COVID-19 Health and Safety Guidelines

Avila Physical Therapy

COVID-19 Guidelines

For Everyone’s Health and Safety

  • We are operating by appointment only.
  • Please wash your hand or use hand sanitizer as soon as you enter our office.
  • Please arrive at your scheduled appointment time. If you are early, please wait in your car until your appointment.
  • Only the patient is allowed in the clinic, unless the patient is a minor. All other family members or friends must wait in the car.
  • Please wear a mask if you have one.
  • If you are picking up items, please call us from your car. We will gladly deliver to you curbside.


  • If you have a fever, cough, or other illness symptoms.
  • Have been around someone with COVID-19
  • Have been diagnosed with COVID-19 within the last 14 days.

We are now open!

Our office is now reopen and we are scheduling patient appointments. At this time we request when you come for your scheduled appointment that only the patient attend the appointment. We request that family and friends either stay at home or wait in the car. Please call our office to schedule your visit. We look forward to seeing you soon!

COVID-19 Temporary Closing Update

UPDATE: Due to the statewide Stay-at-home order which expires 4/29/2020, we will plan to reopen on Monday, 5/4/2020. We will contact you to reschedule your appointments. We hope everyone is following public health guidelines. Please continue to check our website and Facebook page for updates.



UPDATE: Due to the statewide Stay-at-home order which expires 4/29/2020, we will plan to reopen on Monday, 5/4/2020. We will contact you to reschedule your appointments. We hope everyone is following public health guidelines. Please continue to check our website and Facebook page for updates.

Covid-19 Update

With the ongoing concerns of the spread of Covid-19, Coronavirus, we at Avila Physical Therapy wanted to update our patients on the measures we are taking to reduce possible exposure.

  • In addition to our usual procedures, we have increased the frequency of cleaning duties to disinfect shared surfaces in the waiting room, restroom, and each treatment room. This also includes all countertops and door knobs throughout the office.
  • We are requesting all patients use hand sanitizer upon entry of the office, or proceed to washing hands at the sink in the back of the office or in the restroom.
  • We ask that patients attend appointments alone, and that any additional friends or family members wait outside in the vehicle to reduce exposure.
  • If you or any immediate family members are experiencing symptoms, we ask that you cancel your appointment, and contact your primary care physician.
  • At this time our office will be waiving the late cancellation fee for illness related cancellations.

We want our patients to feel confident that their safety is our #1 concern and we are taking all measures to ensure our office is one of the LEAST likely places to be exposed to this new threat. Please follow all recommended measures put in place by the CDC as they are every changing.

The Sexual Revolution and the Health of Sex

The sixties are well known for birthing the sexual revolution, where the radical concept was raised that women also had sexual need and desires.This is the time period of the breakthrough Birth Control Pill, Playboy Magazine, and Sex and the Single Girl was published, and vibrators were beginning to be endorsed by women’s magazines for sexual pleasure.Much has changed in several decades including the easy availability of pornography of every genre via the internet, vibrators of all sorts delivered to your door in 2 days (Thanks Amazon!), and now there is a “little pink pill” to help women have sex (often compared to Viagra).However, it is common for women of all ages to have sexual problems.Often they are uncomfortable discussing these issues with their partners or doctors, sometimes thinking that they are “broken”.Compounding this issue is that most healthcare professionals do not ask their patients about their sexual activity and sexual health.I will discuss some of the most common issues, and debunk some of the myths about sex.

What is Normal?

I get this question a lot in my practice.Women are more and more concerned about what looks and feels “normal”.This has led to an increase in vulvoplasty and vaginoplasty to achieve the “perfect” body part.Every body is different and that goes for our vaginas too.“The Great Wall of Vagina” (2008 by artist Jamie McCartney) illustrates this beautifully.Four hundred women allowed her to makes castings of their vulvas and she made it into art.We are all beautifully and wonderfully made and your vulva and vagina is normal!

