Putting a stop to incontinence

Putting a stop to incontinence

Do you leak when you laugh? Its time to raise awareness for the 5 million+ Australians who experience bladder or bowel incontinence. Yes, it really is THAT common! This can be a very debilitating condition, but unfortunately, a lot of people suffer in silence through fear of speaking out, due to the embarrassing nature of the problem.

What you may not realise is that the majority of incontinence cases can be treated, and a lot of the time, stopped completely. So, to try and help break the silence surrounding incontinence, we are going to give you a little run down on what it is, who it affects, and some tips on what you can do to help.

WHAT IS INCONTINENCE?

Incontinence is the term used to describe the uncontrollable loss of urine from the bladder or faeces from the bowel. It ranges in severity from losing only a very small amount of urine, to a complete void of the bladder or bowel. If you’ve never experienced this, you can only imagine how distressing this must be. There are different types of urinary incontinence, including:

  • STRESS INCONTINENCE, where small amounts of urine leak due to small increases in pressure on the bladder during physical activity, or from coughing, sneezing or laughing.
  • URGE INCONTINENCE, where you get an unexpected, strong urge to urinate with little to no warning. This is usually as a result of an overactive bladder muscle.
  • INCONTINENCE ASSOCIATED WITH CHRONIC RETENTION, where your bladder cannot empty fully, and you get regular leakage of small amounts of urine. There are many causes for this, including an enlarged prostate in men, or prolapsed pelvic organs in women, as well as medications and certain conditions, such as diabetes and kidney disease.
  • FUNCTIONAL INCONTINENCE, where you are unable to get to the toilet, possibly due to immobility, or wearing clothes that are not easy to get off in time.

Faecal incontinence is when you have a lack of control of bowel movements and you may accidentally pass a bowel movement, or even pass wind without meaning to. This may be due to weak muscles surrounding the back passage (Unfortunately ladies, this is common following pregnancy and childbirth), or if you have severe diarrhoea.

TAKING THE STRESS OUT OF INCONTINENCE

For all those suffering in silence, it is time to speak out.  There is no need to be embarrassed, it is surprisingly common – and like we have already mentioned, help is out there! You may not need to look very far. Being your local Osteopath, we may be able to help.

The most common type of incontinence that we see and treat is stress incontinence. Although seen across both sexes, women are three times more likely to experience it than men. It is very common in women following pregnancy and childbirth (when the pelvic floor muscles get over-stretched, and sometimes even damaged), during menopause (due to hormonal changes) and in the elderly. It commonly affects men who have had prostate surgery.

The pelvic floor muscles sit at the bottom of the pelvic bowl, spanning from the pubic bone to the tailbone (front to back) and from one sitting bone to the other (side to side). Imagine a tarpaulin stretched out with a person holding each corner and you kind of get the gist. When these muscles are strong, they help to support our internal pelvic organs (i.e. the bladder, bowel and the uterus in women) and wrap around the openings of the front and back passages, allowing us to control when we decide to do a number one or two. Following pregnancy for example, they may become weak and dysfunctional, and we can lose that ability to control voiding. It only takes something as small as a cough, or an activity like jumping or running (things many of us take for granted) that may cause a person to lose a small amount of urine.

WHAT WE CAN DO TO HELP

The most important thing to point out is that not all types of incontinence will improve or resolve with just strengthening of weak pelvic floor muscles. So, it is very important to get an accurate diagnosis, because there will likely be other factors that need addressing too. For instance, losing weight, stopping smoking, and making other lifestyle changes are just as important in the management of these conditions, if relevant to the person of course. Some people may also require release of tight and over-active muscles.

Once you have your diagnosis, then strengthening may well be a part of your therapy. In order to strengthen, you need to know where the muscles are, and how to activate them. Below is a little step by step guide to getting a grip on those pelvic floor muscles (we don’t mean literally!):

  1. Get in a comfortable position – try sitting or lying on your back and take a few breaths to relax.
  2. Imagine you are trying to stop yourself from urinating mid-stream by squeezing for about a second. If this is not easy to feel, next time you are on the toilet emptying your bladder, have a go at stopping mid-stream and then relaxing again to finish emptying (don’t hold it for too long please – just enough to feel which muscles you need to use).
  3. Do the same as step two for the back passage – this time imagine you are trying to stop yourself from passing wind by squeezing.
  4. Do these quick squeezes 3 x 20 reps a day. Once you’re comfortable, you can do it sitting or standing. Make it routine… Do it when you’re brushing your teeth, eating lunch, or in the ad breaks of your favourite TV show.

