Pelvic Health and You

May is Pelvic Health Month and here at Advanced, we are all about changing the narrative around symptoms/conditions that may be caused by pelvic floor dysfunction.

Did you know that 1 in every 3 women will develop a pelvic floor dysfunction in her lifetime and 1 in every 8 men* will develop a pelvic floor dysfunction in his lifetime?

While very common, it’s certainly not normal.

Pelvic floor issues may be embarrassing to admit to and even harder to talk about, but they affect the quality of your life. We understand that you may have questions; that’s why we are here.

Not all physical therapy practices have a therapist who specializes in pelvic pain/dysfunction, but Advanced PT’s Autumn Pawlowski is a physical therapist with training and experience in the management of a wide range of issues (for both women and men) that occur with compromised pelvic floor muscles.

When you are ready, please call the Appleton North clinic (920.991.2561) to request an appointment with Autumn.

In the meantime, here are a few facts that just might be the inspiration for you to take action and get back to living the life you want. 

What are pelvic floor muscles?

●     Group of muscles in your pelvis that is kind of like a hammock between your sit bones

●      Support pelvic organs

●       Maintain continence

●      Role in sexual function

What happens if there is dysfunction in the pelvic floor muscles?

●     Urinary incontinence

●     Urinary frequency and/or urgency

●     Pelvic pain

●     Heaviness/fullness feeling

●     Low back or hip pain

Are there other conditions that a pelvic health physical therapist could help out with?

●     After a prostatectomy

●     Prenatal and postpartum

●   Post-cesarean delivery care

What should I expect during my first pelvic health physical therapy visit?

Your pelvic health physical therapist has gone through extensive training in order to treat individuals who have pelvic floor dysfunction.

The first visit will allow you to discuss your concerns with the pelvic health physical therapist and they will ask you follow-up questions.

Then the provider will complete an assessment to help determine the root cause of your symptoms. The assessment may include an orthopedic screen (looking at your back/hips) to see if there are any significant findings that may be contributing to your symptoms.

If the pelvic health physical therapist feels like an internal pelvic floor assessment would be appropriate, they will explain what that would entail. The internal pelvic floor assessment would only be completed if you provide consent. Based on the findings, the pelvic health physical therapist will develop a treatment plan for you.

Treatment may include modifying bathroom habits, modifying diet/fluid intake, strengthening exercises, stretching exercises, breathing techniques, and discussing how the nervous system has a role in your symptoms.

How do I set up an appointment with a pelvic health physical therapist?

You are not alone with your symptoms.

We know how difficult it may be to pick up the phone and call to schedule an appointment, but we promise you you’ll be glad you did. The pelvic health physical therapist will be able to answer a lot of your questions during the first visit. 

Call our Appleton North clinic at 920.991.2561 to request an appointment with Autumn Pawlowski PT, DPT.

*Data is limited for our populations that do not align with the above genders; however, we recognize that every population has unique pelvic floor needs and implications.*

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References:

https://www.uclahealth.org/medical-services/womens-pelvic-health/patient-education/pelvic-floor-disorders#:~:text=One%20in%20three%20women%20will,problems%2C%20or%20bowel%20control%20problems.

https://theconversation.com/men-have-pelvic-floors-too-and-can-benefit-when-they-exercise-them-regularly-184451#:~:text=Though%20pelvic%20floor%20problems%20are,pelvic%20floor%2C%20bladder%20or%20bowel.

The Importance of the Lymphatic System and How We Can Help

Photo caption: OT and Certified Lymphedema Therapist, Allie, teaches our Clinicians about Lymphedema management after surgery.

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What is the Lymphatic System?

The lymphatic system is a part of our body that helps keep us healthy.

This system is made up of lymph nodes, lymph vessels, and lymphatic organs, like the spleen and thymus gland. Lymph is a clear fluid that flows through the lymphatic vessels and is filtered by the lymph nodes. It's like a network of tiny tunnels and filters that help remove germs and waste from our bodies.

When germs and other harmful substances enter our bodies, they can get trapped in the lymphatic system. The lymph nodes filter out these harmful substances, like bacteria, viruses, and cancer cells. They also produce special cells called lymphocytes that help fight infection and disease.

