You are here: / / rehabilitation

Tag Archive for: rehabilitation

How Hospital Outpatient Rehab Programs Win by Operating Like a Business

in , ,

Most hospitals treat outpatient rehab like a department. They staff it, schedule it, and hope the referrals keep coming — measuring performance by headcount and complaints, not margin and market share. The hospitals winning right now treat it like a business.

Why the “department” mindset no longer works for outpatient rehab

For a long time, passive management worked. Internal referrals were predictable, reimbursement was stable, and competition was limited. That environment no longer exists.

Today, outpatient rehab is consumer driven. Patients choose based on access, convenience, and experience — not hospital brand loyalty. Major payors like Cigna and Anthem are actively redirecting routine musculoskeletal (MSK) care to lower-cost sites of care. Freestanding clinics are investing in marketing, building referral relationships, and capturing patients earlier. Meanwhile, hospital rehab margins are compressed from both sides — reimbursement flat or declining, labor costs rising. There is no slack left for operational inefficiency.

5 shifts that define a high-performing outpatient rehab program

Running an outpatient rehab program like a business is not about profit for its own sake. It is about the discipline, intentionality, and market awareness that any successful ambulatory business requires to grow and sustain itself.

1.Know your numbers — and act on them in real time

A business does not wait for the annual review to find out it had a bad quarter. It tracks key metrics continuously and builds accountability structures that drive action when performance moves in the wrong direction.

Most hospital outpatient rehab programs lack this infrastructure. Performance data lives in the EMR, gets pulled quarterly at best, and rarely drives meaningful operational changes. The gap between knowing and acting is where margin quietly erodes.

2.Compete actively for patients and referrals

A business does not assume customers will find it. It invests in being found through targeted marketing, active referral relationship development, and a consistent presence with the physicians and community partners who drive volume.

Passive reliance on internal referrals is no longer a growth strategy for outpatient rehab. It is a slow decline. The freestanding clinic down the street calls your referring physicians weekly. It has a dedicated person whose job is to make those relationships stronger. It is building trust through consistent outreach, outcome transparency, and ease of access.

Hospital-based programs that do not invest in proactive referral development and community presence will continue to lose volume to more aggressive competitors — regardless of clinical quality.

3.Treat patient access as a core growth strategy

In competitive outpatient rehab markets, wait time is often the deciding factor for both patients and referring physicians. Patients who cannot be seen within a few days will find a provider who can. Referral sources that receive consistent feedback about long wait times will begin routing patients elsewhere.

High-performing outpatient rehab programs treat access as a strategic lever, not an operational detail. They optimize scheduling models, reduce throughput bottlenecks, and protect their ability to provide timely evaluations because they understand that every additional day of wait time is a patient conversion risk and a referral retention risk.

4.Retain patients through the full plan of care

Acquiring a new patient is only the beginning. Retaining them through a complete plan of care is where both outcomes and revenue are captured.

High cancellation and drop-off rates are one of the most significant and most under addressed drains on outpatient rehab financial performance. Patients who do not complete their plan of care do not achieve the outcomes they came for, do not refer others, and represent a direct revenue loss that compounds across high visit volumes.

Leading programs invest in patient engagement infrastructure: automated appointment reminders, digital touchpoints between visits, and patient education that builds understanding of why each session matters. They also align front office teams and clinicians around shared accountability for retention — not just first appointments, but final ones.

5.Develop rehab directors who manage a business, not just a team

Perhaps the most consequential shift is in how rehab directors understand their own role.

The best outpatient rehab leaders today are not just clinical experts. They are operators. They own the financial performance of their program. They manage referral relationships intentionally. They partner with hospital service line leaders — orthopedics, neurology, oncology — to design care pathways that create value for the whole organization. They recruit and develop talent with the same intentionality a business leader brings to building a high-performing team.

This is a harder job than managing a department. It requires a broader skill set, a wider field of vision, and a willingness to be accountable for outcomes that extend well beyond clinical quality. But it is the role the current market requires of anyone leading a hospital outpatient rehab program.

The competitive gap between programs is widening

The distance between outpatient rehab programs that operate like businesses and those that do not is growing and it is becoming increasingly difficult to close.

Programs investing in real-time data, operational discipline, proactive referral development, patient engagement, and strong leadership are building compounding advantages: stronger physician relationships, faster access, higher retention, more differentiated clinical offerings, and better margins. Programs that are not investing in these areas are losing volume, losing talent, and losing relevance — often slowly enough that leadership does not notice until the damage is significant.

