Tag Archives: Pregnancy

Common Causes of Carpal Tunnel Syndrome

September 28, 2017 Teresa Stockton - Blog, Wrist

Carpal Tunnel happens when the tendons become swollen (tenosynovitis) or if the tunnel size itself decreases because of injury-causing compression to the median nerve. When compression occurs, a person can experience numbness, tingling, or a dull sensation of the thumb, index, middle and ring fingers. Symptoms may include pain during pinching and gripping, or a feeling of clumsiness and the inability to hold things. The best way to avoid carpal wrist pain is to understand the main causes of carpal tunnel and use that information at work and at home.

WHAT IS THE CARPAL TUNNEL?
The carpal tunnel is a small space at the wrist in which the median nerve and nine tendons pass through. The median nerve travels on top of the tendons through the tunnel. The tunnel itself is made up of your wrist bones and along the top of the tunnel is a thick fibrous ligament called the transverse carpal ligament.

COMMON CAUSES OF CARPAL TUNNEL
Carpal Tunnel is typically not related to a specific injury. Some common causes of carpal tunnel syndrome include:

Genetic Predisposition – Many cases can be a result of physical characteristics of carpal tunnel or medical conditions associated with CTS, which also run in the family.

Repetitive Movements – Certain types of work, leisure, and sports activities require use of the hand and wrist repetitively. Occupations such as manufacturing/assembly line workers, grocery checkers, musicians, carpenters, and many others require the same movements. Common hobbies such as golfing, knitting, and gardening also require repeated movements that cause carpal tunnel syndrome.

Injury or Trauma – Sprain or fracture of the wrist can cause swelling and pressure to the median nerve.

Pregnancy & Menopause – Hormonal fluctuation in women plays a role in CTS. Such fluctuation may cause fluid retention and other changes that cause swelling in the body. Fluid retention frequently occurs during the last trimester of pregnancy and is the reason for CTS.

Medical Conditions – Diabetes, hypothyroidism, lupus, obesity, and rheumatoid arthritis.

ACTIVITIES TO AVOID TO MINIMIZE SYMPTOMS

Avoid keeping your wrists bent in either direction. The best position for the wrist is neutral (straight)
Avoid rapid repetitive forceful or prolonged hand or arm use such as seen with factory work or data entry.
Avoid tight gripping and pinching
Avoid pressure to the palm or wrist
Avoid extreme cold or vibration.

Women’s Health: The Sacroilial (SI) Joint and How It Affects You

September 19, 2017 Teresa Stockton - Back, Blog, Women's Health

It has been estimated that about 95% of the population will experience low back pain at some point during a lifetime. Low back pain may be due to many different causes and anatomical structures, one such structure is the SI joint. Here is some pertinent information about the SI joint and how it may affect your general health.

8 FUN FACTS:

What is the SI joint?
It is a joint connecting the sacrum and the ilium, 2 bones included in the pelvis. The pelvis connects the upper body to the lower body, more specifically the spine to the hips.

What does the SI joint do?
It helps to stabilize your core during functional and work activities and helps with shock absorption during weight-bearing activities including walking. Stability is also assisted by the ligaments, fascia, and muscles that attach to the joint. This includes back, gluteal, hip, and pelvic floor musculature.

Who feels SI pain?
People with leg length discrepancies, asymmetrical lower extremity weakness, scoliosis, pregnant women due to increased ligamentous laxity, women > men due to pelvic anatomy, and those who have experienced a traumatic event such as a fall or a motor vehicle accident or that perform repetitive activities with poor body mechanics including lifting and bending.

Where would you feel SI pain?
Directly over the SI joint, in the buttock, lateral or posterior thigh, or sometimes in the groin.

When may you feel SI pain?
Rolling in bed, rotating your trunk, walking, stair ascent or descent, standing from a sitting position, single leg activities

What positions/activities should be adopted?
Sleep with a pillow between your lower extremities, perform slow, controlled movements, maintain equal weight-bearing through lower extremities with transitional movements and standing, log roll during bed mobility to keep lower extremities symmetrical, swing lower extremities out of the car before standing up to prevent trunk rotation.

