Posts by GreenstoneMedia

Pediatric Bowel and Bladder Health

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Pediatric Bowel and Bladder Health

We often hear about urinary incontinence in adults or the elderly population, but did you know it can also happen to children? According to ICCS (International Children’s Continence Society) one in five otherwise healthy five-year-olds and one in seven school-age children are incontinent during the day or night.

There are a few causes for incontinence. It can be associated to psychological, environmental or due to part of the nervous system that controls the bladder not being mature yet. Even though children should gain full control over their bladder by the age of 5 this does not always happen.

Common dysfunctions of the bowel and bladder include:

 

  • Bladder overactivity- when the bladder contracts too much and the child might feel a sudden urge and incontinence can happen
  • Incoordination of the muscles of the pelvic floor- The muscles don’t completely relax when it’s time to urinate, which can lead to urine retention, urinary tract infections and even more serious problems like urine reflux to the kidneys.
  • Nocturnal enuresis (bedwetting) -can be found in 5-10% of children below the age of ten years. Although incontinence is not life-threatening, it is a terrible problem for the child because it can lead to low self-esteem and isolation. Even though the problem can go away with time it can take many years, but with Physical Therapy intervention it may resolve much faster.
  • Constipation- Found in 18-37% of children. It can impact negatively the child’s health causing symptoms like pain and bloating or even a strong urge to urinate (bladder being compressed by the full rectum). With time, constipation can even lead to a dysfunction in the pelvic floor muscles and difficulty urinating.

Recognizing a dysfunction means asking specific questions to parents:

  • Does the child use the restroom less than 4x or more than 8x per day?
  • Does he/she wet the bed at night and is over the age of 5?
  • Does he/she ever have to cross legs or do a little “pee dance” to avoid urine loss on the way to the bathroom?
  • Do you see him/her having difficulty or pain defecating?

These could be signs that this child needs a visit to a Pediatric trained Physical Therapist.

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South Asheville Location

Treatable Conditions:

Bladder

  • Overactive bladder
  • Urinary incontinence
    • Daytime wetting
    • Bed wetting
    • Giggle incontinence
    • Stress urinary incontinence
  • Urinary retention
  • Dysfunctional voiding
  • Urinary urgency/ frequency

Bowel Dysfunction

  • Chronic Constipation
  • Painful defecation
  • Fecal incontinence
  • Fecal urgency/ frequency

Abdominal/ GI

  • Abdominal bloating
  • Abdominal pain

What You May Expect During Your Physical Therapy Session:

A pelvic floor physical therapy evaluation is very different from the evaluation you receive from your doctor. Physical therapists are experts in assessing muscular tone, strength, flexibility, and endurance, as well as the general health of the musculoskeletal system.

Our evaluation of your pelvic floor is very detailed and comprehensive, and the exam often includes an assessment of your back, hips, and any other region of your body that may be involved.

 

Why Choose Cornerstone Physical Therapy:

  • Skilled services in a safe, comfortable and private treatment environment
  • Excellent communication with your health care providers
  • Sound and knowledgeable advice and education about your condition
  • A comprehensive assessment and an individualized rehabilitation program
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Lili Dobbyn

Lili Dobbyn, PT

Certified Lymphedema Specialist

Lili Dobbyn

Lili Dobbyn, a Western NC native received her Physical Therapy degree at the UNC School of Medicine, Division of Physical Therapy in 1993. Lili has been a practicing therapist in the Asheville area and received her certification in Lymphedema Therapy from the Academy of Lymphatic Studies in 2006. Lili also incorporates manual techniques with her patients including Myofascial Release, Cranial-Sacral, and deep tissue methods which are often used in combination for the best results. Lili believes that a genuine feeling of compassion with a good sense of humor can go a long way in helping her patients achieve the most successful outcome. When not practicing Physical Therapy, Lili spends time hiking, swimming, and enjoying the beautiful mountains of Western NC.

Carly Johnson

Lili Dobbyn, PT

Certified Lymphedema Specialist

Lili Dobbyn

Lili Dobbyn, a Western NC native received her Physical Therapy degree at the UNC School of Medicine, Division of Physical Therapy in 1993. Lili has been a practicing therapist in the Asheville area and received her certification in Lymphedema Therapy from the Academy of Lymphatic Studies in 2006. Lili also incorporates manual techniques with her patients including Myofascial Release, Cranial-Sacral, and deep tissue methods which are often used in combination for the best results. Lili believes that a genuine feeling of compassion with a good sense of humor can go a long way in helping her patients achieve the most successful outcome. When not practicing Physical Therapy, Lili spends time hiking, swimming, and enjoying the beautiful mountains of Western NC.

