BREAST CANCER RECOVERY AND THE GIFT OF COMMUNITY

What makes America great is the people in our community. There is power in the people when they are dedicated to making the lives of other people, better. So on Saturday night at the Best Western Inn, the Casting for Recovery, North Idaho and Eastern Washington chapter, lead by Renee Bylthe, held an amazing celebration to honor the ladies in our community that are breast cancer warriors and they raised money to insure their recovery is complete through the art of fly-fishing.

Last Spring I had the incredible opportunity of being asked to join their organization, as a medical facilitator, due to my specialty in cancer care and lymphedema. My staff and I have been caring for oncology patients for over 20 years now in our community and we feel lucky and blessed everyday that we get to help our patients on their journey. And believe me it’s no easy road they are on. They are hit on every side with physical loss, pain, emotional and mental fatigue and lots of worries. But Saturday night you would have never known any of it. They were full of life, laughter and the joy of friendship. You see one of the amazing things that happens at the Casting for Recovery retreats is they meet and become connected with women who have been on their same road and a bond forms that is beyond words. I have done cancer recovery work for a long time and in my office we see these friendships happen, but I had never seen anything like it elsewhere.

So I watched in amazement as the Casting for Recovery volunteers threw a party, so more women in our community have the opportunity for healing in the great outdoors. This I believe allows our retreat participants to live richer, fuller lives, all due to a group of people who our willing to believe that we are better together, than alone when it comes to healing and recovery.

One of the great events of the night was when the Casting for Recovery Executive Director Whitney Milhoan and her sister Hilary Hutcheson, of the famed Trout TV, interviewed each other about their love of family, fly-fishing and the wonder of the great outdoors. Since 2012, these loves lead Whitney to her current position of leadership in our Casting for Recovery national organization. Their inspirational banter about the power of healing in a safe outdoor community, with fly-fishing as a tool to help these ladies step outside their comfort zone in order to reach their recovery, was remarkable. Their passion and dedication, that all women be empowered to live life to its fullest was moving and their smiles and laughter were contagious. Everyone was clear that Casting for Recovery makes a difference in the lives of 14 women every year in our community and in 45 states across the country.

Yet there are women who apply each year and don’t get a spot due to there being not enough funding for them. So as a result, we are determined to raise enough money so everyone gets a chance to be a part of the sisterhood. So this year as the Holidays are approaching and you are wondering what charity to give to, please consider the women of our community and the healing that can happen when we care for one another through Casting for Recovery.

If you are a breast cancer survivor please go online to castingforrecovery.org and apply to go to our 2017 retreat on Coeur d’Alene lake in the late Spring. We hope to see you there!

Race For the Cure Coeur d’Alene

Early morning is always peaceful to me in North Idaho, and no one was out Sunday morning on my way driving to the Coeur d’Alene Race for the Cure. I had my car loaded with items for our booth, and I don’t know what happened or what started it, but a wave of emotion poured over me and I started to tear up.

I guess it just hit me how so many of our lives have been touched by cancer. We’ve lost loved ones to the disease and had to stand alongside our dearest family and friends as they have battled for their life. I guess my heart was overwhelmed by the thought of it and I cried, because I wanted it to go away and never again knock on anyone else’s door. I just didn’t want anyone to have to suffer anymore.

I never knew 31 years ago when I became a physical therapist that I would care for oncology patients as part of my everyday professional life. I had no idea these patients would creep in my heart and make a home in the lives of my staff and mine forever. I didn’t know that I would learn so much from them as I cared for them and their families as they walked into the darkness and then back out into the light.

This past Sunday at the Race for the Cure, I saw so many people and their families that I knew and that I had cared for this past 23 years in North Idaho. I felt honored to know them and to be allowed to help them in their personal journey. I felt a sense of awe as the Survivors and the Fighters took their seat for their picture in front of all of us. These people are incredible to me. They have chosen to live, to participate and to thrive. They were there reminding me that it doesn’t matter what life throws at us, we have a choice to make. Will we choose life?

This is what the human spirit is all about I think. It is about the digging down deep when the going gets rough and making hard choices. A person’s real character shows up with cancer. At the Race, I had the pleasure of seeing a couple that are very dear to everyone in my office and we listened as they talked of their journey. We stood in amazement at their commitment to one another and their choice to live, one fighting for her life and the other as her faithful caregiver. It wasn’t perfect, and maybe it wasn’t what they thought It was going to be when they first fell in love, but they are making it despite this glitch in their plan.

So I guess all the tears were because of all of these incredible people I know, and because their stories move my heart to believe their is something greater going on during race day in Coeur d’Alene than people running and walking. That somehow to have all these people in one place together is a feat in itself and then to know they have struggled, defied death and lived to tell about it must mean that we would all be on hallowed ground on race day. And I was right, we were on hallowed ground, you could feel it and it was definitely time to celebrate. And celebrate we did. We celebrated life and all its abundance, and we won.

