Can I Be See for That? Short answer is YES!!!

practicallyperfectpt — Fri, 06 Dec 2024 02:17:04 +0000

For those who have been Practically Perfect Physical Therapy’s patients in the past, you know exactly what the team can treat – pelvic pain, urgency, frequency, incontinence of bowel and/or bladder, pain with sex, pediatrics, pre- and post-partum concerns, all things pelvic floor! But did you know the clinic has the ability to see patients looking for care for all sorts of traditional physical therapy needs? You can now continue to receive care in the comfortable, welcoming, one-on-one atmosphere PPPT is known for while alleviating your other musculoskeletal concerns. Joining the PPPT team this fall, Becky has spent her career mostly in the orthopedic world. Starting out, she split her time between a traditional physical therapy clinic and the athletic training room at Goldey Beacom College. There, she held annual concussion baseline testing and ACL screens as well as rehabilitating athletes with injuries such as ACL tear, ankle sprains, low back pain, concussions, and hip pain as well as post-operative ACL-reconstruction, rotator cuff repair, tommy john surgery, and more. As 2020 was upon us and life post-covid was quite the change for everyone, she transitioned to a smaller outpatient PT clinic treating a general outpatient population. Hip and knee replacements, low back pain, shoulder pain, gait, balance and falls, lumbar discectomy, laminectomy, and fusion, TMJ dysfunction, cervicogenic headache and posture are all diagnoses with which she gained further experience. With the addition of a team member whose background is outside of the pelvic floor realm, we are happy to now have the availability to treat our patients for all of their PT needs. And have no fear, Becky will be working closely with the Practically Perfect Pelvic Team to allow for continued care of any pelvic floor injuries or concerns that may also be present. So next time you ask yourself “Can I be seen at Practically Perfect PT for that?”, the answer is a resounding “Yes!” If you are not sure if we can help, we highly recommend calling our office manager, Randi, to check out what we can do. We rarely have a patient we can’t help with our staff’s wealth and variety of experience!!

The post Can I Be See for That? Short answer is YES!!! first appeared on .

Managing Parkinson’s Disease with Physical Therapy

practicallyperfectpt — Wed, 16 Oct 2024 15:55:14 +0000

Parkinson’s disease is a progressive neurodegenerative disorder that affects movement, balance, and coordination. While the diagnosis can be daunting, integrating physical therapy into your treatment plan can significantly improve quality of life and help manage symptoms. Here, we’ll explore how physical therapy can aid in managing Parkinson’s disease, highlighting key approaches and benefits. Understanding Parkinson’s Disease Parkinson’s disease is characterized by the gradual loss of dopamine-producing neurons in the brain, leading to symptoms such as: These symptoms can affect daily activities, but physical therapy offers targeted interventions to address these challenges. The Role of Physical Therapy Physical therapy focuses on restoring mobility, improving strength, and enhancing overall function. Here’s how it can help individuals with Parkinson’s disease: 1. Improving Mobility and Balance One of the primary goals of physical therapy is to enhance mobility. Therapists design exercises to improve flexibility, strength, and coordination. Techniques may include: 2. Enhancing Strength and Flexibility Strength training is crucial for countering the muscle weakness often associated with Parkinson’s. Therapists can develop individualized programs that include: 3. Managing Symptoms Physical therapists are trained to use specific techniques to manage symptoms effectively. Thismay include: 4. Promoting Daily Functioning Therapists focus on practical strategies that can help individuals perform daily activities more easily. This might involve: 5. Providing Education and Support Physical therapy isn’t just about exercises; it also includes education on the disease and self-management strategies. Therapists can help patients and their families understand: Creating a Physical Therapy Plan If you or a loved one has been diagnosed with Parkinson’s disease, collaborating with a physical therapist is vital. Here’s how to get started: Conclusion Living with Parkinson’s disease presents unique challenges, but physical therapy offers powerful tools for management. By improving mobility, strength, and overall function, individuals can enhance their quality of life and maintain independence longer. If you or someone you know is navigating this journey, consider integrating physical therapy into your care plan and give Practically Perfect Physical Therapy a call. The therapists at Practically Perfect PT have more than 10 years of experience helping individuals navigate their life with Parkinson’s Disease. With the right support, it’s possible to take control of your health and continue pursuing the activities you love. If you or someone you love is living with Parkinson’s, physical therapy could make a real difference in daily life. Schedule a consultation with us today to learn how we can help!

The post Managing Parkinson’s Disease with Physical Therapy first appeared on .

Occupational Therapy is a New Service Coming to Our Practically Perfect Community!

practicallyperfectpt — Mon, 23 Sep 2024 13:47:32 +0000

Hypermobility and Pelvic Health: What is hypermobility and how does it affect the pelvic floor?

