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Pregnancy Pelvic Support Belit: What is it?

12/29/2019

 

Interview with pelvic belt creator Ingrid Mitton- 
(repost from the Australian Physiotherapy Association  Newsletter 

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Recently Victorian committee member Tafy Seade, principal physiotherapist of Inner Active Pelvic Health, sat down with founder and creator of the Mitton pelvic belt support, Ingrid Mitton.
Physiotherapists who treat pregnant women are well-acquainted with the use of pelvic support in managing pelvic girdle pain in pregnancy, also known as pregnancy-related pelvic girdle pain (PPGP).
The Mitton belt is designed to provide support of the pelvic joints in the presence of pelvic girdle dysfunction that is commonly seen in pregnancy. PPGP refers to pain that is felt in the sacroiliac joints or pubic symphysis. In pregnancy, this is closely linked to hormonal, biomechanical, metabolic and genetic factors. It affects up to 50 per cent of women who are pregnant and can lead to significant physical disability that affects daily activity such as walking, changing position, standing, turning in bed and general mobility.
Ingrid Mitton is the physiotherapist who created the belt over 30 years ago. She delved into the area of women's health early on after her own pregnancies and instantly fell in love with the field. She started running childbirth education classes and progressed into exercise classes with 'Changing shape'. It was around this time that physiotherapy in women’s health was starting to evolve into what we see today.
It was while conducting classes that she noticed the gap, quickly realising that there was not much available for this particular group in terms of effective support they could use to help them continue with their activities. Ingrid took on the task to find a better way. Incidentally, she got hold of some material from her children’s school fete, pulled out the sewing machine, and within months the Mitton pelvic belt was birthed.
During the early stages, many expectant Mums began noticing significant benefits of the belt, so they naturally endorsed and spread the word--which is as good PR as a product designer could hope for. To ensure proper and fit-for-purpose use, Ingrid has tried to make sure that the belt was sourced through a healthcare provider, because it was designed to work 'in conjunction with a good assessment, exercise therapy, manual therapy and education'.
The Mitton belt, now 30 years old, continues to be manufactured in Melbourne. It is now readily available in various hospitals, both public and private, as well as in private practices across Australia. Originally made to address the challenges of pelvic girdle pain in women, this belt has been used in different sectors, including pelvic trauma in the elderly and in men with osteitis pubis.
The Mitton belt is available in various sizes, ranging from 85 cm to 150 cm, either black or white. Ingrid still prefers that the belt is supplied by a health practitioner to ensure fitting, care and instructions are followed through. She encourages those interested in creating products, especially in the field of women’s health, that if you have found a need, give it a go. 
If you would like more information about the Mitton pelvic belt check out Ingrid's website.


References
Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008;17(6):794–819. doi: 10.1007/s00586-008-0602-4. 
Pierce H, Homer CSE, Dahlen HG, King J. Pregnancy-related lumbopelvic pain: Listening to Australian women. Nurs Res Pract 2012;2012:387428. doi: 10.1155/2012/387428. 

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Diabetes in Pregnancy - Physiotherapy Advice

8/30/2019

 
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Often times a diagnosis of diabetes in pregnancy (also known as Gestational diabetes mellitus  (GDM), can be overwhelming and cause feelings of fear and helplessness.
What is GDM?
​During pregnancy the hormonal changes can cause insulin resistance resulting in an increase in blood sugar levels. If the level is too high it can be a health risk to both mom and baby. 

If you have been recently diagnosed, your doctor or obstetrician may prescribe various treatment methods to help you manage with this. Physical activity and resistance training is recognized as a helpful adjunct to managing GDM. The benefits of exercise are in pregnancy alone are countless but in GDM this also offers: 
- improved physical health and well being 
- improved control of blood sugar levels
- reduce the risk of type 2 diabetes beginning in the postpartum period
- weight management 

At Inner Active Pelvic Health, our physiotherapists are specially trained in working with pregnant women who have gestational diabetes. If you doctor has given you the all OK to exercise during this time one of our  physiotherapists can assist and help you identify an effective and safe program. When choosing to exercise with GD they can help you with the following:
  1. Type of exercise - identify an exercise that is appropriate to your level of capability and most importantly something that you ENJOY! Swimming, walking, low impact aerobic, modified aerobics , light weight strength training are just a few examples of activities considered safe during pregnancy.
  2. Frequency - how often and when to exercise are important parameters to establish and ensure your workout is safe and effective
  3. When to stop: It is important to understand the warning signs to reduce  or stop exercising 
    1. pain: chest, pelvic, back 
    2. vaginal bleeding, amniotic fluid loss/leakage
    3. swelling- hands, feet, legs or face 
    4. dizziness, faintness or nausea, shortness of breath
    5. high heart rate 
    6. poor balance 
    7. reduced fetal movements
  4. Intensity - understand how to monitor level of work: use of the talk test, heart rate and exertion rating scales are some of the strategies we are able to assist you with. 
 If you would like more information about exercising and GDM and how physiotherapy can help, then don’t hesitate to get in touch. Contact us at the Mernda clinic or Bundoora clinic or can leave a message in the chat box below. 

