Jane O’Brien, PT and Mary Kay Haughian, PT tech are now certified in the “pfilates” program of pelvic floor training. An exercise program created by a physician to improve sexual function, improve bowel and bladder control, prevent the need for surgery and recover pelvic floor function after child birth and surgery.

Jane is now including this exercise program in pelvic floor rehab.

Jane O’Brien, PT, MSPT Post Partum Pelvic Floor dysfunctions at Purely Pilates Longley Blvd

Have you experienced leakage, painful intercourse, pelvic pain, organ Prolapse or tearing after childbirth? Have you tried Kegels and Advil to no avail? Do you wonder what Kegels are? This talk will review common pelvic floor dysfunctions after childbirth and give information on how to correct them through self help and Physical therapy, review the how, what, and quantity of Kegels and clear up misconceptions often taught by well meaning health care professionals.

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Studies show that the amount of pain you experience does not necessarily relate to the amount of tissue damage you have sustained. The neurons develop a memory for responding to pain signals and can cause one to perceive an area of pain as larger than it truly may be. Think of when you bite your lip and it becomes swollen. As this pain persists, your brain causes you to perceive that the injured area of your lip is larger than it really is.

O’Brien’s message: “Don’t just put up with pain. A headache will propagate more headaches. Back pain leads to more back pain. One should not just deal with it and expect that it will go away with time. Deal with it and see a professional for help.”

The body and mind are connected. Minimizing pain requires a combination of methods that O’Brien has been recommending to her clients for years. First, address the body. Aerobic exercise can increase parasympathetic response (endorphin release) and decrease the sympathetic response (the fight or flight). Then, receive care from a healthcare professional such as a Physical Therapist who can address the musculoskeletal system. Third, change the mindset. Positive thoughts, laughter, socializing, changing the negatives into positives has a pain minimizing effect. Reduce one’s reaction to pain. Finally, decreasing your heart rate and slowing the breathing can lessen pain. “To succeed in decreasing pain, address your whole being. Seek help, stay positive, and breathe,” says O’Brien.

New $35 “Tune-Up” Special Eases Pain, Pocketbook

If a day on the slopes put a new kink in your neck or you’re not sure what to do for that new strain in your leg, the professionals at North Tahoe Physical Therapy now offer a $35 Tune-Up Special to keep you from a long visit at the doctor’s office or wait at a local emergency room. “Our tune-up is a fifteen minute treatment for minor aches, pains, and strains and is designed to get you out of trouble and keep you going in your active lifestyle,” said O’Brien. According to O’Brien, you don’t need an order from the doctor and there are no insurance hassles attached. “Our skilled staff can help you decrease your symptoms, assess your situation and guide you towards the proper path to recovery,” she said.

For more information on pain analysis and pro-active advice, contact Jane O’Brien, MSPT, at North Tahoe Physical Therapy by calling 775 831 6600 or visit www.northtahoept.com. North Tahoe Physical Therapy is located at 889 Alder Avenue, Suite 105 in Incline Village, Nevada and is open Monday through Friday. They also accept clients on Tuesdays and Fridays by appointment in their Reno office which is located at 112 W. Moana Lane, Suite 101.

PELVIC ORGAN PROLAPSE ( POP)

LEVATOR ANI SYNDROME

INCONTINENCE

VULVODYNIA

DYSPAREUNIA

How can physical therapy help?

PAINFUL BLADDER SYNDROME/INTERSTITIAL CYSTITIS

CONSTIPATION

POST BREAST SURGERY

POST PROSTATECTOMY INCONTINENCE

Women’s Health Physical Therapist
recipient of Certificate of Achievement in Pelvic Physical Therapy ( CAPP)

Squeeze Before You Sneeze

When it comes to bladder control, embrace what comes naturally. Forget the prescriptions and surgeries. Simple behavior changes can create huge results. Here are 5 ways in which you can regain control of the frequency, urgency and leakage:

1) Retrain you bladder

Our parents taught us to go to the bathroom before we left the house to avoid the need to urinate while we were traveling in a car. In other words, to go while we have the opportunity “just in case”  the sense of urgency arises and we are unable to answer nature’s call. I call this a “JIC” pee. Our bladders have the capacity to hold 8-12 oz of urine. If we empty the bladder before we reach maximum capacity, we have retrained the detrusor muscle ( the bladder muscle) to hold less and to alert us sooner. Try waiting at least 2 hours between voids. Don’t practice “JIC” pees.

2) Avoid drinking 2 hours before bedtime

Imbibing beverages of any sort within 2 hours of bedtime will certainly lead to the need to arise and void during what is intended to be a time for us to rejuvenate and sleep.  Try to stop drinking early in the evening.  If you must take medicine in the evening, do so with your dinner to allow your body the time needed to process the liquid and send the waste in to the bladder.  Empty your bladder just before you climb into bed.