practicallyperfectpt — Wed, 14 Aug 2024 23:59:39 +0000

Hypermobility and Pelvic Health We had a wonderful Doctor of Physical Therapy Student from Stockton University with us this summer, and she chose to write us an informative blog about Hypermobility and Pelvic Health as her student in-service to share with our community. Jackie graduated in May of 2024 and has been finishing her last clinical rotation with us at Practically Perfect Physical therapy learning everything about pelvic health, pediatric, and our other specialized patient populations. Jackie writes… Most people know that joints can get stiff or tight which can cause pain, decreased ability to move, or lead you feeling like you need a nice long stretch. But what happens if a joint is already super mobile or “too stretchy”? This is called joint hypermobility. Joint hypermobility is a general term for increased motion at a joint that is beyond the normal range. Don’t get me wrong, it is the goal to be flexible, however, it is possible to have TOO much motion. There are many disorders that can cause chronic joint hypermobility but this blog post is going to focus on Hypermobile Ehlers Danlos Syndrome (hEDS). hEDS is a genetic disorder that is considered “rare” and new research is emerging every year. People with hEDS have faulty collagen which is a structural protein throughout the body’s connective tissues. Connective tissues are things like ligaments, skin, fascia, stomach lining, blood vessels, etc. This collagen is not formed correctly due to an inherited malfunction in the DNA. Since collagen is everywhere in the body holding things together, this means that hypermobile Ehlers Danlos Syndrome is a “systemic disorder” that can potentially affect any part of the body- including the pelvic floor! So why is having a stretchy body really a bad thing? Well, too much mobility compromises stability. Tendons, muscles, ligaments and cartilage all work together to keep a joint stable and in good alignment. A muscle is a contractile tissue which means it can shorten its fibers when the brain wants it to. Tendons connect these muscles to the bone. A ligament, however, is not a contractile tissue. It is a band of fibrous tissue that is mostly made up of collagen that connects bone to bone. Someone with hEDS cannot rely on their ligaments to provide proper stability in their joints because their ligaments typically have too much stretch or “laxity” due to the malfunctioning collagen. Decreased stability can cause dislocation, subluxation(partial dislocation), and chronic wear and tear. Let’s think about a knee joint as a kitchen cabinet. If one of the hinges on your kitchen cabinet has one loose screw, over time the other screws on the hinge will loosen. This will start to cause the cabinet to shut unevenly, or maybe it starts to squeak with use. After more time goes by using the cabinet, the screws on the other hinge will get loose too causing even more issues. Maybe now the whole cabinet door is sideways, or maybe the screw holes have become worn down and the screws no longer fit. Joint instability is kind of like a loose screw. If ligaments in your knee are not holding the bones of your thigh and lower leg together tight enough, there is too much accessory motion when the knee is bending.Over time this can stretch the ligaments even more and cause subluxations. This then causes the bones to grind on each other in a way they are not supposed to, causing wear and tear on the joint surfaces. Even more time goes by and maybe next time the person jumps and lands the knee dislocates or the ligament sprains. Over time, chronic joint instability can cause chronic joint pain. Don’t worry, if you have an unstable joint, chronic joint pain, or are very flexible. It does not mean you automatically have this disorder. There is a list of criteria that someone must meet to be diagnosed with hEDS by a doctor. This criteria includes presence of joint pain, presence of associated medical conditions, family history, exclusion of alternate diagnoses, and having a positive score on the Beighton Scale (specific test for joint hypermobility). hEDS is a spectrum disorder. This means it affects everyone that has it differently. Symptoms can vary in severity from person to person or in one person day to day. Like we said before, this is a systemic disorder and affects all body systems causing a wide range of symptoms.There is also research suggesting associations between hEDS with other medical disorders. Let’s break it down by body system. Joints and muscles: Like we mentioned earlier in the blog, hEDS can cause dislocations/ subluxations, joint instability, and increased range of motion. It is common for people to also experience muscle tightness, muscle weakness, or decreased muscle tone. People with hEDS also have impaired proprioception. This means they have difficulty controlling their body through space and have decreased balance, increased instances of tripping and falling, and are often labeled as “clumsy.” People with hEDS can also have increased instances of scoliosis, foot abnormalities, palate and teeth abnormalities, and early onset arthritis.The most common musculoskeletal symptom that is reported is joint pain and instability. Integumentary system: Of course this disorder affects the largest organ of the body – the skin! People with hEDS can have skin described as soft, thin, stretchy, and fragile. Easy bruising, abnormal scarring and unexplained stretch marks are also symptoms. Immune system: Chronic inflammation is also a symptom that people with hEDS experience. MCAS (Mast cell activation syndrome) causes an overactive immune system and is a condition that is associated with hEDS. Gastrointestinal System: Common GI symptoms that can occur include diarrhea, constipation, nausea, abdominal pain, bloating, and reflux. Some associated conditions include IBS (irritable bowel syndrome), gastroparesis (delayed stomach emptying), median arcuate ligament syndrome (compression of an artery that leads to the stomach), and celiac disease (serious allergy to gluten). Nervous System: The nervous system is made up of the central nervous system and the autonomic nervous system. The central nervous system consists of the brain and the spinal cord. The autonomic nervous system controls unconscious/ involuntary processes in the body. Dysautonomia is a malfunctioning of the autonomic nervous system and is a condition associated with hEDS. A more common type of dysautonomia is called POTS – Postural orthostatic tachycardia syndrome. Some symptoms of this disorder include: high heart rate, fainting, dizziness, chronic fatigue, issues regulating temperature, headaches, and brain fog. Other associated conditions of the nervous system include chiari malformation (when the base of the brain slips down a little and puts pressure on the spinal cord), concussion complications, and tethered cord syndrome (when the spinal cord becomes stuck). There is also a correlation between depression, anxiety, and hEDS. Cardiovascular System: Collagen is a component of blood vessels. People with hEDS may have issues with capillary fragility, varicose veins, poor venous return of blood, aortic root dilation (stretching/ widening of the aortic artery) and mitral valve prolapse (a valve in the heart not closing properly). Genitourinary System: Ligaments also help hold up our pelvic organs. Hypermobile Ehlers Danlos syndrome is also associated with pelvic organ prolapse. This is when the bladder, rectum, or uterus can sag into the vaginal canal. Some other associated conditions of this system include inguinal hernias, bladder dysfunction, dysmenorrhea (painful periods), menorrhagia (heavy periods), dyspareunia (pain with sex), and endometriosis (a painful condition where cells similar to the inside of the uterus grow on the outside of the uterus). I know that was a lot of medical information but the bottom line is that this disorder affects the whole body. Different symptoms or associated conditions can come on at any time during life. So how does this all relate to pelvic health? If you have visited this website before, I’m sure you are familiar with the pelvis. The pelvis has two halves that connect in the front at the pubic symphysis joint and in the back to the sacrum to form the sacroiliac joints. The pelvis also connects to the top of the thigh bone making up the hip joints. All these joints related to the pelvis means there are many ligaments in this area helping to hold the pelvis in place and functioning well. This, as you could imagine, could be a place in the body where hEDS causes issues. The sacroiliac and pubic symphysis are supposed to have some motion for normal function. If there is too much motion here, the pelvis becomes unstable and can sublux ( partially dislocate) and then get stuck in malalignment. This can then disrupt motion of the spine, lower extremities, and load transfer abilities. It can also cause pain in the hips, back, and pelvis. The body can try to compensate for these inadequate ligaments by creating pelvic stability by tightening up the pelvic floor muscles. Tight pelvic floor muscles can cause pelvic pain, tailbone pain (coccydynia), impaired coordination and strength of pelvic floor muscles, pain with sex, and issues with bowel and bladder function. Pelvic organ prolapse is another associated condition that can affect pelvic health and function. Pelvic organ prolapse can be mild, moderate, or severe and in severe cases may need surgical intervention. Pelvic organ sagging can cause pelvic pain, pelvic heaviness, pain with sex, urine or fecal incontinence, or trouble fully emptying the bladder or bowels. Another thing to consider for people with hypermobile Ehlers Danlos Syndrome and pelvic health is pregnancy. When someone is pregnant, there is more blood in their body to support the fetus. This can cause POTS symptoms or vascular symptoms to worsen if they have these associated conditions. There can also be some complications with the effects of anesthesia in people with POTS or hEDS. There is also an increased risk of vaginal/ perineal tearing due to tissue fragility. The hormones released during pregnancy including relaxin, progesterone and estrogen increase laxity in ligaments to make it easier for the pelvis to stretch and deliver the baby. This can increase symptom severity in people with hEDS. As you may imagine, Physical Therapy is one of the most important treatment strategies to help manage hypermobile Ehlers Danlos Syndrome. A regular exercise regime can help provide stabilization and support to hypermobile joints. A physical therapist can provide manual therapy to tight muscles, help realign joints that have subluxed, and give feedback for proper strengthening, coordination, and balance exercises. They can also provide insight for orthotics, braces, and referrals when needed. Specifically, pelvic floor PT can help address pelvic floor muscle dysfunction, pelvic organ prolapse, pregnancy symptoms, SI joint dysfunction, and pelvic pain.They can also help treat constipation and other bladder or bowel dysfunction related to hEDS. Discomfort with sex can also be treated in pelvic floor PT and education on joint protection and modified sex positions can be helpful for this issue. I was diagnosed with POTS – Postural orthostatic tachycardia syndrome when I was 12 years old. My middle school years were filled with dysautonomia symptoms, seeing many medical specialists, trying different medications, and lifestyle modifications. A year later my siblings and I were diagnosed with hypermobile Ehlers Danlos Syndrome and at that time not too much was understood other than we had stretchy joints. I felt like my siblings and I were always at the doctor for another symptom or ailment that no one realized were all related to hEDS.Talk about stress (which can have a negative effect on the pelvic floor by the way)! Fast forward 10 years when I was in college and my POTS symptoms were stable, I started experiencing severe back pain. Little did I know, this pain was really coming from a very hypermobile pelvis. My pelvis was subluxing and getting stuck in the wrong position all day every day with even small movements. Overtime, I started getting pain in my tailbone. This pain was so intense I could not sit down for longer than 30 minutes- which was very hard when I was in PT school all day long! My doctor finally recommended pelvic floor...