Get the care you deserve. 

how to take care of your pelvic floor during the winter months

6/3/2019

 

Top  tips to care for your pelvic floor during the winter months 

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 With the cold winter weather here it is hard to avoid the sniffles that comes with it. Unfortunately for some, this time of the year is a harsh reminder of pelvic floor problems. Coughs and sneezes are known activities that cause an increase in the intra- abdominal pressure and in the presence of a weak pelvic floor muscles can result in urine loss also known as Stress urinary incontinence. So what can you do about this? 
1) Seek help 
Do not ignore a persistent cough. Speak to your health care provider to make sure you have covered all ground. Commonly ignored is chronic sinusitis, nasal polyps, post-nasal drip or asthma/chronic bronchitis. Further investigations may need to be done to rule out something more serious. 
2) Check your pelvic floor 
A pelvic health physiotherapist can assist you in your pelvic health problems by assessing your muscle strength and coordination. If weakness has been identified it is important to get a individualized exercise program that is specific to your needs and abilities. 
3) Practice the Knack
The knack is a technique where the pelvic floor muscles are squeezed before an activity that increases the abdominal pressure, in this case coughing. This aims to increase the resistance on the downward pressure consequently preventing urine loss. 
4) Maintain a healthy weight 
It has been found that abdominal weight does increase the pressure on the pelvic floor. Research supports weight loss promotes continence even as little as 10% of the body weight.  
5) Manage constipation
Chronic constipation inevitability places pressure on the pelvic floor. Increase fibre intake through diet to keep bowels soft and easy to pass. 

A pelvic health physiotherapist can help you in managing stress urinary incontinence. It is important that you are assessed and taught how to perform your exercises correctly to prevent your symptoms from getting worse. Further advice can be provided regarding appropriate exercises that effective, fun and most importantly pelvic floor safe. 
If you would like to know more about how a pelvic physiotherapist can help you to manage your pelvic floor during this winter contact either Mernda or Bundoora clinic to make a booking. 
Get the care you deserve!

Mother's Day Dedication: Breast Cancer Survivor My  Hero My Mom

5/11/2019

 

Mother's Day Dedication: Breast Cancer Survivor My  Hero My Mom 

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As mothers day approaches I could not find a more fitting way to honor my mother and share her story.

My Breast Cancer Story
It is something you often hear about, happening to others but never imagine it is something that can happen to you. At 53 years of age, in 2000 I was diagnosed with Breast Cancer. Married with 4 children my concern quickly went to my family and not wanting them to see me suffer.
The journey all began one morning whilst having a bath I felt a lump in my right breast. Breast cancer awareness was not something that was readily shared or seen in the media or news, but I had read enough to know it was something that I had to get checked out. After visiting my doctor, I was advised to have a biopsy. Results confirmed the cancer.
I was overwhelmed with questions of many which I knew no one could give me answers to.  
Within a week, I had a mastectomy done followed by months of chemotherapy and then radiation.  I was fortunate to have been surrounded by amazing care staff in particular my oncologist who contributed greatly to my healing process. Early on I choose to be proactive in my recovery and that meant seeking as much information on what I can do to help my recovery. I attended counselling, I got involved in a support group, watched my diet and took up regular exercising. I know look back and realize I was driven by wanting to be there not only for myself but for my family.  This gave me the strength to move forward even when there were times that I wanted to give up.
My survivorship journey continues, but in that journey, I am most grateful and blessed to be present for my family. Being a mother and seeing your own children become mothers and fathers is something I never take for granted.
I am now an active volunteer of my local cancer centre, reaching out to many women who are at different stages in their cancer journey. The valuable support I received throughout my journey I can only pay it forward and help other women, being there for them providing them support and friendship. Raising awareness continues to be ongoing work for all women to be breast aware.

  
 
  This last week we wanted to highlight some helpful tips moms out there can do to care of themselves and consequently be able to care for thoses around them. Tip 5 Breast Care Awareness is so crucial in your self care! More information check out https://www.cancer.org.au/about-cancer/types-of-cancer/breast-cancer/

Get the care you deserve Mamas! 
Happy Mothers Day!

