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FAQ

Do I need a referral from my doctor?

In the state of PA, you can receive Physical Therapy without a referral from your doctor. We will communicate with your doctor regarding your condition whether you have a referral or not.

What do I need to bring/wear for my appointment?

We recommend that you have shorts and comfortable shoes. Women may want to wear a sports bra.

What is Dry Needling?

Trigger point dry needling is a treatment that is becoming increasingly common among physical therapists. Based on Western medicine, dry needling is used to treat a number of conditions, including arthritis, herniated discs, neck/back pain, headaches, plantar fasciitis, sciatica, and muscular strains, among others. Your Impact Physio therapist is pleased to offer this specialty service.

How does Dry Needling Work?

The technique doesn’t involve injections of any kind. Rather, dry needling is the insertion of the needle itself. The benefits are derived from the muscle’s reaction to the dry needling. When muscles are injured or irritated, the tissues swell. In addition, damaged tissues evolve into state of protective tension, contracting to protect against further damage. This process restricts circulation and oxygen within the muscle, which may lead to the formation of scar tissue. Damaged tissues lead to other problems, like pain in the affected area, limited range of motion, and faulty movement patterns.

How does dry needling help? When the small, solid filament needle is inserted into a damaged or knotted muscle, the muscle reacts which a twitch reflex. The reflex reduces muscle contraction and irritation from your body’s natural defensive chemicals. Patients report improved flexibility and decreased pain almost immediately. As an added bonus, the muscles respond to the dry needle as a foreign object, giving the signal for your body’s immune system to respond. Your whole body benefits from this specialized treatment.

What can I expect during and after Dry Needling treatment?

It’s recommended that you eat a light meal about an hour or two prior to your Impact Physio visit. Wear comfortable clothing that provides easy access to the area that requires treatment.

The response to the dry needling process varies for different individuals. Insertion of the needle into an area without an issue is often not perceptible at all. Your Impact Physio therapist will manipulate the needle carefully to produce a twitch reflex, causing a brief moment of cramping or ache. When your body responds in this way, it’s telling you that the process is working.

With as little as one treatment, you should experience better range of motion, decreased discomfort, and fewer symptoms. Some slight soreness is common in the treated area. This is short-lived and is often gone within a few hours but may last one to two days. Your Impact Physio therapist can tell you more about how dry needling can benefit you and how you can maximize your results from the process.

What is Selective Functional Movement Assessment (SFMA)?

It is a way to systematically evaluate how your body moves in order to identify other areas that may be related to the pain you are experiencing.

What is Dynamic Neuromuscular Stabilization (DNS)?

hrough injuries and inactivity we often lose the ability to perform basic movements that we learned as infants. The DNS system is a method for training stability and movement proficiency by progressing through the same stages we did as infants. It is a method for learning proper breathing and core stabilization.

What is Instrument Assisted Soft Tissue Mobilization (IASTM)?

ries and overuse of muscles causes an accumulation of scar tissue and fibrosis (knots). IASTM is a method of treating these abnormalities.

How many treatments will I need?

This all depends on the condition, and will be determined during your initial session. An average course of treatment usually consists of 6-8 sessions. More severe conditions may require more, while minor injuries often require less.

What is Urinary Incontinence?

There are several types of urinary incontinence, but in general incontinence refers to the leakage of urine at inappropriate times. Stress incontinence is leakage of small amounts of urine when there is increased pressure on the bladder. This can happen with exercise or with sneezing, coughing, lifting or other activities. Urge incontinence is the leakage of medium to large amounts of urine when a person feels a sudden strong urge to urinate. Mixed Incontinence includes symptoms of both stress and urge incontinence. Functional Incontinence is urine leakage that occurs when a person can’t get to the toilet in time.

What causes Urinary Incontinence?