Sometimes, the lymphatic system can become blocked. This condition is called lymphedema. Lymphedema can cause swelling in the arms or legs and can be caused by things like surgery, radiation therapy, or infection.

How can We Help?

Connecting with a physical therapist, occupational therapist or Certified Lymphedema Therapist can help manage lymphedema.

These practitioners can design exercise programs that help move lymphatic fluid out of the affected area, reduce swelling, and improve the range of motion.

They may also use techniques like manual lymphatic drainage massage, compression bandaging, and skin care to manage the condition— In these situations, it may be best to connect with a Certified Lymphedema Therapist to discuss this further.

In summary, it's essential to take care of our lymphatic system so it can keep us healthy. We can do this by eating a healthy diet, exercising enough, avoiding injuries that could damage the lymphatic system, and practicing good hygiene. If we do develop lymphedema or other lymphatic system disorders, it’s best to connect with a trained provider that can help manage the condition to reduce pain, improve mobility and keep you doing the things you love to do!

Connect with one of our skilled Certified Lymphedema Specialists to learn more:

• Occupational Therapist, Allison Salm at our Touchmark location

• Physical Therapist, Lara Bleck at our Appleton West location.

Contact us here if you want to schedule a visit with our team.

What is Modern Cupping Therapy?

Modern Cupping Therapy is a form of alternative therapy that has gained popularity in recent years. It involves the use of cups made of glass, silicone, or plastic that are placed on the skin to create suction. This suction is believed to increase blood flow to the area and promote healing.

Cupping therapy has been used for centuries in traditional Chinese medicine, and its modern iteration has evolved to become a non-invasive and safe therapy.

Here's what you need to know about this popular alternative therapy:

How does Modern Cupping Therapy work?

During a cupping session, a therapist places cups on the skin and creates suction. The suction is created using a handheld pump. Once the cups are in place, they are left on the skin for several minutes before being removed. Sometimes, they are moved in a very specific pattern or sequence depending on the desired effect.

The suction created by the cups is believed to stimulate blood flow to the area and promote healing. It can also help to relax the muscles, reduce pain, and improve overall circulation.

What conditions can Modern Cupping Therapy help with?

It can be used to help many different conditions including, but not limited to, those listed below:

• Back pain

• Neck pain

• Shoulder pain

• Knee pain

• Migraines

• Arthritis

• Fibromyalgia

• Lymphedema

Is Modern Cupping Therapy safe?

Yes! It is generally safe when performed by a qualified healthcare professional. Minor side effects may include mild discomfort, bruising, or skin irritation. It is important to seek the advice of a qualified healthcare professional before using cupping therapy.

Conclusion

Modern Cupping Therapy is a popular alternative therapy that has gained popularity in recent years. It involves the use of cups placed on the skin to create suction, which is believed to stimulate blood flow and promote healing. The therapy is generally safe when performed by a qualified healthcare professional and can help with a variety of conditions. However, it should not be used as a replacement for conventional medical treatment. If you are interested in trying Modern Cupping Therapy, call today and we can chat further to determine if cupping is right for you and how to work it into your treatment program.

References:

1. Wang, Sz., Lu, Yh., Wu, M. et al. Cupping Therapy for Diseases: An Overview of Scientific Evidence from 2009 to 2019. Chin. J. Integr. Med. 27, 394–400 (2021). https://doi.org/10.1007/s11655-020-3060-y

2. Mohamed, Ayman A., Zhang, Xueyan, and Jan, Yih-Kuen. ‘Evidence-based and Adverse-effects Analyses of Cupping Therapy in Musculoskeletal and Sports Rehabilitation: A Systematic and Evidence-based Review’. 1 Jan. 2023 : 3 – 19.

The impact of Athletic Trainers in Industrial Medicine

Heidi demonstrates a simulated pull during a post-offer test to assess the employees ability to perform their job duties.

Advanced PT’s Heidi Bohl had the opportunity recently to share her experiences as an industrial athletic trainer to college students on the AT track in South Carolina. The college seniors who comprised her audience have been the beneficiaries of a number of presenters who highlighted a variety of topics related to pursuing a career in athletic training, but this was their first exposure to industrial athletic training.

