Ask an Expert: Why Do I Need Speech Therapy If I Can Talk Fine?

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Question: Why do I need speech therapy if I can talk fine?

Answer: Though our title of Speech-Language Pathologist suggests we focus on speech only, our scope of practice is much broader!

In addition to speech and language, SLPs assess and treat swallowing disorders and cognitive-linguistic impairments. Swallowing treatment addresses difficulty chewing and swallowing, and can include instruction in exercise, diet texture analysis, and training for compensatory techniques. Cognitive-linguistic treatment addresses changes in cognitive function and may include training in techniques to enhance memory, orientation, problem solving, and executive function skills.

Lisa Pinnell, CCC-SLP

Ask an Expert: Can PT Relieve My Pelvic Pain?

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Question: Can physical therapy relieve my pelvic pain?

Answer: Yes! A pelvic health physical therapist is trained to evaluate and treat the possible causes of abdominal and pelvic pain to include muscle tightness, joint dysfunction, irritation of nerves, weakness, and scar tissue.

After the evaluation is complete the therapist will design a plan of care that may focus on manual therapy to address scar management or tenderness, stretching for muscle tension to improve flexibility and strengthening for added stability for daily tasks. Other treatments may include the use of modalities such as TENs for pain management, biofeedback to gain awareness of muscle tension, pelvic floor relaxation exercises and posture retraining.

Every plan of care is individualized for each patient to assist them with relieving their pelvic pain in order to return to all desired daily activities.

 

Amy Hauerstein, PT, CAPP-Pelvic

Easy Steps to Keep Your Bladder Healthy

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Good bladder habits can improve bladder control whereas poor bladder habits can lead to poor bladder control. Here are four steps to keep your bladder healthy!

Step 1 — Use Good Toilet Habits

  • It is normal to go to the toilet four to six times per day (approximately every 3 ½ to 4 hours).
  • You shouldn’t get up to go to the toilet more than once a night.
  • Don’t get into the habit of going to the toilet “just in case.” Try to go to the toilet only when your bladder is full. Going to the toilet just before you go to bed is fine.
  • Women should sit down to go to the toilet. Do not hover over the toilet seat.
  • Take your time, relax when you are on the toilet. This helps your bladder to empty out fully. If you rush, you may not empty your bladder fully and over time can result in a bladder infection.  You may even need to rock your body while on the toilet and then relax again for a second urination. This is called the double void technique.

Step 2 — Look After Your Pelvic Floor Muscles

  • Keep your pelvic floor muscles strong with pelvic floor muscle training.
  • Practice your Kegels after every bathroom trip (for example, while washing your hands), when you sit at a stoplight, check your watch, or wait on tv commercials. Contact a pelvic physical therapist to make sure you are doing Kegels correctly.
  • Return to physical therapy if you feel you are regressing in any significant way. Remember, you will have “good days and bad days,” but you should feel like you are in control of your bladder for the most part.

Step 3 — Keep Good Bowel Habits

  • Avoid constipation.
  • Do not strain when using your bowels. This puts extra load onto your pelvic floor muscles and may weaken the muscles. The pelvic floor muscles help with bladder and bowel control.
  • Eat two pieces of fruit and five servings of vegetables daily.
  • Keep active. Physical activity helps to keep your bowels regular.

Step 4 — Drink Fluid Every Day

  • Fluid is everything you drink. Fluid includes milk, juice, and even soup, but the best fluid to drink is water.
  • Cut down on how much caffeine and alcohol you drink, as these may upset your bladder. There is caffeine in chocolate, coffee, and tea. Avoid fizzy drinks which contain caffeine, including cola and sports drinks.

Christie DeCraene, PT is an outpatient Physical Therapist who has over 25 years of experience treating not only Women’s Health issues but also orthopedic and neurological deficits. Christie uses a variety of treatment approaches with an emphasis on education, function-based therapeutic exercises, and manual-based treatments.

Rehabilitation for Stroke Survivors: Speech and Motor Recovery

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May is National Better Speech & Hearing Awareness Month, and we thank all Tx:Team Speech-Language Pathologists for their continued dedication to their patient, their community, and to Tx:Team. During this month, we want to raise awareness about hearing and speech problems, and to encourage people to think about their own speech and hearing and seek assistance through a Speech-Language Pathologist.

You may wonder, what does a Speech-Language Pathologist do?

A Speech-Language Pathologist provides skilled therapy services to stroke survivors in the areas of dysphagia, communication and/or cognitive impairments. As we know, seeking medical services immediately while experiencing signs/symptoms of stroke is critical because, “Time lost is brain lost. Every minute counts.”

