Happy 4 year birthday to us!

I am so grateful and also humbled to be able to celebrate our fourth year in business today.

I’ve been taking some time to reflect on the past 4 years in business here in Warman serving the community and surrounding areas (from Lloydminster to Davidson!) and I am so grateful that we have been so fortunate in business. I have enjoyed supporting the community, participating in events, being asked to provide space for groups to meet, and most of all, working with clients to help them help themselves solve their injury, aches & pains.

Looking at where we started November 3, 2014, when it was just Lauren (RMT) and myself at the clinic, to the amazing team of therapists we have, I can’t help but think about the impact we are able to make in people’s lives, and being able to reach more people, more quickly.

Developing a team that truly cares about you – the past, present, or future clients – ensuring that we without a doubt are providing outstanding care for women, children, men, and most importantly families has been my vision for the clinic. We work tirelessly on our end to get people in for appointments, and therapists are often adjusting their schedules just to make things work. We aim to treat everyone as family, because if you are going to be working 40(+?) hours a week, isn’t it wonderful to have a workplace that feels like home?

At Warman Physio we are truly honored to have THE BEST clients – and I know I am biased but everyone we see at the clinic is truly amazing, wonderful individuals. At the end of the day, we as therapists are so honored to be a part of your journey to health & wellness, to not just survive, but thrive.

So a huge thank you to the community in which we reside, without the support of the community, we wouldn’t be able to do what we are doing. I am so grateful for all of you.

Let’s take some time to go through some of our memories throughout the years as well as some of our favorite photos!

 

Chelsea Porter Joins the Team ! July 21, 2015

Sawyer was born Dec 21, 2015

February 27 2016 helping at the Warman Ultimate Cheer Classic

April 2016 Our first MPT student Tamara joined us for a placement

May 2016 our littlest skeleton joined the models for my birthday! (thanks Rob!)

May 2016 Garth Brooks Giveaway!!

Summer 2016 Infant Home assessment

August 2016 Shannon Domres joins the team!

Gus goes to hang out with Valley Action Abilities (he did super!)

DOUGHNUTS! (We do receive many wonderful – albeit unnecessary – treats our amazing clients bring in)

ALL the babies!

Light the Night 2016

Leah Joins the team! Oct 3, 2016

ABEX 2016 

Nov 21, 2016 Cole Joins the Team for Shannon’s mat leave!

Ainsley is Born Nov 29 2016

Christmas party 2016 – Haylie is expecting!

March 21 Colin pops in to cover for an injury!

 

 

 

 

 

Playing with babies!

YWCA Women of Distinction Awards

Anorectal & Peds Pelvic Floor Treatment formal education with Claudia Brown and MJ Lord!

Kendra Joins the team! May 22, 2017

Best New Business WMBEXA

When kids love on the skeleton

Drayton joins the team June 12, 2017

Team golf tournament with Chamber of Commerce

Light the Night 2017 – massage by donation!

ABEX 2017

Sweet success event 2017

Sam joins the team!

Mothers day gifts 2018

 

Megan Joins the Team!

Saskatoon Space in the works!

Light the Night 2018

ABEX 2018 Young Entrepreneur Award Recipient

Warman Physio turns 4!

 



In today’s day and age where information is literally at our finger tips via your smart phone, laptop, and all other technology, it is no surprise when clients come into the clinic armed with excellent information.

However, it is far too common that out-dated information, old wives tales, and unfounded statements are being perpetuated. As with all information, we must be a consumer of information. How do you know what you are reading online is accurate, up-to-date, evidence based, current and progressive for treatment and care? Unfortunately, creating a critical mindset towards what is being presented, and for what purpose, and by whom, often is not taught in school until AFTER reaching university. What does this lead to? Potential difficulty consuming information.

Regrettably, it’s not just the world wide web that is spreading misinformation and falsities, but other well-meaning family members, friends, and, healthcare providers. How does this happen? Some providers must know information across a wide variety of areas, whereas some providers practice in very specific areas or specialties. In both instances the provider will have difficulty either a) keeping up with all the new information coming in through the large variety of areas they need to know or b) they are very well informed in their area of specialty, but haven’t kept up in other practice areas.