While there are many paths open to those earning an athletic training degree, the majority make their debut in organized athletics (secondary schools, colleges, etc.). Already employed at the YMCA when she joined Advanced Physical Therapy & Sports Medicine, Bohl was initially hired for on-call work, covering for full-time athletic trainers to provide care to high school and middle school athletes as well as to club team participants.

Bohl enjoyed the work but made clear to her audience the importance of considering options and thinking about what is most important to each individual as they continue their education and pursue their career goals

“The schedule of a high school athletic trainer isn’t necessarily conducive to raising a family,” Bohl said. “My husband and I knew we wanted kids, and I wanted to be home for them.”

Bohl continued with part-time efforts at both jobs until her position at the YMCA was eliminated due to COVID; to replace those missing hours, she looked to the bourgeoning field of industrial rehabilitation, where companies hire providers to deliver healthcare services onsite to their employees.

It just so happened her current employer was a leader in the delivery of industrial onsite services. And because of the growth in that area, Advanced was looking for additional providers.

“Rob Worth (President of Advanced PT) knew me through the PRN work I had done, and we discussed the kinds of services Advanced was performing at companies,” Bohl said. “We both thought it would be a great fit for me.”

Advanced PT works with over 60 industrial companies, who employ physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants, and, of course, athletic trainers from Advanced to deliver the services necessary to keep employees at their best. The idea driving the model is simple yet profound: reduce the time and money lost to a company by reducing employee injury.

“We look at the employees at our companies as industrial athletes,” said Bohl. “Our presence onsite allows them to work safely at their job and enjoy life outside of work.”

Bohl’s skill set is vast, and good thing, as there are a multitude of areas on which to focus, including early intervention services, job testing, injury prevention, ergonomics, and wellness initiatives, to name a few. Programs are customized by the employer; they choose what best fits their needs and objectives.

After three years in industry, Bohl now dedicates all her hours to a single employer. She’s available onsite, naturally, but she’s also available by phone, text and email when not onsite to discuss injuries and determine plans of care.

“We promise opportunities for access to care within 24 hours if we aren’t onsite, which includes access to orthopedic providers we partner with,” said Bohl. “That kind of rapid response is a win-win scenario for employees and the employer.” Typically, companies utilizing the onsite model will see a reduction in OSHA recordable injuries by at least 50%, along with significant reductions in healthcare costs from both work-related and non-work related injuries. Bohl covered a lot of information in her thirty-minute presentation, but she saved a few minutes at the end for questions.

“Can you discuss the importance of developing rapport with the employees and understanding the company culture?”

“It’s vital,” said Bohl. “You have to know your employees and know how to interact with them. I provide services at a concrete and construction company. My dad was a general contractor. My uncle does concrete for a living. This is just a natural fit for me.”

If students didn’t understand the concept of variety in the world of industrial athletic training at the beginning, they sure were on board at the end.

“You’ll be on the floor, moving from area to area, employee to employee, encouraging people to come talk to you if they have questions, then you’ll head back to meet with the employees who made appointments to see you. Afterwards, you’ll be at a safety meeting sharing data and ROI; following that, it’s time to perform a jobsite analysis and then an ergonomic evaluation,” said Bohl.

After a busy day that included many of the aforementioned tasks plus the Zoom presentation to prospective industrial athletic trainers located a thousand miles away, Bohl was back at her full-time job, the primary focus of which revolves around getting her children to and from a plethora of practices, games and competitions.

She has a vast mom skill set too.

Trail Blazer to Trailblazer

Ray Mack is inducted into the St. Francis High School Hall of Fame by Dr. Deborah Kerr, Superintendent of Schools, on December 9, 2022

Many physical therapists have an injury story that contributes to a career path.

But most don’t include a connection to a legendary Wisconsin team whose mad dash to a national championship helped make March Madness what it is today.

Ray Mack of Advanced Physical Therapy & Sports Medicine vividly recalled a high school football injury from six decades ago that led him from athlete to athletic trainer.