The question for hospital executives and rehab leaders is not whether outpatient rehab should be run like a business. The market has already answered that question.

The question is whether your program is ready to make the shift and whether you are willing to invest in the capabilities it requires before the competitive gap becomes too wide to close.

 

Stroke Support Month – The Power of Rehabilitation Through Every Stage of Recovery

in , , ,

Stroke Support Month – The Power of Rehabilitation Through Every Stage of Recovery

Each May, Stroke Support Month shines a light on the millions of individuals and families impacted by stroke—and the journey of recovery that follows. A stroke can change life in an instant, affecting movement, communication, thinking, and independence. While every stroke is different, one thing remains consistent: rehabilitation therapy plays a vital role in helping people rebuild their lives.

Recovery is not a single moment—it is a journey that unfolds over time. From the earliest days in the hospital to long-term outpatient care, physical therapy, occupational therapy, and speech therapy work together to support recovery, maximize function, and restore confidence.

 Understanding Stroke Recovery

A stroke occurs when blood flow to the brain is interrupted, causing damage that can affect the body in many ways. Individuals may experience:

  • Weakness or paralysis
  • Difficulty walking or balancing
  • Trouble speaking or understanding language
  • Challenges with daily tasks
  • Memory, attention, or problem-solving difficulties
  • Swallowing or voice changes

Recovery looks different for everyone, but therapy is most effective when it begins early and continues as long as progress is possible.

 Therapy in the Hospital: Beginning the Recovery Journey

Rehabilitation often begins within days of a stroke while a patient is still in the hospital. This early phase focuses on stability, safety, and preventing complications.

Therapists may help individuals:

  • Sit up and begin moving safely
  • Stand, transfer, or take early steps
  • Swallow safely to reduce risk
  • Start basic communication

These first steps are critical in setting the foundation for ongoing recovery and regaining independence.

 Therapy at Home: Building Independence

After discharge, many patients continue therapy through home health services. Receiving care in a familiar environment provides comfort while allowing therapy to focus on real-life tasks.

In-home therapy helps individuals:

  • Regain strength and balance
  • Practice walking, dressing, bathing, and other daily activities
  • Improve speech, thinking, and swallowing skills
  • Reduce fall risk and increase confidence

This stage supports the transition from hospital to everyday life, helping patients rebuild independence safely.

 Outpatient Therapy: Maximizing Long-Term Recovery

As strength and endurance improve, many individuals move on to outpatient therapy. This phase focuses on higher-level goals and long-term function.

Outpatient therapy may include:

  • Improving walking speed, distance, and endurance
  • Refining arm and hand function
  • Enhancing communication and cognitive skills
  • Supporting return to work, hobbies, and community activities

Recovery can continue for months—or even years—with consistent therapy and support.

 The Power of Rehabilitation: A Team Approach

Stroke recovery is most successful when therapies work together. Each discipline plays a unique and essential role:

 Physical Therapy: Rebuilding Strength and Mobility

Physical therapists help individuals regain movement, balance, and coordination. Therapy may focus on:

  • Improving strength and endurance
  • Restoring safe walking and mobility
  • Reducing fall risk
  • Managing pain, stiffness, or muscle tone changes

 Occupational Therapy: Restoring Daily Independence

Occupational therapists focus on meaningful daily activities and independence. They help with:

  • Dressing, bathing, grooming, and eating
  • Using the affected arm or hand
  • Cognitive skills like planning and problem-solving
  • Adaptive tools and home modifications
  • Returning to work and hobbies

 Speech Therapy: Supporting Communication and Swallowing

Speech-language pathologists address communication, cognition, and swallowing. Therapy may include:

  • Improving speech clarity and language skills
  • Addressing memory and attention challenges
  • Supporting voice strength
  • Treating swallowing difficulties

Together, these therapies address the whole person—body, mind, and communication—ensuring comprehensive and coordinated care.

 Recovery Doesn’t Stop—And Neither Does Support

Progress after a stroke doesn’t end at discharge. Many individuals continue to make meaningful gains long after the initial event. Rehabilitation empowers survivors to:

  • Regain skills
  • Adapt to changes
  • Build confidence and independence
  • Reconnect with loved ones
  • Reclaim their sense of self

Every step forward—no matter how small—is significant.