Pelvic Health checklist

5/6/2019

 
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Simple tool to check your pelvic floor muscles
Early identification of pelvic floor dysfunction is important for successful treatment. Here is a simple checklist to use to help screen your pelvic health and help identify where you may need help. 

 Bladder 
  • Do you accidentally leak urine when you exercise, play sports, laugh or sneeze? 
  • Do you get up often over night to go empty your bladder? 
  • Do you constantly need to go to the toilet? 
  • Do you find it difficult to empty your bladder? 
  • Do you experience pain with bladder emptying? 
Bowels 
  • Do you suffer from constipation or strain to empty your bowels?
  • Do you accidentally loose control of your bowels?  or accidentally pass wind? 
Pelvic organs
  • Do you struggle to empty your bladder or bowels completely?
  • Do you feel a heaviness, pressure, discomfort, pulling or dragging sensation around your vagina or back passage? 
  • Do you experience frequent stop/start of urine stream?
Sexual Function
  • Do you experience any discomfort or pain during or after intercourse or sexual activity? 

If you answered YES to more than one of these help is available. 
A pelvic health physiotherapist can provide you with a thorough assessment and treatment plan to help manage your concerns and help you get back to doing the things you love.
Contact us now and Get the help you deserve! 

Top tips  to help you prepare for your  gynecological surgery

3/14/2019

 

Top tips to help you prepare for your gynaecological surgery

gynaecological surgery prepare
Many women are undergoing surgery for incontinence, prolapse and hysterectomy. A pelvic health physiotherapist is able to provide support to these women to enhance recovery and optimize the long terms benefits of their procedure. Preparation is key. At Inner Active Pelvic Physiotherapy seeing a physiotherapist will aim to:
  • Optimize bladder and bowel function:  It is important that the bladder and bowels are working effectively through good habits. A thorough assessment of the bladder and bowel function is carried out and appropriate advice and management is given. It is important good habits are started early to enhance your recovery post surgery. check out out blog on healthy bladder and bowels HERE
  •  Assess your pelvic floor muscles function: Evidence shows up to 50% of women do not know how to exercise their pelvic floor muscles correctly under verbal instruction and at least 25% performing this activity make symptoms worse. We are trained to assess these muscles and identify what is specific to you and your abilities when customizing your pelvic floor training program. Often times the weakness is secondary to underlying issues such as muscle tension, fatigue or poor coordination. It is important these muscles are trained in the right way to achieve maximum results. 
  • Assess your breathing, posture and movement: Your breathing muscles that is your diaphragm works very close with your pelvic floor and it is important the two work close together. Good posture improves your core muscles that is your deep abdominal and pelvic floor muscles. When it comes to movement we ensure that this is safe and effective. Prior to surgery this may involve teaching you ways to be able to get in and out of bed or positions of rest. 
  • Management of pain: this can be pain in any part of your body that can affect your movement, function and strength and as a result this can impact your recovery. Common areas that can be issues of pain are lower back, hip pain or pelvic pain that consequently affect can commonly affect how your pelvic floor muscles are performing. 
  • Understand your physical activities: By understanding your current level of fitness before surgery, this allows us to set up a treatment plan that is realistic and holistic in helping you to return to doing the things that you enjoy after surgery. This is also useful in mapping out ways to execute household chores, work duties and daily tasks. Our physiotherapists work with you to establish safe and effective ways for you to return to these activities, use of modifications or alternatives were necessary. Your physiotherapist is able to guide you in a specific graded exercise program that is pelvic floor safe and individualized to your needs and  your surgeon's post operative protocols.
  • Addressing any other issues: With any kind of surgery it can be a stressful time emotionally and physically. We aim to work very closely with your surgeon, doctor and other healthcare providers to make sure that you receive the support you need.  
  • Useful link for more information: http://www.ugsa.org.au/patient-resources/www.ugsa.org.au/patient-resources/
We are also able to support you after surgery and offer guidance in maximizing your recovery with a thorough evaluation.

Book in with our women's health physiotherapist at Bundoora clinic or Mernda clinic

Cancer and the Pelvic Floor

12/14/2018

 
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Author: Lisa Cheek, PT, DPT, CLT-LANA

Everything you wanted to know about the pelvic floor but were afraid to ask.

