Tag Archives: restore motion

RM Hosts DMV Pelvic Floor Study Group

    

Restore Motion hosted the DMV Pelvic Health Study Group Saturday, January 27th.  There were over 23 attendees from DC, Maryland, VA and WV!  Our guest presenter was Dr. Rachel Rubin a urologist who specializes in sexual health.  We were thankful for the chance to discuss scholarly articles and challenging patient care issues with Dr. Rubin.  

One sensitive topic discussed was the general outrage about the sexual abuse by USA Gymnastics Team physician, Larry Nassar . His actions put legitimate treatment of the pelvic floor in questionable light for the general public.  (See link to article below by a pelvic floor PT and doctor of Physical Therapy.)

This determined group of therapists and physician want to speak out for the necessity of pelvic health and sexual health education for all ages.  We also enjoyed catching up with and meeting our colleagues and friends.  Always good to put a name with a face!  

We plan hold more events that bring our network of colleagues closer together to help our patients.  It often takes a team of practitioners to heal pelvic dysfunction and sexual trauma. Physicians (urologists, gynecologists, colorectal, gastroenterologists), physical therapists, mental health therapists, nutritionists and sex therapists refer to each other to promote each patient’s healing and well being.    

Written by: Miriam Graham, PT, DPT, MBA   

Nassar’s Atrocities Stigmatize A Legitimate Medical Treatment article by Lori Mize, PT, DPT

    

RM Friend: Marisa Nickols

Meet RM Friend MarisaNickols, Co-Executive Director of Baby’s Bounty Montgomery County.  Baby’s Bounty MC is a non-profit 501(c)(3) that provides safety, health and wellness essentials to at-risk infants up to six months of age who are born into poverty, homelessness, abuse, neglect, and other disadvantaged situations.

When Marisa was pregnant with her first child she noticed, “my husband and I had lots of support from friends and family.  What we weren’t given, we were able to buy–whatever was needed.”  Reflecting on her good fortune she “started to wonder what happens to new moms and families that don’t have the resources?”  Marisa first heard about Baby’s Bounty when she caught a segment about the charity on the news. “I decided to donate my daughter’s things to the charity when she grew out of them.”  She was surprised to hear a few months later the charity was closing its doors.   

“I have a background in politics–and I thought those skills could be applied to running a charity.”   The needed skills of organizing volunteers and getting a message out to the community overlapped well. Nickols reopened Baby’s Bounty 3 months after the doors were closed. In FY 2015-2016 Baby’s Bounty helped 127 babies, doubled that the next year and in the first 6 months of FY 2017-2018 have helped 220 babies in Montgomery County.

“Some mothers don’t have an infant car seat when it is time to leave the maternity ward.”  Babies in need are identified by hospital case workers, Montgomery County or Health and Human Services referrals. Cribs for Kids is an organization that helps purchase Pack-n-plays (portable cribs) at a good price for the charity. Used infant car seats aren’t allowed to be donated; they have to be purchased and donated new.  Monetary donations allow the Baby’s Bounty to purchase items for “Safe Sleep, Safe Travel, Health & Hygiene.  The charity is funded through a combination of 2 grants from Montgomery County, donations and fundraising efforts. The Baby’s Bounty “Run Rockville 5k and Stroller Derby” will be April 22.  Click here for the flyer.  

To learn more about Baby’s Bounty of Montgomery County visit their website http://www.babysbountymc.org/

 

International Pelvic Pain Conference 2017

Restore Motion physical therapists Carrie Cothran, Patrick Wenning,  and Reshma Rathod attended The International Pelvic Pain Society Conference held in Washington DC October 11-15th. When asked to summarize her “take home discovery” from the IPPS Conference, Carrie Cothran replied, “Pain can be viewed as a neuro-immune response.  Structures within the body that aren’t injured may still undergo an inflammatory reaction due to the tissue changes associated with pain. This in turn contributes to long-term protective responses that affect resting muscle tension and ability to do work. The protective responses that occur with pain make the body more vulnerable to injury.”

Patrick Wenning remarked, “At the conference, there was such enthusiasm for better understanding scientific knowledge of the pelvic floor. Most of the time, pelvic floor rehabilitation is new to people and to other PTs mainly because it is an area of the body that people don’t want to talk about. Discussion with fellow participants was frank and enlightening.  They made me feel that I had something to contribute and that I made the right decision to pursue this specialty. I still have a lot to learn as the science continues to uncover more useful information!”

Reshma Rathod added, “Opioids don’t work with Fibromyalgia or chronic pain since the endogenous opioid receptors are already occupied due to changes associated with chronic pain.  When opioids are given for acute pain, they interfere with mood, sleep patterns and contribute to headaches. Ironically, patients may want to continue on the opioid medication to address their depression, difficulty sleeping and headaches.  The body’s dependence opioid medications ‘stick’ with the person making it more difficult to discontinue and cause more problems in the long run.”

