What is perineal spray?

Perineal spray is traditionally a herbal solution used to help ease prenatal and postpartum discomfort. It can be used during pregnancy and after childbirth Formulated with natural herbal ingredients, including astringent witch hazel, antibacterial lavender, and cooling peppermint pure essential oil.

The perineum is the area between the vagina (birth canal) and the anus (rear end opening). In the first few weeks after childbirth, you will probably have soreness or pain in your perineum. You will also have discharge coming out of your vagina.

What is perineal spray used for?

Cooling perineal mist with herbs traditionally used to helps ease prenatal and postpartum discomfort during pregnancy and after childbirth. Formulated with natural herbal ingredients, including astringent witch hazel, antibacterial lavender, and cooling peppermint pure essential oil.

How do you make perineum spray?

How do I clean my perineum after giving birth?

How do you make postpartum spray?

Why You Need Physical Therapy During and After Pregnancy

Why You Need Physical Therapy During and After Pregnancy lake city physical therapy

The challenges of pregnancy on a women are unique to her and often come with minimal understanding. In a recent study of 569 women, it was estimated that 42% of women will have low back pain and 34% will have some type health d pelvic girdle pain.

That alone points to the need for physical therapy interventions at an early time frame. Evidence also suggested however that these physical changes will most likely begin to occur by week 15 during pregnancy.

Knowing the signs to look for and understanding that early intervention is highly successful is key to a women’s long-term health. Prevention is paramount to attaining and maintaining your physical health during and after baby.

These are some of the most common physical signs and changes that need your attention and intervention before and after baby. It doesn’t matter how long it’s been since your baby, check to see if you have any of them.

1. Low back pain

It is the most common pain women describe during pregnancy and after her baby is born. The increased structural load to the system disrupts normal upright posture and this strains the back. Also due to so many hormonal changes a women becomes exhausted and fatigued as she is often not sleeping well at night either, especially if she is breast feeding.

A Coccyx strain with resulting pain can often occur as well during pregnancy due to the heavy load in the floor, but it is esp common during labor and delivery when prolonged pushing occurs, especially with bigger babies and can occur also with fast childbirth experiences where the transition happens quickly. Often when this occurs, women are unable to sit very well, go from a sit to stand position without pain or they are unable to do prolonged standing due to pain there. This can occur acutely after delivery or can last for years if the coccyx had a severe trauma to it.

2. Pelvic girdle or pelvic floor pain

This is the second most common complaint. The pubic symphysis is at the front of the pelvic girdle snd it separates due to the hormone relaxin to make room for the growing baby and to prepare for delivery.

The Sacro-iliac joint in the back of the pelvis has large ligaments that will often soften as well due to increased hormones and the sacrum and ilium will often become unstable esp during walking, rolling over in bed and with sit to stand. Often during pregnancy a pelvic girdle belt is needed if the instability is interrupting your normal lifestyle at home and work. Tight hip muscles can also be the culprit as well so these need to be addressed as well.

3. Abdominal weakness

The abdominal muscles are one of the 4 pillars of the “core” muscles ans without them functioning well we are unselect I love well. It is possible that a diastasis Rectus can occur due to the hormone changes as these hormones create laxity of the abdominal tissue.

There is also the possibility of an abdominal hernia due to weakening of the tissue. This can look like a vine shaped structure or a pooching of tissue that occurs with movement.
A C-section scar line can disrupt abdominal function as well, creating a downward pull on abdominal muscles, instead of upward lift. Scar tissue needs to be addressed and mobilized after labor and delivery to restore normal movement patterns in the core trunk especially.

4. Diaphragmatic breathing issues

As the baby is growing the ability to do deep breathing due is limited due to the abdominal and pelvic cavity space constraints. We need our ability to breath deeply even during pregnancy as the the diaphragm and the pelvic floor work together in the core. If the diaphragm dies not work properly neither will the pelvic floor.

They are directly related if one is strong they both are strong if one is weak they both are weak.
Often as baby grows we tend to breath up high only in the chest and neck region. This tends to create tightness in our neck and chest wall. Learn to breath down into your lower lateral ribs and use your hand over this area of your ribs to feel the air expanding your ribs there with your breath.

5. Pelvic Floor Trauma during pregnancy and or during labor and delivery

If you have had to have an episiotomy, forcep and/or vacuum assisted labor and delivery it is evidenced that this alone can disrupt the floors neural and muscular integrity. Please have your pelvic floor checked to ensure that it’s muscles are functioning properly.

Large babies, excessive hormones that cause decreased peristalsis and straining during bowel movements along with excessive pushing during labor and delivery can cause external and internal hemorrhoids and bowel constipation. During pregnancy drink more water and eat more soluble fiber to help. Exercise increases blood flow and decreases constipation.

