Bladder health 101

Bladder health 101: tips to improve bladder control

We all have one. Yet the health of our bladder isn’t something many of us give much thought to – at least, not until something goes wrong with it!

It’s important to know how to take care of your bladder, and to get the right advice for your age and life stage. Throughout your life, your daily habits and practices can put you in a better position to avoid bladder leakage or loss of bladder control, also known as urinary incontinence.

Here, Jean Hailes’ own bladder guru, continence and pelvic floor physiotherapist Janetta Webb, explains how to treat your bladder well at every life stage.

For young women (and all women needing to know the basics)

Don’t go to the toilet if you don’t need to go. Many girls and young women are taught to empty their bladders before they go out, before long car trips, or when they arrive at their destination. Instead, listen to your body’s messages and pay attention to your natural urges. Your bladder works best when it can tell you when it needs to be emptied, rather than the other way around!

You can’t get an infection from a toilet seat, so please sit down. Your bladder empties itself much better when you are seated and relaxed on the toilet. If you need to, use a disposable toilet seat cover, but don’t get into the habit of hovering over the toilet.

Don’t strain to empty your bladder. When urinating, relax, take your time and let your bladder set the pace.

Any bladder leakage in young women and girls shouldn’t be ignored. If you (or your daughter) get any sort of bladder leakage – for example, when playing sport, laughing, sneezing or jumping on a trampoline – visit your GP and get it treated early.

Bowel health affects bladder health. Being constipated is a common cause of urinary incontinence in girls and young women. Keep your bowels in check by staying hydrated, eating a diet rich in fibre and whole foods (such as fruits, vegetables and wholegrains) and exercising regularly.

How much water should you be drinking? Unless instructed otherwise by your doctor, aim to drink 1.5-2 litres of fluids every day. This includes everything that you drink, not just water. There is no evidence to support that drinking more than this is healthier. If leakage is an issue, switch to decaffeinated coffee and tea.

For pregnant women

Up to half of pregnant women experience urinary incontinence, so special attention needs to be given to your bladder (and urinary system) during this time.

Dedicate a daily session to your pelvic floor. To avoid incontinence in pregnancy, learn how to correctly exercise your pelvic floor muscles (the ‘sling’ of muscles that support the bladder, bowel and womb). Set aside a dedicated time to do your pelvic floor exercises every day, while doing nothing else.

Squeeze at pressure points. Additionally, get into the habit of squeezing your pelvic floor muscles while doing activities that put more pressure on your bladder; for example coughing, sneezing, bending or lifting.

Change is normal. It’s normal for pregnant women to urinate more frequently and to need to use the toilet during the night. But watch out for constipation, which is common during pregnancy (see tips above regarding bowel health and fluid intake).

Don’t ignore pain. Lower back pain or pelvic joint pain during pregnancy can impact your pelvic floor. Seek a referral to a physiotherapist who specifically treats these conditions – find one by visiting the Australian Physiotherapy Association website.

Keeping fit is key. However, make sure it’s pregnancy-appropriate exercise.

For postpartum women

The first few days and weeks after birth are a crucial time for your pelvic floor. While you’re in hospital after the birth, lie down and rest as much as possible. Start your pelvic floor exercises as soon as you can do so comfortably, without any pain.

Get some extra support. Postnatal compression garments give extra support. Additionally, when first using your bowels after giving birth, and in the first few weeks after, support your perineum with your hand.

Exercise caution with heavy loads. Try to avoid lifting anything heavier than your baby in the first six weeks after birth.

Return to a healthy fitness as soon as you are comfortable. One of the best exercises is walking. But if you experience bladder leakage with any exercise (such as jogging or gym workouts), it’s your body telling you that you are not yet ready for that particular form of exercise. Again, seek treatment for leakage early.

A note for breastfeeding mums. Breastfeeding keeps your levels of the hormone oestrogen low. As oestrogen supports bladder control, you will therefore rely even more on good pelvic floor strength.

