Do you treat anything else, besides the pelvis? Yes, we do!
We have been asked if we treat conditions other than the pelvis and the answer is yes, with details below. Recall that before becoming a pelvic health specialist Dr. O’Keefe worked in general orthopedics treating all joints and conditions. She has a subspecialty in spine care and remains a member of the orthopedic section of the American Physical Therapy Association. Her advanced manual therapy techniques and exercise-based methods to coordinate your body’s muscles and improve strength, joint mobility and range of motion are able to be used to treat conditions anywhere in the body. Additionally, her wholistic approach, which looks at the body as a coordinated system, lends itself to her ability to treat areas outside of your pelvis. She utilizes strength and conditioning exercises and movement-based range of motion and flexibility exercises, as well. She has remained an avid reader of orthopedic physical therapy research updates and offers you uncommon experience in addressing the conditions you will read about below. Don’t see your condition here and wondering if Dr. O’Keefe can help you? Give her a call at 616.516.4334 and we can have a short conversation regarding your needs. Dr. O’Keefe does not like to waste people’s time, if she believes she cannot help you she will let you know.
We use our treatment techniques to also treat conditions outside of your pelvis. Here are some examples:
Temporomandibular joint dysfunction: TMJ syndrome. It turns out that a lot of people with pelvic problems also have TM joint issues. During her education, Dr. O’Keefe completed an extensive project regarding physical therapy evaluation and treatment for TM joint problems. She presented this project, which included a deep dive into the research and treatment methods, to experienced physical therapists to provide them with education on what was then a little-known condition. Thus, began her interest in the TM joint. As she gained experience working in outpatient orthopedics, she noticed neck patients who also had TM joint problems and was able to treat them. Her advancement to a pelvic health specialty revealed that a good number of patients would ask her if she could treat their TM joint. Yes! Dr. O’Keefe can help you with your jaw problems. She has worked with many people and has collaborated with their dentists, as well. The TM joint is a complex system and regaining normal jaw movement can be achieved through the help of Dr. O’Keefe. If you have TM joint clicking, popping or shifting, difficulty fully opening your jaw, inability to fully close your jaw, tenderness, facial pain or ear aches or neck pain, Dr. O’Keefe can evaluate you and develop a treatment program to improve your jaw. The hands-on techniques that she uses are a hallmark of the treatment that Dr. O’Keefe offers for TM joint syndrome. You can expect manual therapy, myofascial mobilization, gentle joint mobilization and trigger point release to your thoracic spine, neck, face, skull and TM joint. Together we are working to resolve trigger points, gently mobilize your joints, optimize fascial lines from the spine to the head, neck and jaw, and to relax/release your jaw so it can fluidly move. You will be given exercises to complete at home to restore your jaw health and function. You also will be provided information on protective behaviors for your jaw and how to avoid aggravating your condition. And, if you also have a pelvic health condition, you may notice treating your TM joint helps ease some of the pelvic problems going on. These things can be related in ways we might not expect!
Hip labral tears, hip problems, hip arthritis: The hip is part of the pelvis, so technically this is still a pelvic condition, and we want to be clear that we have advanced training and offer treatment techniques to address your hip problems. If you are limping around, having trouble with stairs, are unable to run anymore and are tired of your hip pain, Dr. O’Keefe can evaluate and treat you to address your hip problems. Hip arthritis can throw off your pelvic floor, low back, knees, balance, gait quality and pelvic strength. We can help you address these issues. And, yes, even if you have a hip labral tear that was seen on MRI, physical therapy can help. In fact, research shows that a lot of people have hip labral tears on MRI, but they don’t all have pain. Please avoid jumping into surgery based on an MRI finding, physical therapy is strongly recommended as a first place to start. We don’t treat MRI findings, we treat what we see and find in your body through our evaluation and testing measures, which are comprehensive and not isolated to your hip.
