Compiled by our Director, Senior Physiotherapist and Pilates Instructor Helen Dudley. To book an appointment with Helen, or read her Meet the Team profile CLICK HERE.
Incontinence is the involuntary loss of urine at an inappropriate time or place. For a lot of us, incontinence can be an everyday occurrence that puts strain on our mental health and can limit our physical activities and enjoyment. This taboo problem is unfortunately all too common so if you do experience incontinence, whether it is a few drops every now and then to full bladder leakage, you’re not alone. In fact;
- 1 in 3 women have some degree of urinary incontinence
- In women 45-60 years old, this number increases to 50%
- 13% of men have urinary incontinence
As Physios, we obviously advocate the assessment and rehabilitation of incontinence issues with a Pelvic Health Physiotherapist, especially as the research is so propelling as to the success of treatment. In fact, 70% of women with incontinence will get significant improvements with appropriate treatment.
In saying that, we also understand that it can be very debilitating to every day life so management is just as important to enable you to live well and do the things you love. In the past, this has meant using pads that are uncomfortable and not environmentally sound. That is why we were so excited and had to share this great new product with you.
Awwa is a great NZ female founded company that provides pee-proof pants for people of all shapes and sizes. They have a great ethos; making sustainable and climate positive products that are made of natural, organic and recycled fabrics. The pee-proof underwear wicks moisture away from the body and locks it into the centre layer, meaning you feel dry and smell fresh all day long.
Here is more information taken from their website:
How Does AWWA work for bladder leakage?
Our innovative hi tech layers have been developed especially to absord fluid but keep you dry and fresh.
1 - The top layer, sits closest to your skin and wicks moisture away fast and keeps you feeling dry.
2 - An antimicrobial layer that fights odours and bacteria
3 - A super absorbent layer that safely holds 18 ml of fluid (that you do NOT feel)
4 - Bottom layer, is a leak proof barrier
Do they smell?
Our high tech layers mean that all liquid and odour are locked in the middle layer so there’s no smell.
Do you feel wet wearing them?
How long can you wear incontinence underwear before changing them?
This comes down to what you’re comfortable with, but our underwear can hold up to 18ml so you should be able to wear one pair all day long.
They are great for periods too. Our absorbent technology supports you through pregnancy and incontinence. Making us period proof, postpartum proof and pee proof with a range of absorbency levels and styles to suit you.
What AWWA styles do you recommend for incontinence?
We recommend the Eva brief, Cotton Brief or Skye High styles
AP have created a health solution company called The Health Collective. The collective consists of a group of trusted experts in the health and wellness field that have personally selected products that will assist our communities health and wellness.
We stock a wide range of select locally produced, ethically sourced, sustainable products to help you keep healthy, recover from injury, support you while you work and play, help you to sleep and relax and to support women during pregnancy, postpartum and beyond.
Compiled by our Masters trained Physiotherapist Chris Smith. To book an appointment with Chris, or read his Meet the Team profile CLICK HERE.
Foam rollers have grown in popularity over the last decade as a key piece of kit in gyms and home exercise settings. Their uses may vary from warm up prior to exercise, to for recovery afterwards, or simply to increase flexibility to aid in an exercise program. But what benefits do foam rollers provide us with and how might these be achieved in practice?
A recent research review looking at the efficacy of foam rollers found they were better for some things that others (see here). For example, there may be a benefit in sprint performance following pre-foam rolling prior to sports activity. However, in recreational athletes, up to 62% of the population are likely to experience benefits in flexibility from pre-foam rolling as a warm-up prior to sport. Furthermore, this increased flexibility has been shown to be produced from as little as 30 seconds on a foam roller in the hamstring muscles. It has been suggested that these benefits may be due to increase in intramuscular temperature and blood flow. Also, foam rolling may stimulate pressure cells in our muscles which relay information to our brain to reduce pain sensation. This in turn may increase our stretch response to enable us to get a little more range in our downward dog!
When it comes to recovery, the main finding was that post-exercise foam rolling can help with reducing muscle pain sensation or soreness. This is important as muscle soreness has the potential to reduce performance in relation to sprinting, jumping and strength training. Therefore, if we can reduce soreness through foam rolling then this may provide some benefit to further athletic performance. However, this should not be used as an alternative to appropriate physical and mental rest, sleep and nutrition in your training to allow appropriate muscle and soft tissue recovery.