These two contractions together form the basis of what you need to be able to do to begin your pelvic floor muscle training. If you struggle to feel this, then ask for help from your therapist. They will be able to help you perfect the activation of the correct muscles.

We hope you have found this blog interesting and helpful. If you, or someone you know is looking for answers to questions and advice on the management of these conditions, then please get in touch. We are ready to offer advice and/or treatment. 

References

  1. Continence Foundation of Australia. 2019. World Continence Week. [Online]. [Accessed 07 May 2019]. Available from: https://www.continence.org.au/events_calendar.php/482/world-continence-week
  2. Continence Foundation of Australia. 2019. Laugh Without Leaking. [Online]. [Accessed 07 May 2019]. Available from: http://www.laughwithoutleaking.com.au
  3. Continence Foundation of Australia. 2019. Key Statistics. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/key-statistics.html
  4. Milsom, I. and Gyhagen, M. 2018. The Prevalence of Urinary Incontinence. Climacteric. 22(3). 217-222. DOI: 10.1080/13697137.2018.1543263
  5. Continence Foundation of Australia. 2019. Pelvic Floor Muscles in Women. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/pelvic-floor-women.html

Five tips for digestive bliss

Irritable bowel poor gut health

June is bowel cancer awareness month, so we’re here to give you tips on how to keep your digestive system healthy and reduce the risk of disease.

Whether you are a professional soccer player, a tradie or an office worker, a healthy digestive system is key to you being able to function and carry out your daily tasks. Our bodies break down the food we eat into energy and this is what allows us to kick a ball, drill a hole, or sit and type on the computer. Now, your digestive system will only work properly if you feed it the right stuff… So don’t expect to last the 90 minutes and be at the top of your game if all you do is gorge on deep fried or fast food. That’s just a fast track to the subs bench and unhappy insides!

Try out these little gems of advice to ensure your digestive system stays healthy, so you can give 100% every single day:

1. DRINK LOTS OF WATER: We’ll make this one nice and simple… Your body needs water for almost everything! From maintaining the health of every cell in your body, to keeping your blood fluid – you can see it’s pivotal for life to exist. Water is also needed for creating your digestive juices used to break down food and preventing digestive complaints like constipation.

2. EAT A HIGH FIBRE DIET: Fibre is basically all the parts of plant-based foods that we are unable to breakdown and digest. There are different types. ‘Soluble’ fibre (found in fruits, vegetables & legumes) helps to keep you feeling fuller for longer and helps to control blood sugar levels and lower cholesterol. ‘Insoluble’ fibre (found in the skin of fruits and vegetables, wholegrain breads/cereals, and nuts and seeds) absorbs water helping to bulk out and soften our stools and aids in the regulation of bowel movements. Having a good mix is important to prevent diseases such as constipation, bowel cancer, diabetes, and heart disease.

high fibre diet

3. EAT A PROBIOTIC: Probiotics are the bacteria found living in our gut. They are responsible for providing the ideal environment for getting the most nutrients out of the food we eat. They also protect us from the effects of nasty bacteria that may show their faces at different points. Without them, we wouldn’t exist. Sometimes our stores of bacteria can be put under threat, like when we are ill, stressed for long periods, or after a course of antibiotics. Having a poor diet can also be bad for them. Luckily, we can eat foods like probiotic or ‘live’ yoghurt and kefir daily to help keep our gut well-populated with these little soldiers.

4. GET PLENTY OF EXERCISE: The benefits of exercise are endless! When you move, it helps to promote movement of food through your gut, which keeps everything functioning well and helps to reduce the risk of digestive problems like constipation. So, move every day because your gut doesn’t tend to go on holiday for days here and there. It is always working hard for you!

5. LIMIT INTAKE OF ALCOHOL AND SMOKING: Too much of anything is a bad thing, but the effects of too much booze and cigarettes on the digestive system are well documented. Heavy, long term intake may lead to conditions such as reflux, digestive ulcers, and possibly more severe disease such as oesophageal, stomach and bowel cancer.

Remember, you really are what you eat. Gut health is so important for you to do the things you want to do – work, playing with the kids, sports, everything! So don’t be surprised if your Osteopath or Acupuncturist throws in some questions regarding digestive health when they’re treating you. It’s much more than just muscles and bones. We will delve deep if we need to, to make sure you are at the top of your game.