Pudendal nerve irritation or damage can occur as well during pregnancy or following baby due to pressure and compression on the nerve directly, tightening of muscles and/or fascial tissue in the region due to body changes, decreased blood flow to region due to baby size and sustained pressure or trauma during labor and delivery on the nerve itself. Numbness and tingling or poor sensation in the pelvic floor itself can occur. This needs to be addressed quickly to avoid long term damage.

6. Urinary incontinence

This happens often as the baby is growing during pregnancy because the pressure is increasing in the abdominal cavity. Leaking is the most common with activities where there in a quick change of position. This means the front part of the floor is weak and not communicating with the abdominal and other “core” muscles correctly. This should be addressed quickly during pregnancy and afterwards to mitigate long-term health issues.

7. Hip and knee pain

Due to the increased structural load to the hips and knees during pregnancy, along with the increase in hormones, the ligaments and cartilage of the hips and knees soften and are more lax overall. This causes pain with squatting, stooping, descending stairs, kneeling and athletic activities. Often the hip flexors and piriformis are too tight along with the IT band and the antagonist muscles are too weak and need to be strengthened.

8. Pelvic Organ Prolapse

This occurs when the pelvic floor muscles and the surrounding fascial and connective tissue become weakened during pregnancy and then can become damaged during labor and delivery if there is sustained pushing that occurs. The Pelvic organs will fall down inferiorly and begin to push into the vaginal canal. The bladder and the rectum due this most commonly, but there can be vaginal or urethral tube dropping as well. Your OB/ GYN most often will use Grades 1-4 to describe these changes and physical therapy intervention is needed immediately if you are a Grade 1 and 2. Often if you are a three or higher surgical intervention is necessary.

9. Emotional changes

The flood of hormones for a women can cause many feelings during pregnancy and particularly afterwards. The brains system is being rewired and this is the time to ask for help from your loved ones. Please do not do this time alone. Enlist family, friends and care givers such as doulas etc to be part of your tribe. Depression, anxiety and the “baby blues” are real things and need to be addressed, quickly. Please ask for help! We are here for you as a Support in motherhood.

10. Neck, upper back and shoulder pain along with carpal tunnel

During pregnancy the physical changes in the abdomen and pelvic region directly affect the rest of the spine. Due to the instability that often occurs in the low back and pelvic girdle, the upper back, neck and shoulders often become stiff and the muscles tighten in response. The neck, upper back and shoulders muscles will need daily stretching. Cat and cow, neck rotation with chin nods and child pose with side bending and rotation reach can help.
Excess fluid retention can cause swelling around the carpal nerve and compress it in the tunnel thereby increasing numbness and tingling. Often this occurs at night while sleeping, but some women will have it t/o the day as well. Stretching these areas is important t/o these time frames, as well as strengthening the core postural muscles.

11. Abdominal bloating, swelling in the legs and arms and varicose veins

Changes in the vascular system is immense during pregnancy and the system then has to adapt after baby as well. Make sure to exercise daily, walking is esp beneficial to keep the system working correctly and to minimize the likelihood of excess swelling t/o the body. Also daily strengthening exercises activates the muscle pump around the blood vessels and this facilitates vascular health.

12. Breast Mastitis

This can occur whether you breast feed or not. It’s most common during breast feeding when a milk duct becomes clogged. Infection can then set in in the breast and it will become red, hot and swollen and lumps will often occur. See your MD immediately as you will need antibiotics if you have a fever.

Please come see us during pregnancy and afterwards as we specialize in women’s health.

Sheree DiBiase, PT is the owner of Lake City Physical Therapy and she and her incredible staff look forward to taking care of you during and after baby. It’s never to late to make a change. Please come see us at our Hayden (208)762-2100, Cda (208)667-1988, Post Falls (208) 457-3435, Spokane Valley (509)891-2623.

Physical Therapy for Endometriosis: Our Six Step Program

Endometrics physical therapy Lake City Physical Therapy

Endometriosis is one of the most misunderstood health conditions for women. Endometriosis affects 1 in 10 women and can often be extremely debilitating. Endometriosis can occur inside the uterus and this is called adenomyosis and it can occur outside the uterus in the pelvic, abdominal or thoracic cavity. It can cause 50% of all infertility, as it can grow on, around and inside the Fallopian tubes and ovaries. It can affect a women’s daily well being due to pain and the disruption of her active lifestyle.

Physical therapy is an integral part of Endometriosis care. Physical therapy addresses the need for your active lifestyle to be restored and assists you with the appropriate skills, tools and understanding to provide you with the life you desire.

