When Can I....?????

We spend so many hours reading, researching and talking to people about what to expect during pregnancy. Many people begin their deep dive into all things pregnancy as soon as they begin to think about being pregnant, We are inundated with information. We learn about each trimester of pregnancy and how our bodies are changing as well as how the growing baby inside of us is changing. We learn about what is “normal” and what to be concerned about. We learn about what we can and can’t do, what we can and can't eat. We think about what we want our delivery to look like and EXACTLY how it will go. We pack a bag, some of us weeks in advance, just so we are prepared.

We do all these things in preparation for the delivery of our baby, but how many of us spent any time thinking about and preparing for how WE would feel after? I didn’t.

In the United States the postpartum follow up generally consists of a single visit around 6 weeks after the delivery of our sweet bundle of joy.

The American College of Obstetrics and Gynecology have more recently stated that, “To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs.” YES!!!!!!!

They have stated that “All women should ideally have contact with a maternal care provider within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth.” YES!!!!!

These changes are amazing and greatly needed. Postpartum moms are dealing with issues related to sleep deprivation, hormonal changes, body changes and the increased demand of caring for a newborn, not to mention all their other responsibilities.

We begin our postpartum journey excited, elated, happy, and often overwhelmed. We are learning about our new baby and if it’s our first, we are learning about what it truly means to keep another human alive.

In addition to all the emotional, mental and physical changes that are happening we are charged with figuring out what our babies need and often don’t think about our needs. Often our first consideration of ourselves is at our first, and generally only follow up visit with our doctor at about 6 weeks.

Historically, at this follow up visit, Moms are often given the ALL CLEAR to resume NORMAL activity.

What exactly does that mean?

Well, in general, it means that their tissue has healed from the delivery and “THINGS” look good.

If you are anything like I was, being given the “all clear”, gave me very little idea of what I should be doing.

If you are anything like I was, you took that to mean. OK, now I can go run like I used to, workout like I did before and of course, return to having sex. Well, I don’t know about you, but I didn’t feel ready for any of these things. I did head out for a run on that very first day of being given the “all clear”, just to find out that it felt like my uterus was going to drop right out of my body. NOT a great sensation.

Now, fortunately for the moms of today, we have better information.

We know that for most people getting moving early, with short walks or even just walking around your home can be helpful, We know that breath work, and gentle pelvic floor muscle contractions or gentle abdominal engagement can feel good and help to improve that feeling of connection between your upper body and lower body. Stretching of the neck, upper back and chest can be very helpful to combat the postural changes that may occur due to breastfeeding or simply due to the growing chest as a mom’s milk supply comes in. All this and so much more can be done in the very early days after delivery.

For higher level activity, we now have screens that can be done by physical therapists and other providers who specialize in treating this population of people. We have return to run guidelines, impact readiness screens and musculoskeletal and pelvic health assessments that can be done. I believe that every postpartum mom could benefit from an evaluation from a physical therapist that specializes in pregnancy and postpartum. Many people don’t even know that this is an option, and it is currently not the standard of care in of country.

So, what should you do?

In general, my advice to people is to begin slowly. Test the activity out in a safe and controlled way. See how your body feels. And ask yourself these questions:

1. Do I have pain anywhere?

2. Do I have pelvic pressure, bulging or the sensation of falling out?

3. Do I leak urine, stool or gas when performing the activity?

4. Does this activity feel uncomfortable?

If you answered yes to any of these questions, then you may not be ready for that activity, and you may benefit from consulting your physician, physical therapist, or other medical professional for specific guidance. Click below if you would like us to contact you regarding postpartum physical therapy and your specific needs.

If you are able to do the activity, and answer NO to each of these questions, then it is likely ok for you to continue. Listening to your body and progressing slowly is key. Be patient and kind to yourself, recovery is a journey.

If you would like to learn more about Viva Physical Therapy, LLC and the services we provide, you can find me at Enlighten Wellness, you can contact me at 248-318-9722 or contact us here.

You Do What?

Hello Friends!

Oh my gosh, if I had a dollar for every time someone said, “YOU DO WHAT??”, when I say I’m a PT who specializes in pelvic health, or women’s health.