References

  1. State Government of Victoria. 2014. Water – a vital nutrient. [Online]. [Accessed 03 May 2019]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/water-a-vital-nutrient
  2. Nutrition Australia. 2014. Fibre. [Online]. [Accessed 03 May 2019]. Available from: http://www.nutritionaustralia.org/national/resource/fibre
  3. Webster-Gandy, J., Madden, A., Holdsworth, M. eds. 2012. Oxford Handbook of Nutrition and Dietetics. Oxford: Oxford University Press
  4. Enders, G. 2015. Gut – the inside story of our body’s most under-rated organ. Melbourne: Scribe Publications
  5. Drinkaware. 2019. Is alcohol harming your stomach. [Online]. [Accessed 04 May 2019]. Available from: https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/effects-on-the-body/is-alcohol-harming-your-stomach/
  6. State Government of Victoria. 2019. Smoking – effects on your body. [Online]. [Accessed 04 May 2019]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-effects-on-your-body

Living well with diabetes – It affects more of us than you think.

Living well with diabetes – It affects more of us than you think.

Are you living with Diabetes? It can be very overwhelming managing this condition, particularly in the early stages following diagnosis. We’ve put together a little fact sheet and given some tips on things you can do to manage your condition and live well with Diabetes.

WHAT IS DIABETES?

In a nutshell, Diabetes (or correctly named – Diabetes Mellitus or DM) is a condition characterised by increased levels of sugar in the blood, resulting from the body’s inability to either produce or correctly make use of a hormone called Insulin. Insulin helps move sugar (called ‘glucose’) in the blood into the cells around the body so we have energy to function. There are a few different types of DM:

  1. Type 1: The body does not produce enough insulin due to cell damage of the pancreas – the organ in the body that produces insulin.
  2. Type 2: The body is unable to sufficiently use and respond to the insulin produced by the pancreas.
  3. Gestational Diabetes: This form affects pregnant women who have no prior diagnosis of DM. This condition usually resolves after delivery of the baby.

Each form is treated slightly differently. Type 1 requires the person to take insulin, usually via self-injection. Type 2 can predominantly be managed through diet and exercise, but may require medication and possibly insulin, depending on how advanced the condition is. Type 2 is the most common form of the condition and what we’re going to focus on.

WHAT CAN YOU DO TO HELP?

The most common cause of Type 2 DM is a combination of excess body weight and lack of exercise. So it is fitting that one of the best ways to control your blood sugar levels, and reduce the risk of complications (such as heart, kidney, eye and nerve disease) further down the line, is to reduce body weight and exercise regularly.

DIET

Dietary recommendations for people with DM are not too dissimilar to those for any other person. The following tips can be helpful to follow:

  • Eat regular meals and consume healthy snacks spread across the day
  • Eat high fibre, complex carbohydrate foods such as whole grain breads, cereals and pastas, beans, lentils, fruit and vegetables (i.e. foods that have a low glycemic index and won’t spike your blood sugar levels quickly)
  • Be mindful of the amount of fat you eat, especially saturated fats, found in takeaway food, fried food, cakes and biscuits
  • Keep alcohol intake low as a general rule, and ensure you have plenty of alcohol-free days
  • Keep energy balance in mind. If you consistently consume more energy than you burn off in a day, you will gain weight
Exercise Rigth
Diabetes

EXERCISE

It is recommended that people with Type 2 DM participate in both aerobic and resistance-based exercise regularly and consistently. These forms of exercise have been shown to improve insulin action and overall quality of life. And they help decrease blood pressure, heart complications, fat levels and risk of death.

Please remember that these are basic guidelines, and we always recommended that you seek help from a health professional such as your GP, DM specialist, or your local osteo before making any big decisions on diet and exercise to help manage your Diabetes.

References

  1. Diabetes Victoria – https://www.diabetesvic.org.au/diabetes-and-me?tags=Left-Mega-Nav%2FDiabetes%20and%20nutrition%2F&bdc=1
  2. American Diabetes Association – http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/?loc=ff-slabnav
  3. Harvard Health – https://www.health.harvard.edu/diseases-and-conditions/living-well-with-diabetes

What pain relief is right for you?

What pain relief is right for you?

Pain has been an ongoing topic for research and discussion for a long time. Nearly everyone feels it (I say ‘nearly’ because there is actually a very small minority of people with a special condition that does not allow them to feel pain), and it varies in character and severity depending on what part of the body is implicated. And for the most part, none of us like being in pain. When we feel pain, normally the first thing we do is to look for a way out of it (or as some of you like to, ignore it – tut tut!). It’s a bit of a minefield knowing where to go for good pain relief. Some of us like a quick fix, others are more interested in fixing the problem long term by putting the hours in to do the rehab. Luckily for you, we are here to help with both stages!