When Should I Start Physical Therapy For Endo

Physical therapy is often done before endometrial surgery and then can start as early as two weeks after endometrial surgery. Excisional surgery will remove the Endometriosis at the root of its issue. It is different from ablation surgery, as ablation merely burns the surface structures and can often cause scarring according to leading Endometriosis physicians. This is why so many women have had multiple ablation surgeries without lasting results.

Physical therapy’s intervention includes a multimodal approach due to varied health issues that might occur due to Endometriosis. Many other health issues such as Interstitial Cystitis, Irritable Bowel Syndrome, Polycystic Ovarian Syndrome, Mental health issues such as depression and anxiety.

Our six step Endometriosis Care program assists women is restoring their healthy lifestyle. This takes time, as many of our women have had endometriosis since they started their period and some even before that. A women whose mother had endometriosis is 7x’s more likely to get endometriosis herself. So this endometrial growth may have been there for a long time affecting their overall health.

Six Step Endometriosis Physical Therapy Care Program

1) Reduce Pelvic Congestion – this is bloating and pressure that can occur in the pelvic and abdominal region. The pelvic girdle contains the pelvic organs, which are the bladder, vagina, uterus ovaries, Fallopian tubes and rectum. Due to constant pain and pressure to the muscles and nerves in this region, inflammation occurs and collects and then overloads the lymph system. The lymph system removes all the waste products. There are a lot of waste byproducts in Endometriosis as there is no where for the Endometrial tissue-outside the uterus to drain, so it collects in the cavity. Ninety percent of all serotonin, our “happy juice” for the brain, is made in the gut tract. The gut tract is unhappy and the brain can then experience anxiety and depression as part of Endometriosis.

2) Release Short Tight Muscles – (this occurs often due to constant or intermittent pain) in the hips, back and pelvic floor muscles. Many people think it’s their ovaries that are painful, when really it is their muscles that are spasmed and cramped. We start many of our women with nightly propping where we have them lay on their back with their feet and pelvis up on pillows to tilt their pelvis backward for 20-30 mins every night before bed. We then teach them a diaphragmatic breathing technique because the floor is at rest when tilted up in this manner and upon inhalation of air with the breath, the floor can let go of its short tight muscles.

3) Strength – weakness often occurs in response to pain because we stop exercising and doing the activities we use to love. This is a natural response but physical therapy will educate you and teach you what is safe and how to start slowly for good results and restoration to full activities.

4) Neural Relaxation – down regulation of the peripheral nerves and the central nervous system, which is our brain is needed. This is a life long skill set all of us need to be able to handle life’s stressors. Our Autonomic Nervous System Sympathetic often gets “up regulated” or turned on too high, in response to pain and muscles that are too tight and too short. This over excitability needs to get turned down before and after surgery.

5) Mobility of Skin, Myofascial and Visceral tissue – during all of our daily movements the layers of our skin, myofascia around our muscles, nerves and vascular system, and our visceral organs in our abdominal and pelvic cavity, regardless of how many surgeries or Csections we have had, need to be free to move. These layers of tissue in Endometriosis are often scarred down and these adhesions or restrictions can cause pain patterns throughout the body. It’s like getting a snag in your sweater and it pulls at the whole garment.
The physical therapist will be trained in these hands on skills and can release and create mobility in these layers as you move.

6) Education and training – on how the bladder, bowel and sexual health can be affected due to Endometriosis. Learning skills and techniques to make these important activities happen correctly and without pain.

Come To Our Endometriosis Support Group

Endometriosis is a complex disease process and patience and a team of providers is needed as their may be other health challenges that need to be addressed as well.

At Lake City Physical Therapy we believe women with Endometriosis need a place to be taken care of, with education and resources to have a desired quality of life. Education is power and makes for a fulfilled life.

Join our Endometriosis Support Group 1 x a month.

Lake City PT Endometriosis Support Group

lake city physical therapy sheree dibiaseSheree DiBiase, PT is the owner of Lake City Physical Therapy and she and her incredible staff can help you on your journey. Hayden office (208) 762-2100, CDA (208) 667-1988, Spokane Valley (509)891-2623.

Pelvic Floor Exercises: Hula Hoops Encouraged

Pelvic Floor Exercises- Hula Hoops Encouraged lake city pt sheree dibiase

I always thought the hula-hoop was a fun thing to do when I was a kid, along with hopscotch and jump rope competitions in our neighborhood and at school. We would play for hours and would always have a new twist to the game. I never remember being sore or tired from playing all these games, and I never remember having any back pain. I mean, we never even thought of going to the gym to work out or taking a fitness class: we just played outside everyday, and that was just our lifestyle.

