Bladder leakage, no matter how light, is not normal

Although embarrassing, bladder and bowel troubles are common, affecting 1 in 4 people in Australia. Although common, it is not normal to be suffering from these troubles. Pregnancy, the post natal period and menopause are the times we women may experience leaky bladders and other issues ‘down there’.

We need to start talking more openly about this topic - with family, girlfriends, doctors and women’s health physios. If you are at all worried, your GP or even your Fix physio would be a great place to start.

When researching for this blog post with my circle of friends and colleagues, I found an alarming trend. One I had not thought of working within the health industry, as to me, any troubles ‘down there’ would mean immediate attention and appropriate management. Perhaps obvious to me and other physios, but not to all those other women out there.

It seemed that if there were stories and admissions of leaking (or other pelvic floor issues) within a circle of girlfriends or mother groups, there seemed to be an acceptance that this was normal. On a positive note, it is wonderful to hear that at least the conversation had started, however, on a negative note, hearing that as a group, bladder troubles were considered a normal part of being a woman, is very disheartening.

Bladder or bowel control issues can be treated, managed and even cured with the help of a pelvic floor physiotherapist. It will not get better on its own, and it needs specific pelvic floor exercises, and changes and improvements to your toilet habits

There is help at hand.

Here are some important facts

• Leaking is NOT a natural part of childbirth, ageing, or being a woman.

• Bladder or bowel control issues do NOT get better on their own.

• Incontinence CAN be treated, managed and even cured with the help of a pelvic floor physiotherapist.

• Many women lose control during pregnancy or after childbirth and that sets them up for a lifetime of issues, which can be worse after menopause.

• Sometimes the issue is not only muscle weakness. Prolapse, or sagging of the bladder, uterus or bowel could be the cause and a support device called a pessary can give immediate relief.

This all sound a little bleak, doesn’t it? It may, but don’t put up with it. Tell someone who cares and seek treatment. Heba and Tabitha are here at The Fix Program to help. You may not be aware, but they have had extensive post grad training in pelvic floor conditions unique to women.

Vaginismus 

Whilst most women enjoy sex, there are some women who find sex painful and still others who are unable to even have sex at all. One of the main conditions that this occurs in is vaginismus.

Vaginismus is an involuntary tightening of the pelvic floor muscles during attempted insertion of an object into the vagina. This could include penetration during intercourse or insertion of a tampon or speculum. When the muscles tighten, women can feel pain, which can range from a mild discomfort to severe pain that can be stinging, burning, tearing or aching.

Vaginismus is not something women have control over, and some women may be completely unaware that it is happening. In some women the muscles can become so tight, that it feels like the vagina is totally closed and penetration cannot occur. In others, the muscles allow for penetration, but the tightness of the muscles causes enough pain that intercourse must be stopped.

A woman can have primary vaginismus – which is associated with attempting to have sex for the first time, and being unable to. Women may feel like their partner bumps into a wall where the opening should be. This is the most common cause of unconsummated marriages.

Secondary vaginismus is when the tightness and inability to have intercourse occurs after a period of being able to enjoy sex. This can happen for a number of reasons including:

• Yeast infections or recurrent urinary tract infections
• After a difficult childbirth
• Prolapse of your pelvic organs into the vaginal area
• Menopause, due to hormonal changes, leading to vaginal dryness or atrophy
• Abuse or trauma
• Pelvic conditions such as endometriosis, cysts, tumours, lichen sclerosus
• Anxiety or stress
• Partner issues

Vaginismus can be treated by your women’s health physiotherapist, who will use a few different treatment techniques to help you have sex comfortably. For primary vaginismus, these include:

• Vaginal desensitization
• Pelvic floor muscle relaxation exercises
• Internal muscle releases around the vagina and pelvic floor muscles
• Vaginal trainers/dilators

In secondary vaginismus, more techniques may need to be employed in addition to the above treatments. Sometimes a referral to your GP or to a sex therapist or psychologist may be indicated, who will work alongside your women’s health physiotherapist. Treatment choices here include:

• Scar tissue massage

• Pessary for prolapse support

• Discussion about vaginal oestrogen with your GP

• Electrical stimulation

• Hip and pelvic stretches

• Complex management of pathology such as endometriosis including nutrition advice and visceral and fascial release of scar tissue and adhesions

  

Remember, with vaginismus, it is NOT all in your head. With an appropri

ate women’s health physiotherapy management plan, women can overcome vaginismus within a few months, and can go on to enjoy a normal sex life.

Call us if you are experiencing vaginismus. We can help.

Pockets for your shoulder blades. A wonderful gift to your neck and upper back

Struggling with neck tension? A stiff upper back? Shoulder and arm pain? Headaches?

Have you ever asked yourself, “Are my shoulder blades in their pockets?” This trick will help you to hold your shoulder blades in the correct position, alleviating many common problems stemming from this area.

But what does this all mean?

Whether you are in our Fix Program Pilates classes or in physiotherapy treatment, we always emphasise that good pelvis position provides your lower back with a sturdy base. We know that poor pelvic stability and posture is regularly linked to back pain. At the other end of the spinal chain, there are many muscles criss-crossing your upper back and neck, many of them connecting to your shoulder blades. In fact, supporting the neck and shoulder girdles is their main function. In the same way as the pelvis, a well-situated pair of shoulder blades stabilises your shoulders, upper back, and neck by evenly distributing tension and stress across the area. If they are poorly positioned, they can make matters much worse.

 Let’s look closer at the important anatomy of the region

The shoulder blades (or scapulae) float around on top of your ribcage and some of the muscles that hold them in place are highlighted in the picture above.

The big neck muscles (trapezius) connect the neck, shoulder and upper back. If these muscles become tight from being overused ( such as too much PC work), they not only pull on your neck but also on the shoulder blade, which can cause a variety of knock-on effects in the other connected muscles. Your scapula can be pulled out of alignment ( such as sit too high or drop too low on your upper back) or be prevented from sitting flush against your body. This is the ‘winged’ look you see of some shoulder blades. 

How do I get these upper back muscles working in a balanced way about my shoulder blade?

Let’s try to set our blades in a good alignment together now.

• Inhale and widen your shoulder blades across your upper back.
• Exhale and lift the outer points of your shoulders slightly upwards, bringing your shoulders slightly backwards.
• Imagine the lower tip of your shoulder blade gently sliding down your back and tucking into your latissimus dorsi (the purple muscle above), like a hand sliding into a jean pocket on your bum.
• Once you feel them settle into their pockets, your shoulder blades will evenly distribute the stress and tension in your upper back and neck much better than before, so your neck will feel wonderfully free.

This is tricky to do well without the guidance of a physiotherapist, so feel free to ask one of us to check your technique. Less is definitely more – think tiny, subtle movements of the shoulder. Try setting your blades into this posture and holding it for 30 - 60seconds, ten times throughout your day; you’ll be surprised how much they jump out of their pockets when you’re not paying attention! The best time to do it is when you are using your arms. Why not try when:

• you are sitting at your desk?
• you are reading?
• you are lifting groceries, laundry, bags, weights or children?
• you are feeding your baby?
• you are playing sport? during your golf swing, tennis serve, batting stroke.

I’m sure you get the idea. Try using red dots to remind you to reset your blades. You can read more about this at Exercises-to-break-poor-postural-habits. 

As you begin to hold your blades in their best possible position, your neck will begin to feel more free and soft, and your upper back more relaxed. But remember, be gentle as you slide your blades flatly into their muscular pockets and use them as they were intended – to support your entire upper body.