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Vaginismus

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Vaginismus

Vaginismus and Physiotherapy

Vaginismus is a painful feeling of discomfort or inability when inserting a tampon, finger, penis or during a doctor’s internal pelvic exam. It occurs when there are involuntary contractions of the muscles in the outer third of the vagina.

Primary Vaginismus: when a woman has never been able to have pain free intercourse due to pelvic floor muscle spasm.

Secondary Vaginismus: pain that develops sometimes later in life after a traumatic event such as childbirth, surgery, or a medical condition.

With Vaginismus, there is usually significant Connective Tissue Dysfunction that needs to be addressed first before any internal work. It is suggested that you follow up the self-help treatment for connective tissue dysfunction before embarking on the stretching exercises with the dilators.

Pelvic floor exercises and Desensitisation techniques

A physiotherapist may be able to teach you pelvic floor exercises, such as squeezing and releasing your pelvic floor muscles, that can help you gain control over the muscles causing the vagina to close involuntarily. Occasionally, a technique called biofeedback may be useful. A small probe is inserted into your vagina. This monitors how well you are doing the exercises by giving you feedback as you do them.
Biofeedback can help with the following:

• Teach you strategies that may help to relax the muscles that are contracting involuntarily
• Teach you appropriate timing of the contraction and relaxation of the pelvic floor muscles.
• Educate you about your condition and why it might be occurring.
• Teach you various strategies for getting the muscles to relax
• help you to Use manual therapy to release the muscles either externally and/or internally that are causing the contractions.

More information about Vaginismus can be found here.

Some general tips about pelvic floor muscle exercises:

• Choose a convenient time and place where you can exercise regularly.
• Put a reminder about pelvic muscle exercises somewhere obvious to you (or set an alarm on your watch or mobile phone).
• Avoid quick pelvic floor muscle exercises where you don’t hold the contraction. This tends to cause an increase in pelvic floor muscle resting tone.
• Be aware that it will take 6 to 8 weeks of regular exercise before you can expect to see improvement. It will take approximately 3 months for the pelvic muscles to strengthen.
• You could try inserting one finger into the vagina to check the strength of your squeeze as you pull in the pelvic muscles. Alternatively, you may be able to feel a pelvic floor contraction if you place the tip of your index finger on the perineal body (on the outside, between the vagina and back passage).

Other tips to reduce Vaginismus:

• If you are overweight, try reducing your weight.
• Try not to become constipated, as a full bowel will put pressure on the bladder. Straining to empty your bowel will weaken the pelvic muscles.
• If your job involves lifting, think of your pelvic muscles as well as your back. Pull up your pelvic muscles when lifting a heavy weight.
• If you smoke, consider quitting. Frequent coughing puts a strain on the pelvic muscles.

If you or someone you know suffers from Vaginismus, please call PhysioNow today! Our specially trained Physiotherapist can start your treatment Now!

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Dyspareunia

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Dyspareunia and Physiotherapy
Dyspareunia
Dyspareunia is genital pain experienced by women just before, during or after sexual intercourse. Some women have always experienced pain with intercourse from their very first attempt. Other women begin to feel pain with intercourse or cyclically with menstruation. They can also have pain after an injury or infection . Sometimes the pain increases over time. When pain occurs, the woman may be distracted from feeling pleasure and excitement.

Causes

• vaginal dryness from menopause, childbirth, breastfeeding, medications
• skin disorders that cause ulcers, cracks, itching, or burning
• infections, such as yeast or urinary tract infections
• spontaneous tightening of the muscles of the vaginal wall
• endometriosis
• pelvic inflammatory disease
• uterine fibroids
• irritable bowel syndrome
• radiation and chemotherapy

Other factors that affect a woman’s ability to become aroused can also cause dyspareunia.
These factors include:
• stress, which can result in tightened muscles of the pelvic floor
• fear, guilt, or shame related to sex
• self-image or body issues
• medications such as birth control pills
• relationship problems
• cancer, arthritis, diabetes, and thyroid disease
• history of sexual abuse

Symptoms of Dyspareunia

• Pain while inserting a tampon or during penis penetration
• Pain with certain sexual partners
• Deep pain during thrusting
• Burning pain or aching pain
• Throbbing pain, lasting hours after intercourse

Check out this link for more information.

