Tag Archives: physical therapy

Gail Wetzler PT, DPT, EDO, BI-D

Reshma and Miriam first met Gail when they attended her Gynecologic Visceral Manipulation class sponsored by the American Physical Therapy Association (APTA) in 2005.  She has been a teacher, mentor and friend ever since.  Gail is a leader and innovator in the development of new courses for women’s health, manual diagnostics, visceral/structural disorders and integrative therapies for animal health.   She teaches these courses for the American Physical Therapy Association, The Upledger Institute and Equinology.  She is the Curriculum Director for the newly developed Barral Institute of Education Research and Manual Therapy.  She also is currently the co-developer of the new MSAR (Masters of Science in Animal Rehab) at Western University. 

She established her private practice in 1979.  Her fields of study include osteopathic manual techniques, exercise physiology, women’s health, functional assessment, movement analysis, laser/modalities, psychoneurobiology, nutrition/digestive dysfunctions, anatomy, animal rehabilitation and integrated manual therapy.

While Gail loves to talk about physical therapy and all of the new exciting concepts that are improving people’s lives, she is equally passionate about the animals in her life.   She loves her new 12-acre ranch in Denver and was able to relocate her two horses when she moved from California.  She and her husband are happy to be near their children and grandchildren.   She is in the process of setting up a “menagerie.”  She now has dogs, cats, and goats, in addition to her horses and humans, so she can enjoy her whole family!

A 1973 graduate from Long Beach State University, Gail gained her orthopedic, acute and administrative background at Hoag Hospital Physical Therapy Department as outpatient clinical supervisor.

Publications include chapters in the following books: Diseases of the Temporomandibular Apparatus by Douglas Morgan, D.D.S., William Hall, M.D. and S. James Vamvas, D.D.S., Visceral Manipulation and Low Back Pain (IFOMT) and Therapeutic Management of Incontinence and Pelvic Pain by J. Laycock, PhD, FCSP and J. Haslam, MCSP, SRP.

Gail’s research includes: “The Effect of Functional Integration on TMJ Disorders”, with Dr. Mark Reese, “The Visceral Relationship to Low Back Pain”, with Dr. Stanley Paris and “The Effects of Manual Therapy on the Brain”, with Dr. Daniel Amen, Dr. Jean Pierre Barral, and Dr. Alain Crobier.

Playing for Two

There are moments in an athlete’s career that are life changing; winning your first title, becoming world number 1, or finding out you are going to be a mother.  For some female athletes, motherhood can be an exciting time; for others finding out you’re with child can leave more questions than answers.  How will this impact my professional career? My lifestyle? Or even my training? Can I still compete while pregnant? For a long time, the American College of Obstetrics and Gynecology (ACOG) has recognized the importance of exercise during pregnancy.  Unlike old beliefs, exercise is now known… For more information, click on PhysicallySpeaking-Playing for two

 

Written by: Reshma Rathod, PT and Thu Tran, MD for WTA (Women’s Tennis Association)

Manual Therapy Treatment for Concussions

Following a concussion, symptoms such as headaches, light sensitivity, dizziness, cognitive difficulty, emotional irritability, depression, and sleep disturbances can often linger. Waiting for the symptoms to improve is a frustrating experience that can impact all areas of an individual’s life. Physical therapists skilled in manual therapy including Craniosacral Therapy, Visceral Manipulation, and Neural Manipulation have observed improvement in many clients’ symptoms post-concussion. These specific manual therapies are gentle therapies that follow the osteopathic principles that structure and function are interrelated. Craniosacral therapy improves the motion restrictions in the craniosacral system which consists of the meninges, bones, and cerebrospinal fluid from the head to the coccyx (base of the spine). Visceral manipulation is a manual therapy developed by a European osteopathic physician Barral that uses gentle, but specific manual forces to improve the mobility of the organs and the connective tissues. Barral Neural Manipulation works to improve the fascial mobility that surrounds all of our nerves allowing the freedom of motion needed for optimal function.

A recent study published by Gail Wetzler and colleagues confirms manual therapy can improve concussion recovery. In the study of 11 male retired professional football players, these specific manual therapies resulted in statistically significant improvements in pain intensity, ROM, memory, cognition, and sleep. For specific changes observed, here is a link to the research study. http://online.liebertpub.com/doi/abs/10.1089/acu.2017.1222

Gail Wetzler PT was here at Restore Motion this weekend teaching the therapists who already have trained in these manual techniques how to better use these skills to treat individuals with post- concussive symptoms.

