We are pleased to announce the promotion of three associates to new positions at Tx:Team. Please join us in congratulating them on their new roles!

Mitch Parsons has been elevated to the position of Director of Rehabilitation – Employer Based Clinics.  Mitch originally joined Tx:Team in 2004 and worked as a primary Physical Therapist and Outpatient Coordinator.  After leaving to pursue other endeavors, Mitch rejoined Tx:Team in 2017 in the newly created position of Manager – Employer Based Clinics.  Mitch brings over 25 years of clinical and management experience in a variety of settings, including critical-access hospitals, long-term care facilities, continuing-care retirement communities, home health, and employer-based clinics to his new role.  He will continue to work with new and existing employers to offer the best in musculoskeletal Primary Care and Work Injury Management solutions for their employees. Mitch is a graduate of the Indiana University School of Physical Therapy and the MBA Program at University of Tennessee.

Katie Guerdan has been elevated to the position of Director of Human Resources. Katie joined Tx:Team in 2015 and has held the positions of Human Resources Generalist and Manager of Human Resources. Katie has spent the majority of her career working for healthcare-related companies, which has afforded her valuable and applicable experience in the areas of regulatory compliance, employee relations issues, performance management, training, recruiting, and benefits administration.  Katie is a Certified Professional in Human Resources and is a member of Society for Human Resource Management. In her new role of Director of Human Resources, Katie will be responsible for further optimizing Tx:Team’s human resources processes, focusing specifically on growth, efficiency, and maintaining effective internal systems.  Katie is a graduate of Indiana University.

Spencer Sheridan has been elevated to the position of Director of Finance.  In the summer of 2011, Spencer completed an eight-week internship with Tx:Team during which he built or enhanced many of our financial forecasting tools. One week after his graduation the following summer, Spencer rejoined Tx:Team in a fulltime role in Finance department.  He has developed a passion for measuring, analyzing, and connecting operational performance to financial outcomes. Spencer has held previous roles as Financial and Operations Coordinator and Manager of Finance.  Spencer brings a systematic and analytical approach, coupled with a strong desire to help solve problems, to everything he does.  In his new role as Director of Finance, Spencer will be responsible for further standardizing financial processes and systems, leading the development of new forecasting platforms, and overseeing all aspects of accounting and finance for Tx:Team. Spencer is a graduate of Wabash College.

We are proud of Mitch, Katie, and Spencer, and look forward to working with them closely in their new roles. Congratulations, all!

Autumn is a beautiful season with the changing of the leaves, but it also brings about some hefty yard work in removing them. Raking leaves is actually very hard work and good physical exercise at the same time. Your equipment needs are simple: your body and a rake.  Raking burns about 300 calories an hour while toning your arms and strengthening your back and legs.  Just be sure to stretch first and, to avoid muscle pulls, don’t try to do the whole yard at once.

Regular exercise no matter what type can boost energy, build strength & stamina, improve balance and even help to reduce some signs of aging.

Tips for Safe Raking

Do a pre-rake warm-up. It may not seem like a workout, but you can burn nearly 300 calories during an hour of raking!

• Walk around a bit before you start so your blood gets flowing.
• Do a couple of stretches to prevent straining the muscles of your shoulders, neck, and back.
• Side bends and knee-to-chest lifts help open you up and ready you for all of the raking, bending, and lifting you’ll be doing.

Practice proper raking posture.

• To keep your neck and back happy, stand upright and rake leaves to the side of you, alternating your dominant hand now and then.
• Bend at the knees – not the waist – when picking up piles of gathered leaves.
• Keep the rake mostly perpendicular to the ground (i.e. between 65 to 85 ) That will give your body easy leverage on the rake, making it easy to   move, and easy on your body.
• Avoid twisting to toss leaves. Instead, step to the side so your whole body switches position, not just your shoulders and back.
• Switch sides now and then and take breaks, especially if you haven’t raked since last fall.
• Take it easy on your back. Move your whole body and not just your spine.