The post Hypermobility and Pelvic Health: What is hypermobility and how does it affect the pelvic floor? first appeared on .

Spoon Theory… A Spoonful of Sugar Doesn’t Always Cut It with Chronic Illness!

practicallyperfectpt — Thu, 18 Jul 2024 23:22:20 +0000

When I was younger, I was obsessed with the comedian, Dane Cook. Don’t judge me, I was once young and fancy free. He had this skit about a kid who becomes obsessed with snorting Nestle Quik, the chocolate powder. Anyway, one of the jokes from this skit was the kid saying “I can’t kick the ball today, I just can’t!” He was saying it because he was hooked on the cocaine-like addictiveness of the chocolate Nestle Quik drink but it stuck with me. In case you think I’m insane – check out the skit here. On days when I was not really ready to take on the day, I started to adopt the phrase “I can’t kick the ball today.” Did you ever wake up too tired, too overwhelmed, too sad, too anxious, too “something” to do an extra single thing in your day? How about to do the things you need like getting out of bed, brushing your teeth, washing your face, and getting dressed? I’m sure everyone has had a day like that. Maybe you pulled an all nighter working on a project. Maybe a child kept you up all night. Maybe you were ill for a few days and this wiped you out. Just a day where you wake up and feel like you’re not “in it to win it.” That you have to fake it until you make it. Days when dinner will be something quick and easy. Days when the only thing getting you out of the bed in the morning is the prospect of a good nap/ returning to bed. I would like to introduce you to a concept called the Spoon Theory. The Spoon Theory is “a metaphor used by people with chronic illnesses to explain how they manage their energy and cope with their condition. The theory was developed by Christine Miserandino, a blogger with lupus, in a 2003, to explain her chronic illness to friends.” As a physical therapist, what I like about the Spoon Theory is that it helps to illustrate the energetic needs and expenditures of a person with chronic illness or disability. We can look at spoons as a unit of energy. Each chore and task requires a different amount of spoons. This process helps people coping with chronic illnesses visualize their total daily energy. Together, the calculations become a benchmark for pacing and prioritization strategies. Not sure what I’m talking about? Imagine, energetically – whether that be emotionally, physically or spiritually – that you have a certain amount of spoons for a day. For fuzzy math purposes, let’s say you start with 75 spoons! We would then make a list of what you WANTED to complete in a day and how many spoons were needed for each task. Example of my day: The other thing to consider is that a task may not always cost the same amount of spoons from day to day and a similar task may entail different variables. You start out with this bank of spoons and then have to spend them on the tasks you need to do throughout your day. Make sense? If you’d like, take a moment to write out what a day in your life looks like and consider your spoon expenditure. Now think about what might happen if someone or something robs your spoon bank! You normally have 75 spoons and you’re gotten really good at budgeting them, saving them, and spreading their use throughout your life. And then, you sprain your ankle and this takes away 10 of your spoons. Now all you have is 65 to get through your day. Can you see how that day might be more challenging? Imagine that your ankle sprain lasts for a whole week. Everyday, it takes 10 of your spoons right off the top. You try to keep up with your life and so maybe you go into spoon debt, using more spoons than you really have. How do you feel? What happens when you are bankrupt of spoons and your child asks for a cup of water after being tucked in or your partner indicates they’d like to spoon you? You may not feel so open to those things. People dealing with chronic “stuff” whether from things like neuromuscular disease, autoimmune disease, mental health issues, neurodivergence, or cancer are likely to have a disruption to their spoon bank. As someone who has chronic fatigue issues from lifelong thyroid dysfunction, I am pretty familiar with the Spoon Theory. Sometimes you have to save the spoons you would spend on washing/drying your hair to make sure you have enough to entertain your kid until bed time. Sometimes you forfeit the spoons needed to make a healthy meal and opt in to a Wendy’s 4 for 4 so you have enough spoons to fit in a few more hours of work for the night. I wanted to take time to write about this concept as I explain this to my patients who are undergoing and feeling some health issues. Here are some tips from our practice. These tips can help people undergoing any type of struggle to manage their energy more effectively, leading to improved overall well-being and a better quality of life. Leave us a comment to let us know if this was helpful to you! If you missed our free Pelvic Health Check List, you can sign up for it here. Practically Yours, Dr. Mora and the Staff at PPPT

The post Spoon Theory… A Spoonful of Sugar Doesn’t Always Cut It with Chronic Illness! first appeared on .