Now our lives are just so busy that we forget to have physical activity be part of our everyday lifestyle, so we need things that are easy, quick and fun. The core muscles of the trunk are essential to what we need to be well, and you can’t forget what Janet A. Hulme, MA, PT, describes as the Pelvic Rotator Cuff, which stabilizes the back, facilitates balance, and maintains bladder and bowel health, along with the internal abdominal organs. This area includes the pelvic floor and the hip muscles: specifically the muscles that do rotatory work patterns during ambulation.


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Pelvic Floor Exercises: Rotation

Rotation is the most important workout pattern for this region and the most challenging of all. Unfortunately, it is usually the last one to be done. When we train, we often train in the sagittal and frontal planes and forget about the rotational or transverse plane.

This plane is where all the pelvic rotator cuff muscles really work well. Often it is not that we are so weak in this region: it is that we have lost the muscle control patterns that make the motions occur with ease and fluidity.

Muscle control issues are different than muscle weakness issues. Muscle control happens with practice and repetitive activities. There has to be a rhythmical balance of rest and work cycles. These muscles do not work alone but in synergy in order to have reflexive action for continence, support for the abdominal organs, stability for the lumbo-pelvic and sacro-iliac region, and balance for standing and walking.

Easy Pelvic Floor Exercises

One of the easiest exercises to begin with is standing figure eights of the pelvis region. It is a fabulous starting point to train in the transverse plane with a rhythmical pattern for pelvic girdle strength. In the standing position, you start with a slightly bent knee and rock and roll the hips in a figure eight pattern. Begin with 10 reps to the right and then 10 reps to the left, then alternate one to the right and one to the left 10 times. It takes concentration and slow control movements at first to do it; after a while, you can pick up the speed.

It’s quite an incredible tool to keep the low back, pelvic floor and hip motor control patterns working well. Your balance and ambulation will improve as well, along with keeping your bowel and bladder function regular. So start with figure eights and then see your physical therapist to begin a good progression for lower core trunk health. Your bloated tummy and your back will thank you.

lake city physical therapy sheree dibiaseSheree DiBiase, PT, and her staff can be reached at Lake City Physical Therapy in Coeur d’Alene at (208) 667-1988, Hayden and in the Spokane Valley at (509) 891-2623 for a full evaluation of your core trunk health.

Belly After Baby: How to Reclaim Stomach Tone After a DRA

Belly After Baby diastasis recti repair

Cyndy would have never thought that her belly could stretch and a baby could grow that big over 38 weeks. She was amazed what her body did, and with such brilliance that a beautiful baby was born. What she couldn’t imagine now, however, was that her “poochy ” belly wouldn’t go away like she thought it would, and every time she moved it would stick out instead of go in. She became worried and frustrated. She had always had a tight tummy and now she felt like she wasn’t herself.

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Stomach After Baby: Why The Belly “Pooches”

So much change happens to our belly during this time frame and the four layers of our abdominals go through a lot of changes. The rectus abdominus muscles, also known as our “six pack”, really take a hit and a significant amount of women develop something called a diastasis rectus abdominis (DRA). This occurs when the abdominal raphe (linea alba, linea semiluniaris) — which is the connective tissue that connects the right and left side of your “six pack” and runs all the way from your xiphoid process to pubic symphysis bone — splits, separates or thins.

Most often it is due to the extra load that is placed on the structures as the baby is growing, but sometimes it is due to overtraining of the abdominal muscles, gaining weight rapidly over a short period of time, or lifting heavy weight repeatedly at home or work. This separation is considered significant when it is over two fingers in width upon examination.

Diane Lee, a physiotherapist in Canada, reported in a 2013 study of the DRA, that 100 percent of the women she examined who were in their third trimester of their pregnancy, had a DRA present. Another study reported that at 8 weeks postpartum, if the DRA was still present, there was a likelihood it would be exactly the same at one year after having your baby. That alone is an incredible reason to know what you need to do to retrain these muscles safely and efficiently after pregnancy, so as not to harm the core trunk muscles’ ability to function long term.

Diastasis Recti Test: How to Check For a DRA at Home

To check yourself for a DRA, lay on your back and lay your fingers above and below your belly button region at midline. This will be where the raphe is located. Then gently lift your head only up, as if to begin a traditional sit-up. Feel for any space present between the recti muscles. This space should be under two fingers breadth in width. I have also had patients who had no split present with the head lift, but as soon as I had them lift both of their legs off the floor, the DRA appeared. So check each way to be sure.

Often if you have a DRA, the belly looks like you have a “pooch or dome” present along the midline of the “six pack.” This weakened area needs to be retrained via the muscles and fascial component. Please avoid traditional sit-ups, crunches, traditional twist sit-ups or bilateral leg lifts to the “V” sit-ups. These exercises will only further disrupt the health of the DRA and will not reestablish the motor and neural control patterns needed.

