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Mar 26, 2014

Elizabeth Hampton PT, BCIA-PMDB

 

This post was written by H&W faculty member Elizabeth Hampton, who will be debuting her course, Finding the Driver in Pelvic Pain, in May at Marquette University. 

 

Your client presents with a referral from an OBGYN for evaluation and treatment of vulvodynia. During your evaluation, you confirm that she has pubic symphysis instability and that her vulvar pain reduces by 90% with use of a pelvic compression belt. How do you screen for musculoskeletal dysfunction as well as specific urogyn/colorectal and pelvic floor issues in these complex clients? How do you develop the clinical reasoning methods to prioritize evaluation and treatment interventions? If you send a report back relating her pain to pubic symphysis instability, will the physician think that they sent this client to a PT who doesn’t understand the pelvic floor?


Mar 25, 2014

Michelle Lyons

This post was written by guest-blogger, H&W faculty member Michelle Lyons. You can catch Michelle teaching our Pregnancy and Postpartum series courses, Pelvic Floor Series courses, as well as our new courses on Oncology and the Pelvic Floor and the Athlete and the Pelvic Floor. Michelle lives in Ireland and was an integral part of bringing Institute founder, Holly Heman, to the UK to teach two courses this spring.

 

 

As a longtime fan of Holly Herman's work, it has been my pleasure to help bring her depths of knowledge and unforgettable teaching style first to London to teach Pelvic Floor Level 3 and then on to Dublin to allow us Irish PT’s the honor of being the first to attend her new course, Sexual Medicine for Women & Men.


Mar 24, 2014

Psychological distress and cognitive impact are common sequelae of a cancer diagnosis, even once a patient is considered disease-free. Fear of cancer recurrence or progression is a significant issue for many patients, and can have severe impacts on a patient's well-being and function. Research published in August of last year describes predictors of this fear of recurrence, or FOR, in almost 1300 patients who completed a range of validated measures. The study reports that patients within a lower social class, this with skin cancer, colon or blood cancer, palliative treatment intention, pain, an increased number of physical symptoms, depression, and decreased social support were at higher risk of having fear of cancer. 

 

 

Fear and psychological distress could potentially impact a patient's life in many ways, and also may have an effect on a patient's ability to maximally participate in recommended rehabilitation. If a patient is experiencing anxiety and/or depression, getting out of the house, making it to appointments on time, and participating in health programs may be very difficult. Cognitive impact from treatment or from psychological stress can also make remembering a home program or other instruction from you very challenging. What are things we can do to support a patient who has been impacted by a diagnosis of prior cancer? We can ask some simple questions…

 


Mar 22, 2014

Brigid Ellingson, MPT, OCS

This blog post was written by faculty member Bridgid Ellingson, DPT, MPT, OCS, BCB-PMD. Bridgid is a private practice owner in the Chicago area and she is an instructor for the Institute's pelvic floor course series Level 2B course.


For years I resisted taking a physical therapy student into my clinic for their final rotation.  The traditional physical therapy curriculum does not adequately prepare a student for the experience and I do not believe that physical therapy for the pelvic floor is entry level work.  However, I recently had a particularly motivated student convince me to give it a try and I’d like to share my experience to help prepare other clinicians interested in taking students. 

 


Mar 19, 2014

As rehabilitation providers move towards primary care for musculoskeletal dysfunction, the privileges bring responsibilities. Regardless of our level of training and degree attainment, screening for underlying medical conditions is at the forefront of our work at all times. During the postpartum period, it is understandable that a new mother may report fatigue, aches and pains, as she tends first to the needs of her newborn. Many pelvic rehabilitation providers love working with new mothers because we have such a powerful opportunity to serve, support, educate, and nurture our patients. 

 

 

One important health risk to keep in mind in the postpartum period is blood clots, or thrombosis. Changes in a woman's physiology during the peripartum period alter her risk factors for experiencing blood clots, a topic that is discussed in our pregnancy and postpartum courses.  A deep vein thrombosis, or DVT, often occurs in the calf area, but the upper extremity can also develop clots. While local injury can result from a DVT, a major risk of a DVT is the progression to a pulmonary embolism, when a blood clot travels through the blood stream to the lungs- this is a life threatening condition. An article in the New England Journal of Medicine reports that the most significant risk period is within the 6 weeks postpartum. Let's get to the heart of this issue: how do we screen for a DVT or pulmonary embolism?

 


Mar 18, 2014

Pop Quiz

 

  1. Can a pelvic rehabilitation provider help a male patient who has erectile dysfunction (ED)?
  2. Is there research to support a claim that rehab helps with ED?
  3. Are there any medical conditions a pelvic rehab provider should suspect when a patient complains of ED?
  4. Are there any screening tests a pelvic rehab provider can complete to rule out medical causes of ED?
  5. Are there any pelvic rehabilitation courses that discuss ED in men? 
  6.  

     

 

If you answered "yes" to all of the above questions, well done. A pelvic rehabilitation provider can indeed help a patient who presents with complaints of erectile dysfunction, and the highest level of evidence (randomized, controlled clinical trial) has been completed to support this claim. Medically, a patient with ED may be suffering from heart disease, diabetes, metabolic syndrome, or even multiple sclerosis and should be screened by a medical provider prior to working with a pelvic rehabilitation provider. Skilled listening, and screening tests such as blood pressure, balance, and medication screening can be utilized in the clinic to alert the therapist to a medical issue.


