Newsletter & Blog

Duodenum Visceral Mobilization Gives Insight into Patient's Pelvic Pain

Our female patient with chronic pelvic pain recently underwent laparoscopic surgery to repair an inguinal hernia and to remove endometriosis adhesions. She also has suffered from neural tension along the right genitofemoral and ilioinguinal nerves which were temporarily helped via repeated nerve blocks. Upon using visceral mobilization applied to the duodenum we were able to reproduce some of her right pelvic pain. The duodenum is the first part of the small intestine. It receives digested food (known as chyme) from the stomach and helps in the chemical digestion of chyme in preparation for ab[...]

Postpartum Wrist or Thumb Pain Taping

Many postpartum women suffer from tendinitis of the thumb and/or wrist commonly known as DeQuervain’s Syndrome. This occurs due to a likely overuse of the dominant hand when performing baby care such as nursing, changing diapers using the same pattern of movement, and lifting/holding the baby. Pushing a heavy loaded stroller is another causative factor. The mom usually experienced daily pain in the thumb and wrist and pain can worsen night. Swelling can also be present in the thumb and wrist. There may be numbness or tingling sometimes indicating carpal tunnel syndrome at the same time. Touchi[...]

Spinal Stability Exercise for Neck Pain and Low Back Pain

Opposite arm and leg raises on all fours is a comprehensive exercise which uses many muscles essential for core stability. The patient first engages the transversus abdominis by pulling the belly button gently towards the spine or inward. Upon raising the leg straight up behind the gluteals, hamstrings, deep spine stabilizers called the multifidi, and erector spinae contract. If the patient rotated the foot out the deep hip rotators are engaged. Upon raising the opposite arm there is co-contraction of the latissimus dorsi, scapula, and cervical spine muscles. The patient must remain stable i[...]

Pelvic Organ Prolapse Awareness Month

This month we recognize how many women suffer from POP. This is something we successfully treat. Pelvic organ prolapse (POP) occurs when there is a weakness or laxity in the supporting structures of the bladder, urethra, rectum, or uterus. When there is a lack of support, one or more of these organs can drop down, bulge, or prolapse into the vagina. The organ may also begin to exit out of the vagina. The support structures for these organs include the pelvic floor muscles, pelvic ligaments, and connective tissue or fascia. There are several types of prolapses. A prolapse of the bladder is call[...]

Success- A Breech Positioned Baby Turns After 2 Physical Therapy Sessions!

Here is the ultrasound image of our patient’s baby who has now assumed the correct position of head down from breech position. We had quickly evaluated her and found asymmetry in her pelvic girdle and a mild sacral torsion or rotation. This means that sacroiliac joints were misaligned. These findings may have made it challenging for the baby to properly find its way head down due to lack of room or tension in the uterus-making movement for the baby more challenging. If the sacroiliac joints/pelvis are not in alignment it can result in a tension or pulling of the uterosacral ligament(s) or roun[...]

Strengthening Core Muscles to Improve Bladder Function and Gait in a Patient with ADEM

In this photo we are using proprioceptive neuromuscular facilitation to encourage improved core muscle recruitment and strength. Having the patient use gross motor movements utilized in rolling on her weaker side will work her core muscles. It is ideal to give the bladder a lot of support by strengthening the diaphragm, multifidis, pelvic floor muscles, and lower abdominals (otherwise known as the canister muscles). ADEM is acute disseminated encephalomyelitis and is characterized by a brief widespread attack of inflammation in the brain and spinal cord that damages the myelin of nerves. Our p[...]

Preparing for Labor and Delivery with Hip Impingement

Here we are performing hip mobilizations in sidelying on a pregnant patient who has a prior history of hip dysfunction. Because of an old trauma she has a history of hip impingement. Femoroacetabular Impingement (FAI) is also known as Hip Impingement. This painful condition occurs when there is abnormal contact between the femoral head and acetabulum during motion. With hip impingement, patients usually present with groin pain and a reduction in hip range of motion. Even if the disorder is asymptomatic prior to pregnancy or during the 1st trimester, the patient can become symptomatic during th[...]

Scoliosis as a Cause of Chronic Pelvic Pain

Scoliosis is a spinal curvature that can be a cause of an symmetrical pelvis. One side of the pelvis sheers upwards as a compensation of the curvature. Besides causing a functional leg length discrepancy (side of sheered pelvis upwards “shortens” the leg), there are many changes in the soft tissue structures such as pelvic ligaments, pelvic muscles, and nerves. Structures on the sheered or upslip side are tractioned or pulled upwards. In this patient, she is experiencing left sided chronic pelvic pain. Her left pelvic floor muscles are being tractioned or pulled upwards. This can result in pel[...]

Ruling out Hip Impingement as a Cause of Chronic Pelvic Pain

Femoroacetabular Impingement (FAI), also known as Hip Impingement, occurs when there is abnormal contact between the femoral head and acetabulum during motion. FAI and the muscle imbalances around the joint can alter hip and pelvic biomechanics during gait. Performing range of motion testing of the hip and special orthopedic tests such as the FADIR may help diagnose the issue. With the patient supine with one leg extended, flex, adduct, and internally rotate the hip. The test is positive if this reproduces the patient’s anterior groin or anterolateral hip pain. In patients with FAI there is a [...]

Winter/Spring 2018 Newsletter

Featured articles include Osteitis Pubis, Retraining the Pelvic Floor in a Pilates Instructor, and Hip Impingement Can Cause Pelvic Floor Muscle Pain. To view the newsletter, please click here.[...]