It is another New Year. A time of change and reflection. Last year we wrote our New Year blog with the knowledge that the year was going to be VERY different. Forced changes were happening even as the holidays were gearing up. What we didn’t know is how much of a collective experience having control snatched away would be!

This year it feels that instead of jumping into new resolutions and generalizations of what the year has in store, we are all keeping a close eye on 2021. The new puppy that you aren’t sure won’t wreck those shoes or pee on the carpet. Whatever 2021 had had in store for you, we truly wish that 2021 brings the growth and expansion of happiness and health to all our clients and communities.

Eloquence and gushing are not something that many people find comfortable, including us, however this reflection begs some serious accolades. This past year has shown us that our team is rock solid. We have phenomenal staff. Not only were they able to pick up the slack for Haylie stepping back for her own treatment, but they were able to do this AND navigate a pandemic! Our team had nothing but the health and well-being of our clients and community at the forefront throughout the entire process.

It is for these reasons that we are grateful to 2020. It showed us:
  • We can do hard things (very VERY hard things)
  • Everyone has each others back
  • Continuing as a team and supporting our clients remained a top priority
  • Striking a work/life balance made a big difference in our ability to show up for our clients
  • The adaptability and mental flexibility to move from in-person to virtual services was phenomenal
  • Our values and mission has held strong and true through this whole endeavor

Changes are inevitable. Such massive changes as a collective society is less common. Beyond a shadow of a doubt that we are proud of our clients and community to make this pivot in our social and professional interactions. We have also discovered that some massive changes will not waiver the core values.

Warman Physio will continue to provide:
  1. Exceptional comprehensive and compassionate care
  2. A family friendly and welcoming environment where you are heard
  3. Services across a wide span of providers to best suit your needs

So even though we are all watching our backs waiting to see what 2021 has in store for us, we still plan on going out and exploring the ways we will grow this year.

 

P.S. Did you know we have some new services? Check them out and see how to book:

Virtual Services: Physiotherapy, Dietitian, Counselling

In-person: Fitness, Physiotherapy, Massage, Occupational Therapy, Dietitian, Counselling

Return of Haylie to Practice: Virtual exclusive

Often pain with intimacy is brushed off “oh you’ve had kids”, “just relax”, “have a drink and you’ll be fine”. If you have heard this rhetoric be the one to stop the narrative! Here we go through a case study on dyspareunia after having kids!

Case Study PD

What does it feel like?

A mom of two comes into the clinic, we will refer to her as PD. She is anxious and unsure of what to expect for her first appointment, but she knows she can’t continue to live like this. PD says that she started having pain with intimacy (specifically with intercourse also known as dysparuenia) after she delivered her first baby. It wasn’t bad then, just some burning and pinching right at the opening. It wasn’t too painful and didn’t stick around but definitely wasn’t pleasant.

Since having her second more trouble with intimacy began. PD recalls having some tearing during delivery with her second but she didn’t need a referral. Her and her partner have tried multiple times to be intimate but she has 8/10 pain. Her pain now is a pulling, burning, pinching at the opening and she also experiences sharp pains deep in her belly as well. PD has pain that persists after attempts at intimacy and it seems to be taking longer before it goes away now. She tells the therapist that she continues to attempt to be intimate for her partner and to see if it still hurts.

This all-too-familiar story doesn’t just happen just for women who have had children vaginally, but can also occur for women who have had c-sections as well as women without children. Let’s focus on this case and 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 Pain with Intimacy?

There are many reasons why an individual may have pain during intimate encounters with their partner. In this instance PD is experiencing pain after child birth; which can be considered a trauma to the body. Since she had tearing during both her deliveries she will have scar tissue in the area that could be contributing. Couple this with the bodies natural response to pain (protect the area). The anticipation of pain causes the body to also move into a protective mode and it is a recipe for a pain cycle.

If you have pain with intercourse, a physiotherapy assessment could benefit you!

What does an assessment look like?

PD was seen for an assessment at the clinic where she was observed in how she moves generally through walking, squatting and bending movements. When evaluating her breathing PD had difficulty taking a deep breath down into the belly. The pelvic floor exam revealed a hypertonic/protective pelvic floor. At the time of the assessment she reported reproduction of “the pain”. The therapist was able to discontinue further evaluation while assisting PD in relaxing the muscles of the pelvic floor.

PD would be provided with a home program to improve deep breathing, pelvic floor muscle relaxation, and imagery/relaxation techniques to start.