When most people think of physical therapy, they think of rehab for a knee or exercises and stretching for your back, or that old shoulder injury, but they don’t often think about solving problems that women experience as a result of being pregnant or postpartum, they don’t often think about physical therapy for incontinence or pelvic pain. 

Women’s bodies change throughout their lives. First during puberty, next as they enter, the years of being pregnant and giving birth and then again when they are perimenopausal and menopausal.

Women suffer with issues and assume there is no answer for them, they have to give up activities that they love or tolerate the activity through their pain, or dysfunction. 

Which brings up the question I get so often.

YOU DO WHAT?

Women’s health physical therapy is a specialized form of physical therapy that focuses on the issues women experience throughout their lifetime. 

Issues related to pregnancy and childbirth, incontinence, prolapse, pelvic pain and trauma.

Issues related to perimenopause or menopause.

At Viva Physical Therapy we treat issues such as:

• Pelvic pain

• Stress incontinence

• Urge incontinence

• Constipation

• Pelvic girdle pain

• Diastasis Rectus Abdominis

• Pregnancy related pain

• Pre and Postpartum conditions

• Painful intercourse

• C-section recovery

• Lymphedema

• Pelvic organ prolapse

• Low back pain

• SI joint dysfunction

• Hip pain

Every patient’s needs are different and each patient’s individual needs direct and guide the evaluation and treatment.

Generally speaking, each patient will give an extensive history, followed by an assessment of their posture, breathing patterns, movement patterns, strength and ROM. After that is completed, if the patient is in agreement, and it is appropriate, an internal muscle assessment will be performed.

Just as we need to know what is happening with the muscles of the shoulder in a shoulder injury, we also need to know what is happening with the muscles of the pelvic floor when there is an issue there.

The pelvic floor, however, does not work in isolation. The pelvic floor may be having symptoms when the problem is coming from the hip or the diaphragm or even the foot.

So as a physical therapist that treat’s patients with pelvic health issues, NOT all of those issues come from the pelvic floor.

I opened Viva Physical Therapy to create a space where women can come for treatment of issues that are sometimes very difficult to talk about.  Where they would get to tell their story and be heard, and get the treatment that they need and deserve.  

If you would like to learn more about Viva Physical Therapy, LLC or about exactly what the heck we do and how it can help you, you can find me at Enlighten Wellness or you can contact me at 248-318-9722.

Oops, I peed!

Hello Friends!

I wanted to talk today about a topic that 1 in 3 women experience, INCONTINENCE.

I know it’s a word that conjures up images of old ladies wearing adult diapers, or little ladies in the grocery store hiding their box of Poise.

That is not what I’m speaking about, or at least not entirely. I’m speaking about that moment when your best friend says something so funny that you burst out laughing, and have to cross your legs, and squeeze your eyes shut, hoping and praying that you can hold everything in, just to find that, yep, you peed.

Or when your kids ask you to play with them on the trampoline, and you don’t want to disappoint them, so you get on, begin to jump, and then have to slowly climb off because, yep, you peed.

Or when you're walking through the grocery store and God forbid you sneeze and, yep, you peed.

I am a health care provider and in a field where this is often a topic of conversation, but I can’t tell you the number of times this comes up, just in my everyday life. It is sort of the inside joke, “you’ve had kids, of course, you pee on yourself.”

I used to have to stop walking, cross my legs and pray if I had to sneeze. After I had my first baby and I started running again, I had to wear pads or my pants would be soaked when I was done. And just a note, period pads are not as absorbent of urine as pads made specifically for incontinence.

One time I was at a restaurant with my sister shortly after the birth of my first baby, I was so excited to be out, she said something funny and, yep, I peed, all over the chair and ground. Talk about embarrassing.

None of these experiences were proud moments, most of them I laughed off, but in reality, I laughed so I wouldn’t cry.

What I know now, is that it doesn’t have to happen. We don’t have to settle for “Oh, I’ve had babies, of course, I leak.” We can do more.

Physical Therapy is an amazing, conservative way to solve this annoying and embarrassing issue.

There are several forms of incontinence, but the one I have described above is called Stress Incontinence.

Stress incontinence occurs when there is an increase in pressure on the bladder resulting in the loss of urine. Activities such as laughing, coughing, sneezing, lifting or jumping can cause an increase in intraabdominal pressure that can result in leaking.

