North Lincoln

Pelvic floor dysfunction and pelvic pain affecting both men and women can be treated with physical therapy by our Pelvic Physical Therapist, Michelle Spicka, DPT. Many men and women suffer from pelvic floor dysfunction, constipation, fecal incontinence, urinary incontinence, post surgical pain, postpartum pain, diastasis recti and chronic pelvic pain.

For more articles and information about Pelvic Physical Therapy and your specific symptoms, click on any of the links below. Note: We don’t expect you to know every possible thing about your condition—that’s our job. On the other hand, what you do know could help you get better and stay healthy.

Virtual Physical Therapy Sessions are forVirtual Physical Therapy Sessions are for:

• New Moms for which leaving the house is difficult
• Stay at home Moms with littles at home
• Busy working Moms who don’t have the hours to leave work and come to the clinic
• Women for whom transportation is difficult• Women with questions after gynecologic surgery (ex: hysterectomy, prolapse repair, bladder procedures)
• Women who have questions about pregnancy
• Women with questions about any postpartum issues

When you are dismissed from the hospital, home with your newborn, and you have unanswered questions about your new postpartum body, wouldn’t it be nice to chat with a professional about your issues?  Now you can!  You can set up a virtual session with Michelle Spicka, DPT at any time postpartum.  You don’t have to wait until you have your postpartum 6 week check up with your physician.  We can chat as soon as you want to!

Post Partum
• Recovery from cesarean birth
• Recovery from vaginal tearing/episiotomy
• Low back, hip, pubic bone, sacroiliac joint pain, tailbone pain
• Diastasis Recti/Abdominal wall muscle separation
• Pelvic floor muscle strengthening
• Core strengthening
• Posture with postpartum activities
• Urinary leakage (peeing your pants with coughing, sneezing, laughing, exercise, lifting, jumping etc) or urinary frequency
• Constipation
• Pelvic organ prolapse, pressure or heaviness in vagina
• Return to exercise (Best exercises for each couple of weeks/months)
• Return to intercourse (what may help)
• Referral to appropriate health professionals in your community

Pregnancy 
• Pelvic floor muscle strengthening
• Core strengthening
• Best exercises for each trimester
• Diastasis Recti/Abdominal wall muscle separation
• Sacroiliac (SI) joint or pubic bone pain
• Low back pain or hip pain• Pelvic pain/ pressure “down there”
• Painful intercourse
• Urinary leakage (peeing with coughing , sneezing, laughing, exercise, lifting etc)
• Constipation
• Preparation for vaginal delivery or cesarean section
• Referral to appropriate health professionals in your community

*Virtual consults are not covered by insurance but Health Savings Account (HSA funds can be used to pay for virtual sessions).  Virtual sessions are by phone or video.  Call 402-477-3110 to schedule your virtual Physical Therapy session.

Husker Rehab Lincoln’s large wellness center gym offers the newest cardiovascular, fitness and rehabilitation equipment to work out both the upper and lower body. The equipment uses body mass and gravity at different angles to promote resistance for strengthening in safe and controlled movements. We have included generous space between machines to allow easy patient access and minimize interference with other patients during exercising.

Preoperative physical therapy is becoming more of a normal course of treatment in the orthopedic world. In a world of skyrocketing insurance premiums, deductible and copays pre-surgical PT has been shown to decrease the cost of postoperative PT care by 29% for patients that have a total knee or hip replacement. A study conducted within the last 7 years revealed that 1-2 sessions of PT prior to hip or knee replacement surgery decreased the need for postacute care services such as skilled nursing or home health. Preoperative PT is important to instruct and educate the patient on what to expect with postoperative rehabilitation. Preoperative PT sessions tend to focus on functional activities such as transfers, walking, use of correct gait devices, use of adaptive equipment, bathing and other functional activities that will be affected by surgery.

Specific programs are developed in coordination with referring physicians to address the needs of the patient that will allow them to return home with as much independence as possible. This speeds the ability of the patient to return home with less assistance. Patients are educated on specific exercises to increase strength, motion and flexibility to speed recovery following surgery and in some instances to increase function prior to surgery. The goal of prehab or pre surgical physical therapy is to prepare the patient physically and mentally for the upcoming surgery.

Following surgery outpatient physical therapy will begin once ordered by the physician. Treatment may begin as soon as the next day but will depend upon each individual physician’s protocol. An individual and personalized treatment plan will be developed in coordination with your physician. At each appointment your progress will be evaluated to determine your next step in the recovery process. Our therapists believe strongly in providing patients with the resources to take control of their own rehabilitation process. Each patient will be instructed on a home exercise program that will be advanced as improvements in physical condition allow. The goal of post surgical rehabilitation is to restore each patient to their previous level of function.

Graston Technique® (GT) is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes.GT uses specially designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The use of GT instruments, when combined with appropriate therapeutic exercise, leads to the restoration of pain-free movement and function. The instruments also are used diagnostically to assess the kinetic chain, in an efficient manner using the principles of regional interdependence.

Physical therapists use dry needling with the goal of releasing or deactivating trigger points to relieve pain or improve range of motion. Preliminary research supports that dry needling improves pain control, reduces muscle tension, and normalizes dysfunctions of the motor end plates, the sites at which nerve impulses are transmitted to muscles. This can help speed up the patient’s return to active rehabilitation. Some states in the US are now utilizing dry needling in the emergency room to help decrease pain and the use of opioids. Dry needling has been used by therapists for years and is now being more widely accepted as a drug free alternative to relieving pain and restrictions.