Research shows that sexual frequency varies by age, health status, and whether you are single, partnered, or married.Every couple is different. The “right” frequency is one that satisfies both partners.Communication with your partner is the key to success with regard to frequency.

Sexual complaints in women

A study from Laumann published in JAMA in 1999, of 1749 women who were ages 18-59, determined that sexual dysfunction is more prevalent for women (43%) than men (31%). Of these women, 32% complained of lack of sex, 27% were unable to achieve orgasm, 28% found sex not pleasurable, and 21% had pain during sex.

Another study found Baby Boomers, who self-reported good sex exercised at least 2 x/week, enjoyed 1-2 social drinks/week, had good gum health, a healthy BMI, and stayed hydrated.Factors that contribute to poor sexual activity included musculoskeletal problems, cancer, bowel and bladder problems, poor vision, cardiovascular disease, joint pain, gum disease, hearing loss, dementia, poor communication and financial worries.I recommend a good physical exam and treatment to address physical issues that may be contributing to decreased sexual health and satisfaction by a GYN or pelvic health physical therapist.


It can be difficult to have great sex with a partner if you are unfamiliar with your own body.I encourage all women to grab a hand mirror and spend some time examining your girl bits as diligently as we do with our faces.We need to understand what all the parts are, how they work, and notice any changes in skin condition, discharges, odors, etc.Many women have never looked or touched themselves due to shame, fear, and cultural or religious pressures.How can we expect our partners to know how to push the right buttons, if we don’t know ourselves?There are some great books on this subject that I recommend to my patients; two of my favorites are Come as You Are, by Emily Nagoski, Ph.D., and Women’s Anatomy of Arousal: Secret Maps to Buried Pleasure by Sheri Winston.

Lube, Toys, and Care

There is no need for vigorous cleaning of our girl parts.The vagina is like a self-cleaning oven, and needs no special soaps, lotions, douches, or over-cleaning.Our vaginas have a microbiome much like our guts with a special balance of flora and fauna that keeps our pH balanced.Harsh soaps, douches, and some lubricants can disrupt this pH balance and cause irritation at best, and infections like yeast and bacterial vaginosis at worst.The best cares is gentle soap and water to the labia majora, and your backside, but go no deeper than that!No scrubbing needed.

Not all lubricants are the same.Many common brands that are used in doctor’s offices contain ingredients that are vulvar irritants.If you are experiencing burning, itching, or stinging during sex, your lubricant may be to blame.Check ingredients carefully.Coconut oil is often recommended, but this can sometimes disrupt the good bacteria that live in our vaginas.Stick with water-based or silicone-based lubricants for vaginal penetration, oil-based lubricants for anal sex work best.Water-based is also best for use of condoms.Vaginal moisturizers are different than lubricants and contain ingredients to keep the vagina well-moisturized as should contain good hydrating ingredient like what we use on our faces.Many women after menopause, or after cancer treatments, complain of significant vaginal dryness and a combination of vaginal moisturizers, and lubricants, is a winning combination for comfort with sex!

There are many varieties of vibrators, and I recommend that every woman have at least one.Only 30% of women are able to achieve orgasm by vaginal penetration alone.That’s right, most women need some other type of stimulation to achieve climax.Toys of all shapes and sizes can assist with not only orgasm, but there are types that also help with arousal.Women need increased time for sexual arousal (here’s where foreplay comes in) to help with tissue engorgement similar to what men experience. Lubricants and toys make everything more enjoyable with achieving both arousal and climax whether solo or with a partner!

Your pelvic floor muscles are super important for bowel and bladder control, as well as sexual satisfaction.Dr. Arnold Kegel (rhymes with bagel) was an American gynecologist who identified the weakness in pelvic floor muscles after childbirth and the exercises to strengthen them.These muscles can be too tight and inflexible which can cause pain, constipation, and urinary incontinence.Or they can be too lax, causing bowel and bladder incontinence, and pelvic organ prolapse.Getting these muscles working in a coordinated manner can not only eliminate bowel and bladder issues, it can also increase orgasmic appreciation!If you have issues with your pelvic floor muscles, get yourself evaluated by a pelvic physical therapist or gynecologist for a treatment plan.


