Results Physiotherapy has officially launched its Specialty Clinic, specifically for the treatment of male and female pelvic pain, urinary and fecal incontinence, pre and post pregnancy conditions, bowel and bladder related issues and pain associated with sexual intercourse.
The clinic, located at 7796 Wolf River Trail Cove, Suite 102 in Germantown, will offer conservative treatment with a focus on ‘hands-on’ physical therapy or orthopedic manual therapy. Sara Lynn Johnson and Dana Davis, licensed physical therapists with advanced training in women and men’s pelvic health conditions, currently staff the clinic.
Results, which as of September 2013 operates 47 clinics across Tennessee, Alabama, North Carolina, Kentucky and North Mississippi, has identified a need for a specialty clinic of this nature—the first of its kind—in the Memphis market.
“This is different from what other clinics offer,” said Results VP of Marketing, John Nelson, PT. “This is an area of medicine that is underutilized, lesser known and covers a range of conditions that are not talked about. The clinic will offer a comfortable and private environment to address these concerns and help patients avoid potentially unnecessary surgery.”
Sara Lynn Johnson will serve as the Director of Women’s Health Services and lead therapist for the clinic.
“I am excited to make a difference in the community,” said Johnson. “We are going to make it convenient for people to receive world-class treatment for pelvic pain, incontinence, and other bowel or bladder conditions. Unfortunately, many patients struggle with these conditions for a long time because they are not exposed to appropriate interventions. Now, Results offers a potential solution.”
Question: I have been diagnosed with IT Band syndrome. I am currently being treated with focus on strengthening my hips, glutes, etc. However, I am curious about the dry needling technique. I was wondering if I could be treated at your facility for this, and if so, would I have to obligate myself to PT afterwards, or may I still continue my therapy with my current provider.
Answer: We are very experienced with treating ITB syndrome. Every clinic has at least one provider who is trained in dry needling. We only let our more experienced “hands-on” specialists train in dry needling.
We see dry needling being part of physical therapy treatment and not an independent modality. The needling helps either turn off or fasciliate the appropriate muscle groups. This is relevant with ITB issues as this typically results from imbalance in the hip musculature. There are possibly other treatment options that dry needling can also help-especially if there are areas of tightness or restriction-we will want to use dry needling in conjunction with “hands-on” treatment and maximize improvements in mobility.
To get dry needling with us we would want you to transfer your care so we can deliver a complete treatment. After 3-4 visits you can return to your current provider if you are still not happy at this point.
John Nelson, PT
By Special Contributor for Women You Should Know
Ladies, I want to address a subject that very few of us have the ability to talk honestly about. Sex. Some of us have girlfriends we can be open with about “everything,” but I realized through my own set of circumstances that even I was not being true to myself or anyone else in my life when it came to my sex life until a couple of months ago.
So allow me to ask you a few questions:
- Do you ever have pain while having sex?
- Has there ever been a time when you avoided sex because you knew it would hurt?
- Have you ever felt like there was something wrong with you as a woman because sex was not enjoyable?
- Are there certain positions during sex that cause high levels of pain?
- Have you ever thought you might be doomed to a lifetime of unenjoyable sex due to vaginal issues?
If you answered yes to even one of these questions, I’m here to tell you it isn’t normal and those things can probably be fixed.
I started having sex in my mid twenties and had issues from the beginning. First, I found that I was allergic to the spermicide in condoms, resulting in a UTI nearly every time I had sex. Then I started having dryness issues due to birth control, along with a major loss of libido. Then somewhere along the way I began to realize that pain during sex was becoming a normal thing for me.
I had pain upon entry, pain during, and sometimes bleeding after. This not only made things awkward for me in bed, but it also created awkwardness for my partner who felt horrible for being a source of physical pain in my life. And I always brushed it off, telling him it didn’t matter, I was fine, don’t worry about it, only to end up gritting my teeth during the act and crying in the bathroom after.
Finally, I reached a breaking point several years later when I decided to mention this issue to my gynecologist during an annual visit. The moment I started talking to her, I broke down in tears. The emotional baggage of feeling like something was utterly wrong with me all came to the surface and bubbled over in my doctor’s office as I told her how this issue was affecting me mentally, screwing with me emotionally, and ruining the physical side of my relationship with my long-term boyfriend. Her response was, “Oh honey, that’s not normal, and we can fix that.” Wait, what? You can?!