Foam rollers can be likened to a form of self massage, providing some of the health benefits of manual therapy applied by a physiotherapist or massage therapist, although without that human connection and therapeutic relationship, which has a large role to play in positive outcomes. However, multiple lockdowns this year have left us working from home without the option of visiting our favorite therapists.Therefore, a foam roller provides a great self-management option during lockdown, holidays or when away on business and you can't see your therapist.
Take home message
A foam roller can be a great addition to your warm up routine. Only spend 30-60 seconds on each area and then perform a dynamic warm up and stretch routine after to increase flexibility and blood flow prior to exercise. There is no need to spend 10 minutes rolling an area. If you’re going to roll for recovery 2 x 45-60 seconds on each major muscle group to reduce muscle soreness as part of a cool down, which should include adequate physical and mental rest, sleep and nutrition.
If you don't yet have a foam roller as part of your exercise equipment visit our online store to see our range on offer.
Compiled by our Masters trained Physiotherapist Kirsten Rose. To book an appointment with Kirsten, or read her Meet the Team profile CLICK HERE.
What is a Health Coach?
Most people want to be healthy and well, but there is an enormous gap between those thoughts and the everyday reality of actually making it happen. Nearly all of us can probably identify with a time in our lives where we wanted to get healthier, be more active, lose weight, be less stressed, be happier….the list can be endless. Also most of us can probably reflect on how making the required changes was much harder than we might have initially thought it would be. We start off with a hiss and a roar, but then our motivation wanes, our old habits creep back in, and we give up on our new way of life. Sound familiar?
If your answer is yes, then don’t beat yourself up too much. Inside every one of us is the urge to stay with the status quo, resisting change or challenges outside of our comfort zone. There’s another part, deep inside, that whispers to us that maybe we could change, maybe we could actually achieve those health goals and live the healthy lifestyle we dream of. But change is hard so those whispers often don’t get the chance to grow louder. The reality is that most of us need to build new life skills in order to create a truly sustainable plan for our well-being. We need to learn to believe in our own ability to take charge of our health and to implement the necessary changes. Our day-to-day lives are full of small choices that could help us inch our way to the life we want to create, however, in the modern day world there appears to be an overwhelming amount of choice so often we don’t know which ones are right for us.
Health Coaching encompasses the sciences of positive psychology, behaviour change, nutrition, exercise science and lifestyle medicine with the dynamic art of relationships, teamwork and community. As a Health Coach, I am a behavior change specialist who supports you to make sustainable diet, lifestyle, and habit changes that will actually work for you. I help you optimise your health and well-being by enhancing your resourcefulness, self-regulation, and self-motivation, so that you can successfully navigate the journey of change.
Some common areas that clients wish to work on include:
If you think that Health Coaching could help you on your journey to better health and wellness then take advantage of the 30 minute free sample consultation. These are available in the clinic or online.
Our Ask A Physio series is a collection of micro blogs aimed at giving a basic understanding to some frequently asked questions. If you have an injury or are experiencing discomfort please book for an assessment, or contact reception for more information.
Ideally ASAP! A bit like an issue with your car or house, the sooner we can get you doing the right things, the better chance we have of getting you back to normal sooner. Particularly when it comes to sport and exercise, we’ve got good research showing that the first 72 hours can make your recovery a lot faster or slower.
If it’s an injury or issue you’re really familiar with from previous experience, then you’ll already know the routine for the first week. In that situation I usually tell people to manage it how they’d manage a stomach bug; do what you know for the first 48 hours. If you’re not getting anywhere doing what you know, then check in with us.
If in doubt you can always book for a free 15min phone consult with one of our Physiotherapist!
Compiled by our Masters trained Physiotherapist Chris Smith. To book an appointment with Chris, or read his Meet the Team profile CLICK HERE.
Fibromyalgia is a condition characterised by widespread pain in the muscles and connective tissues for 3 months or more. It is defined as a syndrome due to the collection of symptoms rather than a disease, as there is currently no identifiable cause within the medical field.