Neck pain: Dr. O’Keefe’s extensive training in advanced neck and back treatment allows her to offer you gentle, effective techniques to alleviate your neck pain. She has worked with many people with cervical radiculopathy, neck arthritis, neck stiffness and tension headaches. Because her techniques are a strong combination of active range of motion, exercise and hands-on manual therapy, using trigger point release, gentle joint mobilization and fascial mobilization, you can expect your appointment to help alleviate your muscle and joint tension. You will be provided customized exercises to complete based on the findings of your neck mobility at each appointment.
Cervicogenic headaches: These headaches can be awful! They are caused by your neck and often have a hallmark characteristic of pain extending from your neck or base of your skull and up into the back or top of your head. Dr. O’Keefe will evaluate you to determine contributing factors to your headaches. Often, she finds neck stiffness, muscle guarding in the head and neck, weakness in some of the deep neck muscles and non-optimal daily habits related to posture and head/neck alignment. She will work with you to restore fascial lines of pull, joint mobility, muscle tension, trigger points, and postural and activity habits that contribute to your headaches. You can expect a strong amount of hands-on manual therapy advanced techniques combined with exercises that focus on joint mobility, fascial lines of pull, strengthening of the deep, intrinsic neck muscles and the upper back muscles. You will be given home exercises to complete to augment what we do in our appointments.
Ehlers-Danlos Syndrome (EDS): Individuals with EDS have come to Dr. O’Keefe for their underlying pelvic health problems and/or chronic pain. Ehlers-Danlos syndromes involve connective tissue disorders that vary and may result in hypermobility of joints, skin hyperextensibility and fragile tissues. At present there are 13 subtypes of EDS and your signs and symptoms are matched to your subtype and each type has a distinct problem weakening the connective tissue, leading to structural problems within the body. In some cases, especially with joint hypermobility, an individual will experience chronic, debilitating musculoskeletal pain. Other individuals have scoliosis due to the kyphoscoliosis type of Ehlers-Danlos Syndrome. We will sit down with you during your evaluation to get a comprehensive understanding of all of your signs and symptoms and to learn what your goals are so we can develop a treatment plan centered on you, your goals and your needs. While the research does not provide clear evidence for one best way forward to treat an individual with EDS who has chronic pain, we do know the underlying science of helping chronic pain and protecting joints. By partnering with you, creating a safe, patient centered treatment plan, we aim to help you feel better and reach your goals. Individuals with EDS can experience chronic pain. This is where Dr. O’Keefe’s advanced training comes into play. Dr. O’Keefe understands the unique nature of working with individuals with chronic pain and avoiding activating the brain centers that already have long-term activation related to pain. In particular, for people with Ehler-Danlos Syndromes, we must be very careful to protect your joints and avoid worsening your connective tissue loads. Manual therapy techniques we offer can help change the input that is going from your body to your brain; therefore, we do use these hands-on techniques in a gentle way, respecting that you have underlying vascular and connective tissue abnormalities. We have to be careful and progress gently with individuals with EDS. Our training in dry needling can be of particular help with individuals who have Ehlers-Danlos Syndrome because it helps alleviate trigger points. We also use therapeutic pain neuroscience education in our approach to individuals with EDS and anyone we treat with chronic pain. We will partner with you to determine what is the best approach, what gives you relief of your pain and to teach you how to move in ways that are optimal for your safety and wellbeing. We know that “motion is lotion”, meaning you need to move, but we have to work together to determine how to best get you moving. We do not use joint manipulation with individuals with EDS.
Frozen Shoulder (adhesive capsulitis): Dr. O’Keefe has treated many people who have frozen shoulder. It can be a frustrating condition that has a slow evolution and resolution. A hallmark of this condition is trigger points in the shoulder girdle and/or neck and back. Dr. O’Keefe’s background includes a strong emphasis in general orthopedics physical therapy, including treating all shoulder conditions such as shoulder impingement, rotator cuff tear, labral tears of the shoulder and adhesive capsulitis (frozen shoulder). She offers this experience and her advanced training and techniques in myofascial manual therapy, joint mobilization and trigger point release, including dry needling, to her patients who have frozen shoulder. Exercise to include strengthening, stretching and gentle range of motion are also provided and instructed for your home program. If you are looking for another method to address your frozen shoulder, in particular the addition of dry needling and manual therapy to promote restoration of your joint biomechanics as well as trigger point and myofascial release, you have found the right place.