The pelvic floor is an important group of muscles that lives in the bottom of the pelvic bowl.  These muscles influence bladder, bowel, and sexual function, and play an important role in spinal stability.  They even help us breath! The pelvic floor is constantly working, and yet many people have no idea that this group of muscles even exists.  Patients often come to us with preconceived notions of pelvic floor health. You may have heard that we should all be doing our Kegels daily, or that leaking a little urine when you sneeze is “normal”.  It can be difficult to separate pelvic floor fact from fiction, especially in the information age. It is well documented that gynecologic cancers (endometrial, ovarian, cervical, vulvar, etc.) and their subsequent treatments can have a big impact on pelvic floor function, which can in turn negatively impact quality of life.  We hope to help you learn about the pelvic floor and its typical function, how this can be affected by cancer treatments, and how you can take control and manage pelvic floor dysfunction.

What is the pelvic floor, and what does it do?

As previously mentioned, the pelvic floor lives at the bottom of the pelvis and is made of several layers of muscles that extend from your pubic bone to your tailbone.  It is made of three layers of muscle which extend from your pubic bone back to your tailbone, and out to your hips on the side. The pelvic floor has a few main functions:
1. Sphincteric– The pelvic floor muscles form sphincters around the urethra, vagina, and rectum.  They act as the gatekeepers from the pelvic bowl to the outside world. They play an important role in maintaining urinary and fecal continence, and supporting sexual function.

2. Support– Think of the pelvic floor as a hammock for the pelvic organs: the bladder, uterus, and descending colon.  They provide support for these organs as we move around in our daily lives.

3. Sexual function– The muscles of the pelvic floor play an important role in sexual arousal and orgasm.  They help maintain bloodflow to vaginal region, and contract rhythmically to enhance sexual pleasure.

​4. Stabilization– There are four muscles that form a canister of stability in your midsection and keep your spine and pelvis stable, including: the pelvic floor, the diaphragm, the transverse abdominis (the “weight belt” muscle), and the multifidi on the spine.  These muscles all need to work together to provide stability and support normal function.
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When the muscles of the pelvic floor are working together and at the right time, they perform all the functions listed above.  However, this is not always the case. Pelvic floor dysfunction can happen to anyone, regardless of gender, age, or health status.  Symptoms of pelvic floor dysfunction can include urinary incontinence, pelvic organ prolapse, pelvic pain, bowel dysfunction, and beyond.

How does treatment for cancer affect the pelvic floor?

Treatment for gynecologic cancers depends on the tumor size, location, and stage. Surgical treatments may involve local excision, tumor debulking, hysterectomy (removal of the uterus), salpingo-oophrectomy, and removal of pelvic lymph nodes.  These procedures can directly affect the pelvic floor through scar tissue restriction and swelling, and may also have an indirect effect due to hormonal changes associated with removal of ovaries.1  Adjuvant therapies, such as chemotherapy and radiation, may also impact the pelvic floor. Radiation, either external beam or internal brachytherapy, can cause fibrosis (hardening) in tissues of the pelvis, which may lead to narrowing and shortening in the vaginal canal.  Fibrosis in the vaginal wall and pelvic floor musculature can manifest as incontinence and/or urgency of bowel and bladder, pelvic pain, and sexual dysfunction. 2,3,4 Studies have demonstrated that following surgery and radiotherapy for gynecologic cancers, patients are more likely to report lower libido, altered sexual response, change in body image, and distress related to changes in sexual health.5,6
Removal of pelvic lymph nodes also places patients at risk for developing lypmhedema, or chronic swelling.  Dissection of the pelvic lymph nodes can lead to swelling in the abdomen, genitals, and legs. There is some evidence to suggest that genital lymphedema can impact bladder function 7, and it may have implications for sexual health as well.
The degree to which cancer treatment affects pelvic floor varies.  Some patients may have no symptoms, and some may have multiple, severe impairments.  Some issues may arise immediately following treatment, and some may take time to develop.
Why aren’t more people talking about pelvic floor health after cancer treatment?
There are many reasons why patients don’t get help for pelvic floor dysfunction right away.  After cancer treatment, many patients are so grateful to have survived that they feel guilty complaining about these comparatively “minor” issues.6 Many patients are also not aware that pelvic floor treatment exists, or feel that they will just have to live with their symptoms.  As a result, many patients suffer in silence –sometimes for years– before they receive the treatment they need. Patients are also very resilient, and find ways to deal with issues of bladder, bowel, and sexual dysfunction on their own. Everyone needs a little help sometimes, and specialized treatment exists to address cancer-related dysfunction of the pelvic floor.
What can I expect in pelvic floor rehabilitation?
At your first visit, your therapist will take a thorough history to better understand your complaints, establish goals for treatment, and to screen for conditions that require medical treatment.  This will include your history with cancer, types of treatments you received, and symptoms you may have had prior to your treatment for cancer.  Your therapist may then perform a physical examination to include movement, muscle strength, and range of motion. Pelvic floor physical therapy often requires a detailed examination of the pelvic floor.  This can include internal or external examination, often both. Your therapist will talk you through the process of the pelvic examination and give you the opportunity to ask questions or express concerns.  Your therapist will always make sure that you consent to the examination, and you can stop the exam at any point if you feel uncomfortable. The internal examination involves assessing the pelvic floor muscles manually, checking for strength, flexibility, and tone.  The examination may reveal tender spots known as trigger points that refer pain to other areas of the body. The therapist will also assess for fibrosis or muscle spasm, and will check for normal range of motion in the pelvic floor muscles.


