• Urinary incontinence/urgency
• Fecal incontinence/urgency
• Constipation
• Pelvic pain (penile and testicular pain)
  • Pain with intercourse
  • Pain with ejaculation
• Erectile Dysfunction
• Prostate cancer post-chemo/radiation
• Pre/post-prostatectomy
• And more!

Adaptive Equipment is an object or tool that promotes an individual’s independence in daily activities. Occupational Therapists (OT) can incorporate adaptive equipment education during treatments to enhance the performance of tasks that are meaningful to the individual. Adaptive equipment has its purpose across a broad range of conditions and ages that impact functionality. 

You may be wondering what the difference is between adaptive equipment and Durable Medical Equipment (DME).  DME is used for medical treatment and management that is usually covered by insurance. Some examples of DME include walkers, wheelchairs, hospital beds, and respiratory equipment. Adaptive equipment is meant to improve a person’s participation or independence, and is typically not covered by insurance. 

Here’s a short list of common adaptive equipment- 

• Long-handled Reacher: This tool is excellent for multiple purposes! This reduces the need to bend over, and can be for reaching items that are on the ground or out of arm’s reach, and even for lower body dressing. 
• Button Hook: Mainly used to fasten/unfasten buttons on shirts, dresses, cuffs, etc. This is a great tool for someone that has trouble with fine motor tasks, or only the use of one hand. Some button hooks also come with a zipper hook on the other end too!
• Hand Held Shower Heads: This showerhead is attached by a longer cord/hose that can be taken down by the individual, and can be aimed wherever you need it. A great product for even caregivers to rinse with ease or even help an individual bathe independently, by allowing them to clean effectively while seated.
• Toothpaste/Soap Dispensers: This is a great option that can be placed in the bathroom. An easy press button reduces the demand it can be to hold and squeeze a bottle. This option is great for someone with weak grip or only able to use one hand.
• Dycem: This is one of my favorites-  A dual sided non-slip material that is used to stabilize objects. This is great for preventing plates from sliding off the table, and it’s great to improve your grip needed for opening jars or bottles. Dycem can be cut to whatever desired size to fit all needs! 
• Built-up Handles: Thicker and wider handles can be placed on a wide range of utensils, such as- silverware, hair brushes, toothbrushes, and pens. A built up handle can ease the use of these items if there is a weakened grip/pinch or fine motor coordination. 

This list could go on and on, and adaptive equipment is continuously expanding. If you have questions about Occupational Therapy or how adaptive equipment could help you, schedule a consultation with our Occupational Therapist today by calling 269-459-6212!

Bell’s palsy causes a peripheral lower motor neuron palsy, which manifests as the unilateral impairment of movement in the facial and platysma muscles, drooping of the brow and corner of the mouth, and impaired closure of the eye and mouth. Bell’s phenomenon—upward diversion of the eye on attempted closure of the lid—is seen when eye closure is incomplete.

Increasing evidence implies that the leading cause of Bell’s palsy is latent herpes viruses (herpes simplex virus type 1 and herpes zoster virus), which are reactivated from cranial nerve ganglia. Sensitive polymerase chain reaction techniques have isolated herpes virus DNA from the facial nerve during acute palsy. Inflammation of the nerve initially results in reversible neurapraxia, but ultimately Wallerian degeneration ensues.  (Holland, JN, Weiner GM ( 2004) Recent developments in Bells Palsy. BMJ  Sep 4; 329(7465): 553–557)

Facial palsy affects upper motor neuron palsy which causes paralysis of the lower half of one side of the face. Though the prognosis is not 100% , some recovery may be possible if seen early.

How do we treat Bell’s Palsy at Rehab Specialists?

A comprehensive patient evaluation includes testing facial expressions, speech,  and sensory testing.

• Proprioceptive  neuro-muscular reeducation

• Facial reeducation exercises

• Stimulation of facial muscles using galvanic/faradic current

• Microcurrent point stimulation of the facial nerve (MPS)

• Muscle activation techniques

• Taping

• Mobilization of TMJ and cervical spine if needed

• A comprehensive facial home exercise program

At Rehab Specialists, our specialty-trained therapists have treated more than 200 patients with Bell’s Palsy, successfully restoring normal facial expressions, sensations, and normal speech.