Advocating for Yourself in Today’s Healthcare System: Some Recommendations from Your Pelvic Floor Therapist

practicallyperfectpt — Tue, 28 May 2024 21:19:37 +0000

I just want to go ahead and preface this with the fact that there may be some health triggers in this post and also that I have been diagnosed with a form of cancer that is usually very treatable with a good prognosis and I have not been struggling with cancer as long as many people are. I do not want to present this like I am an expert after I’ve had cancer for a whole 5 minutes. However, after this recent experience, I definitely have seen some interesting themes and areas of potential improvement in our healthcare system and it was time to update the Practically Perfect community as well. Welcome to a blog about sticking up for yourself in a medical system that does not always support patients in the best way possible. After having been diagnosed with Papillary Thyroid Cancer in January, 2024, I’ve been navigating the system from a patient’s perspective and I have some things to say! First, I don’t think that people realize how expensive it is to be sick. I know I never knew the full extent and really only knew about insurance benefits from a physical therapy perspective. Being very fortunate enough to have had insurance through a state university for years versus having a private plan for a self employed person also made a BIG difference. Having a serious medical issue means missed work, co-pays, deductibles, coinsurance, etc. It means prescriptions, equipment, travel and most important – time. I find my patients don’t always understand their benefits and sadly get surprised by bills from deductibles or copays they didn’t know about. Even knowing my benefits after having researched and selected a plan, I still felt surprised by the amount of bills after my thyroid testing and surgery. I recommend if using insurance to call up your company and find out what benefits you have and how they apply to each provider you will have to see. Use the insurance portal and your supplemental materials to help you navigate. It’s a shame but in our medical system we have to advocate for ourselves. I wish that there was someone like Dr. House and his team that existed to put together all the different pieces of a patient puzzle, working to create a plan of care to help find a solution. Sadly, when a person typically has an illness or a problem, they can see anywhere from 3 to 10 medical providers and still potentially come away without a clear plan of care or action. As our healthcare system evolves to have different niche practices and specialties, different providers are unwilling to address areas which they do not feel that they are experts on. This results in seeing a primary care provider only to be sent off to different experts. I love a good expert but what I frequently see happen is that one expert looks at a patient from one lens, another expert looks from another lens, another expert looks from a different perspective, and potentially there is not have a lot of crossing over or collaboration in the plan of care When we go to a provider, we want answers. What no one gets told is that frequently there is not an immediate answer, if there is an answer at all. When you have cancer, there may not be an immediate diagnosis, immediate knowing of the severity, and also no immediate knowing of when the cancer is cured. Having cancer is a waiting game. Usually, you get diagnosed with something that looks suspicious. Then you get testing to see if that suspiciousness is actually pathological. Then consultation with providers. Then they do more testing to see how pathological. Then you have more testing to see if you need additional interventions. Then you get to wait and see if the cancer is gone or has come back. My surgery to remove my thyroid was on February 15th, 2024 and they were able to remove my complete thyroid and one parathyroid gland. They biopsied eight local lymph nodes and pathology came back that there was no lymph node involvement in that area. They were surprised that the type of papillary thyroid cancer that I had was more aggressive than the expected as papillary thyroid cancer is usually pretty chill as far as cancers go. At that point my ENT surgeon released me and returned me back to my endocrinologist who would manage my postoperative monitoring. I’d have regular blood work and ultrasounds to monitor my condition. If there is something called thyroglobulin in my bloodstream, that would mean that there is still thyroid cancer somewhere within my system and I will require radioactive iodine treatment. If my levels look good, I will continue to be monitored on a regular basis to ensure that nothing troublesome has popped up. After my conversation with my local endocrinologist, I have also decided to get a second opinion in a different medical system to make sure I had peace of mind. This got me thinking, would I feel as comfortable navigating through these appointments, decisions, and appointments if I wasn’t a medical professional. The answer was “probably not.” I myself felt like I was being somewhat rebellious because I didn’t want to wait 6 months for further answers on how my body was handling its cancer journey. While I sat in a waiting room, I made a list of some ways that a person can advocate for themself including the following. I also made a handy dandy little handout to help you do some of these things, available at the end of this blog! Keep good records Create a list of all of your medical providers, who manages what, who prescribes what and how often you see them. Start a list of appointments with short descriptions of each visit – who, what, where, when, why, how… Be proactive with your medications and supplements Create an up-to-date list of medications and supplements with their purpose, their dosage and when you take them. Don’t be afraid to ask for a second opinion A provider may not feel like your “cup of tea” or a good fit. Feel free to seek out a second opinion so you have options and can make educated decisions. Don’t be afraid to ask for clarification if you don’t understand and answer Providers are people too and sometimes they need reminders to explain things in a way YOU understand. Not everyone processes and learns in the same way. If you don’t understand say something like “Thank you for that explanation, but I’m still not fully understanding, can you elaborate/repeat/describe/etc.” Get it in writing It is your right to have answers in writing, so request a copy of your test results, educational materials, and office visit summaries. Loop everyone in Keep your whole team in the loop, make sure that your records are being sent to all of your providers so they can look at you as a whole person and a whole picture. Bring a support person with you to your appointments This will help you to absorb the information. When we are getting bad news, it can be hard to understand, process, or focus. Having an additional person in the room can help to fill in the blanks if you forget something, help you to ask questions, or just give you support to keep you calmer during a stressful time. Listen to your body and trust your intuition If you don’t think something works for you, make sure to tell your provider that. If you know from past experiences that something is not a good option for your body, tell your provider. As a provider in niche areas, I think I must get to hear people’s tales of woe in navigating the healthcare system more than others. I get to hear stories of people experiencing medical trauma or being medically gaslit by providers and it is terrible. The amount of people wandering through the health system for wellness or during an injury or illness is tragic. You’ll see a document that you can download and fill in to help you keep your medical management organized. Some additional tips in finding quality providers include using a certification or national organization as a way to find them. Using word of mouth and taking recommendations from providers you know and trust is also a great way to find link minded and trust worthy providers. Beware of red flags for providers including a lack of getting your consent, not hearing your concerns, not respecting your rights and autonomy as patients. If something doesn’t feel right, trust your gut and move on. Some other notes… What is medical gaslighting? Medical gaslighting occurs when a medical professional undermines or dismisses a patient’s symptoms, experiences, or concerns, making them doubt their own perceptions or sanity. It can involve downplaying symptoms, attributing them to psychological causes without proper evaluation, or implying that the patient is exaggerating or imagining their illness. This can lead to delayed diagnosis, inadequate treatment, and significant emotional distress for the patient. It’s a serious issue that undermines trust in healthcare and can have detrimental effects on patient outcomes. What is medical trauma? Medical trauma refers to the emotional and psychological distress experienced by individuals as a result of their interactions with the healthcare system. This trauma can stem from various sources, including: Medical trauma can manifest as anxiety, depression, post-traumatic stress disorder (PTSD), or other mental health conditions. It’s important for healthcare providers to recognize the potential for medical trauma and provide empathetic, patient-centered care to mitigate its effects.