How can PT help?
Physical therapy has been found to help patients with SI pain get pain relief, reduce inflammation and muscle spasms, improve healing, muscle extensibility, joint mobility and range of motion, strength, muscle control, and gait mechanics.

What does PT treatment for SI pain involve?
Stretching, mobilization techniques, education on proper body mechanics with functional activities, massage, myofascial release, modalities including electrical stimulation for pain modulation and ultrasound to assist with healing and inflammation, muscle energy techniques, and a core stabilization and strengthening exercise program, tailored to the individual patient. If a leg length discrepancy is found, a heel lift may be helpful to restore abnormal forces being placed through the SI joint with weight-bearing activities. An initiation of a home exercise program is also an integral part of physical therapy treatment.

Bladder Control During Pregnancy

October 18, 2016 Teresa Stockton - Blog, Women's Health

Aside from a growing belly, you may notice other changes in your body now that you are pregnant. One thing you may notice is the loss of urine when you are not trying to urinate. Loss of bladder control, also called incontinence, is common during pregnancy and after childbirth. Needing to run to the bathroom often or leaking urine can make you feel embarrassed. Do not feel shy about asking for physical therapy for incontinence. They can help you understand and manage bladder control, and make sure there are not other conditions causing your incontinence. Here is some information to help you learn more.

HOW DOES THE BLADDER WORK?
Urine is stored in your bladder, which is an organ located in the pelvis. The muscles of the pelvis help keep your bladder in place. When you urinate, urine travels from your bladder and out of your body through a tube called the urethra. Ring-like muscles (sphincter muscles) keep the urethra closed so urine does not pass until you are ready to urinate. Muscles at the end of the urethra (sphincter muscles) and in the pelvic floor also help to hold back urine.

HOW CAN BEING PREGNANT CAUSE BLADDER CONTROL PROBLEMS?
The weight of a baby in your belly and the act of giving birth will put pressure on your bladder and may cause your pelvic muscles to stretch and weaken. This causes your bladder to sag, and your urethra to stretch. Nerves can also be damaged. It is this damage to muscles and nerves that can cause bladder control problems to persist.

HOW CAN I CONTROL MY BLADDER?
The good news is that incontinence may go away once your pelvic muscles heal, usually 6 weeks or so after giving birth. But you can take steps after childbirth to minimize bladder control problems by doing exercises to strengthen your pelvic floor muscles. Kegel exercises are one type of pelvic floor muscle exercise.

Kegel exercises do not require equipment and can be done anywhere—while sitting at your desk, standing in line at the bank, or even lying down in bed. They are done by squeezing your sphincter muscles in the same way you would when stopping urine flow. After 6-8 weeks of doing the exercises, you may find that you have fewer leaks.

Talk to your doctor to learn more about how to correctly do Kegel exercises. Following pregnancy, if Kegel exercises do not control the incontinence, your doctor may discuss other treatments or refer you to a specialist who can help.

Here are some general steps for doing Kegel exercises from the American Pregnancy Association:

• Squeeze your pelvic floor muscles as if you were trying to stop the flow of urine. Do not squeeze the muscles in your belly, legs, or buttocks.
• Hold for 5-10 seconds, then relax.
• Repeat 10-20 times.
• Try to do at least 3 sets per day.

If incontinence is still bothersome, talk to your doctor about other options, such as wearing absorbent pads or briefs. With support from your healthcare team, you will be able to manage incontinence, as well as other bodily changes that come with pregnancy.

by Marjorie Montemayor-Quellenberg, MA

RESOURCES:
American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women’s Health
http://www.womenshealth.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Women’s Health Matters
http://www.womenshealthmatters.ca

REFERENCES:
Kegel exercises. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/kegel-exercises. Updated Aug. 2015. Accessed Feb. 10, 2016.

Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 1, 2016. Accessed February 10, 2016.

Urinary incontinence fact sheet. Office on Women’s Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html. Updated July 16, 2012. Accessed February 10, 2016.

Urinary incontinence in women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 9, 2015. Accessed February 10, 2016.

