Updated: Aug 15
I take a holistic approach to each patient I see. That means, if a patient who has chronic pain at her cesarean scar, I work on the scar tissue mobility. But, I also consider the role of her traumatic birth on her pain. “We keep the issues in the tissues!” I allow space for her to tell her birth story again and again.
If a mama has leaking with her runs, I will prescribe pelvic floor muscle exercises (if she is weak-- some mamas have leaking because their pelvic floor is tight!). I will also look at her ankle and foot and make sure she is shock absorbing. I will look at her neck, ribs and back and make sure she is getting the mobility she needs there. I will look at her hips and other core muscles and make sure she is not tight in her diaphragm (breathing muscle). I will look at her breathing patterns and retrain any breath holding patterns. I look at the whole body from occiput (head) to foot.
If a patient with endometriosis has chronic pelvic pain, I treat the tissue issues like pelvic floor tension, tender points in the muscles of the hips, abdominal wall and thighs and work on using the breath to help her "let go" in her pelvic floor. We might use surface EMG so she can “see” her muscles better. And, I also educate her on the role of specific dietary strategies that will help her liver process the extra estrogen in her body. I might give her a custom guided meditation for relaxation.
A recent young woman with painful sex had such intense burning at the skin layer of her vaginal opening that I helped her connect the dots between this, her IBS, constipation, migraines and TMJ issues with a food sensitivity. Together, we investigated some research on the role of gut health on vulvar pain. Then, she dramatically changed her diet and experienced resolution of her constipation and a 50% improvement in her vulvar pain.
If a kiddo who comes to see me with constipation is struggling, we work on using a squatty potty position, belly massage to help motility, exercises to help motility and pelvic floor coordination with surface EMG. And, I also will educate the family on play vs technology time, healthy potty habits, whole foods diet and the top constipating foods for kids (dairy, gluten, soy and corn) and how to do an elimination diet. We talk about the good bugs in the gut and how to get more good bugs (because gut flora is everything!).
I also take a team approach and refer to nutritionists, sex counselors, therapists, massage therapists, acupuncturists, chiropractors and physicians to optimize a patient’s care. Physical therapy is rooted in science, but the longer I practice, I recognize the art and intuition in it as well. And I find that science is verifying a lot of things that used to be considered “out there” like yoga, meditation, mindfulness, visceral mobilization and the gut microflora.