For menopausal & postmenopausal women

Incontinence issues often arise in menopause. This is due to the falling levels of oestrogen, which can impact bladder control. Incontinence is also more common after gynaecological surgery.

Night-time bladder habits. If you wake during the night because of insomnia or night sweats, don’t just go to the toilet for ‘something to do’, or to help you get back to sleep. Empty your bladder only when needed.

Urinary tract infections are more common in midlife women. This is because of the reduction of oestrogen. Seek advice from your GP.

Tips for healthy ageing

Maintain your levels of fitness. The fitter you are, the better your flexibility, strength and endurance will be. This not only means you’ll be more able to maintain pelvic floor strength, but also helps with the practicalities of making it to the toilet in time.

Get back pain and hip pain treated. Don’t allow pain to limit your mobility.

Learn more about bladder health and urinary continence by visiting the Jean Hailes Bladder & bowel webpages.

Published with the permission of Jean Hailes for Women’s Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)

Your guide to UTIs

Your guide to UTIs

Are UTIs (urinary tract infections) just part of being a woman? Something we have to put up with? By the time they turn 24 years of age, one in three women will have had a UTI, and they affect more than 50% of all women during their lifetime.

Recurrent UTIs are also common, with some women getting an infection again and again, impacting many aspects of life – from sex and relationships, to work or study.

UTIs can affect any part of the urinary system, with the bladder being the most common site. A UTI affecting the bladder is also known as cystitis, or a bladder infection.

Read on to find out what causes a UTI, how to manage and treat a UTI and how to reduce their frequency of recurrent UTIs.

Causes & risk factors

Jean Hailes gynaecologist Dr Judith MacNaughton explains the causes of UTIs and why women are more at risk than men. “UTIs are caused by bacteria that enter the body, usually through the tube where urine comes out [the urethra],” she says. “In women, this tube is much shorter than in men, and it’s a lot closer to the bottom, where bacteria live. This means that these bugs don’t have as far to travel and therefore the risk of getting a UTI is higher.”

While UTIs can happen to anyone, they are more commonly seen in women who are sexually active or menopausal, or those with health conditions such as diabetes or urinary incontinence. It is important to note that these factors do not directly cause UTIs, but may play a part and add insight as to why they are occurring.

Women using spermicides or diaphragms as contraception are also more at risk of UTIs and may want to consider alternative options if they get recurrent UTIs.

Signs & symptoms

While not every UTI causes signs and symptoms, when they do, they may include:

Management & treatment

If you are experiencing these symptoms or suspect you have a UTI, it is important to make an appointment with your GP as soon as possible. Your doctor will likely ask you for a urine sample and, if an infection is present, prescribe a course of antibiotics.

 

Antibiotics are very effective at treating UTIs. It’s important to follow your doctor’s instructions and take the full course of antibiotics, even if your symptoms clear up sooner. This helps decrease the risk of the UTI coming back.

“A good option for women with recurrent UTIs is to take a smaller dose of antibiotics ongoing, or as a preventative after they have sex, if sex is a trigger for them,” says Dr MacNaughton. “There is also another medication called Hiprex, which suppresses and eliminates the bacteria that can cause UTIs. However, both these options need to be discussed with your doctor.”

Many women treat UTIs at home with urinary alkalinisers (powder sachets available over the counter at chemists). While these products can help to relieve some of the symptoms of UTIs such as painful and frequent urination, Dr MacNaughton reminds us that they don’t actually treat the infection, and that a proven UTI should always be treated with antibiotics.

Changing times

At menopause, many things are changing, and some women find they get more UTIs than before. This is usually due to a drop in levels of the hormone oestrogen. Oestrogen levels decrease during menopause and the vaginal and vulval tissues are often affected – becoming thinner, drier and more susceptible to infection.

“If this seems like it’s happening to you, speak to your doctor about the suitability of a topical oestrogen cream [oral oestrogen is not effective for UTIs] and ensure you use a natural lubrication for sex,” says Dr MacNaughton.