Havely

PT, DPT, Pelvic Health Specialist and Orthopedics

Havely@cornerstoneptnc.com

Pelvic Health, Post Partum, Orthopedics, Cornerstone Physical Therapy

Bio

Havely received her Doctor of Physical Therapy degree from Winston-Salem State University. She developed a passion for orthopedics and pelvic health during her education and began taking advanced courses in these areas. She worked at Wake Forest Baptist Health in Winston-Salem in their outpatient Orthopedic and Women’s Health departments until her and her husband relocated back to the Asheville area. Her pelvic health training includes treatment for incontinence and pelvic pain from the Herman and Wallace Pelvic Rehabilitation Institute. Her background in yoga and mindfulness meditation dovetails well with modern pain science when treating a variety of conditions in Physical Therapy. She has a passion for staying current in Physical Therapy research and believes deeply in the innate healing potential of the human body.

She is delighted to be living in Asheville, close to family and friends, and in the beautiful southern Appalachians. When not practicing Physical Therapy Havely enjoys gardening, yoga, cycling, and being outdoors.

Cecilia Pepera

PT, DPT, Pelvic Health Specialist and Orthopedics

Havely@cornerstoneptnc.com

Cecilia Pepera, PT

Certified Hand Therapist

Cecilia  has a way with people. Her knowledge of kinesiology, combined with 20 years’ experience as a physical therapist, makes her very effective with patients. She understands how the body moves, where it gets stuck, and how it heals.

She completed her graduate degree and Licensure in Physical Therapy from the University of Colorado Health Science Center in Denver 1991, as well as a bachelor’s degree in Kinesiology from UC.

“I am passionate about helping patients regain their full function,” she says.

Cecilia’s specialties include Certified Hand Therapy, Pediatrics, treating Orthopedic and Neurological conditions, and Sports Rehabilitation.

Cecilia spent her first years as a PT in a position in the Front Range Out Patient Orthopedics, Sports Medicine Clinic.  She worked extensively with employees of truck delivery companies such as UPS and with post Motor Vehicle Accident patients to get them successfully back to work without limitations from injury.

In the mid 90’s she worked as a Traveling Therapist including extensive work with pediatric population while working in rural Georgia.

In 1997, she joined the staff of an outpatient clinic in Tallahassee, Florida, where she acquired the 4000 hrs of direct practice experience in Upper Extremity Therapy required to sit for the National Exam & became credentialed as a Certified Hand Therapist (defined as “art & science of rehabilitation of the upper limb, which includes the hand, wrist, elbow & shoulder joint”).  As a Certified Hand therapist (CHT), Cecilia has had extensive experience treating the hand and upper extremity, and has passed a comprehensive test of advanced clinical skills and theory in upper quarter rehabilitation. She has worked extensively with neurological and orthopedic conditions of the hand, wrist, elbow and shoulder.

In the spring of 2000, she returned to the mountains and her original PT passion: Orthopedics & Sports Medicine.

"I have spent the past 11 years doing what I love, and working with other therapists I love and respect greatly. As Melinda Halford and my patient’s can attest, I am a huge proponent of patient education.  My goal is to help patients understand their symptom origin & give them the tools to reclaim their function, their pain-free lifestyle.

"During my early years of practicing in various settings, I was reminded repeatedly that I cannot effectively treat a patient if I am only treating the injured body part.  We are all whole beings and individuals. There are no cookbook treatment approaches that work for every shoulder injury or ankle sprain.  It is my job to help each individual regain his or her full functional potential & over the years I’ve developed an eclectic, evidence based approach as a means to that end."

One of Cecilia’s patients tells us “Cecilia was the reason I got the treatment I needed for my elbow.  I had been to many other medical professionals who told me nothing was wrong. Cecilia spent the time with me to really diagnose my problem and helped me get the treatment I needed. I have been to other PTs and have never had someone who was such an advocate for me. I will always choose Cornerstone PT and Cecilia for any needed therapy. "

Cecilia is an avid runner, road biker and enjoys camping and adventure traveling with her husband and son.

Laura

PT, DPT, Pelvic Health Specialist and Orthopedics

Havely@cornerstoneptnc.com

Pelvic Health, Post Partum, Orthopedics, Cornerstone Physical Therapy

Bio

Havely received her Doctor of Physical Therapy degree from Winston-Salem State University. She developed a passion for orthopedics and pelvic health during her education and began taking advanced courses in these areas. She worked at Wake Forest Baptist Health in Winston-Salem in their outpatient Orthopedic and Women’s Health departments until her and her husband relocated back to the Asheville area. Her pelvic health training includes treatment for incontinence and pelvic pain from the Herman and Wallace Pelvic Rehabilitation Institute. Her background in yoga and mindfulness meditation dovetails well with modern pain science when treating a variety of conditions in Physical Therapy. She has a passion for staying current in Physical Therapy research and believes deeply in the innate healing potential of the human body.

She is delighted to be living in Asheville, close to family and friends, and in the beautiful southern Appalachians. When not practicing Physical Therapy Havely enjoys gardening, yoga, cycling, and being outdoors.

Orthopedics

Services

General Orthopedics

Sports injuries, joint pain, spinal disorders, work injuries, and more

MAN_THERwide

Treatable Conditions (including but not limited to):

  • Post-Operative Rehabilitation
  • Joint Replacement
  • Sports Injuries
  • Arthritis
  • Back and Neck Pain
  • Knee Pain
  • Ankle and Foot Pain
  • Frozen Shoulder
  • Muscle Weakness

Generally, any musculoskeletal-related pain issue affecting your everyday function can be treated by a physical therapist.