3) Squeeze Before you Sneeze

Perform a pelvic floor muscle contraction,aka Kegel, before you sneeze, laugh or cough. Tightening the muscles of the pelvic floor will help you to avoid leakage of urine during a forceful contraction, which occurs with the previously mentioned activities. If you are unsure how to perform a Kegel, imagine that you are trying to hold back gas from escaping or trying to stop urine from flowing.The muscles yo,u tightened for this task are your pelvic floor muscles, or your pelvic floor muscles (Kegel muscles).

4) Relax

Urination requires that one relax during the activity. In other words, one should not force the stream. Sit on the toilet, if you are a woman. Men should stand and allow their muscles to soften, not strain. Many people in jobs where their potty breaks are few are far between with an extremely short time to be away from their duties, such as teachers and nurses, are in the habit of trying to urinate quickly. They push the urine out in attempt to get done quickly. This forcefulness can cause pelvic organ prolapse, where the bladder and even the uterus can descend in the pelvic cavity and fall through the vagina. Another consequence can be excess stretch of the pelvic floor muscles, which leads to weakness. When the muscles are not strong enough to support the organs, leakage can occur. So, relax when you void.  It is, however, often necessary to push when you defecate.  Just don’t strain.

5) Exercise

If we don’t use it we lose it. Muscles of the pelvic floor are no different than other muscles in the body. To keep the muscles of the pelvic floor strong, one must practice daily. Contract the muscles 3-5 seconds, for 10 repetitions. Try to work up to 10 second holds, 30 times per day. The exercises are easiest when performed while lying on your back. Challenge yourself by sitting reclined to 45 degrees. Advance to sitting upright, then progress into standing. These exercises can be performed while settling down to sleep, while brushing your teeth or while driving to work. Check to see if you are properly performing the exercise by holding a mirror between your legs. Women will see the area between the legs, called the perineum lift with a squeeze. Men will see the penis rise a bit. If you have any doubts, ask your women’s health physical Therapist or the gynecologist to check your status.

The field of women’s health Physical Therapy has increased awareness of issues, such as bladder control, painful intercourse, pelvic pain tailbone pain, post breast surgery rehabilitation and high risk pregnancy. Physical Therapists in the practice of women’s health have completed special training to enable them to evaluate, diagnose, and treat these sensitive issues. Despite the name, men benefit from women’s health therapy as well. After prostate surgery, men should seek the services of a women’s health therapist to assist with bladder control and erectile difficulties. Most importantly, Women’s health physical Therapy is a natural method of regaining control and function of the pelvic floor without surgery or medicine.

References

1)   Pelvic Physical Therapy, level 1,2,3 course manuals

2)   The Gynecological Manual, Section on Women’s Health of the American Physical Therapy Association, 2002

3)   To find a women’s health PT in your area, go to www.womenshealthapta.org.

For more info, contact Jane O’Brien at 775-831-6600

Dyspareunia is defined as pain before, during or after intercourse. Reviews in the literature indicate a prevalence of as many as 50% of women experience pelvic pain and painful intercourse. Despite the prevalence, this problem is commonly overlooked and untreated. If left untreated, pelvic pain can deter one from engaging in sexual activity.

There are many reasons for dyspareunia including musculoskeletal dysfunction, endometriosis, pelvic inflammatory disease, post-operative scarring, and adhesions.  People experiencing dyspareunia from musculoskeletal dysfunctions may present with associated joint mobility issues, muscle pain, tension and weakness of the pelvic floor muscles.  To effectively treat dyspareunia, intervention must consider the underlying condition responsible for the pain and the secondary muscle reactions that may become a continued source of pain.

Patients with a musculoskeletal dysfunction as the cause of their dyspareunia may be referred to physical therapy for treatment. Interventions may include manual therapies such as trigger point release, joint and soft tissue mobilization, patient education, biofeedback, vaginal dilators, modalities and exercise. Studies have shown that Physical therapy treatment for short, painful and weak pelvic floor muscles can be highly effective.

The pelvis is lined with muscles which move the hips, support the pelvic organs, help with elimination and create sexual pleasure. These muscles are attached to the fascia (connective tissues) of the hip. This links the function of the pelvic floor muscles directly to the hips. If the pelvis is not level, the pelvic muscles will either be stretched (too long) or be in tension (too short). Power is equal to force times distance. If the length of the muscles is altered, the muscle force needs to change to maintain power and for proper muscle function.

An orgasm is defined as sexual climax and is characterized by intense physical pleasure accompanied by quick cycles of muscle contraction in the lower pelvic muscles which surround the primary sexual organs. Tension in the pelvic floor muscles can cause weakened contractions of the pelvic floor muscles. In other words, pelvic floor tension can lead to decreased orgasm potential!

Receiving treatment from a Women’s Health Physical Therapist who is trained in Pelvic Floor Disorders can alleviate pelvic muscle tension, pelvic pain and benefit your sex life. It is not uncommon for a Women’s Health PT to work with a patient to alleviate pelvic pain and find that a by-product of the treatments is improved orgasms.

Intercourse promotes health and vitality, creates pleasure, and provides a means for reproduction. When one person’s pleasure and desire for lovemaking increases, both partners benefit. Disorders in the pelvic region are common, but not the norm for the body. Seek help from a Women’s Health PT to improve your quality of life and recapture your sex life.