The phytoestrogens in soy and linseeds may also improve vaginal dryness. See Jean Hailes naturopath Sandra Villella’s Linseed, banana and date muffins recipe for an easy way to get the required amount of phytoestrogen in your daily diet.

The case for cranberry

There is conflicting information on whether cranberries can reduce the frequency of UTIs. Some research suggests that cranberry supplements are useful; however, as Sandra says, it’s important for women to know that not all cranberry supplements are the same. Research suggests that it depends on the amount of certain compounds in the cranberry supplement. These key compounds are called proanthocyanidins, or PACs.

“PACs may help with recurrent UTIs, as they prevent the unfriendly bacteria from sticking to the walls of the urinary tract. If they don’t stick, they don’t grow – instead they are flushed out and the infection may not occur,” says Sandra.

In line with the research, Sandra recommends checking the labels on supplements for one that contains a daily dose of 36mg of PACs. “Don’t worry too much about the total amount of cranberry fruit in the supplement; more is not necessarily better – it’s the amount of PACs in it that you really want to pay attention to,” she says. “Good products will specify.”

New kid on the block

Another supplement option called Mannose, or D-Mannose, is showing promise in the management of recurrent UTIs. Mannose is a natural sugar that occurs in many fruits, and a recent study found that taking it in the form of a supplement was similar to an antibiotic in its effectiveness for reducing UTIs.

As always, discuss any supplements you are taking, or thinking about taking, with your GP and a qualified naturopath.

Additional tips

These self-help tips may help to reduce the frequency of UTIs:

  • Wipe yourself gently from front to back (urethra to anus) after going to the toilet
  • Drink plenty of water and fluids
  • Treat vaginal infections such as thrush or trichomonas promptly
  • Go to the toilet when you feel the urge to urinate, rather than holding on
  • Urinate after sex, to flush the urinary system.

UTIs are common, but be cautious

It’s important to remember that although UTIs are common, they can develop into more serious kidney infections if left untreated. If your symptoms persist for more than 24 hours and include fever, chills, back pain, nausea or vomiting you should see your doctor immediately. Your symptoms should completely resolve within a few days of starting a course of antibiotics. If this is not the case, it’s important to go back to your doctor.

Also, UTIs can be more dangerous for pregnant women due to an increased risk of kidney involvement. If you are pregnant and you think you have a UTI – even with mild symptoms – see your doctor immediately.

Visit our Urinary tract infections webpages to learn more.

 

Published with the permission of Jean Hailes for Women’s Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)

Looking after you, looking after your baby

Looking after you, looking after your baby

No one can possibly tell you what it feels like to be pregnant, to give birth to a baby or to become a new parent. These are deeply personal experiences and are different for everyone. It is a time of great change and challenge, often bringing feelings of joy and celebration, and potentially also feelings of worry and anxiety.

Many new and expectant parents worry about how a new baby will fit into their lives, or how they will care for an infant. It’s important to remember that if you’re feeling worried and anxious during this period, you’re not alone and these are common reactions that many new parents have.

In fact, up to one in seven women who are pregnant or have recently given birth experience perinatal depression and anxiety (perinatal refers to the time from when pregnancy begins to the first year after the baby is born). Partners can experience mood problems too, so it is important that you are both well supported during this time.

When you are pregnant or have a baby, there are lots of changes going on, from physical and hormonal changes to big adjustments in your sleeping patterns and daily routine; it might feel like things are out of your control, that there is so much to learn and that sometimes it’s difficult to cope.

The good news is, there are lots of things that can be done to support yourself and/or your partner during this time in your lives.