 Based on the results of your examination, your therapist will provide treatment.  Treatment might include pelvic floor strengthening, relaxation, muscle stretching, or trigger point treatment.  Patients may need to use tools called dilators to stretch the vaginal tissues and soften fibrosis in the perineal region.  Treatment might also include stretching for your legs and low back, breathing exercises, scar massage, bladder and bowel training, or establishing an exercise regimen.  No two patients are alike, and the treatment protocols change based on the patient’s particular history, needs, and goals.
Pelvic floor rehabilitation is always based on a foundation of informed consent, and mutual trust between the provider and patient.  Communication is of utmost importance, and your therapist should listen openly to your concerns, questions, goals, and observations.  The success of pelvic floor rehabilitation is dependent on a correct assessment of the source of the dysfunction, the correct treatment plan provided by the therapist, and the patient’s adherence to the plan. 
What’s next?
If you think you might have symptoms of pelvic floor dysfunction (or even if you just want to find out if you do), speak to your healthcare providers, gp, nurse or oncologist or can contact a pelvic health physiotherapist directly. There is care available for these issues that are sometimes difficult to discuss. With the right treatment, it is entirely possible to decrease or eliminate symptoms of pelvic floor dysfunction.  Contact us with any questions you might have, to schedule your consultation!



About the Author: Lisa Cheek, PT, DPT, CLT-LANA
Lisa is a physiotherapst , certified  Lymphedema therapist based in Colorado, USA. She is progressing through her pelvic health certification through the Women’s Health APTA. Her treatment philosophy emphasizes care for the whole person, and considering the big picture when treating musculoskeletal dysfunction. Lisa believes in empowering patients through education and incorporating principles of modern pain science.
References
  1. Huffman LB, Hartenbach EM, Carter J, Rash JK, Kushner DM. Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide. Gynecol Oncol. 2016;140(2):359-368. doi:10.1016/j.ygyno.2015.11.010
  2. Hazewinkel MH, Sprangers MAG, van der Velden J, et al. Long-term cervical cancer survivors suffer from pelvic floor symptoms: A cross-sectional matched cohort study. Gynecol Oncol. 2010;117(2):281-286. doi:10.1016/j.ygyno.2010.01.034
  3. Bergmark K, Åvall-Lundqvist E, Dickman PW, Henningsohn L, Steineck G. Vaginal Changes and Sexuality in Women with a History of Cervical Cancer. N Engl J Med. 1999;340(18):1383-1389. doi:10.1056/NEJM199905063401802
  4. Bernard S, Ouellet M-P, Moffet H, Roy J-S, Dumoulin C. Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: a systematic review. J Cancer Surviv 2016;10(2):351-362. doi:10.1007/s11764-015-0481-8
  5. Rutledge TL, Heckman SR, Qualls C, Muller CY, Rogers RG. Pelvic floor disorders and sexual function in gynecologic cancer survivors: a cohort study. Am J Obstet Gynecol.  2010;203(5):514.e1-e514.e7. doi:10.1016/j.ajog.2010.08.004
  6. Hazewinkel M, Sprangers M, Taminiau-Bloem E, van der Velden J Burger M, Roovers J-P. Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer: Pelvic floor symptoms in survivors of gynaecological cancer. BJOG Int J Obstet Gynaecol. 2010;117(1):39-46. doi:10.1111/j.1471-0528.2009.02411.x
  7. Bergmark K, Avall-lundqvist E, Dickman PW, Henningsohn L, Steineck G. Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls. Int J Gynecol Cancer. 2006;16(3):1130-9.
Image credits
1) http://www.drjenniferashton.com/