If 70% of men were dealing with penis issues every scientist on the planet would be engaged in NASA-level research until the problem could be fixed.
Unbeknownst to me, there is a type of physical therapy called pelvic floor therapy which specifically addresses muscular issues women deal with due to our gender. In doing some research on this I came to learn, “Studies have shown that nearly 70% of women have disorders of the pelvic floor which can lead to discomfort, pain, or embarrassment.”
70%!!!!!!! How can 70% of us be dealing with these problems and not talking about them? I’m sorry, but if 70% of men were dealing with penis issues every scientist on the planet would be engaged in NASA-level research until the problem could be fixed.
Results Physiotherapy is just one company among many throughout the US that has therapists on hand who specifically deal with women’s issues. They tell us, “A common misperception among women is that these conditions will endure for the rest of their lives, when in reality, these problems are either avoidable or easily treated through physical therapy.”
On my first visit to what I enjoy referring to as “vagina therapy,” I admit, I felt totally embarrassed. I walked in with the impression that I was messed up and felt silly for being there due to this issue. The questions I had to answer about my sex life were very personal and I remember telling my physical therapist I thought we needed to grab a cup of coffee and learn more about each other before we started chatting about these things! Those feelings of embarrassment soon disappeared when I realized: A) I’m not the only woman who is dealing with this and B) My sex life will drastically improve and even be (gasp!) fun.
The initial visit involved an internal exam where the physical therapist tested the muscles of my vagina for pain levels by applying pressure to different areas. Every single one she touched had some level of pain or tension. She gave an explanation of why these muscles were hurting, explained the anatomy down there, and encouraged me by saying there were lots of other women with this same issue and many of them had already been helped.
I learned there are more than twenty that muscles make up the pelvic floor. When these muscles are not functioning correctly a woman might end up dealing with incontinence, low back pain, hip pain, and also pain during intercourse, tampon usage, and yearly GYN exams.
There are several explanations for why a woman experiences pain during sex. If you have been evaluated by your GYN and no diseases have been identified, some reasons might include shortened tissues that need stretching, trigger points, and emotional or physical trauma. Pain can also develop over time following surgeries, infections, or childbirth.
For my personal treatment I was sent home with an assignment to do one stretch once a day in the shower. Over the next several weeks I went twice a week for muscle therapy, which involved new stretches, kegel exercises, and “hands on” trigger point treatment that enabled tense muscles to release.
The results were incredible. When my boyfriend and I reintroduced sex after a couple of weeks, I could not believe the change. For the first time in as long as I could remember, I was able to enjoy having sex. As I continued the therapy, I finally reached the point of pain-free sex and was discharged with a 95% improvement from when I first started.
“Some women think that sex is not supposed to be enjoyable for women or that pain with intercourse is normal. This is not normal and physical therapy can help!” – Jen Le Coguic, Pelvic Floor Specialist
I am a changed woman! I actually look forward to sex with my partner, and am able to be emotionally involved instead of dreading the pain I used to associate with intercourse. My boyfriend and I have grown closer, and both of us are so relieved that this is no longer a source of pain for me. The only thing I am still mad about is the fact that it took me years to mention this to my doctor and do something proactive about it.
I asked my physical therapist what changes she hopes to see in the future for women who deal with these issues. She replied, “I hope that more women become aware of options for treatment regarding issues related to pelvic health. I would also hope that more and more practitioners such as OB/GYNs, urologists, gastroenterologists, and primary care doctors recommend these services for women.” She added, “Oftentimes women think that urinary leakage after childbirth is normal and is just part of life, and this is not the case! A large majority of my patients report 90%-100% improvement in their symptoms in six PT visits or less. Some women think that sex is not supposed to be enjoyable for women or that pain with intercourse is normal. This is not normal and physical therapy can help!”
So what can you do if you are dealing with any of these issues? Speak with your doctor and see if they have any recommendations. Some states do not require a physician referral for physical therapy, so you might also have direct access as a patient. Physical therapists that treat pelvic floor dysfunction have specialty training beyond what a normal physical therapist has for evaluation and treatment of the pelvic floor.