Signs and symptoms to look out for

The signs and symptoms of perinatal depression and anxiety can vary from person to person and may include:

  • Excessive worry or fear that is difficult to control. Often the worry and fears are focused on the health or wellbeing of the baby, or your abilities as a mum
  • Losing interest in the things you usually enjoy
  • Fear of being alone with your baby
  • Feeling low most of the time, or crying for no good reason
  • Physical symptoms – such as decreased energy, a change in appetite, difficulty sleeping even when you have the opportunity, increased heart/breathing rate, tight chest and feeling lightheaded
  • The development of obsessive or compulsive behaviours; for example, needing to do the same task a number of times when it doesn’t need repeating
  • Thoughts of death or suicide

If you feel that your worries, anxiety or low mood are interfering with your health, relationships, daily life or ability to care for yourself or your baby, then it is time to get some help and support.

Getting the right help and advice

Start early! Managing mood symptoms well during pregnancy can make a big difference to how things go when your baby is born.

Your general practitioner (GP) or maternal child health Nurse are both great sources of support. If you are unsure about talking with a doctor or health professional, reach out to a trusted friend, family member or your partner. Remember, if it is urgent, please call Lifeline on 13 11 14.

There are also many pregnancy and parenting websites, blogs and apps available. It’s important to make sure the information that you’re accessing is reliable – pick one or two sources you trust and stick with them.

One such resource is the What Were We Thinking! mobile app. It provides week-by-week information on essential topics to help mums and dads (and anyone supporting them) adjust well to the first six months of life with a baby.

Developed by Jean Hailes and Monash University, the app is adapted from the evidence-based parenting program of the same name. It is free and easy to download, and helps to build your confidence by giving you the knowledge, skills and reassurance to navigate this period.

The app helps you to develop the practical skills for settling babies, such as establishing a Feed-Play-Sleep routine as well as ideas to help you strengthen your partner relationship, such as how to best share the workload and communicate each other’s needs.

Download the What Were We Thinking! app or learn more about perinatal depression and anxiety.

 

Published with the permission of Jean Hailes for Women’s Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)

Breaking the worry cycle by being active

Breaking the worry cycle by being active

When you’re in the depths of worry or anxiety, it can be hard to focus on anything but your racing thoughts. You can feel stuck inside your head, inside a situation that won’t let up … on a loop with no end in sight.

So how do you break the cycle of worrying thoughts? With mindfulness and meditation? With stress-relieving or relaxation techniques?

Jean Hailes Head of Translation, Education and Communication, Dr Helen Brown, suggests an additional tool for your self-help kit – getting out of your head, into your body and being physically active.

“Research supports that physical activity can improve mental health. Not only is it a great way to prevent anxiety, it’s also a fantastic way to relieve it,” she says.

As well as being part of the senior leadership team at Jean Hailes, Dr Brown is a renowned thought leader in the fields of physical activity, lifestyle and behaviour change.

“As women, we are often encouraged by society to see being active as a tool to help us look good,” she says. “But in reality, it’s just as important to be active for our mental health, helping us to feel good. Physical activity is not just for maintaining our physical health and toning muscle or losing fat – moving our bodies is key to a healthy mind, including reducing anxiety.”

The body-brain link

So how does movement affect mental health? What’s the connection between body and brain? Dr Brown explains.

“Physical activity can elevate our mood and boost our levels of ‘happy hormones’ such as serotonin,” she says. “Being active is a natural antidepressant and decreases our levels of the stress hormone, cortisol, which often becomes elevated in anxiety or anxious situations.

“What’s also really interesting is that physical activity appears to train the brain to better handle stress. The science is showing us that physical activity actually helps our minds cope with psychological challenges.”

This positive effect of exercise can be particularly helpful when there’s a stressful situation you find difficult to control. For example, if you suddenly get assigned an urgent but last-minute task at work, you may not be able to change the situation, but being physically fit may improve how you mentally respond and cope with the added stress.

Putting it into practice

When we talk about managing anxiety, it’s important to know that worry and anxiety are normal and healthy parts of being human. They help to protect us from dangerous situations and can motivate us to achieve and accomplish great things.

However, when anxiety starts to disrupt your daily life, when you start avoiding normal situations for fear of triggering uncomfortable feelings and thoughts, then you may need some help.