So, at six weeks after having your baby (and once you have been released from your MD), it is time to see your Women’s Health physical therapist. Your physical therapist will do an evaluation to determine how well the four layers of your abdominal muscles are functioning and if you have a DRA.

It is common for you to still have a DRA at this time, but what you do during this next time frame is pivotal in the long term health of your abdominal muscles, your bladder, pelvic floor, back and hips. The muscles in these regions all work together, so if you do not correct the DRA, you could possibly have issues in these areas for years to come. Even if your children are older, it is never too late to try to resolve the belly after baby problems.

Learn more about pelvic floor physical therapy on our services page.

Have questions? Contact us.



lake city physical therapy sheree dibiaseSheree DiBiase, PT, is the owner of Lake City Physical Therapy and she has a provisional teacher certification in Positive Pregnancy, Parenting and Fitness rehab. She and her staff are happy to help you restore your health after baby, whether it’s been two years or twenty years ago. It’s never too late for your health. Coeur d’Alene office (208) 667-1988, Spokane Valley office (509) 891-2623, Hayden office (208) 762-2100.

Baby Body Goodbyes: Babes With Babies

Baby Body Goodbyes lake city pt

To me there is nothing as special as a new born baby. Mom and Dad and all the family wait for nine months to snuggle, love and coo over this precious wonder. The Momma is especially attached to her baby due to all the hormones her body produces to grow the baby and then deliver the small, little wonder.

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Settling Into Your Postpartum Body

Years ago when I had my first son, I got to experience this amazing feat called delivery. I had so many good intentions of natural childbirth and an easy delivery, unfortunately, that was not the case for me. My first baby was three days late and was 9 pounds, 3 and one-half ounces and 21 and three-fourths inches long. He was a big baby, too big for me. Nonetheless he came in to the world in the regular way. Little did I know all the joy and body changes he would provide.

Childbirth is an life changing event. It brings the love and laughter of a newborn and the sculpting of a woman’s body in a whole new way. Because of all of the changes a woman’s body experiences, she now must learn to live with a new set of bodily issues. There may be stretch marks, scar tissue where the episiotomy was located, a bladder that leaks when she coughs, laughs or jumps too much, abnormal bowel movements or painful sex.

The once tiny figure of pre-children is gone, replaced with hips that are rounder, legs that are fuller and breasts that are tender. Oh my, what’s a new mother to do? Good thing the baby is so incredible, because a woman might think twice about having such a precious wonder.

Women’s Health Physical Therapy  Helps Your Postpartum Body

Women’s health physical therapy is your what help you get your pelvic floor tuned. It’s a combination of manual therapy, muscle strengthening machines and exercises. As soon as you are six weeks postpartum, come quickly in for your baseline visit. Research indicates that this is the time to prevent long-term issues with the important parts of your pelvic floor. No I’m not talking about Kegel exercises or tummy crunches. I am talking about a thorough assessment of the important functions of your floor.

Is your bladder working right or is it painful? Are you regular with your bowels or do you have to push excessively? Have you been avoiding sex after the six weeks are up because it hurts too much? All of these things are what the pelvic floor is a part of, and this is the prime time to make sure you stay healthy down under.

I know it sounds scary and you might want to just ignore it, but believe me, you need to pay attention to it. Babies bring life changes, but we are here to help you stay the babe that you have always been.

Have questions? Ask us with the contact form below.

Contact Us Physical Therapy

lake city physical therapy sheree dibiaseSheree DiBiase, PT, is the owner of Lake City Physical Therapy, and she her staff want to see you after your six-week post baby for your baseline assessment of your health. Your body needs us. Coeur d’Alene office (208) 667-1988 and Spokane Valley (509) 891-2623.

Pelvic Floor Incontinence: Your Guide To Reclaiming Bladder Control

Pelvic Floor Incontinence physical therapy lake city pt

I know it’s not something we want to talk about, but sometimes post-surgery, after having a baby, or as we age, we might have trouble with bladder control. Maybe you are trying to get discharged from the hospital after surgery, laughing with your friends, or trying to climb the steps to your front door when all of a sudden, your bladder doesn’t want to work right.

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What Is Urinary Incontinence

Urinary incontinence is the most common type of bladder issue. It is described as an involuntary leakage of the urine. There are two primary types of urinary incontinence: stress and urge (overactive bladder) incontinence. There are other types of bladder issues that may involve the bladder – cystitis (an inflammation of the lining of the bladder), urinary retention, infection, or pain that’s related to other health issues – that can affect the bladders health, too.

