Does Physical Therapy Help for Endometriosis?

We frequently treat patients with endometriosis here at Klein Physical Therapy, we want to bring some awareness to what endometriosis is, what are the symptoms, what treatments are available and lastly, how physical therapy can help. Consider making an appointment if you live near Denver, Colorado. You can book by clicking here.

Article by Dr. Kimberlie Landers

What is Endometriosis?

Endometriosis is a condition where cells similar to the lining of the uterus start to grow outside of the uterus. These cells are affected by estrogen which is why many symptoms begin at puberty. It is classified as an inflammatory disease and it is estimated to affect 1 in 10 women.

Symptoms of endometriosis can vary person to person. Research has found that symptoms don’t always correlate to the severity of the condition. Someone can have 10/10 pain and have mild endometriosis while others may have low pain and advanced endometriosis.

Common endometriosis symptoms include: 

• Painful periods

• Pelvic pain

• Pain with sexual intercourse

• Pain with urination and/or bowel movements

• Excessive bleeding

• Infertility

• Fatigue

• Digestive Issues

• Irritated bladder symptoms 

How is it diagnosed? 

The gold standard in diagnosing and treating endometriosis is with laparoscopic excision surgery. Finding a skilled surgeon is key because the success of the surgery is determined by the skill level of the surgeon. It is best to find someone with years of special training on endometriosis excision (not ablation) and is FMIGS (fellowship in minimally invasive gynecological surgeries) trained.

Common Myths and Facts

Myth: You can diagnose endometriosis with a pelvic ultrasound or MRI

Fact:  Although they are making strides in research, most providers are unable to diagnose endometriosis via imaging at this time. An MRI may show a deep infiltrating endo, but not many doctors/radiologists are trained in reading the results and seeing this on the scan.

Myth: Hysterectomy or menopause will cure endometriosis

Fact: Removing the uterus and ovaries will not remove the endometrial implants that are already outside of the womb and causing symptoms. Additionally, it is thought that the lesions may make their own estrogen or even the small amount of estrogen an ovary produces in menopause may still cause symptoms.  

Myth: Hormonal treatments (birth control, lupron) or pregnancy cure endometriosis

Fact: These drugs or becoming pregnant may temporarily suppress symptoms, but they do not treat or slow the disease process. The only treatment is excision surgery.

A great resource for educating yourself and for finding a list of the top skilled excision surgeons is Nancy’s Nook Endometriosis Education Group on Facebook. Another site for looking up a surgeon is https://icarebetter.com/.

What can be done other than surgery?

If you are still having pain after endometriosis surgery or if you are looking to avoid surgery temporarily, it is important to look at other pain drivers. Some other causes of pain could be hormonal changes at the vaginal tissue, musculoskeletal pain (pelvic floor dysfunction) or nervous system upregulation/central sensitization.

How can physical therapy for endometriosis help?

• Assessing for other pain drivers such has pelvic floor dysfunction or central sensitization

• Manual therapy for improving modulating pain and improving tissue mobility of abdominal, hip and pelvic floor muscles 

• Individualized exercise plan

• Education on nutrition, use of dilators/wands, and bowel, bladder and sexual health

• Help you find the right medical provider and surgeon

At Klein PT, our PTs are trained to perform a comprehensive evaluation which includes a whole body assessment of posture, strength, range of motion, palpation and movement analysis. We can perform manual therapy techniques to help mitigate neuromuscular or musculoskeletal pain including dry needling, cupping, soft tissue release, joint mobilization etc.

We will teach you nervous system down-regulation techniques if needed, as well as prescribe therapeutic exercises that are individualized to meet your needs.  Patient education topics may include nutrition, self care techniques, use of dilators or pelvic wands, and normalizing bladder, bowel and sexual health.

The goal of your physical therapist is to listen to your story, help you find the right doctors, be on your team, and support your recovery so that you can get back to doing the things you love!

Dr. Kimberlie

Landers

Dr. Kim is passionate about all things related to pelvic health, but especially loves treating endometriosis and its accompanying pelvic pain and symptoms.

She is a certified pregnancy and postpartum corrective exercise specialist (PCES). This certification adds to her knowledge and understanding of the pregnant and postpartum body, and assists in her “whole body” approach to care.

When she is not treating patients at Klein Physical Therapy in Denver, you can find her enjoying the great state of CO with her 2 kiddos, 2 dogs and her husband.

 

What Causes Lichen Sclerosus to Flare Up? And What Can Help?

your pelvic health: support from a pelvic floor physical therapist

As pelvic floor physical therapists in Denver, Colorado, our practice has seen many patients suffering from Lichen Sclerosus and its ongoing flare ups. Let’s first break down what it is, and then read to the end to get our personal tips and resources to help you cope with flare ups. Consider making an appointment if you live near Denver, Colorado. You can book by clicking here.

First of all, What is Lichen Sclerosus?

Lichen Sclerosus is a chronic, inflammatory skin condition that usually affects the perineum (anogenital region) that results in scarring and weakening of the skin. It is not contagious and cannot be spread through sexual contact. Common symptoms include:

• Itching

• Burning

• Patches of skin discoloration

• Formation of sores/blisters

• Skin fragility with increased risk of bruising and/or tearing

• Changes in the ability to urinate (ie. weak urine stream) 

• Painful sex

Lichen Sclerosus causes scar tissue build up, which reduces tissue flexibility and can lead to discomfort with things like penetrative intercourse, inserting a tampon, and gynecological exams. 

Who is at risk?

While anybody at any age can develop Lichen Sclerosus, it is most common in:

• Post menopausal women

• People who have another autoimmune diagnosis (ie. hypothyroidism)

• People with an uncircumcised penis

• People with a family history of Lichen Sclerosus

What causes it?

It is still largely unclear what causes Lichen Sclerosus, however, it is widely accepted by healthcare professionals and researchers to be an autoimmune diagnosis. With autoimmune conditions, the body’s immune system attacks healthy cells, rather than solely attacking diseased cells, bacteria, and viruses. In the case of Lichen Sclerosus, the immune system begins to attack skin cells in the anogenital region, leading to the above symptoms.

Lichen Sclerosus can commonly be triggered by hormonal changes, trauma, and in rare cases it can be passed down genetically.

What can I do about it?

First, if you suspect you may have Lichen Sclerosus, it is recommended that you schedule a visit with your physician. A biopsy is required to confirm the diagnosis, if suspected.  Generally, they will prescribe a topical cream that you can use on the perineum to relieve symptoms and calm inflammation of the tissues.  Pelvic floor physical therapists are also trained to look for the skin changes in the perineum and will refer back to the physician.  

Ways to Prevent and Reduce Severity of Lichen Sclerosius Flare Ups

You can also do things on your own to alleviate symptoms and prevent flare ups. Ultimately, it is important to reduce friction and irritation of the perineal tissues.

Here are some things to consider:

• Use just warm water (no soap!) to wash the perineum, pat dry (don’t rub!), and apply a moisturizer immediately following to prevent drying out the tissue.

• We recommend using a vulvovaginal moisturizer such as those offered by Good Clean Love (https://goodcleanlove.com/collections/vaginal-care-collection/products/bionourish%C2%AE-ultra-moisturizing-vaginal-gel-with-hyaluronic-acid-assortment?variant=42220336218296)

• Soak in a Sitz Bath full of warm water twice a day and after intercourse for 10-15 min. Pat dry and make sure you apply a vulvovaginal moisturizer afterwards to seal in moisture!

• You can purchase a Sitz Bath at your local drugstore or on Amazon (https://www.amazon.com/Foldable-Discreet-Postpartum-Hemorrhoids-Episiotomy/dp/B08CDNFMLC/ref=sr_1_3_sspa?crid=AD152CAIVNXC&keywords=sitz+bath&qid=1706558716&sprefix=sitz+bath%2Caps%2C142&sr=8-3-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1 )

• Avoid heavily scented soap, moisturizer, and laundry detergent, as this could cause skin irritation.