Jane O’Brien, PT, MSPT
Certificate of Achievement in Pelvic Physical Therapy from the Section on Women’s Health of the American Physical Therapy Association
Contact Us
(775) 831-6600

Reference:

1. Abrams P, et al. The Standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the international continence society. Neurourol Urodyn 2002: 21:167-178.
2. www.wikipedia.org/orgasms
3. Messelink B, Benson T, Bergam B, Bo K, et al, Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society, Neurourol Urodyn 2005: 24: 374-380.
4. Wurn L and Wurn B. Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique. Med Gen Med, 2004; 6(4): 47.
5. Fisher K. Management of Dyspareunia and Associated Levator Ani Muscle Activity. Phys Ther 2007: 87(7): 935-941.

The requirements for O’Brien’s to receive the tCAPP were studies of the three levels of Pelvic Physical Therapy classes, passage of competency skills tests for the three levels of study, passage of the didactics tests for each level, and submission of a case report on a complex patient with pelvic floor dysfunction.  O’Brien received the tCAPP which is for experienced therapists who completed training in pelvic physical therapy before starting on the Section on Women’s Health CAPP tract of study. During her studies, O’Brien acquired the skills and knowledge necessary to provide physical therapy interventions for male and female patients of all ages with pelvic floor disorders.

“This certification demonstrates dedication and advanced training in the field of Women’s Health,” according to O’Brien. Although the numbers are growing, at the current time, the field of Women’s Health PT’s is small. O’Brien is only the second Physical Therapist in Nevada to receive this certificate. Clients from all over Northern Nevada and Northern California travel to the area to receive treatment. Some clients who benefit from this type of care are those with overactive bladder, painful intercourse, post breast surgery care, prenatal and post partum orthopedic issues and pain, incontinence, pelvic organ prolapse, pudenal neuralgia and vulvadynia.

O’Brien received her Master of Science Degree from Boston University in 1992. She has over 16 years of experience in treatment of orthopedics and pain conditions. O’Brien can be reached through North Tahoe Physical Therapy at 775-831-6600 or through this web site contact form.

5 Ways to Look and Feel Great This Summer… Naturally

In it, you will find tips and techniques on how you can have your best Summer yet!

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We hope that you find the information valuable. Please call us with any questions, or to set up a personalized warm-up routine developed just for you.

If you know someone who would benefit from this information, please pass it on.

Enjoy and have fun!

Jane O’Brien, MSPT
North Tahoe Physical Therapy

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P.P.S. Did you know that we do much more than Physical Therapy?  Browse this site and see what we have to offer.

HOW CAN PHYSICAL THERAPY HELP? By increasing strength, endurance and support of the pelvic floor through Pelvic Floor Muscle training, as well as, behavior modification, proper bracing and body mechanics, and reduction of exacerbating activities.

LEVATOR ANI SYNDROME — A muscle spasm of the pelvic floor, usually caused by trauma.

HOW CAN PHYSICAL THERAPY HELP? Through releasing tension in the muscles, joint mobilization and patient education.

URINARY INCONTINENCE — The involuntary leakage of urine.
STRESS INCONTINENCE — The involuntary leakage of urine during exertion – i.e. cough or sneeze, this is due to pelvic floor muscle weakness.
URGE INCONTINENCE (OVERACTIVE BLADDER) — The involuntary leakage of urine accompanied with urgency, caused by uninhibited bladder contractions.

HOW CAN PHYSICAL THERAPY HELP? A Women’s Health PT can help the client regain control of their bladder, so that leakage, urgency and frequency do not occur or are lessened.  This is done through bladder training, keeping a voiding record (bladder dairy), teaching behavior modification, muscle strengthening, if needed and following a voiding schedule.

DYSPAREUNIA — Painful penetration due to muscle spasms or organ pain.

HOW CAN PHYSICAL THERAPY HELP? With manual therapies designed to reduce muscle tension, with vaginal dilators, electrical stimulation, ultrasound, heat, biofeedback, as well as, exercise and muscle balancing around the pelvis and trunk.

AINFUL BLADDER SYNDROME — Interstitial Cystitis.

HOW CAN PHYSICAL THERAPY HELP? Though the use of biofeedback, electrical stimulation and musculoskeletal correction.

TMJ — Pain at the temporo mandibular joint, where the jaw bone meets the skull – generally associated with clicking, pain, grinding and headaches.  On occasion, the jaw may become stuck open or closed.

HOW CAN PHYSICAL THERAPY HELP? With tender point releases, postural corrections of skeletal system, including head and neck, as well as, craniosacral work.

VULVODYNIA — Pain at entrance to the vagina – associated with localized burning, itching, stinging and rawness.

HOW CAN PHYSICAL THERAPY HELP? Though the use of biofeedback, strength and endurance training and the relaxation of muscles.

FIBROMYALGIA — Chronic pain in muscle and soft tissue surrounding joints, fatigue and tenderness at specific sites in the body.

HOW CAN PHYSICAL THERAPY HELP? Through the use of Myofascial release, tender point releases and strengthening.