For our women’s health, prenatal and post-partum clients, we have seen a trend of misinformation come in that we would like to address piece by piece to help those that may be experiencing similar issues/symptoms figure out what is best for them.

 

Pain during pregnancy is normal and will go away after delivery

Often our prenatal moms come in with significant pain. Ranging from pubic symphysis pain (‘lightning crotch’, groin pain, etc) through SIJ pain (low back and pelvic pain) and sciatica (pain radiating down the leg) to name but a few common pregnancy-related complaints. Although pain during pregnancy is common, it should not be considered normal. We are often explained that during pregnancy the hormone relaxin ’causes’ pain – however, if this were the case, and relaxin is produced during every pregnancy, then wouldn’t every woman who is pregnant be painful? We know that this is not the case, so why do some women become painful and others do not? In my clinical population I have observed many women who are pregnant that are painful, with the start of their pain experience ranging from within the first few weeks of gestation to the last few weeks. The commonalities between these women with pelvic girdle pain in particular, is a combination of muscle length and strength imbalances around the pelvis (muscles that are tight and/or weak), common posture issues (think the typical ‘pregnant’ stance), and activity levels throughout the day (whether that be not enough or too much).

The good news is, pain in pregnancy is NOT necessarily normal! There are many factors that can be addressed, and truly our bodies are very capable of adapting and changing (I mean they grow tiny humans, that’s pretty amazing). When I was taking my prenatal courses while in the Master’s program, we were still being taught that women who are pregnant could not improve, but we could prevent them from getting worse. In a mere 7 years this dialogue is changing; women who are pregnant can and do improve and often resolve pain during pregnancy when appropriately addressed with conservative treatment such as physiotherapy!

How well we are able to do with each client depends on a multitude of factors: what do you need to do on a daily basis, how many weeks gestation are you, what is your pain level when you get started, did you have pain previously or is it new, and of course, how well are you able to do your provided homework?

Pain with intercourse post-partum is normal – just have some wine and relax

As a pelvic floor therapist, I am sad to say I have heard the recommendation for our clients with dyspareunia (pain with intercourse) to ‘just have some wine’ more times than I have kept track of. This sentiment is often expressed when clients get the courage to bring it up to friends, family and their healthcare providers; usually along with a ‘with time it’ll get better’.

Dyspareunia is something that again is common after labor and delivery, but is not normal. To the surprise of many, this pain can occur in those that have had vaginal deliveries with or without tearing, as well as those that have c-sections (scheduled or emergency). Often when we approach medical providers about dyspareunia, they search for a medical cause such as an infection. When there is no medical cause, women will begin to feel the ‘it’s all in your head’ message.

With a physiotherapy perspective, dyspareunia is approached much differently. In my clinical practice I often see women with pelvic pain that have very tight muscles of the pelvis and pelvic floor, restricted movement through scar tissue (either from the perineal tearing or c-section), as well as a variety of postural changes. Very often, it’s these tight muscles that will recreate ‘the pain’ when palpated (on internal and/or external exam). When the clients’ multiple factors are addressed such as muscle tightness, weakness, postural changes, scar mobility and breathing coordination, the dyspareunia is often improved/resolved. Contrary to our all too common advice to just ‘have some wine’, there are many factors that can be addressed with physiotherapy by a trained pelvic floor therapist. Which brings us to our next point…

You are leaking when you cough/sneeze – do your kegels

I am so thrilled to see an increase in awareness and discussion within a variety of groups and campaigns in regards to pelvic floor! The most common discussion is about leaking, usually with cough, sneeze, lifting, jumping, exercise etc (aka stress urinary incontinence). This is where typically women are told to ‘do your kegels’. GREAT! What does that mean? Often when I am seeing clients in-clinic, the understanding of kegels is incomplete – women are aiming to squeeze the pelvic floor for at least 10 seconds, 10 times in a row since that’s what they had read online or in a magazine. I ask – when you try to strengthen another area of your body, do you squeeze it (make it tight in a single position such as tightening your thigh muscle without moving the knee), hold for 10 seconds, pause and then repeat? I also wonder – when receiving this advice has anyone completed an assessment to check what the problem actually is?