What I need to know about bladder control for women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-incontinence-women/Pages/ez.aspx. Updated June 2012. Accessed February 10, 2016.

3/5/2013 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471.

Last reviewed February 2016 by Michael Woods, MD Last Updated: 2/10/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Is Aquatic Therapy For You?

July 14, 2016 Teresa Stockton - Aging, Back, Blog, General Information, Sports and Fitness, Women's Health

Aquatic therapy offers an alternative environment for therapeutic exercise. If you have tried traditional physical therapy, or have restrictions on your physical therapy program, aquatic Therapy may be the perfect solution for your physical therapy needs.

Why Aquatic Therapy is Beneficial

Less pressure: The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%.

Reduced swelling: The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.

Ease of movement: Water is an element that supports and assists movement. It offers a safe setting for regaining strength and joint range of motion.

Faster progress: Aerobic conditioning can often be performed in the water, even when it may be too soon or too difficult to do in the clinic. Staying stable in the water, challenges your core and balance. Plus, sports specific activity can begin earlier than on land.

Who Can Benefit From Aquatic Therapy

• Chronic pain patients requiring a more gentle form of therapy
• Patients at risk of falls due to balance and gait disorders
• Patients with severe arthritis or other weight-bearing restrictions
• Prenatal and postnatal patients
• Patients with general deconditioning
• Sports medicine and orthopedic patients requiring an accelerated component to their rehab protocol

This information was written by Life Fitness Physical Therapy, a privately-owned, outpatient physical therapy practice operating 14 clinics in the metro and surrounding Baltimore, Maryland area. Life Fitness Physical Therapy was founded in 2000 based on the core values of providing the highest level of customer service and clinical excellence in outpatient physical therapy. For more information click here.

Physical Therapy for the Pregnant and Postpartum Woman

May 19, 2016 Teresa Stockton - Blog, Women's Health

If you are encountering problems during your pregnancy, don’t stress. Many women are able to find pain relief by going to physical therapy during pregnancy. A licensed physical therapist, specifically trained in women’s health, can evaluate and address the physical issues affecting you. Some of the techniques a PT would use in alleviating these discomforts are postural awareness/education, individualized stretching and strengthening programs, soft tissue mobilization/myofascial release (types of massage), breathing exercises, bladder education and pelvic floor strengthening. A PT can also assist you in implementing an exercise regimen that is safe and easy to take part in no matter what your level of fitness. All of this is performed in concurrence with your OB/GYN’s care.

Musculoskeletal complaints of the Pregnant Woman:
• Postural stresses (accentuated lordosis)
• Pelvic girdle instability pain
• Back pain or SI joint dysfunction
• Round ligament pain
• Nerve entrapment syndromes: carpal tunnel, tarsal tunnel, thoracic outlet syndromes
• Neck pain
• Foot or Ankle pain (especially overuse of the gastrocnemius muscles due to COG shifted anterior)
• Tendinitis: lateral epicondylitis and trochanteric bursitis
• Circulatory problems:
• Lower leg cramps
• Edema in lower extremities
• Groin / coccyx pain
• Urinary complaints (due to reduced bladder capacity as the fetus pushes on the bladder ): stress or urge incontinence

Musculoskeletal complaints of Postpartum Woman (effects of hormonal laxity):
• Diastasis Recti
• Symphysis pubis separation
• C-section scar or episiotomy scar adhesions/pain
• Pelvic floor Dysfunction: pain with sexual activity
• Postural stresses: nursing, holding and carrying baby
• Low back pain or SI joint dysfunction
• Urinary complaints (due to weakness of the pelvic floor muscles / trauma during labor and delivery)
• Stress Incontinence
• Urge incontinence

EXERCISE CONSIDERATIONS:
Goals and benefits of exercise for the Pregnant Woman:
• Promotes good posture
• Increases or maintenance of aerobic fitness
• Improves muscle tone
• Improves sleep
• Prevents low back pain
• Reduces risk of gestational diabetes
• Improves physiological and psychological health
• Prepares mom for labor and delivery

Goals and benefits of exercise for the Postpartum Woman:
• Faster recovery from labor and delivery
• Increases endurance for taking care of self and baby

Make the right choice today. Ask your doctor how physical therapy can help you!