Over the course of the next 3 months PD attended appointments at the clinic. Starting with once every 7-14 days, to stretching out as her symptoms improved. PD was thrilled with her improvements and adjustments to the home program and in-person techniques were made. These adjustments included home exercises and activity, discussion on optimal positions, and internal techniques as PD’s pain improved. After 6 appointments she reported being pain-free except when she was very stressed, but manageable with her home program. PD was also happy that the program also seemed to help with her light bladder leakage, and tailbone pain!

How long until I am better?

The recovery period usually varies from client to client, depending on the severity and frequency symptoms. Other factors include:

  • How long the pain has been present
  • Activity level
  • Ability to complete homework

Often with pelvic health issues resolution of straight forward cases occurs within 6-8 appointments. In some instances this could be shorter, and in others it could be longer.

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

Everyone dreads being constipated. It’s never fun to be backed-up to the point of difficult, often painful bowel movements. How we often think of constipation, and what constipation can look like may not always be the same!

Constipation is often described as having 2 or fewer bowel movements in a week. These bowel movements will often be difficult to evacuate or require effort. So anything outside of this (more frequent, and easy to get out) would be considered normal… right?

Not necessarily! Our ability to consistently evacuate the bowel may not mean that you aren’t constipated! Some individuals that are constipated evacuate the bowel several times a day. BUT HOW?! In this instance, usually we are getting out several smaller stools throughout the day, and not completely emptying the bowel. These stools may in fact be “easy” to pass, and for some people they will find that they will sit down to go pee, and some stool will come out as well, without any urge to go number 2 in the first place.

So beyond the “usual” signs of constipation, what else should we be watching out for?

  1. Large diameter stools: for adults and children we should not be thinking “whoa! I hope that doesn’t plug the toilet” or “I can’t believe it’s THAT BIG!”
  2. Cracked or dry stools: bowel movements that look cracked or dry, or like little bunches of small balls stuck together
  3. Urge to go with no results: if you have the urge to evacuate, get to the bathroom and just nothing seems to come out… this could be a sign
  4. You wipe and wipe and it never gets “clean”: this could mean that you aren’t fully evacuating the rectum
  5. It feels like there is still some in there: likely that the bowel is not being fully evacuated
  6. Belly aches and bloating: can be signs of constipation
  7. Itchy rear-end (or the wiggles) is common to see in children as well

Being constipated will put a strain on the pelvic floor, as often evacuating the bowel will require effort in the form of pushing of some sort. Sometimes we are spending significant amounts of time sitting on the toilet attempting to get stool out. Development of hemorrhoids, pelvic pain, and pelvic floor dysfunction can be a result of persistent or chronic constipation.

 

Constipation starts young for many people “I have always been like this for as long as I can remember”. With seeing many children with constipation, they have struggled with bowel movements often since starting solids, or when they began potty training. Often other issues start to arise such as bed wetting as well.

 

Helping people to re-educate the pelvic floor to improve coordination, improve evacuation, and go through bowel hygiene tips are all part of our pelvic health assessments. Some things you can start thinking about now:

 

are you getting enough water?

when you go are your feet well supported with knees above hips?

do you take enough time (but not too much!)?

when you get the urge to go, do you make time?

 

These can be some things to consider with your bowel hygiene to help you begin to get things sorted. Determining the abdominopelvic coordination and function, overall pelvic floor muscle strength and ability to relax, as well as a variety of other technical factors will be what we want to dive into with you.

Issues with constipation isn’t just a problem for children, but also men and women alike!

Book in Saskatoon                                                                       Book in Warman (Kendra, Maja)

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.
Ever wonder why you leak when you cough, sneeze, jump, run, or change position? This is called stress incontinence, which is a common issue that can present at any age.
 
“But I’ve been doing Kegels, why do I still leak? And I think it might even be getting WORSE!”
 

Having strong pelvic floor muscles that are not coordinating well, or are simply too tight, can also be a problem as well. So ‘just doing kegels’ may seem ineffective, or could be making the issue worse…

This great introductory video shows some of the underlying reasons why we can develop stress incontinence (SUI).

 
Don’t worry! We at Warman Physio are here to help! We have pelvic health therapists in Warman (Kendra & Maja) as well as a pelvic health therapist in Saskatoon (Maja) for clients experiencing leaking (stress incontinence) as well as a variety of other pelvic floor complaints which we have talked about before.
 
