Osteoporosis Awareness

Written by Heather Hansman, Think Physical Therapy Assistant

Avoid fractured health with Whole Person Health at Think Whole Person Healthcare.

What is it?

Osteoporosis is the loss of bone density. Osteoporosis’s direct meaning is “porous bone,” because the bones become more porous with this condition. Our bones are living tissues that constantly “remodel,” meaning some bone cells dissolve and are replaced by new bone cells. When bone cells dissolve significantly more than they rebuild, that could be the beginning of osteoporosis.

What happens when bodies develop osteoporosis?

When you live with osteoporosis, your chances of fractures are increased because your bones become weaker. Chances of experiencing osteoporosis increase with age. Also with age, muscles tend to weaken if you’re not active. Weak muscles and lack of balance can cause fractures too, because falls are more likely to occur.

Some symptoms of osteoporosis include aching bones, especially vertebra, and shrinking of bones – like height loss.

Do not worry – there’s no reason to be scared. In fact, being scared of living life could just make things worse!
** There are ways you can help yourself avoid falls and fractures. Just keep reading!   


Here’s how to prevent bone density loss:

Exercise! The benefits are three-fold:

  1. Exercise creates muscle and burns fat, which lessens the strain on your bones. This helps your bones have less weight to bear. More muscle helps support those bones.
  2. In the case that you start to feel yourself falling, the strong muscles you maintained through exercise can help you catch your fall.
  3. Exercise builds – and helps maintain – bone strength and density.

** Some think that a good way to avoid falls and fractures is to limit movement. They’ve got the wrong idea! Not living life, but rather living in fear with a sedentary lifestyle, equals less confidence, strength and sturdiness – and makes people more prone to the things they’re trying to avoid. Move, move, move – but with help from the right people.

Speaking of which, I teach Think’s Fall Prevention Class. This could be a great option for you – or a loved one who lives with osteoporosis. The Fall Prevention Class is a small community of adults who come together to have fun while strengthening their bodies to increase their balance. The group is so welcoming, too!

Participants of Think’s Fall Prevention Class are excited about the confidence they build from attending class with peers and exercising with instruction from me. One participant, Jan Turcotte, told me – “I’m not afraid to go out and do things now because I feel more sturdy.” I love it!

Learn more about what class participants have to say.



Another great way to prevent and treat osteoporosis is with the correct nutrition. Bones need nutrients to be healthy – but you already knew that! You need calcium and vitamin D to absorb calcium. You also need a healthy balance of protein, fruits, veggies, vitamins and minerals.

Think Whole Person Healthcare has an in-house Registered Dietitian – Michelle Ring, RD, LMNT, CDE. She will work with you to develop a nutrition plan based on the types of foods you already like to eat and that takes into account your lifestyle. How nice is it to have all your resources in one very cool building?


Other treatments

Oral medications are another common treatment for those living with osteoporosis. Some use hormone treatments, bisphosphonates – or both. There are also injectable medication options since bisphosphonates tend to upset the stomach. The role of these medications is to slow the process of bone cell breakdown.

If you live with osteoporosis you should consult with your primary doctor about which medication treatment will work best for you. At Think Whole Person Healthcare, every patient’s care team includes a primary doctor, nurses and a clinical pharmacists. Together, they help you manage your Whole Health – keeping your healthcare plan coordinated versus “fractured.”


Life Is For Living! Make sure you live it to the fullest by maintaining your health. Think Whole Person Healthcare is here to help!

  • Call us at (402) 506-9050 to learn more about the Fall Prevention Class.
  • Contact Michelle Ring, our registered Dietitian, at (402) 506-9380.
  • Not yet a Think Whole Person Healthcare patient, and want to learn more? Fill out a short form and we’ll contact you with more information.


Top 10 Benefits of Water


Written by: Michelle Cooper Day, Women’s Pelvic Health Physical Therapist

– and the down side for many women…

We all know about the benefits of water:

  1. Regular bowel movements – helps with digestion and keeps our bowels moving
  2. Healthy skin – moisturizes skin from within, decreases wrinkles
  3. Flushes out toxins – urination and sweating after drinking water rids our body of waste preventing kidney stones and UTI’s
  4. Immune system booster – keeps our eyes and mouth moist to repel infection
  5. Headache prevention – dehydration is the leading cause of headaches
  6. Increases our energy – keeping the brain hydrated helps us to think, focus, and concentrate
  7. Zero calories – adding some cucumber or a few berries gives water a natural flavor
  8. Joint lubricant – keeps our joints moving smoothly and muscles fluid
  9. Mood booster – water is required for the brain and body to produce the right neurotransmitters to prevent depression and insomnia
  10. Keeps us cool – water is required so we can sweat to cool our body on those hot summer days

How much water should you drink is a common question? Estimated amount for women is eight 8 ounce glasses per day with a gradual increase to that amount if you have been drinking less. A half ounce per pound of body weight is the recommended amount with more on hot days or if you are working out and sweating. Your urine should be slightly clear yellow in color and not dark.

