Headaches are one of the most common physical problems that many people live with on a frequent basis. Whenever a client presents with a headache or a history of headaches I really like to investigate to see how I can help improve their condition. Just asking a few simple questions might lead us to an idea of where these headaches may originate thus providing a better treatment. It’s important to note that in any case of concern with headaches clients are always encouraged to speak with their family physician. There are many different types of headaches and many may have some significant overlap.

When clients present with a head forward posture (think of the classic chin forward at the computer desk) we are going to consider additional techniques during treatment that will encourage a better and more optimal posture.

In a case dealing with referral pain to the temple area it might lead us to follow a trigger point pattern. When relieving tension in these areas with proper technique a client can experience what sensation we like to refer to as “melting”.

With many of these symptoms overlapping into tension headaches it’s necessary to inform clients on self-care to better their chances of decreasing headaches. Proper follow up for additional treatment is often recommended. Increasing water intake, suitable stretches and hydrotherapy techniques can all assist with your long-term outcome.

There is no “one-size fits all” program for stretching that will help headaches, as the muscles that need stretching will vary from one client to the next. You can never go wrong with changing up what position you are in frequently throughout the day!

For an appointment with Lauren you can check out the online booking or give us a call! To see what any therapist has available you can check it out as well!

Lauren has been working as a Massage Therapist in the Warman area since 2012 and sees a wide variety of issues from tension headaches, to scoliosis and much more. With a focus on health and optimal function, she is able to listen to what is going on and address the key muscles through a variety of techniques.
Her training has lead her to try and improve each individuals’ well-being by working through the areas at fault, but is also able to provide a relaxation massage where the focus is general relaxation and not specific tension release to correct pathology. She has specific training in and provides services for hot stone massage, which is a thermotherapy technique using both warm and cool stones to improve circulation and lymphatic function and prenatal massage.

 

Let’s put it out there from the beginning – the amount of stead-fast, hard research on what “actually works” to “potty train” kids is lacking. For this reason, I have taken the key factors and milestones that are seen clinically for readiness and complied some things for us to think more critically about related to “training” our kids.

First things first, I consider it potty learning. This is a crucial distinction to make as parents and caregivers. Training implies that there is something that the guardian must complete in order for kids to be successful at using the toilet. The shift in focus to being potty learning, is recognizing that no matter how hard you try, you cannot MAKE your child pee or poop in the toilet (I mean, have you tried to MAKE a toddler do anything? It’s not happening!)

“My child was on the potty two minutes ago and then they peed on the floor!”

We often get sucked into the cultural norms of having our children ‘potty trained’ by a certain age, but did you know that most children aren’t ready from a physical and mental perspective until closer to 3 or 4? Regardles, using the potty is a skill that needs to be developed and when attempted before the child is ready may lead to a variety of issues (constipation, later bed wetting and leaking problems, urgency and frequency issues, possible pelvic pain, etc).

For a child to be potty learned they must be able to complete all the components of toileting independently (pulling down/up pants/underwear, sitting on the potty, emptying the bladder and bowel, washing hands) and not only that but be able to recognize that the body needs to go, and leave enough time to get there, then coordinate the muscles of the pelvic floor to relax and empty the bladder and the bowel… phew! It’s actually pretty tough to get the hang of!

If a child is under the age of 3 and they learn that they can ‘hold’ their bowel/bladder they will often wait much longer between voids than inhibited voiding (this is what happens when children are in diapers as a newborn and infant) which can lead to bladder infections and constipation. Over time, bladder holding can lead to what is often referred to as a ‘weak’ bladder where the child needs to void frequently throughout the day (can’t drive more than an hour for your 4, 5, 6+ year old?)

You need to pee AGAIN? You just went to the bathroom!

A few things we want to think about specifically:
*having to guide (not nag, push, or pester) a child under the age of 4 (sometimes even older) to use the washroom is normal
*ensuring the child isn’t constipated before starting potty learning is essential (peanut butter consistency!)
*if it’s frustrating for you or the child likely now isn’t the right time

So what are some of the Potty Learning components?

From my perspective there’s three things kids need in order to potty learn:
~Physical readiness (can the bladder hold enough urine)
~Cognitive readiness (do they understand what their body is telling them with enough time to do what they need to do)
~Emotional readiness (this is whether they choose to actually go potty or not)

How much urine is in a miss? A dribble in underwear or a full bladder?

If it’s just a dribble they probably are ok to continue with underwear changes. If it’s a full bladder (and doesn’t get better quickly) I would say head back to diapers.