Physiotherapy Treatment for Dyspareunia

Education:

To help describe how the pelvic floor muscles can cause pain. Education can also provide techniques that can be used at home.

Manual Physiotherapy: to mobilise muscle and soft tissue, normalize overactive muscles, improve circulation and desensitize painful areas.

Desensitization therapy: learning vaginal relaxation techniques, such as Kegel exercises, that can decrease pain.

Sex therapy: learning how to re-establish intimacy and improve communication with your partner.

Water-based lubricants rather than petroleum jelly or other oil-based lubricants are preferable. Oil-based lubricants tend to dry the vagina.

Psychologic therapies: Cognitive-behavioral therapy and mindfulness-based cognitive therapy can be helpful.

Pelvic muscle relaxation exercises: used with biofeedback, this can help women with tight pelvic muscles learn to consciously relax tight muscles.

If you or someone you know suffers from dyspareunia, please call today to get started on Physiotherapy treatment! We can help at PhysioNow. Often only a few visits with our specially trained Phyiotherapist can help to get you on the road to recovery.

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Hip fracture

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Anatomy of Hip
A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is based on the bones and soft tissues affected or on the level of the fracture.
Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.

? Signs and symptoms of a hip fracture include:
• Inability to move immediately after a fall
• Severe pain in your hip or groin
• Inability to put weight on your leg on the side of your injured hip
• Stiffness, bruising and swelling in and around your hip area
• Shorter leg on the side of your injured hip
• Turning outward of your leg on the side of your injured hip

? Causes of Hip fracture
• falling on a hard surface or from a great height.
• blunt trauma to the hip, such as from a car crash.
• diseases such as osteoporosis, which is a condition that causes a loss of bone tissue.
• obesity, which leads to too much pressure on the hip bones.

? Types of Fractures
In general, there are three different types of hip fractures. The type of fracture depends on what area of the upper femur is involved.
Intracapsular Fracture
These fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.

Intertrochanteric Fracture

This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.

Subtrochanteric Fracture

This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below .

In more complicated cases, the amount of breakage of the bone can involve more than one of these zones. This is taken into consideration when surgical repair is considered.

Treatment for hip fracture: usually involves a combination of surgery, rehabilitation and medication.

? Surgery
The type of surgery you have generally depends on the location and severity of the fracture. Are the broken bones properly aligned? (displaced fracture. What is your age? What are your underlying health conditions?

The options include:

• Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the upper thigh.

• Partial hip replacement. If the ends of the broken bone are not lined up or damaged, your surgeon may remove the head and neck of the femur and install a metal replacement (prosthesis).

• Total hip replacement. Your upper thigh and your hip socket are replaced with an artificial one (prostheses). Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint. This may have been affecting your hip function even before the fracture.

? Rehabilitation

Rehabilitation is begun as soon as possible after hip fracture surgery, often within a day. The initial goals are to help people retain the level of strength they had before the fracture. You want to keep moving to prevent loss of muscle. You also want to prevent problems that result from bed rest. The ultimate goal is to restore your ability to walk properly without a limp.

Benefits of Rehab

Rehab will help you:

• Restore normal movement in your joint
• Build up strength in the joint and surrounding muscles
• Ease pain and swelling
• Let you get back to your normal activities including walking without a limp
• Help with circulation, particularly right after surgery, so you don’t have problems with blood clots

If you have or someone you know has fractured a hip or had hip replacement surgery, please call PhysioNow. Our experienced physiotherapists would be happy to help with your recovery! Call today to book an appointment!

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Trochantric bursitis

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Trochanteric bursitis

 

The Trochanteric Bursa is a fluid filled sac near the hip joint. It cushions between the bones and the muscle and acts as a shock absorber. Trochanteric bursitis is the inflammation of the bursa which is at the outside of the hip.

