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Physical Therapy for Exercise and Eating Disorders

  • Are you or someone you know an “exercise junkie?”
  • Do you worry about your weight, restrict your food and fluid intake, diet constantly or exercise excessively to avoid gaining weight?
  • Has your menstrual cycle been disrupted, is it erratic or has it stopped altogether?
  • Do you feel stressed or depressed?
  • Have you resorted to taking diet pills and laxatives?
  • Do you ever force yourself to vomit after eating?


These are a few of the questions health professionals may ask if they suspect someone may be a victim of the female athlete triad, which includes disordered eating, amenorrhea and osteoporosis. Women and girls with this condition exhibit signs of pathogenic weight control and are at high risk for many medical problems.


Eating Disorders

Eating disorders span the spectrum from restrictive eating or avoiding certain foods to anorexia or bulimia. Disordered eating results in a negative energy balance, where more calories are being used than consumed. An electrolyte imbalance can occur, which can lead to dehydration, decreased thermal regulation, cardiovascular problems, poor healing and even sudden death.


Most people have heard of anorexia nervosa, which is an eating disorder characterized by an intense fear of fatness, an abnormal body image, absent or disrupted periods and weight loss to less than 85 percent of normal. There may also be associated signs like low blood pressure, slow heart rate, dry skin and nails, hair loss or thinning and excessive fine hair on the sides of the face and arms.


Bulimia nervosa is a related eating disorder characterized by recurrent bingeing and purging, two times a week or more. Associated signs may include enlarged salivary glands, periodontal disease, conjunctival bleeding and scars on the back of the hand from repetitive, forced vomiting. Statistics show that about one in every 100 women binges and purges to lose weight.


Amenorrhea

Menstrual dysfunction occurs in women and girls with disordered eating.

Primary amenorrhea is a condition in which girls do not start their periods by age 16 when the usual sex characteristics are present or by age 14, if no other sex characteristics are present.


Secondary amenorrhea is a condition in which the period is absent or irregular and is diagnosed in previously menstruating women when there is an absence of three consecutive periods, or less than two cycles per year.


Athletic amenorrhea is a condition that falls under this secondary category and occurs when there is a combination of caloric restriction, excessive exercise, emotional stress and low body fat.


Health Consequences

Health consequences that may result from eating disorders and amenorrhea include osteoporosis, stress fractures, scoliosis, infertility and cardiovascular disease.


Osteoporosis, in this instance, is a premature loss of bone in premenopausal women, an inadequate formation of bone or a combination of both. People at high risk of osteoporosis are likely to include women of slender build, those with low calcium intake, those with a family history and those of caucasian and Asian heritage.


Female Athlete Triad

When the eating disorders, amenorrhea and osteoporosis exist together, it may be diagnosed as the female athlete triad, which occurs most frequently in athletic women but can also affect non-athletic women and girls. The true prevalence is not known because it is often unreported or underdiagnosed.


Prevention and treatment should include a multidisciplinary approach by physicians, dietitians, psychologists, physical therapists, nurses, coaches, athletic trainers, dentists and family. Appropriate history and education are the keys to recognition of the problem and prevention. Counseling and family support may help in determining the underlying cause, promoting a healthy body image, promoting healthy eating habits and addressing issues, such as stress, anxiety and depression.


Proper exercise should be in an appropriate balance with the fuel consumed to achieve and maintain a healthy body and lifestyle. For more information regarding diet, nutrition, and exercise, please consult your physician, a nutritionist and a women’s health physical therapist.


Ann Sundgren, PT
Palmer Physical Therapy for Women

"Let's Get Physical" to address side effects of cancer treatment

12 February 2024
"After cancer diagnosis, many patients anticipate a treatment regimen that might include surgery, chemotherapy, targeted therapy, immunotherapy or radiation. But there's another type of treatment that can benefit people with cancer, and it's one that they don't always get - physical therapy. Physical therapy can help address side effects of cancer or its treatments, including pain, weakness, body changes and fatigue." "Many people being treated for cancer experience severe fatigue, which often tops lists of common side effects of both chemotherapy and radiation. Although it might seem counterintuitive, physical therapy can play a vital role in fighting fatigue." "You don't have to rehabilitate what you don't lose. Waiting for patients to lose function, and then give it back to them is not best practice. Our job is to keep you happy, healthy, and moving." "Patients often worry that they are not well enough for physical therapy, but people who try physical therapy don't get as sick, don't have as much pain, and tolerate chemotherapy and radiation better." From the winter 2018 edition of Cure magazine. Please follow the link for more information about the benefits of physical therapy during cancer treatment. https://www.curetoday.com/publications/cure/2018/winter-2018/lets-get-physical Research shows that physical activity during and/or after cancer treatment can help you minimize and overcome the effects of cancer treatment. At Palmer Physical Therapy for Women, our therapists are trained in oncology rehabilitation and will evaluate your pain, neuropathy, range of motion, tissue restriction, strength, endurance and balance. An individualized plan of care and exercise program will help you address any deficits and achieve your specific needs and goals. We are ready to help you get your quality of life back! Susan Palmer, PT