I frequently discuss with my clients how differently we approach pelvic floor health versus the rest of the body. If someone comes into my office because their knee hurts, they expect for me to watch them walk, squat, and move in a variety of ways themselves, have me move it for them, take a look at all the muscles, ligaments and surrounding tissues as well as ensure they are doing whatever exercises or stretches I provide them with properly before going. When people come in for a pelvic floor issue, we are often expecting to receive advice, but do not expect to be touched or examined. Clients would not be happy if they came in and I didn’t once look at their painful knee, so why is it acceptable to expect to have no exam of the pelvic floor? A discussion for another day. Why is the exam important?

Pelvic floor analogy: if someone came into the office with an elbow that was stuck in a bent position (because the biceps is too tight), and their complaint is that they are unable to straighten the elbow to catch their cell phone for instance as it falls off the table in front of them (ie leaking), would strengthening the biceps muscle (ie kegels) be helpful? Likely it will not help, and more often than not, a worsening of symptoms may be observed. This is why it is not surprising to me as a therapist when people come into the clinic and their ‘kegels haven’t worked’. Analogy 2: if the pelvic floor to be functional needs to contract AND relax (think the arm bent as contracted and straight as relaxed), does training that muscle to squeeze help it to bend? Not likely. The pelvic floor needs to lift up and in when contracting, and move down and away when relaxing in order to be functional. To top it off, it also needs to have appropriate coordination with the rest of the muscles of the abdomen and pelvis in order to have optimal function. Having a pelvic floor that’s functional without addressing any other postural or coordination issues of the abdomen is like having a perfect pop-can bottom with crumpled sides and top – it’s just not going to be able to do it’s job.

This means, that each client will have a similar, and yet very different treatment approach to leaking. Although many things look the same, with the majority of my clients having a tight pelvic floor (possibly from all the 10 second squeezes we’ve been doing over the years), the underlying cause of tightness is extremely variable.

Having a diastasis means you’ll always look pregnant

First, what is a diastasis recti? This is commonly referred to as the ‘splitting of the abdominal muscles’. Related to women who are pregnant and post-partum, there are now countless ads, programs and ‘healing’ strategies that are being pushed on women to get rid of their ‘mummy tummy’.

I argue that almost 100% of women who are pregnant, that look pregnant at the time of labor and delivery, will develop a diastasis. The diastasis is meant to allow the growing fetus room as the belly expands rapidly, the rectus abdominis (6 pack ab muscles) just doesn’t stretch quickly enough. The size of the diastasis will be dependent on many factors such as the size of the client, the number of fetuses, how many children they have had, etc. There are things we can encourage prenatal to theoretically decrease the impact of the diastasis, including rolling to the side before sitting up, and eliminating exercises that cause what I refer to as ‘tenting’ of the abdomen (if you’ve ever seen the v-shaped tent on your tummy when you go to sit up – that’s your diastasis). The real changes and major impacts happen post-partum.

The size of the diastasis, the amount of space between the muscles, is what the majority of women who come into my clinic are worried about. “How BIG is the GAP?” “Has it CLOSED enough yet?” In my clinical experience the size of the space is not as important as what the muscles are doing. The function of the muscles is key;  both independently, and as a working group of muscles. This is where everyone wants a short answer “What should and shouldn’t I be doing?” “What exercise is going to fix my diastasis?” – and this is where I say; I won’t know unless I am able to do an exam. Not all bodies are created equal and some bodies adapt much more quickly than others from a rehabilitation and healing stand point. This means that for one client doing something like a down-dog in yoga could create excellent and appropriate tension, whereas the next person it could be very dysfunctional and problematic.

