Monday, August 1, 2016

The ART of Physical Therapy


For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

Many times, my patients have questions about what I’m feeling or treating when I work with them. Most people know that physical therapists work with problems within the body, but in my line of practice, people are often befuddled about how and why they were sent to me in the first place. I am going to tell you a little bit about how we (physical therapists) view the patient, how we see and feel their problem and how we justify the treatments that we do.

The first thing physical therapists do is realize that we are treating a whole person, not just a hip, or a bladder, or a sciatic nerve, for example. We understand that the things going on inside your body — what is happening in all your organs and tissues — has influences on neighboring, regional and distant areas of your body (so please, do not be too put off if I’m intrigued by your big toe when you were referred to me for your low back pain). For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

There is an ART to what physical therapists do, both literally and figuratively. Please let me explain: ART stands for Asymmetry, Range of motion and Tissue texture change.

Asymmetry means that your right and left sides don’t match. So, when I’m evaluating a woman with any number of problems, I will check to see if her shoulders rest at the same height, if her arms are the same distance away from the body when she is standing up, if the hips are level, and/or if the feet are both pointing straight ahead. When there is a remarkable difference between left and right, I make a note of it and see if it may be part of a larger problem.

Range of motion refers to how much your joints move. When I evaluate someone with knee pain for example, I will measure how much her knee moves with an instrument called a goniometer. I will take that measurement and compare it the corresponding knee on the other side, and I will compare it to documented “normal” measurement for her age.

Tissue texture refers to the relative health of anything that I may be evaluating: muscle, nerve, fascia, ligament or tendons. Even bone has a particular texture or feel to it. In general, healthy tissue is soft and resilient (even bone has a softness to it). For example, if I am palpating (feeling with my hands) muscle tissue, I may be feeling something soft and then suddenly something hard. Depending on the anatomy, that particular finding could be completely normal, or it could be a problem.


Once I have evaluated the ART in my patient, I can put the pieces together, come up with a working diagnosis and explain to the patient what we are going to do to reduce pain, restore function, and get her on the path to living a happier, healthier life.


About PT Center for Women:
Michelle Landsverk is a licensed physical therapist at PT Center forWomen and has practiced the art of manipulative medicine for over 20 years. She specializes in a combination of modalities such as craniosacral techniques, myofascial release, joint manipulation, soft tissue and visceral mobilization, along with therapeutic exercise as an adjunct to manual medicine.

Michelle began her training at Marquette University where she received her Bachelor’s Degree in Physical Therapy. She then completed the osteopathic manipulative medicine series of courses through Michigan State University and in 2008, she graduated from Concordia University with her Physical Therapy Doctorate. Recently, she finished the Barral Institute curriculum for visceral mobilization and continues to attend conferences to sharpen her skills at osteopathic manipulative treatment.

Michelle’s interest in women’s health came from her own experience as a patient during pregnancy. From her labor and delivery, to her postpartum stages, she found a passion for attending to the special needs of females. She recognizes the importance of understanding her patients’ concerns and listens closely before evaluating and designing an appropriate treatment plan.

To learn more about Michelle’s physical therapy services, visit www.ptcenterforwomen.com or call 920-729-2982.

The ART of Physical Therapy

For everything is connected, and just like dominoes, things can stand together and they can tumble down together.


Many times, my patients have questions about what I’m feeling or treating when I work with them. Most people know that physical therapists work with problems within the body, but in my line of practice, people are often befuddled about how and why they were sent to me in the first place. I am going to tell you a little bit about how we (physical therapists) view the patient, how we see and feel their problem and how we justify the treatments that we do.

The first thing physical therapists do is realize that we are treating a whole person, not just a hip, or a bladder, or a sciatic nerve, for example. We understand that the things going on inside your body — what is happening in all your organs and tissues — has influences on neighboring, regional and distant areas of your body (so please, do not be too put off if I’m intrigued by your big toe when you were referred to me for your low back pain). For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

There is an ART to what physical therapists do, both literally and figuratively. Please let me explain: ART stands for Asymmetry, Range of motion and Tissue texture change.

Asymmetry means that your right and left sides don’t match. So, when I’m evaluating a woman with any number of problems, I will check to see if her shoulders rest at the same height, if her arms are the same distance away from the body when she is standing up, if the hips are level, and/or if the feet are both pointing straight ahead. When there is a remarkable difference between left and right, I make a note of it and see if it may be part of a larger problem.

Range of motion refers to how much your joints move. When I evaluate someone with knee pain for example, I will measure how much her knee moves with an instrument called a goniometer. I will take that measurement and compare it the corresponding knee on the other side, and I will compare it to documented “normal” measurement for her age.

Tissue texture refers to the relative health of anything that I may be evaluating: muscle, nerve, fascia, ligament or tendons. Even bone has a particular texture or feel to it. In general, healthy tissue is soft and resilient (even bone has a softness to it). For example, if I am palpating (feeling with my hands) muscle tissue, I may be feeling something soft and then suddenly something hard. Depending on the anatomy, that particular finding could be completely normal, or it could be a problem.


