Women’s Health


Lymphedema is a term commonly used to describe swelling. Swelling can accumulate anywhere in the body, but it usually happens in upper or lower extremities. Causes of lymphedema are usually after lymph system damage from trauma, surgery or blockage. The most common cause of lymphedema is Breast Cancer after lumpectomy or mastectomy. If lymphedema is left untreated or in some cases very severe it can lead to infection and hospitalization.

Common treatment for lymphedema is daytime sleeve compression, wrapping, pumps, night sleeve compression, taping and manual lymphatic drainage. Our out-patient clinic works closely with your physician to ensure your care is started and working. We also issue home exercise programs, manual massage programs, as well as any other home devices needed for long term maintenance.

Please call our clinic for speedy appointments at (405)265-2255. Physician referral is not needed, but encouraged.


Lymphedema. (2019, January 22). MedlinePlus – Health Information from the National Library of Medicine. https://medlineplus.gov/lymphedema.html



Low Back Pain During Pregnancy

Low back pain during pregnancy can be miserable for many new mothers, interfering with work, fun, sleep and daily activities. The pain usually begins in the 2nd trimester and generally located on one side of the low back and can cause radiating pain down the leg. Pain medication typically do not work for this type of pain and not recommended during pregnancy. Interventional treatment is usually physical therapy. Unfortunately, exercise is not helpful for this type of pain and in some exercise makes it worse.

Research shows acupuncture therapy and manual therapy are the most effective treatment.  Our physical therapy clinic is extremely trained with excellent out-comes of 100% pain free after 1 to 3 visits. You do not need a prescription to schedule an appointment, but recommend contacting your physician before any treatment is started. Our clinic also provides same day service for patients experiencing severe pain.



Liddle, S. D., Pennick, V., & Liddle, S. D. (n.d.). Interventions for preventing and treating low‐back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews9.




Low Back Pain During Pregnancy2021-02-08T19:45:50+00:00


Lymphedma is diagnosis of a specific type of swelling.  The swelling is usually in one extremity, such as one arm or one leg and sometimes the stomach region. Fluid builds up in the soft tissue causing vulnerability to the skin (integumentary system), which can lead to an infection (Scheiman, 2020). Causes of lymphedema include: trauma to the lymphatic system or surgery, cancer, lymphatic system overload from a blockage or excessive weight.

Signs of lymphedema might include: consistent swelling that does not decrease after elevation, + Stemmer’s sign, swelling in toes and foot, orange peel look to the skin, hard and thick epidermis layer, lymph drainage dripping through skin, large and small pink bump clusters, excessive chronic swelling causing elephantiasis and hemosiderin skin staining (Scheiman, 2020). Lymphedema treatment includes manual lymphatic decompression therapy, wraps, intermittent pneumatic compression and other types of compression.


Lymphedema. (2019, January 22). MedlinePlus – Health Information from the National Library of Medicine. https://medlineplus.gov/lymphedema.html

Scheiman, N. E. (2020, June 16). Edema Bootcamp [PDF]. www.summit-education.com





March is Multiple Sclerosis Awareness and Educate Month

Multiple Sclerosis effects over 1 million people in the United States. MS is a chronic neurological condition that creates inflammation causing damage to the myelin that protects the nerve fibers that send signals across the body. If you or someone you know has been diagnosed with MS, there are many treatment options available. One of the options being physical therapy for pain management and maintaining muscle strength and mobility.

Multiple Sclerosis FoundationCommon Questions. (n.d.). https://msfocus.org/Get-Educated/Common-Questions#What%20is%20Multiple%20Sclerosis

March is Multiple Sclerosis Awareness and Educate Month2020-03-04T20:36:34+00:00

Women’s Health

Most people confuse women’s health with just pelvic floor dysfunction, but there are many other reasons women seek help from physical therapist.  Other reasons include: incontinence, pelvic pain, lupus, rheumatoid arthritis, breast cancer, lymphedema, osteoporosis, fibromyalgia and other diagnoses that are more prominent in women than men. Treating women for women’s health issues is really just about treating women throughout their span.

Our team understands women’s health needs are different than men’s Health needs, such as women have different cardiac symptoms like jaw and neck pain. Whereas men will complain of chest pain, shortness of breath and upper body pain.