Thanks Race for the Cure for another year to celebrate with our community the race for life.

Sheree DIBiase, PT, is the owner of Lake City Physical Therapy and she and her incredible staff can be reached in her Coeur d’Alene office at (208) 667-1988 and in her Spokane Valley office at (509) 891-2623. Her office specializes in breast cancer care and in all post-oncology rehabilitation care.

Breast Cancer Rehabilitation: How Soon Do I Start?

Five times. How can that be? Just today I heard it 5 times and I wonder how many days before that I have I heard the same thing. “I Didn’t Know.” For me it would be good to never hear that again from any of my patients.

According to Dr. Sara Cuccurullo, in the Physical Medicine and Rehabilitation Board Review in 2004 she stated that, “Rehabilitation of the patient with cancer should begin when disability is anticipated, rather than after it has occurred.”

I had always done orthopedic and sports medicine care, but 17 years ago an MD I respected greatly asked me to take a look at a patient of his and determine a plan of care for her. She was a breast cancer patient and she had had lymph nodes removed with radiation. Her arm was terribly swollen and she was in a lot of pain. Her arm was so heavy she could barely lift it.

I was taken back. I had never seen anything like this before. And from that moment on I decided that no one should ever have to suffer like that. I didn’t want to hear “Well, I just didn’t know.” So I made it part of my mission to care for breast cancer patients, and all oncology patients in my office along with my sports and orthopedic patients.

Quickly I realized that if I could see a patient after surgery and once their drains were removed, I could decrease the chance of physical disabilities early on just as Dr. Cuccurullo had reported. Prevention I realized was the key to positive outcomes with people who had cancer. So the quest began to never hear those words again.

Step Forward for Oncology Care is the 4 step program that came out of that process. It is for anyone who has had any type of surgery for oncology care. So as soon as your drains are removed, you need to schedule a physical therapy evaluation, by a therapist who is educated in oncology care, to create a baseline for your health plan. Ask your MD for a referral. Come and learn the four steps so you know how to be proactive in your health and healing process so recovery is complete. It consists of exercises, special massage, skin care and compression garments (move over Spanxs).

Recovery from Cancer is not complete without physical therapy rehabilitation. Rehabilitation is not only for problems that are already present, but to help prevent problems from ever occurring.

•••

Sheree DiBiase, PT, has been a physical therapist for 32 years and she is the owner of Lake City Physical Therapy in Coeur d’Alene, Hayden and Spokane Valley. She currently is certified through Stanford University in the LeDuc Method of Lymphedema care for oncology patients. All of her staff is trained in oncology care and is ready to make a plan for you and your oncology needs. Don’t wait, and never say, I didn’t know.

Community’s Roll While Fighting Breast Cancer

casting for recovery spokane

What makes America great is the people in our community. There is power in the people when they are dedicated to making the lives of other people, better.

The Casting for Recovery, North Idaho and Eastern Washington chapter, lead by Renee Bylthe, holds amazing celebration to honor the ladies in our community that are breast cancer warriors – they raise money to insure their recovery is complete through the art of fly-fishing.

In 2016 I had the incredible opportunity of being asked to join their organization, as a medical facilitator, due to my specialty in cancer care and lymphedema. My staff and I have been caring for oncology patients for over 20 years now in our community and we feel lucky and blessed everyday that we get to help our patients on their journey. And believe me it’s no easy road they are on.

They are hit on every side with physical loss, pain, emotional and mental fatigue and lots of worries. But Saturday night you would have never known any of it. They were full of life, laughter and the joy of friendship. You see one of the amazing things that happens at the Casting for Recovery retreats is they meet and become connected with women who have been on their same road and a bond forms that is beyond words. I have done cancer recovery work for a long time and in my office we see these friendships happen, but I had never seen anything like it elsewhere.

So I watched in amazement as the Casting for Recovery volunteers threw a party, so more women in our community have the opportunity for healing in the great outdoors. This I believe allows our retreat participants to live richer, fuller lives, all due to a group of people who our willing to believe that we are better together, than alone when it comes to healing and recovery.

One of the great events of the night was when the Casting for Recovery Executive Director Whitney Milhoan and her sister Hilary Hutcheson, of the famed Trout TV, interviewed each other about their love of family, fly-fishing and the wonder of the great outdoors.

Since 2012, these loves lead Whitney to her current position of leadership in our Casting for Recovery national organization. Their inspirational banter about the power of healing in a safe outdoor community, with fly-fishing as a tool to help these ladies step outside their comfort zone in order to reach their recovery, was remarkable.

