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It’s one of those things that’s happening all around us, but nobody is talking about it. It affects both men and women, young and old, from all socioeconomic and racial backgrounds.

Can you guess what it could be?

There is an entire industry devoted to the management of this problem and yet few think of Physical Therapy as an option in its treatment.

Give up?

It’s urinary incontinence.

Urinary incontinence (UI) afflicts people of all walks of life and it can be debilitating. When left uncontrolled, urinary incontinence can dominate your life. You modify your habits, activities and plans based on bathroom access. Your life starts to revolve around not having an accident.

Your symptoms may include:

1. urinary leakage

2. the need to wear pads to catch urinary leakage

3. feeling like you have to urinate frequently

4. having an intense urge to urinate after you’ve just recently gone

5. erratic bladder voiding

6. being fearful of social activities where a bathroom is not convenient

7. limiting water intake for fear of leakage

8. intense urges to urinate every time you reach with your key to unlock your door

9. leaking urine when you sneeze, cough, and/or laugh

10. fearful that your clothes smell of urine

11. dripping urine upon arising from the toilet

Physical therapy can provide a comprehensive and conservative treatment option for those who are dealing with urinary incontinence. Physical therapists are recognized in the medical profession as the experts on muscular function and health. Your pelvic floor muscles, like any muscles in your body, can be trained and strengthened to enhance their ability to function. Your pelvic floor muscles, which play a large role in your ability to open and close your urethral sphincter may be weakened after childbirth, after prostate removal, and with pelvic pain. However, UI can occur in anyone, at any time in their lives. Physical therapists have specialized knowledge to help address pelvic floor dysfunction.

Urinary incontinence is broken up into 3 general groups: Stress, urge and mixed incontinence.

Stress incontinence occurs when a person experiences urinary leakage with a “stressful” event such as a cough, sneeze or laugh. What these activities have in common is an increase in the intra abdominal pressure that can put an excessive strain on an already weakened pelvic floor.

Urge incontinence is characterized by a sudden, intense urge to urinate even if you don’t need to go or just went. It is a bladder dysfunction that often responds to behavioral modification techniques.

Mixed urinary incontinence is a combination of stress and urge incontinence and can result from pelvic floor weakness, muscular spasm or bladder dysfunction.

The Physical Therapists at Apple Physical Therapy can provide one on one care for pelvic floor strengthening, biofeedback training, and bladder retraining. Many patients see our therapists for as few as four visits. They are given a comprehensive program to address their specific needs. For some, this means pelvic floor strengthening. Others are given strategies to address muscular dysfunction that is interfering with muscle function. We approach this problem with sensitivity, compassion and discretion. Many of our patients comment that they wish that they’d come in sooner.

The Women’s and Men’s health team at Apple Physical Therapy are knowledgeable in a variety of diagnoses related to urinary incontinence including the following:

1. Stress Incontinence

2. Urge Incontinence

3. Mixed Incontinence

4. Interstitial Cystitis

5. Short Pelvic Floor Syndrome

6. Painful Bladder Syndrome

Talk to your doctor or health care provider to see if physical therapy is right for you. Physical therapy may be prescribed as part of a comprehensive plan to help you improve your pelvic floor function. A referral to physical therapy can be the first step in regaining control over a problem that afflicts many of us.

Do you ever have buttock pain when driving?  You are not alone.  Driving is a common cause of low back and buttock pain.  Here are several easy tips to remember when driving:

Tip 1.  If you happen to carry a wallet, cell phone, or other random bulky objects in your back pocket be sure to remove them before sitting down in the car.  Bulky objects can both cause one to sit in a poor posture and/or put pressure on the sciatic nerve as it passes through the buttock muscles.

Tip 2. Adjust your seat while driving.  Many people do not realize that the bottom portion of the car seat can adjust in many ways – forward/back, up/down, and most forgotten is the seat tilt.  The back portion of the bottom seat should be slightly higher than the front portion allowing for a slight tilt downward toward the steering wheel.  This positions the hips slightly higher than the knees and helps decrease strain/stretch on the hamstring muscles which can affect the alignment of the pelvis.  One can also adjust the back rest. Ideally, the back rest should support the back in a good, upright posture.  This can help alleviate back soreness with driving.