It often runs in families and people with Rheumatoid arthritis, lupus and Ankylosing spondylitis are more likely to develop it. However, it is not a condition of the joints or an inflammatory condition. There are many hypotheses for why it may develop, although none of these have been proven and accepted yet. For example psychological trauma or prolonged stress may affect how the body's pain signals react, potentially leading to a sensitised pain system. Another suggestion is a widespread and chronic raised inflammatory response in the body.
As many as 1 in 50 people may develop fibromyalgia at some stage in their life and it is most common between ages 25-55. It affects 9 women for every 1 man, but it can also affect children.
- Widespread pain and stiffness: heightened sensitivity to touch/pressure, common trigger points include neck, shoulders, chest, hips, & knees.
- Fatigue, insomnia and poor sleep.
- Difficulty with concentration (Fibro fog)
- Changes in mood, anxiety and depression.
- Gastrointestinal problems.
How is it diagnosed?
There is no gold standard for fibromyalgia diagnosis. Various criteria have been suggested over the years since 1990, however the most recent were updated in 2016. These include:
- (1) Generalized pain, defined as pain in at least 4 of 5 body regions, is present.
- (2) Symptoms have been present at a similar level for at least 3 months.
- (3) Widespread pain index and symptom severity scales. These are outcome tools that clinicians used to measure pain location and severity.
What are the management options?
There is no cure for fibromyalgia. Management should be aimed at relieving symptoms and improving function. Everyone's symptoms will be different, therefore treatment approaches will need to be individualised. However, they are likely to include both medical and self-care approaches.
Medication may be useful, but active approaches to relieving stress including mindfulness, meditation, yoga and psychological support may be helpful. Reducing stress triggers in your life may also be beneficial, rather than merely managing stress when it occurs. Graded exposure to exercise is also recommended. In addition to this, looking at lifestyle and sleep hygiene may be important as one of the major symptoms is sleep disturbance and fatigue. A recent study from 2017 demonstrated that the agreed treatments between international expert groups on the topic were exercise, cognitive behavioural therapy, and certain antidepressant drugs such as amitriptyline.
As physiotherapists with expertise in persistent pain, we are well placed to support and educate fibromyalgia patients about their condition in addition to producing an individualized exercise and rehab program that may be beneficial. Our training also provides us with a good knowledge of the impact your psychological system can have on any pain condition. If we feel you need more expert talking therapies as part of your management we can signpost to the correct psychology services.
So if you think or know of anyone with fibromyalgia come in and see one of us to see how we may be able to help you.
When you consider it takes up to 40 weeks or more to create a tiny human, you would think mothers would relax and give their bodies time to restore. Instead, according to a 2014 survey of 1,500 women in the United Kingdom, 40 per cent of new mums feel pressured into losing weight quickly. A 2015 study by the American journal Obstetrics & Gynecology found that 75 per cent of women don't achieve their pre-baby weight one year post-birth, while UK-based research revealed it takes an average of 19 months to get close to pre-pregnancy weight.
In my experience I see a huge number of women who have returned to exercise too soon, and too intensively - meaning they've come to see me with aches and strains on their pelvic floor function. Mothers must remember that you have just performed one of the most incredible things – developing and giving birth to a tiny human. Time and patience are vital.
Respect for the healing process is key. If you had an uncomplicated, natural delivery, you might feel tender for five weeks or more, and it is advisable to wait until your six-week, post-partum check-up before returning to gentle exercise. A caesarean section can require six to 12 weeks' recovery, depending on your body, and you should always wait for the green light from your doctor before starting any physical activity.
After six weeks for a natural delivery or eight to 10 weeks for caesarean section, you can start gentle low-impact exercise, such as cycling, cross trainer, Pilates, yoga and light weights. Avoid high-impact exercise such as running and aerobics until four to six months after giving birth. Exercise on your hands and knees or in bridge position should also wait until after six weeks.
Consider the first three months after birth as the 'fourth trimester' – a time of rest, recovery and irreplaceable moments with your newborn. Eat to nourish your body rather than trying to lose weight and under no circumstances try diet pills, liquid diets or other weight-loss products, which can be harmful to you and your baby if you are breastfeeding.