 Honoring Strength During Stroke Support Month

This Stroke Support Month, we celebrate the resilience of stroke survivors, the dedication of caregivers, and the expertise of rehabilitation professionals who guide recovery every step of the way.

Whether recovery begins in the hospital, continues at home, or progresses through outpatient care, therapy plays a powerful role in helping individuals move forward with strength, confidence, and hope.

If you or a loved one has experienced a stroke, rehabilitation therapy can make a difference—at any stage of the journey.

Female Athletes and ACL Prevalence

in , ,

As a former female division 1 gymnast, I personally experienced and witnessed many types of injuries. I had a few teammates who had recurring injuries that impacted their ability to continue the sport they loved. Seeing the sub-par rehabilitation process in a college setting without physical therapy interventions available, re-injury was extremely common. Many of these recurring injuries involved the knee and internal knee structures such as the ACL, PCL, MCL, and LCL. 

ACL injuries are becoming more and more common in the young athlete, but did you know that female athletes are up to 10 times more likely to experience an ACL injury compared to men? This may be due to the anatomy and biomechanics of the female knee joint. Often due to wider hips and a smaller groove at the bottom of the femur where the ACL inserts, the ACL in the female knee may experience greater stress and further restriction during twisting, jumping, changing direction, and landing movements compared to men. Other contributors to increased risk of injury include weakness of the posterior chain musculature (glutes and hamstrings) and ligament laxity during hormone cycles. Recent studies have found that woman may be more susceptible to ACL injury just prior to ovulation compared to the follicular phase due to increased ligament laxity.

The most common form of treatment following ACL injury is a reconstructive surgery using a graft from either the patient’s own patellar tendon, hamstring, or an ACL from a cadaver. Although an athlete may go through ACL reconstruction, it does not guarantee normal functions of the knee or prevention of subsequent knee injury. In recent studies, it has shown that about half of athletes who underwent ACL reconstruction return to high level sports, and only about 20% of these younger athletes will return to higher level sports in the first year following injury. Given these findings, it is extremely important that ACL rehabilitation encompasses deficits related to surgical interventions as well as initial cause of injury occurring prior to surgery.

Current generalized ACL rehabilitations programs may not have all-inclusive motor training, and neuromuscular re-education needed to safely allow return to sport within one year’s time. It has been statistically proven that proper recruitment and strength of the posterior chain as well as muscles that stabilize the knee will decrease risk of  re-injury in the young athlete with a prior ACL tear. Physical therapists have the training and knowledge to specifically pinpoint weakness and instability within the hip and knee complex, analyze gait and movements patterns, and build sport specific training programs to assist in injury prevention of the young athlete. 

In early rehabilitation, it is crucial to protect the graft site, and begin regenerating the quad musculature. Research shows that following knee injury or surgical interventions there is a reflex response to inhibit muscle activation called Arthrogenic Muscle inhibition (AMI). Physical therapy can assist in targeting the muscles that have been affected during this reflex inhibition process. Some examples include quad setting, resisted terminal knee extension, straight leg raises with a knee extension brace until the patient can complete a straight leg raise without knee flexion. Other exercises to assist overall hip and knee stability include closed chain activity such as partial squats, step ups, single leg balance activities, and bridges. It is critical for the physical therapist to ensure the patient is completing exercises without compensatory strategies and progressing toward proper movement patterns. 

Due to the high prevalence of re-injury, as well as muscular inhibition following knee injury, it is highly recommended that athletes, specifically women receive intensive rehabilitative care following ACL repair. Without specific neuromuscular re-education, proper movement pattern restoration, and addressing pre-injury mechanical deficits, young athletes are at risk for re-injury or significant time lapses as they attempt to return to sport. Physical therapy can provide young athletes with the education and tools they need for success as they return to the sports they love. 

Amanda Lievendag, DPT, CMTPT is a Physical Therapist in the outpatient setting at Frederick Health Physical Therapy & Sports Rehab. Amanda’s professional interests are Sports Orthopedics, Sports Rehab, Trigger Point Dry Needling, and Spine Rehabilitation. She is a high energy physical therapist who has specialized experience with post-op, sports injuries, return-to-sport training, overuse injuries, and general wellness with athletes and patients of all ages.

 

Tx:Team Has a New Look

in

After 38 years in business, Tx:Team has a new look.

