Sullivan Physical Therapy

Sullivan Physical Therapy is joining forces with Origin — and we couldn’t be more excited about the changes that come with the name. What isn’t changing: Our amazing PTs and staff, who will continue to be here for you.

For a peek at what Origin is all about, check out www.theoriginway.com

THANK YOU for continuing to be part of our community & stay tuned for some awesome new things coming your way…

It’s never too early or too late in life to get in touch with your pelvic floor. To learn more about this incredible part of your body, check out the Origin blog, where you’ll find information about everything from chronic pelvic pain, to urinary and f***l incontinence, to how to use your pelvic floor contractions to enhance or**sm.

Get there through the link in our bio.

https://www.theoriginway.com/blog

We can’t wait to see you soon!

Testimonial Tuesday...👍🙌👏
"PT was extremely helpful for me. I have recommended pelvic floor therapy to most of the women/mother’s in my life."
Recent Patient of Lauren Steele, PT, DPT

Testimonial Tuesday...👍🙌👏
"Lauren was amazing! She quickly helped me reach my goals for PT and she made me feel very comfortable and at ease each session. Thanks again!" - Lauren Steele, Pt, DPT

Testimonial Tuesday...👍🙌👏
"Krista is 1000% the reason for my review and score. She is super knowledgeable, thorough, and explains things to you along the way, especially when you have questions. She really takes her time to try and fully understand what's wrong with you not only by listening to what you tell her, but by also listening to what your body tells her so that she can try to best tailor your therapy experience to your needs. On top of being a fantastic physical therapist, she is an outgoing, deeply-caring, passionate woman who knows what it means to be a health care provider at the highest degree." - Recent patient of Krista Hartig, PT, DPT

Testimonial Tuesday...👍🙌👏
"Amethyst was the best!! I was so down after having my baby and 6 months later still having severe pain. I was referred to Sullivan PT and saw Amethyst. She gave me hope and motivation. It was a slow process but I’m able to work out and run again!! My son is now a year old! Doing the stretches and exercises was so worth it. Thank you soo much Sullivan physical therapy!!" - Recent patient of Amethyst Guerrero

Testimonial Tuesday👍🙌👏
"I now have regular bowel movements without pain or muscle spasms. Therapy was extremely effective and helpful. Thank you for the help and education." - Recent patient of Sima Shalchi, PT, DPT

Testimonial Tuesday 👍🙌👏

"Very pleased with this treatment. It is the best thing I did for myself postpartum." - Recent patient of Lauren Steele, PT, DPT

Testimonial Tuesday 👍🙌👏
"Christina was lovely. I was comfortable talking all the "taboo" topics and felt safe to ask my questions. Thank you for helping me heal and embrace this new postpartum mama body of mine! My only regret is not beginning with you sooner." - A recent patient of Christina McGee, PT, DPT

Testimonial Tuesday...👍🙌👏
"I enjoyed Sima’s instruction and I am glad I did it! She is very personable, relatable, and communicates well." - A recent patient of Sima Shalchi, PT, DPT

Testimonial Tuesday...👍🙌👏
"I can stand without pain for much longer and I have the knowledge to get out of pain if I get in it. Thank you so much!!!"- Recent Amethyst Guerrero, PT, DPT

Testimonial Tuesday...👍🙌👏
"Wonderful staff and great results. I highly recommend Sullivan Physical Therapy and Sima!" - Recent patient of Sima Shalchi, PT, DPT, RYT

Testimonial Tuesday...👍🙌👏
"The scheduler is very friendly and go extra miles to schedule me as soon as possible to meet my needs. The therapist is professional with passion and gentleness." - Recent patient of SPT

Testimonial Tuesday... 👍🙌👏
"Lauren is amazing. I have been made to feel comfortable from the moment I walked in the door and have been heard and helped so much. My pelvic floor health has improved greatly in 4 sessions so far.." - Recent patient of Lauren Steele, PT, DPT