HAYFEVER AND BLADDER LEAKAGE

11/23/2018

 
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Spring is here and the sun is out but unfortunately that also means there is an increase in pollen in the air. For those who suffer with hay fever it’s a much-dreaded season more so if you experience stress incontinence due to the persistent sneezing. Stress incontinence is the loss of urine when there is an increase in the pressure in the abdomen that in turn presses down on the bladder. This is more common in women due to the effects of pregnancy, birth and menopause that place stress on the pelvic floor muscles but this can occur in men especially seen after prostate surgery.
So here are some helpful tips to help you manage your bladder concerns during this time of the year.
  • Seek help.  It is important to not ignore these symptoms as any form of leakage is NOT normal. It usually indicates a failure in the continence system and if left untreated has the potential to only get worse.
    • Speak to your doctor about your concerns, this may also include reviewing your medication that you are taking and seeing that it is effective in managing your symptoms
  • See a pelvic health physiotherapist. A pelvic health physio is able to carry out a complete evaluation including that of the pelvic musculature to help identify and find solutions to your problems. You do not require a referral.
  • Do your exercises. Once it has been identified that muscle weakness is in fact your main problem, it is important to adhere to the exercise program you are given to see the results you need.
  • Practice the “knack”, this is a protective movement of bracing or engaging your pelvic floor muscles before you cough and sneeze.
  • Stay well hydrated, unless advised otherwise by your doctor aim to have at least 1.5litres to 2 litres of fluid in a day. Unfortunately, many men and women fall into the trap of cutting down their fluid intake. This can cause bladder irritation which can become a further problem. Keeping well hydrated also aids with your bowel health which ensures stool are soft and easy to pass. If not, this can lead to constipation which place further stress on your pelvic floor worsening your symptoms.
  • Minimize your exposure-
    •  check out the weather/ pollen forecast in advance if you are heading out
    • Avoid areas were grass is being mowed
 
 
At Inner Active Pelvic Health Physiotherapy, we can help with your bladder concerns, and help you get back on track Get you back doing the things you love in keeping active and healthy.

Get the care you deserve!
 
Contact us now.   
 

Staying active with pelvic floor muscle dysfunction

11/10/2018

 
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When facing problems with pelvic conditions the last thing most want to do is leave the house let alone break a sweat with exercise.  Here are a few tips to try that are not only pelvic floor friendly but also aim to help you keep moving and keeping  active for your long term health:

1) Check in with a pelvic health physiotherapist
A trained pelvic health physiotherapist is able to carry out a full assessment to identify where the problem is and how best it can be addressed. Part of that may include giving you strategies to manage pain, weakness and loss of movement.  This is a great way to be able to get a complete evaluation and get a program that is individualized and specific to you and your needs. 

2) Engage in low impact exercises
  • Walking is a great low impact exercise that can be adapted to your concerns. Special attention is given to pace, posture and progression. 
  • Water based exercises are great way to reduce pressure on your pelvic floor the buoyancy of the water significantly lightens the load on your pelvic floor and joints This is a great way to get a fully body workout that helps strengthen your core
  • Stretching and flexibility exercises – these can help increase the blood flow to your muscles and in turn help muscles perform more efficiently, improving range and movement.
3) Keep well hydrated
Unless told otherwise by your doctor aim to drink 1.5 to 2 litres of fluid throughout the day. Poor fluid intake not only impacts bladder health but also bowels which can further exacerbate issues with your pelvic floor muscles. In particular, constipation. This can lead to behaviors of straining in order to empty the bowels which in turn weaken the pelvic floor worsening symptoms.   

4) Eat a healthy balanced diet
This not only aims to maintain a healthy weight, but it enhances gut movement and prevents constipation which is essential for long term pelvic health. 

Help is available in getting you back to complete health.  Contact us and see how we can help you. 

Get the care you deserve!  


Pelvic Girdle Pain in Pregnancy

10/12/2018

 
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Pregnancy-related pelvic girdle pain is a condition that causes pain around the joints of the lower back and pelvis during and after pregnancy. 
During pregnancy a hormone called relaxin softens the ligaments around the joints of the pelvis. This is a natural process which assists childbirth affecting the pubic symphysis at the front of the pelvis, or the left and right sacroiliac joints at the back of the pelvis.
The pain can make it difficult for women to walk or participate in activities of daily living such as sitting, going up and down steps, turning in bed,  and exercising. This can occur at any time during pregnancy from 1st to 3rd trimester.  
The most important factor is early and correct assessment so that appropriate treatment can be taken. 
At Inner Active Pelvic Health Physiotherapy we are able to help you manage the pain, address fears and concerns working closely with your support team (midwives, doctors or obstetricians) to help you restore function, movement and most importantly enjoy your pregnancy!
Some of the strategies we incorporate may include:
  • prescription of an individualized program for you which includes specific exercises to optimize the deep abdominal muscles and pelvic floor such as gluteal strength exercises 
  • recommend use of appropriate support wear specific to your condition
  • advice on  care and considerations for postitions and movment whith labour and birth.  
  • advise on strategies to movement and exercises that are pain free, such as advice on positions with sitting, standing and sleeping
Research  reveals up to 25% of women can continue to suffer with pelvic girdle pain after pregnancy. Its never too late to seek help. 
​
Get the care you deserve. 
  
