Is this cold weather making you dream about the sunshine and heat? Here’s a quick reminder on how to stay safe while biking. http://ow.ly/lmo6V
Pelvic health physiotherapists have additional post graduate training in assessment and treatment of pelvic dysfunctions such as urinary and fecal incontinence, pelvic organ prolapse, and pelvic girdle pain syndromes such as vulvodynia, vestibulodynia, dyspareunia (pain during sex), SI joint dysfunction, and piriformis syndrome. When I told my husband I was taking the internal pelvic health course his reaction was” you want to do what? Really?” So what is it that I do? I teach my patients how to properly use their pelvic floor to regain core strength and get back to their beloved activities (back to pain free living).
So how do I do that?
The same way I retrain an injured hamstring – manually testing the muscles’ strength, releasing any trigger points, facilitating a stronger more efficient contraction, re-patterning the correct strategies and giving you a home program to get yourself better. What does that all mean you ask? Well, it means I get my hands on it and in it!
The pelvic floor muscles are often described as a hammock in your pelvis from front to back, although I prefer Katy Bowman’s terminology of a trampoline. I asses vaginally and rectally which allows me to feel the muscles contract and relax against my finger, I can also feel for scar tissue from trauma (pregnancy, birth, surgery, fractured pelvis, tailbone or coccyx), and I can feel the movement of the coccyx. I can tell which muscles are working well and which ones need help. I can see if there is any pelvic organ prolapse and the effects of movement and loading on the muscles and tissues. Treatment involves identifying the cause of the dysfunction and finding the solution that will work best for you.
Who should see a pelvic floor physiotherapist?
Do you suffer from things like diastasis recti (aka mummy tummy)? doming or tenting of your belly when you exercise? scars from an episiotomy, c-section or perineal tear? pressure or pain in your vagina or rectum? pelvic organ prolapse? pain during sex? pelvic girdle pain? leaking when you cough or sneeze or laugh or jump or run? feel like you can’t make it to the bathroom in time? If you answered ‘yes’ to any of these then YOU should see a pelvic floor physiotherapist. We also like to work on the prevention side of things pre-conception, during pregnancy and post natally.
And it’s not only about the women. Men have a pelvic floor too! Men who have urinary incontinence, pelvic girdle pain, or difficulty maintaining an erection can also benefit from seeing a pelvic health physiotherapist.
How do you find a pelvic floor physiotherapist?
We are located in downtown Toronto. There are a handful of us in the GTA. We are all listed on the Women’s Health Division website (Find a physiotherapist – Women’s Health Division http://www.physiotherapy.ca/PublicUploads/229746WHD_%20Povince.pdf) and all physiotherapists that do internal work must be rostered with the college of Physiotherapists of Ontario http://publicregister.collegept.org/PublicServices/Start.aspx
Have you had your pelvic floor assessed? Tell us about your experience.
It’s no secret that the pelvic floor is my favorite group of muscles. I often get asked why, since you can’t see what its doing; it’s hard to even know it’s there. It’s not like someone will come up to you and say “hey your pubococcygeous is really cut!” Nevertheless this muscle is a superstar. It works backstage and ensures all those other “famous” muscles can look good. Here’s just what it does:
When you get the urge, the pelvic floor muscles help control whether or not you make it to a bathroom in time. They also stop that little leak when you cough, sneeze, run or jump.
The pelvic floor muscles work together with the diaphragm, helping air in and out by lengthening (eccentric contraction) during inspiration and shortening (concentric contraction) during expiration
a. The pelvic floor muscles are key in keeping our organs in where they belong. Low tone and/or weakness in the pelvic floor increases your risk of pelvic organ prolapse.
a. The pelvic floor muscles are part of the deep system of core stabilization. They work with the abdominals and multifidus to control movement of the lumbopelvic unit during load transfer.
a. The pelvic floor muscles are integral in sexual satisfaction. Too tight and sex can be painful (dyspareunia), too lax and the woman may not feel any stimulation whereas the man may not be able to maintain an erection.