Take rake breaks. The repetitiveness of raking can become painful after a while.

• Only rake small sections at a time as this will save energy. Take breaks when you get tired every 10 to 15 minutes.
• Sip on water to stay hydrated.
• Stretch to release tension you may have built up.

Using the proper techniques is essential. If part of your body is sore, it is probably telling you that you have overdone it or you are using the wrong technique. Rake so it’s natural and comfortable with the power of your movements coming from your legs.

So, get your family or even some of your friends involved and get your bodies moving. Also, don’t forget to look out for your pets or small children who may jump into your pile of leaves!

Physical therapists are musculoskeletal experts and should see menopause as an opportunity to use their skills to help women ease this life transition.

Menopause is a normal part of aging and is defined as the point in time 12 months after a woman’s last menstrual cycle. It generally occurs between the ages of 45 to 55 and can last for seven to 14 years. It can also be caused by a hysterectomy or surgical removal of the ovaries. Menopause can result in hot flashes, trouble sleeping, pain with sexual intercourse, incontinence, moodiness, and depression.

As a pelvic health therapist, I often treat women who are menopausal for urinary incontinence, constipation, pain with sex, pelvic organ prolapse, and pelvic pain. These women generally have pelvic floor dysfunction, which occurs when the pelvic floor muscles are not working optimally. Pelvic floor muscles function like a sling between the pelvic bones and provide support for the pelvic organs, stability for the lower back, and sphincter control for the bladder.

Let’s look at each of these concerns associated with menopause to determine how pelvic health physical therapy can you achieve your desired goals and return to daily tasks without limitations.

Urinary Incontinence

Urinary incontinence is not caused by menopause. As a woman ages, if her pelvic floor muscles are weak it can result in urinary incontinence. Many women experience leakage of urine with a sneeze, cough, laugh, while lifting, or with exercise which is called stress urinary incontinence. If urinary leakage occurs with an urgent event on the way to the toilet it is defined as urge urinary incontinence.

When a patient has both stress urinary continence and urge urinary incontinence it is called mixed urinary incontinence. Many women may also state that they have difficulty emptying their bladder, which can be related to increased tension in the pelvic floor muscles.

Pelvic floor muscle training can be an effective way to eliminate urinary incontinence and allow a patient to resume all desired activities. Typically, a patient can see improvement in one month and with consistent performance the results can be long-lasting. A pelvic health physical therapist can evaluate you to determine if you need to relax or strengthen your pelvic floor muscles to regain bladder control.

Constipation

There can be many causes of constipation. It is common to experience constipation during menopause due to shifts in hormones, but it can also be related to side effects of medications, lack of physical activity secondary to fatigue and arthritis, fluid intake, and diet. Over time with excessive strain people can develop tension in their pelvic floor muscles making having a bowel movement more difficult. With excessive strain you can also put more pressure on the pelvic organs. If the pelvic floor muscles are weak, this can lead to prolapse. Seeing a pelvic health therapist can help you determine if your muscles are tightening versus relaxing with a bowel movement to reduce strain and prevent additional concerns.

Pain with Sex

With a decrease in estrogen, women can experience vaginal dryness, irritation, and pain with sexual intercourse. The use of vaginal lubricants (which are available without a prescription) can decrease friction and increase your tolerance. The use of vaginal moisturizers can help improve or maintain vaginal moisture, especially in women who have vaginal atrophy or thinning of the tissues.

Pain with sex can also be caused by low back and hip pain secondary to limitations in range of motion for positioning. A pelvic health physical therapist can perform manual therapy to ease tension and pain, prescribe exercises to increase range of motion and flexibility, and educate you on self-care techniques for desensitization to improve your tolerance.

Pelvic Organ Prolapse

With the loss of estrogen during menopause, there is a weakening of both pelvic floor muscles and vaginal tissue leading to a sensation of heaviness. This weakening can result in a prolapse of the colon, uterus, or bladder into the pelvic canal resulting in pressure and pain.