Our rebrand kicks off the next chapter of Tx:Team’s story. Our new brand symbolizes revitalized energy and excitement about where we are going – it is modern, fresh, and relevant. We are building momentum and continuing to forge ahead as a fiercely independent, privately held, therapist-led organization.

In July 2021, founder Greg Jennings transitioned majority ownership of Tx:Team to his longtime executive leadership team, who will guide the company through its next 40 years. Tx:Team was built on a solid foundation focused exclusively on providing high-quality therapy services. This remains the core of who we are, even as we adapt and change to meet the needs of all we serve. No matter what happens in the healthcare industry, we find ways to differentiate ourselves and deliver innovative rehabilitation solutions.

When we were founded in 1983, our clients were primarily skilled nursing facilities. Since then, we have transitioned to working with hospital systems, senior living communities, and employer-based clinics.  As we evolve, so too does our brand.  We are now recognizable as Tx:Team, a national provider of physical, occupational, and speech therapy services operating in multiple states. We help our patients lead happier, healthier, and more active lives, which in turn, benefits the organizations we serve. We pride ourselves on being authentic and transparent.  We deliver customized therapy programs on behalf of our clients, and our nationally recognized outcomes speak for themselves.

Satisfaction doesn’t stop with our patients and partners; it extends to our associates as well. We believe that therapy is fundamentally a human-to-human interaction, and we hire people who are excellent at healing. Tx:Team was founded by a therapist and is still operated by therapists.  We know how our therapists feel because we have walked in their shoes. Throughout the course of the COVID-19 pandemic, we are proud to say we have not furloughed staff or eliminated positions, but instead, have found ways to keep our workforce intact and to continue providing exceptional patient care. We value our people because Tx:Team is our people.

As we move forward with this new phase of Tx:Team, rest assured that we are still focused on providing the best in physical, occupational, and speech therapy. Tx:Team’s mission has always been to give everyone the best possible care, and that is never going to change. It is not just a mission statement up on the wall, it is the core of who we are. Working with us is good therapy.

 

What is Physical Therapy

in

Physical therapy is a branch of rehabilitative healthcare that includes the evaluation, assessment, and treatment of individuals with limitations in functional mobility.

Physical therapists are trained to assess your condition and help you regain maximal functional mobility and independence. They use a variety of treatment modalities and techniques to help you move better and feel better.  Treatment is highly individualized, cutting edge, and research-based to return patients to their optimum functional level.

Often part of a rehabilitation team, physical therapists provide hands-on therapy, exercises and stretching maneuvers to patients with chronic conditions or serious injuries to ease pain and facilitate health and wellness.

Through focused home exercise plans and individual attention, these professionals help patients restore their range of motion, build strength, improve flexibility and manage pain as they recuperate.

Who benefits from Physical Therapy?

If you have an injury or illness that results in pain, physical impairment, limited movement, or a loss of function, a Physical Therapist can help.  Some patients are referred to physical therapy from his or her physician, but others seek therapy directly.

The benefits of physical therapy include:

  • Prevent the onset and or slow the progression of conditions resulting from injury, disease, and other causes
  • Pain management with reduced need for opioids
  • Avoiding surgery
  • Improved mobility and movement
  • Recovery from injury or trauma
  • Recovery from stroke or paralysis
  • Fall prevention
  • Improved balance
  • Management of age-related medical problems

Physical therapists treat people across the entire lifespan. Many therapists have certifications or specializations to treat a certain population, like children, the elderly, or athletes. Regardless of age, if you have impaired mobility, a physical therapy evaluation may be warranted to offer treatment and a strategy to improve function.

6 Myths About Physical Therapy

in

Physical therapy is changing the way people overcome debilitating pain and lack of mobility. It is a conservative, cost-effective approach to restore function. However, common myths and misconceptions often discourage people from utilizing physical therapy. Tx:Team DPT, Megan, is here to debunk some of those myths.

Myth #1: Physical therapy is only used following an accident or an injury.

False. Physical therapy is often used to treat nagging pain due to sustained postures, abnormal movement patterns, and repetitive stress. Physical therapists are skilled at evaluating and diagnosing musculoskeletal issues and can be effective in treatment of these underlying causes, potentially preventing issues from becoming a bigger problem.

Myth #2: Physical therapy is painful.

