of some of the therapy services offered by Lizanne:
patient receives Lizannes personal attention with hands-on
therapy, expert advice and education. Treatment programs include
continual reassessment, resulting in a unique session that
is perfect for you alone.
select from the list below to read a detailed description.
list is not comprehensive, but serves as a guide for potential
clients who are interested in what Lizanne does. Please contact
Lizanne via email or phone to discuss your needs prior to
scheduling an appointment.
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Mobilization of the Spine and Extremity Joints
Passive joint mobilization is an integral part of manual therapy.
It is used when there is stiffness, pain, or lack of function
in a joint. Frequently, after a joint is passively moved by
a therapist, the individual experiences less pain, more active
movement, and increased function. When joints are free, it
helps the surrounding muscles relax and it helps align that
region of the body, thus allowing one to heal more quickly.
For example, after an auto accident, the injured person might
have a very stiff neck. After a thorough assessment, it might
be appropriate to gently traction or move the neck bones to
allow more range of motion and decrease the neck stiffness
and pain. Any joint in the body may be mobilized.
Nerve mobilization is a fancy way of saying moving or stretching
a nerve. Nerves can experience tension, just like muscles.
But unlike muscles, nerves are more fragile and need to be
mobilized very carefully, and only after a sound assessment.
People with certain kinds of repetitive stress injuries or
sciatica often benefit from good nerve mobilization in addition
to other kinds of manual therapy.
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Myofascial release, deep tissue work, cross friction massage,
scar tissue massage are just a few types of soft tissue mobilization.
Almost everyone benefits from some form of soft tissue work.
Muscles often spasm and contract during trauma or in response
to insidious injury or poor posture. It is important to get
them worked out and to follow through with good stretching.
Ligament, and Other Soft Tissue and Connective Tissue Rehab
There are good and not-so-good ways to work with tendons and
ligaments. They require certain types of therapy. Tendon injuries,
if severe, can take up to 12 months to heal! Tendons also
need certain progressive exercises to build themselves up
after injury. It is important that clients understand the
nature of their injuries so that they dont re-injure
a weakened structure.
and Flexibility Training
At some point, everyone has either stretched or done some
kind of physical strengthening exercise. After ones
pain is under control, an individualized home program becomes
a way to self-manage ones own injury. Frequently, stretches
and strength exercises are provided.
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Functional skill training encompasses many things. It might
mean working with an individuals gait, ones posture
at work, or ones ability to bend and lift correctly.
Frequently there is a need to return to work or sports, and
a regular strength program isnt enough. It becomes important
to retrain an individual very specifically for certain tasks.
Not only is it vital to regain strength, flexibility and movement
after injury or illness. It is equally important to regain
the subtleties of movement. Neuromuscular re-education implies
a way of teaching an individual to fire the right number of
neurons at the right time for the correct duration of time.
Its tricky business getting the timing, balance, and
strength all coordinated. We use balance exercises, like on
a ball or roller. We can also perform special exercises that
train us to re-think the way we move. Sensory awareness and
movement awareness techniques help with this too.
Cranio-sacral therapy is a way of working with the fluid system,
which surrounds our nervous system. It is an extremely gentle
and calming hands-on technique. It is often beneficial for
those who cant tolerate much touch, for example immediately
after a trauma, or for those in severe pain. It is also great
for clearing areas of swelling. It has a somewhat mobilizing
effect on the nerves and connective tissue.
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The Arvigo Techniques of Maya Abdominal Therapy
"The Arvigo Techniques of Maya Abdominal Therapy TM (ATMAT) for the reproductive and digestive systems is an external, noninvasive, manipulation using only the hands to reposition reproductive organs and improve blood flow to digestive organs." (from The Arvigo Techniques of Maya Abdominal Therapy Professional Care, level 2 Manual Sixth ed. p. 19)
This gentle, yet powerful modality is used to enhance other techniques used for a variety of issues, including pelvic organ prolapse, constipation, reflux, pelvic pain and other colorectal and urogenital problems. Patients learn how to perform their own self-care using these techniques. For more information see https://arvigotherapy.com
and Sensory Awareness Training (Somatic Education)
Awareness training is just what it sounds like. It is a way
of helping a person become more in tune with his/her physical
and/or emotional sensations. Sometimes, after trauma or after
being in pain for a long time, we learn to block out certain
sensations or feelings. Sometimes, there are negative
feelings like anger or resentment that are held in the body
and we experience these feelings as bodily pain.