 

Written by: Stephanie Bloom, PT

 

“For information on what to do if you or your loved one sustains a concussion, please refer to https://www.cdc.gov/traumaticbraininjury/recovery.html

Image Source: https://www.flagspin.com/youth/youth-flag-football-concussions

 

Is this Backpack Too Large?

What to look for in a Backpack:

  • Wide, padded shoulder straps distribute the weight over a larger area around the shoulders. This avoids that “cutting into the shoulders” feeling.
  • Chest and waist straps also help distribute the load of the pack. Use of a chest strap (and/or waist strap) decreases load that would completely weigh on the shoulders if it were not used.
  • Padded back cushions the load as it rests on the back. Some backpacks feature no padding directly over the spine – This is favorable because it creates a comfortable “cut out” for the spine bones. It decreases load contact directly over the “spinous processes” of the bones.
  • Multiple compartments even out the load and are preferable to one large cavernous compartment.   It makes retrieving items easier as they don’t all fall into one single “pit” of the pack.

Consider the size of the backpack wearer—the overall length of the backpack should not go below the waist of the wearer.   Appropriately sizing the shoulder straps to distribute weight evenly over both shoulders and using the chest or waist strap can help the pack sit at the waist of the wearer.

Wear the pack with both shoulder straps not just one strap over one shoulder—Really! Wearing the pack on one side contributes to neck, shoulder and hip strain in addition to back pain.

Avoid filling the pack too full. It is too full if the wearer has to lean forward to bear the weight. This can contribute to bad posture and back pain. Full packs can cause havoc when the wearer turns and unknowingly knocks into people or priceless artwork.

Rolling packs have their advantages and disadvantages as well:

  • Some school lockers aren’t big enough to accommodate the rolling packs.
  • Need to be carried over stairs or rough terrain.
  • May be a trip hazard.

When using a rolling pack remember to switch arms frequently and to engage core/abdominal muscles to balance the strain on the body.

Written by: Miriam Graham, PT

MAPP: Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain


Malassezia spp. Skin Microbiome.  https://skinmicrobiome.wordpress.com/tag/malassezia/

MAPP (Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain) Finds That Fungus In Urine Might Be Linked to Urgency and Pain.

One of the most promising lines of research in urology today is the study of the biome, the diverse population of bacteria and fungi that live harmoniously in the human body. In previous MAPP Research Network studies, IC patients were found to have high levels of candida/fungi in their urine during flares (1). Another found that IC patients are deficient in some important bacteria in our bowel while having higher levels of other harmful bacteria (2). This latest MAPP Research Network study now links changes in fungal communities with the symptoms of urinary urgency and pain (3).

Researchers obtained urine specimens from 12 IC patients, 17 Over Active Bladder (OAB) patients and 14 patients without urinary symptoms. DNA was extracted, deep sequenced and compared to multiple fungal sequence databases. They found that patients with more severe symptoms, regardless of the symptom type, had decreased fungal diversity. Individual symptoms were associated with distinctive species of fungi. Patients with severe bladder pain had altered levels of Malassezia spp. composition while patients struggling with incontinence were inversely correlated with Wickerhamomyces spp.

The researchers concluded that the urinary microbiome is altered inpatients struggling with lower urinary tract symptoms, and that the loss of diversity in the microbiome correlated with worsening symptoms. Specific fungal patterns were found in patients with the symptoms of bladder pain and urinary urgency but interestingly this did not correlate with a diagnosis or medical condition. The researchers concluded, “These results suggest the intriguing possibility that particular microbial patterns maybe associated with specific symptoms, not necessarily diagnoses. This could lead to new diagnostic and treatment algorithms for patients struggling with lower urinary tract symptoms.” Clearly, there is a need for greater testing for fungi in urine screening.   Bacteria may not be the root problem in some patients. It is time to consider the roll of fungus in bladder dysfunction.