​October 2018


Healthy Habits: Bladder and Bowel Care

8/31/2018

 
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Going to the toilet is a big part of our lives. But unfortunately, it’s not something commonly discussed. As a result not many of us have a great sense of what is normal and what is not when it comes to bladder and bowel habits.  Some habits are learnt early on and unfortunately carried into adult life and can become problems. Here are some habits to optimize your bladder and bowel care.
 
1) Be aware of your pelvic floor muscles

The pelvic floor muscles are a group of muscles and ligaments at the base of the pelvis. They play an important role of bladder and bowel control hence keep us continent. Are you aware of what your pelvic floor muscles are doing? Having a sense of awareness of how these muscles are behaving makes it easy to detect when things don’t feel quite right. Like any other muscles in the body the pelvic floor muscles should be able to contract/tighten as well as relax fully to allow complete bladder and bowel emptying.

 2) Drink adequate fluids
Unless instructed otherwise by your doctor, about 1.5 to 2 litres of fluid in a day is advised. It is not always the case: the more water you drink the more you have to go the toilet.  It is true the less water you drink the less the bladder will fill up but this can also lead to concentrated urine in your bladder. This can be a bladder irritant meaning that it can upset the lining of the bladder wall. Consequently, what may happen the bladder will try to empty frequently.

 3) Avoid going “just in case”
Essentially what "Just in Case" voiding is, is when you go to the bathroom before you need to, for example before you leave the house, head out on a road trip or a hike just in case you might have to go later. The bladder is able to hold an adequate amount of fluid. It has a well-regulated mechanism in place that lets us know when its time to go when full.  When we start emptying it before its full the bladder learns this and can take advantage.  Consequently, over time, the bladder gets used to holding smaller amounts and signals are sent to the brain to go more frequently. This can potentially lead to problems such as urgency and frequency.  So really listen to your body go when you actually feel the urge to go. 
 To avoid this, simply wait to use the bathroom until you truly need to!
On the other end of the spectrum holding for long periods of times (such as more than 3 hours) can also be detrimental. Be mindful of the number of trips you make and trying not to go beyond 3 hours as a guideline. 

4) No need to strain
When emptying either bladder or bowels on the toilet no straining should be required.  By bearing down to initiate or complete a motion places pressure  and stretching on the supporting structures within the pelvic floor and weaken the muscles. With the body’s mechanism the muscles and sphincters controls are designed to allow emptying to occur without much effort required.  Ensure you have adequate fibre and water intake for important stool regularity and consistency.
5) Proper toilet posture
Good posture when sitting on the toilet is vital. This allows proper emptying and reduces straining on the pelvic floor muscles. Try the following
·         Lean forward slightly with elbows resting on knees.
·         Place your knees higher than your hips ether raising your heels or use of a foot stool
·         Keep you back straight try not to slump
Push your lower belly out, this helps to relax sphincter muscles in particular the anus(back passage).
  
These habits are vital for the health and wellbeing of your pelvic organs and muscles. Seek help if you have any problem with your bladder or bowel control.

Get the care you deserve.

Disclaimer: Information in this blog is general and not to be used for medical diagnosis or treatment. Please consult your health care provider if you have any concerns with your bladder and bowel health. 


Running and your "floor"

7/30/2018

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This past weekend a friend and I went to the local parkrun and yes were one of the “first timers”
It was great being part of such a large group of 200+ of like-minded people, cheering each other. It had a sense of community, belonging and fun. We were all coming from different walks of life but shared the common goal of pursing fitness and wellbeing. I spoke to one woman who said he had been doing this for over 20 years! Absolutely amazing! 
However, this prompted me to think of a different kind of group, women who may be suffering in silence or not able to take part in running due to pelvic floor dysfunction (incontinence, pelvic pain or prolapse) Most commonly reported with running is stress incontinence. This is loss of urine due to an increase in the abdomen that pushes down on the bladder.  In running this is due to the impact of the body through the feet on the ground that causes an increase in abdominal pressure. This pressure acts on the bladder and if the pelvic floor muscles are weak results in leakage. This usually happens when running hard, running downhill and sprinting.
Just like pain, bladder leakage must be treated with the due care it deserves. It is not NORMAL, and in fact it’s presence is one of the ways the body tells you that something is not quite right or not working as it should. Its reported about 30% of women suffer from incontinence, these are only the reported cases. With any dysfunction if left untreated it has the potential to only get worse. More so with running due to the force pressures involved acting on the pelvic floor muscles.
Stress incontinence is more common in women due to the effect of pregnancy and childbirth but can also be present in those without children. Chronic constipation, chronic coughing and obesity are other risk factors. 
If you are running and are experiencing the above here are a few tips to consider:
 
