Interview with Gastroenterologist - Insight into Chronic Constipation
In this month's blog, Tafy had the opportunity to interview Dr Simon Glance, a gastroenterologist based in the Northern Suburbs and part of the health care team at the Bundoora Health Specialist centre.
As pelvic health physiotherapists we treat conditions impacting both bladder and bowels. Constipation continues to be major problem worldwide and common complaint in Australia.
In this interview we talk about the importance of seeking help and recognizing when bowel habits are not normal. Chronic constipation can be primary or secondary and often can be accompanied with other issues the longer it continues including the musculoskeletal system and the pelvic floor muscles!
Topics covered are:
For more information on the following, see resources and links below:
Dr Simon Glance- GastroNorth
Bowel anatomy - Continence foundation of Australia
Looking after your bowel booklet - Continence Foundation of Australia
If you would like to know about how a pelvic physiotherapist can help you with your bowel concerns, please reach out and contact us at email@example.com
ARE MY PELVIC FLOOR MUSCLES TOO TIGHT? - OVERACTIVE PELVIC FLOOR MUSCLES
What is Pelvic Floor Muscles Overactivity?
As defined by the ICS (international continence society) this is "a situation in which the pelvic floor muscles do not relax, or may even contract when relaxation is functionally needed, for example when emptying the bladder or the bowels." (Refence 1)
Although it may appear to be a definition with a somewhat obvious simple solution: RELAX ......it is actually a lot more complex than that. Many women are faced with this problem and unfortunately despite ongoing research findings and evidence they are continually told JUST RELAX when these muscles are not cooperating. The aim of this post is to help highlight what it means having an overactive pelvic floor muscle, what can be involved and who may be needed in your care team to help you manage.
An overactive pelvic floor muscles can be a result of
1) Medical - doctor, specialists such as urogynecologist, urologists,
2) Psychologists specialising in pelvic pain
3) Specialized Pelvic Health Physiotherapists -
At Inner Active Pelvic Health Physiotherapy our physiotherapists are trained in the management of overactive pelvic floor muscles that can result in pelvic pain and/or bladder and bowels issues. We work closely with other healthcare providers to ensure a holistic approach. Treatment is based on taking a very detailed history of your condition and understanding your story. An assessment that is suitable and appropriate to your situation can be done of the pelvic area, including the pelvic joints, muscles, movement and posture assessments. Treatment can include the following: education, manual therapy, use of biofeedback or electrical physiotherapy, use of trainers or graded exposure therapy.
If you suspect you may have overactive pelvic muscles that may be associated with your condition, reach out and see how our physiotherapists can help. Contact us HERE
Tafy Seade (Pelvic Health Physiotherapist)
1) Messelink B, Benson T, Berghmans B, Bø K, Corcos J, Fowler C, Laycock J, Lim PH, van Lunsen R, á Nijeholt GL, Pemberton J, Wang A, Watiert A, Van Kerrebroeck P Standardization of terminology of pelvic floor muscle function and dysfunction: Report from the Pelvic Floor Clinical Assessment Group of the International Continence Society. Neurol Urodyn 2005;24(4) 374-380.
Understanding the Menstrual Cycle
Want to know just how complex a female’s menstrual cycle is?
Take a look at this video which details the intricate relationship between the endocrine system (hormones) and the menstrual cycle.
It’s so important to understand “normal” menstrual function in order to identify times when this process is disrupted or impaired. Although there is natural variability amongst women, a typical menstrual cycle is around 28 days and is essentially the body’s monthly response to not being pregnant (i.e. the egg released by the ovaries is not fertilised and thus the endometrial lining is shed).
The delicate interplay of hormones, genetics, nutrition, physical health and behavioural factors can all play a role in the female menstrual cycle. These influences are incredibly important to maintain normal cyclic menstrual function and if necessary, they can be used to address any changes or abnormalities that may arise throughout the female lifetime (e.g. menopause).
Written by Sarah Henderson
Armando Hasudungan (2014). Female Reproductive System - Menstrual Cycle, Hormones and Regulation, Retrieved from https://www.youtube.com/watch?v=2_owp8kNMus, May, 2020
Norman, R.L. (2014). The Human Menstrual Cycle, In: Robert-McComb J.J., Norman R.L., Zumwalt M. (eds) The Active Female. Springer, New York, NY
How to check for an abdominal muscle separation.