• Wear breathable, cotton underwear and avoid synthetic and/or more abrasive materials (ie. lace, silk).

• Wear loose fitting clothing, if needed.

• Avoid prolonged pressure on the perineum (ie. riding a bicycle, horseback riding, riding a motorcycle, etc.).

• Change out of wet and/or sweaty clothing right away.

• Use lubricant during intercourse

• We recommend the following: 

• Good Clean Love (https://goodcleanlove.com/collections/personal-lubricants-collection/products/bionude%C2%AE-ultra-sensitive-personal-lubricant-assortment?variant=42220336644280)

• Maude Organics (https://getmaude.com/products/shine-organic-lube)

• Uberlube (https://uberlube.com/products/uberlube-glass-bottle)

• Sliquid (https://sliquid.com/shop/sliquid-naturals/h2o-sliquid-naturals/ )

• Consider removing inflammatory foods from your diet (ie. dairy, gluten, refined sugar, alcohol, heavily processed foods, etc.) as these can lead to sustained systemic inflammation and worsening of symptoms.

• Consider techniques to manage stress, as stress and anxiety can be major triggers for flare ups. Consider seeing a mental health therapist (contact us for recommendations!), practicing deep breathing and relaxation techniques, trying regular meditation, and ensuring you are getting 7-9 hours of sleep a night. 

• Talk with your medical physician about a prescription for low-dose estrogen (and/or testosterone, if appropriate) in cases where there are hormonally-driven symptoms such as genitourinary syndrome of menopause (AKA volvovaginal atrophy).

• Try using dilators with lubrication to help slowly and progressively stretch the perineum and restore flexibility of the tissues.

• We recommend one of these sets by Intimate Rose: (https://www.intimaterose.com/collections/vaginal-dilators?gad_source=1&gclid=CjwKCAiAtt2tBhBDEiwALZuhAMFyE4Mu-_xp07fZ5eeNAIvuCg5sQDQsLJCd2A2uKZ_KUWZKQyf4zBoC0sQQAvD_BwE )

it is also recommended to see a physical therapist that specializes in pelvic health. (We can help!)

Physical therapy can help preserve flexibility in the tissues and prevent scarring with the use of manual techniques. These techniques aim to promote blood flow and optimize pelvic floor function.

Pelvic floor PT will also improve adjacent muscle pain and/or dysfunction by taking a total body approach to your care and optimizing the function of ALL your systems. The aim is to ultimately reduce pain with penetrative activity (ie. intercourse, inserting a tampon, gynecological exams, etc.), improve bowel/bladder activity, reduce itching, burning, and stiffness, and get you back to leading the life you want to live!

Dr. Tara Loveland,

PT, DPT | Klein Physical Therapy

Physical Therapy Stretches and Strength Training for a Healthy Ski Season

Physical therapy and mobility exercises can help you strengthen and avoid injury this ski (or snowboard) season.

If you’ve already gotten a day or two under your belt, ask yourself how you felt. Did you experience that all-too-familiar “thigh burn” that makes you wrap up by lunchtime (even though your mind wants to keep going!)? Did you find yourself distracted by those aches and pains that come from “knocking the rust off”? 

Now ask yourself what you did to prepare for ski season. If you’re like most folks, you may have hit the gym once or twice for some squats and lunges to get strong for the upcoming season. For most, the intention is there, but the holiday season inevitably derails your plans to truly commit to a preseason routine. So, like most, you probably put your boots on, buckled on your equipment, and set on your way down the mountain “hoping for the best”. 

The good news is, even if your pre-season prep was lackluster, it’s never too late to initiate a ski/board specific strength and mobility routine to KEEP you healthy all season long! 

Both skiing and riding require heavy amounts of hip and trunk rotation to initiate and complete turns. This becomes even more important on steep, narrow, and/or ungroomed terrain, as you need to make smaller/quicker turns to maintain a safe speed and navigate terrain changes. Skiing and riding also require leg strength and endurance.

Hip and calf strength are needed to properly hold your edge during turns, thigh strength is needed for shock absorption and smoothly transitioning from edge to edge, and trunk/core strength is needed for optimal force transfer between your upper body and lower body. 

“A well-rounded program HELPS optimize your performance on the slopes and prevent injury. This requires both mobility and strength components.”

TARA LOVELAND, PT, DPT

Incorporate the following exercises 2-3 times per week to keep you healthy all season long. If any of the following exercises cause pain, please reach out to your physical therapist for tips on how to modify them!

Mobility Exercises

Hip 90/90 Flow

This exercise is great for promoting hip rotation mobility. By alternating between each of the positions shown above, you are working on hip internal rotation and external rotation of both hips. Both motions are required for initiating turns. In addition, improving hip mobility will serve to offload the demand on the knees and prevent knee injury. Bonus!

How to perform: 

• Sit in the position shown above. Both knees should be bent to 90 degrees (no less!).

• First, focus on sitting your “sit bone” of the back leg down toward the floor. Keep your torso as upright as you can and slightly rotate your chest so you are facing your back foot. You should feel a “deep ache” on the outside of your hip. 

• Sit in this position for 5-10 sec.

• Then, rotate your chest to face the shin of the forward leg and lean your chest forward as shown. You should feel a stretch in your glutes.

• Sit in this position for 5-10 sec.

• Repeat this flow between positions 5-10 times.

Pigeon

This exercise is great for stretching the glutes and improving hip external rotation mobility. This is one that is used in yoga and many other activities. And oldie, but goodie!

How to perform:

• Start in a “plank position”. Bend one knee and fold it under you so your foot is generally in line with your opposite hip as shown.

• Relax your body weight onto the bent leg until a stretch is felt in the glutes. 

• You can stay propped up on your hands for a lighter stretch, or relax your chest towards your shin for a deeper stretch.

• Hold this position for 60-90 sec each side.

Quad/Hip Flexor Stretch

Since skiing and riding are such quad-dominant sports, it’s important to maintain length and flexibility of the quads and hip flexors. Ensuring these stay flexible will help prevent the onset of things like patellar tendonitis (irritation of the tendon on the front of the knee) and knee pain. 

How to perform:

• Kneel on one knee with your foot propped up on an elevated surface behind you as shown above. The higher the propped surface, the deeper the stretch, so adjust according to what you can tolerate. 

• Keep your torso tall and upright.

• “Tuck your tail” and think about drawing your pubic bone up towards your belly button and tucking your tailbone under you. 

• You should feel a deep stretch in the thigh and front of the hip.

• Hold this position for 60-90 sec each side.

Strengthening Exercises

Heels-Elevated Goblet Squat

This exercise heavily biases the quads, which helps develop and maintain the necessary quad strength for a long day on the slopes. Elevating the heels creates a pseudo “downhill slope” to more closely mimic the weight distribution and forces experienced while skiing and riding.

How to perform:

• Stand with your feet shoulder-width apart with your heels elevated.

• Hold a dumbbell/kettlebell (or any type of weighted object) at your chest.

• Slowly lower yourself into a squat, focusing on control and maintaining a relatively upright torso.

• Return to standing and repeat. 

• Perform 3-4 sets of 12-15 reps.

• You can adjust difficulty by adjusting the weight you’re holding, adjusting the speed of the squat (slower is more difficult, faster is easier), or even adding a 3 second pause at the bottom of the squat before returning to standing (that one’s spicy!).

Rear Foot Elevated Split Squats

This exercise is great for working on single leg strength. Single leg strength and endurance is important because turns require greater force production by one leg, as the other leg follows through. It is fairly common to have leg strength asymmetries, especially if there is a history of previous lower extremity injury, so working on strengthening your legs independently is crucial for injury prevention.

How to perform: 

• Place your foot on a chair behind you. If you can, hold weights in each hand for added challenge.