Mar 17, 2014

Jenni Gabelsberg  DPT, MSc, MTC

This blog was written by H&W faculty member Jenni Gabelsberg DPT, MSc, MTC, WCS, BCB-PMD. You can catch Jenni teaching Care of the Postpartum Patient later this month in Oakland, CA.

 

Physical Therapists specializing in Women’s Health are in a unique position to help guide and inspire women during their perinatal years, affecting both the health of the woman, as well as the long-term health of any unborn children.

 


Mar 14, 2014

A recent article titled "Pain, Catastrophizing, and Depression in Chronic Prostatitis/Chronic Pelvic Pain Syndrome" describes the variations in patient symptom report and perception of the condition. The article describes the  evidence-based links between chronic pelvic pain and anxiety, depression, and stress, and highlights the important role that coping mechanisms have in reported pain and quality of life levels. One of the ways in which a provider can assist in patient perception of health or lack thereof is to provide current information about the condition, instruct the patient in pathways for healing, and provide specific care that aims to alleviate concurrent neuromusculoskeletal dysfunction. 

 

 

Most pelvic rehabilitation providers will have graduated from training without being informed about chronic pelvic pain syndromes. And as most pelvic rehabilitation providers receive their pelvic health knowledge from continuing education courses, unless a therapist has attended coursework specifically about male patients, the awareness of male pelvic dysfunctions remains low. If you are interested in learning about male pelvic health issues, the Institute introduces participants to male pelvic health in the Level 2A series course. The practitioner who would like more information about male patients can attend the Male Pelvic Floor Function, Dysfunction, and Treatment course that is offered in Torrance, CA at the end of this month.

 


Mar 13, 2014

 

 

Tracy M. Spitznagle

This blog was written by H&W instructor, Tracy Spitznagle,PT, DPT, MHS, who instructs the Movement Systems Approach course with Herman & Wallace. You can catch Tracy in the next offering of her course, April 12-13 in Houston, TX

 


Mar 10, 2014

Does wearing a pelvic belt affect the activation of the gluteus maximus and gluteus medius muscles in healthy males? Recent research asked this question, and the results, although difficult to extrapolate to other patient populations, are interesting. Surface electromyography (sEMG) amplitude was measured in 20 male patients during 6 exercises, and the amplitude during the exercise was compared to a maximum voluntary contraction. The findings demonstrated that muscle activation increased in the gluteus maximus when a pelvic belt was worn. Activation in the gluteus medius was unchanged for all exercise except during the clam exercise when the gluteus medius was noted to be more active. 

 

 

Mean age in the study was 23 years, and all participants reported a lack of disease or injury. All were able to complete the exercises without pain. The 6 exercises that were instructed by an experienced physical therapist included hip clam, side lying hip abduction, single limb squat, single limb deadlift, frontal planar lunge, and frontal planar hop. Each exercise was performed 3 times, the order of exercise was randomized, and the dominant limb was used. 

 


Upcoming Continuing Education Courses

Pelvic Floor Level 1 - Durham, NC (SOLD OUT)
Apr 25, 2014 - Apr 27, 2014
Location: Duke University Medical Center

Myofascial Release for Pelvic Dysfunction - Portland, OR
Apr 25, 2014 - Apr 27, 2014
Location: Legacy Meridian Park Medical Center

Finding the Driver in Pelvic Pain - Milwaukee, WI
May 01, 2014 - May 03, 2014
Location: Marquette University

Visceral Mobilization of the Urologic System - Winfield, IL
May 02, 2014 - May 04, 2014
Location: Central DuPage Hospital Conference Room

Rehabilitative Ultrasound Imaging: Women's Health and Orthopedic Topics - Seattle, WA
May 03, 2014 - May 05, 2014
Location: Swedish Hospital - Issaquah campus

Rehabilitative Ultrasound Imaging Orthopedic Topics - Seattle, WA
May 03, 2014 - May 04, 2014
Location: Swedish Hospital - Issaquah campus

Pelvic Floor Level 1 - Scottsdale, AZ (SOLD OUT)
May 16, 2014 - May 18, 2014
Location: Womens Center for Wellness and Rehabilitation

Pelvic Floor Level 2A - Maywood, IL (SOLD OUT!)
May 16, 2014 - May 18, 2014
Location: Loyola University Stritch School of Medicine

Pelvic Floor Level 3 - San Diego, CA
May 30, 2014 - Jun 01, 2014
Location: FunctionSmart Physical Therapy

Pelvic Floor Level 1 - Arlington, VA (SOLD OUT)
Jun 06, 2014 - Jun 08, 2014
Location: Virginia Hospital Center

Care of the Postpartum Patient - Houston, TX
Jun 07, 2014 - Jun 08, 2014
Location: Texas Children’s Hospital

Bowel Pathology and Function - Minneapolis, MN
Jun 07, 2014 - Jun 08, 2014
Location: Park Nicollet Clinic--St. Louis Park

Oncology and the Female Pelvic Floor - Orlando, FL
Jun 21, 2014 - Jun 22, 2014
Location: Florida Hospital Sports Medicine and Rehabilitation

Myofascial Release for Pelvic Dysfunction - Dayton, OH
Jun 22, 2014 - Jun 23, 2014
Location: Southview Hospital

Pelvic Floor Level 2A - Derby, CT
Jun 27, 2014 - Jun 29, 2014
Location: Griffin Hospital