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Pelvic Floor

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A Physio can help me with THAT?!

So, Brooke and I had a bit of an online chat for you. And  it's probably a good thing that it was an online chat, as most of our face to face chats involve a glass of bubbles! 

Brooke is the director of Back In Motion: Melbourne on Collins, a fantastic physiotherapist who just happens to specialise in Continence and Pelvic Floor Physiotherapy and a wonderful friend with a very enviable shoe collection!

So, Brooke, what exactly is Women's Health Physiotherapy?

Women’s health physiotherapy, is a sub-branch of musculoskeletal physiotherapy that has arisen from a need for specialists to treat and manage all things pelvic floor based. There’s been a real push in the last 5 yrs or so to call ourselves “Continence and Pelvic Floor Physiotherapists” because we treat so much more than women. We are involved in:
  • all things Continence based (both urinary and faecal),
  • all things bladder and bowel related (pain, constipation, long term diarrhoea),
  • all things pelvic organ prolapse related,
  • and any pelvic pain (vaginismus, vulvodynia, painful intercourse, erectile dysfunction).
And in fact, there is a large area of my work that covers Men and the management of their conditions which can include many of the above areas too. Most of the male treatment has arisen very recently with the advent of better Prostate Cancer diagnoses, treatment options and thus better referral on to us to assist in helping these men recover from their surgery, which nearly always results in a stint of significant incontinence and long term erectile dysfunction.
Given the pelvic floor is a muscle, it makes sense that Physios, who are experts in all things muscle and rehabilitation, would be perfectly placed to manage these types of problems. We should be the first line of treatment for anyone who experiences any kind of pelvic floor dysfunction – incontinence, prolapse, chronic pelvic pain, because we are so well trained in fixing it and luckily for us, the research and many studies back this up :-)
Many in this field will also treat children and their pelvic floor issues, but for me, after learning it at university, I haven’t had any clinical experience so I wouldn’t say I can treat kids as confidently as I can a woman or man who presents to my clinic.
We also manage pre and post-natal musculoskeletal pain; pelvic girdle pain/instability, spinal pain related to pregnancy, mastitis, blocked breast ducts, teach and run exercise classes for pre and post-natal ladies and generally manage the women who are in that peri-natal period.
All “women’s health Physiotherapists” or continence and pelvic floor physiotherapists will have gone back to university and studied either a masters or a post grad certificate on top of their bachelor degree to become one. We have the skill set to perform vaginal and rectal examinations and are thus able to identify the type of incontinence, or the extent of a prolapse and manage the very painful and debilitating chronic pelvic pain syndromes. This makes us or sets us apart from a regular physio who may have a real time ultrasound that can image your pelvic floor through a full bladder. These physios and this treatment can be quite useful in many circumstances, but as a general rule, if you are suffering from any of the above, we’d always recommend you see someone a little more qualified to get a more rounded examination and assessment of the condition.

How do I know if I need to see a Continence and Pelvic Floor Physiotherapist?

If you experience leaking, either of urine, wind or faeces, then you should definitely see a Women’s health physio :-) The important thing to realise is that it shouldn’t be seen as something embarrassing; in fact 1 in 3 women who have ever had a baby will wet themselves. And 50% of the population will experience a prolapse. So as I like to say, it is quite common, but please don’t consider it normal. I think women particularly, are hopeless at looking after themselves and tend to organise everyone around them before taking the time to attend to their own health needs. I see this a lot in my clinic, mums coming in years after the delivery of their first child and they’ve been leaking or suffering the whole time. If you can’t get through an hour of high impact exercise eg. A body attack class/ aerobics or running without stopping half way through to toilet, then you would most definitely benefit from an assessment.
Similarly, if you experience pain with/after intercourse, pain when passing a stool, if you couldn’t consider riding a bike because it would be too painful, then you would be helped immeasurably by seeing a women’s’ health physio.

What made you want to specialise in this field of physiotherapy?

Like a lot of career pathways, I pretty much fell into it. I was working in the UK at the time and accepted a locum/contract position on an obstetrics ward and fell in love with it. I had done a placement at uni in my undergraduate course at the Mercy Hospital and got a taste for it then so when I landed the role in the UK I realised that it was for me. One returning home from the UK, I completed the Post Graduate and have been doing it ever since! I’m now the clinical lead across the Back In Motion network, of which I’m a Practice Director. I now mentor the junior physios, run professional development sessions and am the go-to for all the network’s clinical questions.
My real love for this type of physio is more to do with make a real change to my patient’s lives and their day to day activities. Something that is so simple as being continent can be life changing for many. It’s the small wins and the average Joe who is helped by my skills as a clinician so this makes be very happy. It’s also pretty fun seeing all the babies too!!