• Lower your trunk as if you are going to tap your back knee to the floor (you may or may not reach. If you can’t reach, that’s OK! Just focus on the intention of tapping your knee to the floor). 

• Keep a mild forward trunk lean. Think about keeping your eyes fixed on your toes of the forward leg throughout the rep.

• Return to standing. 

• Ensure your kneecap stays tracking over your toes. Ie. your knee should not “dive in” or “collapse” towards your midline throughout any portion of the rep. 

• Perform 3-4 sets of 10-12 reps.

Supported Single Leg RDL

We can’t forget about the muscles on the back side of the legs! The previous two exercises focused heavily on quads and glutes, but this Single Leg RDL gets the hamstrings involved! The hamstrings are incredibly important in maintaining a strong posture when accelerating downhill. They also play a crucial role in knee stability and supporting the ACL. An ACL injury is never a good thing, so don’t forget those hammies!

How to Perform:

• Start by standing on one leg with the opposite toe lightly touched down behind you like a “kickstand”. 100% of your weight should be on the forward leg. The toe touch is simply for balance, NOT to bear weight through.

• Hold a weight in the opposite hand of the leg you’re standing on.

• Start with a “soft knee” (ie. unlock your knee, but don’t excessively bend it) and push your hips back as you drop your chest towards the floor. Keep your back straight and think about “sticking your booty out”. Your hips should maintain their height and your knee should remain where it is without traveling forward over your toes. 

• At the bottom, you should feel some tension in your hamstrings (ie. the backs of your thighs) and your weight should feel biased towards the heel (NOT the ball of your foot). 

• To return to standing, think about driving your heel into the ground and pushing your belt buckle forward, ending with tall posture.

• Your low back should not hurt during this exercise!

• Perform 3-4 sets of 10-12 reps.

Paloff Press with Resisted Rotation

Trunk strength and stability is also essential for skiing and riding, as it is responsible for force and momentum transfer between your upper body and legs (and vice versa). The quality of your turns while carving is heavily dependent on the strength and control of your trunk, so adding in resisted trunk rotation into a ski program is key!

How to perform: 

• Anchor a band (or use a cable machine) about chest-height to the side of you.

• Begin by holding the band/cable at your chest with your feet shoulder width apart.

• Press the band/cable straight out in front of you, making sure the weight doesn’t rotate you towards the anchor point.

• Once your arms are fully extended, rotate just your shoulders away from the anchor point. Maintain slow and controlled movement. Your hips/legs should not move while you rotate away from the anchor.

• Return your shoulders to a forward-facing position.

• Finally, bend your elbows and bring the band/cable back to your chest.

• Repeat this series - press out, rotate, return to forward-facing, and return to the start for 3-4 reps of 15-20 reps.

• You can make this more/less challenging by adjusting the weight/band strength or narrowing/widening your stance (i.e. wide feet make this easier, narrow feet make this more challenging).

These strength and mobility exercises are crucial in gaining and maintaining the functional strength and flexibility required for skiing and riding. So give them a try and don’t hesitate to reach out to your Physical Therapist if you have any questions or are experiencing discomfort at any point! 

Enjoy the season! - Tara Loveland, PT, DPT

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MEET KLEIN PHYSICAL THERAPY IN DENVER

Klein Physical Therapy is located at 2401 S Downing St, Denver, CO 80210 in the University Hills neighborhood near Denver University.

Klein Physical Therapy in Denver provides individualized care to help patients prevent and recover from injuries, manage pain, and work on healing a variety of issues including pelvic floor dysfunction. Our experienced physical therapists create customized treatment plans using the latest evidence-based techniques to get you moving again and feeling like yourself.

Klein Physical Therapy in Denver, Colorado

Address: 2401 S Downing St, Denver, CO 80210

Phone: (720) 252-6304

Email: lea@kleinphysicaltherapy.com

 

Hours:

Monday 7 AM–3:30 PM

Tuesday 8 AM–3 PM

Wednesday 7 AM–6 PM

Thursday 8 AM–5 PM

Friday 7 AM–3 PM

Saturday Closed

Sunday Closed

Klein Physical Therapy: Q&A with Dr. Tara Loveland, PT, DPT

At Klein Physical Therapy in Denver, Colorado, we have an incredible team of professionals. We wanted to highlight Physical Therapist Dr. Tara Loveland, PT, DPT. So, here is a little more about Tara! (And learn even more about her on her bio here.)

What is the most amazing recovery you have seen in your experience as a PT?

While I’ve been lucky enough to witness several amazing recoveries (that’s why I love being a PT!), the one that sticks out most was a woman who came to me with a long-standing history of steadily-worsening vertigo over 60 years!

Her vertigo episodes started in her mid-teens and were initially mild and infrequent, but over time they worsened to the point where she was unable to leave her bedroom. It was debilitating to her social life and her ability to care for herself and her household.

While her recovery took nearly a year of diligent rehabilitation focusing on everything from re-calibrating her sense of equilibrium to improving neck mobility, she improved to the point where her vertigo episodes were barely perceptible and only occurred once in a while. Best of all, she was able to return to playing cards with the girls and eating her meals in the dining room of her living facility! She had gone from being unable to remember a day where she wasn’t dizzy to living almost entirely dizzy-free. Her progress was not only remarkable, but incredibly rewarding for both of us!

What is one of the most frustrating conditions your patients have had that you have helped them with?

I think some of the most frustrating diagnoses for my clients involve the foot and ankle because we, as humans, stand and walk on our feet all day long. Unlike an injury elsewhere in the body, it can be hard to simply “take it easy” or “let it rest”, which is often the advice my clients with these diagnoses receive. After all, you can’t expect someone to just stop standing and walking; it’s inevitable. I have treated countless cases of Plantar Fasciitis, Turf Toe, and Bunions and have found that simply “letting it rest” doesn’t go over well. It takes a thorough assessment of ankle and foot mechanics, as well as looking “up the chain” at the knee, hip, and spine to truly identify the root cause of the problem.

Foot and ankle injuries require treatment of the movement system in its entirety, rather than simply throwing a pair of orthotics in your shoes or simply “stretching your calves”. This is often the approach made by many healthcare providers and, unfortunately, it rarely gets positive results. The way these diagnoses are commonly treated is incredibly frustrating, which is part of the reason why I love to treat this area! Finding the right provider that can see the “bigger picture” is a must!

What made you want to be a PT?

From a young age I became fascinated with the human body, although I don’t totally recall a specific experience that initially fueled my interest. Anatomy and physiology had always been one of my strongest subjects in school and I was one of the few that actually looked forward to the frog dissection in 7th grade science.

I decided young that I was going to grow up to be a Medical Doctor and go to Medical School. After graduating with my undergraduate degree from the University of California in San Diego with all the necessary Med School prerequisites, I began the process of applying. At the same time, I was looking for employment in the medical field to gain hands-on experience prior to school. I ended up with a job as a Physical Therapy Aide for a clinic that served both professional and recreational athletes. There, I began to appreciate the rehabilitation process.

I had the opportunity to see our clients come into the clinic on crutches - fresh off of an ACL reconstruction, for example - and leave our clinic a year later with the ability to play their sport to their full potential. I enjoyed being an integral part of the recovery team where I had the opportunity to spend hours on end seeing our clients heal and ultimately return to the activity they love. The decision to make the switch to PT was easy from there!

Who do you most look up to in the field of PT and why?

It is so tough to choose just one person I look up to most. I’ve had the good fortune to work with some amazing PTs in my career, including the lovely ladies here at Klein PT!

My admiration for different individuals tends to change over time based on what new PT podcast I’m listening to, what new techniques I’m learning, and what recent continuing education coursework I’ve taken. There are some true rockstars in the PT field! If I had to choose just one person, it would have to be Lynn Shulte, PT who is a Pelvic Health Physical Therapist in Boulder, CO that specializes in pregnancy and postpartum.