Sex is an Activity of Daily Living (ADL)

Sexual health is a state of mental, physical, and social well-being that requires a positive and respectful approach to sexuality and sexual relationships.It is integral to having pleasurable and safe sexual experiences, free of coercion and discrimination. It is every bit as important and eating, sleeping, and exercising for our bodies. So start exploring your bodies, and enjoy some fabulous sex.

The Benefits of Physical Therapy During Cancer Treatment

Many people do not realize that physical therapy is an important part of cancer treatment, especially as it relates to quality of life during and after treatment. Physical therapy can help patients with cancer overcome pain, weakness and fatigue, as well as other physical changes as a result of chemotherapy, radiation and surgery.

Physical therapy is commonly a part of the treatment plan for those diagnosed with breast cancer because of issues related to shoulder mobility and pain. Women who begin a post mastectomy physical therapy program within days of surgery have been proven to have a higher quality of life than those who do not.However, treatments for other types of cancer often find physical therapy under-prescribed – not because it isn’t beneficial, it’s often just overlooked.

A common side effect of lymph node removal, and radiation is lymphedema. This swelling occurs from a backup of lymph fluid under the skin and can occur weeks or years after surgery. The best way to prevent a lymphedema flare-up is to get educated about signs and symptoms, risk reduction activities, and begin a prescribed exercise routine. By working with a physical therapist that specializes in lymphedema and cancer rehab, treatment is personalized to your individual needs and functional goals. If you already have an exercise regimen, the physical therapist can also recommend exercise modifications that will enable you to optimize your physical condition.

When faced with a cancer diagnosis, it’s important to discuss the addition of physical therapy with your doctor as early as possible. Together, a plan can be made not only to get you on the road to recovery, but will have you back to enjoying life as quickly as possible.

Deep Vein Thrombosis and Physical Therapy

March was national Deep Vein Thrombosis Awareness Month. The public initiative is aimed at increasing understanding of this common medical condition and its complications. Deep Vein Thromboses (DVT), also known as a blood clot, affects up to 900,000 people in the United States annually, according to the CDC.

Deep Vein Thrombosis usually occurs in the legs but can also be present in other extremities, and can be very serious. Blood clots in the veins can break loose, travel through the bloodstream and lodge in the lungs – blocking blood flow. This, often life-threatening condition, is known as a pulmonary embolism.

DVT can be caused by a recent surgery or injury, medical condition, or could be an inherited condition.

Medical conditions that can increase your risk of developing a blood clot are:

  • Cancer
  • Increased age
  • Obesity
  • Pregnancy
  • Chronic venous insufficiency

Physical therapy is a method used to manage or decrease the risk of occurrence of DVT by improving the circulation deep in your veins. At Avila Physical Therapy, we work with patients to improve circulation by teaching them how to perform exercises that improve range of motion. We also recommend and provide compression garments that encourage circulation.

Medical-grade compression stockings provide graduated pressure that is firmer at the bottom of the leg and becomes less at the top of the garment. Because gravity makes it difficult for blood to flow in an upward direction, the graduation of pressure provided by the compression garments aid in improving blood flow back to the heart.

If you are pregnant, have a family history of DVT or blood clots, or had a DVT due to a medical condition, the therapists at Avila Physical Therapy in Greenville, NC can help you. Please contact our office to schedule an evaluation today!

Walk-in Fittings Welcome!

Walk-in Fittings Welcome! We now have (2) certified mastectomy fitters at Avila Physical Therapy to best meet your needs. Natalie Hardee has earned her CFm through the American Board for Certification of Orthotics, Prosthetics, and Pedorthotics (ABC). We have the largest selection of mastectomy bras and breast prostheses in the region, and Natalie is delighted to provide you the best fitting and most comfortable products. You can call to schedule an appointment, or walk in during business hours.