So how do you know if your pelvic floor muscles need a tune up? Well, if you leak urine (even just a drop) when you cough, are a upper chest breather, have or suspect a prolapse, have pelvic pain or feel weak in your core, have pain during sex or a loss of sensation during sex, are pregnant, have just had a baby, are going through menopause or are just one of those health conscious people who like to know everything is working the way it should. Make an appointment to see a pelvic health physiotherapist now!
Spring cleaning? Don’t forget about your biological self-cleaning oven http://ow.ly/jQI1E #LipService
Prevent a yeast infection; eat 1 cup of yogurt everyday! http://ow.ly/jQGnu #LipService
April is vagina month and here are a few tips from our amazing team of Naturopaths to keeping your vagina healthy.
1. Eat 1 cup of plain yogurt everyday – Make sure the yogurt you are eating contains “live cultures”. These friendly bacteria help maintain the delicate ecosystem in your vaginal canal and can help prevent yeast infections and bacterial infections such as bacterial vaginosis. If you would like to sweeten your yogurt, try adding fruit or a bit of honey.
2. Maintain adequate vitamin D levels in your blood – Low levels of vitamin D are associated with a higher risk of bacterial vaginosis. This condition can be particularly harmful in pregnancy as it can cause pre-term labour. Even in non-pregnant women, it can increase the chances of becoming infected with sexually transmitted diseases, and can be quite unpleasant and difficult to treat. Take a daily vitamin D supplement (especially from October to April) and consider having your vitamin D levels checked occasionally to make sure you are taking the appropriate dose.
3. Use only water when cleaning “down there”- when functioning properly, your vagina is like a self-cleaning oven! While bathing, be sure to only use water when cleaning the vaginal area. Soaps can be irritating to the delicate skin and mucous membranes of the vagina and can throw off the pH of your vagina.
4. If something seems off, seek help – If you notice a strange odour, or something seems off, it is best to seek professional help. Most vaginal infections are not yeast infections but rather bacterial infections. The naturopathic team at PhysioExcellence can assess your concern by checking the vaginal pH and doing a swab for culture to determine exactly what is going on. There are several natural treatment options for a variety of vaginal health concerns but it is important to get the proper diagnosis first.
Want more? Have questions? Call to book your Free 15 minutes consult.
Many problems that send us to doctors, physiotherapists, dentists and dermatologists are due to some type of inflammation: arthritis, tendonitis, gingivitis, dermatitis, colitis, neuritis, or any other ‘itis’ which signifies inflammation.
Inflammation is an immune response to injury, toxins, infections and allergy. 70% of our immune cells exist in the lining of our digestive system, so your immune system, and thus your inflammatory response is greatly affected by how the foods you eat interact with your gut.
For individuals with food allergies, this makes perfect sense. They are well aware of the negative reactions they experience after eating certain foods. Not just the obvious digestive symptoms such as diarrhea or cramping, but often skin reactions, body aches, eczema, joint pain, headaches, fatigue, etc.
For individuals with chronic pain and inflammation who have never explored the idea of food allergies however, the idea of modifying their diet to eliminate pain may never have occurred to them.
What we are learning in nutrition and natural health is that when people with inflammation remove certain foods from their diet, their pain is reduced and often eliminated.
It all comes down to the gut.
A healthy gut determines which nutrients are absorbed, and which toxins, allergens and microbes are kept out.
A healthy gut knows how to digest and assimilate food.
A healthy gut does not provoke an immune and inflammatory response to real food.
Unfortunately, I don’t see many clients with healthy guts. The standard diet today is high in processed ‘food-like substances’ which lack the essential elements digestive systems needs to work properly, such as vitamins, minerals, enzymes, fiber, water and good bacteria. Combine that with stress, overindulgence and eating genetically engineered food, and digestive systems don’t stand a chance at staying healthy. Bad bacteria begin to multiply; digestive enzymes fail to work, and these ‘food-like substances’ are not recognized as nutrients to be absorbed but instead as foreign particles; a potential allergen or virus. An immune and inflammatory response follows and with it pain and inflammation.