The pelvic floor is a large part of women’s health and our clinic has over 24 years of pelvic floor experience. Pelvic floor conditions include post-surgical complications, post C-section, episiotomy and hysterectomy.

Our clinic is an evident based practice using research to provide successful treatment to meet our patient’s goals. There’s adequate research out there supporting pelvic floor dysfunction and physical therapy intervention.


Wojciechowski, M. (2009). Women’s Health: It’s More Than You may Realize. PT in Motion, 1-8.


Women’s Health2020-03-04T20:39:31+00:00

Osteoporosis – What You Need to Know

Got Calcium? May is Osteoporosis Month.


Osteoporosis is the thinning and loss of bone density over time.

Osteoporosis occurs when the bone mass decreases when bone resorption is greater than bone formation. As a result, the bone weakens and easily fractures especially in the hip and vertebrae. (Image credit: American Recall Center) #YWCR #osteoporosis #calcium #fractures

Osteoporosis – What You Need to Know2019-01-22T19:42:29+00:00


The Function of a Physical Therapist Treating Lymphedema

Lymphedema is progressive chronic swelling usually in extremities, but can occur in the chest, stomach and groin regions. Currently there is no cure for lymphedema, but treatment from a physical therapist is extremely helpful to prevent immobilizing side effects and possible dangerous complications (APTA.org, 2009).

Prompt discovery of limb and / breast lymphedema is key to managing and preventing complication (APTA.org, 2009). In our practice we work closely with physicians and patients to treat lymphedema quickly with minimal to no pain. We use manual lymphatic drainage therapy and begin immediate compression for long term management.  Other physical therapy terms used to describe lymphedema treatment are decompression therapy, complete decongestive therapy and complex physical therapy (APTA, org,2009). Complex physical therapy for lymphedema is the gold standard of care and includes: manual lymphatic drainage, compression garments, exercise and education about skin and nail care (APTA.org, 2009). In most cases patients who receive lymphedema therapy see an 80% improvement in just one to two weeks.

Evidence based research has proven success in lymphedema treatment and management using patient education, exercise, compression and lymphedema therapy can stop lymphedema from returning (APTA.org, 2009). Early onset of lymphedema improves outcomes and reduces complications. Patients with breast cancer should be aware of the risk factors and warning signs that include:


  • Overweight or increasing weight during and throughout cancer treatment.
  • Lymph node removal
  • Radiation therapy
  • Infection or blood clot in affected extremity.


  • Pain and fullness in affected limb
  • Tightness in affected limb
  • Noticeable swelling in affected limb
  • Numbness and tingling in affected limb (APTA.org, 2009).

In conclusion, the role of physical therapist treating patients with lymphedema is to help patients identify lymphedema early to prevent lasting side effects and possible dangerous complications. Currently there is no cure for lymphedema. However, treatment from a physical therapist is highly successful in eliminating lymphedema and preventing reoccurrences.

Sincerely, Sherri Boos, PT, DPT

Physical Therapist Play Integral Role in Lymyphedema Prevention, Treatment. (2009). Retrieved from APTA.org, 2009
Role of Physical Therapist in the treatment of Lymphedema. (2009). Retrieved from http://APTA.org




Sleep Health

What is sleep?

Inactivity of the body, but electrical activity of the brain continues in a predictable pattern of brain waves – from slow wave sleep to brain states that mimic wakefulness in 90 minute cycles.

Stage I

Light sleep

Refreshes memory / dreaming occurs

Stage II

Stable sleep /diff to wake

Stage III

Deep sleep, growth hormone released
Sleep restores learning, memory, temperament and regulates hormones.

Average adult needs 7 to 7 1/2 hours each night.

Lack of sleep is defined as frequent daytime sleepiness as a result of sleep deprivation daily for at least 3 months.

Lack of sleep can be unintentional or intentional.

Sleep Disorders:

  • Insomnia
  • Circaid rhythm sleep-wake disorders
  • Sleep-related breathing
  • Parasomnias disorders
  • Central disorder of hypersomnolence
  • Other sleep disorders


Facts about sleep:

34% of US questioned stated less than 7hrs sleep nightly.