Blood lost during and after delivery can also lead to iron deficiency, which exacerbates the chronic fatigue that new mothers often experience. Fill up on iron-rich food such as free-range, grass-fed organic beef, dark green, leafy vegetables and dark beans such as kidney or aduki beans, and avoid too many raw foods (unless in easily digestible green juice or smoothie form) as these require more energy to process.
Breastfeeding mums who are tempted to cut calories to lose weight should also be aware that you need, in general, up to 500 more calories a day to support the process. Lactogenic foods can help with milk supply issues, try consuming things like moringa [add to smoothies to help mask the taste], oatmeal, brewer's yeast, salmon and fenugreek seeds.
I recommend booking in for a Women's Health physio appointment after your six week check-up. At this appointment we can check your pelvic floor function, discuss any developing aches and pains, discuss specific exercises for you to do/avoid, and give you some general piece of mind over your body changes.
We also have a number of specialty pre / post natal pilates classes. These group sessions are tailored for individual abilities and allow you to exercise safely and encourage movement through your body. To join a pregnancy, or mums & bubs class we do require you to have a 1-1 prep session first just to make sure you're not in any pain, and to identify any potential complications.
Our reception team is happy to discuss with you your best options and to assist with booking. 093664480 or firstname.lastname@example.org
If you’re in doubt, it’s probably best to see a physiotherapist first. Massage is a maintenance and self care tool, but it might not get to the reason behind why you feel an area needs some attention. If an area feels stiff or sore, seeing the physio will allow them to assess and diagnose the issue, and figure out if massage is appropriate. Often people can jump into a massage a bit too early, and end up making their issue worse.
Once your issue is stable and safe, then asking your physio if you're ready to see a massage therapist can really help with longer term maintenance. It’s often a nice reward for a job well done after a month of diligent rehab. As with all hands on treatment, remember that the massage is a cherry on the top of your plan, the bulk of your management should be homework!
Absolutely, there’s a reason that they are such a staple in so many different fitness environments. One big reason why massage, manipulation and other types of manual therapy get criticised is that you don’t want to build too much of a dependence on other people to manage your aches and niggles, so foam rollers allow you to take some of that power into your own hands.
Massage in some form or another has been used in sport and exercise at least as far back as the Roman gladiators, and for good reason. Self massage with foam rollers can be used to improve recovery times after workouts, to lengthen restricted muscles and even to copy the “cracking” or “pops” that you get to free up a stiff spine. Similar to other types of exercise kit, if you’re not already comfortable with foam rollers, make sure that you check in with a physiotherapist or good personal trainer to show you a few techniques before you bring them into your weekly routine.
Pilates may sound intimidating, but it's actually the most accessible way to build strength and mobility for better posture, balance and flexibility.
If you’ve wanted to try Pilates but something has been holding you back, now’s your time to sign up. Pilates offers plenty of benefits, no matter your fitness background. The technique cultivates body awareness to support everyday movements that are efficient and easeful.
Pilates is a full-body exercise method that consists of low-impact exercises on a Mat, Reformer, Cadillac or Chair. With equipments system of pulleys and springs, handles and straps - the apparatus can provide either resistance or support depending on your needs. You can do Pilates with or without equipment, but no matter what, expect the moves to involve slow, precise movements and breath control. The method emphasises core strength, proper postural alignment and muscle balance.
Pilates is named after its creator, Joseph Pilates, who developed the method in the 1920s. Joseph Pilates believed mental and physical health were closely connected.
A Pilates routine generally includes low-impact flexibility and muscular strength and endurance movements. Exercises aim to promote proper posture and movement patterns as well as balance, flexibility and strength.
Pilates has something to offer people of all ages from beginners to athletes. There are countless ways to modify and adapt Pilates exercises, depending on your age, physical ability, and level of fitness. The exercises are designed with modifications so that people of all levels and abilities can stay safe while being physically challenged.
We love getting people moving. We offer a variety of Pilates classes morning, noon and night out of our boutique Newmarket clinic. This includes mat, equipment classes, and specialty classes for pregnancy and post-natal. We keep the classes small to make sure everyone is completing the exercises safely and effectively. The classes are suitable for all levels as the instructor will provide variations on the exercises to suit your level.