Unfortunately, many women do not drink enough water because they report it increases their urinary incontinence episodes especially when exercising. If pelvic floor muscles are not functioning as they should, urine can leak from the bladder despite our best efforts. Kegels are often recommended to help the muscles strengthen but Kegels aren’t for everyone (see previous article) and many women do not know if they are actually doing a Kegel correctly.

Michelle Cooper Day, MPT, is a specially trained physical therapist that treats women’s pelvic floor muscles.  She can determine if these muscles are flexible, coordinated and strong and help you with a plan to improve your bladder control so you can drink the necessary water to keep you healthy. These visits are covered by insurance under physical therapy including Medicare.

Recipe: Cucumber, Mint, Cranberry Spa Water

  1. Fill a pitcher with water.
  2. Add slices of cucumber, washed mint leaves crushed, and fresh cranberries. You can substitute blueberries, strawberries, pineapple slices. I tend to avoid lemon and citrus fruits because it can irritate the bladder.
  3. Refrigerate until chilled.
  4. Pour into your favorite glass and enjoy the fresh flavor!
  5. Store in the refrigerator.


Don’t be afraid to ask about bladder issues

You’ll learn that physical therapy can work wonders

Sponsored Feature – Omaha World Herald – Dec 10, 2018


It started about six years ago for Joan. After hip surgery, she slowed down — drastically. Along with a lack of exercise and fear of falling, she also suffered from incontinence.

Incontinence can be caused by problems with the muscles and nerves that help the bladder hold or pass urine. One in four women suffers from it. Ninety percent of residents in nursing homes end up there because of it. Michelle Day, MPT, a Women’s Pelvic Health physical therapist at Think, focuses on bladder, bowel and pelvic pain issues in women. Therapy includes thorough education and treatment to address pelvic floor muscle flexibility, coordination and strength. Michelle’s practice emphasizes strategies to address the nervous system as well.

“Anxiety, depression and stress can exhibit themselves through physical conditions, including pelvic floor issues,” Day said. “By collaborating with doctors, mental health providers, specialists and care managers, we can get to the core of what is causing the symptoms and provide a physical therapy approach to improve their function.”

Joan was referred to Day by her Think doctor. With therapy, she now walks the mall three times a week with walking sticks to strengthen her core. She also does a daily exercise routine while standing at her kitchen sink.

“Aging is a process we all go through, but it doesn’t have to mean an end to being active,” she said.

Another client of Day’s, a retired nurse, couldn’t pick up her 13-month-old granddaughter without experiencing incontinence problems. After her doctor referred her to Women’s Pelvic Health physical therapy, she saw improvement in her bladder control after the fourth session.

“She (Day) is so positive and has given me so much confidence,” the 77-year-old said. Now she exercises every day at the YMCA and teaches a class that gets Parkinson’s patients moving. Both Day’s clients admit they would never have talked with their doctor about incontinence; you just didn’t do that 40 years ago. Think doctors ask patients about it now.

“We’re giving them tools and strategies, so they can overcome their incontinence issues,” Day said. “That improves their health by keeping them active and socially engaged, resulting in fewer visits to the doctor’s office.” Physical therapy is a first-line treatment proven through research to be the most effective before the use of surgery, alternative treatments like Lasers, and medication. It’s covered by Medicare. “Unfortunately, urinary incontinence is a very common problem, especially for women,” said Dr. Debra Esser, Blue Cross and Blue Shield of Nebraska’s chief medical officer. “Physical therapy is so beneficial, and you can improve your symptoms dramatically.” Day’s patient, the retired nurse, said: “Don’t hesitate, go find out and you will love your results.”

Michelle Day, MPT, a Women’s Pelvic Health physical therapist at Think, focuses on bladder, bowel, and pelvic pain issues in women.