25% of US adults report lack of sleep 15 out of 30 days.

50-70 million US adults have sleep or wakefulness disorder.


Poor sleep is a public health concern!

Common causes of sleep disorders:

  • Stress
  • Occupational worries
  • Medical illness
  • Loneliness
  • Pain
  • Bereavement
  • Family dynamics
  • Financial worries

Health effects of insufficient sleep:

  • Decreased immunological function
  • Higher risk of chronic disease
  • Higher cardiovascular death
  • Higher risk of diabetes
  • Higher risk of hypertension
  • Higher risk of obesity
  • Decreased mental performance
  • Considerable higher risk in injury and accidents

Inadequate sleep is associated with behavior

  • When sleep is inadequate to support sufficient alertness, work routine,      and health from decreased total sleep time or fragmented sleep by short term awakenings.
  • Lack of sleep syndrome is characterized by increased daytime sleepiness caused by shortened sleep daily for at least 3 months.

3 Most common sleep disorders:

  • Insomnia- trouble falling asleep, staying asleep, or waking up early 3 times week for 3 months and affects daily activity.
  • Sleep Apnea- respiratory disturbance index > 15 per night with or without symptoms.
  • Restless leg syndrome-painful legs causing overwhelming urges to move legs during inactivity

Quantity verses Quality:

  • Quantity- hours of sleep per night.
  • Quality – number of times awaken from sleep and percentage / duration and type of sleep stages entered REM verses NREM

How much sleep do we need?

  • Sleep need is different for everyone and across the lifespan it changes.
  • 6 to 8 hours is sufficient for most adults.
  • Healthy people may feel refreshed with 6 to 10 hours.

Sleep intervention techniques:

  • Sleep hygiene education
  • Exercise
  • Stimulus control
  • Reducing sedentary rest
  • Relaxation
  • Positioning for rest
  • Weight control
  • Progressive relaxation
  • Cognitive behavior therapy
  • Medication – antidepressants, ADHD meds, corticosteroids, thyroid hormone, high blood pressure meds, contraceptives, pain relievers containing caffeine, diuretics and diet pills
  • Medical appliances
  • Mindfulness sleep induction

Positive lifestyle changes to restore your sleep facilitates daily recovery and promotes improved health:

  • Go to bed and get out of bed at the same time daily
  • Avoid screen activity before bed
  • Drink caffeinated drinks in in AM only
  • Get out of bed if you cannot sleep after 20 min and return when sleepy
  • Avoid alcohol
  • Avoid smoking in PM
  • Make your bedroom cozy, quite and cool
  • Weight reduction if overweight
  • Exercise on regular basis but  not 2 hours before bedtime
  • Eat a light snack (food with tryptophan)
  • Use bed only for sleep and sex
  • Avoid daytime napping
  • Mouth exercise to stop snoring and improve sleep
  • Weighted blanket
  • Sleep temperature 67-69 degrees

Natural sleep remedies that do work need 4 essential ingredients:




5 essential herbs for sleep health

  • Valerian
  • Passionflower
  • Lemon balm
  • Hops
  • Chamomile

#1 Nocurest Advanced sleep support     5 out 5

#2 NaturesWellness Natural sleep aid   3 out 5

#3 SourceNaturals NiteRest                   3 out 5

#4 NowFoods Sleep Sleep                     2 out 3

#5 Somnis Natural sleep aid          2 out 5

Newest natural sleep aid

#6 RediNite

Sherri Boos, PT, DPT




Clark, D., Lein, D., & Morris, D. (2017, July 17). Integrating Sleep Health in Physical Therapy Clinical Practice.

Sleep Disorders & Problems – National Sleep Foundation. (n.d.). Retrieved from https://sleepfoundation.org/sleep-disorders-problems





Sleep Health2022-01-12T14:53:52+00:00

Clarifying Women’s Health

Women’s health is much more than just treating lady parts or pelvic floor complications. Physical therapist address women’s health conditions from infancy through geriatric years focusing on specific women’s health needs. 