If we imagine the diastasis like a zipper that’s undone, the zipper being down doesn’t matter so long as you aren’t straining into it with the abdomen from behind (pushing into the open zipper). Think of doing a crunch, when you go to lift your head and shoulders off the ground what does your tummy do? Does the tummy stay relatively flat while you move, or does it push/balloon forward and become more round? From a movement perspective your tummy should not push forward as you do ‘core’ exercises, and this can be an indication of dysfunction and a potential factor for pain and problems. Now, someone may see me at the clinic and have a 3-4 finger ‘gap’ but be able to keep the abdominals coordinated without any pressure forward, whereas another client may have a 1-2 finger gap but be unable to hold appropriate tension.

Endometriosis – young girls, women; painful menses is ‘normal’

A diagnosis for endometriosis requires a surgical procedure to examine for the presence of lesions of uterine-like tissue outside of the uterus. What happens is this tissue continues to work the same as the tissue that is within the uterus, and can lead to fibrous tissue and issues within the pelvis. Often women live with common symptoms of endometriosis starting in their teens and it takes years to achieve a diagnosis. In addition, young women and teens often have difficulty being believed about the pain that they are experiencing.

Although physiotherapy cannot change endometriosis, just like we cannot reverse arthritis, there are many factors that a therapist can look at to help manage, reduce and improve symptoms. Think of the first thing you do when something is painful, say get a paper cut on your finger. You will pull the hurt hand/finger into your body, grasp it with the other side and squeeze. This instinct to protect the area that is painful is pretty universal throughout the body. What will this increase in tone and tension of the surrounding muscles of the pelvis do when repeatedly, month after month, the pain continues to return, do to the muscles? Determining the underlying factors, which muscles are more tense, what the surrounding tissue is doing, and helping come up with a home program can be beneficial in managing pain. Just as addressing muscle length and strength imbalances around an arthritic joint can make a difference in the clients’ pain, it doesn’t change the arthritis, it changes some of the other factors.

Managing these symptoms as soon as possible, will help to reduce the chronic pain cycle that often develops and persists for years.

Haylie has been practicing women’s health and focused in prenatal and post-partum care since graduating from the U of S MPT program in 2011. Officially adding to her practice pediatric pelvic floor therapy in 2017. She has been advocating for treatment for women, ensuring appropriate and effective care throughout pregnancy and post-partum, and helping all expecting and post-partum moms brought her to open her family-friendly clinic; where clients are encouraged to bring their infants and children to treatment. Adding pediatric pelvic floor. Warman Physiotherapy & Wellness has been nominated as a finalist for the 2018, 2017, & 2016 WMBEXA, is a WMBEXA award recipient of 2017, and a finalist in the ABEX 2017 & 2016, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017.

At Warman Physio our therapists focus on excellence. Providing excellent, comprehensive, up-to-date care, as well as a personable and compassionate care.

This is why going to courses, reading research, is so important… and being a little bit “nerdy” comes in handy 😉

 

This past weekend I took a course from Antony Lo, an outstanding therapist and physiotherapy educator from Australia, called The Female Athlete. This course was designed to challenge the status quo on current standard practice recommendations for women’s health related to Diastasis Recti, Prenatal, & Postpartum care.

During this course my belief system was challenged in some ways, and affirmed in others. My take-away from this course? First, we need more research in pretty much everything – we have far more questions than we do answers, and although we would like to have specific YES and NO answers for our clients’, everyone is individual with unique needs (not surprised here!) – basically, you are your own person, and the rules may not apply, and may need to be broken in your instance.

Another thing that we need to consider is pain. What is pain exactly?

 

“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.

What does this mean? Sensory and emotional experience – does anyone find they have more pain when they have more stress? How about if you have pain with something that doesn’t actually damage your tissue – like when your foot falls asleep and you get the painful pins and needles. We do not need tissue damage for pain, and no matter what is going on, your pain is exactly that, YOUR PAIN. Not the therapist, not your family, yours. No one can tell you that you don’t have pain, because it is your experience alone. Because of this reason, some pain can be resolved and changed very quickly, and some may take longer.

Last, our bodies are extremely strong, capable, adaptive, and resilient (SCAR)! We can change our perspective and make our weaknesses into strengths.