There are also several online resources for finding a pelvic health PT, if you’d like to do some research before seeking treatment:
This post originally appeared on www.womenyoushouldknow.net and is being reprinted with the exclusive permission of Women You Should Know®
By Sara Lynn Johnson, PT, MS, ATC/L, CSCS, Director of Women’s Health Services Results Physiotherapy
I have an embarrassing situation. After having 2 children, I frequently wet my underwear when I cough, sneeze, and exercise. Is this normal? Can something be done about it?
Urinary leakage at inappropriate times is known as urinary incontinence. This condition is very common but definitely not normal. Although it is more common in women, it can occur in men as well. Urinary incontinence usually involves the muscles of the pelvic floor. The pelvic floor muscles form a “hammock like” structure in the pelvis that helps support internal organs and maintain bowel and bladder control.
Pelvic physical therapy can help! A physical therapist can assess the strength and function of your pelvic floor muscles and then design a program specifically for you. Goals of physical therapy include gaining control over incontinence and reducing the need for pads, medications, and surgery. You will learn how to find the right muscles, use them correctly, and learn how to “retrain” your bladder.
I am training for a bike race and have started experiencing pain in my lower abdomen, tailbone, and groin. Sitting is very painful, and nothing seems to help. What can I do?
Pelvic pain is pain in the lower abdomen, pelvic floor, or tailbone and is common in men and also in women. Other common complaints include pain while sitting, difficulty with movements of hips and back, bowel and bladder issues, as well as painful intercourse. Causes of pelvic pain include pressure on nerves in the pelvis, sacroiliac (SI) joint problems, weakness in the muscles of the trunk, pelvic floor, and abdomen trigger points in the pelvic floor muscles, scar tissue after abdominal or pelvic surgery (such as a C-section, hysterectomy, episiotomy, or vaginal tear) and pregnancy and/or childbirth.
A physical therapist specifically trained in pelvic pain will do a thorough evaluation and determine if your pain is due to problems with your muscles, nerves, or joints. Based on the findings, an individualized treatment plan will be developed to relieve pain by reducing muscle tightness, increasing strength, and improving mobility. Your physical therapist will use “hands-on” techniques to work on the muscles and joints, and work with your doctor to provide you with the most beneficial and comprehensive care.
I am pregnant and have pain shooting from my low back into my leg, and have been diagnosed with sciatica. Can a physical therapist help?
Discomfort during pregnancy is normal. However, when the pain interferes with your normal activities and sleep, it is not normal and physical therapy can help. During pregnancy, your joints become more flexible to prepare for childbirth; however, this puts extra strain on your low back and pelvis. A physical therapist will examine your back, pelvis, and hips and design a treatment program for your needs. This will likely include “hands-on” techniques for mobilizing your joints, soft tissue massage to decrease tender points, exercises for stretching and strengthening muscles, and taping or bracing to support your back. Physical therapy also can help with other conditions that you may experience during pregnancy or after childbirth, such as neck pain, upper back pain, tailbone pain, and carpal tunnel syndrome.
Results Physiotherapy is excited to announce that we have added therapists with this specialty training, as well as additional space, to our clinic in the Franklin/Cool Springs area. With our existing locations of West Nashville and Hendersonville already providing services for incontinence, pelvic pain, and pre- & post-natal services, Results is now better able to meet the needs of a specific population in the Nashville region.
The expertise of a physical therapist specializing in pelvic floor assessment and treatment comes from advanced training. All specialty-trained therapists at Results commit to a two-year external training program. Contact us today to schedule an appointment for an evaluation, 800-888-0531.
During 2012, Results clinics raised funds through the ‘Blue Jean for Charity Friday’ program for employees. A minimum $5 donation allows employees who donate to wear blue jeans the last Friday of every month. Over 300 Results therapists and employees participated and our donations have amounted to $13,288.20 – the sum that we were pleased to award to Fort Campbell Fisher House on May 13, 2013.
These funds were donated in support of the mission to provide a “home away from home” where military families can be close to a loved one receiving medical treatment at Blanchfield Army Community Hospital (and other local hospitals) for an illness, disease or injury.
“As a Non-Appropriated Funds (NAF) Army program, we rely on charitable contributions to fund our operation and I am simply amazed by the generosity of our friends and neighbors in the Fort Campbell community and beyond,” said Wendy Carlston, Manager at Fort Campbell Fisher House. “This donation from Results Physiotherapy was a wonderful surprise and we couldn’t feel more blessed that we were chosen to receive such a remarkable gift.”
