March 2019 Newsletter
Multiple Sclerosis and the Pelvic Floor
Multiple Sclerosis (MS) is a disease that affects the central nervous system. When the immune system attacks the myelin, which is the protective coating around the nerves, it results in a process called demyelination. The exact cause is unknown, but is believed to be contributed by a combination of genetics, environmental factors and immune system deficiencies. Common symptoms include fatigue, weakness, blurred or double vision, changes in balance or coordination, pain, and impaired attention or concentration. How does this relate to the pelvis? Unfortunately, with this patient population, up to 80% have bladder dysfunction, more than 40% experience constipation, and 91% of men and 72% of women report sexual dysfunction, according to some studies. Most common bladder dysfunctions include urinary urgency, frequency and incontinence. This happens because the demyelination process affects telling the bladder muscle and pelvic floor muscles what to do. Constipation is a common result not only from changes in nerve function, but also due to a lack of inactivity as weakness and fatigue worsen. Sexual function changes include decrease in sensation, vaginal dryness, erectile dysfunction, and reduced libido.
Research in this patient population is limited, but shows that the best candidates for pelvic floor therapy are those who get treated in the early stages of MS. Pelvic floor physical therapy, with or without the use of biofeedback, has been shown to improve urinary incontinence, nocturia (nighttime voiding), and bladder emptying. Patient education for behavioral modifications including timed voiding, bladder training, and fluid and dietary management assist with improved bladder storage. Conversely, improved bladder emptying can be improved by techniques for triggered reflex voiding, muscle training for both the pelvic floor and abdomen, and positioning. Extensive research has been performed for managing constipation utilizing abdominal massage; this massage helps facilitate fecal matter through the colon. A pelvic floor therapist can provide education on direction, pressure, intensity and frequency of massage routine for optimal results. In regards to sexual function, a skilled physical therapist can assess pelvic floor muscle tone, flexibility and ability to relax for optimum function in both men and women. It may also be important to look positioning, lubricant, mindfulness and fatigability for improved intimacy. With this in mind, please speak up to your provider regarding pelvic health as symptoms may change over time.
Research in this patient population is limited, but shows that the best candidates for pelvic floor therapy are those who get treated in the early stages of MS. Pelvic floor physical therapy, with or without the use of biofeedback, has been shown to improve urinary incontinence, nocturia (nighttime voiding), and bladder emptying. Patient education for behavioral modifications including timed voiding, bladder training, and fluid and dietary management assist with improved bladder storage. Conversely, improved bladder emptying can be improved by techniques for triggered reflex voiding, muscle training for both the pelvic floor and abdomen, and positioning. Extensive research has been performed for managing constipation utilizing abdominal massage; this massage helps facilitate fecal matter through the colon. A pelvic floor therapist can provide education on direction, pressure, intensity and frequency of massage routine for optimal results. In regards to sexual function, a skilled physical therapist can assess pelvic floor muscle tone, flexibility and ability to relax for optimum function in both men and women. It may also be important to look positioning, lubricant, mindfulness and fatigability for improved intimacy. With this in mind, please speak up to your provider regarding pelvic health as symptoms may change over time.
Self Recovery
Self Recovery is a private, online addiction recovery program designed by a highly respected local psychiatrist, Daniel Hochman, MD. The program makes a difficult process simple by seamlessly integrating all the best proven strategies that normally take many treatments to discover. It is so effective because of its holistic model that guides people through the underlying emotional causes of addiction.
Being online and on-demand, Self Recovery solves real life challenges like hectic schedules, family needs, tight budgets, and fear of judgment. It can be as private or shared as you'd like and still fill in gaps to reach a healthier life.
To read a blog written by Dr. Hochman, please see https://www.selfrecovery.org/blog/
Learn more at: https://www.selfrecovery.org/
Being online and on-demand, Self Recovery solves real life challenges like hectic schedules, family needs, tight budgets, and fear of judgment. It can be as private or shared as you'd like and still fill in gaps to reach a healthier life.
To read a blog written by Dr. Hochman, please see https://www.selfrecovery.org/blog/
Learn more at: https://www.selfrecovery.org/
SPT Spotlight
Nicole Rodgers, Physical Therapist
Nicole received her Bachelor of Science degree in Public Health from East Carolina University and her Doctorate in Physical Therapy from Elon University.