Otherwise known as, “No pain, go gain,” this myth is partially false. Post-treatment soreness can occur; however, the goal of physical therapy is to mitigate pain and correct dysfunction. The physical therapist that you work with can adjust your treatment program, modify movements and exercises, and minimize discomfort to help you achieve your goals. The main goal of 95% of patients seen in the clinic is to decrease pain, so most of the time, that’s our goal too.

Myth #3: It hurts, so I shouldn’t move it.

Usually false. In some cases, it may be recommended that you rest and allow tissues to heal, so always check with your physical therapist first. But in most cases, the opposite is recommended. It’s usually more beneficial and will actually speed up recovery if you move the injured area. Most of the research out there suggests that early mobility leads to a faster recovery. The more you move, the better your outcomes. Or as we in the therapy world often say, “motion is lotion.”

Myth #4: I need to see my doctor/surgeon prior to going to physical therapy.

False. Patients have direct access to physical therapy. This means that you can see a physical therapist without a doctor’s prescription.  Some insurance plans require a prescription to utilize physical therapy services, so always check with your individual insurance provider. When accessing a Physical Therapist first, there are also the potential cost savings in co-pays, prescriptions, and imaging that could potentially be avoided.

Myth #5: Physical Therapy is just massage.

False. Physical Therapy is a multifaceted approach to restoring function which often includes, but is not limited to, manual techniques such as massage.  Neuromuscular re-education, exercise and activities, and the use of therapeutic modalities are also treatments used in your recovery. Your plan of care is specific to you based on your functional limitations and activity restrictions. The massage or manual  techniques are just one part of the comprehensive approach that may target specific tissues to complement other interventions within a treatment session.

Myth #6 I have to go to a clinic to be treated by a Physical Therapist. 

Not at all! With today’s technology, a patient is able to receive evaluation and treatment through telerehab platforms that enable virtual visits with your physical therapist from the comfort of your home.

Specialized Wound Care in Rural Indiana

in , , ,

In 1908, twenty-six Putnam County female citizens started what would be the founding of a hospital to serve their family and friends. The hospital would offer solutions to their ever-changing healthcare needs, and would bring technologies only previously offered in larger cities to their rural community.

The team at Putnam County Hospital (PCH) provides comprehensive inpatient and outpatient physical, occupational, and speech therapies to the residents in Putnam County. Today, over 100 years later, one program in particular is a continuation of its founding females’ goal of bringing the latest in technologies to the hospital:  Wound Care.

wound care

Wound care at PCH is a comprehensive team approach using the latest technology including treatment, nutrition, labs, radiology, surgical, and AOI services. With the newest technology and the vast experience of treating wounds, Putnam County Hospital Rehabilitation can treat the residents of the community locally without the need to travel to Indianapolis.

The PCH Team provides Wound Care Services that include but not limited to compression, specialty wound care treatments, swelling relief, education, debridement and modalities. The functional piece of the program is the continued monitoring and guidance with the specialty dressings used.

Wound Care services are so important to speed the healing of the wound and educate the patient from the wound returning in the future. The impact is better healing at a faster rate and return to prior function so they can return to a better life.

Terry Schaefer, PTA, WCC, CLT, CEAS, CCI, COF is no stranger to the current and innovative treatment with complex open wounds. Having spent 30 years treating wounds, he has learned the importance of using the most advanced equipment as Qoustic Ultrasound Machine. Terry is very passionate about the treatment of wounds and its possibilities for healing. He strives to help his patients to achieve their goals of healing and his varied background provides the perfect foundation for helping to achieve those treatment goals.

“Our goal is to speed healing in the best manner with the less impact on patient’s life.”

If one were to walk into the PCH gym, you would see a caring environment with lots of education about wound and wound healing and our team answering all patient questions. Treatment plans for wounds vary depending on the level of care needed. A typical plan would include treatment 2- 3 times per week for about 8 weeks.

Many patients do not understand the complexity of a wound, the way it affects their lifestyle, or the treatments that are available for them. As a clinician, the Wound Care Program has made Terry realize the varied degree of patient understanding and involvement with their wound care prior to treatment.

Our partner, Putnam County Hospital, knows for a fact that patients are getting the best wound care with the best equipment and technologies in Putnam county. It’s not uncommon for hospital employees to give referrals to patients.  “Go see Terry!”

