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.

Pelvic Floor Incontinence: Your Guide To Reclaiming Bladder Control

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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.

Learn More About Pelvic Floor Physical Therapy

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.

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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.


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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!


Have Questions? Ask with the form below.

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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

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, 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 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

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
Please join us this Friday night as we make a difference for our community!.  Be the change needed for growth in our region.

Gratitude: For the Women Entrepreneurs Before Me

womens entrepreneur day coeur d alene 2018 lake city pt

Thanksgiving is one of my favorite times of year. It’s a time of reflection and planning for the new year. I always look back over the past year and see all the good things that occurred, along with all the challenges that lead to opportunities for growth.

Our past teaches us things If we are willing to glean from these lessons. These challenges create resilience, strength and courage. I have learned however, that you cannot stay focused on the past, you must accept it for what it was, live in the moment for the next unique possibilities and commit to a plan for the future.

Women in Leadership: Choose to Grow

I have recently had three great books on my desk.” Dare to Lead”, by Brene Brown, “The Leadership Gap”, by Lolly Daskal and “Building a Story Brand, by Donald Miller. All three of these amazing authors have been challenging me to grow and move forward in my professional physical therapy role and my business endeavors.

All of these books in different ways, use introspective thinking to help you move forward in your thinking and to ask yourself hard questions about what might be holding you back from your full potential. All of us possess different strengths and weaknesses and the ability to use our energy to freely develop our potential is powerful to make a difference for ourselves and others in our community.

This freedom means shedding some of our old habits and the negative words we might have experienced in our life, that may be holding us back, so we can do what we are called to do.

Young Female Entrepreneurs: The Value of Mentors

Last year I was asked to be a delegate for the WED Women’s Entrepreneur Day CDA/ Spokane event. It was thought provoking event and it called me to consider what it would be like to work together with women in our community to make our own community better.

I began networking with women our community and then joined a group in my own physical therapy profession called “Women in PT Summit”.

These things challenged me to look locally at making a difference and globally at making Women’s Medical Health a priority for me personally and professionally. With that, we started a study at Lake City Physical Therapy, PA to assess how well our community is doing in caring for Postpartum Moms after having their baby.

We have collected over 60 surveys so far so we can see how well we are doing in our medical community with the “Fourth Trimester”. Our next step is coming, with a free PT screening and a 12 week exercise program for postpartum Moms to get the correct early interventions so the women in our community can have a higher quality of life.

Come To CDA’s Women’s Entrepreneur Day

This year I’m a delegate again for WED CDA/ Spokane and I’m exited to invite you to our WED CDA/ Spokane, “Women’s Entrepreneur Day” evening event at North Idaho College on November 30, 2018, 5:30-8:30 pm with an after party sponsored by Vine and Olive.

WED is an international organization that is global movement to empower women in business. The goal is for women who are in business to make a difference by helping other women, locally and globally.

All of our local proceeds this year will go to fund scholarships at NIC through the NIC Foundation, for their Entrepreneurship Certificate program, so that we can further facilitate those who wish to train and develop their entrepreneurial skills for their own business or their potential new business.

We will have an amazing lineup of speakers from our own region to help motivate you whether you have been in business for years or you are just getting started.

Tickets are available on Eventbrite. You won’t want to miss this, last year we had over 350 women who attended. If you wish to be a sponsor and get in front all these incredible women please contact me at We look forward to seeing you there!

lake city physical therapy sheree dibiaseSheree DiBiase, PT is the owner of Lake City Physical Therapy, PA and she and her amazing staff look forward to seeing you at WED Women’s Entrepreneur Day at NIC. Women’s Choice, Choose Well Lake City PT. Cda office (208)667-1988, Hayden office (208)762-2100, Spokane Valley (509)891-2623.

Breast Cancer Support Groups: Northwest Nature Inspires Healing

Breast Cancer Support Groups lake city pt 1

I have had the amazing opportunity to be a medical facilitator volunteer with an incredible national organization called “Casting for Recovery.” This organization takes 14 Breast cancer survivors, from our geographical region of Northern Idaho and Eastern Washington, on a 3 day experiential fly fishing trip to facilitate healing of not only the body, but the mind.

Participants apply online, and are randomly selected to attend. Each year it is held in a different area. Last year we were at the Flying B Ranch in Kamiah, and this year we will be on Lake Coeur d’Alene.

How Nature Inspires Healing

A few weekends ago we had our training weekend preparing for our upcoming retreat in June at N-Sid-Sen Camp. As my mind usually has a natural curiosity, I wondered about the meaning of their name. It was not a name I had ever heard before so I figured it stood for something significant.

As we toured the retreat camp, the director of the camp told the story of how the family who owned the camp wanted to give their land to something as a way of service and then they asked the native Americans if their land had any special significance in this region. He told us that the land did hold importance, and that the Indians would often hike to the top of the ridge and look out over Lake Coeur d’Alene and that it became their “Point of Inspiration.”