Their passion and dedication, that all women be empowered to live life to its fullest was moving and their smiles and laughter were contagious. Everyone was clear that Casting for Recovery makes a difference in the lives of 14 women every year in our community and in 45 states across the country.

Yet there are women who apply each year and don’t get a spot due to there being not enough funding for them. So as a result, we are determined to raise enough money so everyone gets a chance to be a part of the sisterhood. So this year as the Holidays are approaching and you are wondering what charity to give to, please consider the women of our community and the healing that can happen when we care for one another through Casting for Recovery.

If you are a breast cancer survivor please go online to castingforrecovery.org and apply to go to our 2017 retreat on Coeur d’Alene lake in the late Spring. We hope to see you there!

•••

Sheree DiBiase, PT, is the founder of Lake City PT. She and her staff believe that family, community and quality medical care, along with a spirit of hope, are what make the difference in your cancer care recovery. Please come see us so we can help be part of your healing process. Coeur d’Alene (208) 667-1988, Spokane Valley (509) 891-2623, Hayden (208) 762-2100 and Post Falls.

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.

Learn more about Lake City PT natural herbal peri spray with the button below.

Herbal Perineal Spray lake city pt

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 To Use Perineal Spray

If you have a perineal spray then you simply use it when you need it. This is especially the case after going to the toilet or after having a bath. You can store your spray in the refrigerator if you want to take advantage of more cooling properties, but this isn’t for everyone. Some find that their skin is very sensitive after giving birth and find the cooling properties somewhat uncomfortable, so they prefer to use the mist at room temperature. Either way, when you use the spray, you can choose to ­store it at whatever temperature makes you feel more comfortable. You can use the misting spray as often as you need, especially after going to the toilet or after a bath. Please note that perineal spray is for external use only.

Is Perineal Spray Necessary?

What is Perineal Spray lake city pt

Perineal care- why is it important? Before childbirth or pregnancy, it’s unlikely that you had regular, casual conversations about your perineum. If you ask any mother who has given birth by vaginal delivery however then they will tell you that after birth, your perineum will certainly require some TLC. The perineum is essentially the surface area that is between the vagina and the anus. During childbirth, this will stretch to allow the baby to come through.

It’s not surprising to see that so many women experience a tear in this region. There’s only so much the skin can stretch. A tear could be in the labia or it could be deeper and stretch to the perineum and the muscle around it. Perineal spray really is a fantastic remedy if you want to alleviate some of the pain after childbirth. So many women experience tears, bruising and swelling, so having something like perineal spray to hand can be useful.  Usually you will experience a numbing sensation, but ultimately, it will help you during those painful toilet trips. The antibacterial properties can help you feel refreshed too.

Perineal Spray vs Balm

Balm is much thicker when compared to spray. Spray is lighter and often comes in the form of a mist. If you have super sensitive skin or if you have a severe tear then spray is the better option as it covers a wider surface area and it stops infection as you won’t need to touch the area. If you have a balm, then this may be more suited to smaller tears that aren’t as painful. Balm is good as it can be applied in a thicker coating, and therefore can offer more relief. If you have dry, cracked or irritated skin then the soothing thickness of balm can be more favorable. It doesn’t matter which one you go with of course, as long as you choose one that is reflective of your needs.

Perineal Spray VS Foam

What is Perineal Spray lake city pt 1

The great thing about foam is that it can offer you the best of both worlds. It can help to provide you with some relief as the foam is thicker and can be applied more liberally without you having to touch the affected area too much. The main thing that you need to know about foam is that it can be a touch messy. You may find that it’s harder to direct as well, but this will come with practice. As always, foam can be kept in the fridge alongside balm and misting sprays, so you can easily cater it to your personal requirements.

Perineal Spray VS Dermoplast

Dermoplast is highly recommended if you are in pain. Other perineal sprays might not offer you as much pain relief because they are based on soothing the skin while also providing some relief from irritation. Dermoplast on the other hand is designed to soothe pain when you go to the bathroom, if you have a significant tear. Some people prefer to use a perineal spray purely because they don’t like the numbing sensation, but this all comes down to personal preference. If you are due to give birth and you want to make sure that you are getting the best result out of your experience in general, then it may be beneficial for you to buy more than one bottle, so you can find out what works for you.

Herbal Perineal Spray

Herbal perineal spray is a cooling solution that consists of lavender and peppermint. These natural ingredients are soothing and promote healing. Herbal perineal spray can be used prenatal or postpartum. Herbal perineal sprays have been used for thousands of years and are a more natural solution that dermoplast and other more modern perineal numbing solutions.

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 physical therapy lake city physical therapy button

 

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.

 

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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

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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.