Offering solutions for common problems faced by women.

Table of Contents:

Morning Light, Physical Therapy For Women.

DIABETES MELLITUS
Female Athlete
FIBROMYALGIA SYNDROME*
Incontinence
Post-Mastectomy
Obsteric P.T.
Osteoporosis
Pelvic Floor Dysfunction

DIABETES MELLITUS

Evaluation

Complete History
Physical Exam
-Pain intensity and orgin
-Range of motion/muscle strength
-Sensory testing

Glucose Training
-Resting heart rate
-Heart rate during exercise
-Post-exercise heart rate

Written report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Effects of exercise on glucose levels
-Safe blood glucose levels before intiating exercise
-Dietary concerns
-Calculate target heart rate
-Exercise guidelines

Therapeutic Exercise
-Warm-up exercises
-Aerobic workout
-Cool down
-Mild strength training

Home Program
-Independent monitoring of glucose levels
-Independent monitoring of target heart rate
-Independent aerobic workout & cross-training 4-5X/wk/30-40min.

Female Athlete

Evaluation:

Complete History

Physical Exam
-Pain intensity & origin
-Range of motion/muscle strength
-Sensory testing
-Girth for edema
-Gait analysis

Menstrual Diary - as needed

Food Diary - as needed

Written report to M.D.
-initially
-All follow-up appointments

Treatment Options:

Education
-Anatomy/function of injury site
-Understanding of the female athlete triad when indicated
-Effects of menstrual cycle & hormonal changes on exercise
-Risk factors for osteoporosis

Therapeutic Exercise
-Range of motion or strengthening as evaluation indicates
-Sports specific training as indicated

Modalities/Orthosis
-Heat and/or cold as indicated
-Instructions & fitting of support or brace as indicated

Home Program
-Independent home exercises

- Sports Injury - Female Triad

FIBROMYALGIA SYNDROME*

Evaluation

Complete History

Physical Exam
-Pain and intensity origin
-Range of motion & muscle strength
-Sensory testing
-Postural limitations
-18 tender point evaluation
-Sub-categories

Written report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Body mechanics: work ADL
-Posture/resting posistions
-Work/rest cycle

Therapeutic Exercise
-Individualized aerobic exercise based on principles
1)start slow
2)exercise consistently on alternate days and
3)systemically build endurance

Modalities
-Heat/cold/massage
-TENS for pain control
-Myofascial release
-Craniosacral therapy

Complimentary Care*
-Weight loss
-Stress management
-Relaxation/meditation

Home Program
-Independent home exercise program
-Instruction for self-management
-Fibromyalgia resources

*Can be used for related disorders, i.e. Chronic Fatigue, PMS, Seasonal Affect Disorder, Menopausal discomforts.

Incontinence

Evaluation

Complete History

Physical Exam
-Sensory testing
-Pain intensity & origin
-Muscle strength
-Pelvic asymmetry
-Scar tissue

Urinary Diary

Baseline surface electromyography (Perineometry)

Written report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Anatomy/function of perineal & abdominal muscles
-Dietary concerns
-Apparel options
-Avoidance of stressful activities for pelvic muscles
-Bladder training

Therapeutic Exercise
-Kegels - assistive though resistive exercises
-Coordination for urinary musculature
-Myofascial release
-Relaxation

Modalities
-Perineometer/Biofeedback
-Electrical stimulation
-Vaginal weights

Home Programs
-Self preineal massage
-Training in bladder control
-Independent home exercise program

-Pelvic floor laxity

Post-Mastectomy

Evaluation

Complete History

Physical Exam
-Pain intensity & origin
-Range of motion/muscle strength
-Sensory testing
-Functional limitations
-Girth for edema
-scar tissue adhesions
-Posture changes

Written report to M.D.
-initially
-All follow-up appointments

Treatment options

Education
-Safe work/resting positions
-Apparel options
-Awareness of physical issues

Therapeutic Exercise
-Range of motion & strengthening as individually needed
-Circulatory exercises
-Joint mobilization or myofascial release

Modalities
-Lymphatic massage
-Scar tissue massage
-Heat for flexibility
-Ice for pain
-TENS for pain
-Pneumatic pump/compression garment

Home Program
-Self-massage for edema or scar tissue
-Independent home exercise
-Self-management
-Aerobic exercise program

-Mastectomy -Breaat reconstruction -Lymphedema -Frozen shoulder

Obsteric P.T.

Evaluation

Complete History

Physical Exam
-Pain intensity & origin
-Range of motion/muscle strength
-Sensory testing
-Postural asymmetry
-Functional limitations

Written report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Anatomy/function of muscles
-Postural instructions & apparel
-Back School
-Safe work/rest positions/breast feeding
-Precautions with exercise during pregnancy

Therapeutic Exercise
-Diaphragmatic Breathing exercises
-Individualized program based on dysfunction
-Circulatory exercises
-Non-strenuous aerobic exercise

Modalities
-Ice/heat/massage
-Myofascial release/joint mobilization

Home Program
-Home exercise program
-Home modalities
-Modification of home environment
-Self-management

-Perinatal -Back pain/orthopedic problems -Compression syndromes -Sacro-iliac joint -Pubic symphasis

Osteoporosis

Evaluation

Complete History

Physical Exam
-Pain intesity & origin
-Range of motion & muscle strength
-Sensory testing
-Mobility/coordination
-Postural assymmetry with flexible ruler
-Functional limitations

Written Report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Back School
-Body Mechanis/work & ADL
-Posture
-Proper lifting
-Anatomy
-Diaphragmatic Breathing
-Resting positions
-Prevention with premenopausal female
-Fall prevention
-Dietary Recommendations

Therapeutic Exercise
-Balace & Safety training
-Postural corrections
-Individualized program using active range through resistive range of motion as determined by evaluation
-Weight bearing exercises
-Progressive resistive exercises

Modalities/Orthosis
-Instruction & fitting of support orthosis
-Use of heat, cold, massage
-TENS for pain control

Home Program
-Exercises
-Adaption of home environment
-Instruction for self-management

Pelvic Floor Dysfunction

Evaluation

Complete History

Physical Exam
-Sensory testing
-Contract/relax sequence
-Postural and pelvic asymmetry
-Pain intensity & origin
-Degree of spasm
-Scar tissue
-Muscle strength

Baseline sureface electromyography

Urinary Diary

Written report to M.D.
-Initially
-All follow-up appointments

Treatment Options

Education
-Anatomy/function of perineal & abdominal muscles
-Awareness & mobility of pelvic & abdominal muscles
-Awareness of contact/relax sequence

Therapeutic exercise
-Program to restore contact/relax sequence
-Relaxation
-Myofascial release
-Stabilization
-Kegels

Modalities
-Ice/Heat
-Ultrasound
-Biofeedback

Home Program
-Self-perineal massage
-Independent home exercise program
-Relaxation program

(Dyspareunia * levator ani syndrome * Vaginismus * Vulva pain, etc.)