For days I have pondered this idea. What is my “Point of Inspiration”? Does everyone have one? Do they need to get one, if they don’t have one? Do you multiple points of inspiration? What does Inspiration mean?

Inspiration is the “process of being mentally stimulated to do or feel something, especially to do something creative.” When I thought of this, I thought of my brother-in-law. He told me once that he knew he wanted to be a veterinarian since he was 8 years old. How is that possible, I asked him. He told me, he just knew. Well he did really know, as he was a talented, brilliant and kind man that served as a veterinarian in our community for years.

Surround Yourself With People Who Inspire You

In my profession of physical therapy I have had many people who cared enough to inspire me professionally and personally. The first ones were my parents. They told me there was nothing a woman couldn’t do and I believed them.

The next one was a woman who owned her own PT practice and I interviewed her when I was a junior in high school working on my career project. She was enlightening and she planted a seed in a young girls heart about what it meant to serve others and care for their physical losses so they could have a better life.

Then in my junior year of PT school my Professor Bob, became my next inspiration and mentor. He believed in me and motivated me to always do my best to care for the needs of my patients.

There have been countless others and I could go on and on about the people who have inspired me in my life, but I think it’s important to remember that it’s in relationship with others and in nature that often our meaning comes to us.

Something happens when we are vulnerable, care deeply and see the world as a canvas to have our own adventure on. There is only one you. You are special. You are made for this. You can do it, you just have to choose it.

I am lucky to have had time with the innovative and remarkable volunteers that run “Casting for Recovery” at N-Sid-Sen Camp. We will, I am sure, have a memorable retreat there in June with our Breast Cancer Survivors. There will be many “Points of Inspiration” that will happen that weekend, as they always do. My hope is that each of you will look at your points of inspiration in your life and that they will lead you to know, without a shadow of a doubt, that the plan for your life is worthy and divine and our hope is that you will never give up on the dreams you are dreaming.


lake city physical therapy sheree dibiaseSheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her amazing staff believe that life is full of things to inspire us and they hope you will take a chance and live boldly, because your health matters. Reach us in Coeur d’Alene at (208) 667-1988, in Hayden at (208) 762-2100 and in Spokane Valley at (509) 891-2623.

Breast Cancer Rehabilitation: How Soon Do I Start?

breast cancer rehabilitation lake city pt

Five times. How can that be?

Just today I heard it 5 times and I wondered how many days before that 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.

Does Seeing A PT Right After Breast Cancer Surgery Help

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.


lake city physical therapy sheree dibiaseSheree DiBiase, PT, has been a physical therapist for 30+ 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 breast cancer and 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”.

Fourth Trimester of Pregnancy: A Momma’s Brain

Fourth Trimester of Pregnancy lake city pt sheree dibiase pt

So I wish I knew what I know now about how a mother’s brain literally changes during pregnancy and afterwards.

We’ve known for years about all the physical changes, but it’s only been in the last few years that research has uncovered powerful evidence of what occurs in a mother’s brain. The level of cognitive changes is incredible and a lead researcher on pregnancy and the brain, Elseline Hoekzema, at Leiden University in the Netherlands states, “I’ve never seen anything like this in any of the data sets I’ve worked with”.

Hoekzema says “In a way, it’s no surprise given the extreme nature of the hormone floods that women are exposed to during this period, but still I hadn’t expected such remarkably robust findings and this degree of differentiation” when describing how much a women’s brain changes during this stage of her life.

Ask any mother you know about the way she felt after having her baby and she will tell you stories of forgetfulness about little things like whether she loaded the laundry into the dryer or whether she ate or slept for two days, but then she will explain how she can sense her babies every need, whether it’s due to hunger or a dirty diaper and she knows the sound of her babies cry in a roomful of other babies without hesitation.

She will become fiercely protective and she will obsess over things she never thought of before, like how to lay her baby down to sleep at night, and what organic food they should eat, so she can ensure her child’s safety at all costs.


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4th Trimester Symptoms: What Mom’s Experience

She will often experience a level of anxiety like she has never felt before when her baby has a fever or can’t sleep at night because they are teething. She can break into a full sweat at the thought of her baby having its first shots or feel a fear beyond belief when she wakes in the night and does not hear her baby breathing on the baby monitor.

This range of emotions can feel frightening and a women can suddenly feel at loose ends. She has so many responsibilities being thrown at her with her new baby and she literally feels, “out of control” with her own emotions.

Research data states that after childbirth the parts of the brain involved in “social processes and the ability to attribute emotions and mental states to other people”, which are key to raising children, increase in activity dramatically.

These changes stimulate a mother to develop a higher level of emotional attachment to their children. These changes in the brain are normal and help a women grow into a good mother. Without these changes in the brain, maternal attachment and nurturing would be much more difficult.

