Aparna Rajagopal, PT, MHS, WCS, PRPC, Capp-OB Certified is the lead therapist at Henry Ford Macomb Hospital's pelvic dysfunction program, where she treats pelvic rehab patients and consults with the sports therapy team. Her interest in treating peripartum patients and athletes allowed her to recognize the role that breathing plays in pelvic dysfunction.
Leeann Taptich DPT, SCS, MTC, CSCS leads the Sports Physical Therapy team at Henry Ford Macomb Hospital where she mentors a team of therapists. She also works very closely with the pelvic team at the hospital which gives her a very unique perspective of the athlete.
Aparna and Leeann co-authored the course, Breathing and the Diaphragm: Pelvic and Orthopedic Therapists, which helps clinicians understand breathing mechanics and their relationship to the pelvic floor.
Abdominal bloating and distension are two very commonly reported GI symptoms in the pelvic practice setting. However, these symptoms are not commonly recognized in other physical therapy settings. While many people experience occasional bloating/discomfort it does not necessitate medical intervention, but repeated and long-standing bloating/distention can impact the quality of life.
One diagnosis which is associated with these symptoms is Abdomino-Phrenic dyssynergia where patients develop a paradoxical abdomino-phrenic response. Normally, as a response to an increase in intraluminal gas, the diaphragm relaxes, and the abdominal musculature contracts. When dyssynergia is present, the opposite happens and the diaphragm contracts, and the abdominals relax. Abnormal pelvic floor function is also associated with this diagnosis. Treatments typically used are biofeedback therapy and breathing techniques.
Where Leeann and I work, we are seeing patients increasingly referred with this diagnosis. Recently we treated a 72-year-old female patient with a long-standing history of troublesome bloating and distention, with the diagnosis of Abdomino phrenic dyssynergia.
Upon examination, amongst other findings, the patient demonstrated:
In addition to biofeedback and visceral mobilizations, treatment techniques included joint mobility techniques inclusive of simple rib and thoracic spine mobilizations, soft tissue mobility techniques including gentle diaphragm releases, breath training, and breathing techniques to aid in pelvic floor relaxation.
The patient received 9 treatment sessions and a home maintenance program which she followed with good compliance. She reported a 70% overall improvement and was now able to sleep through the night and eat in the evenings without discomfort.
In our course, Breathing and the Diaphragm: Pelvic and Orthopedic Therapists, you will learn:
Description: This remote course is an integrated approach where participants will learn how the diaphragm, breathing, and the abdominals can affect core and postural stability through intra-abdominal pressure changes while looking at structures from the glottis and the cervical region to the pelvic floor.
This course includes assessment and treatment of the barriers by addressing thoracic spine articulation and rib cage abnormalities in the fascial system of muscles related to breathing and the diaphragm. Instructed techniques are applicable to patients who present with Diastasis Rectus Abdominis, pelvic pain, incontinence, and prolapse, as well as cervical, thoracic, scapular, and lumbar pain.