“To use physical activity as a way to help manage anxiety, you don’t have to overhaul your whole lifestyle to feel the effects,” says Dr Brown. “It could be as simple as taking a walk each day at lunchtime, or walking the dog after work. Moderate and regular activity is key.

“It’s also important to realise that it doesn’t have to be strictly ‘exercise’, such as scheduled sport or dedicated gym training. Anything where you’re physically active counts; from doing the housework with vigour to taking the stairs instead of the lift.”

Part of the plan

Dr Brown recommends that all women with an anxiety disorder or issues with anxiety should seek help from a medical professional. However, including at least 2.5 hours of moderate-intensity physical activity across a week is a great step towards preventing chronic anxiety.

“Of course, other therapies such as cognitive behaviour therapy (CBT), mindfulness, meditation and anti-anxiety medication definitely have their place, depending on the individual,” says Dr Brown. “However, being physically active is beneficial for all aspects of our health and can be done by anyone, anywhere. It can be easily used alongside these other therapies for added benefit. Plus, there are no side effects from being more physically active – except positive ones!”

Note: If you try physical activity as a way to manage your anxiety and it’s still a problem after two or three days, speak to your GP about other ways to support your mental health.

Learn more about ways to manage worry, anxiety and anxiety disorders by visiting the Jean Hailes Anxiety hub.

 

Published with the permission of Jean Hailes for Women’s Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)

Women’s Health Week – September 5-9

September 5-9 is Women’s Health week, so let’s celebrate Women, Exercise and Pregnancy

Clifton Hill Physiotherapy is teaming up with The Jean Hailles Foundation to promote women and their health during women’s health week.

http://www.womenshealthweek.com.au/

Women are often told to exercise comfortably when they are pregnant. This is certainly true to a point; women should absolutely listen to their bodies, but the recommended guidelines are actually more precise than this. In fact, it is recommended that women do 30 mins of moderate intensity, safe exercise, most days a week.

Moderate exercise means you are breathing heavily, can hold a short conversation and are somewhat comfortable, but the exercise is becoming more challenging. 30 minutes does not have to be done all in one go either; you can break this up during the day. It is important to stay fit and healthy during your pregnancy for your baby’s health but also so that you are comfortable, remain active and give yourself the best chance for recovery.

Apart from the obvious postural and hormonal changes that the mother goes through, there are also significant changes to the heart, lungs, kidneys and gastrointestinal systems. One important change is that pregnant women produce a hormone called relaxin. Relaxin allows the ligaments in the body to stretch and this hormone is great because it allows your pelvis to adapt to the growing baby. Relaxin is in the bloodstream and therefore it is throughout the entire body, not just the pelvis. Consequently, your newfound flexibility may be counteracted by your muscles tightening and this will cause a different strain on your body.

The combination of all these changes means that the mother needs to be educated about how much and what type of exercise she should be doing. This is very important that the mother and baby stay safe, fit and healthy. These are some of the basic recommendations for pre and post-natal exercise:

First trimester: Correct pelvic floor exercises, proper technique for core exercises, fix any postural imbalances and continue exercising.

Second trimester: Correct pelvic floor exercises, no exercising on your back, no heavy lifting, no new exercise (except Pilates), prevent pelvic pain, maintain muscle strength, improve deep core strength.

Third trimester: Pelvic floor exercises, no exercising on your back or tummy, maintain fitness and strength.

Post-natal:  Whether you had a natural or caesarean delivery, the first 6 weeks is gentle. Enjoy being a mum and focus on walking, pelvic floor exercises and correct deep core exercises. It is best to get your tummy and pelvic floor muscles checked by a physio before returning to exercise. When your baby is 12 weeks old and you have been cleared by your health professional, you can slowly return to your normal exercise routine.

At Clifton Hill Physiotherapy, Pilates & Rehab we have expert Physiotherapists to safely guide your fitness and rehab through the ante natal to the post natal period, including pre-natal pilates and mums and bubs post-natal classes. Call 9486 1918 for more information.

