Phoenix Physical Therapy, PLC would like to share a blog post with you that is not only well written, but gets to the point that all pelvic floor conditions and treatments should not be categorized as the same!  The author, Angela Law, has interviewed numerous medical physicians who are experts in the field of pelvic floor muscle dysfunction.  She offers great information that will prove useful to those of you who suspect or have been told you have a tense/high tone muscle. 

I urge you to take a few minutes and read this article from POPSUGAR. The information is well represented and concise.   You can view the article here: https://www.popsugar.com/fitness/symptoms-tight-overactive-pelvic-floor-muscles-47577094

POPSUGAR, the source for this blog post from June 28, 2020 is an American media and technology company that is parent to the media property POPSUGAR. Phoenix Physical Therapy, PLC is a pelvic floor physical therapy practice well known for treating all pelvic floor issues in all genders and ages.  

With Governor Phil Scott’s ‘continual and gradual turning of the spigot’, he is now allowing healthcare providers in private practices to resume treatments!  This is great news for the staff at Phoenix Physical Therapy as we are anxious to return to the work we love and to helping people like you over come the symptoms which led you to our practice in the first place. 

So what does this re-opening mean to you? 

• Employees, patients and necessary companions (no more than one person accompanying patient please and only if absolutely necessary) are required to wear a face mask.  Bring your own mask.  We only have enough Personal Protective Equipment to protect our staff and we will send patients away if not wearing required masks.

• We ask that all employees and patients that exhibit a fever, cough, or shortness of breath to not come to the office.  A sign on the outside door reflects this:  DO NOT ENTER If you suspect you have a fever .  You  will be refused entry and sent home with a plan for follow up to a physician for testing and a plan to reschedule an appointment with Phoenix PT.  If you have encountered someone you know that has traveled out of state or knows to have been exposed to someone else with COVID-19, you will be asked to reschedule your appointment after self-quarantining for two weeks.  All of these measures are to help keep everyone safe and protected against this virus!  Our staff does their temperature checks daily upon arrival to the office. 

• We are sanitizing our treatment rooms before and after each patient.  You will not be allowed to wait in the waiting room but will go to your treatment room as soon as your temperature is taken.  This will only occur after you have sanitized your hands with the sanitizer located within the hallway entering the office. 

• We have one waiting room chair, designed for those who cannot stand for more than a minute or two.  Please save that chair for someone in need.  You  will be taken quickly to your treatment rooms after your temperatures is taken.  We designed this plan to ensure social distancing.

• Hand sanitizer is essential to anyone entering the office.  Please look for the station just inside our entry door. 

• Your therapist will have hand sanitizer available for your use during your treatment, if requested, in addition to what is available outside the treatment areas.

• We have clearly displayed signage emphasizing social restrictions on distancing, coughing/sneezing etiquette, wearing masks and hand hygiene in all common areas, treatment rooms and bathrooms. 

• We disinfect all treatment rooms and common areas three times a day as well as after every treatment.  We are using FDA approved hydrogen peroxide wipes for cleaning and have the option to supplement with alcohol wipes or Chlorox wipes.  We disinfect the bathrooms frequently and as you will note there are signs in the restrooms indicating proper hygiene to flush the toilet.  Sink faucets, towel dispensers and trash cans are automatic.  Kick the base of the trash can to open the lid and wave your hand in front of the paper towel dispenser to activate. 

We understand your hesitancy while being able to resume important medical care and we are happy to answer any questions you may have.  We are here to be of assistance to you to achieve your goals and eliminate your symptoms.  REST ASSURED WE ARE TAKING EVERY MEASURE WE CAN TO KEEP STAFF AND PATIENTS SAFE AND HEALTHY.   YOU MAY ALSO CHOOSE TO MEET YOUR THERAPIST OVER TELEMEDICINE.  PLEASE LET THE KNOW THAT IS OF INTEREST TO YOU.

Let’s all work together to get through this pandemic – working as one makes us stronger!

On March 18, 2019, Phoenix Physical Therapy welcomed Shanna Duffy to their staff of therapists specializing in pelvic floor therapy.

Born and raised in Vermont, Shanna attended UVM’s College of Agriculture and Life Sciences, receiving her undergraduate degree from the Department of Nutrition and Food Sciences. She then received her Doctorate in Physical Therapy from the College of Nursing and Health Sciences in 2016. While earning her Doctoral degree, Shanna worked at clinics on opposite sides of the USA, Boston MA and San Diego, CA. After becoming a licensed PT, Shanna provided physical therapy in a home care environment in NH and VT and more recently worked in an outpatient hospital setting in New Hampshire.