The post Advocating for Yourself in Today’s Healthcare System: Some Recommendations from Your Pelvic Floor Therapist first appeared on .

What is a manual therapy? What is a certified manual therapist? What does “CIMT” mean??

practicallyperfectpt — Fri, 19 Apr 2024 20:00:31 +0000

Written by Jessica Soltys, PT, MPT, CIMT As a long time physical therapist and certified integrated manual therapist (CIMT), I often get asked “what is a manual therapist?” That got me thinking about what would be the easiest way to explain this concept and niche of therapy to my patients. Let’s start with what to expect with your visits. As a CIMT, we utilize a “test-treat-retest” model. At the beginning of your session, I will take a detailed history and run you through tests, as well as assess body movements. Don’t worry, I will explain each test and walk you through what is needed to perform it. Once manual therapy techniques are chosen to address your issues, I will then retest to see if your pain has improved. This may include testing of positions that normally exacerbate your pain symptoms. Assessment includes looking at pain issues through the “Joint-Muscle-Fascia-Compensation” model. We are looking for the “driver” of your pain. Sometimes, we have to think outside the box and look to see if other areas of the body are contributing to your pain. Did you know that a pelvic alignment issue could cause shoulder pain. Once we get the pain under control, then the real work begins. This requires patient involvement. We teach you how to stabilize to prevent further pain. It’s like building a house, if the foundation is not stable then things will begin to break down as the forces of life occur around it. Think about a beach house with a failing foundation, shaking on the shoreline. Our final goal is to prepare you to return to activity. These could be goals for things like cleaning your house, performing job activities, running a marathon. We want you to be able to do whatever it is that you want to do, we make every effort for you to get back to those things. Even if it’s being able to do the things we don’t want to do, like cleaning toilets or scrubbing floors! I think many of the factors mentioned above could be included in the sessions of many physical therapists, chiropractors or massage therapists, but the take-away is that you should expect a lot of hands-on treatment during your visit with a CIMT and that you will be super involved in your sessions. Our hope is that one day you won’t need us and can live life the way you want, doing the things you love! Always remember this manual therapist is here if things slide back or pain gets in the way!

The post What is a manual therapy? What is a certified manual therapist? What does “CIMT” mean?? first appeared on .

“Sit Happens: Conquering Coccyx Pain with the Power of Physical Therapy”