Call us at 269-459-6212 or request an appointment via the website to see if you would benefit from our treatment. For those not able to travel to the clinic, tele-medicine may be available. Call us to learn more!

Before-treatment and after-treatment pictures:

Bell’s Palsy and Facial Palsy Therapy In Portage and Kalamazoo

Whether we are using our hands during athletics, working around the house/yard or to complete the demands of our jobs; our hands endure strain and stress on a daily basis. These daily activities can often lead to preventable injuries. Preventing hand injuries starts with knowledge and a few simple tips:

1. Perform daily stretches/warm-ups: Stretching the hands, wrists and elbows improves range of motion in the joints, increases blood flow and allows for smooth gliding of the tendons. Stretching and warming up either dynamically or statically will reduce the risk of muscle and tendon injuries. 

2. Increase Strength and flexibility: Strength training helps to improve muscle strength, endurance and flexibility. By incorporating a few hand and wrist exercises into your exercise routine you will be reducing the risk for injury to muscles, tendons and ligaments. 

3. Use proper equipment: Consider purchasing ergonomic tools in order to reduce the risk of injury. Ergonomic tools promote proper hand positioning, which results in decreased demands on the muscles and tendons. Some examples would be:

4. Be mindful of proper technique: It is important to pay attention to your body mechanics. Keep your wrists in a neutral position (not bent up or down for prolonged periods) and avoid repetitively bending the wrists. Place yourself close to the equipment you are working at to avoid awkward wrist and hand positions. And, pay close attention to proper technique with hands, wrists and elbows during sports activities. 

5. Avoid overuse: An overuse injury comes from constant repetitive movements and stress on a body part. If you are starting to feel fatigue and pain in your hands or wrists, it is important to stop and take a break. Learn to listen to your body and do not avoid these warning signs that your body is being overworked!

6. Schedule frequent breaks: As a rule of thumb, stand up and move around for at least 30 seconds for every 30 minutes that you sit at a desk job. If you are working on a repetitive task such as shoveling or raking, stop every 30 minutes for a short break.

It is important to listen to your body and pay attention to any pain you may have in your hands or wrists. If you are experiencing pain for greater than three weeks, it is a sign that you may need to seek medical assistance. Remember, pain is your body’s way of indicating that something is wrong and it should not be ignored. If hand or wrist pain persists, it is recommended that you see a hand therapist or your medical provider.

Low back pain can be a debilitating condition and it affects millions of people worldwide. While there are many potential causes of this condition, one factor that is often overlooked is the types of shoes that we wear.

The shoes we choose to wear can have a significant impact on our posture and the way we walk, which in turn can contribute to low back or leg pain. Let’s explore the connection between shoes and low back pain in more detail!

How Shoes Affect Your Posture

When we walk, our feet absorb the impact of each step we take. The way our feet hit the ground can affect the alignment of the rest of our body, including our hips and spine.

Wearing shoes with heels that are too high or too low can alter the way we walk, causing us to compensate for the lack of support. High heels, for example, force the feet into an unnatural position, putting extra pressure on the lower back. On the other hand, shoes that are too flat or lack arch support can cause the feet to roll inward, leading to overpronation, which can also cause low back pain.

Choosing the Right Shoes for Low Back Pain

If you suffer from low back, hip/knee or ankle pain, it’s important to choose shoes that provide adequate support and promote good posture. Here are a few tips to keep in mind when shopping for shoes:

1. Look for shoes with good arch support. This can help prevent overpronation and keep your feet in a neutral position. Most shoe manufacturers have groups of shoes that are meant for stability and would be a good choice for people with low or fallen arches. Look for the search bar on their websites and search the keyword “stability” to help find those options.
2. If you have a high arch or tend to supinate (walk on the outsides of your feet), it is best to choose a neutral shoe. These types of shoes provide the right amount of support and cushioning for those with high, rigid arches. Additionally, there are different levels of cushioning available in neutral shoes to suit your preferences on how responsive (low) or how soft (high) you want your ride to be.
3. Choose shoes with a low heel. While high heels may be fashionable, they can contribute to low back pain by putting extra pressure on the lumbar spine.
4. Avoid shoes that are too flat. Shoes without adequate arch support can cause the feet to roll inward, which can contribute to low back pain.
5. Consider shoes with a cushioned sole. This can help absorb shock and reduce the impact on your lower back.
6. Make sure your shoes fit properly. Shoes that are too tight or too loose can cause you to change your gait, leading to low back pain.
7. Make sure not to use the shoes for more than 1 year (everyday use).
8. Consider wearing supportive sandals while at home. 
9. Buying expensive shoes doesn’t necessarily mean that they are good for you.  
10.  A custom or off-the-shelf orthotic may be beneficial in cases where you wear a work boot, dress shoes or in shoes worn in high-impact sports.

Now, look at your shoes. Are they wearing out more on one side or near the heel? 

Imagine your car’s tires wearing unevenly. If you replace your tires without aligning or balancing them, they will wear out faster. If you have been suffering from foot/ankle, knee, or hip pain, have a professional look at your foot alignment before getting new shoes. 

In conclusion, the shoes we wear can have a significant impact on our posture and the way we walk. Choosing shoes that provide adequate support and promote good posture may help alleviate low back and leg pain and prevent future pain episodes. If you have low back pain that has lasted more than two weeks, do not ignore it. Most low back issues may resolve within a week with activity modifications and NSAIDS (anti inflammatory medications like ibuprofen or naproxen).  If you suffer from chronic low back pain, it’s important to speak with a healthcare professional who specializes in the spine to determine the underlying cause and develop an appropriate treatment plan. 

The role of the Occupational Therapist is to determine what activities of daily living skills (ADL’s) you are having difficulties with and establish goals to improve on your level of independence in these areas.

What are ADL’s?  ADL’s include but are not limited to:

• Dressing skills (including manipulating clothing fasteners, tying shoes)
• Grooming and hygiene (brushing teeth, washing face, applying makeup, brushing hair)
• Bathing/Showering
• Feeding yourself
• Household chores
• Work
• Handwriting, computer skills

The Occupational Therapist will interview you and assess your skill levels.  The OT will identify your strengths and weaknesses.  Based upon your symptoms and strengths the OT will teach you strategies to allow you to continue to do those ADL’s that are important and meaningful to you.  Often, the OT will focus on arm movements and fine motor skills to help improve on your ADL’s.

There are also specific exercises that are highly recommended in order to help maintain and improve on your mobility.  One of these specific programs is called the LSVT BIG  program.  At Rehab Specialists we have several PT’s, Physical Therapist Assistants and 1 OT all trained in the LSVT BIG program.  This is a specific movement based program to help improve on balance and mobility for those individuals with Parkinson’s Disease.  As part of this program the patient can be seen by both OT and PT in a joint effort to improve on both upper extremity and lower extremity movement.  The goals are tailored to the individuals needs and wants and are very specific to the patient.

At Rehab Specialists we do offer free consultations.  If you would like to discuss your concerns with an Occupational Therapist please feel free to call and schedule a consultation.  You may also discuss with your Primary Care Doctor or Neurologist the option to obtain a script for Occupational Therapy.

Blood flow restriction therapy is a recent “hot topic” in Physical Therapy. Blood flow restriction or BFR is a type of training technique that blocks blood flow to a muscle which, through cellular processes, creates protein metabolism and muscle hypertrophy or growth. 

One of the greatest benefits to using BFR is the fact that one can achieve clinically significant strength improvements. These improvements are traditionally seen through high intensity/high volume training, but can be achieved with low intensity exercise when in combination with BFR. In the physical therapy world, this can be a useful tool for those who may be unable to tolerate high load, but require strengthening or stabilization to aid in pain reduction such as those suffering from chronic pain. 

At this time, there are multiple different indications for using BFR in rehab such as post-operative recovery including knee replacement and ACL reconstruction. Blood flow restriction has even been shown to be beneficial in rock climbing! Rehab Specialists therapists are active in learning the evidence based research on BFR to be able to provide safe and effective treatment to their patients.