The tricky part is we often associate using the potty with being a big kid so if they aren’t ready they will become upset. HOWEVER, mom/dad/caregiver gets to decide underwear or diapers, and little gets to decide if they pee/poop in the potty or not. There is absolutely nothing you can do about when they pee or poop or where they do it.  Toddlers love control. So you give the little control: ‘ok, pee and poop need to go into the potty or into a diaper. If your body isn’t telling you when to go potty with enough time to get there then we need to wear diapers and that’s ok. We can try again later’
Wearing diapers also doesn’t mean they can’t go pee on the potty. They for sure still can! Tell them that too and celebrate pee in the potty ‘wow! You listened to what your body was saying, great job!’ (No big kid stuff)

If you have questions about potty learning, or want to learn more about normal continence and skill development, the clinic runs a Peds Pelvic Floor Workshop intermittently throughout the year (next one is Tuesday Feb 5!), and is developing an online program for the public to have access to!

Haylie has been practicing pelvic 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 ultimately brought her to open her family-friendly clinic. At Warman Physio clients are encouraged to bring their infants and children to treatment. Warman Physio has been nominated as a finalist for the 2018, 2017, & 2016 WMBEXA, is a WMBEXA award recipient of 2017 New Business Award, and a finalist in the ABEX 2018, 2017 & 2016, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017, and has been nominated for the 2019 SABEX and WMBEXA Awards.

 

Physiotherapy Case Study

Carpal Tunnel

A 28 year old individual came into the clinic with right sided dull forearm pain, tingling with pins and needles into the hand. The pain started without any cause and has just gotten worse over the last two months. It also seems that the hand is worse at night and in the morning.

They have started having difficulty holding heavy pots and pans, and opening tight jars – which they don’t recall having difficulty with before.

 

Although there are many reasons why someone may have pain in the forearm, wrist, and hand, let’s go through some of the possible reasons WHY this happens, what we can do about it, and how you can start your road to recovery TODAY! 

 

What causes carpal tunnel?
To have a true Carpal Tunnel Syndrome, the issue is specifically coming from the wrist – the tunnel in which one of the nerves (the median nerve – see above) of the arm goes through and into the hand. More often than not, there will be other contributing factors to wrist and hand pain!

The median nerve is the culprit in Carpal Tunnel Syndrome, and although there can be issues in only one spot causing problems, the nerve is kind of like a garden hose… the hose starts at the tap (the neck), and then runs to the end (the hand). You can lose pressure at the end of the hose by pinching it right at the end (hand symptoms), but you can also lose pressure by pinching it just a little bit on other points through the hose, ending up with the same reduced pressure (hand symptoms!)

So how can we determine what the contributing factors are? Some people will find that if they are looking one direction that their hand symptoms will get better or worse. Others will find that the chair that they are sitting in will seem to impact their symptoms.

If you have hand and forearm symptoms like pain, tingling, or numbness, a physical therapy assessment could benefit you!
What you may expect from this assessment is a postural assessment to look at your alignment, flexibility of the upper body muscles, mobility of the spine and neck, shoulders, elbows, and wrist, with an evaluation of how you move.

In many instances by the end of the assessment there is a clear driving factor to the pain and symptoms that can begin being addressed by home programming. This will put you in charge of feeling better, and not relying solely on having to come to the clinic to improve. Your therapist may provide you with a variety of homework items including stretching of muscles that are providing too much tension, strengthening of muscles that aren’t providing enough support, give exercises that will help the nerves slide and glide, and to help the joints move with more symmetry to restore balance.

A common question we are asked is how long until I’m better?

The recovery period will vary from client to client, depending on the severity and frequency of signs and symptoms, the duration of symptoms, the activity level the client is needing to maintain, and the commitment to their program. Typically, with a straightforward case we tend to see client’s 1x every 1 to 2 weeks for a total of 4 to 6 sessions. These sessions include manual therapy to help restore joint, neural, and muscle mobility as well as progressing exercises for your home program to help you help yourself.

 

Treatment Results for our Case Study

This individual having experienced pain for a relatively short period of ended up having stiffness in the neck and the position of the head changed their symptoms quite a bit. Getting started with some stretches and movements to help the neck, shoulder, and forearm move better, was the first step along with some manual therapy in clinic. The client at the next appointment the following week had a significant improvement in symptoms and found the stretches very helpful with managing their pain. Treatment continued to progress and included range of motion, stretching, and strengthening. When the client came in for their last appointment (a short 5 weeks later!) they were pain free, and able to manage their symptoms quickly themselves if things started to get sore.

Don’t delay! Schedule your assessment today to get started your journey to recovery!

Haylie has been practicing pelvic 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 ultimately brought her to open her family-friendly clinic. At Warman Physio clients are encouraged to bring their infants and children to treatment. Warman Physio has been nominated as a finalist for the 2018, 2017, & 2016 WMBEXA, is a WMBEXA award recipient of 2017 New Business Award, and a finalist in the ABEX 2018, 2017 & 2016, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017, and has been nominated for the 2019 SABEX and WMBEXA Awards.

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 to 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? In our instance at the clinic, it sometimes leads to clients coming in firmly believing misinformation.

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.