practicallyperfectpt — Tue, 19 Mar 2024 17:51:09 +0000

This blog was written by our wonderful Stockton physical therapy, Cassidy Hogan. SPT. Welcome to a blog about pains in the butt, well, coccyx pain. Many people know the coccyx by the name “tailbone”. Coccyx pain, also known as coccydynia, is more than just a passing discomfort, it’s an unwelcome companion that disrupts the ebb and flow of everyday activities. From the seemingly simple act of sitting, to the complex dance of standing and moving around, each moment becomes a strategic negotiation with pain. Tasks that once seemed so simple like working at a desk, exercising, going to the bathroom, having sex, or lounging comfortably all transform into daily challenges. The persistent ache serves as a constant reminder, casting a shadow over the once-effortless activities of life. Have you ever cringed at the thought of sitting through a movie marathon or a long car ride? Well, you’re not alone. Up to 20% of people experience coccyx pain throughout their lives. Stay tuned as we unravel the challenges of coccydynia, and how you can seek solace and solutions. So what is it about this little bone that can be so uncomfortable? The coccyx is a tiny, curved, triangular-shaped bone at the very end of your spinal column below the sacrum. It is made up of 3-5 smaller bones fused together and creates the very end of the spinal column. The coccyx has several important jobs such as: bearing our body weight through the pelvis in sitting and moving positions, maintaining proper posture, and serving as an attachment site for many ligaments, tendons, and muscles in the area. It also plays a large role in supporting the body when we sit and with other activities such as standing and walking. Because so many other structures attach to the coccyx, it greatly contributes to the stability of the pelvis and the spine. As you can see, something so small can be so mighty! Many people experience coccydynia in their lifetime due to injuries, falls, pregnancies or childbirths, being over or underweight, sitting for a long time, and weak and/or tight muscles and ligaments. Coccydynia can feel tender, achy, or sharp and can be pinpointed right to the coccyx or refer to other areas like our pelvis or lower back. The journey through coccyx pain begins with uncovering its origins and being able to address the cause to reduce the cascade of consequences resulting from the pain. When discomfort lingers in this region, the first step towards relief is a precise diagnosis, a task that often requires the expertise of healthcare professionals, particularly those well-versed in the language of coccyx pain. To uncover the underlying nuisance of coccyx pain, healthcare professionals put on their detective caps to become investigators. They thoroughly explore their patient’s medical history, examining the history of falls, childbirth, and lifestyle habits. This narrative, combined with a thorough physical examination, forms the initial clues in unraveling the complexity of coccydynia and pinpointing the root cause. While the history and physical examination offer valuable insights, the quest for a precise diagnosis may also involve imaging studies. X-rays and other diagnostic tools become the magnifying glass to reveal any fractures, dislocations, or structural abnormalities that might be concealed beneath the surface. These images serve as the roadmap, guiding healthcare professionals to the heart of the matter. Now, we have our physical therapist, a seasoned detective in the realm of many musculoskeletal abnormalities. Specializing in detecting and understanding pain and dysfunction, physical therapists use their expertise to assess how the pelvis, spine, and surrounding structures move in our bodies. Through palpation, range of motion tests, and other diagnostic techniques, they can put the pieces of the puzzle together and come up with some comforting solutions. At Practically Perfect Physical Therapy, there are amazing pelvic floor physical therapists with years of experience who have the capabilities to assess coccydynia thoroughly through an orthopedic examination, including the muscles and structures of the pelvic floor. Combining a comprehensive understanding of a patient’s story with insights from imaging studies as well as physical examinations and assessments, healthcare professionals can offer a diagnosis. This diagnosis becomes the foundation for effective treatment strategies, paving the way for a targeted approach to coccyx pain management. This diagnosis allows healthcare providers, including physical therapists, to create a tailored plan that manages coccyx pain and brings back the ease of daily activities once taken for granted. Physical therapists are able to implement various treatment strategies to alleviate coccydynia, restore function, and specifically tailor & adapt treatment sessions according to patient tolerance. It is not a one-size-fits-all, cookie-cutter type of treatment: each patient is unique. Joint mobilizations of the lower back, sacrum, and coccyx as well as soft tissue mobilizations to the surrounding soft tissues (muscles, tendons, ligaments, fascia) are beneficial in reducing pain and increasing range of motion. Freeing up any tension that is putting stress on the coccyx can provide tremendous pain relief. Physical therapists can utilize many techniques to access these areas and mobilize or relax them including manual techniques on the outside of the body as well as internally through the vaginal and rectal openings to access those pelvic floor muscles. Sometimes the muscles of our pelvic floor become tight, cranky, and irritated and may require some manual relaxation techniques, just like tight neck or back muscles people so often experience. Once these regions can relax and become more mobile with the help of physical therapy, we will notice decreased pain levels and can begin to hone in on postural exercises, breathing, stretching, and strengthening in combination with skilled manual therapy performed by a physical therapist. Strengthening the muscles surrounding the coccyx helps to reduce pain by stabilizing the area and reduces undue pressures on the coccyx that lead to symptoms of pain and discomfort. Our pelvic floor muscles work together with the muscles of our core and lower extremities to support our internal organs, to regulate bowel, bladder, and sexual functions, and support for many other daily functional tasks. Physical therapists can provide patients with exercises that strengthen and/or relax muscles surrounding the coccyx and related structures at the proper times. They are able to teach patients when we should be strengthening versus relaxing muscles and coordinate the timing of each to maintain proper alignment, function and decrease pain. Each patient is unique and their symptoms will change with time. Physical therapists are there to adapt and modify according to how patients are feeling and can provide patients with pain relief, motion, strength, and the tools to maintain their progress through exercises, stretches, and utilization of helpful equipment properly at home. There are many beneficial pieces of equipment a patient can use at home themselves in conjunction with learned exercises and stretches to carry on their progress. Posture, often a silent culprit, plays a significant role in coccydynia. Activities impacting posture, like sitting for long hours or bending over frequently, can create a chain reaction of changes in the body. Sitting at a desk for a long day at the office, leaning over to get a closer look at a client’s nails, bending over to see your students’ work at their desk: the possibilities of daily activities that impact our posture are endless. While pain may stem from the coccyx or other areas, addressing overall body posture proves key. This cascade of changes from pain and abnormal postures can result in our body moving differently in attempts consistently trying to avoid the pain. Mindful sitting, standing, walking, and transitioning between movements can make a significant impact on managing coccydynia. Some common ergonomic adjustments physical therapists often employ include proper erect sitting posture, wedge cushions for sitting, or donut-shaped cushions to reduce pain and discomfort. As we conclude this exploration of coccyx pain, I hope the various interventions and strategies we have explored can offer some relief and reassurance as you navigate what will best address your body and lifestyle. Although coccydynia is an annoying, uninvited guest disrupting everyday life, being armed with understanding and the expertise of healthcare professionals, particularly physical therapists, can uncover pathways to comfort and relief. The coccyx, though small in size, holds such a significant influence over our well-being. Its role in supporting the body during various activities is nothing short of mighty. Yet, injuries, falls, pregnancies, and other factors can turn this structure into a source of persistent discomfort. The diagnostic journey, led by healthcare professionals, involves unraveling the complexities of coccydynia. Patient narratives, physical examinations, and imaging studies serve to provide answers, guiding us to the heart of the matter. The physical therapist, a skilled detective in the realm of musculoskeletal complexities, takes on the role of crafting unique, tailored plans that manage pain and restore function. Physical therapy emerges as a symbol of hope, offering a variety of strategies to alleviate coccyx pain. From targeted pain relief and posture correction to personalized exercises and lifestyle adjustments, the approach is holistic and patient-centered. The journey towards comfort is dynamic, with therapists adapting and modifying strategies as needed. So, as we conclude this chapter, remember that coccyx pain may feel like it is taking over, but with the right guidance, it doesn’t have to define the narrative. Armed with knowledge and the support of healthcare professionals, the path to reclaiming comfort becomes easier. Here’s to a future filled with comfort, mobility, and the resilience to face each day, coccydynia-free. Resources, Sites, Links, Studies

The post “Sit Happens: Conquering Coccyx Pain with the Power of Physical Therapy” first appeared on .

