Services

What types of problems are treated?
» Incontinence
» Pelvic pain
» Lymphedema
» Osteoporosis
» Surgery pain, limited motion and weakness
» Menopause
» Musculoskeletal dysfunction
» Muscular or joint impairment related to pregnancy or childbirth
» Fibromyalgia

How are these problems treated?
» Therapeutic exercise
» Therapeutic activities
» Neuromuscular reeducation
» Balance and gait training
» Superficial and deep heat
» Cold therapy
» Electrical stimulation
» Biofeedback
» Manual lymphatic drainage
» Massage
» Extensive education

Additional Information

URINARY INCONTINENCE IN WOMEN
Definition: Incontinence is the loss of bladder or bowel control resulting in involuntary loss of urine or stool. Pelvic floor weakness resulting in a loss of muscular support for the bladder, uterus or rectum may be the cause. Incontinence of urine may be termed stress, urgency or frequency. Electrical stimulation, biofeedback and exercise, with or without vaginal weights.

The Problem: Women of all ages, children as well as adults, may experience an uncontrolled loss of urine, called urinary incontinence. Weakness of the pelvic floor muscles which form a sling around the vagina (birth canal), the urethra (tube from the bladder) and the rectum may cause incontinence (leakage). Aging, pregnancy, childbirth, chronic constipation and chronic coughing can weaken the pelvic floor muscles. If you notice urine leaking when you cough, lift, sneeze or exercise, you may have the most common type of leakage called stress incontinence. If you feel a sudden and strong need to urinate and sometimes do not make it to the bathroom in time, you may have urge incontinence. A combination of both types of incontinence is called mixed incontinence.

A Suggested Program may include:
» Instruction in strengthening exercise or "Kegels" for the weakened pelvic floor muscles
» Gentle electrical stimulation to help tighten the muscles and help the bladder to be less irritable
» Biofeedback training to help you learn to correctly tighten and relax the pelvic floor muscles.

Other Physical Therapy suggestions that may help you in the future:
» Designing a home exercise program to meet you needs
» Instructing you on correct lifting and moving techniques
» Teaching you how to keep a bladder diary and move toward normal voiding habits
» Suggesting foods to avoid which may be irritating to the bladder.

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PELVIC PAIN
Definition: Pelvic floor tension or pain in the sling of muscles which support the bladder, uterus and rectum can be caused by muscle, nerve, joint or nerve problems. The patient may have difficulty sitting, pain during intercourse or pain in the hips or lower abdomen. Rehabilitation includes pelvic floor relaxation training, manual therapy and biofeedback.

The Problem: Gynecologists often see patients with chronic pelvic pain. The pain may be associated with sitting through a movie or a meeting, during intercourse or urination. It may include lower abdominal pain or numbness or tingling in the vaginal region. You may have pelvic pain caused or worsened by low back pain.
Pelvic pain may be closely connected to problems in the muscles, joints or nerves. Scars from surgery or childbirth may contribute to this painful condition. If you have been in pain for several weeks, you may be unconsciously holding parts of your body in a tense and rigid position to protect yourself from more pain. These tense positions may cause weak and painful muscles, strained joints and compressed nerves.

A Suggested Program may include:
» Exercises designed specifically for you to stretch or relax tight muscles and strengthen weak ones
» Manual therapy techniques for tight or tense muscles
» Improvement/restoration of joint movement
» Electrical stimulation, TENS, heat, cold or ultrasound for pain relief

Other Physical Therapy suggestions that may help you in the future:
» Designing a home exercise program to meet your needs
» Helping you to change poor habits such as holding muscles in a tense position
» Educating you in good work postures, rest positions and relaxation techniques
» Helping you develop a program for life long fitness.

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LYMPHEDEMA
Definition: Lymphedema is a persistent swelling of the arm or leg. It may occur after mastectomy, when lymph nodes are damaged or removed or following infection or scar formation which blocks the lymphatic fluid flow. Lymphedema may occur weeks, months or years after the initial injury. Exercise, massage and custom-made compression bandaging and compression garments are among the treatment choices.

The Problem: Lymphatic fluid, or lymph, is the transparent cellular fluid that bathes our internal organs and travels through lymph channels (similar to the blood vessels). Infection fighting cells, or lymphocytes, are produced in this fluid. The normal function of the lymphatic system is to remove waste products from our tissues and to transport fat, protein and water.
Lymphedema occurs when the normal drainage of fluid is disrupted. A persistent gathering of this lymphatic fluid causes swelling of the arm or leg. It occurs most commonly in women who have had breast surgery with removal of lymph nodes followed by radiation therapy, and can appear weeks, months or even years after the initial surgery. It can also occur following injury or infection. In each case, normal drainage of the lymphatic fluid is interrupted.

A Suggested Program may include:
» Manual lymphatic drainage to help improve the flow of lymph from the affected arm or leg
» Compression bandaging following lymphatic drainage
» Instruction in proper diet to help decrease the retention of fluids
» Assistance in designing an appropriate regime to improve cardiovascular health.

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OSTEOPOROSIS
Definition: Osteoporosis is a condition in which bones become thin and brittle and break more easily. Therapy programs include instruction in proper body mechanics and exercise, fitting of braces or orthotics and treatments like moist heat and electrical stimulation to relieve pain.