Adapted from Jill Osborne 8/10/17 Interstitial Cystitis Network Blog, Research https://www.ic-network.com/mapp-research-network-study-finds-fungus-urine-might-linked-urinary-urgency-pain/

 

References:

  1.  Osborne J. Could IC Flares Be Caused By Candida – New research study finds higher rates of candida rather than bacteria during IC flares. IC Optimist Winter 2016.
    https://www.ic-network.com/could-flares-be-caused-by-candida/
  2. Osborne J. The DIPP Mystery – Why are IC patients deficient in some good bacteria. IC Optimist Summer 2016.
    https://www.ic-network.com/dipp-mystery-ic-patients-deficient-bacteria-gut/
  3. Journal of Urology, April 2017 Abstract MP29-10 Alterations in the Urinary Fungal Mycobiome in Patients with Bladder Pain and Urinary Urgency
    https://www.ic-network.com/mapp-research-network-study-finds-fungus-urine-might-linked-urinary-urgency-pain/

Ursula Sukinik, Doula and Entrepreneur of Birth You Desire

Ursula is not only a certified childbirth educator, but is also a birth doula, a birth assistant, a doula trainer, and a mother of two teenage boys. Known for her easy laughter, radiant energy and knowledge of the birthing woman; to say that she is an inspiration is an understatement.

She is a true believer in honoring women’s bodies and the natural process, Ursula not only inspires her students to better understand how choices affect well-being, but she takes the mind-body connection to a whole new level with her practice as a birth worker. Ursula has personally worked with thousands of women during the birthing process.  

With this passion, she owns and runs Birth You Desire where you can find a list of doula training, childbirth classes, TENS rentals, workshops and speaking engagements in the DC Metro area as well as choose a doula to support you at your birth.

Ursula’s sons are going to college this fall University of Pittsburg & St Mary’s College of MD. She loves German Shepard dogs and her current dog’s name is Ohana Koa (called Koa, ko-ko, or when bad… Ko-ko loco). She is an avid gardener & hiker in her spare time. 

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Our Restore Motion Friend, Ursula Sukinik, doula and entrepreneur of Birth You Desire,  suggests how to stack the deck for an uneventful vaginal delivery.  Adapted from her BYD blog below, are 10 easy ways to avoid and reduce your cesarean risk.  

  • Prepare yourself.  Take a comprehensive childbirth class, learn your choices. 
  • Practice good body mechanics through out your pregnancy
  • Have a supportive and educated labor partner.  Your partner is your anchor. No matter how wonderful your birth team is they cannot replace the love and security you have from your partner.
  • Let baby come when they are ready, avoid unnecessary inductions and subsequent interventions.
  • Build a tool kit of coping methods and practice them.  Relaxation is the cornerstone to spontaneous birth.
  • Labor at home as long as possible with provider permission when applicable.
  • Avoid continuous monitoring when at your birth place if possible.  If continuous monitoring is necessary ask for a wireless monitoring to facilitate coping skills.
  • Use medications and interventions wisely. There are many tools for labor and they all have their place. 
  • Labor upright and change positions frequently whenever possible.  An active mother is an active baby.
  • Consider hiring a professional Doula to assist you in your birth.

Adapted from intellectual property of Ursula Sabia Sukinik/Birth You Desire. Used with permission. Do not reproduce or distribute without written permission from owner. Copyright 2011. All rights reserved. 

 

Pilates and Your Game

 

PILATES AND YOUR GAME
The Pilates principles of core stabilization address posture, breathing, muscle performance and motor control. Pilates sessions break down faulty movement patterns, and enable the practitioner to work on new movement strategies. Pilates can be integrated into any rehab phase, from the most acute to advanced sport-specific training.

Q: What is Pilates and how do you say it? 
A: Pilates (pronounced Pi-La-Tees) in named after Joseph Pilates who first devised the exercise program during the Second World War. Pilates is a form of exercise that concentrates on the “core” or trunk area, including the stomach and low back, promoting strength and flexibility in a controlled manner. People who do Pilates often describe themselves as getting “longer and leaner”. 

Q: I have some friends who do Pilates mat classes and others who do it on equipment. Is there a difference?
A: Pilates can be done on a mat or the floor, but it can also utilize equipment called reformers that resemble a table with different springs and attachments that alter resistance. There are many different pieces of equipment that are now being used in a Pilates program.

Q: Is it better to take classes or do private lessons?
A: Pilates is a very specific form of exercise, and it is best taught on an individual basis initially. Progressing into small group classes can then be done. Of greatest importance is learning from a highly-qualified Pilates instructor.