“As defensive end, it was my job to get crushed first on a student body left,” Mack said. “Hurt my back and that was it. To continue participating in sports, I decided to become a student athletic trainer.”

And the rest, they say, is history. A history that includes the improbable journey with the Marquette Warriors basketball team from 1973 through 1977.

Understand that at the time of Mack’s injury, circa 1970, athletic training was in its infancy: it was the coaches who primarily handled injuries to their athletes. Outside of football hotbeds like Texas, the presence of athletic trainers was few and far between.

The year after Mack’s injury, he became the student trainer at St. Francis High School and would continue for the remainder of his high school career.

“I wanted to continue participating in sports and I had the aptitude for the health and medical stuff,” said Mack.

As a result of his performance, the St. Francis football coach obtained a scholarship for Mack to Marquette University as a student athletic trainer, which also allowed him to attend physical therapy school there. He covered multiple sports at the university including soccer, wrestling and cross country/track. Ray was also one of the first student athletic trainers for the new Marquette University's Title IX women’s sports program.

It was Division 1 college basketball, however, that powered the engine that was Marquette sports.

“I was blessed to be part of the national championship at Marquette in 1977 under legends Al McGuire, Hank Raymonds, Rick Majerus, and Bob Weingart,” said Mack. “All Hall of Fame members.”

While many know the names of the coaching legends, Mack highlighted Weingart’s impressive resume, which included 38 years as Marquette’s head athletic trainer as well as trainer for the USA track team in the 1972 Olympics.

“He was the man at Marquette,” said Mack. “Working with Bob was both an honor and an opportunity.”

It was during Mack’s senior year stint as the Warriors student athletic trainer when he was told he couldn’t continue with the basketball program during his second semester, as he was being sent to New York for his physical therapy residence—exactly when Marquette would make their run to college basketball’s ultimate prize.

Though Mack didn’t exactly appreciate the timing of the move, he later came to appreciate the wisdom of the choice his advisors made, sending him to areas that took him well beyond his identified niche in sports medicine.

“As a function of that experience, I became through my VA tenure an amputee specialist and a medical surgical clinic specialist,” said Mack. “It broadened my horizons dramatically.”

After 45+ years as a physical therapist, Mack continues to treat patients, specializing in the non-operative treatment of orthopedic-related injuries of the spine/pelvis and extremities. His personal interests are as vast as his medical pursuits and include photography, website development, history, learning theory and aquatics.

Oh, throw in mustaches and Hawaiian shirts too.

Mack described his work as an athletic trainer and physical therapist not as an occupation but a vocation, something he was meant to do in life. And while there is plenty to look back upon, there’s much more ahead.

“I'll do this for as long as I feel like I can contribute and make a difference.”

Advanced PT Presents at the 4th International Physical Employment Standards Conference

Traci Tauferner, Director of Industrial & Tactical Medicine at Advanced Physical Therapy & Sports Medicine, presented “Developing a Return to Work Assessment for an Injured Police Officer: A Case Report” at the 4th International Physical Employment Standards Conference in Gold Coast, Australia on February 26, 2023.

 The prestigious conference, hosted by the Bond University, will address the three T's essential to supporting physical performance in physically demanding occupations: Theory, Testing and Training. Specific topics will include physical employment standards, identifying and mitigating injury risk factors, physical conditioning and assessing occupational readiness.

 The conference content will be a blend of research and applied practice in a range of physically demanding occupations including military, law enforcement, fire and rescue and first responders.

 Modeled on some of the world’s best educational institutions, the vision for Bond University, Australia’s first private, not-for-profit university, is to provide an educational experience of the highest international standards under the tutelage of the country’s leading academics.

 During the past 30 years, Bond University has become one of Australia's leading institutions of higher education, renowned for its expertise in study areas ranging from business, law, medicine, architecture, and data analytics, to film and television, communication, sports management, and occupational therapy.

 Home to the Tactical Research Unit, Bond University research facilities attract world-renowned academics, working with state-of-the-art technologies and resources to develop cutting-edge innovations.

 Previous conferences were held in Australia (2012), Canada (2015) and the United Kingdom (2018).