We have experienced Physiotherapists and Pilates Teacher taking the classes so you can find the right class for you. We ask everyone that joins the classes to have a 45 minute 1-1 session prior to starting. Here you will discuss your goals and what you want to achieve. You will be shown how to find your neutral spine, how to engage your pelvic floor and deep abdominals, along with a few basic moves. You will then start a graduated Pilates exercise program that is individualised to your body and needs. Depending on your experience we may advise that you have at least 2-3 one-on-one sessions with a Physiotherapist or Pilates Teacher before proceeding on to a class.
It was once said by the US Chief Medical Officer that if exercise was a pill it would be a billion dollar industry. This is not an understatement, physical activity really is the equivalent of a wonder drug, and without the negative side effects of many of its pharmaceutical counterparts. Exercise has been demonstrated to have positive impacts on multiple body systems including the cardiovascular, gastrointestinal, musculoskeletal and neurological system.
Cardiovascular - Regular physical activity increases the efficiency of the specialised heart muscle allowing it to pump oxygenated blood to all your body tissues easier. Regular physical activity also leads to increased lung capacity, increased number of functioning alveoli in which gas exchange occurs and improved strength of respiratory muscle including the diaphragm and intercostal muscles. All this allows for improved function of the cardiorespiratory system and increased cardiovascular fitness.
Musculoskeletal - Regular physical activity can have positive impacts on various soft tissues including bone, muscle, ligament and tendon. Increased mechanical stress on soft tissue causes cells within these tissues to increase production of collagen leading to increased tensile strength of these tissues. This process is known as mechanotherapy and can be used to explain why tissues increase strength in response to mechanical load and why exercise prescription is such a key part of a rehabilitation program with a physiotherapist. Likewise gradual increase in mechanical loading can increase bone density so long as sufficient opportunity is allowed for rest and bone cell production in between loading cycles. In relation to muscle regular exercise provides a training stimulus which leads to an increase in the ability of the nervous system to recruit more muscle cells to provide a contraction, leading to increased strength. An increase in muscle size (hypertrophy) is due to increase in muscle cell size following repeated bouts of exercise, followed by sufficient rest.
Neurological - Physical activity has been associated with reduced risk of alzheimer's, dementia and improved cognitive function, likely due to improved vascular supply to brain tissue. Regular physical activity is also associated with improved mental health and reduced rates of anxiety and depression. Exercise leads to the release of various endorphins and neurotransmitter chemicals responsible for improving mood and reducing pain. In addition to the likely hormonal and chemical contribution to improved mental health with exercise, it can also improve self-efficacy and provides opportunity for social interaction with others, a factor which is important in managing mental health. Exercise also has been demonstrated to regulate appetite and sleep pattern.
Given the range of body systems on which exercise helps the human body it is not surprising that it has been shown to help in the management of various medical conditions such as obesity, Type II diabetes, stroke, cardiovascular disease, anxiety and depression in addition to a variety of musculoskeletal conditions such as arthritis, spinal pain and tendon issues to name a few.
Recommendations for exercise:
The World Health Organisation (WHO) are the global experts in managing the health of humanity. Given that lack of physical activity and preventable health conditions is seen as a crisis by the WHO, it's not surprising that in 2020 they reviewed their guidelines for physical activity. For adults aged 18-64, at least 150–300 minutes of moderate-intensity aerobic physical activity are recommended weekly or 75–150 minutes of vigorous-intensity aerobic physical activity. In addition to this, adults should also do muscle-strengthening activities that involve all major muscle groups on 2 or more days a week.
Research shows that it takes on average 66 days to create a new habit forming behaviour, although this number varies widely between individuals (see here). Furthermore, in terms of fitness, after 2-4 weeks people start noticing changes in their strength and fitness when exercising. However, changes in body composition and muscle size more often take 12 weeks on average.
So, if you stick past the first month then your strength and fitness should improve, stick past the 2nd month and the exercise should become a habit. Once things are a habit they become a lot easier to maintain as part of managing our long-term health.
Type of exercise:
There are no suggestions for specific types of exercise. The key is finding something you enjoy and can stick to to make it a habit and part of your life in order to prolong and manage your health throughout your life. Get creative, do what you love! If you don't know where to start or are nervous, get myself or any of the physiotherapists or personal trainers at Auckland physiotherapy to help you. We also offer pilates classes which keep you healthy and moving and are fun at the same time. Win, win!