Putnam County Hospital is a critical access hospital committed to providing affordable, high-quality healthcare close to home. For more information about Putnam County Hospital and the expanded services and specialties now being provided, please visit www.pchosp.org.

Aquatic Therapy Can Help Get You Back to…

in , , ,

There is no worse feeling than the aching pain that won’t go away, prevents you from accomplishing everyday tasks, and keeps you from doing the activities you love. If you have recently been injured or identified with having a debilitating diagnosis, aquatic therapy may be your answer to a pain-free lifestyle and get back to the activities you enjoy.

Diagnoses for Patients who benefit from Aquatic Rehabilitationaquatic therapy

Spinal Issues: Thoracic, Cervical, and Lumbar Spine Issues, Posture Issues, Spine Compression Fractures, Herniated Discs, and Spinal Stenosis

Imagine you are floating vertically in the pool using a floatation device. Since you are not touching the bottom, the water decreases the effect of gravity on the spine and creates traction. This process removes the pain you are feeling so you can now focus on learning the therapist’s exercises and doing them appropriately. Core stabilization will be the focal point of your exercises as it permits increased trunk/back movement with less pain due to the warmth, buoyancy, and pressure of the water.

Lymphedema Issues

If you have lymphedema issues, you may be experiencing swelling in your extremities. When you find yourself in the SwimEx Pool, you will notice a decrease in the swelling due to the hydrostatic pressure, making it easier and less painful to do strength exercises. This decrease in swelling will also make walking much easier.

Foot and Ankle Issues: Achilles Tendon Repairs or Tears and Toe, Foot, or Ankle Fractures

Typically, your doctor will give you weight bearing restrictions and you will most likely need a device to assist you while you walk and/or a boot. However, due to the anti-gravity properties of the water, you would not have to adhere to the restrictions. Other positive effects would be a decrease in swelling and less painful side effects. The pool helps you recover much faster because it allows you to work on balance in the early stages of recovery. Normally, patients have a hard time working on this if they are not in the pool due to the stress and pain of their foot or ankle.

Knee or Hip Replacements: ACL Repairs, Arthroscopic Repairs of Hip/Knee, and Patellar Tendon Repairs

The water provides a good environment to work on range of motion, stretching, and strengthen of these tender areas. An important distinction between aquatic and land therapy is the level of soreness associated with each, with aquatic causing much less soreness. Also, aquatic therapy allows you to perform most exercises sooner than on land with much less pain, getting you back to normal in much less time.

Fibromyalgia and Chronic Pain patients

Normally physical therapy is the last straw for this type of diagnosis. However, physical therapy in the pool should be one of the first choices since it will help you build stamina, endurance, and strength and manage your pain.

There are many more diagnoses that can be treated utilizing aquatic therapy. If you are not able to tolerate the pain associated with land therapy, aquatic therapy is an excellent alternative due to the anti-gravity environment. You will feel less pain and pressure in the pool and be able to make progress sooner than typical land therapy.

Get the therapy you need so that you can get back to your day-to-day routine and the actives you love. The goal of any rehabilitation team is to get you back to doing the activities you enjoy. Swinging a tennis racket. Walking through the woods. Peddling a bike around town. Pushing a cart down the grocery aisle. Even folding laundry! No matter the activity, enjoy life!

The ultimate goal of any therapy program is to get you back to _______ .   What is your blank?

Contributors: Morgan Thompson, Amelia Iams, DPT, Cynthia Brendle, PTA

 

Does your Bladder Dictate your Life? Let’s talk.

in , ,

May 8th through the 13th is Women’s Health Week and the goal is to empower women to make their health a top priority and educate on the steps women can take to improve their health.  During the week, you can get the answers to top questions that are asked about Women’s Health. 

~Lynne Schill, Physical Therapist, Guest Author
Lynne Schill is a Women’s Health Physical Therapist at FMH Rehabilitation Women’s Center Crestwood. She has experience in treating women’s health diagnoses and has found this work to be extremely rewarding because of how significantly it can improve quality of life. Her compassionate nature coupled with an incredibly warm bedside manner inspires confidence, determination and empowers the individual to become proactive in their own recovery.

Does your bladder dictate your life? Do you have to plan your day around where the next bathroom is?  restroom signAre you afraid to leave your home for fear of not making it to the next bathroom or leaking? Do you feel something bulging in your vagina or have you been diagnosed with pelvic prolapse? Do you suffer from pelvic pain which affects your lifestyle and intimacy? Do you skip the jumping jacks or walk instead of run during your exercise routine?