Testimonial Tuesday...👍🙌👏
"Christina was amazing. She is caring and knows so much. She helped me avoid surgery." - A recent patient of Christina McGee, PT, DPT

Testimonial Tuesday...👍🙌👏
"Very kind and gentle about such a taboo subject. It's really a safe haven for women!" - A recent patient of SPT

Patients with interstitial cystitis with more severe pelvic floor dysfunction demonstrated higher rates of dysfunctional voiding than those with nonsevere dysfunction, and may benefit from advanced pelvic floor therapy.

http://ow.ly/Vb7d50EYQfd

Think of sliding down a slide with soft sweat pants, both surfaces are slick so we slide down quickly and smoothly. When we do not use lubrication when our tissues are dry then it often times we have an increase in friction, think of sliding down a slide in short shorts and our skin gets stuck the whole way down the slide. Lubrication can be extremely helpful during s*xual activity, either with self, a toy, or with a partner. Lubrication is what minimizes friction allowing for an easy glide.

Unfortunately, many lubricants have chemicals and parabens that can cause irritation or can make us more vulnerable to getting urinary and yeast infections and bacterial vaginosis. Read the labels of lubricants to make sure certain ingredients are not included. Most lubricants are scented and flavored have chemicals that effect pH, if you do enjoy these types of lubricants search for organic ingredients.

Slippery stuff
-water based lubricant
-paraben and glycerin free
-unscented
-does not alter pH levels
-can be absorbed fairly quickly, potential for reapplication during s*xual activity
-safe to use with silicone toys

Uber L**e
-silicone based with vitamin E
-paraben and glycerin free
-unscented
-does not alter pH
-Longer lasting than water based products
-potentially not safe for silicone toys

-Good Clean love
-Water based with organic aloe vera
-paraben and glycerin free
-Safe to use with silicone toy and latex condoms
-does not alter pH
-options for fertility- friendly by supporting s***m health
-Also has different moisturizers

Lubricants are not a 1 size fits all. Due to slight variations in v***a and vaginal tissues, one product may work for you. Vaginal dryness may just be one piece of the puzzle. Pick a product and trial it for 10-14 days to see if you begin to see a difference. If you are not satisfied, trial another product, it can take time to find what works best for you.

Pelvic Floor in Runners

One of the major relationships that can contribute to incontinence in runners is the diaphragm. The diaphragm works in coordination with the pelvic floor and the transverse abdominis to assist in spinal stabilization by increasing intra-abdominal pressure during limb movement(Hodges 2007, 1999). More specially, high impact activity, such as running, can be very abrupt and increase that pressure. To counteract the increase in pressure requires the muscles of the pelvic floor to react with the same speed and power. However, research has shown that women with SUI tend to have impaired ability to recruit these fast twitch muscle fibers.

Having a specific running and pelvic floor routine is important in order to retrain these muscles. Research has shown that gait, how one’s heel strikes and less miles per week with increased speed has an effect of continent vs incontinent runners.(Silva 2019).

Causes of SUI: pelvic floor muscle weakness, supportive dysfunction(ligament and tendon injuries), lack of pelvic floor endurance, or overactivity of muscles.

How to manage:
1. Speed and timing
2. Power
3. Endurance

Exercises to begin in modified positions
-supine, seated, quadruped to progress to
-jump rope, skipping, block jumps(assists in the monosynaptic reflex of the pelvic floor)

Additional management of SUI:
-bladder irritants
-scar or restrictions abdomen/pelvic floor
-running mechanics(how the foot is contacting)
-restrictive foot mobility: Studies indicate that runners who overstride will have increased body weight load through their lower extremities. Meaning, that if one has symptoms of SUI then changing your stride, putting foot closer to body, may help.
-supportive devices: tampon, poise impressa, pessary
-diaphragmatic breathing
-rib lateral expansion breathing practice

Reference: Amanda Olson, Underactive Pelvic Floor Dysfunction in Runners: Focus on Stress Incontinence, Prolapse and Postpartum, Pelvic Global, 14 May 2020

Testimonial Tuesday...👍🙌👏
"Amethyst has been great and has made PT an enjoyable and productive experience." - A recent patient of Amethyst Guerrero, PT, DPT

This summer, Sullivan Physical Therapy is joining with Varian Hans to host a Summer Health Series focused on nutrition.