While completing her undergraduate degree, Nicole developed and conducted a research project that assessed college-aged women’s knowledge of pelvic floor, identifying a large deficit in accurate information available to the population. This sparked Nicole’s interest in pelvic health and led her to pursue a career that would help to close this gap in knowledge and positively impact the lives of both women and men. Nicole strives to work collaboratively with patients to ensure that each patient's personal goals are being met.
Nicole is a native of Wilmington, NC and has relocated to Texas to follow her passion for the field of pelvic health physical therapy. She has since fallen in love with the Austin area. Nicole enjoys cooking, walking the Brushy Creek Trail, and going to the movies.
While completing her undergraduate degree, Nicole developed and conducted a research project that assessed college-aged women’s knowledge of pelvic floor, identifying a large deficit in accurate information available to the population. This sparked Nicole’s interest in pelvic health and led her to pursue a career that would help to close this gap in knowledge and positively impact the lives of both women and men. Nicole strives to work collaboratively with patients to ensure that each patient's personal goals are being met.
Nicole is a native of Wilmington, NC and has relocated to Texas to follow her passion for the field of pelvic health physical therapy. She has since fallen in love with the Austin area. Nicole enjoys cooking, walking the Brushy Creek Trail, and going to the movies.
Josephine "Jo" Alice McGee
On February 15, Christina McGee, PT, DPT gave birth to a beautiful baby girl named Josephine "Jo" Alice McGee at 6:40 pm. She weighed 7 pounds and 7 ounces and her length was 20.5 inches. Both mom and Jo are doing well. Christina returns from maternity leave on May 1.
Updates from the Physical Therapy Team
- On February 12, the physical therapists had Dr. Deborah Dunn come speak on prolotherapy for pelvic floor conditions.
- On February 14, Angela Dobinsky had the opportunity to speak to the OBGYN Residents at Dell Medical School in February. She educated them on vulvodynia and vaginismus from a physical therapist perspective.
- On February 15, Lauren Steele gave a talk at the Austin Area Birthing Center off Duval about various conditions pregnant and postpartum women may develop. Conditions that were mentioned include: SI joint pain, pubic symphysis dysfunction, sciatica, prolapse, diastasis recti, pelvic pain, urinary/fecal leakage, and constipation.
- On February 16, Lauren Steele attended an event called Arfo Futuristic Birthworks hosted by Barbara Verneus, a doula in the Austin area. She dove into the challenges that women of color face in the healthcare industry; including patients and their healthcare team. She discussed inequalities and ways that everyone can work together to ensure that everyone comes out ahead. At the event I met doulas, midwives, and trainers that all focus on treating pregnant and postpartum women.
- Rachel Madera wrote a newsletter post for Breastfeeding Success about Sullivan Physical Therapy and Physical Therapy for Clogged Ducts.
- Jamille and Jessica were interviewed by Top Knot Squad podcast on Feb 19, 2019. This podcast is about motherhood run by 3 local moms. Among various topics that were discussed, Jamille and Jessica discussed what the pelvic floor was, how PT can help treat bladder, bowel, sexual health issues, and discussed recommendations for women Post partum and how they can seek help and support.
- We are sad to say good bye to Becky Maidansky. Becky joined us in the Fall of 2017 and we have enjoyed working with her over the last year and half. Becky is moving on to work in home health physical therapy and her last day with Sullivan Physical Therapy will be March 29, 2019. We wish her the best. All of Becky's patients will be assigned a new physical therapist starting April 4.
Upcoming Dates
March 1
Our calendars will be opening for April, May and June. Please call or email our office to schedule your appointments or bring your calendars to your next appointment.
March 3
Rachel Madera will finish Yoga Teacher Training and will receive recognition for over 200 hours of class.
March 4
Lauren Steele will be speaking at the Austin Area Birthing Center on Duval from 11:30 to 12:15
March 5
UsToo Prostate Support Group: Mike Jones Memorial Chapter will be
at 7pm to 8:30 pm at St.David's South Austin Medical Center
March 9
Pelvic Pain Support Group 10 to 11:15 am 4131 Spicewood Springs Road Suite M-1 Austin, Texas 78759
RSVP prior to joining the group: brittanyneece@gmail.com or 512-814-6027
March 15
Jamille Niewiara, PT, DPT and Jessica Chastka, PT, DPT will be sitting for the American Board of Physical Therapy Specialties. Wish them luck as they become board certified in Women's Health.