I recently took a course taught by her and was blown away by her knowledge and ability to heal. I’ve learned so much from her and look forward to continuing to apply the knowledge she has given me to my clients with amazing results.

What is the best compliment you have gotten in your work?

I will never forget when a client once told me “I thought PT didn’t work, but now I realize PT works if it’s the right PT”. Often, people’s experience of physical therapy involves short visits treating only the area of pain and/or injury.

I pride myself on seeing the “big picture” when it comes to assessment and treatment of injury and/or pain. This often leads to tapping into areas of impairment that many clients have never had treated before, even with multiple rounds of physical therapy prior. Ultimately, the entire movement system is intimately connected and it takes treating the system in its entirety to truly see positive results.

Klein PT Supports: Leukemia & Lymphoma Society's Light the Night Event

Dear Friends and Colleagues,

I am joining my patient's team and walking Light the Night for the Leukemia and Lymphoma Society. She created a team because she just lost her mom to Leukemia. My aunt (Auntie Ann) is currently battling AML and it's been a really tough road.

I am fundraising for it as I have a goal to hit (follow our journey here), and I am humbly reaching out to you, my business community, to support this noble cause. 

Here are some pics of my family and I visiting Auntie Ann in San Francisco recently, as well as one from the event. I hope you will join us as we fight for cures and support for those with AML.

Thank you for reading, 

Lea

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A bit more about the event….

In the world of philanthropy and community support, one event stands out as a shining beacon of hope. On September 21, 2023, the Leukemia & Lymphoma Society (LLS) will host their highly anticipated Light the Night event. This exceptional gathering aims to bring together individuals from all walks of life, uniting them in a common cause: to raise awareness and funds for research and support services.

Light the Night serves as a powerful testament to their commitment, providing a platform for survivors, supporters, and those who have lost loved ones to share their stories and find solace in a community of understanding.

At Light the Night, participants will carry lanterns, each representing a unique connection to the cause. The red lanterns signify the unwavering support of dedicated individuals, while the white lanterns serve as a symbol of hope for survivors who have triumphed over the challenges of blood cancer. Additionally, gold lanterns will be lit to honor the memories of those who have sadly lost their lives to this relentless disease. Together, these lanterns will illuminate the night sky, creating a breathtaking display that embodies the resilience and determination of the human spirit.

The event invites individuals and teams to fundraise in support of LLS's mission, empowering them to make a tangible difference in the lives of those affected by blood cancers. Attendees will have the opportunity to connect with like-minded individuals, share their experiences, and forge lasting bonds within a community that understands the unique challenges posed by these diseases.

Light the Night is more than just an event. It is a poignant reminder that by joining forces, we can overcome even the most formidable obstacles. The funds raised through this event will fuel groundbreaking research, enabling scientists and medical professionals to develop innovative treatments and improve the quality of life for patients. Additionally, the event's proceeds will provide comprehensive support services to patients and their families, offering them the much-needed assistance and guidance throughout their journey.

As the countdown to September 21, 2023, begins, individuals from all corners of society are eagerly preparing to come together under the banner of Light the Night. With each step taken and every dollar raised, they will illuminate a path of hope, resilience, and progress. The Leukemia & Lymphoma Society's Light the Night event promises to be an unforgettable experience.

Thank you for your support!!

The Team at Klein Physical Therapy

Low Pressure Fitness (Hypopressives)

Is it the

new

wave

of

core strengthening?

I just finished my Level 1 Low Pressure Fitness Certification last weekend. I am still in awe at all of the concepts learned.  

Do you find that you struggle with that lower belly pooch that will NOT go away?  Or Pelvic Organ Prolapse (POP) or Diastasis Recti (DRA)?  Or that unwanted leakage when you cough or sneeze (or even just laugh)?  Are you always being told by your physical therapist that you aren’t quite able to isolate contraction of your lower belly muscles (but instead find that you “grip” your upper abs or are very tight in your lower rib area)?  Do you struggle with constipation? If so, continue reading!  Low Pressure Fitness may be perfect for you!

As a PT in the industry for over 20 years, I have witnessed a huge paradigm shift in the way we look at core strengthening.  At the beginning of my years, we had found out that doing traditional sit ups or even crunches was not the key to a truly strong “deep” core system that supports our spines and looks aesthetically pleasing.  We began to adopt belly breathing and deep core contractions with pelvic tilts.  At that point I also remember teaching a head lift exercise for diastasis recti with a sheet wrapped around patients’ midsections to approximate the muscle.

Then with the rise of pilates, we began to teach similar concepts but with a neutral spine.  However, we still use many cues such as “draw your ribcage toward your pelvis and funnel the ribcage” to get further activation of these muscles.

In more recent years, we are beginning to understand that true diaphragmatic breathing is more of a 360 ribcage expansion rather than just a breath into the belly.  We are also realizing how much intraabdominal pressure (mismanaged) can create many issues such as prolapse and leakage.    The issue that I see for many is that when I cue a core contraction, the lower ribs tighten, the upper abominals grip, and patients then create a lot of pressure in their bellies.  

I still think there can be such benefit to the pilates based movement system, but this new course helped me to put it all together and realize we can actually create a vacuum or NEGATIVE pressure system that not only strengthens the core and tensions the linea alba (HUGE for diastasis recti), but also widdles away our midlines and lower bellies.  What is even more fascinating is that we can get all of this without ever cueing the lower belly to contract at all!  We were able to use live ultrasound on our bellies to watch the contraction of the tranversus abdominus (our lower bellies that co-contract with our pelvic floor and support our lower back).  

This new system can be a visceral mobilization of our organs because we are able to achieve a big lift of everything in the peritoneal cavity (our liver, bladder, intestines, etc).  This can tremendously help with constipation.  We are also able to get our diaphragm and thoracic spines moving more as well.  

The other aspect that I love about this new movement system is that it is extremely good for our posture.  Every single pose is very active from head to toe, and one of the most used cues is to lengthen and grow tall (similar to pilates).

To learn the vacuum can be a little confusing and difficult at first, as it isn’t a move we really ever do.  But, once you learn it, it continues to get easier.  Many other PT’s in this course were hardly able to do it at the beginning of the weekend, and by the end of the weekend they were killing it!  We even took before and after pictures at the beginning and end of the weekend and already noticed a change in our bellies and our posture.

Curious to know more?  What do you think about this and have you heard of it?  I’d love to hear from you and whether you are interested in learning this!  I’m thinking about setting up small classes in a series, so please let me know if you’re interested!

Klein Physical Therapy: Q&A with Dr. Kimberlie Landers

At Klein Physical Therapy in Denver, Colorado, we have an incredible team of professionals. We wanted to highlight Pelvic Floor Physical Therapist Dr. Kimberlie Landers, PT, DPT, PCES. So, here is a little more about Dr. Kim! (And learn even more about her on her bio here.)

Photo Credit: Lindsey Mladinich

What is the most amazing recovery you have seen in your experience as a PT?

One of the amazing recoveries I have seen is a patient with severe endometriosis who continued to have high pain levels (8-10/10) post surgery. After completing PT she was able to return to work and exercise with little to no pain and felt confident in being discharged. 

What is one of the most frustrating conditions your patients have had that you have helped them with?

Vaginismus and dyspareunia are frustrating conditions that I often help with. It can be frustrating because it is not only physical but psychological and treatment needs to reflect that. I have been able to help patients be able to tolerate tampon use and have sexual intercourse that is pain-free. 

What made you want to be a PT?

I had knee pain while playing competitive volleyball in high school and went to PT. I saw how active the job is and how social it is. Additionally, I wanted to be in a field where I can make a difference and help people live their best life. 

Who do you most look up to in the field of PT and why?

I look up to Nicole Cozean, PT, DPT, WCS, CSCS who is a pelvic PT and business owner  in California. She puts out great continuing education, has a podcast, and is always advocating for physical therapists to continue to grow and provide the best care possible. She gives great clinical pearls in her podcast that help me continue to learn new things.