If you would like to join us for the webinar or receive the recording please email us at [email protected].

The first one up is Surviving The Texas Heat With Herbs and Food - May 23, 2022 at 11 am CT
Anybody who's experienced a Texas summer knows how suffocating the heat can be. If you're prone to winding up on the summer struggle bus and avoiding the trek across a parking lot or a walk around the block, join us for this webinar. You'll learn some amazing herbal and dietary allies that can help cool you from the inside out. So whether you're a native Texan or you just arrived, you'll gain some powerful information that will make the heat bearable.

Here is the rest of the line up for the summer:
How To Navigate Your Summer Sweet Tooth - June 13, 2022 at 11 am CT

How To Pack A Nourishing Summer Ice Chest - July 18, 2022 at 11 am CT

How To Reduce The Likelihood of Sunburns and How To Recover From One With Food - August 22, 2022 at 11 am CT

Happy Mother's Day from all of us at Sullivan Physical Therapy!💐

Menopause and Exercise:

Hormonal changes during menopause can increase inflammation, insulin resistance, reduce bone turnover and create cognitive changes. With these shifts the female athlete may have to consider changing or supplementing their workouts. Outlined below include three type of workout regimes that should be included before and during the stages of menopause.

1. High Intensity Interval Training: Short sessions :20 minutes with 2 sessions a week to increase to 4X a week)
Benefits:
a. Increase in blood glucose control: body is under stress it translates the glucose(pull into liver, muscle and fat cells)
b. Acute inflammatory response leads to a greater anti-inflammatory response
c. Increase in BDNF to improve cognition and working memory

2. Heavy Resistance Training:
a. Due to womens decrease ability to maintain or gain mass, heavy resistance should be incorporated
b. Protein intake afterwards is recommended

3. Plyometrics/Power Training:
a. During menopause, women loose the fast twitch and performance power they may have had. Therefore, the need to train explosive power and speed is important.Eg. Overhead medball slams
b. Increases GLUT4 proteins(enhance bodies ability to handle blood glucose)

Additionally, nutrition is important along with exercises. Nutrition is more of a timing concern and need up to 40g of protein and 6g of amino acids or leucine(focus on plant based protein). Nutrient timing decreases catabolic state, improves glucose control, stimulates muscle protein synthesis, reduces LEA risk and supports microbiome support.

Reference: Dr. Stacy Sims, Menopause for Athletes, Pelvic Global, 1 Nov 2021

Progesterone...

One of the major hormones involved during pregnancy is that of progesterone. This hormone has a catabolic nature and acts as an antagonist to estrogen. More specifically, progesterone inhibits muscle protein synthesis and decreases contractile strength.However, the benefits fo progesterone include increase in ligamentous tension and neuroprotection. Progesterone can help to modulate pain and tolerance, increase bone density, respiratory rates, core temperature and can function as an anti-inflammatory steroid. During pregnancy this hormone maintains the endometrial layer for implantation, relaxes uterine smooth muscle, stimulates breast lobes, facilities maternal fat store deposits and stimulates an increase in ventilation.Due to the relaxation of smooth muscle of the respiratory tract, we can see an increase in minute ventilation, meaning the number of breathes taken within a minute increases.

Reference: Dr. Stacy Sims, Menopause for Athletes, Pelvic Global, 1 Nov 2021 and Rachel Kilgore, Herman&Wallace, Care of the Pregnant Patient, June 29-30 2019

Happy Work Anniversary, Kimia! We are very lucky that you chose to work with us. You are extremely smart and caring. You inspire us to be better every day.

