endometriosis, Incontinence, News, Pelvic Floor, Physical Therapist, Physiotherapist, Physiotherapy, pregnancy

Pelvic Health Appointment – What to Expect

As a pelvic health therapist one of the biggest questions I get is – wait, WHAT exactly do you do?!

For an adult (age 18+) pelvic health assessment there is a wide variability as to what this will look like, but for a general appointment you can expect for us to ask a detailed history – and this will include some really thought provoking questions for many! The questions and history will vary slightly depending on the issue that you are coming in with (leaking, pelvic organ prolapse, pelvic pain, etc) but the basics will all be covered. I want to know… What are you coming in for, what is the story behind it? Is this getting better/worse? What have you tried to date? (remember, pelvic health therapy is more than kegels!) Your OBGYN history (kids, how they were delivered, when, how big, instruments, length of labor/pushing, etc). Bladder & bowel history (all about voiding patterns, changes, etc) among others.

Once we are done all the questions, and we get an idea of what you are hoping to accomplish, we will complete a physical exam as well. Looking at how you move (walking, squats, etc) may be completed, and abdominal evaluation (diastasis recti, coordination and palpation).

When explaining to people what we do throughout the day we often get these skeptical looks!

In the majority of cases for adult pelvic health we will also aim to complete a pelvic exam**. In order to be a pelvic health physiotherapist, we have additional coursework that allows us to be certified to complete these exams. We check for reflexes and sensation, movement and positioning of the pelvic floor, as well as muscle contractility and pelvic organ position. Muscle coordination between the pelvic floor and rest of the abdominal muscles is also evaluated (what happens when someone coughs or creates what we call a valsalva maneuver). In some instances, usually not on the first day, there may be an indication to evaluate the client in standing as well.

**In some instances when individuals are experiencing pelvic pain conditions, a complete pelvic health evaluation may not be achieved on the first appointment – and this is ok! We do not need to push through pain in order to get the process going, so there is no need to “grin and bear it” for these appointments, we want to know if something is uncomfortable! There are also instances where a pelvic exam is not appropriate which is evaluated on a case by case basis. It is important to remember that there is always an option to not complete a pelvic health exam at an appointment, with careful consideration with your provider we want to ensure you get the best treatment in a fashion that is suitable for you.

What you will head home with for homework will be dependent on what exactly we find (tightness, weakness, coordination issues, etc) to get you starting your road to resolving your particular issue or issues, but each person will have a unique plan to achieve their goals!

Many people come to their appointments worried about how things will go, anxious it will be awkward, and end up leaving feeling relieved and confident in their plan. As pelvic health therapists we do our best to keep you comfortable and provide the education you need to really take control.

Start your road to recovery today! Book an appointment with one of our therapists!

Have questions? Feel free to send us a message and we will do our best to help you get your answers!

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 has been nominated for the 2019 SABEX and WMBEXA Awards.

March 11, 2019/by Haylie Lashta

Incontinence, Injury, News, Pelvic Floor, Physical Therapist, Physiotherapist, Physiotherapy, pregnancy

Prolapse – A Case Study

As with many issues, often we aren’t sure if what we are experiencing is normal and expected, if it will just go away, or if we need to have it looked at. For many women who are pregnant and postpartum, this is made even more difficult as we are often told that symptoms we are experiencing are normal because “you’ve had kids” and that “this is just how it is now” which can delay effective treatment of these issues! Here you can see a case study on Prolapse, which outlines some of the issues that someone may experience.

The presenting symptoms:

A 31 year old woman attends the clinic mentioning a history of intermittent pelvic floor heaviness “feeling like things are falling down” and discomfort. She has noticed that the heaviness has been worse since starting back with weight lifting at her gym 1 month ago. She has two children ages 2 years and 4 months old. She had continued to go to the gym throughout her pregnancy (symptom free), but notes she had reduced her weights somewhat during her third trimester.

She hadn’t returned to the gym until now, as her life has been quite busy since the delivery of her second child! No pelvic floor pain, urinary or fecal incontinence is reported. She had felt like now was a good time in her life to return to the gym and is quite devastated at this setback. Going to the gym and working out had been an

important part of her life-mentally, socially and physically and she is worried she won’t be able to do any activity at all anymore.