May 8th through the 13th is National Women’s Health Week with the goal to empower women to make their health a top priority and to educate women on the steps to take to improve their health.   Women’s issues are important and most women suffer needlessly because they are not aware of the rehabilitation programming designed especially for women.

So, did you answer yes to any of the questions above? If so, you may be a candidate for women’s health physical therapy!  Physical therapy (PT) is a great alternative for women who don’t want to take medication and want to avoid surgery for incontinence, pelvic pain, and pelvic prolapse. Don’t let your bladder dictate your life or continue to suffer from pelvic pain, which can affect your lifestyle and intimacy.

Women often suffer in silence, not mentioning these problems to their healthcare provider and think they just have to “live with it”. However, there is hope—and help available, with physical therapists who have been specially trained to treat these conditions.

According to the National Association for Continence (NAFC), 26% of women between the ages of 18-59 have involuntary leakage, 20% of women over 40 also have overactive bladder, and 66% of women and men ages 30-70 have never discussed their bladder health with a healthcare provider.

It’s time to start the conversation!

My incontinence…

There are three types of incontinence: urge, stress, and mixed (which is combination of the first two).

Urge incontinence is when there are strong urges to urinate even though the bladder may not be full and there is an increased frequency of urination. Physical therapy treatment approaches include filling out a detailed three-day bladder log. Information gathered in this log includes the number of voids per day and night, how much is voided, what the patient was doing at the time, determining if the patient is drinking enough water, and identifying any dietary triggers.  Often, eliminating bladder irritants from the diet including caffeine, alcohol, citrus, carbonated beverages, and artificial sweeteners can help decrease or stop the problem.  Smoking can also be a factor, as can constipation.

Running to the bathroom and frequent emptying ‘just in case’ can actually make the problem worse. Teaching patients urge control techniques including standing or sitting quietly, doing a few quick Kegel contractions, and deep breathing can help decrease the urge. Another mistake women make is restricting their fluid intake.  This can not only lead to dehydration, but it can also cause the urine to be more concentrated, which can be irritating to the bladder lining and lead to further urgency.

Urge incontinence and overactive bladder sufferers can benefit from physical therapy relaxation techniques including deep breathing and nervous system quieting in order to help calm the bladder.

Stress incontinence happens with coughing, sneezing, laughing, exercising, or lifting. The increased pressure in the lower abdominal and pelvic region can cause leakage because of weakened pelvic floor muscles.  Pelvic floor muscles provide support to the pelvis and pelvic organs.  One exercise many women know that can help strengthen the pelvic floor is Kegels. However, it might be surprising to know that more than 50% of women perform Kegels incorrectly! A physical therapist can educate you further on pelvic floor anatomy to help identify which muscles you need to be contracting, how to isolate the contraction in order to do a correct Kegel, and then advise you on a home exercise program.   Strengthening the pelvic floor and lower abdominal muscles is especially important for this type of incontinence.  Also, modifying activities and exercise by avoiding a lot of heavy lifting, jumping and running can decrease symptoms.

My pelvic prolapse diagnosis…

Pelvic Prolapse is when a pelvic organ—such as your bladder, rectum or cervix—drops from its normal position. If you suffer from pelvic prolapse, you may benefit from postural education, strengthening of the pelvic floor muscles, activity modification, and positioning techniques to help reduce prolapse symptoms. Eliminating constipation is also important; a physical therapist can teach strategies to achieve regularity in order to avoid bearing down hard, which can potentially increase prolapse.

My pelvic pain…

Pelvic pain can be another life-changing problem for women—causing problems with simple daily activities and affecting intimacy. Pelvic pain and pelvic discomfort can be associated with menopause, post hysterectomy and other surgeries, trauma/injury, pregnancy/child birth, and pelvic malalignment. A physical therapist performs a thorough assessment and develops a program to meet individual needs.  Treatment may include hands on soft tissue techniques, biofeedback, and/or relaxation techniques.

Biofeedback is a valuable tool that is used to assess the muscle activity of the pelvic floor muscles and helps patients recognize when their pelvic floor is relaxed versus in a contracted state. While being coached by a physical therapist, the patient can become more aware of the pelvic floor muscles and how to use them via visual feedback.

