• HIS THERAPY PT and PELVIC HEALTH
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Author: Sabina Kapasi

His TherapyArticles by: Sabina Kapasi
By Sabina Kapasi Pain, Pelvic Floor

Symptoms and Causes of Pelvic Floor Pain

In the US, approximately 15 percent of women report chronic pelvic pain. However, it is not a subject we feel comfortable talking about publicly, so often it can go undiagnosed and untreated. Chronic pelvic pain is pain in the area below your belly button and between your hips that lasts six months or longer. This can be severe and steady pain, intermittent pain, or pressure and cramping within your pelvis. Other symptoms may include pain during intercourse, pain while having a bowel movement or urinating, or pain when sitting for extended periods of time. Chronic pain can make it difficult to sleep, work, or enjoy life. It can also lead to depression and anxiety. Pelvic pain may stem from the musculoskeletal system, urinary tract, gastrointestinal tract, gynecological, or even psychological factors, so it is important to get evaluated to see what is causing your pain. Pelvic floor physical therapy is a huge component in the treatment of pelvic pain. During treatment, our specialized PT will address the muscular component of pain- teaching you to relax the muscles of the pelvic floor, may provide manual therapy of the pelvic floor muscles, as well perform myofascial release of painful trigger points of pelvic floor when necessary. There are several modalities that can assist in rehabilitation- biofeedback, electrical stimulation, and dilators, to name a few. Also during your visit, your PT will address the behavioral component of your pain- what you eat and drink, as well as bathroom and sleep habits. If you would also like emotional support, His Therapy offers a monthly women’s support group for chronic pelvic pain. Call our office today for more information and to reserve your spot. 864-534-1780.

By Sabina Kapasi Pelvic Health

Fireside Pelvic Health

At His Therapy we realize it’s not easy to relax during the holiday season. However, we want to remind you, for your pelvic health, to delight in a little rest and relaxation! Stress, anxiety, and tension can lead to an increase in muscle tightness in the pelvic floor. Hypertonic muscles in the pelvic floor can be painful and potentially cause symptoms like: 
Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying.
Constipation, straining, pain during or after bowel movements 
Unexplained pain in your low back, pelvic region, hips, genital area, or rectum 
Uncoordinated muscle contractions causing the pelvic floor muscles to spasm 
Statistics show 1 out of every 3 Americans (of every age) will suffer with pelvic floor dysfunction at some time in their life. Unfortunately, less than 50% of those who suffer will receive help. At His Therapy, we are driven to change that. We wish you all a very Merry Christmas and remind you to curl up by the fire with a good book, enjoy a hot chocolate and bask in the most precious gift this Christmas season, Jesus Christ!  

By Sabina Kapasi Cash Based

Cash Based PT Cost vs Traditional PT

The question is not ‘Will my insurance cover this?’ but ‘Whom can I trust to give me the best care for my money?’ This is the pressing question many are asking themselves more and more as healthcare becomes difficult to afford. Insurance may pay only after deductibles have been met and even then may only pay a percentage of your bill.   

At His Therapy, we are a cash based practice. We believe we can give you more care for less. To understand our value we have put together a chart to demonstrate the affordability of a cash based practice.  

Imagine a practice that doesn’t demand your insurance card and ID before they say hello. Imagine a practice where money doesn’t get in the way of patients getting to know their therapist. 

By Sabina Kapasi Osteoporosis

Do's and Dont's with Osteoporosis

Osteoporosis is a disease that causes a persons bones to become thin and weak over time. Osteoporosis is more likely to occur in women after menopause because the estrogen hormones are declining. Estrogen helps women maintain bone strength, so with declining estrogen levels the bones can become weaker and more fragile. Since the bones are so fragile and thin, it can be easy to injury oneself or break a bone. However, there are things you can do to keep your bones stronger and prevent further bones loss. First, it is important to assess your risk factors and learn how bones change over time as you get older. Next, make sure your diet has enough calcium, avoid alcohol, and do not smoke so your bones can stay as strong as possible. Lastly, get plenty of exercise and make sure you are living in a safe environment so you can prevent any accidents from happening.  Also, talk to a healthcare professional about the ways you can fight bone loss and osteoporosis. 