When Life Hands Your Thyroid Cancer…Get a Lemon Colored Thyroid Stuffy?

practicallyperfectpt — Thu, 08 Feb 2024 17:57:02 +0000

I had big plans for 2024. This was the year to choose peace, love and happiness. 2022 and 2023 brought a lot of change to my life and I was looking forward to continuing to find a healthier version of myself. If you’ve been here for a while, you may remember my blog called “Lumps and Lymph and Tests, Oh My” where I shared about having some issues with random lymph nodes in my armpits. As part of that follow-up care, I had to continue to see my endocrinologist and the breast specialist every 6 months for the next 3 years as per the protocol, getting regular mammograms and thyroid ultrasounds to make sure my systems behaved themselves. I was approaching the end of my screening protocol when I had my bi-annual appointment with my thyroid specialist in June. We talked about how my thyroid was due for an ultrasound and since I had already met my insurance deductible for the year, we decided to have the test done in December of 2023. When I went for my follow-up appointment, my endocrinologist saw that one of my cysts had grown beyond the “allotted” amount and he said this warranted a biopsy. I had previously had a thyroid biopsy 6+ years ago and was not worried at all. My body likes to grow cysts and so I was really just annoyed to have to schedule another appointment. I’m not going to lie, being a busy business owner who’s also a single mom and self insured, I didn’t really want to have to pay my deductible and make time to go for a semi-painful test right at the start of the new year and I debated pushing off this test until later in the year. Luckily, I decided to be a responsible adult and scheduled the test for as soon as possible. I had a lovely experience at Atlantic Medical Imaging in Galloway. I was in and out in under 30 minutes with no pain! I was quite surprised when I got an email two days later from the pathology lab saying that I had thyroid cancer. I have worked with patients with cancer my whole career but I don’t think anything ever prepares you for getting that diagnosis for yourself. I sat in my office on a Thursday, about to shut down my computer and rush to the school bus stop to meet my daughter and read the words “malignant” and “papillary thyroid carcinoma” multiple times before they sank in. I immediately called my endocrinologist’s office and asked them to interpret the results. Unfortunately, my provider was on vacation and they hadn’t even received the results. My doctor very kindly called me the next day and I texted him a picture of the results and he confirmed that I had thyroid cancer based on that report. I was shocked. I had no new symptoms other than my usual thyroid problems – temperature insensitivity, fatigue, weight fluctuation, dry skin. I’ve had thyroid issues since I was 23 years old and have been on thyroid medicine since then, so these were not new to me. My doctor recommended that I find an endocrinologist oncologist as soon as possible for a consultation for surgery. I lucked out and it snowed enough for a snow day, which meant I had a day to research some of the local programs that took my insurance and decided to go with Cooper’s program. I went for my surgical consult and was given the option of a full thyroidectomy or a partial thyroidectomy with the pros and cons being listed for both. If I did a partial, the cysts on the remaining part of my thyroid would have to be regularly monitored with more ultrasounds and biopsies and I just don’t have the time or mental bandwidth for that. I chose the full thyroidectomy because that would mean less invasive and easier screening with just a blood test on a regular basis to know if the cancer came back versus having to undergo more ultrasounds and more biopsies. (Side note: If you have to have a fine needle aspiration biopsy, don’t be scared. They’re not terrible but it’s also not something that you want to do every 3 to 6 months. It’s honestly no worse than having a cavity filled and much shorter.) My surgeon wanted to schedule the surgery as soon as possible due to my age and I was scheduled for the procedure a week later. I had to do some pre-op testing to look at the lymph nodes in the surrounding area and do additional blood work to make sure that I was healthy enough for surgery. I had a planned long weekend trip to California with my significant other that I chose to continue to take as a last hurrah before the medical stuff that would be upcoming for me in the next few months. Unfortunately for me, I picked up a bug along the way and returned home with the snuffles. The pre-op ultrasound showed that I had some “weird” lymph nodes that needed to be biopsied before my surgery because there was not way to tell if it was due to my sickness or my thyroid cancer. I went from having a surgery date of 2/2 to 2/15. The most frustrating part for me was the disruption in my scheduling. Anyone who knows me, knows I like to run a nicely scheduled life, and having to cancel, reschedule, then cancel my patients was really tough for me emotionally. I went for my second biopsy procedure (at Cooper this time) and will await those results. The big difference for my surgery on the 15th will be whether they take my whole thyroid and only my whole thyroid or whether they take my thyroid and the problematic lymph nodes that they see. The reason they don’t want to go taking lymph nodes out willy nilly is that the lymphatic system runs how fluid moves in the body and being without lymph nodes can cause problems such as lymphedema. I am truly lucky that my doctor followed protocols to ensure that I was screened appropriately for cancer. I did have the added benefits of having a medical background and knowing to be proactive with a strong family history of cancer. Because I had no symptoms, if I was not routinely assessed, I could have lived a lot longer not knowing that I had cancer which could have allowed it to spread even further into my body. I am told that because of my age and because of the stage and location of the cancer, that the odds are very much in my favor. After the surgery, they will do pathology on my thyroid to decide if I need any further intervention afterwards. But my surgeon was very hopeful that the thyroidectomy would be the “cure” for this particular type of cancer with regular follow up monitoring. Why am I writing a blog telling you very personal details about my medical history and situation? My “Practically Perfect” community shares a lot of their personal details to help them get better and I believe in some transparency as a provider. I get to be there with our patients as they go through trials and tribulations. I wanted to “keep it real” and show you that providers also sometimes undergo these things. It helps to make us more compassionate and empathic providers to you, and it also helps us to understand how to help you advocate for yourself. If you’ve worked with me, you know I’m brainstorming a worksheet on “how to medically advocate for yourself in a sticky situation…” IYKYK If you’re worried about your services at Practically Perfect, please do not! For the past year and a half we have built a team of skilled providers that can all take excellent care of our patients. If you’re not sure what services Practically Perfect Physical Therapy offers, you should know we basically do everything. We treat newborns to the very elderly and although we market ourselves as “pelvic health and pediatrics,” we do ALL OF THE THINGS! A list to include the things that we do as far as therapy goes includes: * Pelvic floor therapy – pee, poop and sex things, plus prolapse, pain and “down there” cancers * Pediatric therapy – torticollis (tilted head), plagiocephaly (flat head), delayed gross motor skills (baby not doing what they’re supposed to OR doing it in a weird way) * Pediatric pelvic floor therapy – potty training, constipation, pee leaks, poop smears, bed wetting, etc. * Lactation support and breast body work and positioning for tethered oral tissues including tongue, lip and cheek ties * Vestibular therapy – for vertigo, balance and dizziness * Neurological therapy – for things like Parkinson’s & MS * TMJ therapy – for those painful and clicking jaws * Chronic pain services – for those aches and pains that won’t go away * General orthopedic stuff – that tricky knee, sore back, painful neck etc. We also offer a variety of wellness activities because we believe in preventative and maintenance care: Monthly Birth Preparation Classes Weekly Baby+Me Play skills We also intermittently offer infant massage classes and sex education classes based on interest. If any of these things sound amazing to you, follow along on our mailing list to find out when these events will be happening. I’m so grateful to have such a supportive network of family, friends and patients. I’m anxious to have my surgery completed to move on to the next phase of healing. I will continue to give updates as I have them. In the meantime, please be patient with us if we have to reschedule appointments. It does not help that our electronic record keeping system broke up with our billing company the day after I got diagnosed! I will have to always battle with myself to put my care before that of taking care of patients but unfortunately the next few weeks do not give me much of an option. You can best help me by sending us positive vibes, be patient if we must reschedule and continue to support our small business!