4th Trimester Theory: How The Brain Changes

The brain has two types of matter, gray matter and white matter. They believe the grey matter decreases in size in that region of the brain that relates to socialization and emotions, thereby allowing the white matter in that same region to increase its connectivity which enables a women to become an amazing multitasker in all avenues of her life and form deep attachments to her children.

They relate this idea to the same type of processing called “pruning” that occurs in the brain, during puberty. Only the important process are kept for the progression of life and the others are gotten rid of that do not appear as valuable.

A women needs these brain changes to raise children but it can change a women’s brain so much she barely recognizes herself anymore. This can lead to anxiety, loneliness and a feeling of separation from the rest of the women she knows.

Because many women have no understanding of how the brain will change when their baby comes, they will suffer with mood swings and possible postpartum depression alone and without understanding on how to describe their dilemma to their husband, family, friends or healthcare provider. They often feel ashamed they even have these feelings and will never speak of them to anyone as they see this as a failure in their life.

Recently, the American College of Obstetricians and Gynecologists recommended redesigning Fourth Trimester care to have a more inclusive mental and physical plan of care. This includes a screening and assessment of a women’s emotional health, along with an assessment of their musculoskeletal health by a Women’s Health Physical Therapist trained in postpartum care.

I believe their needs to be more education and understanding about what a mom’s brain and body goes through when having a baby, so that women will be open to sharing their feelings with others and not feel any judgement about their ability to be a good mother.

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lake city physical therapy sheree dibiaseSheree DiBiase, PT is the owner of Lake City Physical Therapy and the mother of three 20 something sons. She and her incredible staff believe Mom’s need to have education and training after having their babies for their physical and emotional well-being.

Please come see us at any of our three offices: CDA (208)667-1988, Spokane Valley (509)891-2623 and Hayden (208)762-2100.

Pelvic Pain After Birth: Finding Body Balance After Baby

Pelvic Pain After Birth

A new baby, there is nothing better!

Snuggling them, loving them and nurturing them becomes your new life. Suddenly the aches and pains of pregnancy and delivery are forgotten. But don’t kid yourself this is no little feat that your body just went through to make this precious new addition.

Your body goes through an amazing transformation to make your baby and if you are nursing them, you will still have hormones in your body after the birth of the baby. No wonder your body seems a little bit different or odd in its behavior.

No wonder you have stiff shoulders, a cranky back or hips that pop around when you move. Maybe your bladder is a little leaky with laughing, sneezing or coughing. Maybe you have pain with intercourse or are completely disinterested in sex at all. Maybe you are constantly constipated after baby and you are wondering why because you never were before. Well we know what it’s like and you are not alone.

What Is The Pelvic Floor

The pelvic floor is an intricate set of muscles. There are layers of them and they perform unique work as the bottom of the abdominal container. They hold the bladder, fertility organs and the bowels, and they need to remember how to work again after having a baby, because these muscles are often overstretched and over worked during pregnancy. It takes time for these muscles to heal along with the abdominal muscles.

These muscles work together with the diaphragm and you can start training them with deep breathing techniques. Take a deep breath to the count of four. Feel the lower lungs fill with air and push the ribs out to the sides. Upon inhalation the floor moves downward. Then upon exhalation count to four and feel the floor muscles contract and draw upwards towards your nose.

You can feel these pelvic floor muscles externally by placing your hand besides your sitter bones medially. As you draw the floor upwards think about lifting all the organs inside the bowl-like muscle container. The floor is not flat. The pelvic floor has front and back muscles which have an apex in the middle.

Imagine this apex moving upward as if a string is pulling the floor towards your diaphragm as you contract the floor. This incorporates all the floor muscles to work together, different than the kegel exercise, which concentrates on merely one level of the floor muscles.

The first four to six weeks after having a baby are meant to be a time of bonding, adjusting to your new life and allowing your body to heal. Don’t be hard on yourself and the way you look. Gentle re-training of the floor, abdominal muscles and core can begin once your body has healed and your body will restructure itself with time.

Pelvic Floor Health: How To Get Back To Normal

After your six week check-up with your MD you should schedule your visit with your physical therapist and they will begin training your pelvic floor and core again for daily activities and return to your active lifestyle.

If you have a leaky bladder or bowels that are not working well they can help you re-train them. If you have pain with intercourse you may have muscles that are not working properly and need to re-establish good patterns of floor movement.

If you have never been active, don’t worry they will teach you how to develop a new healthy lifestyle with baby. We look forward to seeing you, your health is your greatest asset.

lake city physical therapy sheree dibiaseSheree DiBiase, PT is the owner of Lake City Physical Therapy, PA and she and her incredible staff take care of our Mom athletes everyday.

Please make an appointment before you head to the gym if you have any concerns, our pelvic health specialists can help:
CDA (208)667-1988,
Hayden (208)762-2100, and
Spokane Valley (509)891-2623.