Certain moves prove therapeutic, rehabilitative
By John Quinlan
Tuesday, May 31, 2011
A passionate pelvic health specialist, Michele Kreisberg Palmer has brought a new look to physical therapy in Siouxland with Embody, the one-room clinic she opened last fall above Rebo's at Fourth and Court streets that is dedicated to holistic and inspired health care and well-being.
Through a variety of hands-on manual therapies, movement, breath, therapeutic yoga, awareness training and self-care practices, Palmer integrates traditional western medicine with eastern health practices and philosophy. This comes on top of her 16 years of manual therapy experience, a foundation for treating the root of pain and functional issues.
With a large Indian rug, a big ball, comfortably exotic artwork, earth colors and what appears to be a big bed as its centerpiece, this is not your ordinary medical office. Bright and vibrant, it looks inviting. The bed is a Rolfing massage therapy table. And that big ball? It's a useful exercise tool. It may seem more at home in Boulder, Colo., where she continues to operate a clinic one week each month (her move to Sioux City coming after marriage to entrepreneur Marty Palmer of Palmer Candy Co.) Embody opened aboout seven months ago.
With 18 years of experience in the body healing field, her early career as a massage therapist and yoga practitioner gave Palmer a different perspective when she entered the physical therapy field.
"With all the information that I had gathered before and my experiences, I then compiled it and took a much more holistic approach to physical therapy," she said. "And I specialize in areas where most physical therapists don't go into, which is pelvic health, women's health, men's pelvic health issues."
Men's issues, too
While a great deal of her work deals with women's health issues, from pregnancy and postpartum care to menstrual issues and vaginismus, men's pelvic health is a big priority.
She noted that men must often deal with misdiagnosed prostatitis, chronic pelvic pain or urinary incontinence. So she works holistically in a team approach with other health care professionals, when possible, in dealing with prostate issues in the bladder and rectal area, anything that's contained in the bowl of the pelvis and spine, as well.
"I do work with some traditional things like back pain and neck pain," Palmer said, "But I go again into those areas that a lot of men don't feel comfortable talking about ... or that their doctors don't know exactly what to do with them."
Some medical professionals may insist, for instance, that the problem is prostatitis.
"With an 'itis' and an inflammation, they think that there is a bacterial infection. So a lot of times they continue to give maybe up to 6 months of antibiotics to the man," she said. "And that's not necessarily the problem. Unfortunately, there are other issues, a lot of them musculature in nature, that can reproduce symptoms that might look like what he is having is prostate issues, which would be constant urination or painful ejaculation or painful intercourse or frequent urination in the night, nocturia."
In such cases, Palmer looks at the pelvis, its structure, movement and alignment of the bones.
Mysteries of the pelvis
Men and women often fail to understand what goes on in the pelvis.
For men, the problem could simply be a chronic shortness in the pelvic floor muscles, depriving them of the ability to relax, she said. And not having the ability to relax can impact normal urinary function because of the relationship between the pelvic floor and the bladder. So when the pelvic floor is too tight and doesn't know how to relax and shut off, it simply confuses the bladder, she said.
"You know how women's health always used to be the sleeper," she said. "I used to say there's a lot of information about women's health issues. There is more information about that now than there is for men's pelvic health issues."
Her interest in pelvic health issues came from her work in Boulder when she noted that patients simply didn't talk about certain issues, like the pelvis and the birthing process and maybe urinary issues or bowel and bladder issues. "Painful intercourse is another big thing that I work on with women. No one was talking about it," she said.
"And if you look at the rest of the body, the rest of the body is informed by the pelvis, in my mind. So there might be issues elsewhere in the body. But if we're not looking at the relationship on how the pelvis sees the spine, we're missing a pretty important piece of the puzzle."
She does a lot of hands-on body work, applying visceral manipulation, an osteopathic technique, to the physical therapy techniques she learned first. She has also studied Arvigo techniques of Maya Abdominal Therapy, combining what she considers the best of many worlds. That includes yoga therapy and Myofascial Release.
It's about education
Since no one practitioner can put it all together, she said a multidisciplinary team approach, looking at it holistically, is the only way to go. It works in Boulder where she confers with physicians, some of them very non-traditional, urologists, gynecologists, acupuncturists, midwives, birthing professionals, doulas, massage therapists, Pilates and yoga instructors and chiropractors. She said she hopes to build such relationships among Siouxland's medical professionals as well.
"For me, it's really about education, teaching people and practitioners that there are options out there that maybe even the doctors themselves usually are not fully aware of," she said.
And while doctors are a big part of the team, "super-important" she said, she wishes more would be willing to recognize the other players.
The pelvis, she admits, is a "scary" part of the body. And as a physical therapist, she is licensed to work internally, both vaginally and rectally. Yet that kind of work remains optional, depending on the comfort level of the patient.
"My big goal is to send people home with things to do so that they can take care of themselves, so that I can empower them to participate in their health care," Palmer said.
It could be exercise, yoga, self-massage. Whatever the take-home remedy, it is geared to each individual.
Even candy has its place. As Palmer puts it, "There's a time and a place for everything."