Women who have had at least one vaginal birth are 50% more likely to experience a prolapse which may or may not be symptomatic. A pelvic health physical therapist can evaluate you for pelvic organ prolapse and also determine if you have pelvic floor muscle weakness to assist you in gaining strength to further support your prolapse and prevent worsening of your symptoms.

Weight gain can also contribute to pelvic organ prolapse. Weight gain is common during menopause as the loss of estrogen results in redistribution of weight to your abdomen. Exercise can become uncomfortable leading to lack of physical activity. A pelvic health physical therapist can also assist you in creating an exercise routine focusing on gaining not only pelvic floor strength but core and hip strength to assist with an improved tolerance for both daily tasks and exercise.

Pelvic Pain

There are many causes of pelvic pain. It can be related to inflammation, infection, or trauma. It is generally caused by a combination of things. A pelvic health physical therapist will evaluate your pain for your pelvic region externally but possibly internally if consent is given to determine the cause.

Again, with menopause there is a depletion of estrogen causing the tissues to thin and get more easily irritated. Pelvic organ prolapse can also lead to sacroiliac joint pain which is pain located in your lower back to buttocks. A pelvic health physical therapist can assist you in eliminating this pain with manual therapy, exercise to strengthen the pelvic floor, core and hips for stability and stretching as needed to reduce tension. They can also educate you on proper body mechanics to reduce strain with your daily tasks including those for your home, work, sports or with exercise.

It is never too late to seek out a pelvic health physical therapist to assist you with these concerns. They can create a plan of care designed especially for you to achieve your goals during this transition. They will help you to determine which type of exercise will allow you to achieve your best outcome. Exercise has been shown to improve a person’s quality of life and help them to achieve an ideal weight which can lead to both a decrease in the severity and length of their menopausal symptoms.

 

Amy Hauerstein is a Physical Therapist who specializes in Pelvic Health in the outpatient clinic setting.  She has extensive experience and combines her passion for wellness with physical therapy, addressing the physical and emotional limitations of men and women.  Over the past 20 years, Amy has lived all around the US working as a physical therapist in a variety of healthcare settings. Three years ago, she changed the focus of her practice to pelvic health. She started taking courses with the APTA’s Academy of Pelvic Health and received her CAPP-Pelvic in July of 2021.  She enjoys working in this specialty and seeing first-hand how much Pelvic Health can improve someone’s quality of life.

When the snow starts to accumulate and shoveling becomes a common household activity, injuries occur more frequently. Low back pain affects 70% of people at some time in their life, and can often be caused by unaccustomed strain or exertion like shoveling snow.

To avoid getting hurt while shoveling your sidewalk or driveway this winter, we have some simple tips for you to protect your body.

1. Stretch before you shovel. Warming up your muscles by stretching before you go outside to shovel will help prevent injury and fatigue.
2. Keep a wide base of support. The wider your base, the less strain you put on your back in trying to get low. Let your arms and legs do the work. Rely on your legs by keeping your back straight and engaging your shoulder muscles, pushing the snow instead of lifting by using your legs.
3. Don’t try to be a hero! You don’t need to cover half the driveway in one shovel, take smaller shovel-fulls and work your way down. It will be easier on your body and it will take about the same amount of time. In addition, try to pace yourself and take breaks when you get tired. Don’t overwork yourself and be aware of your heart rate.
4. Routinely switch sides back and forth. For every stroke you take on the right, swap it around and take a stroke on the left. But don’t twist and toss – twisting your back when handling heavy snow can lead to injury. Don’t forget the first tip: rely on your legs when possible.
5. Keep the shovel close to your body as you work. The further the shovel is from your body, the heavier it will feel and the more strain it will put on your back.
6. Have a plan. Try to get out and shovel every three inches or so to avoid the snow building up. Don’t forget to bundle up in warm layers and stay hydrated.

Watch this short video to see how Dan puts some of these tips into action while shoveling: