Written by Anna Geraets, Physiotherapist, Pilates Instructor and Women's Health Specialist

What are these and how do they work?

A pessary is a device used for a number of gynaecological problems. They are used frequently by gynaecologists, continence nurses, or pelvic health physiotherapists. At Auckland Physiotherapy we use pessaries to either support a prolapse or assist with incontinence.

So, why a pessary?

Sometimes there has been an overstretching of the structures that support the vagina. This can be from birthing a child, or from more chronic conditions such as constipation, COPD, or other causes of repetitive strain on the pelvic floor.

This overstretching can cause “prolapse”, where there is a movement of the vaginal walls into the vagina, or difficulty in closing off the urethra when you want to stop urine from passing through, such as on coughing or sneezing. These can cause symptoms such as heaviness, dragging, or deep backache, the sensation of “something there”, bladder difficulties with incontinence or leaking or urgency, or difficulty in passing bowels. This can be all the time or just with particular exercise or activities, such as running or lifting weights.

Pessaries are an effective tool for managing these concerns. They are an internal support to the vaginal walls and can help with the closure of the urethra. The pessaries we work with are made of medical-grade silicone and come in a vast variety of shapes and sizes for all sorts of presentations and symptoms. We will identify that a pessary might be useful during your initial or subsequent appointments.

We use fitting kits to help us choose the correct pessary to ensure it is comfortable and provides adequate support to the areas of concern.

A pessary can be self-managed, where we teach you to insert and remove the device yourself. This is particularly helpful when the pessary is only needed for a particular sport or activity, and a woman can choose to use it just during these tasks. It can also be managed by your physio, in which case you will need to come in every three months to have it checked. The pessary itself lasts a year (under manufacturing guarantee), and needs to be replaced annually.

If you were self-managing your pessary, you would need to come in for a fitting appointment, a review at two weeks, a review at 3-6 months, and an annual review. Usually, though, a pessary is an adjunct to physiotherapy and it is more likely you will be working with your physio on pelvic floor exercises and other areas of rehabilitation such as retraining your bladder.

The decision to use a pessary is really up to you. They are a great option, but not the only option in management. Sometimes a woman may be waiting for surgery and just buying time (e.g. those anticipating more children in the coming years), or perhaps wanting to avoid surgery altogether. Sometimes we use a pessary for the first postnatal year while working on rehabilitation and during the postnatal recovery period.

There are very few contraindications to the use of a pessary; active infections of the vagina (e.g. pelvic inflammatory disease), patients who are unable to manage their pessary (e.g. won't attend follow up appointments), or an allergy to silicone are the few situations in which we would not fit a pessary when one is indicated.

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?

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. - WHO (1948)

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. 

Intro To The Pilates Method

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.

What is Pilates?

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.

What are the Benefits?

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.

Who is Pilates for?

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.

Pilates at Auckland Physiotherapy

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.

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