Posts

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!

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!

You’ve already read all about WHY pelvic health is also important for men, now let’s dive into a case study!

Case Study – Male Pelvic Health

CT is a 43 year old male seeking help because he is having problems with leaking urine whenever he does physical activity. He has also been experiencing consistent sharp/burning pains around his rectal area. In the beginning he was leaking only a few drops of urine and feeling slight discomfort in his pelvic floor… but after a few months CT is leaking his full bladder and his pain has greatly increased. He is afraid to participate in golf, fishing, and jogging because this is when he leaks the most urine.

During the pelvic assessment it is found that CT has a weak pelvic floor (2/5 strength), and a lot of tension/tightness of his pelvic floor muscles. He is educated that he needs to strengthen his pelvic muscles in order to close his urethra (tube which pee comes out), so that he does not leak before he is able to get to the bathroom, or when participating in golf, fishing, and jogging. CT also requires training in relaxation exercises, and stretches for his pelvic floor, which will decrease the tightness and therefore stop the pain that he has been experiencing.

After the assessment CT is sent home with a breathing exercise, several pelvic floor stretches, and a muscle strengthening exercise.

At the next session CT reports having decreased episodes of leaking and reduced pain in his pelvic area. During a follow up evaluation CT now has 3/5 pelvic strength and a decrease in muscle tension. The therapist manually releases his pelvic muscles and he is once again sent home with progressed pelvic floor strengthening exercises and stretches.

After a few more weeks and 2 or 3 more sessions CT is no longer leaking and feels no more pain and discomfort in his pelvic floor. He is educated to keep up with his exercise program occasionally to maintain strength and proper length of his pelvic floor.

 

Not all pelvic health issues will present the exact same, and as such there is no one-size fits all program that will work for everyone. Need help with your pelvic health complaint? Don’t hesitate to contact us or book an appointment. Not sure if your issues can be helped by a physiotherapist? Give us a call, or send a message, we are happy to help you sort through it.

At Warman Physio we have been working hard behind the scenes to get a secondary location going for all the clients that are unable to get out to Warman. We are pleased to announce that as of June 3, 2019 we will be located in Saskatoon!

To top it off, we are not only opening a second location, but we also have two NEW staff members to introduce to you!

Maja Stroh PT

First, our physiotherapist Maja Stroh!

  • Prolapse
  • Incontinence
  • Back pain
  • Sports Rehabilitation
  • General orthopedics

Maja is passionate about pelvic health and is always on the search to ensure that all angles are considered for every client. Her attention to detail and comprehensive exams ensure that you are obtaining the whole picture when you come in for any injury or issue.

 

We are also pleased to announce our RMT Signe Bone to the team in Saskatoon!

Signe has been working as a massage therapist for a number of years, and has always had a desire and drive to understand the human body from a very young age. She has been working in Saskatoon as an RMT as well as continuing her education in Prenatal Massage through Axiom Collage, and has begun her Visceral Manipulation through Barral Institute and Craniosacral Therapy through Upledger Institute. The areas of practice that Signe is most drawn to includes:

  • Prenatal & postpartum massage
  • General Injuries (whiplash, TOS, piriformis syndrome, etc)
  • Abdominal Health thorugh Visceral Manipulation
  • Critical Alignment Therapy
  • Cranial Sacral Therapy: CS1

Her love for learning and solving problems helps her provide the best care and treatment she can through working with her clients to better understand them as a person, not just as a body.

The schedule for physiotherapy assessment and treatment can be found HERE and to get on the list for booking for massage can be found HERE.

 

Spread the word and make sure you share this fantastic news with your friends! As per our vision – the Saskatoon location will be infant and child friendly, providing compassionate, comprehensive, and personable care to each and every client.

 

Location of the Saskatoon clinic is: 2543 Dudley St, Saskatoon

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.