It boils down to WHY is continuing education so important? Why do we at Warman Physio put such an emphasis on continuing education? The answer is that it is our belief that being up to date, learning new information, making sure we are at the forefront of practice changes benefits our clients. We are open to education, views that challenge our current beliefs, and learning something new in expected, as well as unexpected ways. There are more ways than one that I find myself learning not only from colleagues and coworkers, but also from my clients and those I meet in day to day life. The curious mind, and attitude of intrigue, and being able to take new information and integrate it into practice is something that at Warman Physio we are striving for, not just on weekends we are learning formally, but every single day!

Do you think this is AMAZING? Have some questions? Want to tell me how it resonates with you? Send me a message!

 

Haylie has been practicing women’s health and focused in prenatal and post-partum care since graduating from the U of S MPT program in 2011. Adding to her practice pediatric pelvic floor therapy in 2017. She has been advocating for treatment for women, ensuring appropriate and effective care throughout pregnancy and post-partum, and helping all expecting and post-partum moms brought her to open her family-friendly clinic; where clients are encouraged to bring their infants and children to treatment. Warman Physiotherapy & Wellness has been nominated for the 2018 WMBEXA, is a WMBEXA award recipient of 2017, and a finalist in the ABEX 2016, 2017, & 2018. Haylie was also recognized as YWCA Women of Distinction for Health & Wellness in 2017. 

WHAT? Pelvic Floor Physiotherapy and KIDS?

Pelvic floor physiotherapy is not just for adults. Even our little people have pelvic floors, and they do have issues with those pint-sized pelvic floors sometimes.

Ok sure, but what could they need help with exactly?

Pediatric Pelvic Floor refers to children under the age of 18. So we are looking at a wide variety of issues that can be addressed with pelvic floor physio.

  • Daytime Leaking (“Accidents”): leakage of urine in inappropriate places over the age of 5 can occur during the day and at night
  • Bed wetting (Nocturnal Enuresis): leakage of urine at night WITHOUT daytime symptoms or issues
  • Constipation: stools that are often infrequent and hard to pass (but did you know you can be constipated and still poop every day?!)
  • Poop Accidents (Encopresis): leakage of stool in inappropriate places

What should I be watching for?

If your child is having issues with any of the above, they may benefit from pelvic floor physiotherapy for kids. One of the biggest contributing factors to ALL of the issues listed above, is constipation itself.

How does constipation affect day time wetting, bed wetting, and poop accidents?

When we are constipated (and this is true of adults as well), our rectum stretches and stores stool instead of emptying fully. This stretching eventually leads the stored stool in the rectum to put pressure on the bladder. This irritates the bladder leading to increased trips to the bathroom, and accidents throughout the day. This same pressure is what can cause night time wetting; essentially the poop takes up so much space the bladder just has to void.

 

If a child is constipated they can’t have poop accidents though, right?

FALSE! Depending on how long this has been going on, the child may also still poop regularly. There are a couple ways poop accidents can happen.

As the colon is stretched, the normal receptors in the bowel that signal your brain that you need to poop don’t work as well, similar to a deflated balloon. The receptors need to be stretched against tension to work well. As your bowel collects and stores stool in the stretched out colon, you become constipated. But, softer liquid stool can sneak around the hard stool (this is called bypass). Sometimes people think their child has diarrhea when they see bypass and the idea that they are constipated seems far-fetched, but it’s true!

This can happen in young children, pre-teens, and teenagers. The longer constipation goes undiagnosed/treated, often the harder it is to resolve.

What does Pelvic Floor Physio for kids look like?

We require a parent or guardian to be present at all appointments with children for pediatric pelvic floor therapy. At the first appointment we will take a detailed history including potty learning statistics, diet, bathroom habits, social impact, among other things. We will also take a look at movement, strength, stability, and we usually do some sort of abdominal exam. Many children that are having issues have been poked, prodded, and had some scary procedures done, so at physio my goal is to make it fun, engaging, and not painful whenever possible. But this isn’t enough, we also need to make it something important for the child as well!

Giving them things that they can do to take ownership, and see change in – like a poop and pee diary – is very important. Ensuring that we are celebrating the successes, and down-playing the misses is also crucial.