She went to see her family physician as was concerned about her symptoms and was referred to pelvic floor physiotherapy for prolapse. She reports no symptoms first thing in the morning, but these progressively worsen as the day goes on. Some days are better than others with her symptoms. Lifting weights at her gym and lifting her children aggravate her symptoms. She notes she did just get over a bad cold and had been coughing/sneezing quite a lot during the past month. She also identifies that she has always had issues with constipation. Both of her deliveries were vaginal with no instrumentation (forceps or vacuum) or complications. She is currently breastfeeding.

Assessment and Treatment

The client was assessed with an internal pelvic examination by a pelvic floor physical therapist. A Grade 1 cystocele was found. (A cystocele means the prolapse was from the bladder descending into the wall of the vagina and a Grade 1 prolapse means the organ descent was halfway to the vaginal opening). The pelvic floor muscles were weak with a Gr. 2 strength (a weak squeeze and no lift of the pelvic floor muscles) and tight.

The client and the therapist worked together to increase her pelvic floor strength and coordination, as well as to optimize her intraabdominal pressure management systems. Toileting positions and discussion around constipation management were discussed and the client was able to implement these at home. Optimizing postures during breastfeeding and throughout the day were discussed to reduce strain on the pelvic floor and discussed on how to successfully get them implemented at home. Education on anatomy of the pelvic floor and the pelvic organs/their supports as well as POP was provided which will help the client to take control and understand the why behind the recommendations.

Activity modifications were implemented but keeping her active was part of the plan and exercises were progressed as appropriate. The client returned to her gynecologist for a pessary fitting to use intermittently during heavier weight lifting at the gym. She was seen in follow up 2 weeks after the initial assessment and then 1x/month for 6 months. She was able to return to her weight lifting and was symptom free with all tasks and activities at the conclusion of therapy, although her Grade 1 prolapse remained.

Have you been struggling with prolapse symptoms? Not sure if your symptoms could be part of prolapse, please feel free to contact us and we will help chat you through what you are experiencing as best we can.

Don’t delay start your road to recovery today!

Maja Stroh is a physiotherapist that has a particular interest in pelvic health and perinatal care. She graduated from the U of S MPT program in 2009 and has been working with pelvic health populations since 2013. Maja’s interest in helping her clients and spending quality time with her family has brought her to Warman Physio where she will be providing services in the Saskatoon and Warman locations.

March 8, 2019/by Haylie Lashta

News, Pelvic Floor, Physical Therapist, Physiotherapist, Physiotherapy, pregnancy, Staff Spotlights, Warman

Welcome to the Team Maja Stroh!

We have been practically bursting waiting to be able to announce our newest physiotherapist to you! Maja Stroh is joining us and is starting with clients the week of March 11, 2019, and she already has her first clients booked in! As many of our new and current clients are aware, we have been very busy at the clinic since Shannon went on maternity leave and we have found Maja, the perfect therapist to join our Warman Physio family to help you help yourself!

Maja will be working out of both our Warman and Saskatoon locations, and has a specific interest in perinatal health.

Biography

Maja graduated from the University of Saskatchewan with a Bachelor of Science in Biochemistry in 2007. She went on to graduate at the same university with a Masters of Physical Therapy in 2009. Maja has been working as a physical therapist since 2009 in private clinic settings, both in Saskatoon and rural areas. Maja has experience in treating orthopedic based populations, as well as pelvic health clients. Her particular interest is in treating the prenatal and post-partum pelvic floor populations.

She considers continuing education a high priority as well as strives to provide the best evidenced based practices. She has completed a variety of post graduate continuing education courses. These include courses relating to pain management, her Level III for both the Upper and Lower Quadrant Orthopedic Division courses, as well as a variety of pelvic health continuing education courses/lectures. She plans to continue to advance her knowledge with treating pelvic floor populations by continuing with further pelvic health courses.

Maja loves spending time with her two young boys. Some of her other interests include, cooking, gardening, painting and camping/hiking.

Areas of Practice Interest:

*Pre-natal & Post-partum assessment and treatment

*General Orthopedics

*Urinary Incontinence

*Pelvic Pain

*TMJ Dysfunction

*Spinal Assessment & Treatment

February 22, 2019/by Haylie Lashta

carpal tunnel, Injury, News, Physical Therapist, Physiotherapist, Physiotherapy, Sports Injuries, Sports Rehab, Warman

Carpal Tunnel – or a pinched hose?

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.

January 7, 2019/by Haylie Lashta

Frontpage Article, News, Physical Therapist, Physiotherapist, Physiotherapy

It’s Our Birthday!

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