Contact us to learn more about the details of the case report and how it helped the officer and agency.

“Police Support Staff Person of the Year.”

Traci Tauferner supplying rehab services at Wausau PD.

On January 7, 2023, the Wausau Police Department recognized Traci Tauferner as “Police Support Staff Person of the Year.” Tauferner, the Director of Industrial & Tactical Medicine at Advanced Physical Therapy & Sports Medicine, provides onsite preventative and reactive care for members of the Department and has been doing so since 2020.

Those who know Traci understand how squirmy this blog will make her, as she is the consummate team player who shuns any form of self-aggrandizement; however, the award is in her name, so we’re going to roll the dice and hope she’s too busy to notice we posted this.

And to put us in an even more precarious situation—because Traci flips really big tractor tires just for the fun of it—we’re going to use her own words to explain what she does and why:

“My passion to do my job to serve and protect others can be directly linked to the events of 9/11. The moment I saw TV news footage of departing soldiers leaving their families at airports across the country, I knew I was also going to help. I joined the Army soon after, and my 17 year old self went from "What have I gotten myself into?" to "I am capable of so much more than I have ever thought.

“I spent nine years in the National Guard, including a six-month deployment in Iraq providing security and surveillance support for tactical units. This training led me to where I am today. Helping others do what their job requires is what fuels and excites me, and a good deal of my energy now goes into developing programs and strategies that ensure essential job requirements can be performed safely.

“The day-to-day work with my tactical teams puts me in the unique position of understanding the physical and mental stressors they face; more importantly, it affords me the opportunity to do something about these circumstances. By providing the most advanced conditioning and rehabilitation resources available to the professionals tasked with keeping their communities safe, we can keep them performing at the highest levels while dramatically reducing the financial burdens placed on their departments.”

Congratulations, Traci!

Advanced Physical Therapy & Sports Medicine provides onsite therapy for Wisconsin companies, organizations and municipalities ranging from 50 to over 5,000 employees. To learn more about how we can customize an injury prevention and management program for your workforce, contact Traci Tauferner at 920-979-5597.

Make a Resolution to Not Make a Resolution

It’s the time of year when many people (well, perhaps not George Costanza) ponder making some improvements in their lives.

But let’s not consider this blog a catalyst for creating a list of New Year’s resolutions, as 25% of us quit those in the first week and nearly half of us are done by February 1.

So, how about trying to be a little more mindful in 2023?

Studies suggest practicing mindfulness leads to a plethora of benefits that include the reduction of anxiety and depression, greater enthusiasm for life, and improved self-esteem.

Best of all, mindfulness is accessible to all!

So this year, instead of joining the Seinfeld 4 (show creator Larry David insisted Jerry, George, Elaine and Kramer were to show absolutely no growth, ever) let’s try a little mindfulness, often described as the ancient art of being present in the moment.

First, Mindfulness Meditation:

Find a place where you can sit quietly and not be disturbed. For a few moments, anyway. Let’s start with 8-10 minutes, but don’t get overly concerned with timing.

Focus attention on your breathing, as it enters and exits the body. Won’t be long before your mind wanders, which means you’re being pulled out of the present. That’s all right. Try to notice your thoughts and feelings as if you’re an outside observer. Return focus to your breathing. Notice where your thoughts are going, accept what’s happening, but always try to return your concentration to your breathing.

Try to do the 8-10 minutes once a day. Before long you will be able to put more focus on your breathing and less on any upcoming plans you may have.

Next, Mindful Eating:

A practice food often used is the raisin. Yes, a single raisin. Move slowly through the following steps.

· Pick up the food. Notice it’s texture, color, size.

· Hold the raisin to your nose and notice the smell.

· Place raisin on your tongue but don’t eat it. Notice texture again. Roll it around your mouth and notice taste as well as paying attention to the feeling.

· Finally, begin to chew the raisin. Pay close attention to the flavor, the texture inside, how it reacts with your body—saliva, temperature of your tongue, any other sensations.

This process just slows everything down and helps you become more aware. Once you do this with a raisin (should take a minute or two), imagine how much more enjoyable your favorite foods become? And you don’t have to wolf things down. Practice often.

