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

We have talked before about headaches from a massage perspective previously. However, there are many reasons for headaches that may be cause to see a physiotherapist as well. Check out this case study for headaches from the neck!

Case Study NP

What does it feel like?

NP comes into the clinic, he is a 35 year old father of 3 and works a desk job for the past 5 years. Before that he was working on-site in construction, often looking overhead. In the past 2 years since his third child was born he is noticing he is getting more frequent headaches. Often his headache is is on the right side behind his eye and in the temple. As NP gets talking he realizes that he also has some dull pain in the shoulder and arm; but this pain is occasional compared to the headaches. He finds that when he is working at his desk by the end of the day the headache is nearly unbearable. By the time he gets home he has difficulty playing with his kids, and it’s starting to impact his ability to work around the house and cabin.

He doesn’t recall a specific injury to his neck, but NP does have a cabin and boat at the lake and loves trying new water sports. Just before his third child came friends came to the lake and decided to take the tube out where he was flipped multiple times.

This all-too-familiar story can have multiple ways that it could have begun – a whip lash injury, strain of the neck or shoulders, etc. Let’s focus on this case study 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 Headaches?

The neck is actually a highly complex unit. We have multiple bones in the neck (seven to be exact!), nerves that travel from the neck up into the scalp and down into the arms, plus all the ligaments, tendons and muscles. The body is an amazing thing when you think of all the moving parts. Generally speaking we are able to maintain a pain-free lifestyle; however sometimes we need a little help.

One of the reasons that we can develop headaches is because of neck dysfunction. In this instance NP is experiencing referral from the upper cervical spine (C1-3). This is why he has pain near his eye. Increased stress and posture issues can also significantly impact headaches.

If you have headaches, a physiotherapy assessment could benefit you!

What does an assessment look like?

NP came for an appointment at the beginning of the day because it worked better with his schedule. He was worried that not being severely symptomatic would be a problem for the assessment. He was relieved when he heard that the therapist would be able to evaluate the neck regardless of the amount of current pain.

The assessment took a look at his overall neck range of motion. NP was surprised to discover that he had more difficulty tipping his right ear to his right shoulder, and shoulder checking over the right. When the therapist had him lay down to evaluate the neck movement and muscle tension he was significantly more tender on the right side at the base of the skull.

During the assessment the therapist identified some specific muscle weakness and tension that would need to be addressed.

NP was surprised that during the appointment the therapist was able to recreate his headache symptoms and shoulder pain. He wanted to make sure that he could get back to his normal home-life routines. NP booked his next 4 appointments weekly and was sent home with exercises and stretches to get him started.

Over the next four weeks NP attended his appointments for some manual therapy from the physiotherapist and updates to his home program. He was pleased that by week 3 his headaches seemed to be significantly better.

NP resolved his headaches within 6 weeks, and returned for a flare-up 4 months later. The flare-up lasted 2.5 weeks and after resolving has not returned since he is able to manage any issues with his home program.

How long until I am better?

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

  • How long the headaches have been going on, how severe they are
  • What areas are contributing (neck mobility, muscle tension, etc)
  • Commitment to the home exercise program

Straightforward cases we tend to see client’s 1x/1-2 weeks for a total of 4 to 6 sessions. These sessions include manual therapy to help restore joint and muscle mobility as well as exercises for their home program.

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

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!

With icy sidewalks and streets, falls during the winter can become more prominent. One injury that can occur is ankle sprains.  Have you ever sprained your ankle before? Wondering if you should seek physiotherapy? Lets look at a case history of one example of an ankle sprain and what physiotherapy may involve…

Ankle Sprain: Case Study

A 35 year old woman attends the clinic after she was walking her dogs outdoors when they lunged suddenly, causing her to slip on some ice. She fell, rolling her right ankle to the side and was able to get back up and weight bear through her injured ankle, although limping back home. Her ankle was pretty sore with some noticeable swelling so she went to see her family physician the following day. X-rays were taken of the ankle and she was advised she did not have a fracture, but rather sprained her ankle. She was recommended to rest the ankle for the next 3 days and to limit her weight bearing as tolerated using a lace up brace. She was also prescribed anti-inflammatories and referred to physiotherapy.

Dance Ankles and Feet

For the assessment she was weight bearing with a lace up ankle brace. The ankle was noted as still sore but improving.

Some mild swelling over the lateral ankle and some tenderness to touch over the ankle ligaments were noted. With in-clinic testing it was determined she was dealing with a moderate ankle sprain. She was prescribed some basic neuroproprioceptive and gentle strengthening exercises. These early phase exercises set the base foundation for return to regular activity and sports and she was eager to get back to her regular routine with her dogs.

The client was seen for 6 further follow ups over the next 3 months.  During this time she was provided with some manual therapy techniques to the ankle. She was also given a progressive home exercise program which included progressive strengthening, balance and proprioceptive training. The client noted full resolution of symptoms at the conclusion of her treatment and return to her activities which included walking her dogs and her dance class.

Often people find that their ankle will feel “good enough” part way through rehabilitation but ensuring that all systems are truly “go” will help prevent a recurring injury from incomplete rehab programming.

What is the current evidence for acute lateral ankle sprains and the role of physical therapy?

If required a short period of immobilization may be used, however exercise and a functional support (either bracing or taping) is recommended over immobilization. Clinical practice guidelines support the inclusion of an active exercise rehab program following an acute lateral ankle sprain as soon as possible to help prevent recurrent lateral ankle sprains. 1

It is commonly misunderstood that someone must wait a certain period of time before attending physiotherapy, however, keep in mind that physiotherapists can assess injuries right from the moment of impact; just like when an athlete becomes injured. Coming for an appointment early in healing can give you the right tools to start with immediately. Alternatively, the body is capable of healing and change even after extended periods of time so it is also never too late to start.

If you have unfortunately sustained an ankle injury, we at Warman Physiotherapy and Wellness have trained physiotherapists who can offer a progressive rehabilitation program to help you on the road to recovery and return you to your activities/sport!

 

References:

  1. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. BJSM. Volume 52, Issue 15. August 2018. Gwendolyn Vuurberg, et. al.

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.