Shanna has been fortunate to treat patients with a wide range of conditions such as acute and chronic pain, joint pain, post-surgical repairs, musculoskeletal disorders, balance impairments, gait impairments, and work and sports-related injuries.

She became fascinated with treating pelvic floor dysfunction in 2014 when Phoenix owner Jane Kaufman was a guest lecturer at UVM during Shanna’s graduate school program. With two years of clinical experience behind her, Shanna was prepared and excited to pursue her passion for pelvic floor PT.  “As a native Vermonter I wanted to try working and living in other areas before making any job decisions when I graduated from Physical Therapy school at UVM. I chose to have my student internships in California, Massachusetts, New Hampshire and Vermont. I had plans to move to those bigger states, but what I found was my favorite clinical experience was actually in Milton, Vermont and the reason was I loved connecting with my Vermont patients the most. It was extra special for me to help fellow Vermonters get back to what they loved doing, whether that was running a marathon or going back to doing farm work. Working for Jane was on my dream job list, since hearing her speak during one of my classes in graduate school at UVM. I can say working at Phoenix PT is everything and more than I imagined. It feels like home for me and most importantly our patients.”

Shanna enjoys getting to know patients and creating individualized treatment plans to ensure the most successful outcomes, using a combination of a holistic approach and evidence-based practice.

When not at the clinic, Shanna enjoys being physically active in the outdoors, eating out, spending time with friends, family and her tabby cat Xena, the “Warrior Princess”.

Everyone experiences constipation, sometime! Maybe it was on vacation and you felt bloated and miserable; or when you were busy at work and had to rush to complete a task. In any event, you felt ‘awful’. Maybe you couldn’t zip your favorite jeans due to abdominal bloating, maybe you experienced lower abdominal discomfort or experienced a painful ‘movement’ once you went. There are many people who experience these symptoms and more on a daily basis. When someone finally gets the courage to see a specialist about this problem, they might be diagnosed with ‘pelvic floor dyssynergia’ or ‘muscle incoordination’.

Pelvic muscle dyssysnergia (incoordination) refers to the action that occurs in the pelvic floor musculature at the time of defecation. It can become a withholding pattern and in the case of vacation or a change in your work schedule, it can simply be tensing the muscle to avoid the bowel movement (due to inconvenience) rather than heeding the ‘call’. Over time, if this behavior is repeated, it becomes muscle memory; instead of relaxing the pelvic muscle to defecate, the patient tenses the muscle; thus the term dyssynergia or incoordination.

The function of the pelvic floor for bowel function is to provide closure of the anal canal to maintain continence. The muscle should signal the rectum and the colon when to defecate and should provide opening of the anal canal by total relaxation to allow for complete and effortless elimination. A dyssynergic pattern shuts the opening of the canal by tensing the muscle to prevent elimination. Thus an incoordination.

The research by Heymen, Scarlett, Ringman, Drossman et al entitled “Randomized, Controlled Trial Shows Biofeedback to Be Superior to Alternative Treatments for Patients with Pelvic Floor Dyssynergia-Type Constipation” supports the value of biofeedback in the treatment of this withholding pattern associated with stool elimination. This study supports the benefit of biofeedback treatments using sensors to provide the feedback displayed on a computer screen for visualization. This study goes on to say, “We also have shown that the machines are necessary—instrumented biofeedback is an essential element of successful training; however, there is a shortage of practitioners who are trained to provide this form of biofeedback, and there are few clinics where biofeedback instruments are available and where this form of biofeedback can be obtained”.

Biofeedback provides visual and auditory feedback of muscle tension, It is a non-invasive technique that allows patients to adjust muscle function, strength, and behaviors to improve pelvic floor function. The small electrical signal (EMG) provides information about an unconscious process and is presented visually on a computer screen, giving the patient immediate knowledge of muscle function, enabling the patient to learn how to alter the physiological process through verbal and visual cues. This mechanism allows the patient to assess muscle resting tone, creating an environment that teaches how to downtrain a tense pelvic floor while providing the means to teach coordination of muscle function.

In short, biofeedback treatment/training using the proper instrumentation provides the precise information necessary to change behaviors associated with tensing the pelvic floor for defecation instead of the proper relaxation of the pelvic floor for release of stool from the anal canal.