To help celebrate Women’s Health week Clifton Hill Physiotherapy is hosting a FREE seminar to learn about the importance of exercise and pregnancy at our clinic, from 10am – 12pm, at 101-103 Queens Parade.

Spaces are strictly limited and RSVP by Tuesday 29 August is essential. If you’d like to attend email debbie@cliftonhillpilatesandrehab.com.au 

Seminar flyer information

Rosie Purdue

Women’s Health physiotherapist

Research update at Clifton Hill Physiotherapy

Exciting research update at Clifton Hill Physiotherapy, and your chance to help make a difference…Stroke

Many of you may already know that many of the physiotherapists from Clifton Hill Physiotherapy and Clifton Hill Pilates and Rehabilitation are involved in ongoing clinical research, in an effort to improve clinical services and health practises for everyone.

Traditionally, treatment for chronic pain has been associated with poor results. Recently, with a huge increase in scientific knowledge about chronic pain, things have started to change, with a big shift in services provided and increasing success of targeted treatment interventions.  However for people who experience stroke, the knowledge base surrounding chronic pain still has a long way to go.

Chronic pain persists in 40 to 60% of all people who experience stroke. 

Brendon Haslam, one of our physios with an interest in chronic pain and neurological conditions, has been researching chronic pain following stroke. His research is looking to identify what contributes to people with stroke developing chronic pain, and he is involved in numerous studies in the area.

Your chance to help people who have had a stroke…

One of these studies is an online survey, looking to have as many people as possible participate. (EVEN IF YOU HAVEN’T HAD A STROKE). Any adult over 18 can join in. It involves answering a few questionnaires online and looking at your ability to recognise various pictures of hands and shoulders. Sounds simple doesn’t it, so why not give it a go? You can go straight to the survey by clicking on this link here  http://research.noigroup.com/?_p=stls

To get all the important information needed, it does take a little while, so if you have a spare 15 minutes (now or later), grab yourself a coffee and see what all the fuss is about. As well as having an interesting time in doing the recognition tasks (and we promise you will), you’ll also be doing your bit to help a group of people who are really doing it tough.

We’ve already had nearly 700 people (without stroke) participate, but we need over 1000!

Early results from the study so far have already been presented at a Stroke Conference in Canberra last year (Smart Strokes) and Brendon is due to present at next weeks’ Stroke Society of Australasia Conference in Queenstown, New Zealand. To show that this study is having a global impact, further findings are being presented at the American Society of Neuro Rehabilitation’s Conference in Baltimore in November. The National Stroke Foundation of Australia also recently invited Brendon to be a panel member in their podcast series on “Pain after stroke”, you can listen to that here https://enableme.org.au/Community/Podcasts/Pain  (it’s racing up the iTunes charts).

Thanks for reading this, and we hope you all take up the opportunity to participate!

If you have any queries, please feel free to contact Brendon directly at brendon.h@cliftonhillphysiotherapy.com.au

 

How to progress your Pilates workouts

Let’s have a peek into a daily Pilates session with Andrew Firth…

Pilates_2

 Hmmm. Your gluteals don’t seem to be firing properly. That’s okay – we can work on that. Let’s just do a few activation exercises…

Okay, so you can activate your glutes now. Great. Now let’s intensify the stresses we place on them, so that your glutes develop some new strength and mobility.

What’s that? Our strength work is getting a bit too easy? Alright then, let’s start working your glutes without activating your lower back, or your quads for that matter. Let’s train your body how to do true hip extension. Let’s develop some skilled body mechanics.