This information about physical therapy during pregnancy was written by by Rachna Mehta, PT, DPT, CIMT – Hamilton Physical Therapy Services, L.P. in Hamilton, NJ. Hamilton Physical Therapy Services is a well established provider of rehabilitation services in Mercer County since 1978. They take pride in offering personal and compassionate care with a patient-centered approach helping transform lives, one life at a time. For more information click here.

PT News

May 10, 2016 Teresa Stockton - Blog, PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

1. What does RICE and MEAT have to do with Physical Therapy?
Written by the Therapy Team at Cornerstone Physical Therapy. located in Canal Winchester, OH

When you hear the words rice and meat, we won’t blame you for thinking about food! In the physical therapy world, the RICE method (rest, ice, compression, and elevation) has long been the recommended treatment for sports injuries. Read more

2. Slow and Steady Still Wins the Race
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Middleburg, VA

As the days get longer and warmer, we’re more apt to engage in outdoor activities like walking and running. Spring also begins the season for charity 5k races and half marathons―great inspirations for starting a new exercise program. Read more

3. Staying Active During Pregnancy
Written by Jennifer Ryskamp, PTA at the Center for Physical Rehabilitation – Grand Rapids, MI

I wanted to take this opportunity to connect with my fellow women who are currently pregnant, and let you know that you are not alone. I am speaking specifically to those who have historically always been very active and are now finding themselves forced to slow down due to the immensely wonderful and yet altogether difficult task of growing another human being. Read more

PT for Pregnancy

May 5, 2015 Kevin - Blog

Pregnancy should be a time of anticipation – not pain. Working together with an OBGYN a physical therapist can create a safe and appropriate exercise routine during pregnancy. See more from an article featured on TodayinPT.com.

Melissa Gaskill writes; exercise can ease most of the common complaints of pregnancy, complaints that often lead women to a PT. Exercise helps reduce backaches; increase energy; improve mood, posture, and circulation; increase range of motion; and promote muscle tone, strength, and endurance. Exercise can help women sleep better, and may help prevent or treat gestational diabetes. Regular activity, particularly abdominal workouts, also may improve a woman’s ability to cope with labor, make it easier for her to get back in shape after the birth, and decrease the risk of pelvic floor and organ prolapse. Pregnant women should, however, receive clearance from their obstetricians before beginning any exercise regimen. CLICK HERE TO READ THE FULL ARTICLE

Low Back Pain in Pregnancy?

March 3, 2015 Kevin - Blog, Women's Health

Pregnancy and new motherhood should be times of joy and promise – not pain. Fortunately, times have changed, you don’t have to live with pain or other problems related to pregnancy or delivery. That’s because physical therapy has changed too. It is no longer solely for joint problems; it’s also a safe, proven and widely prescribed treatment for pregnant women and new mothers.

Physical Therapy can help you manage your low back pain in pregnancy safely!
Many women experience low back pain during pregnancy. This is due to several factors such as:

Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload the neck and upper back.
Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

A physical therapy evaluation will include an assessment of:

Pelvic/Sacro-iliac joints
Abdominal Musculature
Spinal Alignment
Strength/Flexibility
Posture
Body Mechanics

Treatment objectives are to:

Reduce Pain
Promote improved posture
Education re: safe movement patterns
Teach proper exercises for strengthening and flexibility and guidance toward cardiovascular fitness

The physical therapist may also plan a specialized exercise program for a pregnant or postpartum patient.
The goals and benefits of exercise for pregnant women include:

Promotes good posture
Increases or maintains aerobic fitness
Improves muscle tone
Improves sleep
Prevents low back pain
Reduces the risk of gestational diabetes
Improved physiological and psychological health
Prepares mom for labor and delivery

The goals of an exercise program for new moms (postpartum patients) are.

Faster recovery from labor and delivery
Increased endurance for taking care of self and baby

If you are experiencing low back pain in pregnancy please check out our Find A PT Page to find a women’s health specialist in your area.