Tip 3. When taking a long driving trip, be sure to stop every 1-2 hours for a short stretch and walk break.  This allows the back and legs muscles to stretch out.

If these tips do not help, or only partially help, talk to a physical therapist about other positional changes that can be made.  You also may need a specialized home exercise program developed for you to address decreased flexibility in your back and hips as well as weakness in your core muscles.

Ah, September. The fresh start of a new school year is upon us. Before your child enters the hallowed halls of academia, let’s review this simple back to school check list:

• New haircut? Check.
• New jeans? Yep.
• Pee-chees in four different colors? Got ‘em
• Number two pencils sharpened and ready? Double check.
• Education on how to wear a backpack to prevent injury? No! What do you mean, no?

Teaching your child the proper way to way to wear a backpack is not something you want to skip! In a study reported by the University of California in 2004 it was reported that 64% of American children, aged 11 to 15, complained of backaches attributed to a heavy backpack. The following tips will help your child reduce discomfort from wearing a backpack and focus on learning this new school year.

 TIP 1: Have your child use both straps. Wearing a bag slung over one shoulder can cause your child to lean to one side curving the spine causing pain and discomfort.

TIP 2: Select a pack with well cushioned shoulder straps and adjust the straps accordingly so the pack fits snug to your child’s back. Have your child wear the waist belt if there is one.

TIP 3: Make sure the bottom of the pack rests in the curve of the lower back. It should not rest more than 4 inches below your child’s waist line.

TIP 4: Choose the right pack to fit your child’s size and activities. Your child doesn’t necessarily need overnight backpacking gear to make it through the school day.

TIP 5: A child’s back pack should way no more than 15% of your child’s body weight. If your son or daughter weights 100 pounds, that means their backpack should way no more than 15 pounds. Keep heavier items closer to the back to decrease torque on the spine.

TIP 6: Be active in your child’s schooling. See what they bring to and from school everyday. Do they need all 5 of their favorite transformers; why do they have 7 uneaten sandwiches at the bottom of their pack?

TIP 7: If it seems your child consistently has a heavy bag with necessary materials, try switching to a bag on wheels. This will give your child’s back a much needed break.

For more information please visit the American Occupational Therapy Association website’s page on backpack education or contact an Apple Physical Therapy location near you!

Scoliosis is a deformity of the spine in which the individual spinal segments bend in an unnatural way. While there are three naturally occurring forward and backward spinal curves in the body, with scoliosis the individual spinal segments bend to the side and rotate. Scoliosis is a relatively common disorder, especially amongst teenagers. It affects one in twenty-five teenage girls and one in two hundred teenage boys. The cause of scoliosis can be due to many things including genetics, diseases such as polio or muscular dystrophy, or even an injury. Often however the cause of scoliosis is unknown.

Monitoring Your Child for Scoliosis

Scoliosis can often develop slowly over time. So what sort of signs can a parent watch for?  Often as scoliosis develops an unusual curving of the upper body will begin and will become more and more noticeable in your child. You may also observe uneven shoulders, a sunken chest and your child leaning to only one side. Sometimes you child may complain of back pain. One other classic sign of scoliosis is what is called a “rib hump”. In this condition a child’s ribs will protrude further on one side than the other. It can be especially noticeable as the child bends forward.

If you are suspicious that your child has scoliosis it is important to have them screened by a nurse or physician. Many schools perform screenings as well and can provide advice on whether or not your child should see a physician. Your healthcare provider may then recommend an x-ray to determine if a scoliosis is truly present. If there is a curve present, it can be measured on an x-ray. Many curves will measure less than 25 degrees and require only that they be monitored every 6 months, with a referral to physical therapy a possibility. Curves greater than 25 degrees are often treated with a brace for your child to wear. The brace can often be easily hidden by clothing and will still allow your child to participate in many of their usual activities. Surgery can sometimes be necessary; however this is reserved for the most severe cases.