When it comes to the body, we usually feel pain because our body is sending us a signal letting us know something is not quite right. That might be down to a simple muscle imbalance or joint restriction, which is leading us to walk or run differently. Or it might be down to something more serious like a tear of a muscle or tendon, changes in the nervous system or a problem with an organ deep inside the body – the list of causes is long and complex.

Regardless of the cause, when in pain it’s human nature to want to know how to get rid of it. Some of you turn to the experts (i.e. like your local Osteo/Myo/TCM practitioners, and other professionals like doctors), and some prefer to self-diagnose using www.DrInternet.com (how’s that been working out for you?!).

Some of the most common and well-known forms of pain relief include manual therapy, use of temperature, medications, supplementation and diet – you’ll find a brief overview of each below:

Manual therapy

We as humans have been using our hands to treat the body for a very, very, very long time! If you walk into a clinic in pain, be it you have a swollen ankle or the inability to lift your arm above your head, your practitioner will get to work on you using a whole host of techniques (after they have carefully and correctly diagnosed you of course!). Soft tissue massage and myofascial release techniques are widely used in the management of musculoskeletal pain and evidence suggests you aren’t wasting your time by getting the help of your local therapist. Your practitioner may also utilise other techniques, including joint mobilisation and manipulation, to correct your problem and to help get your pain lowered and under control. Usually you will also be given some form of flexibility or strengthening exercises to perform between treatment sessions to back up what happens in the treatment room.

Sore shoulder necl
Heat pack

Heat and cold therapy

If you’ve hurt yourself in the past, there is a good chance you’ve tried some form of treatment relating to temperature to help relieve the pain. Cold therapy can help to reduce pain, blood flow, swelling, muscle spasm, and inflammation. Heat therapy can help to relieve pain, increase blood flow, and tissue elasticity. It’s worth getting advice for the best approach for your problem.

Medication

There are countless different medications out there that can help with pain relief – these are called analgesics. Without getting too complicated, they can generally be split into Non-opioid and Opioid analgesics. Non-opioid analgesics include your well known and easily accessible medications such as aspirin, paracetamol, and anti-inflammatories (such as Ibuprofen) – these are generally good for the control of musculoskeletal pain. Opioid analgesics are there for cases of more severe pain, and include codeine, tramadol and morphine (you won’t be able to get these ones over-the-counter though!). Remember it’s always safest to consult a medical professional before using any form of medication.

Supplementation & Diet

There is no shortage of nutritional supplements available to assist you in the non-pharmacological management of pain also. From anti-inflammatory herbs like Curcumin (derived from Turmeric), Boswellia and Ginger to Fish Oil and Glucosamine and Chondroitin. Similarly, diets high in Berries, Fatty fish like Salmon or Sardines, Green Tea, Avocadoes and Broccoli can assist with reducing inflammation. In conjunction with the avoidance of sugar and highly processed/refined foods, alcohol and trans fats.

If you are injured or in pain or would just like to know more about pain and the many ways to manage it we recommend you to book a consultation with one of our practitioners today so they can talk through your problem, assess you thoroughly, and then advise the best course of action for you.

Our aim is to help get you out of pain and moving better again! Say ‘au revoir’ to pain! 🙂

Rectus Diastasis (Abdominal Separation)

Rectus diastasis physiotherapy
What is it?

Ask any woman who’s been pregnant and she’ll tell you that the bigger the baby grows the harder even the simplest tasks become (try putting your socks on with a basketball strapped to the front of you sometime!). With growth and uterine expansion there is a widening and thinning of the gap between the two sections of the rectus abdominis muscle, the “6-pack” muscles.  This gap is called a diastasis. The split occurs at the mid-line collagen structures of connective tissue at the front of the abdomen.These muscles have not “torn”, simply separated.

As easy way to check if you a diastasi in if you have a ‘pooching’ or ‘doming’ of your stomach, especially when coming up from a lying position on your back. Sometimes you appear still a few months pregnant.

Whilst rectus diastasis most commonly occurs during pregnancy, women are not the only ones to suffer it. Newborn babies can also have a diastasis. Men can also experience a diastasis as a result of yo-yo dieting, an incorrect technique of doing sit-ups or weightlifting. It is most commonly linked to poor internal abdominal pressure control and biomechanics. Which means you can be fit and still have a diastasis.

Is it common?

Yes! 2 out of 3 women will experience some degree of diastasis in the first two trimesters of pregnancy and 100% of women have a diastasis during their 3rd trimester. A staggering 66% of women with a diastasis will also have some level of pelvic floor dysfunction and 75% of women will suffer from a pelvic organ prolapse. Although common, this is not normal and can be improved with correct exercise.