What is the best compliment you have gotten in your work?

The best compliment that I get is the ability to make patients feel comfortable and relaxed in a setting that might otherwise feel awkward. Additionally the ability to provide trauma informed care and provide a safe space for my patients. 

Photo: Faceted Media | Dr. Kimberlie Landers, PT, DPT, PCES

Pelvic Floor Pain Relief: Physical Therapy in Denver

Pelvic floor pain is a common and often debilitating problem that can have a huge impact on our quality of life. 

It can often go undiagnosed and is regularly misdiagnosed, leading to a lack of understanding about the condition, confusion about how to manage it, and a sense of desperation as nothing seems to relieve the discomfort. 

What does pelvic floor dysfunction feel like?

Pelvic floor dysfunction can cause a variety of symptoms depending on the type of dysfunction. Common symptoms include chronic pelvic pain (anywhere in the lower abdomen or pelvis), difficulty with voiding (urinating or having bowel movements), pressure or heaviness in the pelvic region, frequent urination, pain during sexual intercourse, and/or a sense of incomplete emptying of the bladder or rectum after voiding.

Pelvic floor dysfunction can also feel like general pelvic pain, burning or painful sensations during urination, evacuation, or intercourse; or bladder or rectal pressure, and difficulty initiating or maintaining a stream of urine.

Pelvic pain can really affect your life. 

Michaela was a client of ours, and a stay-at-home mom of two young boys, aged 2 and 4. She really enjoyed taking care of her kids and her family, but she was feeling discomfort in her pelvic area that she just couldn't ignore. It was a dull, chronic ache that seemed to be getting worse over time. She tried to take it easy and take care of her body but the pain kept coming back. Since she’s also known as Wonder Woman in her house, she kept thinking it would “just go away” eventually. But, it didn’t.

She began to limit her activities, finally giving up on the running and yoga classes she used to love so much. She felt frustrated that she couldn't do all the things she used to enjoy and it was taking a toll on her physical and mental health. 

She talked to her primary care doctor and was told that the most likely cause of her pain were issues with her pelvic floor muscles, which can cause a lot of distress in the low back and belly. She was then referred to a physical therapist for pelvic floor physical therapy, which she was excited about as a solution. 

At her appointment, our physical therapist team assessed her entire body to determine the source of her pain.  Like many other moms, her deep core stabilizers were not firing like they should (including her hips), causing her pelvic floor and low back to be working too hard.  We used manual therapy techniques to establish more normalized joint and soft tissue mobility. She was also taught exercises to do on her own to help breathe more optimally, strengthen the lower abdominals and hips, and coordinate how she was using her pelvic floor. She was stunned at how quickly her pain began to subside and even more pleased at seeing the improvements in her overall function. Hurrah!

Michaela was so happy to resume the activities that she had to give up due to her pain. She was able to start running again, go to her yoga classes, and even enjoy going to the park with her two young boys again. 

Michaela was so grateful that she sought out help from a physical therapist and got on the road to recovery. If it wasn't for her care, she would still be struggling with her pain, unable to be the active mom she and her family deserved.

What else can physical therapists do for pelvic pain?

Physical therapists can help individuals with pelvic pain by developing and implementing individualized treatment plans that address the underlying issues causing the pain. 

This can involve using a variety of specialized manual therapy treatments to reduce tension along the areas of pain, strengthen weakened muscles and promote coordination and mobility of the pelvic floor muscles. 

Techniques such as myofascial release, dry needling, trigger point release, joint and soft tissue mobilization, and pelvic floor muscle retraining can all help to alleviate pain and improve overall function. 

In addition, physical therapists can provide education on posture, ergonomics, and activity modification to maximize mechanical efficiency and reduce the risk of re-injury - so you get back to being you!

At our Denver physical therapy practice, we offer a complimentary Discovery Session to see if PT might be a good course of action for you. Just click here to get started.

Common Reasons Women See Physical Therapists

In our practice, while we use a variety of physical therapy modalities to help treat a wide range of conditions, many of our clients are women experiencing pelvic pain. 

However, we have a team of physical therapists with their own unique specialty. We help men and women with many different muscular and structural ailments. Our care is holistic - meaning we compliment your primary care doctor and other treatments in a supportive way to get you back to being you.

Here is a short list of common reasons women see physical therapists. And, if you’re unsure, just schedule a complimentary introductory consultation with our team below.

1. Pre or post-natal care - Prenatal care helps expectant mothers prepare for the physical changes that accompany pregnancy as well as preparing for labor and delivery. We also treat common ailments during pregnancy such as carpal tunnel syndrome and sciatica, as well as symphysis pubis dysfunction.  Postnatal care helps mothers recover from labor and delivery (including assessing the perineum for tearing or the c-section scar if cesarean).  This also includes a diastasis recti check (and treatment if necessary).

2. Pelvic health - Physical therapy can help many pelvic health symptoms such as pelvic pain, urinary incontinence, constipation and pain with intercourse.

3. Orthopedic conditions - Physical therapists can help reduce pain, improve joint range of motion, decrease inflammation, and increase strength in women with orthopedic conditions such as low back pain, tendinitis, and bursitis.

4. Post-surgical rehabilitation - Physical therapists help individuals after surgery, such as hysterectomy, to rebuild strength and improve function.

5. Cervicalgia, headaches, TMJ and other issues - Physical therapists provide treatments for pain, limited range of motion, and postural impairments to help women manage their neck pain, headaches, and other posture related problems as well.

Many people who are trying physical therapy for the first time often have a few (or more) questions.

Here’s a list of some of our most frequent physical therapy frequently asked questions.

Q: What is physical therapy exactly?

A: Physical therapy is a healthcare specialty focused on helping individuals improve their physical abilities, restore mobility and reduce pain. This is achieved through the use of specialized treatments such as manual therapy, strengthening, stretches, and modalities (we primarily utilize dry needling, guasha and myofascial decompression, or cupping). Physical therapists work with individuals to improve their lifestyle, overall wellbeing, and quality of life.

Q: Who needs outpatient physical therapy?

A: Individuals who suffer from musculoskeletal pain or any ailment related to pregnancy or after delivery, or have post-operative needs can benefit from physical therapy services. Physical therapists can also help individuals restore their maximum physical state, improve coordination and strength, and decrease pain and discomfort. Physical therapists further help with issues related to cognitive and motor skills, balance, or improve sports performance. We can even help with proactive and preventative care, like proper return to exercise after delivery.

Q: What does a physical therapist do?

A: Physical therapists are healthcare professionals who use specialized treatments and therapeutic exercises to help patients achieve their desired outcomes. They provide individualized instructions and guidance to improve strength, flexibility, coordination, and mobility. Physical therapists develop treatment plans that are tailored to the individual’s needs.

Q: Is physical therapy safe?

A: Physical therapy is a safe and effective option for treating a variety of musculoskeletal issues. Physical therapists are dedicated to providing the most appropriate treatment and exercising plans to best fit the individual’s needs and abilities. All physical therapists are licensed and have a minimum of a Bachelor’s degree to ensure quality care.  In fact, all programs are now at a doctoral degree.  Here in the state of Colorado, physical therapists have direct access, meaning you do not need a script from a doctor to legally be seen.

Q: How much does physical therapy cost? 

A: Depending on the type of treatment, therapy, and the number of visits required, the cost of physical therapy can vary greatly. While we do not accept insurance, we do issue a super bill (a detailed receipt) that you can submit to your insurance if you have out of network benefits.

Q: How do I prepare for my physical therapy appointment?

A: It is important that you provide your physical therapist with a detailed medical history and any relevant information about your diagnosis that they may ask you at your appointment. You should also come prepared to ask questions and seek clarification on any treatments, exercises or recommendations. Wear comfortable clothing and we’ll have everything else you need here at our office in Denver, CO.