Testimonial Tuesday...👍🙌👏
"Everyone is very respectful and my therapist always goes above and beyond in helping me with my symptoms. She is very detailed in explaining what she will be doing. The clinic is very clean and friendly." - Recent patient of SPT.

Estrogen - 3 types

Estradiol(E2): This hormone is predominant in the reproductive years and is produced by both males and females. The main function of Estradiol is to mature and maintain the reproductive system. During menstruation, increased levels cause the maturation and release of an an egg. This hormone is made primarily in the ovaries, with levels declining as a women ages and reaches menopause. If there is a decrease in estradiol, bone growth and development can slow leading to osteoporosis.Estradiol has additional functions that include stimulating protein synthesis for recovery, appetite regulation, thermoregulation, bone health and a relationship with serotonin.

Estriol(E3): Predominant during pregnancy as it helps the uterus grow and prepare for delivery.This hormone peaks right before birth and is produced in large quantities by the placenta.

Estrone(E1): predominant in menopause. Less potent than E2 but can convert to other forms of estrogen. Produced in the ovaries but also adipose tissue and adrenal glands and can be converted to Estradiol.

Reference: Dr. Stacy Sims, Menopause for Athletes, Pelvic Global, 1 Nov 2021

Menopause ...

Research has shown that there is a difference in performance of men vs women as they reach the age of 50. Men tend to age in a linear projection as women show a decline in overall performance. One of the major contributors to this difference is the stage known as menopause.

Menopause can be broken down into various pre-stages, identified by distinct changes outlined below:

Perimenopause :Periods are the same with no major changes in cycle.Women can experience sleep problems, night sweats, heavy flow, poor training adaptation and recovery during this time. Women will notice that exercise classes such as crossfit or bootcamps that they were able to attend 4-5X a week is decreasing to 1-2X a week. From a hormonal level there is a change in the ratio of estrogen and progesterone that starts to change.

Early Menopause: During this stage there is irregular cycles.

Late Menopause: Continued changes of cycle with skipping periods

Late Perimenopause: Amenorrhea

The stage of menopause begins when there has been a year of no menstruation with an average age of 5 1years.In addition, hormonal tests can be done to determine if this stage as been reached.

Postmenopause is the stage when menopause is complete and the menstrual cycle has stopped. During this time there can be two stages: of the first year and years 2-6 where women can experience vasomotor symptoms, iron deficiency, and autoimmune diseases.

The key hormones at play include: estrogen, progesterone, FSH, LH and Testosterone. During the post-menopause stage the FSH and LH will increase with Estrogen decreasing. Due to the ratio mis-step of the hormones there can be changes in body composition within the first 3-4 years before menopause, changes in bone structure and loss of lean mass.
Reference: Dr. Stacy Sims, Menopause for Athletes, Pelvic Global, 1 Nov 2021

Let's explore the two types of desire and find that while your interest in s*x may be changed, it may still be around and well. The information following is based on the book Come as You Are by Emily Nagoski.

Spontaneous desire: Sudden interest in s*xual activity. The type that arises out of the blue, when you are say, cooking eggs, walking down the street, or doing any normal life activities. The type that everyone seems to aspire to and talks about lacking when they talk about a ‘loss of desire’.

It’s very understandable for s*xual activity to be de-prioritized when other life demands, like work, screaming children, or a general anxiety about the state of the world are on the forefront of your mind.

Reponsive desire: Interest in participating in s*xual activity that arises only in response to external stimulus like touch. Desire that comes to the surface only after your body says, when you’re touched by a partner or yourself, “hey…now that you mention it, that does feel pretty good. I guess I could be into more of that”.

Neither type of desire is more innately valuable or real. Especially during times of high stress, you may have to actually schedule s*x into your calendar, as you would any other activity, in order to make it happen. It may not be until you start to feel touch that your body remembers that it enjoys s*xual feelings.
If you’re finding that neither type of arousal is becoming available to you, refer back to the last eblast and check out more information in Emily Nagoski’s book. There are so many avenues possible in finding s*xuality again. And YOU ARE NORMAL.