After years of abuse, eventually digestive systems can become so compromised that even natural, healthy whole foods can produce negative effects.
So what do you do once the damage is done? Luckily the body is remarkable at healing itself, and if you remove the substances that are doing it harm and give it the tools it needs to heal, you can heal your gut, and your body.
The 4 R’s of Gut Healing:
1. Remove foods and substances that are causing inflammation. To discover what these are, try an elimination diet (removing foods temporarily before re-introducing them to provoke a response), or have a specialized blood test performed. Speak to your Nutritionist or Naturopath to learn more.
2. Replace what your digestive system is missing: fiber, digestive enzymes, vitamins, minerals and enzymes.
3. Re-inoculate with probiotics. These friendly bacteria keep the ‘bad’ bacteria, excess yeasts, viruses and toxins at bay; help you digest and assimilate food and keep your digestive system healthy and vibrant.
4. Repair a damaged digestive system with the right vitamins, minerals and food substances that help heal your gut. Foods high in vitamin C such as red peppers and foods with natural gelatin such as high gelatin chicken stock can soothe and repair your digestive tract.
So you had a baby and everyone told you to do the famous kegel exercises. You nod and say yes I’ve heard of that, then go home with your newborn baby and try to pull up your pelvic floor muscles, only to find you can’t feel them and really don’t know where they are anymore, let alone how to lift them up. You’re too embarrassed to say anything, cause everyone knows what kegels are, right? WRONG.
You’re not alone. Many women (like 30% of women who haven’t even had a baby) have no idea, in fact many health professionals don’t even know how to teach them. I’ve seen everything on the internet, from: stop your flow of urine (bad) to pick up beans (good)
Here’s the low down ( haha punn intended):
In order to understand how to use them, it helps to know where they are and what they do. The PFM are a group of muscles that extend from the back of your pelvis to the front. Some say they form a hammock, really it’s more like a trampoline. They shouldn’t be too slack, nor too tight. There are three openings as they figure eight around the rectum, vagina and urethra. Healthy PFM are integral to core stability, help to keep you from peeing your pants when you cough or jump, make sex more pleasurable, and keep your pelvic organs from prolapsing (falling out of your vagina). As part of the anticipatory core, they work in synergy with the diaphragm, transverses abdominis and multifidis. Their role in this strategy cannot be ignored.
So how do you contract these lovelies?
Let’s start with finding them. Here are cues that i have found to work:
-pick up blueberries with your anus and your vagina
-pretend you are sucking a milkshake through a straw in your vagina
-bring your rectum towards your pubic bone (beware: do not pelvic tilt with this)
-imagine the flower closing into your vagina as it closes in the evening
But my favorite is imagine picking up blueberries with your anus and vagina, bring them up and into your body, do not squish them (you will engage other compensatory muscles). You can also do this with your fingers. Insert your fingers into your vagina, gently squeeze around them and pull them up and into your body.
Now remember, relaxing your pelvic floor after each contraction is essential to proper PFM function. Here are some cues for that:
-let your PFM melt
-put the blueberries back down
-imagine a flower blooming out from your vagina
But, the most important thing is to learn to use it in it’s true function. The PFM are best friends with the diaphragm and TrA, they all work together. So here is how to get the best contraction from your pelvic floor:
1- get into perfect posture, that means your bum should not be flat, get your tail in the air and hollow your low back giving you a neutral curve in your spine
2- take a deep breath into your side ribs, as you inhale, let all your muscles relax using one of the PFM relax cues above
3- as you exhale contract your PFM with one of the cues above
4- inhale repeat steps 2-3 this time as you are pulling your PFM up and in, feel the band of tension that is created in your lower abs, this is TvA
5- inhale let all your muscles relax, repeat
This is the core breath. It is the base exercise for restoring pelvic floor function and diastasis recti.
That’s it. It’s that simple. Try it right now. What’s your favourite cue for the pelvic floor? Which one worked for you?If you still aren’t sure you are doing it right, get checked by a pelvic floor physiotherapist. It’s what we do.