In clinic a thorough a assessment can be carried by one of our physiotherapist that aims to establish the integrity of these muscles and tissues but measuring the width, length,depth, tension and surrounding muscle activity.
However at home you can assess yourself for the width and the tension.
How can I measure it at home?
A measurement of 2 fingers or more represents a separation & will require further rehabilitation. Although generally not painful abdominal muscle separation can consequently result in poor truck and pelvic floor support due to the weakened abdominal wall.
Usually this separation becomes apparent when women start noticing a bulge or doming in this area when getting out of bed or a chair.
To be continued.......
Written by Sarah Henderson
Abdominal Muscle Separation, also known as Diastasis of the Rectus Abdominus Muscle (DRAM)
What is it?
DRAM is the separation of the connective tissue along the midline of the abdominal muscles. In some cases, this separation can also be evident on effort or exertion where a bulging can be seen along the mid-line.
What causes it?
A study has found that 100% of women experience some form of DRAM during pregnancy (Mota et al , 2015) due to the following factors:
What happens after pregnancy?
Abdominal separation is a natural mechanism of pregnancy to accommodate for the growing foetus.
The separation itself is not a medical emergency, however, the impaired abdominal wall function & weakened deep core muscles can result in back pain, pelvic pain, constipation and in rare cases a hernia. In addition, this condition can be associated feelings of negative body image & reduced self-confidence
This separation generally resolves within 6-8 weeks post-partum. In some cases, this laxity remains and varying levels of separation can result.
Those women that may be at greater risk of persistent post-natal separation:
Coming soon Part 2 How to check and manage a DRAM......
If you suspect you have an abdominal separation and need further advise or guidance contact us via email on firstname.lastname@example.org or make a booking HERE
By Sarah Henderson
Sarah has completed post-graduate study in women’s health & manual therapy of the pelvic floor, gaining experience in conditions relating to the pelvic region including pregnancy-related pain, postnatal rehabilitation, urinary incontinence, pelvic organ prolapse, diastasis rectus abdominus, as well as pre & post-surgical recovery of the pelvic region.
As you know, the health of our clients, our team and the community are first and foremost our focus. Due to the recent public health concerns and the emergence of the coronavirus (COVID-19) occurring we wanted to update you on the impacts to your sessions and the practice.
What are we doing?
As per the requirements from the Department of Health, all team members who have been to traveled from the listed countries are excluded from returning to work for 14 days from the date they left that country. This is also the case for any team member who is feeling unwell or showing signs or symptoms of being unwell, will remain at home. We want to to assure you that we are working hard to keep you safe by he following:
- Increased the cleaning frequency
- Regular cleaning of all equipment including exercise equipment
- Use of hand hygiene and hand sanitizes use in and around the clinic including the front desk
What can you do?
We request you follow the guidelines and recommendations set by the Department of Health and self-exclude if you have been to any of the countries with exclusion periods or have been in contact with someone with confirmed or suspected COVID-19. We also ask that you not attend the practice when you are unwell regardless of whether you think this may be COVID-19 or a cold or flu.
Please make sure you are practicing excellent hygiene as hand washing and containment of bodily fluids continue to be the best defence against the spread of cold, flus and COVID-19.
In addition simple measures we can all take to help prevent the spread:
Please respect our policy to cancel your appointment if you feel sick. if you cancel outside of the 48 hour period or cancel due to sickness, there will be no fee charged. We do however, request you provide us with as much notice as possible as we have a lengthy list of people waiting for appointments.
If you do wish to keep your appointment and would like to instead complete a video session with your clinician, please feel free to contact the practice and we will be more than happy to arrange this for you.
We will continue to keep you updated if there are any changes or concerns, however if you have any difficulties at all, please do not hesitate to contact us on 03 94708300 (Bundoora Health) or 03 97171200 (Mernda) or email email@example.com
Endometriosis and Persistent pelvic pain … The role of Pelvic Physiotherapy