Newsletter & Blog

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[...]

Patient with Chronic Pelvic Pain Presents with Severe Swayback

Posture does matter! Swayback posture is when the spine hinges backwards or extends through one or more segments. It is one of the leading causes of low back pain. This patient has a sway back with a hinge at T12-L2 vertebral segments. In sway back your the chest lean backwards, with hips turned in and pelvis and chin thrust forward. The spine extends backwards from the hinge region. Ideally, a neutral pelvis (the ideal position) supports a mild lumbar curve (called a normal lordosis) in the low back. The spine stacks correctly upwards with even transmission of forces. Swayback posture cau[...]

March is Endometriosis Awareness Month

It’s time women ended the silence of their suffering. Women with Endometriosis suffer from pelvic pain, bloating, painful periods, painful intercourse, digestive issues, elimination problems, excessive bleeding, headaches, depression, infertility and inability to perform activities of daily living. We are passionate about helping this population. The best way to approach endometriosis is through a multidisciplinary approach which includes a skilled and experienced physical therapist that specializes in pelvic pain and myofascial release techniques, including visceral mobilization. At Pamela Mo[...]

Figuring Out Pelvic Pain Isn’t Easy

We treat female and male pelvic pain successfully therefore I’m pressing the “This Is Easy Button”. The pelvis is so complex and called the “hub of the wheel” meaning most musculoskeletal function occurs off of it. We need to have abdominopelvic stability to efficiently move our arms and legs or extremities. Digestion, elimination, and genital-reproduction functions, and emotional holding all occur in this high traffic area. I refer to it as “high traffic” because of all the connecting muscles, blood vessels, and nerves that cross through. Compression of nerves such as the genitofemoral, ilioi[...]

Scoliosis & Pelvic Pain

Scoliosis can play a huge factor in chronic pelvic pain. Notice how high her right iliac crest is compared to the left. There is even an indent on the left side on top of the iliac crest and not the other. There is an obvious curvature. Imagine the superior shearing forces placed on the right sacroiliac joint, sacrotuberous ligament, sacral plexus, pelvic floor muscles, and other attaching structures. This posturing can cause pelvic floor muscle dysfunction, vulvar pain, low back pain, and pubic pain. Those are all of this postpartum patients symptoms. During treatment we must address the scol[...]

Joint Hypermobility Syndrome and Pelvic Pain

Abdominal and pelvic pain can have a variety of causes. Joint hypermobility syndrome can often be an undetected and underdiagnosed comorbidity in chronic pelvic pain conditions (I.e. like endometriosis). Joint hypermobility syndrome, or benign hypermobility syndrome, is a connective tissue disorder and considered a milder variant of Ehlers-Danlos Syndrome. This syndrome is characterized by chronic musculoskeletal pain as a consequence of joint hyperextensibility. Patients with this syndrome are commonly afflicted by pain in their pelvis, fingers, hips, knees, and elbows. A physician and/or phy[...]

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[...]