If you had one message for the ladies reading this, what would that be?

If any of the above resonates with you, take action! You can do something about it, you can fix it and it’s not nearly as hard as you think!!!

 

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Women's Health and Fitness Summit 2015

It's pretty exciting and very inspiring to sit alongside some of Australia's leading Women's Health professionals while hearing from some of the world's leading Women's Health professionals!

Held at the Crown Promenade on September 12 + 14 and coordinated by Michelle Wright of MishFit, the weekend kicked off with the hilarious Elaine Miller 'Gussie Grips'. Her award winning show brings to light and starts the conversation on the 'taboo' topic of incontinence. Shockingly, 1 in 3 women will suffer from incontinence in their life (typical causing factors include childbirth, obesity and the hormonal changes of menopause). But there is hope! The under-performing muscles of the pelvic floor, that are the reason you might be incontinent, can be trained just like any other muscle. With the help of a great Women's Health physiotherapist, there is an 80% cure rate. In Victoria, we can use the Victorian Continence Resource Center for more information and to help you find a physio for you. 

Day One - Opening Ceremony, Elaine Miller and Jenny Burrell

Day One - Opening Ceremony, Elaine Miller and Jenny Burrell

Following Elaine's hilarious session, we were all inspired by the amazing Jenny Burrell, all the way from London, who encouraged us to help women 'Stand in their sacred space' in her informative Post Natal Core and Restore session. Jenny is very passionate about Women's Health and it is hard not to leave her session without a renewed sense of needed to empower Every. Single. Woman. around you to do more and be more!

In the final session for the Saturday, we heard from the incredible knowledgeable Robin Kerr. With over 20 years' experience, Robin's insight into posture and gait informed our views on transegrity - with a focus on the pelvic floor being integrated into our movement patterns and how poor movement patterns can affect the function of the pelvic floor.

Day Two - Lisa Westlake and just having a bit of a Play!

Day Two - Lisa Westlake and just having a bit of a Play!

Day Two kicked off at 8am as we sat down to hear from Lisa Westlake in her Exercising for 2 session. An hour with Lisa was just not enough! She gave us so many great ideas for helping beautiful mothers to be enjoy a healthy pregnancy and to prepare their bodies for birth and beyond. One pearl of wisdom that came from this session is to remember to 'Live life like you're wearing a mini-skirt' during pregnancy to help keep your body safe.

Following Lisa's informative talk, we got to get up out of our seats and have a bit of a Play with Mel from PTAcademy! For me, this session helped me consolidate what I already try to do in most of our group sessions. As adults, we don't often get the experience of unstructured play. Sure, we play sports. But have you ever watched children play? It's exploration. It's experimentation. It's an experience! Mel gave us some great ways to incorporate play into our group sessions.

During our extended lunch break, I got to 'network' with Antony, The Physio Detective, and Jenni of ZipRFit. Both are doing fantastic things in their own fields. Both Antony and Jenni are finding new and better ways of human movement. I even got to record a small segment for one of Antony's podcasts!

Day Two - Zoe Nicholson, Elaine Millar and Lisa Westlake presenting BodyArt.

Day Two - Zoe Nicholson, Elaine Millar and Lisa Westlake presenting BodyArt.

After lunch, I attended a fantastic session about mindful eating and 'Why Diets Don't Work' with Zoe Nicholson. I actually can't wait to share her ideas with you and so won't write too much here. This session was the session that resonated personally with me the most.

The final session for the weekend for me was again presented by Elaine Miller. Except this time, she wasn't being funny. In fact, she was serious and she was angry! We had a fantastic, semi open floor session about integrating Women's Health across all health professionals - bridging the gap between doctors, physios, chiros, all the way to personal trainers. Robin Kerr brought up such an interesting point in this session - she asked why pelvic floor physiotherapy STILL is not part of Medicare?! Elaine empowered us to start the conversation, to bring this topic to the attention of our government. She then asked for ideas for a Twitter # to use for this topic, and guess what this little word whiz did? I came up with one that everyone loved!! So, #sharethefloor is the one that will be used by Women's Health professionals around the world as we try to bring the topic of pelvic floor health to life.

The closing ceremony was filled with inspiration and emotion. We heard more of the MishFit story. The 'door prizes' were drawn and I was lucky enough to score myself a mini-facial from Endota Carlton! Lisa Westlake took to the stage again, this time to finish off with her keynote address, 'Reach for the Rainbow'. It was a very inspiring, uplifting talk that culminated with some meditation and a physical reminder of our own Rainbow in the form of a rainbow bracelet to wear.

I am so happy to have been a part of the Summit. I am looking forward to attending next year's and can't wait to see what's in store!

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