When this bursa is irritated it causes pain on the outside of the hip and thigh.  Sometimes you may feel the pain down to the knee on the same side.  Another symptom is pain which will stop you from lying on your painful side.  It will be painful when you press on a specific spot on the outside of the hip.  The pain gets worse when climbing stairs, getting up from a low chair getting out of a car.  Sitting with crossed legs hurts.  Both  walking and running may also cause increased pain.

Causes of Trochanteric Bursitis

  • Any direct Injury to the outside of the hip like falling, or bumping into an object.
  • Incorrect posture due to muscle imbalance
  • Leg length difference.
  • Stress of soft tissues surrounding the hip due to hip Osteoarthritis
  • Friction of the ITB (Ilio Tibial Band: a muscle along the side of the hip)
  • Overuse injuries like standing for long periods of time
  • Other diseases which affect the hip like Rheumatoid Arthritis
  • Previous surgeries around the hip
  • Very rarely infection of the bursa

Registered Physiotherapy Treatment

Your Registered Physiotherapist can help you to reduce the pain and inflammation.  They will use electrotherapy modalities, taping, or acupuncture.  They will give you  advice on activity limitations in the early stages.

Later the treatment is focussed towards increasing the flexibility and strength in the muscles.  Your Physiotherapist will  increase the hip joint range of movement and correct your hip joint mechanics.

Trochanteric bursitis

Trochanteric bursitisTrochanteric bursitis

Finally the focus is towards preventing it from happening again.

General Advice on prevention

Your Registered Physiotherapist will look at your posture, hip stability, and core strength.  They will look to see if you  need Orthotics to address any problems with your legs or feet.

 Tips for prevention of Trochanteric Bursitis:

  • Whenever you start a new activity, try to take it slow and build up your activity level gradually.
  • Start with  less force or resistance, less repetitions and progress gradually.
  • Avoid or modify repetitive activities if it is putting any stress on the hip joint
  • Your footwear should be comfortable
  • Maintain flexibility and strength in your lower extremity muscles
  • Improve your core muscle strength

If you or someone you know may have Trochanteric bursitis, call PhysioNow Today!  We would be happy to get you started on your treatment and back to enjoying all the things you love to do!

 

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Vertigo

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Benign paroxysmal positional vertigo(BPPV)

Vertigo

Vestibular Systems
• Comprises five sensory organs that provide your brain with information about head position and movements including head rotation, linear movements and static positions of the head relative to gravity
• Five sensory organs including 3 semicircular canals and 2 otoliths

 

BPPV is a mechanical problem in the inner ear. It occurs when some of the  crystals that are normally embaded in gel in the ear become dislodged.  They then can move into one or more of the 3-fluid filled semicircular canals.

Benign paroxysmal positional vertigo(BPPV) is  one  of the most common causes of vertigo. It creates a false sensation of spinning.
• Benign: it is not life threatening
• Paroxysmal: it comes in sudden, brief spells
• Positional: it gets triggered by certain head positions or movements
• Vertigo: a false sensation of rotational movement

 

Symptoms
a)      Dizziness
b)      Vertigo (sensation of spinning)
c)       Nausea
d)      Sense of imbalance or unsteadiness
e)      Poor gaze stability
f)       Vision disturbance

Visual Coordination screening

 

Diagnosis

• The relationship between the inner ears and the eye muscles are what normally allows us to stay focused on our environment while the head is moving.  The dislodged crystals make the brain think you are moving when  you are not. This mistakenly causes the eyes to move, which makes it look like the room is spinning. This is called Nystagmus.

• The Nystagmus will have different characteristics that allow the practitioner to identify which ear the displaced crystals are in and which canal is involved.
• The most common tests are DIX hall pike and Roll test.
• There are two types of  BBPV.  One type, where the loose crystals can move freely in the fluid of the canal(canalithiasis). The more rare type is one where the crystals are thought to be hung up on the bundle of nerves that sense the fluid movement(cupulolithiasis).