Nordic Walking

12 February 2024
Nordic Walking—What Is This New Craze? Popular in Europe for many years, Nordic Walking, also known as Urban Poling, is recently becoming an exciting exercise option here in the United States. To understand Nordic Walking better, envision cross-country skiing without the skis. There are many great benefits from Nordic Walking. Namely, there is 80% more muscle activation than traditional walking, with up to a 40% increase in calorie burning. Nordic Walking improves posture, gait pattern, and balance, while increasing core and upper body strength. Using the poles with walking significantly decreases stress on the back, hips, knees, ankles and feet, enabling those with painful or chronic conditions to tolerate and enjoy more physical activity. Working out with the Nordic poles helps to increase overall strength and endurance, which can carry over to other daily activities and enhance the quality of life. Weightbearing and resistance activity with the upper body helps prevent bone loss due to osteopenia or osteoporosis as well. At Palmer Physical Therapy for Women, we are utilizing the poles as part of our individualized rehab programs for those with balance or falling issues, for those with spine or lower extremity pain or dysfunction, or for those with postural problems. There are many great exercises that utilize the poles to assist with stretching, strengthening or balance. We have also been promoting Nordic Walking to our clients and to other community groups as a new, unique form of fitness activity. Especially during the recent COVID-19 pandemic, Nordic Walking can easily be done outdoors for social distancing, nearly anytime, anywhere. It requires little equipment, with minimal expense. Once the proper gait pattern is achieved on level surfaces, Nordic Walkers can challenge themselves on uneven ground, hills, or inclines. Palmer Physical Therapy for Women is now offering classes for an introduction to Nordic Walking. Participants learn a comprehensive home exercise program using the poles to help with stretching, strengthening and balance. Physical therapists adjust and fit the poles properly to the individual, and educate them about proper gait pattern, posture correction and control. Some of the comments from our recent classes: “I started walking with Nordic poles July 18, so have been walking with them for a month. Previously, my walking was a chore and just something I felt I had to do for health reasons, not so much because I enjoyed it. Now, every morning, I am eager to exercise with the poles. I also started doing the recommended stretches, balance and strengthening exercises using the poles. I feel like I have settled into an exercise program that I totally enjoy! Even after only one month, I sense that I am more aware of having correct posture. I can tell from my Apple Watch app that I am burning more calories with the poles. I initially thought I would be embarrassed walking in my neighborhood, but I mostly get smiles, thumbs up, and inquiries about this form of exercise. Now I like being the unique exerciser! I would highly recommend walking with Nordic poles!” Jan Dav is Future ongoing fitness classes will be offered for those interested in advancing with more comprehensive exercise and conditioning. For further information about class times, please call Palmer Physical Therapy for Women, 316-630-9944. Our office is located at 10333 E 21 st ST N. #406, Wichita, KS 67206. We look forward to working with you!

Pelvic Pain and Physical Therapy

12 February 2024
For years, women have suffered in silence from pelvic pain, often not even discussing the problem with their physician. Others visit numerous health care practitioners desperately seeking answers about the source of their pain. The pain they experience can affect their ability to work and perform daily living activities. It can also affect relationships with spouses or significant others. Many women avoid sexual relations because of pain. Worse yet, many feel that no one can help them. Chronic pelvic pain can present itself in numerous ways. Symptoms may include: Lower abdominal pain Painful sexual intercourse Itching or burning around the vagina or pelvic floor (may have diagnoses of frequent yeast infections) Pain in the bladder or rectal areas (may have diagnosis of interstitial cystitis) Painful clitoral area and/or inability to achieve orgasm Lower back pain Sometimes these symptoms can be related to endometriosis, ovarian cysts, or other medical problems. Symptoms may be as a result of a yeast infection, but this diagnosis can be inaccurate. In other instances, the woman has undergone numerous diagnostic procedures including laparoscopy, and the source of the pain remains unknown. That’s where a relatively new area of physical therapy can help. A physical therapist specially trained in women’s health can assist with pain relief and return a woman to a more normal level of functioning, whether it be normal bowel and bladder function or pain-free sexual intercourse. A women’s health physical therapist can evaluate the pelvic area from a muscular, skeletal and nerve standpoint. The physical therapist may find that muscles are in spasm, the spine or pelvis may be positioned incorrectly, and nerves may be irritated or not functioning correctly which all result in pain and dysfunction. I very frequently see women in my clinic who have complaints of painful sexual intercourse. This can be devastating to a relationship. The woman often feels as if it’s her fault, in some way, that she experiences pain with sex. Her partner doesn’t understand the problem and becomes frustrated. This can lead to diminished sexual interest or avoidance altogether. However, this problem can be treated very effectively. The spine is evaluated for abnormalities, irritated nerves are calmed and muscles are gently stretched back to normal lengths. After the physical problems are cared for, the couple may need additional help from a behavioral therapist specializing in sex therapy in order to complete the healing. A women’s health physical therapist can also help a women who has a diagnosis of interstitial cystitis. Interstitial cystitis can include a variety of symptoms and the cause is unknown. Women with this diagnosis have inflamed bladder walls, bladder or pelvic pain and pressure which can be intense, and the need to urinate very frequently, often with urgency. These symptoms can worsen during their menstrual cycle and most complain of pain with sexual intercourse. Medications are not very effective in controlling this problem. Again, physical therapy is efficacious in fighting these symptoms. Evaluation of women with this diagnosis can reveal long-term lower back pain which is not always severe in nature but causes nerve irritation. The lower back pain can be treated, which decreases the nerve irritation. Other elements of treatment include bladder and pelvic floor muscle re-training. The important thing to remember is that chronic pelvic pain and its variety of symptoms can be effectively treated with physical therapy. Recent studies show that a manual physical therapist that specializes in pelvic floor dysfunction can relieve discomfort, and improve muscle and bowel and bladder function. Women don’t have to live with pain nor is it “all in your head” when you experience pain with sexual intercourse. There are physical reasons for your pain! If you are experiencing symptoms of chronic pelvic pain, I encourage you to consult with a women’s health physical therapist to evaluate your needs and move towards recovery. Pam Palmer PT Women’s Health Physical Therapist Palmer Physical Therapy for Women
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