Here are some final thoughts from Missy on what she has learned during her time in our clinic. We see a variety of specialty conditions that can be eye-opening to interns when experiencing them for the first time. Marnie
I am an intern doing a rotation in women's health and chronic pain with Marnie Clemens, DPT. During my rotation, I have learned that not only is physical therapy useful for the typical shoulders, knees, back...it can be very helpful in chronic pain and pelvic floor dysfunction. Many things have surprised me during this rotation. Among them, the lack of awareness of physical therapy's effectiveness for pelvic floor dysfunction, how chronic pain can be decreased with skilled manual techniques, and the effectiveness of biofeedback for relaxation and pain reduction.
Many patients and even healthcare professionals aren't aware that pelvic pain can be caused by things other than pelvic organs. Also, many men can have pelvic pain too. Many cases of pelvic pain can be remedied or controlled by internal myofascial / trigger point release, and therapeutic exercise prescribed by a physical therapist. I used to think that urinary incontinence was caused by childbirth and that it was a normal process of aging. It turns out, that is a misconception. It is NEVER normal to have leakage during a cough, laugh or sneeze. Sometimes it can be caused by weak muscles but it can also be caused by the muscles not kicking in when they should. The problems can be determined by a simple internal pelvic floor examination and exercises prescribed for the particular problem.
Chronic pain problems can be an issue for many. Surprisingly, it can start with pain in a localized region and then seem to "spread." This is because the brain gets confused where the pain actually is located, then causes the pain to become more spread out and not easy to locate. Calming the nervous system down with specialized physical therapy techniques improves the body's relaxation response and ability to control pain.
Biofeedback has so many uses in physical therapy. For instance, with chronic pain symptoms, patients can learn to perform deep breathing / belly breathing exercises to calm the heart rate, nervous system, and subsequently the entire body. Patients can see their body's natural rhythm and make real-time changes to improve. Most generally, after deep breathing exercises, within a short time, the body calms itself and they spend more percentage of their time in the more relaxed state. Patients then can use this technique every day in either stressful events or painful episodes. Biofeedback also has a great utility in managing painful headaches.
In physical therapy school we learn how to treat patients in a more acute state and we have minimal classes in women's health. Dr. Clemens is a great PT that really connects with and educates her patients, not only about their current condition but also how they can manage their chronic pain on a daily basis in any situation.
Melissa Hickman SPT
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