Balance deficits: Dr. O’Keefe has worked with many people to address their fear of falling and balance deficits. Her university training actually included several semester classes called “Falls in the elderly”. She takes falling and fear of falling seriously and has noticed that balance deficits can be persistent in people and they don’t know what to do about them and sometimes don’t even recognize their balance is off. As women go through menopause, maintaining the integrity of their balance system is very important to avoid fractures, given the bone loss that occurs when estrogen levels naturally decline. If this is speaking to you, Dr. O’Keefe offers you a safe place to be evaluated and to develop meaningful treatment interventions to address both your static and dynamic balance. Having trouble keeping your balance when reaching overhead? We have exercises and techniques to help address this! Not confident when walking on uneven grass or at the beach? Feel like you are too wobbly in your yoga poses? Dr. O’Keefe’s balance-focused exercises can help restore your confidence. Remember, the pelvis is a strong stabilizer of your body during all activities. Dr. O’Keefe uses her training in core strength and the vestibular and proprioceptive systems to design a treatment program for you. This program will challenge the multiple aspects of your balance system to improve your body’s coordination and response to dynamic positional changes and to enhance your stability.
Breathing enhancement manual therapy & exercises: Have you experienced a coronavirus illness and now find that your breathing is impaired? Have you recovered but would like hands-on treatment and exercises to improve your breathing? Do you feel tension in your midback, pain in your neck or difficulty effectively engaging deep breaths? Dr. Maureen O’Keefe has been treating and teaching patients how to improve their breathing for years, when working with neck, back and pelvic patients. She offers these services to individuals who, following recovery from their Covid infection or other illness, continue to struggle with breathing. Your cardiovascular pulmonary systems generate the oxygen supply for your body, including your muscles. If you find yourself short of breath, feeling weak and unable to function at the level you desire, working on your breathing to optimize oxygen to meet the demands of increasing activity can help you to improve your function. We will work together to improve your ability to:
- Take deep breaths
- Effectively use your primary breathing muscles and reduce non-optimal breathing techniques or habits
- Move your ribs to allow for full expansion of your lungs
- Coordinate your breathing and deep core muscles with the rest of your system during functional movements and activities
You can expect a combination of very specific manual therapy methods to address your lymphatic system; joint mobility between your thoracic spine, ribs and sternum; diaphragm engagement; visceral mobilization, connective tissue mobilization and trigger point release. You will perform exercises designed to facilitate effective and deeper inhalation and slow, relaxed, complete exhalation by working through various postures, activities and movements. We also will work to improve the non-optimal recruitment of accessory breathing muscles, including those that contribute to neck pain and tension, so that your diaphragm serves as your primary muscle of respiration. You may also benefit from biofeedback heartrate variability coherence training to facilitate balance within the autonomic nervous system. These hands-on and movement-based services are for individuals who are in post-Covid recovery (or other illness that altered breathing mechanics) and desire a high level of specific manual therapy methods and exercise instruction to enhance breathing. Dr. O’Keefe does not work with individuals who are actively fighting Covid, unless it is via telehealth. If you have Covid, Dr. O’Keefe can perform a telehealth appointment to evaluate your breathing and provide you instruction in how to use some of these methods (hands-on techniques, exercises, postures and movements) on yourself.
We are proudly located in Grand Rapids, Michigan and are here to serve our community in the fluid ways that may emerge. We offer flexible scheduling and make every effort to get you seen right away. P.S. We’ve also followed physical therapy professional updates on Post-Covid bowel and bladder issues. So, if this is you, we’re here to help that, also.
Don’t see your condition or concern on this list and wonder if Dr. O’Keefe can help you? We are here to answer your questions. Please give us a call at (616) 516-4334 and we can determine if we might be able to help you. We know the strengths of our training, experience, techniques and programming and if your condition will not benefit from what we offer, we will let you know this.