Physiotherapy Treatment
• One maneuver that is used for the most common location and type of BPPV is called the Epley maneuver. However , that will not work for all people . Often people have tried the Epley maneuver themselves or had it performed on them without success.
• In the vast majority cases, BPPV can be corrected mechanically by a Registered Physiotherapist. Once your  provider knows which canal is involved and what type it is , we can take you through the appropriate treatment maneuver.

Check out this video for an example of the  Epley Maneuver.  Please do not attempt this yourself until you have been properly assessed and screened by one of our Registered Physiotherapists to see if this maneuver will be appropriate for your condition!

If you have any further questions, please call PhysioNow today! Our experienced Vestibular Physiotherapists would be happy to help you.

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Baseline Testing Concussions

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Baseline Testing

Why is baseline testing Concussions important?

There are no  special tests to diagnose and gauge the severity of concussions.  Athletes are recommended to undergo baseline testing before the beginning of the sports season. Baseline test results are helpful  for most healthcare professionals  involved in an athlete’s concussion care. This includes Physiotherapists, Physicians, Concussion Specialists, and Vision Therapists.  Baseline tests let the Physiotherapist compare the before injury  function to the results of post concussion baseline testing. It’s a great tool  to measure the severity of concussions.  It helps therapists to make  treatment goals.  Safe return to sports following concussions can be determined with this tool.

 

Components of Baseline testing  Concussions

 

  • Impact Test, This is the gold standard test.  It  looks at different functions of your brain before and after concussion. It is a computer based test. It usually takes about 30 minutes. The test assesses your ability to process information, and remember things.  It also tests how quickly you can follow  instructions/tasks. It’s the most scientifically validated test and recently got approved by the FDA.

 

  • Visual Coordination screening 
    Visual Coordination screening
     Following concussion, functioning of the visual system  is greatly affected. This involves the eyes and part of the brain that processes visual information.   Correct vision and clarity of  vision is not affected. However, the ability of your eyes to move together is affected. This usually leads to symptoms like dizziness, difficulty focussing,  and headaches. Testing the visual system before the sports season provides valuable information about the function of the visual system.  It allows for treatment of any problems.

 

  • Balance and Postural stability– With Post-concussive injury, both static and dynamic balance is affected. You can feel dizzy with standing, change in position or with certain movements. Most sports require an intact balance system to improve performance.

 

Registered Physiotherapists at PhysioNow are trained to conduct baseline testing before the beginning of  the sports season and following concussive injury. Registered Physiotherapists at Mississauga are skilled to assess any deficits in your baseline testing and treat them. Visual coordination exercises  will be done to help you  return to sports faster .

Please call today to get your baseline testing done or to treat your concussion.

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Prostatitis

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Prostatitis

Prostatitis

Prostatitis or Prostatodynia Physiotherapy

Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition in men. This means ‘inflammation of the prostate’. There are two basic types of prostatitis, acute and chronic.

Acute Bacterial Prostatitis

Acute Bacterial Prostatitis is an infection of the prostate. This type of Prostatitis causes chills and fever. In this case, you need your Doctor’s attention promptly!

Nonbacterial or Chronic Prostatitis

The other is Nonbacterial or Chronic Prostatitis. This can be treated with alternative treatments such as Pelvic physiotherapy, exercises, lifestyle modifications etc. Investigations in this case show that bacteria and yeast are negative. The physical examination does not usually show anything unusual. However, the prostate may be swollen. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, pain-killers, and medications prescribed are often not effective. Many men have been told that they must learn to live with the symptoms because a cure is not available.

Symptoms may include a few or all of the following:

• Pain in the testicles, or tip, shaft or base of the penis
• Pain at the perineum (the area between the testicles and penis)
• Urination Causes Pain
• Increased pain in sitting
• Pain or discomfort with sexual arousal, or during or after ejaculation
• You May notice Pain or discomfort above the pubic bone
• Urinary frequency
• Urinary urgency
• Pain before, during or after a bowel movement
• Decreased interest in sex

Treatment

The Pelvic Health Physiotherapist creates an individualized treatment program. Treatment is based on pelvic floor dysfunction, symptoms, and response to the treatments.