At our Denver physical therapy practice, we offer a complimentary Discovery Session to see if PT might be a good course of action for you. Just click here to get started.

Reminder: Take Care Of Your Bladder

Bladder Health Awareness Month

Bladder Health Awareness Month is recognized every November as an opportunity to raise awareness about bladder health, which affects nearly everyone at some point in their lives. It's a good thing it gets a full month - it currently affects over 80 million Americans and a common topic for a pelvic floor physical therapist to discuss with their patients.

During this month, we are sharing tips on taking care of your bladder, staying active and eating right, as well as ways to avoid incontinence, overactive bladder (OAB), and frequent UTI’s or bladder infections.

How to Practice Good Bladder Habits

• Urinate when you wake up and just before you go to bed, avoiding frequent stops to the restroom in the evening before bed.

• Drink plenty of water to help dilute your urine and reduce its acidity.

• Only void when your bladder is adequately full (avoid going “just in case” without an urge).

• Avoid bladder irritants like alcohol, caffeine, carbonated beverages, artificial sweeteners, cocoa powder (in chocolate), and hot spices (such as cayenne). These can all contribute to bladder irritation.

• Try not to panic when you feel a strong urge to urinate.  If you use mental distraction (like counting backward by 7 from 100) and sit down with deep breaths, that strong urge will dissipate and allow you to head to the restroom with less panic and less chance of an accident.

• Never strain (or push) to urinate.  Your muscles of the pelvic floor should just be relaxed so your bladder can contract to urinate.

Stay Hydrated

One of the most important things to remember when you are trying to keep your bladder healthy is to stay well hydrated. Water can help prevent bladder infections, chronic pain and many other bladder issues. Drinking plenty of water every day will also make it easier for you to go to the bathroom when you need to.

When it comes to staying hydrated, there are a few things that can help:

• Avoid drinking too much alcohol or caffeine

• Eat foods that are high in water content (like fruits and vegetables) instead of foods with a lot of salt or sugar content.

• Sipping warm tea throughout the day can be a great way to hydrate slowly and evenly.

• Use of a straw can help you drink more water, and a well-labeled water bottle so you know how much you are drinking to hit your goals.

Eat a nutritious diet with plenty of fiber

A nutritious diet is important for a healthy bladder. Fiber helps keep your digestive system healthy and can help prevent constipation and hemorrhoids, both of which can cause you to strain or push harder, which affects your pelvic floor and bladder.

Avoid bladder irritants like caffeine, carbonated beverages and alcohol

Avoid bladder irritants like caffeine, carbonated beverages and alcohol. These can all cause bladder irritation. Caffeine, for example, may cause frequent urination and urgency. Drinking carbonated beverages can also cause pain when urinating and make it difficult to hold your urine in. Alcohol can lead to incontinence as well as other urinary tract problems as it dehydrates the body's tissues.

Practice pelvic floor muscle coordination (both relaxation and strengthening).

This can help with bladder control and also help to decrease excess urinary urgency and frequency.

• To practice pelvic floor muscle coordination, first try lying down on your back with your knees bent.  One of the most important parts of learning coordination is to be able to start with a good diaphragmatic breath.  Place one hand on your upper chest and one hand at the side of your lower ribs (just under your breast).  Inhale into your nose and try to aim for expansion at your lower ribs (only feeling your upper chest move at the top of the inhale).  The inhalation is when your pelvic floor should be the most relaxed.  

• Now, as you exhale try to do a kegel by thinking about scooping a blueberry with your vagina or “closing the openings”.  You can also think of stopping the urine stream.  As you then inhale, think of dropping your pelvic floor and completely relaxing.

• Aim for two sets of 10 per day: one in the morning and another later in the day or before going to bed at night.

• If you have excess urinary urgency or frequency, pelvic pain, constipation, or frequent UTI’s, your pelvic floor may have excess tension so you should not be doing many of these, and your focus should be more on relaxation.

• Note: It's best to do these under the guidance of a professional physical therapist.

Conclusion

Bladder (and pelvic floor) health is something that should be taken seriously. It's important to keep your bladder and pelvic floor happy, because it can affect the rest of your body if not taken care of properly. If you have any questions about this topic or feel you need further assessment, we are here to help.  We offer a free, 30 minute consultation so you can ask your questions and decide if pelvic floor physical therapy is right for you.

National Depression Awareness & Health Screening Month

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Paying tribute to the life of a dear mom

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The words I read in an email from the principal of my kids’ school left me reading it over and over again.  As I processed what it meant, I felt sick and was flooded with emotion.  A dear mom that I knew from our church and school community tragically died after a struggle with postpartum depression following the birth of her third child.  She left behind a loving husband, and three beautiful daughters, 5, 3, and 4 months.  

This did not happen, this can’t be true, I thought. 

I quickly recounted the last encounters I had with her, trying to recall if I noticed any signs of depression.  I could only recall her love and kindness, always.  She was so patient with her girls, and took the time to listen to anyone around her.  I was inspired to be a better mom whenever I was around her.

Her girls already exude her kindness, and her oldest (in my son’s class), is known for always checking on anyone upset and telling them that she loves them.  However, the girls have been robbed of feeling the comfort of their mom’s arms, kissing their boo-boos and helping them do all their “firsts”.  This mom’s life on this earth ended all too soon.

So, all I keep thinking since this horrible tragedy and knowing how many postpartum moms we see at Klein Physical Therapy, is “What more can I do??”  Ironically as I was pondering this, an email came through from Herman and Wallace (pelvic health continuing education company) entitled “October is National Depression Education and Awareness Month”.  Education and Awareness are some small steps we can take to identify this.  We at Klein Physical Therapy are committing to an increased level of education on this topic, and plan to add screening questions to our evaluations and assessments.  

Postpartum Depression occurs in 6.5% to 20% of postpartum mothers. 

It is different than having postpartum blues, in which women recover more quickly.  Postpartum depression lasts longer and causes trouble with the mom’s ability to return to normal function.   Unlike previously thought, directly asking if a person has had suicidal thoughts does not mean that it would be the cause of that ideation for that person.  It is quite the contrary.  It reduces the stigma and helps them to feel supported.

There are wonderful resources out there as well.  There is Postpartum International Support which offers support groups for postpartum moms:

https://www.postpartum.net/get-help/psi-online-support-meetings/ 

In working with so many postpartum moms over the years and being a mother of 3 myself, I believe that we need to keep looking for opportunities to help our fellow moms out there.  This mother will always have a fond place in my heart as I continue to pray for her and her beautiful family.  Please reach out if you have more ideas on ways Klein PT can help.

References:

https://www.ncbi.nlm.nih.gov/books/NBK519070/

Hip Flexor Pain And Causation, Plus Treatment Approaches

The hip flexor pain or iliopsoas related pain is pain that takes place in your hip flexor muscles located at the front of the hip. One of the main hip flexors is the iliopsoas muscle which is made up of two parts: the psoas muscle and the iliacus muscle.  

The psoas muscle begins at the lumbar spine while the iliacus muscle begins at the inside of the pelvis. These muscles run together and ultimately merge at the iliopsoas. Iliopsoas pain, or hip flexor pain, can be tied to these muscles themselves, the tendons fusing the muscles, or the tendon and the bursa. 

What Is Hip Flexor Strain? 

There are many hip flexor conditions that can cause a pain to an individual including: 

• Hip Flexor Strain

• Hip Flexor Tear

• Iliopsoas Bursitis

• Anterior Snapping Hip

Symptoms Of Hip Flexor / Related Pain

If you are experiencing pain as a result of groin or hip flexor stress, you are most likely experiencing discomfort around the front of your hip or upper thigh. Occasionally, depending on the condition, pain can extend into the lower back or lower abdomen. This pain is often described as a tightness in the area. 

There are a few symptoms one may be experiencing related to hip flexor or iliopsoas pain. If you experience pain when doing hip flexion or hip extension moves, chances are these may be related to your hip flexor. Levels of pain differ from individual to individual, and make everyday tasks like walking and even lifting the leg uncomfortable. 