Q: Would doing Pilates regularly improve my sports performance?
A: Many people think that powerful tennis strokes come from the arms and shoulders. This is untrue. The power comes from proper weight transfer and rotation of the trunk and hips region. A strong “core” will certainly help the tennis game, and Pilates is an excellent form of exercise for the core region. Pilates can also be made “sport specific” by doing arm and leg movements whilst keeping the trunk stable. In fact, many of the top professional players are now incorporating Pilates into their fitness program to improve their game.

Q: Will I become more flexible and be able to move better?
A: Quite possibly, and in addition to strengthening, Pilates also increases flexibility and will improve any sporting performance. It will even carry over to your golf game!

Q: I have a chronic back problem, is Pilates a good idea?
A: Pilates can be extremely effective for back pain patients. We have seen tremendous results with our caseload of patients, and it is a low impact form of exercise that can be undertaken by people with many different physical conditions. If you already suffer from an ailment, make sure that your Pilates instructor understands the condition and teaches you appropriately.

 

Written by: Reshma Rathod
Picture from: www.premapilatesbarre.com

 

 

Postpartum Pelvic Health: Vol. 1.

During pregnancy and delivery, natural changes occur that impact your pelvic floor and abdominal wall. These changes can cause pain and discomfort for many women during pregnancy and/or after delivery. Childbirth takes a toll on our bodies regardless of the method of delivery.

The toll of postural changes and weight gain on the body can lead to conditions such has back pain, abdominal separation (diastasis recti abdominis), urinary urgency and leakage. It is a misconstrued notion that these symptoms are normal because they are common. Common is not the same as normal. Many women need assistance treating these symptoms so they do not deal with life-long consequences. The good news is therapists at Restore Motion are skilled in treating both pre and postpartum symptoms.

Physical therapy can help pregnant women be strong and fit while decreasing complications during delivery and improving the birth experience. Physical Therapy can also assist postpartum women in regaining their pre-pregnancy body.

 

Lowell Weiner, D.D.S., F.A.G.D.

Dr. Lowell Weiner is board certified Dentist practicing through National Intergrated Health Associates. His interests and studies in Holistic health started in 1969, when he first became interested in how jaw and tooth problems affected swallowing, snoring, breathing, the sinuses and the rest of the body’s total compensating mechanisms from head to toe.  Dr Weiner has served either as a consultant, faculty or staff at various universities in the area. He has limited his practice to sleep apnea and dental sleep issues, cranio mandibular dysfunction. He has served as an expert witness and is frequently asked to give second opinions for unusual complex dental medical treatments. The educational and treatment areas on which Dr. Weiner has placed special emphasis are sleep apnea, snoring, the infection and integration of the teeth, head, neck and shoulder with the rest of the body, both as a cause and result of acute and chronic problems.

Outside of work, Dr. Weiner started a fencing club at the University of Maryland and he enjoys cooking.

 

 

Reshma taught Muscle Energy Technique to Women’s Tennis Association Physical Therapists and Miriam taught Sex Therapy U at the Chicago School of Professional Psychology in D.C.

Reshma and Miriam dedicated time to help others in their professional development in January and February.  Reshma taught a nearly full day webinar to physical therapists of the Women’s Tennis Association (WTA) February 4th.  The topic was Muscle Energy Technique (MET), an osteopathic manipulation technique where the action of a muscle is used to improve joint range of motion and the ability of muscle to fire.  Reshma and Miriam started their study about and using MET in the 1990’s at Michigan State University School of Osteopathic Medicine CME.  Reshma is one of a hand full of primary health providers in the world for the WTA! 

Miriam also spent February 4th teaching for Sex Therapy U at the Chicago School of Professional Psychology in downtown Washington, DC.  The topic was Women, Sex and Therapy: Ongoing Sexual Pleasure and Couples Interventions for Healing – Treating Pelvic Floor Issues with PT and Sex Therapy.  She presented various issues that affect pelvic floor and sexual function and how physical therapy can help those dysfunctions.  The students got to practice breathing into the pelvic floor, and using racquet balls to roll out muscular trigger points in the legs and back and tips to help their patients understand pelvic floor function.  They also learned ways to help their clients experience and explore communication through touch. 

The staff of Restore Motion is planning to offer a pelvic floor and manual therapy continuing education course for Physical Therapy CEUs in the near future – “watch this space.”