Our calendars will be opening for April, May and June. Please call or email our office to schedule your appointments or bring your calendars to your next appointment.
March 3
Rachel Madera will finish Yoga Teacher Training and will receive recognition for over 200 hours of class.
March 4
Lauren Steele will be speaking at the Austin Area Birthing Center on Duval from 11:30 to 12:15
March 5
UsToo Prostate Support Group: Mike Jones Memorial Chapter will be
at 7pm to 8:30 pm at St.David's South Austin Medical Center
March 9
Pelvic Pain Support Group 10 to 11:15 am 4131 Spicewood Springs Road Suite M-1 Austin, Texas 78759
RSVP prior to joining the group: brittanyneece@gmail.com or 512-814-6027
March 15
Jamille Niewiara, PT, DPT and Jessica Chastka, PT, DPT will be sitting for the American Board of Physical Therapy Specialties. Wish them luck as they become board certified in Women's Health.
PT Below the Waist
Jamille Niewiara and Jessica Chastka are co-hosts of Sullivan Physical Therapy's podcast called "PT: Below the Waist", a patient oriented podcast discussing topics related to pelvic floor physical therapy and how it addresses bladder, bowel, and sexual function issues. The podcast features two pelvic floor physical therapists casually conversing about their experiences and thoughts towards pelvic floor related issues.
Every few weeks, they will be posting podcasts about different diagnoses, tips/recommendations to address symptoms, and interviews with medical professionals. Subscribe to their podcast on iTunes, follow them on Twitter @PTBelowTheWaist, and like them on FaceBook. Leave comments and questions on their email: PTBelowTheWaist@gmail.com.
Sullivan Physical Therapy encourages you to listen to their podcasts and get enlightened about "Better Pee, Better Poo, Better Sex".
To listen to our latest podcast please click here.
Every few weeks, they will be posting podcasts about different diagnoses, tips/recommendations to address symptoms, and interviews with medical professionals. Subscribe to their podcast on iTunes, follow them on Twitter @PTBelowTheWaist, and like them on FaceBook. Leave comments and questions on their email: PTBelowTheWaist@gmail.com.
Sullivan Physical Therapy encourages you to listen to their podcasts and get enlightened about "Better Pee, Better Poo, Better Sex".
To listen to our latest podcast please click here.
Sullivan Physical Therapy & Austin Area Birthing Center
Postpartum pelvic floor physical therapy is standard in some other countries, with health systems recognizing that preventative care during the crucial healing period following delivery can save women from future suffering and save the system hundreds of thousands of dollars in medications and surgeries farther down the line. Problems such as incontinence, prolapse, scar pain, diastasis recti, back or hip pain, and pain with intercourse can be addressed and eliminated or even prevented all together with a post partum evaluation and recommendations or exercises from a pelvic floor physical therapist trained in postpartum health. To this point, these services are rarely offered in the United States.
Sullivan Physical Therapy is excited to partner with Austin Area Birthing Center in creating this type of whole- person care for clients. Christina McGee PT, DPT, will be on site at Austin Area Birthing Center South Thursday afternoons to provide physical therapy evaluations and treatments to pregnant and postpartum AABC clients to maximize health and healing and allow patients to get back to activities safely following delivery. At this time, insurance will not be accepted for visits performed at AABC.
Please contact Sullivan Physical Therapy to learn more about this service and schedule an appointment or email christina@sullivanphysicaltherapy.com.
Sullivan Physical Therapy is excited to partner with Austin Area Birthing Center in creating this type of whole- person care for clients. Christina McGee PT, DPT, will be on site at Austin Area Birthing Center South Thursday afternoons to provide physical therapy evaluations and treatments to pregnant and postpartum AABC clients to maximize health and healing and allow patients to get back to activities safely following delivery. At this time, insurance will not be accepted for visits performed at AABC.
Please contact Sullivan Physical Therapy to learn more about this service and schedule an appointment or email christina@sullivanphysicaltherapy.com.