Some Causes of Hip Pain

Outside of a clear hip related injury, hip flexor pain can present itself gradually over time. If there is not a clear injury behind your hip discomfort, there may be some other common causes of hip flexor pain such as: 

• Repeat Hip Flexion/Extension: This could be the result of an athletic activity or sport that requires hip flexion and hip extension like sprints. 

• Weakness of the core: When your abdominal muscles and gluteal muscles are weak and improperly firing, the hip flexors end up overfiring.

• Postures: Sitting, standing, or remaining in fixed postures for long periods of time can cause an increased load of stress on your hip flexors

Treatment Options for Less Hip Pain

There are a number of treatment options depending on the level of discomfort and stress in the area. As physical therapists, our job is to determine if the muscle is truly tight, or just in spasm and weak.  We can perform manual release techniques or dry needling as well as stretching and strengthening as needed to relieve pain.

Other options include injections, most commonly in the form of cortisone shots.  However, this is a more invasive option that should only be tried if conservative measures don’t work.  

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Klein Physical Therapy is here to help. We meet our clients where they are at, providing a thorough assessment and treatment plan to help you heal and get back to doing the things you love.

Our goal at Klein Physical Therapy is to become the best version of yourself with personalized, high quality, and one on one physical therapy sessions. Schedule a free discovery session with us online today!  

We now have two locations for physical therapy in the Denver area. Klein Physical Therapy is located in the Pilates Collective near the University Hills Shopping Center and inside Harmony’s Family Cooperative in Cherry Creek.

OUR LOCATION

Address: 2401 S Downing St, Denver, CO 80210, United States

OUR HOURS OF OPERATION

Monday 7am–3.30pm

Tuesday 8am–3pm

Wednesday 7am–6pm

Thursday 8am–5pm

Friday 7am–3pm

Saturday Closed

Sunday Closed

OUR PHONE NUMBER

(720) 252-6304

5 Ways Men Can Benefit From Physical Therapy

The truth of the matter is men (and women) of all ages can benefit from physical therapy. Do you have or know of a man in your life that is experiencing aches and discomfort but has yet to consult a physical therapist? Physical therapy will not only help cure your current discomforts but can work to help manage chronic conditions and teach you long term pain management tips.

Whether it’s a yearly checkup or bi-weekly routine trips to your doctor, there are a number of benefits to physical therapy.

At our Denver physical therapy practice here at Klein PT, we find these five ways men can benefit from physical therapy to be the most common (and the most successful!).

#1: Physical Therapy Can Help Cure Sexual Dysfunction in Men

Although this is a common issue that plagues men and women alike, it doesn't make it any less embarrassing. One way men can benefit from physical therapy is discussing and curing problems of sexual dysfunction. Most men that experience problems with incontinence and erectile dysfunction are embarrassed and end up suffering for years without consulting treatment or the help of a professional. 

Some other issues that plague men include interstitial cystitis and prostatitis. Physical therapy is capable of resolving a number of bowel or bladder issues and if you are experiencing issues of bladder infection, sexual dysfunction, or irregular bowel problems consulting your physical therapist or doctor can make a world of difference. 

#2: Post Injury and Sports Performance Recovery is Enhanced with Men’s PT

Chances are at some point in life you have lifted something too heavy or competed in some sort of sports related activity. While these activities are great for your overall health and wellbeing they oftentimes result in unwanted injury.

One common injury that plagues most men are labral tears. These tears can be caused quite frankly by a number of reasons including sports related injuries, overuse, or overextension. Labral hip tears affect the cartilage on the outside rim of your hip. This affects the cushion that connects your hip joint and leads to extreme discomfort.  Physical therapists can help restore movement and ease discomfort to any part of the body including: ankle, feet, arm, foot, head, knee, back, etc. 

#3: Helps Support Pain Management Techniques

According to the American Physical Therapy Association (APTA), a physical therapist is a trained professional with experience in diagnosing physical abnormalities, restoring function, maintaining physical function, and promoting physical activity. 

With training and licensing physical therapy has many benefits to offer pain management is at the top of that list. Physical therapists take care of a patient from the initial assessment and are trained to diagnose and treat a wide range of conditions. One example of a common discomfort treated by a physical therapist is male pelvic pain. This condition can be produced by a number of causes including cystitis, prostatitis, or even sexually transmitted infections and causes pain in the lower of your abdomen. A physical therapist can help cure your discomfort by performing a physical examination and working with you to come up with a treatment plan to help ease your discomfort and manage your pain.

#4: Physical Therapy (Often) Drastically Shortens Recovery Processes

One very common benefit of consulting and working with a physical therapist is the ability to work with a professional in your recovery process and reduce the need for opioids. Common clients that physical therapists work with are those that are recovering from an injury, trauma, stroke, or paralysis.

Most people consult a physical therapist because they need the help of a professional to aid them in the recovery and healing process. Physical therapy is a great alternative when you are trying to avoid surgery and the use of pain management via opioids. This physical consultative approach allows you to continue on your road to recovery as you work alongside a professional.  

#5: Reduces Aches and Pains

Physical therapists aren't just here to help in the recovery process from a traumatic event. In most cases, customers consult a physical therapist to help them reduce everyday aches and pains and learn how to more efficiently manage their discomforts and practice healthy pain management techniques.

Regardless if you are experiencing stress from work, home, etc or simply just learning to deal with the repercussions of aging. Physical therapists are a great option for men that want to cure their everyday pains before they turn into chronic conditions. 

Oftentimes the idea of a physical therapist can spark bad memories of recovery from a college injury or surgery. As physical therapy continues to become increasingly popular and different offices specialize in different areas, physical therapy has many benefits outside of post surgery related rehab. 

As a physical therapy practice in the Denver area, we are no stranger to the benefits physical therapy has to offer to men and women alike. For more tips on best practices, physical therapy tricks, and pain management tips head over to our full blog or book a complimentary Discovery Session with us today! (For new clients only please.)

Can Systemic Joint Hypermobility Cause Pelvic Pain?

Here at Klein Physical Therapy, we often have to be a bit of a sleuth for our patients.

And, many, many times, it all comes back to the pelvis (you’ll notice on our website that treating pelvic floor conditions is a prominent feature of our physical therapy work).

Recently, we worked with a patient with systemic hypermobility who was experiencing neck, jaw, low back, and pelvic pain. Could it all be related? What is the connection, they wanted to know.

The leg bone’s connected to the… well, you know the song, right? So, short answer, yes, everything is connected. And, when we can help simultaneously strengthen, relax, and help support the body with physical therapy, we find that symptoms even from chronic conditions such as joint hypermobility syndrome can be greatly relieved.

First, let’s take a look at what joint hypermobility is, what symptoms can appear, and some solutions.

Joint Hypermobility is a syndrome resulting in joints that are very flexible, yet also occasionally painful. This often starts at a young age and lessens as one matures, but that is not always the case. That’s where Physical Therapy comes in. It can often help reduce the pain and make it less of a focus during your day.

What Is Joint Hypermobility?

Often those that have joint hypermobility syndrome think of themselves as double jointed. However, if a number of your joints are “supple” or affected, this becomes joint hypermobility. While this isn’t by nature a medical condition, those that have hypermobile joints may experience pain in their muscles or joints and find that they are exceptionally prone to injury or dislocation. 

What Are The Symptoms? 

There are a few factors that play into joint hypermobility. While this often presents itself at a young age, it can be carried into older age and there are a few symptoms and signs you can look at. 

• Muscle pain or strain: If you experience pain after physical tasks, this may be the result of hypermobility. Your muscles have to work harder due to the flexibility in your joints, and this can cause strain over time. 

• Stiffness in joints: If you feel constant stiffness or a tense feeling in your joints this may also be a sign. The pain will often feel worse throughout the day as you continue to move and alleviate itself through the night with rest. 