A Physical Therapy Approach

If your child’s physician refers you to physical therapy, what can you expect? Physical therapy treatment of scoliosis will begin with a formal evaluation of your child including observation of his or her posture and an assessment of specific muscle strength and flexibility problems. Children with scoliosis often develop muscle weakness on one side of their body and poor flexibility on the other side. These side to side deficits can develop in the lower body or spine and contribute to his or her scoliosis. A physical therapist will determine if your child has developed any of these problems and give him or her specific exercises to treat them. Your therapist will also help your child change any postural habits that might be contributing to the scoliosis. These habits can include lying too often on one side while reading, standing with all of their weight on one foot, and carrying their backpack only over one shoulder. If your child is diagnosed with scoliosis, be sure to ask his or her physician if physical therapy can help.

The diagnosis of scoliosis can be a concerning one for parents. However with proper screening measures and appropriate treatment, which often includes physical therapy, scoliosis can be well managed. Most children will avoid surgery and be able to participate in their usual activities.

Donate Coats to Those In Need

From September 7 through September 17 Apple Physical Therapy will be collecting new and “gently used” coats for the Salvation Army.  Donations can be dropped off at all twenty-two Apple Physical Therapy locations in the Puget Sound.  For a complete list of locations, visit www.applept.com.
]]> http://applept.wordpress.com/2010/08/26/share-the-warmth-fall-coat-drive/feed/ 0 applept fallfamily http://applept.wordpress.com/2010/08/18/kids-cup-a-success/ http://applept.wordpress.com/2010/08/18/kids-cup-a-success/#comments Wed, 18 Aug 2010 22:17:49 +0000 applept http://applept.wordpress.com/?p=155 Continue reading →]]> Last Friday was a perfect day for golf!  Over 120 players and volunteers participated in the 13th annual Apple Kid’s Cup golf tournament.  Together we raised $25,000 for Young Life programs in the community.  A big thank you to our corporate sponsors, in-kind donors, golfers and planning committee!

Presenting Sponsors

Kent Gypsum Supply and Apple Physical Therapy

Platinum Sponsors

Abshur Construction, Bank of America, Brian &  Spine Center/Cascade Creations, Inc., Award Metals, Therapists Unlimited, CertainTeed Gypsum, Favors Rettig CPAs, P.S., G-P Toughrock, Korum Automotive, Les Schwab Tire Centers, Manage Incorporated, MarketQuest, Tegument Financial, Inc., Timberland Bank, USG

Gold Sponsors

Supplemental Health Care, US Food Services Northwest, Grabber

Silver Sponsors

Redmond General Insurance Agency, Inc., Comcast

Bronze Sponsors

Hamilton Drywall, Dan McClung –State Farm Insurance, Custom Security, Sunset Builders, Cigna, Charlie’s Restaurant, Thera-Tek, Staples

Golf Cart Sponsor

Conover Feek

In-Kind Donors

Best Western Park Plaza/Holiday Inn Express, Print Solutions, Zebra Graphic Design, Mountain Mist, Tim’s Cascade Snacks, Mama Stortini’s, C.I. Shenanigans, Stanley and Seaforts, Golf Pro Tad, Dick’s Sporting Goods

Kid’s Cup Award Winners

1^st Place: Dan Absher, Andrew McDonald, Eric Mills and Scott Peterson

2^nd Place: Don Coltom, Chad Lackey, Jon Snyder, Greg Sutherland

3^rd Place: Dano Bagnel, Dan Maki, Mike McCormick, Paul Stone

Longest Drive: Brandon Graham

Shortest Drive: Michelle Rivera

Closest to Pin: Josh Waltier

Accuracy: Paul Stevens

Hit the Green: Paul Stevens

Apple PT CEO Randy Johnson (second from right) and his team hit the links

visit www.applept.com today

Apple Physical Therapy launched its redesigned website, www.applept.com.  More than just a fancy new look, improvements to the website make it easier to find information quickly and integrate with facebook, twitter and other social media. 

Features of the new www.applept.com include:

Improved maps and directions.  Find any of our 23 clinics using Google maps and search for clinics by zip code directly from the homepage.

Prior to their appointment patients can download and complete registration forms, as well as learn what they can expect during their first visit to Apple Physical Therapy. 

A detailed description of all the specialties offered: physical therapy, massage therapy, hand therapy, work injury program, women’s health, sports medicine, custom foot orthotics, headaches, temporomandibular disorders, vestibular rehabilitation and custom bike fits.