Or, we can lose awareness of our actual bodily postures. For
example, a woman who works on a computer all day may have
no idea that she is sitting in a dangerous posture, which
is a major factor of her neck and arm pain. There are myriad
exercises and ways of working with people to increase their
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Frequently when we understand the etiology and physiology
of our pain, we experience less of it. We also have to learn
to work with our fear of contributing to ongoing pain. For
those individuals with severe, chronic pain, it is important
to live as normally as possible. Usually, for these people,
it is unlikely that actual damage occurs in the old painful
areas with normal activity. Yet, often we modify our behavior
and develop patterns of movement, postures, and belief systems
that only feed into the pain. In some instances, it is possible
to re-train the brain to decrease ones experience of
pain. This becomes the core feature in creating functional
goals to manage pain and loss of function resulting in an
increase in quality of life.
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A more appropriate term for this therapeutic approach would be “visceral fascial mobilization.” This hands-on technique is a form of myofascial release, but instead of working on muscle we target the fascia, ligaments, and connective tissue that surround our ‘viscera,’ or organs. For example, in people with chronic psoas tightness I might check the kidneys, sigmoid, and cecum—their fascia lies along or near the psoas muscles.
Fascia is rich in nerves and often responds to a type of touch that engages with those nerves or the broader nervous system. We do this by accurately assessing the direction of the restriction and working with it, rarely against it. By engaging with the person’s own restrictions (as opposed to fighting against them, say with deep tissue massage or cross friction massage) the practitioner encourages the patient’s inherent self-correcting systems to assist in the release work, and the effects can be quite long-lasting. Visceral mobilization is usually performed as an external technique, although there are internal techniques for the urogenital region. Patients may experience a range of palpation from very light to quite deep, but the techniques themselves are usually subtle and comfortable.
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Biofeedback or sEMG
Biofeedback is a process of gaining improved awareness over a body part or bodily function. Often equipment is used to help us achieve this improved sensation—think about electrodes attached to the head monitoring muscle tension in the treatment of migraines for example. But biofeedback can be as simple as touching the body part we want to stimulate to bring more attention to it.
For my patients with pelvic floor issues I use biofeedback both for up-training—to improve motor control, and down-training—to calm & reduce muscle tone and ease pain. There is a great deal of evidence supporting its use with pelvic floor dysfunction. I use a Pathway dual channel MR-20 biofeedback unit that connects to my computer so that we have a large, colorful visual of what your pelvic muscles are doing in real time. I enhance this with guided imagery and visualization techniques as well as manual therapy.
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Electrical stimulation, or E. Stim, or NMES (neuromuscular electrical stimulation,) is the process of using electrical currents to affect/stimulate different types of nerve endings to treat a variety of neuromuscular problems. In my practice, I use E. Stim for Stress Incontinence, Urge Incontinence, and Mixed Incontinence. It can also be used to treat pelvic pain. We use internally placed vaginal and rectal electrodes. The sensation ranges from subtle to more strong pulsations that the patient controls herself.
Rectal Balloon Catheter Bowel Retraining
Rectal Balloon Catheter Retraining sounds like exactly what it is. I gently insert into the rectum a small medical grade "balloon" equipped with a little straw in it for inflating, which is done via an air-filled syringe. For those with bowel problems, such as difficulty feeling bowel urge, being overly sensitive to bowel urge, or problems evacuating stool, this modality can be enormously helpful in re-training the person to notice, feel, tolerate, or better evacuate their poop. It’s really not as bad as it sounds!
A word about Home Exercise Programs. If you’ve been to PT before, you’ve no doubt been given a home exercise program (HEP). Often it’s a cornerstone of therapy—a way to encourage a patient’s active participation. Often I’ll hear my patients say, “I saw a PT and all she did was give me a HEP. She never even touched my back!”
First, I always work manually, except in rare situations when it isn’t indicated. Research overwhelmingly supports the use of manual therapy for almost every musculo-skeletal condition there is! Second, my HEP’s are extremely individualized and are often an extension of what the treatment has been. They are an active and dynamic thing—not a once-given and forgotten-about thing. I often make things up on the spot to try to replicate what I’ve just done with a patient. My HEP includes do’s and dont’s. It might include “rescue poses” for my pain patients—positions or postures you can try if you have a painful flare. It might include breathing exercises for calming the nervous system. It includes multiple ways of doing a particular stretch, so you can do it at home or at your desk at work. I modify things often, change things that don’t work, simplify things if you just don’t do it, advance things if you are motivated and work hard. My goal for your participation is for you to be well as soon as possible and for you to realize how much control you have over your own healing journey. As much as I LOVE to see you each week, I want you to find your own way as soon as possible!
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