How to Prevent Falls in Older Adults

According to the U.S. Center of Disease Control and Prevention, one-quarter of Americans aged 65+ fall each year. That’s way too many – especially when you consider the high costs and serious injuries that follow. And the myths don’t help. Many think if they limit their activity, they won’t fall. That’s not true and we’ve developed a Fall Prevention Class, which proves that movement, strength, balance, coordination and confidence decrease chances of falling. Listen to our Fall Prevention Class Leader and Physical Therapy Assistant Heather Hansman and two Fall Prevention Class participants to learn more about the benefits this program offers. If you are interested in joining the classes please call (402) 506-9050.


What is Pelvic Floor Physiotherapy?

Kegels Aren’t for Everyone

Women typically don’t think about the importance of our pelvic floor muscles until something goes wrong. If you’re leaking urine with running, jumping, coughing, sneezing (stress incontinence), can’t quite make it to the bathroom in time (urge incontinence), going more than 5-8 times per day, waking up more than once every night (urinary frequency), or if you have pain with intercourse, you should seek help from a Pelvic Floor Physical Therapist.

The pelvic floor is a group of muscles attached to the pelvis, hips, and sacrum that support the abdominal contents and reacts to changes in pressure created by the diaphragm above. This group of muscles supports the bladder, urethra, uterus, vagina, and rectum. The pelvic floor is responsible for our bladder and bowel function plus sexual function. Pelvic Floor Physical Therapy is research proven as a first-line of defense against Incontinence and Pelvic Pain prior to medication and/or surgery. Schedule an appointment now (402) 506-9050.

Kegels are commonly recommended when a woman reports urinary or bowel incontinence – it’s not a normal part of aging! However, not all women should do Kegels because it may cause more harm than good. And if you are performing Kegels – how do you know if you are doing them properly?

A specially trained Pelvic Floor Physical Therapist can assess your pelvic floor using internal and external techniques to evaluate the function of your pelvic floor muscles. It’s important to assess the surrounding structures of the pelvic floor such as the connective tissue, sacroiliac joint, pubic symphysis, low back, and hips. It is necessary to assess your ability to contract AND relax the pelvic floor muscles. Assessing your patterns of active pelvic floor recruitment of your core and breathing plus function with tasks such as lifting, running, and transfers is crucial.

If the muscles are determined to be tight, you might be experiencing:

  • Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
  • Constipation, straining, pain with bowel movements
  • Unexplained pain in your low back, pelvic region, hips, genital area, or rectum
  • Pain during or after intercourse

If the muscles of the pelvic floor are weak, you might be experiencing:

  • Vaginal or rectal heaviness or pressure – prolapse
  • Urinary incontinence with cough, sneeze, run, jump or position changes

A Pelvic Floor Physical Therapist will determine the status of your pelvic floor muscles and treat any tight muscles until they reach their normal flexibility. Then the strength and coordination will be addressed (which might include a form of Kegels) and monitored to make sure the exercises are being performed correctly.

Our pelvic floor is an area that tends to hold our emotions. Addressing depression, anxiety, and stress plus realizing the importance of our thoughts, attitudes, and beliefs is essential. A mental health care provider can assist in this area, if needed, combined with Pelvic Floor Physical Therapy resulting in a faster and more effective recovery.

See our specially trained Pelvic Floor Physical Therapist, Michelle Cooper Day, MPT, BScEd and find out if you should be doing Kegels and make sure you’re doing them correctly! Schedule an appointment (402) 506-9050


Women’s Pelvic Health

Are you a woman who?:

  • Leaks urine when you exercise, cough, sneeze, or laugh?
  • Doesn’t quite make it to the toilet before leaking urine?
  • Is running to the restroom frequently to prevent urinary leakage or you just feel like you have to “go” often?
  • Wakes during the night more than once to urinate?
  • Wears protective pads for urine leakage?
  • Suffers from constipation?
  • Has pain with intercourse?
  • Is having issues recovering from childbirth?
  • Is experiencing pelvic pain?

Just because these are common issues doesn’t mean they are “normal”. There is no need to suffer with pain or spend countless dollars on protective pads. These issues do not just “go away” on their own and can worsen if not treated.
There is something you can do about it!

Women’s Pelvic Health Physical Therapy is a specialized area of rehabilitation focused on the assessment and treatment of women’s pelvic health concerns. Meet Michelle Cooper Day, MPT and start living your life again!

What Michelle’s patients are saying –

“Why didn’t I find out about this sooner?”

“I did not know this type of treatment even existed or could be so helpful.”

“I learned so much about what I can do to help myself with Michelle’s guidance.”

“I never knew the pelvic floor muscles were so important and needed proper care and attention!”

Speak to your doctor, specialist, or physical therapist to find out more. Call 402-506-9050 to schedule an appointment with Michelle Cooper Day, today!