Laser application in physical therapy

If you have ever had physical therapy, you are aware that manual therapy techniques and exerciseprescription are usually the cornerstone of your treatment program. Perhaps you’ve also had experience with modalities such as ultrasound, electrical stimulation, and even laser therapy.

What is a laser?
There are two different types of lasers primarily used in clinical treatment, Class 3 and Class 4. They are classified according to their ability to cause retinal damage, thus wearing appropriate protective eyewear is a must when working with these lasers. Class 3 lasers emit power of 5 to 500 mW while class 4 lasers emit power greater than 500 mW.

Class 3 lasers are low level, low intensity, cold lasers as they cause no thermal effect in the superficial tissue when used. Class 4 lasers are high power and considered hot lasers as they do produce an increase in the temperature of superficial tissue when proper exposure time is exceeded.

Under proper and normal treatment protocols, class 4 lasers emit greater photonic energy in a shorter period of time than class 3 lasers without a significant rise in tissue temperature, allowing it to treat deeper tissues, such as ligaments, muscles, tendons and cartilage.

What types of conditions benefit from laser treatment?
Physical therapists use class III and IV lasers as a treatment modality. These different types of lasers, whether they are cold lasers or provide a thermal effect, such as red, near infrared, or CO2 lasers provide pain relief and aid in the healing process of many musculoskeletal and neuromuscular conditions.

These conditions include:

  • Neck and low back pain
  • Tendonitis
  • Bursitis
  • Capsulitis
  • Carpal Tunnel Syndrome
  • Plantar fasciitis
  • Migraine
  • Bell’s Palsy
  • Arthritis
  • Strains and sprains
  • Adherent scar tissue
  • Wound healing
  • Muscle spasm
  • Pelvic pain
  • Stress urinary incontinence

How does it work?
Lasers work by stimulating collagen synthesis to aid in tissue healing, limiting the formation of edema and hemorrhage, increasing/stimulating the production of ATP (the energy source for our cells), and accelerating the inflammatory process by reducing levels of painful inflammatory marker, decreasing neutrophil influx, and decreasing oxidative stress on the body.

The use of laser for vaginal health is becoming increasingly popular among women who experience vaginal changes secondary to aging, childbirth, and hormonal fluctuation. These changes in vaginal tissue can contribute to loss of sexual gratification, dyspareunia (pain with intercourse), pelvic pain, and stress urinary incontinence. By stimulating collagen synthesis and reducing inflammation, pain is reduced and intravaginal tissue is strengthened, improving continence.

Please consult your physician for additional information.

 

Image: www.pixels.com

RM Friend: Susan Hurson, MD

Originally from Long Island, Sue Hurson has been a Washington, DC transplant since receiving her undergraduate education from Georgetown University.  She worked at the National Cancer Institute for 6 years before attending Georgetown Medical School. While at the Cancer Institute she worked on projects that developed Taxol and Carboplatin for use in the treatment of cancer.  She finished her residency at the Washington Hospital Center. 

When asked why she chose OB/GYN, she recalls experience during clinical training drew her to gynecology.  “I felt I could make a real difference in women’s lives by taking care of women though the continuum of life; I liked the combination of obstetrics, medical and surgical interventions.” Sue was drawn to medicine early in life.  Her father was a physician and she volunteered as a candy striper as a teen.  Dr. Hurson has practiced in Washington, DC for 25 years, she discontinued obstetrics in 2015 to focus on gynecology.

Sue Hurson’s practice philosophy is to forge a partnership between patient and physician to guide her patient through to optimal health. “Sometimes patients don’t know what to ask.  I try to tell women what to expect, real ‘education and empowerment.’ To tell you what you need to know before you need to know—sometimes, as a patient, you don’t even know what to ask.”

She became interested in integrative medicine because of its focus on mind, body, and spirit.  She says, “Functional Medicine is putting it all back together so the systems are connected and integrated because they all impact each other ~integrated specialization.”  She uses a team approach with other physicians and practitioners such as acupuncturists, physical therapy, nutrition counseling, mental health and health coaching.  She guides and encourages her patients, “Be the best you can be at your age, the body will change, knowledge is power.”

What is her most frequent recommendation for women to stay healthy?  Sleep!  She adds she more fully appreciated the benefits of sleep first hand after she stopped delivering babies to focus exclusively on GYN.  “Get enough good quality sleep.  It impacts so many areas of health.  Prioritize sleep.  There is better resilience and improved immune function with proper sleep.”  

 

As told to Miriam Graham, PT, DPT, MBA

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

 

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.