Do’s
walk or climb stairs when possible 
pay attention to proper posture
when standing in one place for a long period of time, keep the knees and feet about hip width apart
bend from the hips and knees NOT the waist 
Don’ts
walk or exercise of slippery surfaces
wear backless bedroom shoes or shoes with slippery soles 
slouch when standing, walking, or sitting
sit in a deep cushioned chair or couch 
move too quickly
engage in activities that require a twisting of the spine or bend from the waist(sit-ups, toe touches, golf)
finish a task if you feel short of breath, fatigued, or in any pain
sit in a chair or bed for an extended period of time

By Sabina Kapasi Pelvic Floor, Physical Therapy

Pelvic Floor Therapy

Pelvic floor therapy is a special type of physical therapy which specializes in the treatment of the pelvic floor.

The pelvic floor is a group of muscles that attach from the front of the pelvis to the tailbone. They act like a hammock to our body by supporting the bladder, uterus and rectum. The support mechanism of these muscles is critical for men and women to understand and use for everyday function to occur normally.

Weakness and dysfunction in these muscles can occur from childbirth, pregnancy, poor postural control, constipation, organ prolapse, obesity, and lack of use and awareness. There are many problems that may arise with the pelvic floor including urinary or fecal incontinence, organ prolapse, pelvic pain, pain with intercourse. 

Physical therapist who specialize in the pelvic floor have special training and certification in this field. Physical therapy treatment can help strengthen the pelvic floor, allow improved tone and decrease pain in areas which are affected. Increased tension and tone can occur in the muscles and cause pain and pressure during exercise, intimacy and other activities of daily living. Manual physical therapy treatments can help reeducate these muscles and to patients to learn to relax these muscles and gain more optimum function. Biofeedback treatment is also used which allows reeducation of the pelvic floor muscles to work effectively. There are many other treatment options that are available through physical therapy that can help rehab the pelvic floor. Each treatment is created based on patient’s diagnoses and needs.  

If you have any questions on this type of therapy you can contact me and I will be happy to discuss your treatment options and where and how you may seek help.

Sabina Weaver, MSPT
Sabina@histherapy.net 

By Sabina Kapasi Dry Needling

Dry Needling

Trigger point dry needling is a technique that uses a solid filiform needle to deactivate hyperirritable areas within muscles with the goal of decreasing pain and restoring function. These hyperirritable areas, or also called trigger points, can have wide referral patterns. The needles vary in diameters and lengths depending on the target tissue depth. Dry needling is not the same as acupuncture. The needle used is similar but the assessment, technique and goals are very different between the two practices.

Trigger point dry needling reduces pain by affecting the local and spinal pathways. Active trigger points have a higher concentration of inflammatory markers, cytokines, neuropeptides and catecholamines. After the needle is inserted these markers have been shown to decrease thus decreasing pain and other symptoms.

The procedure of dry needling can cause muscle soreness, fatigue and some bruising. At times it can be painful, but overall it is a safe procedure. Some other complications that can occur are headaches, dizziness and on occasion some nerve injury. On very rare occasions serious complications like pneumothorax would occur.
There are many research articles with randomized controlled trials and case reports done to show the effectiveness of dry needling:     Chronic neck pain (Itoh 2007),    Upper trapezeius trigger points (Tsai 2010),        Shoulder pain (Ingber 2000, Osborne 2010), Fibromyalgia (Casanueva 2013), Chronic Lower back pain (Furlan 2005, Gunn 1980)
Any of the resources listed or information provided can be provided upon request.  If you have any questions regarding dry needling or if you feel you may benefit from it, please do not hesitate to contact me.
 
Sincerely,
 
Sabina K. Weaver, MSPT, ATC-L
sabina@histherapy.net
864-534-1780

By Sabina Kapasi Dry Needling, Migraines

Headaches or Migraines Can be Relieved With Dry Needling

Are you or someone you know suffering from chronic headaches or migraines and need some type of relief? Then I encourage you to try or tell them about trigger point dry needling.

Dry Needling can help relieve headaches and migraines caused by stress and chronic, severe muscle spasms/tension which are found in trigger points. A trigger point is another term for what most people would consider a knot or lump in the muscle.  It is a highly sensitive area that is painful with light palpation or massage.  Trigger points can be sources of painful stimuli that house metabolic toxins which, over time, can lead to increased sensitivity to pain.

Dry Needling involves inserting long or small filament needles deep into the trigger points of the affected muscles with active trigger points. Trigger point dry needling works to improve muscle extensibility, as well as creating chemical, vascular and central changes.