The Problem: Normal bone is constantly being built and broken down. When not enough bone is built, or too much is broken down, osteoporosis results. The bones become brittle and break more easily. More than 25 million Americans have osteoporosis. About 250,000 hip fractures, 3 times more common in women than men, occur every year because of bone thinning. One third of all women over the age of 50 will have broken bones in the spine due to osteoporosis.

Several factors that you cannot control place you at increased risk for osteoporosis:
1—Family History—blood relative with disease
2—Age—older adults have increased risk
3—Gender—women are at greater risk than men
4—Race—Asians and Caucasians have increased risk

A Suggested Program may include:
» Techniques to stretch or relax tight muscles
» Exercises to strengthen leg, hip and back muscles to improve posture, balance and walking ability
» Electrical stimulation, TENS, moist heat, massage or cold for back pain relief
» Fitting of a back brace or orthotic.

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AFTER ABDOMINAL SURGERY
The Problem: Abdominal surgeries, including hysterectomy, removal of ovarian cysts or hernia repair, my disrupt the abdominal muscles. Hospital stays following surgery have shortened. After surgery, you may be afraid to move. Abdominal muscles disturbed during surgery may be weakened and may continue to weaken as you lie in bed. Weak muscles make moving more difficult and lead to poor posture.
Now, more than ever, you should take an active part in recovering from your abdominal surgery. Also, you can help yourself recover with exercises or other self-care activities after you go home.

A Suggested Program may include:
» Deep breathing and coughing techniques to decrease the change of inflection in your lungs
» Leg exercises to maintain good blood circulation and prevent stiffness, while on bed rest
» Movement techniques to lessen the pulling on your stitches
» Exercises and self-help techniques to encourage bowel activity and reduce post-surgical pain from gas
» Relaxation training.

AFTER BREAST SURGERY
The Problem: Breast surgeries, including mastectomy, lumpectomy and reconstructive surgery (such as implants), can irritate or disturb the soft tissues in the shoulder, chest wall and under the arm. Scars and radiation can make the tissues under the skin "stiffen" and cause a pulling sensation in your chest or shoulder when you try to move your arm.
After surgery, you may be afraid to move your arm because of the pulling sensation or pain. This lack of movement may cause stiffness in the shoulder and pain or swelling in the arm. You may then find it difficult to do daily activities like reaching the top shelf of a cabinet or washing your hair.

A Suggested Program may include:
» Exercise to overcome tightness, weakness and pain in the shoulder, neck, chest and abdomen
» Exercises to improve posture and strengthen upper back muscles which may include the use of elastic bands, light weights and pulleys
» Scar massage and stretching
» Physical therapy manual techniques to improve mobility of the shoulder and ribs and to improve circulation.

Other PT Suggestions:
» Designing a home exercise program to meet your needs
» Instructing you on wound and skin care including scar massage
» Educating you on how to prevent or reduce arm swelling
» Making suggestions on relaxation techniques
» Suggesting lifting and energy saving tips to make your daily activities easier.

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DURING PREGNANCY
Obstetrical Dysfunction (orthopedic and high risk) Definition:
Pregnant women may suffer from pain or aching in the back or shoulder blades, rib cage, groin area or wrists due to changes in posture, weight or hormonal factors. Not only are these women more susceptible to injury during pregnancy, but related orthopedic problems may persist or begin following pregnancy. Maternity supports, manual therapy, strengthening or retraining techniques are typical treatments.
For a woman in a high risk pregnancy, bed rest is often necessary. The physical therapist designs an individual program of exercises and positioning as well as incorporating relaxation training into the patient's overall program. Post-delivery rehabilitation including strengthening and endurance training is also included.

The Problem: While pregnancy is a time of excitement and joy, more than half of all pregnant women suffer from back pain or some other orthopedic problem. Although back pain during pregnancy is common, it is not normal. Neither the pain sometimes felt in the groin area, rib cage, mid-back or should blades.
A combination of factors may cause back pain such as an increase in maternal hormones resulting in increased elasticity of the "soft tissues" of the body (ligaments, tendons and cartilage) as well as changing posture secondary to the growth of the fetus (baby). Together, these changes can make the pregnant woman more susceptible to injury or lead to development of problems in the spine, pelvis or rib cage.

A Suggested Program may include:
» Exercises to stretch tight muscles, strengthen weakened ones or improve posture
» Massage or soft-tissue techniques to increase circulation, relieve pain or improve tissue mobility
» Joint mobilization to allow movement at the joints and to relieve pain
» Fitting of therapeutic belts and supports
» Suggestions for appropriate body mechanics and energy saving tips for home and work.

Symptoms:
» Aching in the low back or between the shoulder blades
» Intense pain in the groin or pubic area that interferes with sleep, climbing stairs or walking
» A "catch", spasm or pain in the ribs or mid-back that may be worsened with use of the arms in front of the body.

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FIBROMYALGIA
Definition: Fibromyalgia is a chronic condition with persistent and widespread musculoskeletal pain along with specific tender points. A variety of other symptoms, varying patient or patient, include generalized stiffness, fatigue, anxiety and cognitive impairment. Treatments to reduce pain and promote function include stretching and strengthening exercises, heat and cold modalities and instruction in proper body mechanics to incorporate throughout daily activities.

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Information provided by The Section on Women's Health of The American Physical Therapy Association.
www.apta.org/womenshealth