Re-training the pelvic floor muscle is what Phoenix Physical Therapy is all about; treating patients with pelvic floor muscle dysfunction is the sole focus of our staff of highly skilled pelvic floor therapists. Whether treating patients for constipation, or bowel or urinary incontinence or pelvic pain, Phoenix is recognized and acclaimed locally, regionally, and even nationally for our compassionate and successful treatment of pelvic floor challenges for patients from young children to the elderly.

Phoenix Physical Therapy is pleased to announce the addition of Kathryn Stanton, PT, DPT to our staff of compassionate and knowledgeable physical therapists.  Kathryn’s roots originate in Vermont where she grew up locally.  She and her husband share the Vermont tradition and are raising their young children here as well.

Kathryn’s education includes an undergraduate degree from Cornell University with a focus in psychology.  She went on to gain her Doctorate in Physical Therapy from the University of Vermont  and gained clinical experience in orthopedics, cardiac care, oncology, neurology and a variety of other conditions and patient populations.    She collaborated with the UVMMC in writing a systematic review on exercise in patients with metastatic bone cancer.

In her spare time she has trained for several marathons, triathlons and ironwoman competitions.  She loves spending time with her young family, cooking, reading, and continuing with lifelong learning. 

Kathryn’s patient care approach is wholistic, connecting mind, body and spirit.  She is passionate about connecting with people and helping them meet their goals in an effort to live life to the fullest. 

Welcome Kathryn!

During May, all mothers were celebrated with a special day known as Mother’s Day.  How each and every family honors mother is different and special in their own unique way.  Women, as mothers, often celebrate the designated day with cookouts, brunches, dinners and just relaxation with (hopefully) breakfast in bed or a ‘bye’ on cleaning up the dinner dishes.  

Interesting, many women remarked that their celebrations included grandmother, greatgrands, aunts, children, neighbors and anyone else in need of a family support system for the day.  As women, we are collectively known as the ‘tend and be-friend’ gender versus the men who exhibit the ‘fight or flight’ behavior.  All of this jargon is based from research over years that indicates how the hormonal differences between men and women influence the relationship with others.

Women are, as many of us realize, the ones to care for others.  We are the nurturers, the caregivers, the ones to help spouses, parents, children and grandchildren.  As a collective and generalized ‘whole’ we take care of everyone else before we care for ourselves.  Sound familiar?

Women, as patients, are always in need of care, but will often put their needs aside to take care of others in the family, whether it is caring for a grandchild so the son or daughter can work, or driving a parent to an appointment, etc.  On average, women wait 6.5 years from the first symptom of bladder issues until they seek a diagnosis for their bladder control problem. (National Association for Incontinence, Facts and Statistics, www.nafc.org). When is the time to care for ourselves as women?  “Now”, would be my answer!!  

If you, as a female caregiver/nurturer of others, don’t care for your own needs, who will do it for you?  If you leak urine when you sneeze, laugh, dance or otherwise are active, who can help you if you don’t help yourself?  How about at a baseball/softball game; do you need to head to the woods to pee?  Pregnancy, childbirth and menopause are major reasons of the increased prevalence of incontinence in women as compared to men. (WomensHealth.gov, Urinary Incontinence fact sheet, https://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html).  Who can help if you don’t accept you need help with this problem and seek intervention?  

So here we are; a group of professional women, willing to help you solve your problem so you can learn to help yourself!  What better way to learn to control this hidden muscle that is responsible for letting pee or poop out of your body.  Learn to control the muscle, learn to eliminate the problem and guess what?  Get control back in your life without drugs or surgery, just with you!!

At Phoenix PT we often hear, “I don’t have time”, or “I can’t do this as I have too many people to care for”.  These are NOT reasons to avoid treatment; we can help with those time jams.  After all, we are women too, with a great sense of how to help you deal with life’s uncertainty.  

Come see us.  Schedule an appointment.  Wouldn’t you love to attend your daughter’s wedding without a pad as protection in your underwear?  Wouldn’t you love to not worry about finding a restroom at your granddaughter’s softball game or track meet?  And wouldn’t you love to sit on the beach in the sun in your bathing suit and not worry about finding a restroom to pee all the time?

If you want to improve, we can help and Phoenix PT will also help you recognize the time in your schedule that you need to make this work.  Phoenix PT helps exclusively with pelvic floor muscle issues including pain, incontinence, infections, retention, constipation and many, many other embarrassing issues.  Call today and ask our personal staff if we can help.  A little information goes a long way to see if you can gain benefit from treatment, and we can then make that happen for you.

If you don’t care for yourself, who will care for you?  Learn to control this embarrassing issue now and enjoy your summer.  No surgery, no drugs, just you.  Call us today.