Stress incontinence usually results from weakness and lack of support in the muscles of the pelvic floor. These are the muscles that attach to the bottom of the pelvic bones and run front to back, forming a bowl-like structure that lifts to support the internal organs and controls the sphincter muscles. The pelvic floor muscles also work to strengthen the low back, stabilize the pelvic bones, and help with sexual function. Women with stress incontinence often have “under active” pelvic floor muscles. Causes of under active pelvic floor muscles include:

  • Pregnancy and Childbirth
  • Injury or trauma
  • Surgery in the vagina or rectum
  • Episiotomy (during childbirth)
  • Lack of exercise and lack of use

Women with urge incontinence often have weak and “over active” pelvic floor muscles. Possible causes of mixed incontinence can include any combination of the causes of stress and urge incontinence. Functional incontinence can be caused by:

  • Joint pain or muscle weakness
  • Problems with mobility
  • Confusion, dementia or delirium
  • Environmental barriers (i.e., the bathroom is too far away, use of a walker or cane, too many obstacles to navigate around)
  • Psychological problems such as depression or anger

How can physical therapy help?  

Because many symptoms of urinary incontinence are caused by pelvic floor muscle weakness and dysfunction, a specially trained Women’s Health Physical Therapist is the ideal provider to help you gain control over your symptoms. (Many treat men with urinary incontinence as well). Physical Therapists use their specialized medical training to completely evaluate and design a treatment program that is individualized for each patient.

Physical Therapy can:

  • Give you control over your life and your bladder
  • Save money and embarrassment by allowing less use of pads and undergarments
  • Reduce use of medications for incontinence
  • Possibly prevent the need for surgery

Physical Therapy Treatment may include:

  • Education on diet and nutrition to avoid food and drinks that may irritate the bladder
  • Advice on how to change behaviors that make symptoms worse
  • Techniques to help you find the right muscles and learn to use them correctly
  • Pelvic floor exercises to strengthen the pelvic muscles
  • Exercises to stretch and strengthen other important muscles
  • Ways to decrease urinary urge and frequency
  • Biofeedback that shows you how your muscles are working
  • Electrical stimulation to improve awareness and strength of the muscles

Who Should be Referred to a Women’s Health Physical Therapist?

Those with:

  • Trouble leaking urine during normal daily activities
  • Urine leakage with sneezing, coughing, or laughing
  • Trouble starting the urine stream
  • Trouble holding urine when feeling a strong urge to go
  • Trouble with frequent urination (more than every 3-4 hours during the day, up more than once to urinate at night)
  • Trouble getting to the bathroom because of other problems such as knee or hip pain or balance problems

What is Pelvic Pain?

Pelvic pain is described as pain in the lower abdomen, pelvis, or perineum and is considered to be chronic when symptoms have been present for more than six months. The pain may be described as aching or burning in the area of the perineum or abdomen.

What causes pelvic pain? 

Pelvic pain can be caused by problems such as pelvic joint dysfunction, muscle imbalance within the muscles of the pelvic floor, trunk, and/or pelvis, incoordination in the muscles related to bowel and bladder function, tender points in the muscles of the pelvic floor, pressure on one or more nerves in the pelvis, and weakness in the muscles of the pelvis and pelvic floor. Pelvic pain can also be related to the presence of scar tissue after abdominal or pelvic surgery. There can be organic disease processes related to pelvic pain as well therefore it is important to consult your physician to fully determine the cause of your pain,

What are the symptoms of pelvic pain? 

Symptoms of pelvic pain, in addition to pain in the lower abdomen and pelvis, may include:

  • Pain in the hip or buttock,
  • Pain in the tailbone
  • Limited sitting tolerance
  • Pain in the joints of the pelvis
  • Pain with sexual intercourse
  • Tender points in the muscles of the abdomen
  • Reduced range of motion in the hips and lumbar spine
  • Urinary frequency, urgency, or incontinence
  • Painful bowel movements, constipation and/or straining with bowel movements,

How can physical therapy help?

Physical therapists are trained to evaluate and treat joint dysfunction, muscle tightness, weakness or imbalance in muscle groups, and nerve entrapment- all potential signs of pelvic pain. Physical therapists trained specifically in the area of pelvic health can identify the possible generators of pelvic pain and develop a treatment plan specific to the patient suffering from pelvic pain. A physical therapist trained in this area may utilize hands on techniques to address muscle tightness or targeted exercises to improve muscle strength and reduce faulty patterns of muscle recruitment. Other treatment strategies may include biofeedback, retraining of uncoordinated muscles, postural training, and strengthening of the abdominal core muscles.

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