Physical Therapists are able to diagnose, manage and treat disorders and injuries of the musculoskeletal system as well as rehabilitate patients post orthopedic surgery.

Our therapists utilize joint mobilization/manipulation, strength training, and core stabilization routines as well as various modalities (electric stimulation, ultrasound, dry needling, hot packs and cold packs) to expedite recovery and improve overall well-being.

All of our physical therapy treatments are geared toward improving overall functional mobility and improving our patients' quality of life.

Crossfit/Lifting Injuries

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Crossfit/Lifting Injuries

Do you ever experience shoulder pain with snatches/jerks/overhead squats, back pain after doing deadlifts, knee pain during or after squatting, and or limited mobility with gymnastic drills?

If any of these sounds familiar to you or maybe you have a different concern, one of our certified lifting specialists can help you.  Seth, Jessica T.  and Caroline are level 1 USA Weightlifting Certified instructors

 

At Cornerstone Physical Therapy, our therapists have been trained in evaluating, diagnosing, and rehabilitating a wide array of injuries that can occur from participating in CrossFit and other weightlifting activities.

We offer one-on-one sessions with one of our lifting specialists to work with you to develop a plan of care based on your specific needs

Common  injuries treated:

  • Shoulder pain
  • Low back pain
  • Muscular Strains
  • Neck pain
  • Knee pain

Any of there injuries can limit your ability to perform at optimal levels of performance. If you are not experiencing any pain but would have concerns regarding your form and technique then you can sign up for:

Crossfit/ Lifting Assessment Package:

1 Session $100

3 Sessions $250

Lifting Assessment

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Lifting Assessment

At Cornerstone Physical Therapy, our lifting specialists will perform a lifting assessment on you to evaluate your form and technique with feedback on how to improve your form and efficiency.

We offer one-on-one 60-minute sessions with one of our certified lifting specialists. Our clinic offers a Crossfit rig, drop mat, and lifting equipment up to 300 pounds to allow for a wide variety of assessments.

One session: $100

Three sessions: $250

If significant issues are found that cannot be resolved within three sessions, we will discuss physical therapy and how it could benefit you. Many insurance policies will cover physical therapy.

North Asheville Location

Orofacial/TMJ Disorder

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Orofacial/TMJ Disorder

In a study of over 45,000 American households, almost 22% experienced orofacial pain in the past six months. Nearly 40 million adult Americans experience orofacial pain on a regular basis. In addition, many children experience pain in their face, jaw (TMJ pain), and suffer from daily headaches.

Do you have TMD? Use this quick TMD Pain Screener to see if you could benefit from a consultation.

Treatable Conditions (including but not limited to):

  • Chronic Headaches/Migraines
  • TMJ Disorders
  • Trigeminal Neuralgia
  • Bell's Palsy
  • Post Surgical Orofacial Procedures (i.e. orthognathic surgery and mandibular fracture)
  • Cervical Spine Disorders
  • Asymmetric Mandibular Movements

South Asheville Location

East Asheville Location

Signs and Symptoms

Craniomandibular disorders (CMD) are characterized by a combination of symptoms that may include pain, tenderness and dysfunction of the temporomandibular joint (TMJ), the mouth and the occlusal contacts (how the teeth touch with closing), the cervical spine, and the muscles of chewing. Temporomandibular disorders (TMD) are usually treated by both a dentist who specializes in TMJ dysfunction and a physical therapist.

  • Headaches that begin in the back of the neck or the sides of the head
  • Popping or clicking in one or both sides of the jaw
  • Loss of jaw motion (normal movement is 44 mm)
  • Facial Pain
  • Difficulty biting or chewing
Orofacial
tmjmodel

How can Orofacial Physical Therapy Help?

Our Orofacial Physical Therapy approach includes an extensive examination of the jaw, mouth, neck and spine.

Following the initial physical therapy examination, the therapist develops a comprehensive treatment plan, which forms the basis of the physical therapy program.

 

Can any Physical Therapist Treat TMJ?

Yes. By State Regulations, any licensed Physical Therapist can treat TMJ dysfunction, but there is minimal training given for this complex problem in physical therapy school.

There are multiple continuing education courses that train a therapist to specialize in this area which goes beyond the basics. Before scheduling an appointment with any physical therapist regarding your TMJ issue, you should ask if the therapist has taken any continuing education classes specifically dealing with TMJ dysfunction as well as how often they are seeing TMD patients.

At Cornerstone Physical Therapy, our orofacial pain specialists Seth J. Fibraio, Sonya Anderson and Brad Basch are the only physical therapists in the Asheville area with advanced training in orofacial physical therapy.

They have completed advanced coursework with through the University of St. Augustine, the CRAFTA course series and through Dr. Mariano Rocabado, one of the World’s leaders in this field.

Please call our office with any questions or to schedule an appointment.