Therapy services should be implemented as soon as the patient is able to participate, as early intensive therapy may lead to better outcomes. Depending on the location and severity of the stroke as well as impact on functioning, a patient may participate in skilled services while in the hospital and subacute rehab with home health or in the outpatient setting.

Impairments treated by a Speech-Language Pathologist are varied secondary to location of the stroke and may include the following:

A swallowing disorder known as Dysphagia may demonstrate impairments in oropharyngeal functioning. A patient may have an objective swallow study completed such as a Modified Barium Swallow Study (MBSS) or a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to assess oropharyngeal functioning, rule out risk of aspiration, and recommend an appropriate diet texture/liquid consistency that may need to be modified. The objective swallow study will also drive the Speech Therapy plan of care to provide appropriate swallow rehabilitation including recommendations, exercises, and strategies to facilitate safe intake of least restrictive diet to maintain nutrition/hydration orally.

Communication impairments include motor speech (Dysarthria or Apraxia) with deficits in articulation, respiration, and resonance via reduced coordination and strength as well as motor planning. Receptive and/or expressive language deficits (Aphasia) to understand communication (verbal and written) as well as being able to express wants, needs, thoughts, etc. to familiar and unfamiliar communication partners. A stroke survivor may also experience Dysphonia, which is a voice disorder with deficits affecting vocal quality and vocal functioning. A Speech-Language Pathologist will provide rehabilitation services as well as educating and developing appropriate compensatory strategies to enhance a patient’s ability to communicate independently without fear, frustration, or embarrassment.

Cognitive impairments may include deficits in memory and attention skills, which can directly impact their ability to communicate in addition to impaired safety awareness impacting a patient’s ability to maintain a level of independence.

It is important to recognize that a Speech-Language Pathologist will be a part of a Stroke Survivor’s multidisciplinary team. Research indicates, “Screening for dysphagia (within 24 hours) and communication impairment (within 48 hours) is critical in working toward optimal outcomes for stroke survivors,” indicating the need for immediate medical attention if someone demonstrates the signs or symptoms of a stroke.

 

Johanna Ebbs, MS, CCC-SLP is an outpatient Speech-Language Pathologist who specializes in a wide variety of speech-language & cognitive abilities. She has extensive experience treating the adult neuro population and is LSVT LOUD® Certified. Johanna also treats patients undergoing/following treatment for head and neck cancer.

 

References:  

1. CDC. (2022, November 2). About Stroke | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/about.htm#print 

2. Dilworth, C. (2008). The role of the speech language pathologist in acute stroke. Annals of Indian Academy of Neurology, 11(Suppl 1), S108–S118. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204112/ 

 

Debunking Speech-Language Pathology Myths

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In honor of National Speech-Language-Hearing Month, we’re dispelling some misconceptions to highlight the vital role of speech therapy.

Myth #1: Speech therapy is only for those with lisps or stutters.

While addressing lisps and stutters is indeed a common aspect of speech therapy, it encompasses a far broader spectrum of issues, including problems with expression, sound production, comprehension, speech clarity, hearing, cognition, swallowing, and memory.

Myth #2: Speech therapy is only for children.

Contrary to popular belief, the benefits of speech therapy extend across the entire lifespan. From the earliest stages of development to the golden years of adulthood, individuals of all ages can reap its rewards. Speech-Language Pathology focuses on motor speech function, cognitive-language abilities, voice, and swallowing to help each patient reach their highest level of function and independence. Even in adulthood, tailored speech therapy programs are available to address the needs of those affected by disease, traumatic injury, or disorders of the nervous system, aiming to enhance functionality and elevate overall quality of life.

Myth #3: Speech therapy is only for talking.

Beyond speech, therapy plays a crucial role in addressing various challenges beyond verbal expression. Through targeted exercises and techniques, speech therapists help patients enhance cognitive abilities, memory retention, and improve swallowing function, thereby enhancing overall communication and quality of life.

Speech therapy encompasses interventions for memory, cognition, and swallowing issues, commonly associated with conditions like stroke, brain injury, Parkinson’s Disease, Multiple Sclerosis, and Alzheimer’s Disease, among others. Furthermore, individuals affected by cancer in the mouth, throat, or esophagus, as well as those recovering from head and neck injuries or surgeries, may also benefit from speech therapy interventions.

By dispelling these misconceptions and highlighting the multifaceted nature of speech therapy, we hope to foster a deeper understanding and appreciation for the invaluable contributions of speech-language pathologists in enhancing communication and quality of life for individuals across diverse backgrounds and circumstances.

We thank our Tx:Team Speech-Language Pathologists for the invaluable work they do every single day in improving the lives of their patients.