Stress incontinence usually happens when people laugh, sneeze or cough. It may occur with certain exercises like jumping or running, or with any increase in abdominal pressure. Often it is the muscles of the pelvic region that are the problem with stress incontinence, or problems with the muscles in the bladder itself. The bladder often drops down due to the weakened muscles, and then the urethra does not close completely. Other changes can happen with pregnancy, during childbirth, menstruation and menopause, or due to certain surgical interventions.

Urge incontinence happens when your bladder contracts involuntarily – often at the sign of a “trigger” – and releases urine. It often occurs when the nerves are somehow affected, like after surgery, or with irritation to the nervous tissue as with an enlarged prostate, where the nerve is compromised.

Many times, we think there is nothing that can be done for these types of issues. That can’t be further from the truth. Your doctor/urologist and then your physical therapist can be of great benefit. The doctor will diagnosis what the issue is, and then a physical therapist who specializes in this type of care will do an extensive evaluation to help you regain control of your symptoms and reduce the need for the daily use of your pads, medications and possible surgery.

How Does Physical Therapy Help With Leaky Bladder

The physical therapist will show you how to utilize the right muscles and facilitate those muscles in the correct patterns. The pelvic floor muscles strengthen the muscles that surround the bladder so you can control the bladder better. These exercises include the “Kegel” exercises, but are not limited to them. You want to include exercises for the buttocks, thighs and stomach as well so they can support proper bladder function. We often use Biofeedback to ensure that the right muscles are firing, and electrical stimulation to facilitate the pattern of those muscles firing.

Your physical therapist can help you with information about your diet and nutrition, and identify the food and drink that may be irritating your bladder. It is evidenced that certain behaviors make symptoms worse; there are ways to decrease the urinary urge and frequency by changing these behaviors.

The more knowledge you have regarding this, the better. So don’t suffer and be afraid to laugh, run across the street or leave your house. Visit your doctor and then see your physical therapist.

Need pelvic floor physical therapy to help incontinence? Well help you get a referral from you doctor. Use the form below or call (509) 891-2623

Contact Us Physical Therapy

lake city physical therapy sheree dibiaseSheree DiBiase, PT, is the owner of Lake City Physical Therapy. She and her staff can be reached in Coeur d’Alene at (208) 667-1988 and in the Spokane Valley at (509) 891-2623. We are trained in the care of incontinence, and want you to live a full life.

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All About Pelvic Health: It’s A Lot More Than Kegels

All About Pelvic Health lake city pt sheree dibiase pt

Kegel mania started years ago. In fact most of the women I know have heard about Kegel exercises, even if they don’t really understand them or know how to do them very well. Often women will say, “I think I’m doing it right, but I’m really not sure.”

It hit such a craze for a while that now we have many women that have made their pelvic floor so tight that their muscles in their floor are spasmed and painful with intercourse, or their bladder or bowels don’t void or evacuate very well. And then other women seem to have no muscle tone in the floor at all, and are frustrated with their lack of understanding of how to control the floor.


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The History of the Kegel

Dr. Arnold Kegel was an American gynecologist who researched and studied the effects of the pelvic floor muscles on women’s’ health. He realized that many of these muscles were weakened after childbirth, and that it was important to restore their health as they are directly responsible for supporting the bladder, uterus and bowels.

He noted that when these muscles were strained, women would often experience urinary incontinence (leaking of the bladder), vaginal pain and dysfunction, or vaginal prolapse — where the bowel or bladder would fall into the vaginal cavity.

He published a study in 1942, after 18 years of research, that described a non-surgical approach to increasing the tone of these pelvic floor sphincters and their supporting structures. He espoused the idea that the pelvic floor muscles could be exercised like any other muscles in the body, and the Kegel exercise was therefore named after him.

Pelvic Floor Muscles Explained

The pelvic floor is made up of layers of superficial and deep muscles that go from the pubic bone to the “sitter”bones to the tailbone. They are a sophisticated set of muscles that control different activities in different layers and they then work in concert together to provide support to the organs above them.

The floor works rhythmically when we breathe with the diaphragm muscle, like a piston moving up and down all day long. It elongates when breathing in and shortens on exhalation. Dr Kegel stated in his research that these muscles were “the most versatile in the human body and could still be strengthened after years of disuse.”

The most common use of the Kegel exercise was used with urinary incontinence. Urinary Incontinence can come in different forms, and is often related to pelvic floor weakness or poor motor and sensory patterns of control. There can be urge incontinence, stress incontinence or a mixture of the two.

The Pelvic Floor & Incontinence

Urge incontinence, sometimes called overactive bladder, occurs when you suddenly have an intense urge to void, and before you have time to get up to go, you void. Stress incontinence occurs when you exert a pressure on the bladder, like when you sneeze, cough, laugh, lift something heavy or jump on the trampoline with your kids.

