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.

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Draft timetable for our:

• pregnancy pilates
• pilates classes
• beginners pilates

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Cancellation Policy

At The Fix Program we aim to provide a professional service at a time that is most suitable to you. We also aim to have same day appointments available for urgent enquiries and all other appointments available within 1 week of your enquiry.

Unfortunately, we are experiencing a large number of last minute cancellations and clients not attending their allocated appointment times.  This is having a major impact on our waiting list and can negatively affect treatment progress.

What we are doing about it

Reminder emails 24 hours prior to appointments are a proactive approach on our behalf. This gives our patients the time to contact us via email or phone to cancel and shift appointment times.

So that we can continue to provide a timely service, Fix is now implementing a CANCELLATION AND FAILURE TO ATTEND POLICY.

Effective from Monday 16th March 2015 the cancellation policy will apply if:

• You cancel your allocated appointment time with less than 24 hours notice; or

• You fail to attend your allocated appointment time.

Failing to attend or notify within the 24 hours will incur a fee of $50.00 (to be paid at your next appointment)

If we receive advance notice that you are unable to attend it will provide an opportunity to offer the appointment to other clients from our waiting list or those requiring emergency physiotherapy.

We would like to avoid having to apply a cancellation fee - your co-operation would be greatly appreciated.

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Learn to breathe well and relax

There are many reasons why we should learn how to breathe well. Appropriate breath can help our bodies in many ways and its importance is somewhat overlooked. Breathing can bring about relaxation, reduce stress levels, decrease pain, increase feelings of good health and wellbeing.

So, what makes me stressed?

We’ve all heard the expression ‘fight or flight’. This is how the body has evolved to respond to any threatening situation. In times of stress the body uses a hormone called cortisol. Cortisol turns on processes we need for survival and switches off processes that are not needed for survival. This is great in an emergency, but if you are stressed all of the time, prolonged elevated cortisol levels have been found in blood streams. These chronically high levels are linked to depression, mood swings, memory changes, poor healing, pain, weight gain and immune problems.

On the flip side, when you’re relaxed and feeling good, your body produces ‘happy hormones’ such as opioids and serotonin.

How do I de-stress?

• For a start, try to stop worrying. Pilates, Yoga, relaxation, meditation and breathing techniques have also been proven to reduce the level of circulating stress hormones and increase your level of happy hormones.
• Try going for a walk, listening to relaxing music, or just clearing your mind for twenty minutes every day.
• Try to set aside ‘worry time’. Rather than worrying about things constantly (and keeping your cortisol levels elevated) make a specific time every week when you think about your worries. If a worry enters your head at another time, like when you’re trying to fall asleep, set it aside for your ‘worry time’.
• Try this relaxation technique when lying down or sitting comfortably. Close your eyes and focus on your deep breathing. Focus on the cool air as you breathe in through your nose and the warm air and you breathe out through your mouth. Focus on one body part at a time starting from your head all the way to your toes imagining all your muscles releasing and feeling heavy.
• Try to take time to practice mindfulness throughout your day. Even a minute here and there to become mindful of your breath, the comings and goings of your body sensations, tensions and your surroundings can help to de-clutter your brain and provide energy and calmness.

And there’s even more to the importance of breathing well

We also know that learning to make your diaphragm stronger by breathing well has many a physical effect. This is the breath we strive for at your Fix Program classes. These can include:

• A more efficient delivery of oxygen to your body. Using your diaphragm allows for greater volumes of air into all corners of your lungs.
• The physical mobilising and stretching effect of breathing into your lower lungs will improve movement of your ribs and the stiff thoracic or middle spine.
• The prevention of extra work and tension of the chest and neck muscles which are often inappropriately used for daily breath. Most of us know how tired these muscles typically are anyway. Why add to that with your breathing style?
• A stronger deep postural ‘corset’ for our spine and pelvis. The diaphragm has connections to many organs and muscles in the trunk via fascia and via this connectivity has a crucial role in stability and movement control in the region.

Yes, the diaphragm is a muscle that too can be strengthened! And a stronger diaphragm will lead to a stronger deep abdominal corset, pelvic floor and spinal alignment.