This is Results’ way of giving back to the communities in which we serve and the men and women who serve our country every day. Through these efforts, it is our hope that employees will remain active volunteers and positive forces within their communities.
Results as a company is honored to thank all employees, organizations and private persons, who contributed to this fund. We look forward to continued support of this organization, members of military and their families.
Question: I’m 36 and I’ve always had genu valgum (knock knees). With this condition, every time I walk a bit faster for a longer period of time, the outside of my lower leg burns terribly. What can I do to prevent the terrible pain while walking? Are there any orthopedic insoles I can buy?
Answer: Thank you for the question. The pain in the outside of your leg may be coming from a couple of different sources. You may be getting some “wear and tear” or early arthritic symptoms which could be related to your knock knees. To intervene if this is the problem we would need to assess your biomechanics and work out the right solution. A solution may be some form of foot insert to change the impact of your foot with the floor. We would also need to make sure that the problem was not related to poor hip muscle control that was causing more torsion and stress at your hips. This pain may also be due to hip muscle imbalance and tightening of the iliotibial band which runs to the outside of your knee. Here is an article that talks about this condition as it relates to runners but it is also prevalent in the non-running population.
In summary, we need to assess what is going on with you before being sure of the solution. I hope this information helps.
It is that time of year again. Winter is winding down and runners are hitting the pavement and trails, many of them in preparation for upcoming races. Injuries and pain with running typically come on with a significant increase in training.
Over the past decade, the popularity of running marathons, half marathons and 5k’s has greatly increased. Running is known to have a positive influence on a person’s physical fitness, as well as reducing chronic health problems such as the incidence of obesity and cardiovascular disease. However, running may also cause injuries, especially to the lower extremities. Illiotibial band syndrome or ITB syndrome is the second most common cause of pain of the knee in runners.
What are the common symptoms of ITB syndrome?
This condition almost always presents as pain on the lateral or outside part of the knee and sometimes in the lateral thigh. It is often described as tight, inflamed, stiff or achy. It is usually worse with repetitive activity, such as running or cycling.
What are the causes of ITB syndrome? The ITB becomes painful after repetitive friction of the illiotibial tendon on the outside of the knee. Training factors such as increased mileage, running one direction around a track or loop, on a sloped surface, and downhill running can influence the friction and stress on the ITB. Studies have also shown that lateral gluteal (hip abductor) strength has a significant influence on the ITB during running. The ITB is a common structure to compensate for weak gluteals, in an effort to create stability around the hip and pelvis.
What treatments are available for ITB syndrome?
Physical therapy treatment involves identifying the contributing factors and addressing these through corrective exercises, manual therapy and orthotics. Specific deep tissue mobilization to the ITB and hip muscles help relieve the stress at these sites. Specific strengthening and re-education of the hip muscles, specifically the gluteals has been found to significantly reduce stress on the knee by controlling excessive motion of the thigh and limiting the work done by the ITB. Flexibility exercises of the hip flexors and hamstrings have been shown to be beneficial in reducing the over-activity of the ITB as well. Orthotics, or changes in footwear, are occasionally utilized to help stabilize the foot or allow improved shock absorption with running.
A study in the Clinical Journal of Sports Medicine demonstrated the relationship between lateral gluteal (hip abductor) strength and Illiotibial band syndrome (ITBS). Researchers took 24 distance runners with ITBS and compared them to a control group (no symptoms). The injured group demonstrated about a 20% decrease in hip abduction strength on the injured side compared to the non-injured side. A six week hip rehabilitation program with strengthening exercises focusing specifically on gluteus medius strengthening was performed by the injured group. After rehabilitation there was a significant increase in strength and 22 of 24 of the runners were able to resume regular running without symptoms and at six months had no reports of reoccurrence of symptoms.
Physical therapy with a focus of “Hands-On” manual therapy is an optimal treatment for ITB syndrome. At Results Physiotherapy, every therapist has been through specific training in the treatment of ITB syndrome. It is important to find a therapist who understands running injuries and Results has established a reputation of expertise in running.
If you have been experiencing knee pain that has been unsuccessfully treated by medication or are only getting temporary relief, it is time that you called to schedule an appointment for an evaluation. This will prevent your condition becoming chronic and threatening your training program. Most insurances do not require a referral from a physician for physical therapy.