Physical therapy is prescribed for both of these types of incontinence and good restoration of the pelvic floor muscles can occur in 1-3 months with the use of specific exercises, neuromuscular stimulation and biofeedback training for the floor.

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Kegels Don’t Solve All Pelvic Floor Problems

The interesting thing is that the Kegel exercise, which encouraged the patient to contract the floor muscles by stopping the flow of urine and holding the contraction, actually only targets a particular layer of the muscles that directly involve the bladder activity.

However, this exercise does not include the other necessary muscle cues to stimulate the entire floor to know how to contract, so all the layers of muscles know how to work together for the best floor health.

The muscles that attach to the pubic bones and the muscles of the deep layer are not being stimulated with this exercise, so there are exercises that are “Beyond the Kegel” that need to be done. Your Women’s Health Physical Therapist knows what these exercises are and how to cue you in learning these muscle contractions so the whole floor can have full restoration of function for good bladder, bowel and sexual health. It’s never too late to have a healthy pelvic floor, you just have to choose it.

Need pelvic floor physical therapy? Contact our team now.

lake city physical therapy sheree dibiaseAuthor Bio:

Sheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her staff can help you with your pelvic floor health. Call us for an appointment in our Coeur d’Alene office (208) 667-1988, in our Spokane Valley office (509) 891-2623 and in our new Hayden office beside Gourmet Way in the Hayden Creek Shopping center (208) 762-2100.

Pelvic Floor Weakness After Childbirth: After Baby Body Screening

Pelvic Floor Weakness After Childbirth lake city pt sheree dibiase

All I can remember is that feeling that came over me each time I looked into my brand new babies little faces. You can’t put it into words very well, but I felt my heart melt and my world change and I was suddenly fixated on my sweet little one and I forgot about anything that I might need for my own health.

New Moms have so many hormones that are circulating in their bodies and they are often so overwhelmed with their babies needs that they forget about what their post-pregnancy body needs.

So all you new Mommas with your sweet new babies, as soon as you are six weeks from your delivery date and you have already seen your MD for your final check-up, it is time for you to come to physical therapy for a post-partum physical health inventory check-up.

This is the time that you need to make sure everything is working well again in your back, trunk and pelvic floor muscles so your bowel, bladder and sexual function returns to normal. The muscles in your body take quite a hit with pregnancy and your physical therapist is the movement specialist for you following the after baby body.


3 Myths About The Pelvic Floor – Download Our FREE Ebook Now

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Symptoms of Pelvic Floor Problem After Pregnancy

Research indicates that at six weeks you need to begin training to insure that the pelvic floor muscles return to their normal level of function for good bladder control, bowel ability and optimal sexual health. A leaky bladder is a sure sign at 6 weeks post baby that your pelvic floor system is not working right. It is a sign that the core is not bouncing back as it should be and that the muscles are not firing correctly throughout the trunk and the pelvic floor.

Don’t be confused this is not a problem that just “goes away,” and often it is happening when we are laughing, coughing sneezing or participating in sport activities, like jumping running or having fun. Often times we don’t see people till years later and then the leaky bladder, which signifies a weak dysfunctional core, has changed a persons life in too many ways to count.

A Third of Active Women Have A Pelvic Floor Disorder

In 2002, Thyssen et al surveyed 291 elite women athletes who participated in all types of sports from basketball to ballet and questioned them about their urine loss when they were doing their sport or just in their daily activities. He found that 151 of the women reported urine loss and only 5 spoke to their medical provider about their problem. Then what was really bothersome to me was that only 6 people out of the 151 had pelvic floor training to get the muscles functioning correctly.

Wow, only 6 people knew that a physical therapist could help them with their leaky bladder and weak pelvic floor. That’s not a good statistic and that’s why we are talking about it today. You need to know its not going away unless you do something about it, and you need to know exactly what to do. Don’t be afraid to seek help and if you are told its normal, just know that it is not normal.

There is nothing normal about a leaky bladder, bowel constipation or painful sexual intercourse after having a baby or being an active Mom. So with that in mind, every Mom at six weeks should have a pelvic floor screening and begin the process of retraining no matter what. Please be proactive and do not suffer with these issues even if it has been years since you had your children. There is help for you and your after baby body!


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Sheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her staff can be reached in their Coeur d’Alene office at (208)667-1988 and in their Spokane Valley office at (509) 891-2623. Please call for an appointment to have a After Baby Body screening.

Women’s Entrepreneurship Day WEDO CDA/Spokane! 