Think of squeezing a balloon from the center. The pressure inside the balloon increases as you squeeze and the bottom of the balloon bulges out. This is what can happen when your intraabdominal pressure increases.

Your breath plays a role in how your pelvic floor functions to prevent leaking. Your respiratory diaphragm and your pelvic floor work together in a type of “piston” action.

Posture is another thing to consider when looking at urinary leakage. Proper posture is important so that your pelvic floor can function properly, and is in the optimal relationship to the diaphragm to reduce the risk of leaking.

Pelvic floor muscle weakness can also contribute to stress incontinence.

Physical Therapy is a very effective way to treat urinary stress incontinence. Educating patients on how to manage their intraabdominal pressure, strengthening their pelvic floor musculature during functional activities and postural education are just a few things that can be greatly helpful in reducing the occurrence of stress urinary incontinence.

If you can relate to my story, if you have stopped activities that you love out of fear of leaking, if you also have to pray every time your going to sneeze, that you wont leak, and would like more information regarding stress urinary incontinence,

Please contact us at 248-318-9722, or email us at dannansiano@vivapt.com

Hello Friends!

I wanted to take a minute to introduce myself. My name is Dannan Siano. I am the owner and founder of Viva Physical Therapy. My family and I recently moved to Park City from River Forest, IL a suburb just west of downtown Chicago.

Our desire to move was based on the need for a complete lifestyle change.

In the midst of a pandemic, we were faced, like everyone else, with trying to homeschool our children, work virtually and maintain our sanity. Park City is a place we had visited quite a few times and absolutely loved it. Some of our dearest friends had homes here.

In June of 2020, when we had reached our breaking point in Chicago, we came to Park City to decompress for a few weeks, it was then that we decided the mountains were calling us.

When we returned to Chicago, we got our house ready to put on the market and started making plans for the big move.

The decision should have been a challenging one, our friends and family were in the mid-west, our kids loved their school and their neighborhood, they were involved in sports and on several different teams, I had my practice there and it was doing well.

To say it simply, our lives were there. None of that mattered. We were craving something different, something new and we hoped for something more.

Fast forward to now, we did it. We sold our house, succeeded in the herculean task of finding a house in Park City, enrolled the kids in school and in sports.

We made it!

We now call the mountains home.

We have been here just a little over a year now and are settling in nicely. We have met wonderful people and are enjoying all the new activities the mountains have to offer.

I’m a runner and boy were my eyes opened to how different running is here compared to Chicago!

Let’s just say my distance is much shorter and my speed are much slower, but I love running here, the trails are amazing.

I took this last year to get my family settled and to just experience our new life and now it’s time to embark on a new journey, reopening my business.

Leaving my practice in Chicago was hard, but I knew when the time was right I could and would do it again.

Viva Physical Therapy is a boutique physical therapy practice that focuses on the unique challenges experienced by women, issues related to pregnancy and postpartum recovery, urinary incontinence, pelvic pain, and issues related to breast cancer recovery, to name a few.

I have been a physical therapist since 1997. The beginning of my career was focused primarily on outpatient orthopedics, which I loved.

When I was pregnant with my first child, I became acutely aware of what a women’s body goes through during pregnancy and the issues that can create. I also became acutely aware of the fact that there weren’t many people who I could turn to that knew how to help me.

I was frustrated…

I didn’t want to pee on myself when I ran, and I was not going to stop running. I needed help and I wanted answers. It was then that I decided to delve into the world of pelvic health.

I have spent the last 14 years learning how to better serve this population.

In 2017 I opened Viva Physical Therapy in River Forest and Oak Park IL and I couldn’t have been happier.

I had my own business where I could help the population of patients that I felt most needed me, in the way that I felt would best serve them.

It is now my great hope that I can do it again here, in this amazing place.

Initially, I am offering virtual and in-home visits with a clinic location to open in the near future.

If you are experiencing issues related to pregnancy and postpartum recovery, if you avoid activities because you are afraid you may leak or have pelvic pain that has plagued you, feel free to contact me at dannansiano@vivapt.com or call me at 248-318-9722.

I’m here to help!