 Great. Your glutes are strong, you can extend your hip joint correctly, and you’ve got your lumbopelvic area under control. Let’s work for muscle fatigue now. It’s time to crank up the resistance, the load, the repetitions, the sets. A couple of new exercises wouldn’t hurt either…

 Awesome. You’re a hip-extending dynamo. Your glutes are practically superhuman – a superb Level 8 out of a possible 10. But did you realise that your abdominals are lagging behind at Level 6? Let’s work your transversus abdominus a bit more now, and don’t forget your obliques! We need more chest lifting, more roll backs, more long stretches, and more long-lever positions. I’ll just incorporate those into your routine…

 You’re strong. Flexible. Energetic, and invigorated. Your abs and glutes are equal now; both are firing at a sky-high Level 9. But we haven’t talked about your shoulder girdle for a while. Let’s spread the love a little – First off, let’s talk about your thoracic spine…

Pilates is much, much more than a few isolated exercises to be learned once and quickly discarded. It is a system of movement, driven by goals and fuelled by education. Forget grunt for the sake of grunt; learn what you’re supposed to be doing, ensure that you’re doing it properly, and THEN grunt to your heart’s content!

Want to learn more? Drop in for one of my classes and we can talk!

 

Andrew Firth

Pilates Instructor at Clifton Hill Pilates and Rehab

Person – Centred Exercise

What does your exercise routine look like? Is it designed for you? Is it tailored to your individual needs? Who prescribed the exercises that you perform? Do you understand it? Are you doing it safely and effectively? Who is helping you to reach your goals? How do you remember each exercise? Who do you ask if you are not sure that you are doing it correctly? Are you actively involved in the design of your exercise routine?

Providing answers to these questions is essential if you are interested in achieving an optimal state of health. Too many people make the mistake of performing exercise that is not suited to them or that doesn’t account for their individuality. This leads to poor results!

A person-centred exercise routine is essential for success. Your routine should be based on your unique needs, your abilities, explained to you in a way that you understand, and enable you to choose the path of success.

Working in partnership with your trusted health professional such as an Exercise Physiologist, Physiotherapist and General Practitioner is one of the best ways to successfully engage in exercise. It becomes a team effort, with you at the centre of the plan. The health professionals communicate clearly with each other and yourself, share information, and build trust along the way. You feel supported and motivated to improve.

Common understandings should be developed between the client and the care giver. You need to understand your role in the routine, and ask questions about the exercises to ensure you are successful. The communication between yourself and the care giver should be honest and open, enabling any barriers to be understood, and modifications made to the routine if needed.

At Clifton Hill Pilates and Rehab and Clifton Hill Physiotherapy, our team will enable you to exercise safely and effectively by prescribing person centred exercise. The support and guidance will facilitate long term change and maximise your potential.

Feel free to contact our highly qualified and professional team to discuss your exercise routine. We look forward to continuing to provide best practice exercise advice to help you get the most out of your life! See you soon!

Pelvic Girdle Pain

Pelvic girdle pain (PGP) refers to pain felt at the back of the pelvis, on either side of the pelvis and/or over the joint at the front of the pelvis which is called the pubic symphysis. PGP is common during pregnancy and studies report more than half of all pregnant women experience some PGP. Fortunately, almost all of these women (90%) recover before their baby has turned one. It is important to know that pelvic girdle pain cannot harm your baby, but by reducing the symptoms you are more likely to remain active and comfortable during your pregnancy.

Cause

The cause of pelvic girdle pain is normally a combination of changes happening in your body as your baby grows. Your growing baby stretches your abdominal muscles and the position of the baby changes your centre of gravity. This can affect your balance and the way you stand and walk. The pelvis is actually made up of three bones; a left and right pelvic bone and the sacrum, which is the triangular shaped bone at the base of the spine. These three bones are held together like a jigsaw and the joints do not normally move.  When you are pregnant your body produces a hormone called relaxin. Relaxin loosens your ligaments so that the pelvis can widen to hold the growing baby and helps prepare your body for the birth. When the ligaments in the pelvis are looser, the muscles around the pelvis have to work extra hard in order to maintain good support for the pelvic joints.

Symptoms

The symptoms of PGP range from pain in the pelvis as mentioned above, but can also refer into the lower back, hips, groin, thighs and even sometimes knees. Often the pain is made worse by movement such as walking long distances, getting in and out of the car, climbing the stairs, rolling over in bed or during sexual intercourse. PGP can be mild or severe and can occur at any stage of the pregnancy, but it is more common in the second and third trimesters.