The following treatment programs and techniques may be involved in Pelvic Physiotherapy for Prostatitis:

Trigger point release therapy

Trigger point release therapy is also known as myofascial trigger point release. Trigger point release therapy is an alternative treatment for chronic prostatitis. It is often helpful for treating CP/CPPS symptoms that are associated with stress and tension of the pelvic floor muscles.

Trigger point release therapy is often combined with paradoxical relaxation therapy. This exercise method involves autonomic self-regulation. This decreases pelvic floor muscle tension. It teaches you how to release this tension. Paradoxical relaxation involves a specific breathing technique to help relieve anxiety.

Total body

Total body (exercise, chronic stress management, lifestyle) changes help relieve pain. It is important to know which foods make the symptoms worse. Try to avoid those foods. The most common foods that have been found to trigger symptoms include:

• Spicy foods
• Hot peppers
• Alcoholic beverages
• Acidic foods
• Wheat
• Gluten
• Caffeine

Check out this patient’s experience.

Please call PhysioNow today to get started on your recovery from Prostatitis.

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Foot Pain Treatment Mississauga

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strong>Foot Pain Treatment Mississauga
Trending Now: Blue Jays’ Jose Batista on 15 day disabled list

Foot Pain Treatment Mississauga

Blue Jays’ Jose Batista hurt his big toe during a June 16 game against Philadelphia. After running into the outfield wall, Bautista had to leave the game early because of pain. An MRI showed that he had suffered a sprain of his left big toe. He had to be in a walking boot for the time being. It may seem like it’s an excessive treatment plan for just a simple sprain. In reality sprains can sometimes be more complicated than a fracture.

What is a Ligament?

A ligament is a soft tissue structure that connects two bones together. Ligaments do not receive a good blood supply like muscles or tendons and as a result, they cannot heal as well.

Types of Sprains

A sprain is defined as a stretch or tear of a ligament.
Furthermore, sprains can be classified into three groups based on the severity of injury. A grade I sprain means that there is mild damage to the ligament and the joint is stable. A grade II sprain means that there is a partial tear in the ligament and the joint is overall less stable or loose. The most severe type of sprain is classified as grade III and it means that the ligament has completely torn or ruptured and the joint has lost stability.

How can a Registered Physiotherapist help with Foot Pain treatment Mississauga?

A Registered Physiotherapist helps with all three types of sprains. The treatment for sprains starts with rest and reducing inflammation. Depending on the type of sprain, it may be necessary for immobilization in order for this to occur. For example a grade II sprain you can get a removable walking boot. A grade III sprain you can get a cast. Once inflammation is reduced and pain is better, treatment seeks to improve range of motion and strength and a return to activity or sport.

Since Jose Batista has been wearing a walking boot, it seems that his injury is at least a grade II. Considering the poor blood supply of ligaments and the severity of his particular sprain it is definitely best for him to be out of the game for at least 2 weeks. Proper foot pain treatment Mississauga in the early phase of injury is very important so that the ligament is well protected and given the best chance for healing. Once the walking boot comes off, his injury will be re-evaluated and the Blue Jays’ medical team will decide on his further treatment plan and eventual return to play.

Jose Bautista’s toe injury improving

If you have been injured, call PhysioNow today! They can help with Foot Pain treatment Mississauga!

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Physiotherapy : Total Hip Replacement

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Physiotherapy : Total Hip Replacement – Do I really need it?
Physiotherapy: total Hip Replacement

Surgeons often recommend that patients seek out community Physiotherapy

Surgeons often recommend that patients seek out community Physiotherapy : Total Hip Replacement services to continue with your recovery after you have had a total hip replacement (THR). You may wonder how doing extra treatment would help? – isn’t the surgery enough to correct your hip pain?