• Neck and back pain: This can be one of the worst symptoms of joint hypermobility. If your spinal joints are especially supple, the muscles surrounding your spine may struggle to support itself. 

Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome is a subset of hypermobility that is more specific.  It affects the skin, joints, and blood vessel walls.  It can cause dislocation due to overly flexible joints.  

Many times, patients with Ehlers-Danlos Syndrome suffer from pelvic floor dysfunction.  This is due to the pelvic floor muscles going into a hypertonic state to attempt to help stabilize the lumbar spine, pelvis, and hips.  

Pelvic floor physical therapy is an excellent form of conservative care to help to manage symptoms such as pelvic pain and increased urgency or trouble with constipation.

What Causes Hypermobility

There are a number of traits that may play a part in joint hypermobility including genetics, gender, age, etc. Women are more likely to experience joint hypermobility than men and can potentially be a result of inherited genetics in the form of shallow joint sockets. 

Some common causes of hypermobility in the joints include:

1. Shape of bones: If you inherit  shallow sockets in your hips or shoulder, your range of movement will be wider and you have a higher likelihood of discoloration and injury. 

2. Weak or stretched ligaments: If you have weak ligaments, caused by a number of situations such as lack of collagen you may be subject to hypermobility in the joints.

Treatment Options

Unfortunately, this syndrome is not something that has a cure since it is a result of your body's personal build. There are a combination of steps one can take to help alleviate pain caused by hypermobility. 

Physical therapy is a great option for those suffering with hypermobility. Through this form of treatment, a patient will use exercise to strengthen and treat the muscle around the joints for greater stability. Professionals will be able to show you the correct exercise to strengthen the muscles while making sure they are not over stretched. 

If you’re over the pain and want to find solutions, Klein Physical Therapy is here to help. Our goal at Klein Physical Therapy is to become the best version of yourself with personalized, high quality, and one on one PT.

Whiplash After a Car Accident: What Happens Next?

(And How Physical Therapy Supports Long-Term Recovery)

Whiplash is a very common injury when it comes to car accidents, and although it can be very painful, it is also very treatable. Whiplash injuries that occur in car accidents are typically due to forceful, rapid back-and-forth action of the neck and upper spine in some cases. Understanding what whiplash is and how to treat it can help to protect your health or any possible long-term complications or physical disabilities.

What is Whiplash?

A whiplash injury is commonly caused by rear-end accidents but can also be caused by many other things, such as physical abuse, sports accidents, and other types of trauma such as falling down the stairs. It is not uncommon for whiplash injuries to be referred to as a neck sprain or strain, but this term is inclusive of other injuries other than whiplash.

Symptoms of whiplash can start to appear within hours or days of the injury, and can include:

• Neck pain and stiffness

• Worsening of pain with movement near the injury (e.g. turning your head)

• Loss of range of motion in the neck

• Tenderness at the base of the neck, shoulder, upper back, and/or arms

• Headaches that start at the base of the skull

• Tingling or numbness

• Fatigue and dizziness

Some additional whiplash symptoms people have reported experiencing include:

• Blurred vision

• Difficulty sleeping

• Irritability

• Memory problems

• Ringing in the ears (aka tinnitus)

What is the Best Treatment for Whiplash?

Depending on how you were injured, your treatment plan may be different, but your first step to treating whiplash after a car accident or any other type of trauma is to seek medical treatment. Whether your accident was minor or severe, if you believe you could have a whiplash injury, it’s best to seek medical attention as soon as possible. An important thing to keep in mind is that whiplash injuries are soft tissue injuries, which means symptoms might not appear for hours, days, or even weeks, which is why it’s best to seek treatment and/or medical attention as soon after the accident as possible. It’s also important to note that whiplash injuries don’t show up on an x-ray, so the person treating you will likely need to perform other tests to decide how serious your injury is.

After you are treated for your whiplash injury, your doctor or medical care provider will likely provide you with at-home care instructions and connect you with a Physical Therapist, who will help guide you along the healing process. The doctor will likely give you some sort of pain medication if your injury is severe enough and they also might recommend you wear a neck brace or cervical neck collar for a few weeks.

Why Physical Therapy is Key to Healing from Whiplash

Once you are healed enough from your injury, Physical Therapy is your next step – and also a very critical part of your long-term healing process. Depending on your injury, your doctor might recommend you integrate Physical Therapy early on in your treatment plan in order to avoid any future problems or concerns. The main benefit we hear from our patients is that they feel relief from their pain while also strengthening their muscles, which is our ultimate goal.

Treated properly, whiplash can be healed. Working with a Physical Therapist throughout your recovery process will often lead to quicker and more efficient healing as well as improved muscle strength over time. 

PT’s will encourage slow and careful movement (which can seem like the last thing you would want to do after a car accident), but it actually will help you more than bed rest. The oxygen created in your body through movement is what’s needed to heal a whiplash injury.

About Klein Physical Therapy, P.C. | Denver PTs in Cherry Creek and University Hills 

Owner & Founder, PT Lea Klein, along with Dr. Katie Peters and Dr. Emily Roberts make up the Physical Therapy team at Klein PT, 2401 S Downing St, Denver, CO 80210. To learn more about the services we offer at Klein Physical Therapy please contact us here!

Chronic Pelvic Pain in Men: How Physical Therapy Helps

By Dr. Emily Roberts, DPT, OCS

Chronic nonbacterial prostatitis. What is It?

Chronic nonbacterial prostatitis is a common referral to pelvic floor physical therapy clinics. Yet, the journey to find physical therapy, and to learn that your symptoms aren’t related to a UTI or STI, can be a long and frustrating process. There’s a common misconception that pelvic floor physical therapy is only appropriate for women, particularly related to pregnancy, postpartum care, or in relation to sexual dysfunction. Awareness that males, too, can struggle with pelvic floor dysfunction is improving, albeit slowly. 

Males dealing with urinary issues report first seeing their general practitioner, a urologist, or sometimes even gastroenterology, but after a few negative tests, are likely sent on their way with medication(s). Most patients report that this process is repeated multiple times, prior to pelvic floor physical therapy being brought up at all. This can take consulting with multiple providers prior to finding a provider familiar with the connection to our pelvic musculature. It is a frustrating and drawn-out process for many. 

If we dive a little deeper into why physical therapy can help, we can look to the muscles in our pelvis specifically.

The muscles in the pelvic floor help us retain as well as release urine at the appropriate times. We get into “dysfunction” when these muscles are chronically tight, have poor coordination, or cause pain with urination or bowel movements due to an unregulated nervous system. 

Chronic nonbacterial prostatitis, or chronic pelvic pain syndrome, accounts for almost 90% of individuals with a diagnosis of prostatitis according to NIH.

Symptoms that you may be experiencing include frequency of urination (<3 hours between voids), a small amount of leakage or dribbling after urination, burning or pain during/after urination, or waking at night >1x to urinate. It is common, as was mentioned before, for these patients to be put through a number of tests, given a few medications that may mildly improve their symptoms, but truly find minimal to no real relief. Symptoms can come and go related to stress, changes in your diet, increase in activity, or may increase with prolonged pressure at the pelvic floor (ie. biking, sitting for extended periods, or chronic constipation/straining for bowel movements). 

Pelvic floor physical therapy can help with your symptoms by teaching you to relax and stretch these muscles, improve your body awareness of how you manifest stress or anxiety, change urinary habits, improve coordination of the pelvic floor muscles, and improve your body’s ability to fully void as well as hold in urine with improved control.

Additional symptoms may include difficulty with achieving erections, difficulty with ejaculation, low back or hip pain, testicular pain, pain to the tip of the penis, or pain at the groin line and abdomen. 

If any of these symptoms sound familiar to you or someone you know, seek out a consultation with a pelvic floor physical therapist to start your journey towards an improved quality of life and reducing painful symptoms.