This year the “Women’s Entrepreneurship Day” WEDO CDA/Spokane is taking place at a new venue.  North Idaho College (NIC)  is partnering with us to house a group of over 350 women and students at NIC this Friday night November 30, 2018 from 4:00-8: 30 pm, at Schuler Auditorium, with an after party at Vine and Olive in Riverstone.

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WEDO is a conference for women entrepreneurs, business owners, policy makers and women who desire to make changes for the good of their community and globally.  WEDO believes that when leaders grow, revenues grow, jobs are created, and lives are changed.  This is the mission of WEDO- to celebrate, empower and support women in business, to alleviate poverty in our local North Idaho and Eastern Washington communities as well as worldwide.

We are excited to be partnering with NIC in this endeavor, as NIC has recently won the “2018 Heather Sickle Entrepreneurial College of the Year” Award by the National Association for Community College Entrepreneurship (NACCE).Ryan Arnold is the Director of Regional Entrepreneurial Strategy at North Idaho College and he will be with us this Friday night to share how the college is responding entrepreneurially to change in our community.

NIC President, Rick MacLennan stated, “The heart of our work is developing our business and community relationships to help fuel the economic vitality of North Idaho. Creating relevant learning opportunities for our students in today’s ever-evolving economy”.  NIC has an Entrepreneurship Certificate program at the Center for Entrepreneurship on campus, learn more at www.nic.edu/venture.

There are still tickets available at WED CDA/Spokane Eventbrite for VIP and regular access.  There is special VIP early access for guests at the “Inner Circle” Reception with swag bags and a look at some special projects going on at NIC to facilitate forward thinkers and agents of change, at the local level. General tickets and reception starts a 5:00 pm and the event begins at 5:30 pm to 8:30 pm.  All students from NIC can get in free, but must register to do so.

The TEDx keynote speaker at this years WEDO night, is Rachel Strawther, Director of Leadership Training and Development at Gonzaga University’s School of Leadership Studies.  She designs and leads executive leadership programs on topics such as emotional intelligence, conflict resolution, innovation and interpersonal communication.

A few of her presentations were for organizations such as Boeing, Washington Agriculture, and the International Leadership Association. She is a powerful story-teller and she uses humor and candid antidotes to elevate leaders at all levels in their organizations.  Her topic is on “The Power of Shame” and how it shapes decisions we make everyday.

An exciting panel of speakers will be on hand again this year as well.  One of our topics is  “Does Entrepreneurship Create the Independence You Want”? with Michaela Corcoran-Hall, Rookie of Year, Top Female Agent at Caldwell Banker Schneidmiller Realty, Naomi Boutz, owner of Vine and Olive, Judge for Wine Press Northwest, and Evie Fatz, owner of EvieFatz.com, Contributor Editor INSIDER, Elite Daily, Prevention Magazines.  Moderated by Lacey Moen, Owner of the Earthly Beauty Bar.

Our own lead ambassador for WEDO CDA/Spokane and the reason we are in global partnership with this organization, is Latisha Taylor, CEO and Founder of HealthMeasured.net and she will be moderating the panel,   “Scale Our Business to New Heights”, with Linda Olson, Co-Founder of M+L Advisors, Kristin Ahmer, CEO/Founder Original Squeeze, Mandy Manning TEDx Speaker, Washington Teacher of the Year 2018, Allison Glasunow, Ph.D., Attorney Perkins Cole LLP and Tara Wear, Instructor Gonzaga University’s Women’s Leadership.

Globally, the WEDO organization held a United Nations Summit this month in New York City, where they had 75 underprivileged girls attend the conference and where they gave out 1,000 micro-loans to help new women in business start their own businesses.

This is an exciting time to come together in our local CDA and Spokane community to inspire and support women in business, regardless of gender, age or current skill sets.  It’s about everyone who gets involved, helping other people become the best version of themselves, so they can bring innovation and change to our region.  This can be the change that will make a difference for generations to come.

WEDO CDA/Spokane, in its partnership with NIC,  will use all of its proceeds this year to assist in scholarships for Entrepreneurship Education at NIC.  We will also be working together with NIC to  launch a business pitch competition, think Shark Tank, for the local high school students to receive coaching and mentorship for their business ideas. The WEDO CDA/Spokane will have an exclusive partnership with them for the next three years, which means all community sponsors will have the opportunity to be a part of this process as well.

To learn more about WEDO or to be a sponsor  follow us on Facebook at WED CDA/Spokane or online at womensdayidaho.org.

Sheree DiBiase, PT is the owner of Lake City Physical Therapy, PA , with three offices in our region with a speciality in Women’s Health Care and she is proud to be a WEDO CDA/Spokane delegate again this year. For sponsorship opportunity please contact me at shereelcpt@gmail.com.
Please join us this Friday night as we make a difference for our community!.  Be the change needed for growth in our region.