The challenge

Try to become more aware of your breath as you go about your busy lives. This can happen anywhere – at work, rest or play. Slow down the rate of your breath, relax your neck and shoulders and visualise the breath into your lower ribs. Imagine breathing widely and sense the expansion and movement in your trunk.

Slow your breath and the mind will follow. Healthy mind, healthy and strong body.

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To plank or not to plank? 

It is a common claim that a strong core will enhance movement ability, such as for walking and running. ‘The Plank’ and similar ‘core’ exercises are therefore often prescribed to achieve this. But how appropriate are planks for our everyday movement requirements? Postural control sitting at your desk, turning, reaching, walking, swimming or running? Do we really sit, walk or run looking like a plank?

In effect, if we strengthen muscles in a particular way, they will be terrific and strong in that, but not necessarily with a cross over effect to other movements or requirements. This is called ‘training specificity.’ Muscles and movements needs to be precisely and specifically trained to optimise gains in strength and movement quality.

So what about muscles involved in ‘core stability’?

When we speak about ‘core stability’, stability suggests rigidity and no movement. However, don’t we really want to be able to bend and move through the spine and body? Think about your average day and the range of movements involved - turning, twisting, and bending, from popping on your socks to start the day, to twisting your head and trunk to reverse out of the driveway in your car.

In exercises like ‘the plank’, there is the need to brace and co-contract multiple muscle groups at one time. This is a model relying on stiffness. However, stiffness in our bodies does not necessarily result in better function. Walking and running activities are perfect examples of this where there needs to be free trunk rotation as the arms swing, and free rib expansion and movement for greater breath capacity.

Instead of ‘core stability’, a better term to use would be ‘postural control.’ This suggests that muscles need to be strong and efficient within movement, controlling you throughout. When we move, there is a whole team of muscles working. There are the little deep ones holding on at your joints, while the team of bigger ones move you. Even these bigger ones work to control the movement speed and precision. So to get these teams working like a well oiled machine, exercises should be practiced to mimic both the movement and postures involved.

At The Fix Program pilates classes, we work really hard at making sure we follow this theory of strengthening, exercise and movement. How do we do this?

• Have you noticed we spend a lot more time now strengthening your ‘postural control’ muscles in many varied postures – standing, sitting, stepping, twisting and lying?
• We teach you how to be more precise and aware about control (not rigidity) about the pelvis, the ribs, the neck and shoulder blades.
• We use visual cues such as ‘float through your postures’, ‘feel more fluid in your movement,’ becoming aware of breathing symmetrically through the rib bases. All of this is in contrast to bracing or rigidity in postures.
• We have introduced more Feldenkrais and Yoga type sequenced exercises where movement is free and awareness is paid to differences/asymmetries across our bodies.

There is nothing wrong with continuing to plank, so if you enjoy these, go for it. They do always feel like a brilliant challenge for the body. But do be aware of the need to exercise with movement also.

At the end of the day it’s more about beautiful movement, free and flowing.

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Draft timetable for our:

• pregnancy pilates 
• pilates classes
• beginners pilates

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A silly name for a difficult Pilates move

Taking me several years to get the name right for this exercise, I really have struggled with the ‘Bird Dog’. You know the exercise. Lifting and stretching out your arm and opposing leg from your hands and knees. We assume the name comes from the hunting dog poses. The dogs that hunt birds?

Perhaps it is these little critters we are trying to be?

Then again …

All in the name for a good laugh. Check these ones out too.

http://imgur.com/gallery/tyQrv

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Draft timetable for our pregnancy pilates and pilates classes in our sydney cbd studio

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Tips on choosing the right back back

Considering that 60-80% of us will experience back pain in our lifetime, choosing the correct back pack for us or our children should be a priority. The high number of children and adolescents already complaining of back pain is astounding. Studies recently in South Australia of 2500 children found half of them repeatedly complained of pain episodes. Victorian studies concluded that 1 in 3 school children suffered back or upper neck pain, caused by heavy schoolbags.

Providing a good back pack to everyone is crucial, and educating on its proper use vital.