Ask yourself, “Would I like to improve my pelvic health and quality of life without surgery or medication?” It’s time to do something about it and Women’s Health Week is the perfect time to start!

A Physical Therapist trained in treating pelvic floor dysfunction is available for your specific needs and diagnosis. Your bladder doesn’t have to dictate your daily routine; you don’t have to live with pelvic pain in silence. You deserve your life back!

Tx:Team Women’s Health Physical Therapy programs can be found at FMH Rehabilitation in Frederick, MD, St. Vincent Frankfort Hospital in Frankfort, IN, and St. Vincent Jennings Hospital in North Vernon, IN. Ladies, it’s time to take the steps to improve your health and Women’s Health Week is the perfect time to start!

 

 

Playing with Purpose: A Pediatric Speech Therapist’s Perspective

in ,

With holidays and birthdays, come many toys that cycle in and out of your home. They come in many different brands and styles but all have the same underlying potential for developing your child’s communication skills. Here are just a few commonly found toys that I use as a Pediatric Speech Therapist with the children I work with in order to develop and expand their speech and language abilities.

 

toy farmToy Farm: This toy is loaded with opportunities for you to model early developing speech sounds to your child. Some of the first sounds acquired by infants and toddlers are made with their lips such as “b” “p” and “m”. When playing with this toy with your child, exaggerate these target sounds while modeling animal names and noises.  Some of the target words I use include: “baaa”, “moo”, “pig” with exaggerating the initial sound of each word. Try to have your child watch your mouth while you are saying these words. Allow wait time after saying a target word to give your child an opportunity for imitation.

Cause and Effect Toys: These toys come in many varieties but all have the same underlying theme.popup They are toys that allow a child to “cause” an event to occur. In the case of the pictured toy, when your child pushes a button, the window opens and an animal appears. Communication is founded in cause-effect. Even before a child learns to speak, they understand that when they cry, it results in an event. This event can be a diaper change, a feeding, or attention from their caregiver. When a child understands this relationship, the door for purposeful communication is opened.

Kitchen Set: Pretend play is a huge component of a child’s language development. It is their way of taking scenes from their environment and re-enacting them using language they hear daily. When you listen to your child play, you may hear some familiar phrases!

Kitchen play

This is a great toy for children of all ages. When playing with this toy, help your child to pretend. Model actions such as: stirring with a spoon, putting food in the oven, or turning the sink on and off. While performing these tasks, keep your language SIMPLE.  Phrases such as “too hot”, “all done”, “more please”, and “all gone” are simple beginning phrases that can be used in many situations throughout the day.

While these are just a few suggestions for your holiday and birthday gift list, there are many other options of toys and play that stimulate communication. Any toy that encourages an opportunity for interaction between you and your child is a learning opportunity!

When you go shopping, look for toys that encompass interaction. Although there are several toys on the market that light up or make noise, many of these toys only have a visual component, but do not allow your child to manipulate or physically engage in active play. Much of our early language consists of “active” words that rely on motion or position. Some of the best toys set the scene for using words such as “go”, “stop”, “up”, “down”, “in”, “out”, “on” and “off”.

Why is this type of play important? Young children understand much more than they can verbally express. Even before your child says their first word, they are acquiring and understanding of multiple vocabulary terms daily. By the age of 2, a typical child understands 200-300 vocabulary terms! This makes your task of modeling these early vocabulary terms during play that much more meaningful.

If you are concerned about your child’s speech and language development, below are a few warning signs that may warrant assessment by a Speech Language Pathologist:

  • reduced eye contact
  • disinterest for communication
  • does not respond to their name or sounds in their environment
  • frequent ear infections
  • limited babbling or verbal output
  • difficulty understanding simple commands
  • For toddlers who have speech that is very difficult to understand, resulting in frequent anger outbursts and temper tantrums

There is no “right” age for seeking help for your child’s speech and language. Speech and language development varies for every child. A child who is behind may catch up on their own without intervention, especially when developing their speech sounds. With that being said, do not ignore your parental instincts. It never hurts to seek assistance or an expert opinion.

Michelle Keenan, SLP-CCC is a Tx:Team Speech Language Pathologist treating the Pediatric population at FMH Rose Hill Outpatient Clinic. You may contact Michelle at 240-566-3132 or find out more about Speech Language Therapy go to www.fmh.org/Rehabilitation