Additional Resources:
http://eds.b.ebscohost.com/eds/detail/detail?vid=2&sid=d3836fea-a074-4e3c-8ea4-dcb45b4234be%40sessionmgr101&bdata=JnNpdGU9ZWRzLWxpdmU%3d#AN=144916605&db=ccm

https://www.physio-pedia.com/Blood_Flow_Restriction_Training

https://www.youtube.com/watch?v=R96Ir3GoLqo

Millions of people every year are diagnosed with a Brain Injury.  Brain Injuries can be classified as Traumatic or Non-Traumatic.

Traumatic Brain Injuries can result from:

• Falls
• Assaults
• Motor Vehicle Accident
• Sports Injuries

Non Traumatic Brain Injuries can result from a result of lack of oxygen, exposure to toxins or pressure from tumors etc.

• Stroke
• Aneurysm
• Tumor 

No matter how mild or severe the symptoms are many people will experience visual disturbances of some kind.  These may include: 

• Blurry vision
• Double vision
• Eye strain, eye fatigue or headaches from reading or doing close work
• Words move around or appear to float when doing close work
• Lose your place when reading; skip words or the entire line
• Frequently bump into objects on one side of the body or fail to see an object on one side of the body (visual field deficit)
• Feeling anxious in crowded environments

An Occupational Therapist trained to evaluate your visual concerns can work with you to develop a treatment plan to help you improve on your daily activities.  The therapist may make recommendations on adaptations and changes to the environment such as increase the lighting in the room, enlarge the print on the computer, choose larger print books.  In the case of a visual field deficit (impairment to the peripheral field) the therapist can teach you compensatory strategies to improve on your visual search skills to prevent you from bumping into objects. Many strategies and exercises can be utilized to improve on reading skills and up close work as well.   The therapist may also recommend you see either an Optometrist or an Ophthalmologist for corrective lenses or prisms to reduce double vision, blurry vision or improve on how clearly you are seeing near or distant objects. 

 I have 20 years experience working as an Occupational Therapist and have extra training in this area of working with visual deficits following a Brain Injury.  I would love to help you return to doing the activities that are so meaningful to you.

Having urinary leakage pre and post childbirth is common, but it is definitely not normal! This includes leakage with coughing, sneezing, laughing, and exercising, and yes even jumping on the kids’ trampoline. About 1 in 4 women have reported this common pelvic floor dysfunction and reports keep getting higher with more awareness of this issue. Pregnancy and giving birth puts increased tension throughout the pelvic floor muscles which increases the urge to urinate and decreases the amount of control you have of the muscles around your bladder. The good news is that pelvic floor physical therapy is able to help eliminate and prevent issues such as urinary leakage- this means no more crossing your legs every time you cough and sneeze or wearing a pad “just in case.” Traditionally, after having a baby people were told to “keep doing your kegels”… however, research is showing that kegels are no longer the only answer and can actually increase the risk of urinary incontinence. It is recommended that after your 6 week postpartum follow up that you get checked by a pelvic floor physical therapist to see if you have any dysfunction that could be eliminated early on. You can even see a pelvic floor PT years down the road after having kids or if you have similar issues and have never given birth.

Knee and hip pain are common complaints amongst runners. However, pain in one area does not always mean there is an injury in that same area. Our bodies are all connected and this is amplified with running due to the high level of impact involved in this sport. 

There are 5 main classifications of running impairments as described by RunDNA. These include: Collapser, Weaver, Bouncer, Glute Amnesiac, and Over Strider. Individuals may fall into one or multiple different categories. Determining which classification you may be can be done  through gait analysis. This is beneficial to treating your specific pain and re-training correct running mechanics. 

While there are hundreds of muscles essential to running, there are certain ones that are “extra” important for both stabilizing and moving. Physical therapy aids in assessing weak muscle groups, reveals any abnormal length/tension relationships, and can find range of motion deficits needed for efficient and pain-free running. 

If you are a runner and struggling to maintain or reach your goals due to pain, Rehab Specialists can offer a free consultation or evaluation today (call 269-459-6212 to schedule!).