Clarifying Women’s Health:

I have provided women’s health care for years and find many people including women are confused about women’s health care. The definition of women’s health is providing specific care during the entire life cycle for women’s issues including: incontinence, pelvic dysfunction, osteoporosis, breast cancer, lymphedema, fibromyalgia and other diseases that differ for women than men (Wojciechowski, 2009).

Kristie C. is a patient of mine and is an avid female runner that I admire and appreciate. Kristie has ran 9 marathons all over the world including Ethiopia in 2015. She suffered a right knee injury requiring meniscal repair with osteoarthritis debridement. As a result of her injury and lack of post-op rehabilitation she gained 60 lbs and began suffering additional complications of depression, anxiety and chronic pain. As a women’s health therapist I was able to treat Kristie’s knee, but also considered her complete lifestyle and surpass traditional knee rehabilitation to meet her goals of resuming running. Meeting Kristie’s running goals resolved her depression, anxiety, weight gain and chronic pain. Returning women or any patient to their previous lifestyle or passion, like running marathons is a true blessing.

Another example of women’s health is a patient of mine that was diagnosed with breast cancer resulting in several lymph node removal with lumpectomy. As a result of lymph node removal she suffered with lymphedema in her arm making her job as a hairstylist and being a grandmother difficult. Treating her lymphedema, shoulder range of motion and shoulder strength allowed her to return to full function using her arm as a hairstylist and playing with her grandson again.

Many times women’s health focuses on women during menopause, for things like urinary incontinence and constipation or in younger women with diagnoses of pelvic pain and / or sexual dysfunction (Wojciechowski, 2009). However, pelvic floor diagnoses are not the only conditions women are affected with more than men. Women also are more often diagnosed with rotator cuff tears, shoulder impingement, shoulder adhesive capsulitis, carpel tunnel, osteoarthritis, rheumatoid arthritis, fibromyalgia and lupus (Wojciechowski, 2009). All injuries and diseases affect women differently than men and physical therapist should be aware of the differences even if they don’t treat gynecological  and obstetric care (Wojciechowski, 2009). Not only do women recover and heal differently than men they also have heart disease signs and symptoms differently (Wojciechowski, 2009). For example, women usually complain of difficulty breathing, nausea and vomiting, fatigue, back pain, shoulder pain and jaw pain (Medline, 2014).

In conclusion, treating the pelvic floor is a huge part of women’s health physical therapy for condition such as post-surgical complication after c-section, episiotomy, hysterectomy, sexual dysfunction, bowel and bladder disorders. In addition, women’s health physical therapy is treating all women’s health conditions throughout their life cycle for their specific needs and differences.


Sherri Boos, PT, DPT


Wojciechowski, M. (2009). Women’s Health: It’s More Than You May Realize. PT in Motion 7. Retrieved from http://www.apta.org/PTinMotion/2009/11/Feature/WomensHealth

Women’s Heart Disease: Heart Disease Risk Factors. (2014). Retrieved from https://medlineplus.gov/…/winter14/articles/winter14pg26-27.html



Clarifying Women’s Health2018-01-02T21:47:35+00:00

Women’s Health

Women’s Health
Women’s Health Physical Therapy is a specialized area of care that requires additional education and training. Women of all ages can suffer with complication including: pelvic pain, urinary and bowel incontinence, pelvic prolapse, breast cancer complications, osteoporosis, female athletic injuries, fibromyalgia, pediatric pelvic problems and diastasis recti.
The leading women’s health diagnosis is diastasis recti (separation of abdominal muscle) and pelvic floor weakness following childbirth. To restore abdominal and pelvic floor strength and function exercise can begin week 1 or 2 after delivery to regain core strength. Strengthening will improve carrying newborn, transitional movements in and out of bed, car and chair. As the abdominal gap closes advance exercises are prescribed.
Pelvic floor strengthening (kegel exercise) can begin immediately after delivery and progress to functional sitting, standing and daily activity. Strengthening the pelvic floor also develops sexual fulfillment, as well as prevent prolapse and incontinence.
Sherri Boos, PT DPT
APTA. (n.d.). Health Center for Women – MoveForward. Retrieved from http://www.moveforwardpt.com/forhealthcareprofessionals/detail/health-center-women.
Women’s Health2019-01-22T19:42:33+00:00
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