Here’s the physio’s guide to choosing a good back pack.

• Make sure it is appropriately sized for you. It should neither extend past your shoulders when sitting down with it, nor be wider than your chest.
• Be comparatively lightweight. Fully packed it shouldn’t weigh more than 10% of the your body weight.
• Be sturdy and reasonably water-resistant (or have a rain cover). The material should be firm to prevent sagging. The base should be abrasive-resistant and/or reinforced.
• Have a moulded frame and/or an adjustable hip or waist strap, so most of the weight rests on your hips and pelvis, not on your shoulders and spine. The waist/hip belt is particularly important to secure the load when walking, running or cycling.
• Have adjustable, broad, padded shoulder straps that help distribute the weight evenly across your shoulders and and don’t dig into you.
• Have a padded or quilted back for comfortable wear.
• Have compression straps at the sides to draw the load together and bring it close to your back. They’ll also help stabilise the contents of a partially filled pack.
• Have a sternum (chest) strap to help stabilise the load and prevent the straps slipping off the shoulders. It should sit about 10 cm down from the Adam’s apple.
• Have several pockets to help with even weight distribution and organisation inside. A drink bottle holder on the side keeps potential spillages outside the pack.

So, now that you have the right back pack, here’s how to use it properly.

• Backpacks are designed to carry a load safely — symmetrical, stable and close to the spine — but not if they’re worn casually slung over just one shoulder.
• Put it on safely. Try to lift it up by the loop with both hands and bent knees, facing the straps and pushing up with the legs. Place one strap over the shoulder, then the other, or put it on the edge of a desk and loop both arms through together.
• A backpack should be worn so the waist strap (or hip belt) sits firmly where intended.
• Shoulder straps should be adjusted so that you don’t have to lean forward and the base of the pack rests on their hips, not on the bum.
• Pack your back pack properly. Items shouldn’t be able to move around; the heaviest ones should be packed closest to your back to reduce stress on the spine, lighter items away from the spine.
• Pack only what you need to keep the weight down.

The Australian Physiotherapy Association (APA) endorse a back pack for children. Called the PhysioPak, it meets the standards of the APA. With multi-adjustment straps at the shoulders, waist and chest, and a moulded back that rests well and at the correct angle to the spine. See http://www.spartanss.com.au for further details.

For more information please contact us

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Lost focus? 

Do you ever feel that your exercise really isn’t grabbing you? Are you bored with it? Not looking forward to the next session? Making excuses to avoid exercising altogether? We are all individuals and therefore the gym/running/getting sweaty is not for us all.

So we all know the well documented benefits of exercise. From heart and vascular health, to muscle strength, reduced pains, improved sleep patterns, and a happier mind. So why do the majority of us not find these reasons for exercise inherently motivating?

Perhaps some of these reasons sound like you? If you are struggling with a regular exercise routine and you acknowledge one of these reasons, make a change.

• Motivation is waning.

If you just don’t feel like exercising and the enjoyment is not there, you will never want to exercise. Convenience sometimes is not enough. Make the effort to find what’s right for you, and not everyone else.

• Clock watching

If you can’t get yourself finishing your workout quick enough, then the enjoyment is not there. Not only that, you are risking injury and perhaps not the best out of your workout, especially if you are using weights.

• Tired all of the time

Regular exercise should give you more energy, not less. Perhaps you are pushing yourself too hard, or it is just not the right exercise for your physical and mental wellbeing.

• I’m bored

Just because your friends are loving the gym, or their yoga DVD or Pilates class, doesn’t mean you will. Getting that endorphin rush after exercise is different for us all. Perhaps it’s dance classes, BMX riding, bush walking or skate boarding with friends. This all counts as exercise and the benefits will be the same.

• Exercise is always the same

Perhaps you have been doing the same workout for as long as you can remember. Like anything, routines can become stale. Interest and motivation are sure to decrease and time is wasted as the benefits of your exercise are also decreased.

So if you are dreaming of bacon when you are exercising, perhaps your focus has been lost.

Pop on your thinking caps, find a new exercise and keep your body on your toes.

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