It is never too late (or too early!) to have your pelvic floor issues addressed. Pelvic floor issues can happen to children (assessed and treated by Haylie), women, and men. Whether you feel like it’s just getting started and you are only leaking a little, or it’s been going on for a while, and perhaps you’re leaking a lot; we are here to help you, help yourself!
 
Start your road to recovery and book your appointment TODAY!
 
*Now conveniently providing care in Warman and Saskatoon
 
Wondering what to expect in your pelvic health assessment? We’ve got you covered! Remember, your comfort is the most important

Bed wetting can be an extremely frustrating problem to have, for kids and their parents. Why does it happen? What might be causing it? How can physio help?

Pediatric pelvic health physiotherapy is an integral part of the care team for children that are experiencing persistent bed wetting aka nocturnal enuresis. Many children go through daytime potty learning, and just seem to never really quite get the night-time down pat. For others, they breeze through daytime and night-time dryness, and then at some point the night-time problems start and just get worse over time. If you are struggling with potty learning check out our blog.

So why does bed wetting happen?

Evaluating movement and coordination is critical in identifying underlying reasons for bed wetting

Bed wetting can in some instances simply be a result of a deep sleeper and an immature bladder. These are kids that will eventually just grow out of it. Many children, however, fit into the “underlying contributing factors” category. Our ability to be continent (hold our urine) at night can be impacted by a number of factors. Here we will go through two main issues:

  1. Constipation
  2. Daytime urinary dysfunction

Constipation

Often times we think of constipation as children going days on end without bowel movements, having extreme difficulty evacuating the bowel, tears, and an overall dramatic experience (which definitely may be the case). BUT some of the time constipation looks like multiple bowel movements a day, quick trips to the washroom, and stool being evacuated without having an actual sensation of the “I need to poop”

The question is how does constipation impact bed wetting? During appointments we take the time to sit down and draw out the relationship (clients get signed copies to take home because the artistic talent is top notch!) – but imagine that the bladder is a balloon, and the abdomen is like a Tupperware container. If the bowel is a long skinny balloon that also fits into the container there is only a certain amount of space in there. When we start to stuff the bowel with some extra stool, it will take up more space in the container. This will leave less space for the bladder, and it will get squished before it can send a signal of “I’m full go pee!” resulting in bed wetting. Biggest take away?

Really the child has no signal that they need to go!

Discussing bed wetting can be challenging especially as a child ages, but making children comfortable and confident is the goal

Daytime Urinary Dysfunction

When a parent comes with their child for an appointment and the only reason is “bed wetting” there is a good chance that it isn’t JUST bed wetting. In order for the problem to be strictly nocturnal enuresis, it needs to be present in the absence of any daytime abnormalities. Many children that come in have several daytime issues going on, and often the parents don’t even realize it! Here are a few things that often come up during discussions with children:

  • decreased urinary frequency during the day (<4x/day)
  • increased urinary frequency during the day (>7x/day)
  • leaking urine during the day
  • altered sensation to void (not sensing the urge to go, or having the urge and being unable to go)
  • voiding difficulties (feeling the urge to go and not being able to)

We struggle especially with school aged children as we often don’t know what their bathroom habits are! Our society tends to significantly limit our bathroom involvement with our kids after they have potty learned, even though they may need parent support until age 5 to ensure they are building positive bowel and bladder hygiene routines!

 

If you have a child that is holding their bladder all day, you can imagine that might impact night-time dryness. If they are having any sort of daytime dysfunction, the night-time wetting will have difficulty resolving independently, since our kids are sleeping (hopefully!) at night, the greatest impact we can have on bed wetting is by working on the daytime dysfunction and/or constipation!

 

Ultimately, bed-wetting in many instances is not something that the child is wanting to do or has control over (despite what many of our friends and relatives will tell us). If you have a child that is wetting at night at any age, it may be worth it to think about some of these factors. When in doubt, give us a shout!

 

Book an assessment for your child!

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. She officially added to her practice pediatric pelvic floor therapy in 2017. Haylie 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 since opening in 2014. She now adds to this education and treatment provision her knowledge and experience in pediatric pelvic health providing workshops and presentations in addition to assessment and treatment. At Warman Physio clients are encouraged to bring their infants and children to treatment. Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017, the ABEX Young Entrepreneur Award Recipient in 2018, and a finalist in the 2019 SABEX and WMBEXA Awards.