about why?
Read on to learn more.
In-home physical therapy: where does it fit in treatment?
Many of our patients come to us for orthopedic rehabilitation. This is the side of physical therapy that treats musculoskeletal pain – bones, muscles, joints and tendons.
Injury and degeneration of the musculoskeletal system can lead to tremendous pain. At its worst it can mean lost function in these essential body parts.
Pain may also result from overuse or overexertion. Ask any of your weekend warrior friends who push the limit of their athletic exercise and end up with injuries.
Musculoskeletal joint-related pain, in particular, makes up a good portion of what we treat in our centers:
- Low back
Aside from injury and overuse, joint pain can also be brought on by repetitive stressors, like typing, lifting, bending and other activities going long periods without interruption.
In most cases, we treat in-center using hands-on or manual therapy techniques and exercises tailored for your condition or injury.
But there’s an aspect of joint-related conditions where combining in-center and in-home physical therapy is a win-win: joint replacement surgery.
Surgery can reduce the severity of joint pain or get rid of it entirely.
But it’s not a magic bullet, as anyone who’s had a knee or hip replacement can tell you.
Surgery is disruptive to the body.
Post-surgery pain is real.
Also called post-operative pain, it can include inflammation of tissue at the incision site. The surgical site and surrounding ligaments – and the new joint – will need time to adapt to movement. This can be very uncomfortable.
Physical therapy rehabilitation post-surgery will help with reducing pain and discomfort, and regaining function.
Recovery in these early stages after surgery is effective at home, when led by a clinical therapist, in-person.
In the comfort of your home, therapy exercises will help you safely work through muscle and joint stiffness to get back to normal movement. At this point, we like to get patients back for in-person sessions at our centers to continue toward full recovery.
“We see positive outcomes if patients leave their house and come to an environment that provides social, hands-on interaction,” said Kelly Scott Kover, national director of clinical innovation at Select Medical. “Those are the patients we’ll have the best impact with – in a hybrid care model.”
About 8 in 10 patients in our physical therapy programs take part in therapy before and after joint replacement.
Let’s take a look at that.
As effective as physical therapy is for rehabilitation after surgery, it’s also effective in preparing for surgery.
Called “prehab,” it’s becoming better known as part of joint replacement therapy.
Post-operative studies show it leads to better outcomes, including:
- fewer days in the hospital
- more stamina for physical exercise after discharge
- getting familiar with therapy equipment – before surgery – that will be used in your recovery
Of course, there are many other considerations where in-home physical therapy can be effective in rehabilitation.
You may be limited by travel, injury or a weakened immune system from cancer treatments. Our clinical experts will bring our services to you to help you heal in place and rebuild strength.
Both in-home and in-center options have benefits. Both may be considered when we put together your treatment plan in an initial evaluation. Combining the two may work well for you.
If you’re on the road to surgery, joint replacement or other, or need rehabilitative treatment for other reasons, fill out our online Request an appointment form. A member of our team will connect with you to confirm your visit.
Posted 11/3/2022 | 5 min. read
If you google physical therapy definition you’ll find this short explanation. You’ll even be able to hear how to pronounce it.
the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.
While that’s pretty straight-forward, unpacking this definition reveals much more about this medical practice than a simple definition.
It may surprise you to learn that physical therapy isn’t a new thing. In fact, the roots of modern-day physical therapy go back in time…
Back to ancient Greece and Rome and the early practice of water therapy and massage to help improve movement. Water therapy and massage are still widely used as part of physical therapy treatments.
As its name suggests, physical therapy (PT) had its beginnings in physical, hands-on treatment.
Today’s physical therapy, also called physiotherapy, is still a hands-on practice. But it also includes technology in care delivery, like telerehab care. This lets people work with a therapist over the internet for in-home physical therapy.
Whether hands-on/in-person or web-based, physical therapy is a way to treat movement and mobility issues, without the risk of surgery, and is drug-free.