We’ll revisit mindfulness throughout 2023. There’s so much to learn, but it’s best to start small and doable. Declaring that the new year will be a veritable “Summer of George” is a bit vague, much too broad, and entirely unrealistic.

Remember, mindfulness is all about paying attention to your thoughts, your actions, and your body. Taking these little steps on a regular basis—grounding yourself in the present—can lead to big benefits and a healthier life.

Near-Site Care for School Districts

Advanced Physical Therapy & Sports Medicine's location at 402 Eureka Street is part of a multi-specialty clinic delivering high quality, low cost services to Ripon Area School District employees in 2023.

Only a generation ago, you’d be hard-pressed to find a school district in Wisconsin self-funding their health insurance.

Oh, how times have changed.

About 40% of school districts statewide are now self-funded, and that number continues to trend upwards. With self-funding, employers pay for claims out-of-pocket as they are presented instead of paying a pre-determined premium to an insurance carrier for a fully funded plan.

In essence, the employer becomes the insurance company.

One of the most recent to join the ranks is the Ripon Area School District (RASD), which will go self-funded in 2023. They will add a near-site medical clinic as well, with multiple care providers including a primary care physician, cardiologists, an orthopedic surgeon, and physical therapists available free to RASD staff.

Advanced Physical Therapy & Sports Medicine, a leader in direct contracting and onsite/near-site physical and occupational therapy care, will supply the physical therapy at the near-site clinic.

School districts must be laser-focused on the cost of health care, generally the second biggest budget outlay after salaries. With rising health care costs, districts know that money has to come from somewhere, and the simple truth is this: when revenue doesn’t increase and the cost of health care and operations does, those dollars will come from just about every student-centered program in the district.

Becoming wise consumers of health care is on every district’s and employer’s agenda—looking at data, doing their homework, finding the best care at the best cost—so money that is saved can go to the education of students, facility needs, or employee cost of living increases.

To learn more about the money-saving steps being taken in Ripon and other districts across the state, read Bethany Gengler’s article from the Ripon Commonwealth Press here:

https://www.riponpress.com/news/ripon-area-school-district-will-make-switch-to-self-funded-insurance/article_873ec986-605e-11ed-a2af-17529821152a.html

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Dry Needling

Autumn Paul, PT, DPT

You may have heard about dry needling from one of your friends or family members and now you are thinking, “What is dry needling? Could I benefit from it?”

Dry needling involves the practitioner using a solid filiform needle or hollow-core hypodermic needle (similar to an acupuncture needle) to place it through the skin and enter the muscle. The goal is to place the needle specifically into a myofascial trigger point (hyperactive muscle fibers).

These trigger points can be located in a tense band of muscle. For example, many people have tightness or soreness in their shoulders or necks from the tension they carry throughout the day.

These hyperactive muscle fibers (tense bands of muscle) can send signals to other parts of your body which are considered “referred pain”.

The goal of dry needling is to pierce these trigger points in order to allow these muscle fibers to relax, which can help reduce your pain levels.

“So what conditions may dry needling help with?”

● Headaches

● Shoulder/neck pain/tightness

● Lower back pain/ tightness

● Tennis and golfer’s elbow

● Knee pain

● Shin splints

● TMJ/jaw pain

● Plantar fasciitis

● Hip Pain/ tightness

“Can any physical therapist perform dry needling?”

In order to be able to perform dry needling, the physical therapist is required to go through extensive training. This training includes studying human anatomy and hands-on practice. These training sessions are often a weekend course or even several weekend courses.

“Awesome, I want to see a physical therapist who can assess and see if I could potentially benefit from dry needling. How do I make an appointment?”

First, look online to see what location is closest to you. Then, you can request to schedule an appointment with a physical therapist who is certified to perform dry needling.

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References:

Firth C, Meon J, Price M, Taylor J, Grace S. Dry Needling: A literature Review. Journal of the Australian Traditional-Medicine Society . 2020;26(1):22-28. Accessed January 14, 2021.

http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143040461&site=eds-live

http://www.kinfolkwellness.com.au/dry-needling-adelaide