Pelvic floor muscle awareness - Have you got a sense of what your pelvic floor muscles are doing? Are you able to tighten and lift them as well as relax and let go?  It is important to be able to carry out the two movements for effective muscle function and hence strength training.  Being able to have a consistent training program in place for your pelvic floor muscles is a good way to get effective results. (see article on essentials of pelvic floor workout).
Breath work - Breathing well is an important role of working the inner core/muscles. Ensuring the diaphragm (breathing muscle) is moving and doing its job allows good coordination and connection with your pelvic floor muscle. These two-work hand in hand for optimum core strength and stability.  
Do not dehydrate yourself- common misconception less in less out. This is far from the case during a physical activity.
Check your speed -Be mindful of how you are increasing your intensity. Stride length and pace rate can also impact your pelvic floor movement (that is faster pace results in an increase in abdominal pressure).
Check your form - As we run faster our body alignment can often break down as the body adopts compensatory movements to make up for any weakness and imbalance.
Last but not least a few self-assessment questions to ask yourself:
  1. How is my footwear?
  2. How is my posture?
  3. What is my running track like – surface type, flat or uphill/downhill?
At Inner Active Physiotherapy, we have women’s/ pelvic health physiotherapist that specializes in pelvic dysfunction can help you with the above. They can screen your musculoskeletal system and carry out a full assessment of your pelvic floor muscles. They would be able to provide you with the information and steps you need to resolve this. Information is empowering!
​
 If you are considering on starting or getting back to running after birth, surgery or injury please see your women’s health physiotherapist. At Inner Active Pelvic Physiotherapy we take a patient-centered  approach and create an individualized treatment program designed to address your specific concerns and help you to get back to doing what you love. 
 
Get the help you deserve! 
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Q & A WHAT IS PELVIC HEALTH PHYSIO?

7/25/2018

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​What is Pelvic Physiotherapy?
This is a specialized advanced area of physiotherapy that assesses and treats Pelvic floor dysfunction (PFD), which can affect men and women. PFD is a general term that is used to describe a number of conditions that may affect the urinary, reproductive, digestive, sexual and/or stability systems in the pelvis.

​What kind of conditions do we treat?
Conditions that are commonly treated are:
· Bladder issues such as incontinence, urinary frequency or urgency 
· Bowels problems for example constipation and incontinence (leakage) 
· Pelvic organ prolapses
· Gynaecological surgery support pre or post operation 
· Pelvic pain (including pain with intercourse, and pelvic examinations)

In addition 

· Pregnancy related pain and/ or dysfunction (pre- and post-natal)
· Abdominal separation (rectus diastasis)
· Pelvic floor strengthening/awareness
· Caesarean or perineal scar management
· Pelvic girdle pain
· Orthopaedics 
o Low back pain 
o Neck pain 
o Hip
o Post-surgical 
 
How can Pelvic Physiotherapy help? 

For a lot of women, I see getting treatment in this specialized area is life changing. Unlike a sore arm or leg that is obvious to those around you, pelvic issues are considered a taboo to discuss and as a result so many people suffer in silence.  Restoration in this area comes in different forms and the most common statements are: 
I am no longer in pain 
I can jump on the trampoline with my kids 
I can go back to running 
I don’t have to hold back on laughing 
I can leave the house 
Our treatment goes beyond making you feel better but aims to empower you with the knowledge, tools and strategies you need to live your life the way you want.  

What makes Inner Active Pelvic physio unique? 
We have a holistic approach that goes beyond just focus of the pelvic floor.  Our knowledge and expertise in both the musculoskeletal and pelvic floor dysfunction allows us to have a comprehensive approach in your assessment and management.  
We aim to provide a range of care that goes beyond rehabilitation. It is our passion at Inner Active Pelvic Physiotherapy to not only get you better but to present you with opportunities to continue to promote your health to achieve optimal fitness and wellness beyond your time in physiotherapy. By offering a wellness/Pilates program and a functional assessment we aim to assist you in reaching your goals with health and fitness. 
We provide quality of care and passion in the services we provide. Do not wait to seek treatment, Begin the conversation with a health care provider and get the care you deserve.  
Tafy Seade 30 June 2018
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    Author

    Tafy is a physiotherapist who specializes in women's and pelvic health physiotherapy in Bundoora and Mernda, the northern Suburbs of Melbourne


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