Newsletter & Blog

Cross-Friction Massage Applied to the Inguinal Ligament After Hip Surgery

Tension along the inguinal ligament can be a cause of groin, hip, genital, abdominal, or pelvic pain. The inguinal ligament attaches to the anterior superior iliac crest of the ilium and inserts onto the pubic tubercle of the pubic bone. The inguinal ligament is formed by the external oblique muscle aponeurosis and continues to be come the fascia lata of the thigh. Many lower quadrant structures are influenced by the inguinal ligament based on its location and surrounding structures. The femoral nerve, artery, and vein run underneath the inguinal ligament and if compressed can cause nerve pain[...]

Vulvar Varicosities and Scoliosis in a Pregnant Patient

This incredible pregnant patient complained of heaviness in the vulvovaginal area and mild low back pain. Looking at her from the front we see a curve along her right flank or rib cage (scoliosis) and varicosities along her right thigh. Scoliosis appears more pronounced when looking directly at the spine. There is an un-leveling at the shoulders, scapulas, ribcage, and pelvis, also an “S” curve is noted. She also has mild vulvar swelling on the right and a vulvar varicosity on the right labia majora and interlabial sulcus. This causes her sense a of vulvar heaviness. Her spinal mobility was wi[...]

Sacroiliac Joint Dysfunction and Piriformis Syndrome in Pregnancy

Many pregnant patients come to us with complaints of sacroiliac joint pain and/or piriformis muscle pain. Sometimes the pain refers into the buttock and down the back of the leg. One great intervention for pregnant patients with strained piriformis muscles is cryotherapy. Cryotherapy is cold application like an ice pack or ice massage. Here we chose to do an ice massage because the patient’s piriformis muscle was too painful for soft tissue mobilization/massage. Performing an ice massage to the region or muscle in a cross-friction like stroking approach quickly soothes pain and addresses infla[...]

Treating Abdomino-Phrenic Dyssynergia (APD) Successfully

Treating abdominal phrenic dyssynergia successfully: this patient has slowed digestive motility and mobility, and a distended abdominopelvic region. Both of her diaphragms (respiratory and pelvic) were restricted in mobility and discoordinated. We utilize manual therapies, pelvic floor rehab, visceral manipulation, sEMG biofeedback, intestinal massage, dietary discussions, Thiele's massage, MFR, and a home exercise program (HEP). The HEP consists of many visceral and pelvic floor exercises. Important aspects of rehab for APD are: improving the mechanics of breathing, balancing the pelvic and r[...]

C-Section Scar Mobilization

All women who have undergone a C-section would benefit from physical therapy to help prevent scar mobility restrictions and optimize appearance of the post-operative scar. Physical therapy can occur postpartum when the area is healed and you are cleared by your physician. Scar mobility techniques can be applied directly to the scar when it is still a little swollen and red. However, if the physician did not recommend it you can benefit at any time from scar tissue mobilization, even years afterwards. Ask your provider for a prescription for physical therapy for abdominal wall scar mobilization[...]

Evaluating the Sacrococcygeal Joint Alignment to Treat Coccydynia

Sometimes coccyx pain results from a direct fall but pregnancy and childbirth can also be a cause. Coccyx pain can also result from pelvic floor muscle dysfunction, constipation, lumbar spine or sacroiliac joint issues, or hypermobility syndrome. One of the first tests we do is to determine the alignment of the coccyx in relation to the sacrum (the fused bone directly above it). By palpating along the joint line we can determine if there is misalignment. One side may feel more prominent or rotated posterior and the other side may feel deeper or more anterior. Identifying a misalignment is key [...]

Supportive Taping for Postpartum Belly Stretch Marks

We evaluate and treat postpartum women for core weakness including the abdominals, pelvic floor muscles, respiratory diaphragm, and deep low back muscles called the multifidus. This also includes treating any diastasis recti that may exist. Sometimes the woman expresses concern over extensive stretch marks or connective tissue laxity causing a belly pouch or distension and bloating. Using topical scar creams and oils on the stretch marks can be very beneficial. But because the abdominal muscles and belly connective tissue has been overly stretched providing external support is very helpful. [...]

Myofascial Release & Deep Tissue Work to Improve Nerve Pain

When patients complains of “sciatica”, pain around the sitting bones, or pelvic pain upon sitting, it is important to fully assess the mobility of the nerves in the area. Nerves move through muscle and connective tissue like floss. Any microadhesions or abnormal connections can impede mobility and the signal along the nerve, cause burning, tingling, or aches, and cause weakness to a muscle. By using myofascial release and deep tissue massage we can release the microadhesions along the nerve path. Here we are helping a patient with sciatic nerve pain and cluneal nerve pain. Her symptoms include[...]

Balancing the Respiratory and Pelvic Diaphragms (Pelvic Floor)

Here we are treating a pregnant patient who is preparing for labor and delivery. Because the pelvic floor muscles traverse the body it is considered to function as a diaphragm by many. When we tested the mobility of her diaphragms they were out of sync. The respiratory and pelvic diaphragms should move in coordination together. This could impact breathing and efficiency of delivery. This technique helps to release any tension and asymmetries and correct excursion in the diaphragms. The patient only feels mild pressure over the rib cage and pelvic bone (ilia). This is a strain-counterstrain t[...]

30 Years of Dentistry & Many Dollars Later Patient Gets Relief After 1 PT Visit

The patient reported having onset of dizziness 30 years ago and undergoing dentistry with mouth guard/bite plate fittings with 3 different TMJ/TMD specialists overtime. His jaw was clicking and he also had poor occlusion or closing. But despite good mouth guards and pillow posture, he awakened with feelings of extreme dizziness, haziness, and could not leave the house for work in the morning until it cleared. Here were the golden questions during our history taking: “Have you ever had a motor vehicle accident!?” And the answer was “Yes, I’ve had 3 and all hit from behind.” Now we realize tha[...]