What is important to remember is that the surgery does take care of the affected joint. However, there is still work to be done to get you back on your feet and back to your desired activities. The surgery involves a cut through the muscles that stabilize the hip. Also, the body has to relearn how to move and function with a new joint.

Normally, the usual process for Physiotherapy: Total Hip Replacement surgery involves:

• Receiving Physiotherapy : Total Hip Replacement as an in-patient for 3-4 days for learning to walk with a walker, using the stairs and initiation of strengthening exercises for the hip
• You also receive education with respect to their precautions and how to ensure you are protecting your new joint and preventing dislocation
• Once you are safe to return home, you will be discharged
• At home, you are usually entitled to receive home care physiotherapy sessions for a few sessions.
During these sessions, the physiotherapist will re-assess your ability to move and progress your exercises as able.

After receiving homecare treatments, it’s then usually up to you to continue with your exercises. This includes progressing your strengthening and conditioning. However, a lot of people have difficulty doing this on their own and need help to further progress. It can be difficult to assess your own strength and safely progress your exercises. Seeking help from a Registered Physiotherapist will help with this process. It will get you back to your optimal function. The physiotherapist can assess where there are still remaining limitations. They will prescribe the necessary treatments to address the issues.
Please check out this link for further information regarding Physiotherapy: Total Hip Replacement.

In addition, we often see patients that have had a Total Hip Replacement, develop Low Back Pain. This happens because the muscles in the hip get very tight after surgery, and tend to tighten up into the Low Back. It is also caused by increased sitting during the recovery process. The good news is that we can help! Registered Physiotherapy and Registered Massage Therapy will help these symptoms to go away.

At PhysioNow, we have well trained Registered Physiotherapists and Registered Massage Therapists available to help you with your recovery. We will help to find the areas that you need in order to walk properly without an aid and get back to all the things you like to do. Call today to get started on your full recovery!

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Pelvic Health Physiotherapy

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Pelvic Health Physiotherapy
Pelvic Health Physiotherapy

What is pelvic health physiotherapy?

Pelvic floor muscles form the ‘bowl’ or ‘hammock’ that supports our lower back and pelvic organs (bladder, uterus/prostate and rectum).
Pelvic health physiotherapists have taken courses allowing them to perform an internal evaluation in order to assess the tension and strength of these muscles. Often there is too much tone of the pelvic floor leading to weakness.

What are common symptoms of pelvic health dysfunction?

• Leakage of urine with coughing, sneezing, laughing and exercise
• Urgent need to urinate or leaking before you get to the washroom
• Constipation/straining with bowel movements
• Heavy feeling or bulge in the vagina
• Pain in the pelvic or low back or genital area
• Pain with intercourse
Check out this link for more information.

Some benefits of Pelvic Floor Physiotherapy

• Leave your house without worrying about your bladder
• Exercise without worrying
• Sleep through the night
• Learn to control urgency

What can I expect on my first Visit for Pelvic Health physiotherapy?

A medical history will be taken with a discussion of your concerns. Questions will be asked to further understand your symptoms. Your posture, muscles of your hip, low back and abdominal will be assessed for contributing factors such as weakness or tightness. In addition to the external exam, an internal exam of your pelvic floor (vaginally and rectally) may be included to assess imbalances and dysfunction of the muscles and soft tissues.
Based on the assessment findings and your goals, the physiotherapist will put together a treatment plan.

What can I expect for treatment with Pelvic health physiotherapy?

Pelvic Health Physiotherapy Treatments Typically include,

• Correcting postural dysfunction
• Manual therapy
• Connective tissue release
• Pelvic floor muscle facilitation with breathing techniques
• Exercises for other core muscles
• Training for healthy bladder and bowel habits
• Education such as behavioural therapy/stress management

We have fully trained Pelvic Health Physiotherapists at each of our clinics ready to help you. If you have any questions, or would like to book an appointment, please contact the clinic .