The active trigger points refer pain that mimic the symptoms experienced with headaches and migraines. These trigger points can also cause headaches and migraines to occur.  The most common muscles affected are the upper trapezius, sternocliedomastoid, levator scapulae, temporalis and masseters. The three muscles that make up the sub-occipital triangle also have referred patterns of headaches.

Trigger point dry needling, posture re-education, in conjunction with therapeutic exercises for flexibility is an effective way to help manage chronic migraine symptoms. The effects of dry needling can usually be felt instantly as the affected muscles return to a relaxed state, but multiple treatments may be needed to eliminate pain and have lasting changes to someone’s posture.

Any questions feel free to call us at HisTherapy.  864-534-1780
www.histherapy.net

By Sabina Kapasi Bladder Problems, Incontinence, Physical Therapy

What Does a PT Do for Urinary Incontinence

As many of you may know that a physical therapists can help people to exercises with weights to help with strengthening or they can teach someone how to use crutches after surgery to help them walk. But how can physical therapists help with bladder or bowel problems like incontinence?

The pelvic floor muscle is a skeletal muscle just like other muscles in our body and they respond to

the same training techniques. Some physical therapists have developed special skills in

training the pelvic floor muscles. These therapists are called pelvic floor therapists.

If someone wants to strengthen their biceps arm muscle they have to learn the correct

exercises. Then they perform the exercises with the correct difficulty (not too hard, not too

easy) for the correct duration of time (it takes 4 to 6 months to increase the size of a

muscle). Pelvic floor muscle training is the same. First you have to learn the correct

exercise. This is challenging as it is an inside muscle and sometimes hard to find. In

fact, 40% of people are doing the exercise wrong. The best way to tell if you are doing

the exercise correctly is by palpating inside the vagina or rectum. A trained physical

therapist can measure the muscle by palpating just inside the vagina or rectum and asking

you to squeeze. This usually not painful but gives a lot of information about the muscle

How big is the muscle?

 Can you feel the muscle?

 Is the muscle painful and tense? – it is very important to relax and this may be the primary reason exercises do not work.

 Can the muscle elevate and support the organs – especially important when the organs are sagging?

 Can the muscle squeeze tight – to stop urine leakage?

 Can you hold the contract – long enough to get to the bathroom?

 Does the belly muscle work with (or against) the pelvic muscle?

 Does the breathing work with the pelvic floor muscle?


All these things are helpful in developing the correct exercise program. In many cases

the exercises are difficult to learn and additional information is needed. EMG

biofeedback can help. This device allows you to see the muscle contraction just like the

EKG allows you to see the heart contraction. To monitor the pelvic floor muscle a sensor

is placed inside the rectum / vagina or stuck to the outside of the rectum. If the

contraction is strong the line goes up (and stays up). If the contraction is weak the line

does not go up very high and fall quickly. Seeing this can help you to activate the correct
muscles and keep them activated increasing the effect of the exercises.

A proper exercise program includes the answers these questions:

 How long to hold the contraction?

 How long to rest between? – rest is as important as hold

 How many to do at a time and how many times to do them in a day? – studies tell us that you must do more than 45 per day to get results

 What position should the exercises be done in?

 How do you breathe during the exercises?


If you want more information about this or any of our services please call us at 864-534-1780.

By Sabina Kapasi Pelvic Floor, Physical Therapy

Pelvic Floor Therapy and Prostate Cancer

Men who have been diagnosed with prostate cancer or have other medical problems related to their prostate may have some symptoms that a pelvic floor therapists can help them with. Many men suffer from urinary incontinence, urgency and retention issues and many more things that affect their way of life and every day function. Both pre and post therapy is very beneficial to these patients. Treatment may include:

1) Education on the anatomy of the pelvic floor and physiology of micturition process

2) Bladder retraining including assisting patients with proper bladder voiding schedules and avoiding bladder irritants

3) Education on proper posture and body mechanics

4) Manual cueing and biofeedback training on proper pelvic floor contractions

5) Biofeedback for pelvic floor training

6) Core stabilization exercises

Outcomes are fantastic! Patients gain the control they need of their bladder. Many men decrease the amount of pads they have to use secondary to leakage, wake up less at night to void, have less urgency and overall feel better with a more active daily lifestyle!

Please call His Therapy for more information. 864-534-1780 or visit our website for more information     www.histherapy.net