Once I have evaluated the ART in my patient, I can put the pieces together, come up with a working diagnosis and explain to the patient what we are going to do to reduce pain, restore function, and get her on the path to living a happier, healthier life.


About PT Center for Women:
Michelle Landsverk is a licensed physical therapist at PT Center forWomen and has practiced the art of manipulative medicine for over 20 years. She specializes in a combination of modalities such as craniosacral techniques, myofascial release, joint manipulation, soft tissue and visceral mobilization, along with therapeutic exercise as an adjunct to manual medicine.

Michelle began her training at Marquette University where she received her Bachelor’s Degree in Physical Therapy. She then completed the osteopathic manipulative medicine series of courses through Michigan State University and in 2008, she graduated from Concordia University with her Physical Therapy Doctorate. Recently, she finished the Barral Institute curriculum for visceral mobilization and continues to attend conferences to sharpen her skills at osteopathic manipulative treatment.

Michelle’s interest in women’s health came from her own experience as a patient during pregnancy. From her labor and delivery, to her postpartum stages, she found a passion for attending to the special needs of females. She recognizes the importance of understanding her patients’ concerns and listens closely before evaluating and designing an appropriate treatment plan.

To learn more about Michelle’s physical therapy services, visit www.ptcenterforwomen.com or call 920-729-2982.

Thursday, March 31, 2016

Meet Kali!


Hear why she is thankful for the midwifery services at Women's Care!


I became a first time mom to my beautiful daughter Brylee about 8 months ago and I was blown away with the care my husband and I received at Women’s Care of WI. We unfortunately lost a pregnancy at 8 weeks – this was a few months before we found out we were pregnant with Brylee – and Becky was there throughout that experience to support us. It was a very difficult time, but it was made easier by the caring and helpful staff at Women's Care. This is why we decided to continue care here as we continued our journey to get pregnant.

I am a practicing chiropractor in Neenah and I really wanted to have a provider that supported my requests for more natural decisions throughout my pregnancy and during the birth. My husband was uncomfortable with a home birth, so a great compromise was to deliver in a hospital with the guidance of a midwife.

Becky Kahler was an amazing guide and resource throughout my pregnancy and did an awesome job explaining the reasons why we should or shouldn't do certain things. She supported my natural mindset but also made sure that I knew what the supporting research showed.

I had complete confidence in Becky's ability to help me deliver my daughter and because of that I felt ready to become a first time mom. Brylee came quickly after only 6 hours from my water breaking to delivery and I was able to deliver completely naturally, without epidural, a beautiful 9 lb 3 oz girl!

I recommend Women's Care, and specifically Becky, to all of my friends and family that are looking for great women's healthcare. These are all the reasons I am thankful for Women’s Care of WI!

Friday, January 15, 2016

Cervical Cancer Screening


New Pap Smear Screening Guidelines...


In the fall of 2012, 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met to review and update the cervical cancer (Pap smear) screening guidelines. They reviewed data that included the following information:


- Invasive cervical cancer deaths have been reduced by 70% in the U.S. over the past 50 years.

- New Pap smear screening technology (liquid based testing) has become available. These new technologies provide greater sensitivity to detect precancer and cancer.

- Current evidence shows that HPV (Human Papillomavirus) causes cervical cancer. Research demonstrates that most young women will clear cervical HPV without intervention.

- Cervical cancer is a slow growing cancer, often taking many years to develop.


The American Cancer Society, American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology worked collaboratively to examine the data while the U.S. Preventive Services Task Force performed an independent evaluation of the data. It is reassuring to see that these endeavors resulted in essentially identical recommendations. The purpose of the new recommendations is to maximize the benefits of screening tests while minimizing potential harm (psychosocial impact, additional clinical visits and procedures, and treatment of cell changes that would naturally resolve on their own). The following are the most up-to-date cervical cancer screening guidelines:


  • Begin screening by Pap smear at age 21
  • Ages 21-29 - Pap smear every 3 years
  • Ages 30-65 – Pap smear every 3 years or preferably Pap smear with HPV test (co-testing) every 5 years
  • Stop testing at age 65; except for special circumstances
  • Stop testing in women who have had a hysterectomy (removal of uterus and cervix); except for special circumstances


Evidence shows that an annual Pap smear is not necessary to prevent death from cervical cancer. The new screening guidelines save as many lives as annual screening, but with half the number of colposcopies and fewer false-positive tests.


“We are screening less often, but we’re screening smarter.” Dr. Diane Solomon of the Breast and Gynecologic Cancer Research Group in the National Cancer Institute’s Division of Cancer Prevention.


Please note: It is still recommended to have an annual preventative exam including a breast and pelvic exam even though cervical cancer screening can now be done less frequently.



About Women’s Care of Wisconsin
The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, midwifery, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com or call 920.729.7105 for any questions or concerns.