Thank YOU!

In a blink we are nearly into June 2020. Halfway through the year. Nearly half of that time spent in a pandemic. Feels weird to some days be “ok” while others feeling like you can barely hold it together long enough to get through that next task.

It has felt like from the moment we announced the clinic closure to in-person care March 18 we have been consistently adjusting, moving, re-planning. Through it all we have been forever grateful to the community and our clients for your understanding and grace you have given us during this time. I don’t think we can ever over-state how deeply we appreciate your support during these many transitions!

In-Person Care

Although things are still seeming to be ever changing, we have settled on some specifics for those that are appropriate for our in-person appointments we are providing for Physiotherapy & Massage services at this time.

  1. Ensure you have completed your online COVID screening questionnaire and re-book if you are feeling at all unwell
  2. When you arrive please stay in your vehicle! Our team will call you when they have your personal waiting room ready
  3. We are required to have everyone who enters the building to wear a mask (please bring one with you to your appointment)
  4. There will be hand sanitizer available for you to use once you enter the building
  5. The bathrooms at this time are closed to public use
  6. Contact-less payment is preferred whenever possible

*Please note that depending on the type of appointment you are scheduled for, your therapist may have differing levels of PPE on

 

PPE (Personal Protective Equipment)

At the clinic the therapists and staff have access to approved PPE for all levels of available services. This means various levels of equipment will be used for different treatment types, in addition to personal protective measures that each therapist feels necessary to take for their own/family safety.

You will always see your therapists and staff in a mask if they are unable to remain physically distanced (this includes Laura until our fancy new sneeze guard comes!) – which of course will be the case for any in-person/hands on appointments. You may also see: protective eye wear, a gown/specific lab jacket (we have special ordered some), and/or gloves.

It must be noted that at this time we are not completing any assessment or treatment intraorally. This means that until further notice appointments for TMJ will not be able to evaluate the muscles within the mouth. We can however, still provide assessment and treatment of any additional factors that would be related to the neck and external to the mouth!

 

Why are we so diligent?

We are so fortunate to have such understanding clientele at the clinic, and haven’t had any issues with our new protocols and procedures. It is important that we ensure that our clients understand why it is important that we follow the guidelines, are honest in our COVID screening questionnaires for a couple main reasons.

1) There are hefty fines for not following the proper protocols

Businesses that do not comply with the government or association guidelines are at risk of fines up to $250,000. We have been so grateful to persevere through this pandemic to date. Fines during this time not only for our business, but any business, could prove catastrophic for any business.

2) We need to protect those that are at risk that are coming in to provide care

There are some individuals at the clinic that are at-risk themselves or have family members that are at greater risk for COVID.

Although I am a generally private person, I have felt that now is the time to let our clients and community know that I have been diagnosed and started treatment for cancer. COVID has thrown a real wrench in the entire process and brings a new element to have to navigate during an already challenging time. As many people know, my dad has leukemia and has for years so I am very familiar with the increased protective measures required for a compromised immune system during a typical flu season. I am confident in our team’s ability to navigate these uncertain times and continue to provide the high level of care that we have become accustomed to.

~Haylie Lashta

Our top priority is the health and safety of our staff, the clients, and the community. We appreciate that we are all working together through these processes.

Thank you for choosing us to help you, help yourself!

Lightning Crotch. Ouch! Our pubic symphysis is the point where the two halves of our pelvis meet in front – the bone at the top and front of the groin. For those that have had pubic symphysis dysfunction (PSD) or “lightning crotch” you well know that this can go from slightly irritating pain to WHAT IS GOING ON HERE! B(#%P! pretty quickly.

Commonly associated with pregnancy, we well know that individuals suffering with PSD can get to a point of despair and resignation that this pain will become a new normal; often because that is what we are being told about pain during pregnancy! “This is just part of becoming a woman” is a term I have heard yet again this past week from a client. I urge us to think of pain in pregnancy (any pain, but in this instance PSD), as something that although is common is not normal.

We wouldn’t tell someone who has just started running that has developed knee pain that “this is just part of becoming a runner – it will go away when you stop

 

There is research now that shows that pain in pregnancy can often be addressed with physiotherapy (1,2) – from PSD to back pain, and that staying active during pregnancy (3) has many benefits (which is hard to do when you are painful!). When there is pain, there is usually something we can do about it!

 

Case Study

An active mother of 28 comes into the clinic complaining of groin pain – it’s sharp, shooting, sometimes take your breath away pain that is getting progressively worse as her pregnancy continues on. She is only 26 weeks gestation and has been struggling with pain since about 16 weeks and finally decided to come to an appointment after talking with a friend about it. She is having difficulty rolling in bed (she tries squeezing her knees together because that is what she read on a few blogs on google) which has helped a little but not much, standing on one leg, and she sometimes notices popping and clicking with movement that really hurts as well. She tried kicking an empty laundry basket out to the side the other day and found that extremely painful as well.