 Deb Van Horn, LMT

Deb has been a licensed Massage Therapist since 1995 completing her training at the Myotherapy Institute. She has been part of the Husker Rehab. family for many years providing massage and also working part time in the front office in past years. She feels that working with the Therapists at Husker Rehab. both as an employee and a patient herself has helped her grow as a Massage Therapist.

Deb specializes in Swedish and Executive Chair Massage, her main focus is caring for others and beside her massage talents she is an in home care giver.
Deb has been a life- long Lincoln resident and enjoys spending time with her two children and three grandchildren. Her hobbies include sewing and gardening.

Specializing in:

Swedish / Executive Chair Massage

AMTA, Medical Referrals, State Licensed, Nationally Certified

Using our owners’ and senior therapists’ years of experience, we designed large, comfortable, private physical therapy and rehabilitation rooms at our Husker Rehab Locations to provide exceptional support for patients’ needs. We use treatment rooms for acute treatment and manual therapy.

In addition to therapeutic exercises, we tackle pain and function challenges with services such as hot packs to promote healing and muscular relaxation, electrical stimulation for pain relief and prevention of muscle loss, and ultrasound for treatment of inflamed or damaged tissue.

We encourage our therapist to attend postural restorative therapy courses so as to develop the appreciation of postural patterns and how it affects our everyday life. Understanding of the normal postural motion allows us to evaluate and find postural patterns that exist in all of us. When a pain or injury develops, these patterns will create the lack of ability of the body to heal properly and thus contribute to the ongoing pain and compensations. The knowledge and skill in understanding the importance of respiration, myokinetics, neuromuscular and postural imbalances are the key to getting clients back to their functional activity. Without postural neutrality, typical rehabilitation techniques may make patterns worse and contribute to more pain. Once neutrality is managed, progress to the home program and wellness centers will be guided and instruction in each program with postural emphasis will be discussed. Each exercise will need to keep the corrected postural alignment and position, and thus continued stability and core awareness going forward without the need of formal therapy. Once a client has achieved this goal, they can be discontinued from our care and continue independently.

Functional ergonomics is the daily exercise program and instruction that is given to a client with regards to their everyday activity while keeping the functional neutral positions and postures in the correct alignment.

When we think of ergonomics, we often think of workplace evaluations and how we do our job. And that is one component of the instruction. However work is only one place in which we develop these patterns and restrictions. Patients must learn how to not only sit at a desk but also learn how to get in and out of that chair each time they get up. How about driving your car to and from your work and how the postural position of your commute contributes to the poor postural patterns.

We discuss sleep positions to minimize stress to the hips, lumbar, thoracic, and cervical areas all while keeping postural alignment neutral. Proper support and position in the bed at the hips and waist, and in the cervical areas are key to minimizing stress to these areas no matter how good your mattress. The neck often needs special attention and the use of a postural pillow may be needed to assist in keeping the proper alignment.

Standing desks are one way in which clients are trying to minimize the effects of the seated position, however if you are standing in a torsional pattern with compensation, the standing position could be making your symptoms worse not better. Instruction is given for proper weight distribution in the LE’s and pelvic alignment to minimize these issues as well as further instruction in desk height and position to give good feedforward postural positions that promote neutrality.

The use of a laptop or phone versus the desktop provides its own postural challenges. Use of wireless keyboards, iPad holders, and supportive arm positions assist in keeping the cervical and lumbar spines in a state of relaxation and neutral positions without compensation. Specific instruction with both verbal and manual cues are utilized by your rehabilitation specialists to put you in a successful position to give you an opportunity to manage your posture with such activity.

Vision is such a vital role with the postural compensations and often is the driving force that leads to the inability to manage a neutral position. Placement of the monitor in the correct position is key to keeping a mid neck in neutral alignment however the most neutral position can be affected by a progressive lens or bi/trifocals. Several times the vision will drive the neck position in order to be able to focus on a screen and instead of being able to move the eyes, we simply move our entire head, usually in a non-favorable position that promotes loss of cervical lordosis and puts additions stress to the muscle of the cervical spine. Headaches and neck pain are promoted with these poor alignment and vision compensations as a result. Referral to your vision doctor may be needed to correct lenses so that the client can be successful at holding the proper position. For more difficult cases with vision, a neuro-opthamologist will need to evaluate further looking for midline shifts, anterior and posterior or left to right that could also play a role in the postural issues. Prisms will often be used to train the eyes and correct these compensation leading to less headaches and pain.

In the most difficult cases of facial pain and headaches, evaluation by a craniofacial specialist may be needed. Bite can play a crucial role in not being able to correct postural alignment, especially in the head and neck. If a client is not able to hold a corrected neutral position that the therapist is able to get them to and the vision is tested and is good with no issues, the bite may be the key component. Quick tests and specific questions direct us on the need for the specialist referral so as to get the client the assistance they need for long term management of their pain. Bite splints for day and night may be designed to assist the client and in more advanced cases, clients may require braces or other more advanced work to get the postural correction they need.

In summary, ergonomics is not the same as it was 20 years ago and the need for a therapist trained in postural restorative therapy and functional biomechanical- ergonomics is a must if one is really interested in correcting their posture and treating the cause of the pain, not just the symptoms.

Contact our therapist should you have any questions regarding your ergonomic assessment.