Signs to look out for:

• Looking pregnant even though back to pre-pregnancy weight

• Pooching or doming of your stomach

• Weak core and pelvic floor

• Lack of strength and stability in the entire pelvic region and midsection

Why is this so important to fix?

Healing the connective tissue and reducing your diastasis is important as these muscles are what protects our internal organs and back. Other areas where you can be at increased risk of if not fixed include:

• Lower back pain

• Constipation

• Incontinence

• Breathing difficulties

• Hernias

• Pelvic organ prolapse

What should I avoid and what should I do to heal or prevent a diastasis?

Exercises to avoid include those that place a huge load on your back and excessive forces through your pelvic floor like running, jumping, sit-ups, deep lunges and some pilates movements. Holding your breath when lifting heavy objects (including your toddler!) should be avoided also.

The majority of cases can be greatly improved as well as prevented through specific core and breathing exercises, correct lifting technique and posture, as well as wearing a splint. Walking, swimming and stationary cycling are all safe forms of cardiovascular exercise you can partake in with a diastasis.

For an assessment of your diastasis and comprehensive exercise rehabilitation program call 02 4655 5588 and make an appointment to see one of our Osteopaths today.

Stretching: the what, when, why and how

exercise stretching osteo

Most of us know that stretching is beneficial for flexibility. Did you know it also helps to improve blood flow and prevent injuries? So when is the best time to stretch, and what type of stretching should we do when?

Before a work out = Dynamic stretching.

These types of stretches mimic the movements you will do in your workout but at a lower intensity. Dynamic stretching moves a muscle group fluidly through its an entire range of motion. For example, walking lunges, butt kicks or arm circles. This type of stretching prepares your muscles for the stress they are about to be placed under by increasing the blood flow to the muscles. It can even lead to improved performance so add some of these into your workout routine today.

After a work out = Static stretching.

exercise stretch pain camden narellan mount annan

Each stretch should be held for a minimum of 20 – 30 seconds and held to the point of mild discomfort but not causing pain. A post-workout stretching routine will also slow down your breathing and heart rate, bringing the mind and body back to its resting state. For example, bending forward to touch your toes or grabbing your foot behind your back to stretch your quads. Static stretching is also great for people who spend lots of time in a stationery job to loosen up stiff joints and tight muscles. Remember not to hold your breath when holding a stretch. Instead, relax by inhaling, holding for 2 seconds and then exhaling for longer than the inhale.

When NOT to stretch:

It is important that you don’t do static holding stretches when your body is cold, such as when you first wake up. Your risk of injury increases if stretching under these conditions so make sure you wait at least one hour after awakening or even better, stretch after a hot shower.

Stretching exercise physio

It is ideal to stretch all muscle groups every day, however being realistic, stretching 3-4 times a week will still provide you with multiple benefits. It is best to concentrate on stretching the muscle groups most used in your workout on that given day to prevent delayed onset muscle soreness (DOMS) for the following few days.

For more information or help to design the ideal pre and post-workout stretching routine for your sport or injury call 4655 5588 and let our team assist you to get the most out of your workouts today.

 

Do you sometimes feel like a leaking tap?

urinary incontinence physiotherapy camden

Have you ever laughing too hard, coughing too much, or simply trying to recapture your youth by jumping on the trampoline with the kids and started leaking like a broken tap. It’s called urinary incontinence and it’s common! It’s often associated with childbirth, pregnancy, and menopause and can range in severity from just a small leak to complete loss of bladder control. Some women also experience the need to urgently or frequently go to the toilet. Almost 1/3 of women who have ever had children experience some form of incontinence, and while this makes it common it is never normal! Bladder control problems can affect people of all ages, gender, cultures and backgrounds and should not be considered a normal part of the ageing process.

How do you know if your bladder or toilet habits are normal?

If you answer yes to any of the following questions there is a good chance that they are not and you should seek some advice on how to improve them.

 

  1. Do you leak urine when you cough, sneeze, lift or exercise?Bladder weakness camden
  2. Do you pass urine frequently?
  3. Do you have to run to the toilet or experience urgency?
  4. Do you feel that you cant completely empty your bladder?
  5. Do you have a poor or slow flow of urine?
  6. Do you have to strain to empty your bladder?

There are many things you can do to improve if not cure urinary incontinence, including correct pelvic floor exercises.

If you would like any help in improving your urinary incontinence or would like to discuss this further please call 02 4655 5588 to find out how we can assist you further. Alternatively, you can book your appointment now with Jaclyn our Osteopath.