Although there are many reasons for PSD, we will go through some of the things that may be found during a physiotherapy assessment of this type of pain

Assessment

Upon evaluation the client was clearly limping while they were walking, more on the right than the left leg, they had pain with standing on the right leg more than the left leg, and had difficulty bringing their knee toward their chest on both sides in standing. Generally speaking these individuals will have some restriction of movement on one side (same side as pain or the opposite – everyone is different!), significant muscle tightness of the inner thigh, and poor coordination of the gluteals. We also often see a change in posture – the individual may be hinging backwards (rib cage back over the pelvis), but there is a huge variation in the changes seen here depending on the underlying cause.

What can I do NOW?

In many instances our protective mechanisms related to pain may end up being one of the additional driving factors of our pain – your groin hurts, and when you hurt you tend to ‘protect’ the area (curling in) and the muscles around the area will tighten. Increased tension often doesn’t help serve us to feel better or less painful, but may drive a continued pain cycle! Squeezing the knees together to roll like in this instance, may help initially, but overall results in increased tension and often stops being helpful over a short period of time. Relaxing the muscles – particularly the inner thigh – and activating the gluts can go a long way to improving PSD pain. As always, an individual assessment is best, but when you are rolling over, try pushing yourself over with a bent knee (leg straight to the side you want to roll to), and spending some time in a ‘butterfly’ position.

At Warman Physio we have experienced physiotherapists that will use a variety of hands-on treatment while you are in-clinic, as well as home programming and exercises so that you can continue to help yourself to feel better between appointments!

PSD can be a draining, exhausting, and very painful experience for some people, and merely annoying, irritating, and minorly problematic for others. Let us help you, help yourself!

 

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.

 References:

  1. E Vermani et al (2009). Pelvic Girdle Pain and Low Back Pain in Pregnancy: A Review. World Institute of Pain. Volume 10, Issue 1 (60-71)
  2. E Richards, G van Kessel, R Virgara, & P Harris (2012). Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Nordic Federation of Societies of Obstetrics and Gynecology. (ahead of print)
  3. MF Mottola et al (2019). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine. Volume 52, Issue 21

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

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.

March was Endometriosis Awareness month, and we have provided some information related to endo for everyone on our social media (Facebook and Instagram). If you are wondering what endometriosis looks like for someone living with it, you can check out the story we posted earlier in the month. As promised here are some of the things that Pelvic Floor Physiotherapy can do for you…

Pain Science

Physiotherapists that work with pelvic pain conditions, such as endometriosis, have additional training specific to the actual science behind pain. Having this knowledge to give to our clients allows us to de-mystify pain, help us understand pain perception, and why the symptoms are occurring. Globally with pain science, one of the most important things to understand are there are no pain signals to the brain. The brain receives information from the body, and depending on what all those signals are saying, will determine if something is painful or not. Have you ever stubbed your toe when you are having a great day? It hurts SO MUCH. But, if you stub your toe while you are in the middle of an argument with someone, it doesn’t hurt the same; that’s pain science!

Everyone has heard a story of someone being in an accident of some kind and being able to get to a hospital (or civilization) before feeling pain.

How does this apply to endo? Endometriosis is the presence of uterine-like tissue outside of the uterus, within the pelvic bowl and abdomen (generally). Endometrial tissue contracts during menses to shed the lining of the uterine wall. If this tissue is outside of the uterus… it still contracts on the tissue it is adhered to.

Which brings us to….

Assist muscle tension

If you have a muscle that is contracting and creating more tension over time, and you aren’t stretching it, eventually it becomes tighter. Have you tried stretching tight muscles? How about making them contract more?

Here is where we talk about what happens in a painful body – when we have abdominal and pelvic pain, we try and protect the area. This protection leads us to adopt a fetal position. Tightness develops in the abdominals, hip flexors, pelvic floor, and diaphragm, which plays into the pain cycle. Pelvic floor physiotherapists will work with each woman to obtain appropriate length, strength, and coordination of the muscles in the abdomen and pelvic bowl.

Tight muscles are often painful muscles.

Provide self-assistance tools

We are here to help you, help yourself. Giving you tools to reduce pain for between episodes, things to try during painful episodes, and ultimately manage your pain.

Some things that could be helpful include: stretching your hip flexors, deep breathing, yoga, meditation, using a wheat bag, and releasing muscles using an acupressure ball (or tennis ball).

 

Endometriosis can’t be cured by physiotherapy, but the symptoms can be managed. Contact us today to see how we can help you, or use the Book Now section to schedule your assessment today, and take control.

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. 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 2016 WMBEXA and ABEX Awards, is a WMBEXA award recipient of 2017, and Haylie was recognized as YWCA Women of Distinction for Health & Wellness in 2017.