Treatment

PGP can be treated at any stage of the pregnancy and the quicker you get help from your health professional, the more comfortable you will be. Your physiotherapist can help treat both the symptoms and the cause. Using ice to settle inflammation and resting the joints for a couple of days is a good place to start. Some ways you can help reduce PGP are standing with correct posture, sitting to get dressed, keeping your legs together when getting in and out of the car and lying with a pillow between your legs to sleep.

If your muscles are overworking, they probably need loosening and they will certainly need strengthening. Your physio can show you safe exercises to strengthen your core muscles including your pelvic floor, back and deep abdominals as well as your glute muscles. In some cases, if your muscles require extra support, then your physiotherapist can fit you with tubigrip (a bandage to give your tummy support), or a pelvic belt that provides firmer support to the pelvis. Very occasionally, if your symptoms are more severe and persistent, then your physio may recommend using crutches

Remember, PGP is not something you just have to ‘put up with’ until your baby is born. Early diagnosis and treatment relieves symptoms and our experienced Physiotherapists can help you continue with your normal everyday activities and be well for this exciting time in your life.

Please speak with us if you have any enquiries and remember our new Pelvic Smart Pre- Natal Pilates classes begin in April on Monday evenings and Saturday mornings (9486 1918).

 

Rosie Purdue

Physiotherapist

Rosie has particular interest in sports and women’s health having recently completed the APA Level One Continence and Pelvic Floor course’. Rosie also has extensive pilates experience and has continued her education with courses in APPI Pilates, pre and post-natal Pilates, the DMA method and high-level suspension training.

 

 

 

Slow and steady wins the race

“The Biggest Loser” – a TV show that reinforces the myth that exercising to near breaking point will help you. There’s a lot to learn from observing the participants Ex-Phys-img01flogging themselves to near breaking point. I commend them for trying to improve their wellbeing; it takes courage and perseverance to undertake such a change. They feel better from exercising and challenging themselves, they lose weight quickly and they gain self-belief.

But the show is a perfect example of why so many people fall short of their expectations when exercising. This model of exercise is unsustainable in the longer term and significantly increases the risk of injury, poor compliance, and poor results!

For most of us (elite athletes may be an exception, although they are not exempt) exercising at maximal or near maximal intensities in a boot camp style environment is an excellent way to injure yourself and will ultimately prevent you from achieving your wellbeing goals.

An exercise routine requires a few essential ingredients: it should be tailored to individual needs, coordinated and delivered by a team of health professionals (collaboration between an Exercise Physiologist and / or Physiotherapist and / or GP), be evidenced based, target specific outcomes (weight loss, rehabilitation, mental wellbeing, chronic disease, increased muscle tissue), be person centred, be clearly understood by its participants, and be designed to gradually overload the body. It is this ingredient, gradual overload, which is often neglected.

Gradual overload is the consistent and steady increase in exercise load and volume over a mid to long term period that can be as little as 2 weeks and as much as 10 years. There are many examples of people “getting it wrong” when overloading. It is one of the most difficult ingredients of any exercise routine to get right, as it requires an understanding of our unique individual physiology. If we maintain a consistent routine at moderately graduated loads, then we increase our chances of success significantly!

Where do we start? Who do we ask for advice? How do we determine an appropriate training load? What exercises are the best to do? How will our exercise routine deliver results safely and effectively?

Engaging the services of a health professional who specialises in Exercise Prescription is the best way to ensure your progress will be gradual, consistent, safe and ultimately effective. Moving correctly, learning good technique, activating the key muscles that promote stability and control, before gradually increasing loads to build endurance and strength is the safest and most effective approach. Learning good movement patterns and unlearning faulty movements enable you to gradually overload the body safely and effectively.

Have a chat to one of our team so that we can enable you to discover that when it comes to exercise routines, “slow and steady wins the race”!