The post When Life Hands Your Thyroid Cancer…Get a Lemon Colored Thyroid Stuffy? first appeared on .

What is play…and why won’t Practically Perfect PT stop talking about it?

practicallyperfectpt — Sun, 07 Jan 2024 20:54:00 +0000

Nicole Sturgill, PT, DPT, and Pediatric Program Coordination for Practically Perfect Physical Therapy brings us today’s blog. Nicole writes: What is play? What does it mean to have play skills? How can play possibly be important? Let’s dive into this topic together! Play is one of the most essential activities babies do. Through play, babies explore their environment and make sense of new and different information. They figure out how toys work and how their body works through play. Watching a baby discover their hands for the first time is one of the most fascinating events to witness as they figure out what this little body they are in is all about. The experiences babies have during play help strengthen and expand networks of connections in their developing brains. During the early years, babies’ brains form many more connections than the brain will ever need. Connections used regularly, through play and other experiences, become stronger and branch out into more complex networks. Connections not used regularly are eventually eliminated through pruning (similar to how you prune a plant to promote new growth). Play is crucial for brain development because it gives babies and young children opportunities to experience new things and practice existing skills, which strengthens those connections made and promotes new connections. Babies learn through exploration, exploring with their hands, feet, and mouths. The more exposure a baby has to different faces, textures, sounds and environments, the more connections will be made in their amazing, growing brain. This is why some infants, babies, and toddlers seek sensory or movement experiences. They are trying to learn all the things in as many ways as they can by looking, listening, touching, and mouthing, to name a few. This explains the oddities like licking something disgusting or trying to eat rocks: they didn’t know how the experience would go and decided to find out! What does play look like for an infant? Babies start by playing on their back and observing the world around them while figuring out how to move their arms and legs against gravity. Tummy time is another great position for babies to play. In this position, they learn how to pick their head up against gravity, and use their arms to support themselves. Once they figure out both of those positions, next up is to figure out how to move between laying on their back and laying on their tummy. They need motivation to do this: they need toys and textures around them to reach for. Before you know it, your baby will be sitting up and learning how to reach for those toys without falling over! It seems like movement would be simple, and for some babies it really is. I like to call these kiddos “motor marvels”, they are the babies doing things a week before expected that make all the other parents worry if their baby is behind. For other children, movement may not come as easily and that is okay. As a pediatric therapist with years of experience, I find that children can excel in one area and may struggle in others. When we look at play skills, there are a few different categories. Some include visual and auditory development, gross motor skills (big movements), fine motor skills (small movements), language skills, sensory milestones, feeding benchmarks, and vestibular senses. In order to fully engage in their play environment, a baby must learn to wrangle all of these to have balanced life experiences. Let’s take rolling as an example. It seems easy enough, right? Just roll over from your belly to your back! But it requires a lot of different systems to interplay. Baby has to lift their head, get their arms and legs in the right position, optimize or override their primitive reflexes, be motivated (looking for fun or straight up MAD), and then put it all together to make it happen. Some babies do it once and go, “Oh hey, that was fun,” or “Cool bruh, I got to this new place.” Others feel rolling from tummy to back was a terrifying fall and refuse to ever go near that movement again. You never know what baby you will get as a parent. Some of us get the cautious little turtles slowly plodding towards movement, and some get the adventurous little hares, racing through their milestones at a breakneck pace. The other important thing to remember is that not all babies develop at the same rate. You can’t compare to your friend’s kids. You cannot compare your child to a similarly aged family member. You can’t even compare one kiddo to another in the same family. Achievement of milestones and the timing of such is as unique as a fingerprint. There are approximations and ranges for development, and we talk about them a lot in our online course “Baby’s Practically Perfect First Year,” but it is important to remember these are just guidelines and windows. Practically Perfect Physical Therapy offers something unique to the Atlantic County area. We host weekly classes for babies (and their caregivers) to come learn, play, and interact. If you read through this and thought, “I think we need help,” these classes are for you. If you have been stressing over things like, “Is my baby normal?” and “Should they be doing that?” Also perhaps you may be thinking, “It looks like they’re trying to crawl,but I don’t know what age babies even do that…” Let me say this: please come play with us at a Baby+Me Playskills class. This class is aimed for babies ages 0 – 9 months, and we promise they are fun for caregiver and baby. You may not be really sure how to motivate your baby to explore their environment. You may be wondering what toys will appeal to your little one at their stage of development. Are you thinking about why your little love bug keeps getting their arm stuck when trying to roll over? Join a baby class led by a pediatric physical therapist that can show you all the tips and tricks to help your growing miracle thrive! Your baby will benefit from group play with babies their age by watching and demonstrating what they see all around them! Playing starts at birth, and babies love to be surrounded by other babies. Another benefit of baby class, that is just as important, is having other parents in the same season of life to chat with, learn from, and laugh with about all the ups and downs of having a little one under the age of one. We offer two options for our Baby+Me Playskills classes, including a drop in rate and a deeply discounted monthly package. We want you to come learn with us and we want to help you and your baby in all of the ways possible to help them learn all they can from their surroundings. Sign up for a class today. These also make great gifts for those you know with littles.

The post What is play…and why won’t Practically Perfect PT stop talking about it? first appeared on .