Physical therapy’s scope and purpose
In practice, physical therapy covers a broad scope of treatment for:
- Joint motion
- Spinal misalignment
- Bone malformation and breaks
- Muscle weakness
- Respiratory dysfunction and endurance
- Joint inflammation and pain
- Limb loss and limb difference
- Cardio-vascular function
- Nerve damage
- Parkinson's disease
- Inner ear disorders
- Soft tissue damage
Physical therapy, at its core, treats impairment and functional limitation. Therapists are medical professionals and highly skilled in understanding anatomy and body function. They are also licensed to perform treatment.
Before delivering any services, a therapist will take a thorough history of your condition to understand its severity. Depending on your symptoms, they may also gauge:
- Standing and walking ability
- Skin and muscle tone
- Comfort and fit of orthotics and prosthetics
This consultation helps determine the kind of care and treatment techniques that may be of benefit for healing and recovery.
If physical therapy can help, this is the best time to ask questions and learn more about what your treatment will include.
What might physical therapy treatment look like for you?
Everyone’s body structure is different. As we age, our bodies change.
Pain and discomfort may become less tolerable. Healing may take longer.
Between any two people, pain, discomfort and healing ability are different too.
At HealthWorks, we take all of that into consideration. After an initial consult, a treatment plan will be tailored for you. The treatment plan is the guide for what, when and how treatment happens. This is a key factor in the success of your physical therapy experience.
To begin, there’s a time element for physical therapy and getting the best results.
Typically, therapy sessions last from 30-90 minutes.
Sessions are scheduled two to three times per week. Your first session may start right after the initial consult or be scheduled for a different date.
At each session your therapist will assess your progress based on your treatment plan.
Sessions involve physical activity, so it’s important to dress comfortably.
Tip: Wear loose clothing. If you choose to wear exercise gear, be sure that you can roll up your pant legs and sleeves (or wear shorts/t-shirt). This allows your therapist to easily work on your arms and legs.
Your treatment may include the use of a variety of therapy exercise equipment to get the best experience in your sessions:
- Training stairs
- Balance stabilizers
- Recumbent bikes
- Free weights
- Therapy bands
- Parallel bars
- Posture mirrors
Some of these may be unfamiliar at first, but therapists are your partners in learning. They will teach you what the equipment is and what it’s for. They will also explain proper use and the results you can expect.
Some therapy aspects are more familiar like water, ice and heat.
Others may be specialized therapies delivered by therapists with advanced training. Some of the leading techniques:
- Dry needling for pain relief
- IASTM treatment using specialized instruments
- Balance assessment to reduce the risk of falling
Your physical therapist may recommend doing some exercises at home. These will be prescribed by your therapist so that they are consistent with your treatment plan. The goal is to keep moving and improving in between one-on-one sessions.
A proactive benefit of physical therapy
Physical therapy is most often done for corrective and rehabilitative reasons.
But physical therapy is moving beyond being just for recovery. It’s now also a preventive practice to help avoid injury.
Athletes and individuals who are active in hobby or league sports may benefit from therapy designed for athletic health.
While a physical therapist may work with athletes, treatment can also be given by certified athletic trainers working with the newest techniques for treating athletes.
A primary focus of athletic health is education on injury prevention. It’s designed to optimize athletic performance, specifically to avoid injury or re-injury.
Preventive therapy crosses into other functional areas. This includes working with people who engage in active, physical or repetitive activities.
Called prehab in some medical circles, here, again, the emphasis is on the proactive side of preventing injury. Prehab uses education and preventive techniques with patients to strengthen muscles and joints used on a regular basis.
Prehab can be especially effective in on-the-job safety to manage work injury risks and with performing artists to help prevent common injuries in their art form.
Physical therapy and its specialty areas have the goal of restoring movement and improving impairment for better quality of life.
This is our goal. If physical therapy sounds right for you, fill out our online Request an appointment form. A member of our team will connect with you to confirm your visit.