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.

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.


Female Sexual Pain After Cancer

As more patients with cancer are surviving and living longer lives, new challenges emerge that may be difficult to address. For many female survivors, one of these challenges is a disturbance to their sex life. Many physicians and patients are unprepared to discuss these issues, and feel uncomfortable talking about them. This leads to conditions being overlooked and untreated.

A systematic review by two leading gynecologists found that prevalence of sexual pain ranged from 29 to 64%. The most common causes of sexual pain in women after cancer treatment are related to surgery, chemotherapy, radiation, and hormonal changes.

Women’s Health PT can help with sexual pain, and allow these women to move forward through their recovery. Our Pelvic Health Therapist is also a member of ISSWSH, and is completing her fellowship in women’s sexual health with this organization.

Here is an excellent article that was published by Cure magazine that details the review. If you are having sexual side effects from cancer treatments, treatment is available! If you are interested in learning how our services can help you, call today to schedule an evaluation. You do not need a physician referral to schedule with our clinic. We look forward to meeting you soon!

Physical Therapy May Help Kids with Constipation

Constipation in children creates a hardship on the parent and child. Research shows that physical therapy can help the problem. When potty training is paired with exercises to improve posture and strengthen pelvic muscles many children have an easier time going to the bathroom.

If constipation has persisted for a long period of time, behavioral issues of withholding stool or postponing defecation, or if a child seems unable to have a bowel movement even when trying are indications that a pelvic floor physical therapy evaluation could be beneficial.

A pelvic physical therapist can give recommendations on dietary changes, positioning on the toilet to make it easier for the child to go, and exercises to aid in successful bowel movements. This article published on Fox News Children’s Health blog gives great information on statistics for children in pelvic physical therapy.

If your child has issues with constipation or urinary or fecal incontinence this is something that our therapists can help with. Please contact our office to schedule an evaluation today!

Now Offering Custom Breast Prosthesis

Avila Physical Therapy Chosen as Specialty 3D Breast Prosthesis Center

American Breast Care (ABC), an international leader in post-surgery breast care products, has chosen Avila Physical Therapy in Greenville, NC, to be one of only twenty regional 3D breast prosthesis centers in the US. Avila’s physical therapist, also a certified mastectomy fitter, is specially trained in using ABC’s innovative 3D imaging process to create custom fitting breast prostheses as unique as the women who wear them. Previously, 3D imaging of this kind was available only in larger metropolitan areas, but through this partnership, Avila is proud to bring the advanced technology and specialized care to eastern North Carolina.

As a regional 3D breast prosthesis center, Avila offers patients exceptional custom fitting services. 3D imaging captures each patient’s exact chest contours quickly and easily, allowing for the creation of lightweight, comfortable, and realistic breast prostheses, complete with a wide variety of skin colors and nipple sizes from which to choose. Women looking for a non-surgical alternative to breast reconstruction can turn to Avila for help, compassion, and individualized care in an upscale, boutique-like setting.

Understanding treatment options and therapies after breast surgery can be overwhelming, but Avila’s Allyson Daugherty, PT, CLT, CFm, is an expert in post-mastectomy care with over eighteen years of physical therapy experience. The process of creating custom fitting breast forms, according to Daugherty, “used to be very cumbersome and time-consuming, and the results were not always satisfactory.” Of ABC’s advanced 3D imaging technology, Daugherty states, “Now the process is quick, and significantly more accurate.” Appointments for imaging are one hour long, during which time the 3D scan is taken, creating a detailed map of the patient’s chest. Daugherty reviews the scan and breast prosthesis design to be sure each prosthetic breast form created will best meet patients’ needs for balance, symmetry, and comfort. Breast prostheses are made and returned to Avila within six to eight weeks, at which time patients return for a fitting in Avila’s private, post-mastectomy dedicated fitting room.

Along with offering 3D imaging for custom fitted breast prostheses, Avila has the region’s largest selection of mastectomy products. Avila is dedicated to helping patients through every step of the process, including understanding and filing for insurance coverage. Patients do not need a physician’s referral to make an appointment for a private consultation at Avila. To learn more about Avila’s newest custom breast prosthesis, or to request a consultation, contact Avila at 252.215.5225 or visit our contact page.

About Avila’s Physical Therapy

Avila was founded in 2008 by Allyson Daugherty, PT, CLT, CFm. The practice aims to provide comprehensive evaluation and treatment of conditions related to cancer rehabilitation, lymphedema, pelvic health, sexual health, and prenatal/post-partum care. Avila prides itself on compassionate one-on-one care and attention for both women and men in a private, comfortable setting.

Young Survival Coalition


The Young Survival Coalition is an organization designed to empower, educate, and support young women diagnosed with breast cancer. There are over 150 support systems in place across the US. There is also one located right here in Greenville, NC. They offer many resources through their website, No woman should have to face breast cancer alone and that is why YSC was formed.

Rehabilitating Cancer Care

It seems as if weekly we hear from a patient “why didn’t my doctor or surgeon tell me I would have these problems?” This is a common question after breast cancer surgery. Surgeons and Oncologists are focused on removing the cancer and focusing on a cure. Patients have learned to accept the pain and challenges as just a “new way of life.” Most patients do not know how to ask their providers or tell them what it is they need. They are so thankful for these doctors who have saved their lives, and are unsure how to bring up their new problems of limited daily function. “Just dealing with it” should not be the solution. Rehabilitation prior to and after surgery helps significantly impact a patient’s quality of life and physical functioning in everyday life.

Some issues patients may have are limited range of motion in their arm or shoulder, pulling in the chest or underarm, and myofascial pain like axillary webbing syndrome (cording). Physical therapists with special training can help with all of these issues, as well lymphedema concerns. It doesn’t matter if it has been just a few weeks since surgery or years, rehabilitation is possible. Physical therapists work with the surgeons and oncologists as part of the treatment team to enable patients to return to their usual activities they were able to do before their surgery.

In the State of North Carolina patients do not need a physician referral or prescription to attend physical therapy. They are free to schedule their own appointment. The most important thing for survivors to understand is that they deserve the opportunity to function optimally no matter their cancer.

Avila Physical Therapy specializes in breast cancer rehabilitation, as well as providing post mastectomy fitting services for patients that are in need of bras or breast prosthesis. Just like with physical therapy, a patient does not need a referral or prescription before coming in for a fitting, our office obtains all paperwork necessary on the patient’s behalf. We take post mastectomy fitting patients on a walk-in or appointment basis. If you have any questions about our services or wish to schedule an appointment please give us a call today at 252-215-5525.

Cure Magazine posted an excellent article on ‘Rehabilitating Cancer Care’, click here if you would like to read the article in full. Survivors and Caregivers can also subscribe to Cure Magazine for free on their website.