Prospective employees will discover an enhanced career center with information specifically for physical and occupational therapists, massage therapists, clinic administrative staff and medical billing professionals.  Applicants can apply for open positions directly from our website.

Complete social media integration.  Apple Physical Therapy’s blog and twitter feeds appear on the homepage with quick links to our facebook page and e-newsletter sign-up.  Applicants can share job openings through twitter, facebook, linked-in and RSS feeds.

Custom foot orthotics are shoe inserts fabricated to compensate for specific biomechanical faults. In contrast to “over-the-counter” inserts, custom orthotics are individually created to address the unique construction of your foot. 

Who Can Orthotics Help?

Orthotics are designed to improve foot and leg function by altering the position of your foot and limiting how much your foot moves in certain directions.  These changes minimize abnormal movement in your lower body to decrease strain on your feet, legs and back.

Orthotics may be an effective choice in the treatment of foot, ankle, knee, hip, or back pain.  Specifically, plantar fascitis, Morton’s neuroma, medial or lateral ankle pain, medial knee pain, patello-femoral syndrome, trochanteric bursitis of the hip, general hip pain, and low back pain may be effectively addressed by custom foot orthotics.

How Do You Make Custom Orthotics?

Custom orthotics are fabricated from a plaster impression of your foot and altered based on the findings of a complete physical examination and biomechanical analysis.  From a mould of the plaster impression, a lab makes our recommended alterations by incorporating specific degrees of correction to the rear and forefoot of the orthotic. Measurements and casting of your foot takes about 90 minutes, and your orthotics are completed by the lab in 2-3 weeks. When you orthotics arrive, we schedule an appointment with you to ensure proper fit and answer any questions you may have about your new orthotics.

Will My Insurance Pay for Orthotics?

Most insurance companies cover part of the cost of orthotics. Apple Physical Therapy will verify your insurance benefits before we evaluate you for orthotics.  Most insurance companies require your doctor or primary care provider to specially prescribe orthotics.

If you have suffered from chronic lower extremity pain that has not responded to stretching and strengthening, then orthotics may be a viable alternative to resolve your pain and dysfunction.  Talk with your doctor and physical therapist. 

Healthy Feet are Happy Feet

Ready to Hit the Links?

The Pacific Northwest has always been a great place to golf.  With the mild Puget Sound climate and over 65 public and private courses, many golfers hit the links year round.  The announcement that Chambers Bay in University Place, WA will host the 2010 US Amateur and 2015 US Open Championships has excited golf enthusiasts and inspired many to take up the sport. 

While the risk of injury from playing golf is low compared to other sports, common golf injuries include injuries to the lower back, shoulder, elbow and wrist.  You can reduce your risk with the following tips:

Improve Your Technique – Incorrect technique dramatically increases the risk of injury on the course. Examples include poor swing style and hitting the ground instead of the ball. Golfers who perform correct technique are less likely to injure themselves.   Consider taking private lessons if you are a new golfer, or making an appointment with the club pro for tips on improving your swing.  Also, make sure equipment, such as clubs and shoes, are professionally fitted.

Warm up and Cool Down  – Warming up and cooling down are extremely important to reduce the risk of muscle and joint injuries.  These simple stretches should help you get the most out of your game. 

• Walk briskly for a couple of minutes to raise your heart rate.
• Warm up your neck and upper back by dropping your chin to your chest, gently rolling your head from side to side in slow half-circles.
• Warm up your shoulders. Hold a golf club horizontal to the ground, keeping your hands about shoulder width apart. Slowly raise the club overhead, hold for a few moments, and lower. Hold the golf club in a similar way but this time behind your back. Raise as high as you can, hold for 20 seconds, then lower.
• Warm up your torso with side bends. Slide your hand down your leg to support the weight of your torso. Hold for 20 seconds on each side.
• Twist through the waist; gently and slowly turn from one side to the other.
• Using your club for support, stretch your calves, quads and hamstrings in your legs. 
• Take 5 full practice swings of progressive speed and intensity.

Regular golf can help improve stamina, cardiovascular fitness and muscular endurance.  The average golfer playing an 18-hole game walks a little over 4 miles. And now that summer is finally here, there is no better time to hit the links!