Why is it important to address pelvic floor issues in childhood?

Clinically, we see a possible correlation between adult pelvic floor dysfunction and childhood issues. In the population of clients seen for pelvic pain conditions as adults (dyspareunia, vulvodynia), there is often a history of constipation and childhood toileting issues. Adults that have increased voiding frequency, urge incontinence, and a ‘weak bladder’ often speak of pre-teen and teenage issues as well.

What can I do?

Start out right, keep poop mushy, a peanut butter or hummus consistency is key. Often kids will start solids and become constipated, some will have one instance of constipation and have difficulty because they are scared of being painful (which leads to a vicious cycle). If your child has a history of straining, large stools (the whoa that might clog the toilet ones), works hard to get stool out, has poop ‘stains’ on their underwear, or has had multiple days without passing a stool, constipation could be an issue.

Regardless of how it starts, pelvic floor dysfunction in children can and should be attended to by a qualified physical therapist.

Haylie has been practicing women’s health and focused in prenatal and post-partum care since graduating from the U of S MPT program in 2011. Adding to her practice pediatric pelvic floor therapy in 2017. She has been advocating for treatment for women, ensuring appropriate and effective care throughout pregnancy and post-partum, and helping all expecting and post-partum moms brought her to open her family-friendly clinic; where clients are encouraged to bring their infants and children to treatment. Adding pediatric pelvic floor. Warman Physiotherapy & Wellness has been nominated for the 2018 WMBEXA, is a WMBEXA award recipient of 2017, and a finalist in the ABEX 2017, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017.

✨!LIGHT THE NIGHT TIME! ✨

As many of you know, our clinic does fundraising for the The Leukemia & Lymphoma Society​ via Light the Night in Saskatoon. Every year we have tried to do a little more, and last year we were able to raise over $1000 for Light the Night!

Haylie’s Story:
Another year has come and gone! Back to fundraising for Light the Night for 2018, and although many people know why I have chosen Light the Night as my fundraiser I want to share my story.

My dad, Hank, was diagnosed with CLL when I was in school. This type of LEUKEMIA, unlike others, is a type where treatment in the beginning is to “do nothing”. Over the next 10 years or so, dad went through a variety of monitoring, chemotherapies and appointments. February 2012 he received a stem cell transplant – his brother Stephan was a perfect match. The transplant was successful and although he was dealing with some graft versus host, he was in excellent shape compared to some. Tragically, my uncle Stephan passed away in June 2012 from a heart attack, despite multiple cardiovascular stress tests undertaken to be fit to be a donor. Unfortunately in 2016 during routine scans, further cancer was found – CLL again, just slightly different “mutation” from the last one. He has been doing well, and thanks to many drug advancements has been effectively treated to date.

had the drugs that are available now, been available when dad was going through stem cell transplant, he likely wouldn’t have needed the transplant in the first place!

Because of treatment options available to him my dad was able to:
*See me graduate from University, and get a job in my chosen profession
*Watch me get engaged 
*Helped me move into my first home 
*Attend my wedding and walk me down the aisle 
*Welcomed two grandchildren (and a grand-dog!) 
*Helped and supported me open my own business 
*Been present for countless events, big and small and celebrate with our family and friends 

In discussion regarding some of the treatment options, we were told that had the drugs that are available now, been available when dad was going through stem cell transplant, he likely wouldn’t have needed the transplant in the first place! I believe that this cause, raising money for research and to help support families is a huge part of progressing treatment options and ensuring that we can get the best outcomes for our family members, coworkers, and friends that are diagnosed with blood cancers.
~Haylie

What are we doing at the clinic THIS YEAR and how can YOU help?

*We are kicking off this year with a FUNdraising FUN RUN & BBQ on June 3! We have multiple distances for people to run, jog, or walk (2km, 5km, 10km) with 100% of proceeds going to Light the Night! Not only do we have a run happening, we will also be doing a BBQ at the Warman Co-op!

Stay tuned throughout the summer and fall to find out more ways you can participate in our FUNdraising this year!