Brittany Endres, PT, DPT, COMT Results Physiotherapy – Green Hills
John Nelson, Vice President of Marketing – Results Physiotherapy
For a complete list of locations and information regarding Results Physiotherapy, visit our locations page here or call (615) 373-1350 / (800) 888-0531.
Results Physiotherapy is proud to announce the appointment of Adam Risinger, PT to Regional Education Coordinator for the Memphis area. Results currently has six clinics in the Mid-South region and this appointment is part of an initiative to develop further expansion opportunities in Memphis and North Mississippi.
“This is a significant investment for Results in maintaining the quality of our product as we grow,” explains John Nelson, VP of Marketing for Results. “Risinger will be charged with training, developing and mentoring new therapy staff as they join our team. We have very sophisticated and extensive training programs for new therapists—our growth in Memphis now demands that we have someone locally deliver and oversee them.” Nelson adds, “Adam is one of the most recognized therapists in Memphis and has forged a reputation with physicians, patients, and the medical community.”
Risinger’s credentials include a BS in Biology from Harding University and a BS in Physical Therapy from the University of Tennessee Health Science Center. Risinger is also certified in the McKenzie Method for mechanical diagnosis of the spine and extremities, as well as board certified in orthopedics by the American Board of Physical Therapy Specialties.
“I am excited to be charged with the responsibility of delivering excellence in the physical therapy community while continuing to develop my skills in education,” commented Risinger on his new position.
One of Adam’s chief interests has been in providing education for physical therapists, physicians, students, and the general public. Since 2005, Adam has served as a guest lecturer for the Program of Physical Therapy at the University of Tennessee Health Science Center in the area of orthopedics. He has also more recently served as a guest lecturer and consultant for the Rheumatology Fellowship Program at the University of Tennessee School of Medicine. Throughout his career, Risinger has presented many workshops for community groups and served as an industry consultant in the area of on the job injury and prevention.
Question: First let me say that there was not an option under what area you are hurting where I could select multiple areas. I have been diagnosed with a connective tissue disorder called Ehler’s Danlos Syndrome (EDS). I have both Hypermobility and Classic forms of this. Physical therapy specifically designed towards EDS is a must for such patients but difficult to find. Is your facility and staff versed in this type of physical therapy? I have just started (assigned by the geneticist who diagnosed me) walking in a pool of water. I look forward to hearing your reply.
Answer: Thanks for the question. EDS is a relatively rare condition and so none of our therapists will have seen many cases. Having said this, the key is understanding the condition and then proceeding with caution in establishing an individual program that you are able to tolerate without risk of damage to any structures. I would be in favor of having you seen a senior clinician. Which location would be most convenient for you?
Vice-President of Marketing
Question: I have been diagnosed with fibromyalgia . I have been reading lots on the Internet about the condition , I then came to some information on mayofacisal syndrome on reading I investigated some of the tender points , I came to find a large amount in my thighs of a pea sized lump when pressed cause severe pain , I then rubbed the area to feel the bands in the muscle , I tried all the spots I could physically reach and found lots just under my collar bone , armpit area and sides, I really am not sure if I should be telling my GP or are these just more fibromyalgia tender points , I was confirmed as 18/18 tender points. Any advice would be fantastic.
Answer: Thank you for your question. Has your GP seen other similar tender spots in prior examinations? If not I would suggest you seek out an assessment of these areas with your GP.
There is significant debate in the medical community about what is fibromyalgia. What we do know is that the disorder is not a life threatening or shortening process and that there is opportunity to make a complete recovery if a successful systematic approach is adopted to treatment.
Most sufferers of fibromyalgia have a “sensitized” nervous system. What this means is that low grade activity that would not normally stress the body or elicit a pain response in a healthy individual, cause a pain response. This is consistent with other chronic pain presentations. Once your body has had pain for awhile it becomes easier to illicit a pain response. The key to success with treating this disorder is the de-sensitize the nervous system or to increase the threshold before a pain response is stimulated.
At Results we manage fibromyalgia by 1) using “hands-on” treatment techniques, including dry needling to address trigger points, 2) re-focus attention from an all-over body pain to any specific movement or bio-mechanical issues 3) Improve aerobic conditioning and improve core stability-which both allow the body to cope better with the stresses, 4) work with physicians to ensure there is appropriate medicinal plan to allow good sleep patterns.
Hope this helps. Let me know if you need any additional help.
John Nelson, Bachelor of Applied Science (Physio)
VP of Marketing