Pelvic Health – for ANYONE!

The public is becoming more aware of the benefits of pelvic floor physiotherapy (PFPT). When we first opened in Warman in 2014, about 20-25% of people had even heard of PFPT! Now there appears to be an assumption that leakage or pelvic floor pain issues ONLY happen to people that have had kids. That it can’t happen for those who have never been pregnant or given birth before – but that is not the case!

Pelvic Floor Dysfunction

There are people of all backgrounds and ages of any gender, who suffer from pelvic floor problems. There are many different reasons for why this may be the case. First, here are some issues that are common symptoms:

  • low back or hip pain
  • leaking of urine (or stool)
  • pain (with intercourse or otherwise)
  • night wetting (or waking to void)
  • constipation
  • hemorrhoids
  • pressure/heaviness (feeling like things will fall down/out)
  • tailbone pain
  • pelvic girdle pain (SIJ, hips, pubic symphysis)

 

Some of the reasons for pelvic floor dysfunction include post op complications or side effects from surgeries performed in the abdominal or pelvic region, radiation therapy to the pelvis due to pelvic cancers, prostate issues, and menopause. Stress, anxiety, and overall pressure system problems can also be an underlying cause.

Weigh the Risk

There are some risk factors that may contribute to leakage of the bladder including:

  • chronic strain to the pelvic floor from a persistent cough (ie smoking or asthma/COPD)
  • chronic constipation
  • highly athletic populations (especially with a vagina)
  • individuals that have obstetric injuries
  • someone that has had trauma to the pelvis
  • anyone that has received abdominal surgery

Our athletes in particular may have some leakage issues or heaviness/prolapse symptoms. This may be associated with heavy lifting or running/jumping sports due to the strain that can be placed on the pelvic floor with these activities. The exercise itself is unlikely to be the culprit, but the strategies being used may be contributing.

 

The Pelvic Floor and What you Consume

There are some behavioral components that may impact urinary leakage as well including:

  • consuming or drinking caffeine(!!) and carbonated beverages
  • spicy foods
  • citrus foods
  • alcohol (red wine in particular!)

 

Our Pelvic Floor Helps us Compensate

Sometimes anxiety can have a role as well if we have a tendency to hold too much tension in the pelvic floor muscles. This in turn can contribute to pelvic pain or incontinence issues – or even constipation!

People with chronic pain conditions such as:

  • endometriosis
  • irritable bowel syndrome
  • inflammatory bowel diseases
  • interstitial cystitis

…for example may have tightness in their pelvic floor muscles which may be contributing to some of their pain presentation. Sometimes back or hip pain can actually be originating from the pelvic floor. When someone has had “problems forever” and they haven’t seen a PFPT – this is often a good place to start.

 

How does PFPT Help?

A PFPT can be helpful as part of the medical care team in addressing pain that may be contributed to by the pelvic floor muscles. PFPT utilize various techniques, either with internal manual therapy techniques or external techniques. If the client is comfortable with internal, this via a vaginal or rectal exam. Some people are not comfortable and we can proceed with education and exercises for relaxation/stretching of these muscles.

 

If there is urinary leakage then there can be behavioural techniques that a pelvic floor physiotherapist can teach to help address these issues. This is especially true if there is leakage preceded by a strong urge to pee. Should there be weakness of the muscles then this can contribute to leakage of the bladder or bowel as well. Although this weakness is not a common finding, it can happen post operatively in the pelvis or abdomen. Regardless of the reason, a PFPT can be helpful in teaching specific exercises to address the issues.

 

If you are having problems with any of these issues seeing a pelvic floor physiotherapist may be beneficial:

  • leaking with laughing/coughing/sneezing
  • leaking due to urgency of the bladder
  • chronic constipation
  • pain with intercourse
  • pelvic pain/low back or hip pain (especially if addressing the back and hip tissues with prior rehab does not appear to be resolving the issue)

If you are finding yourself worried about what to expect as an adult coming for a first appointment, check out this blog!

 

Ready to take control? Book your assessment today in Warman HERE and in Saskatoon HERE

 

/by

Why You Should Just Eat the Cookies

December is a time for being with friends and family and usually losing your regular routine for a while. That’s okay, even if that means your eating changes. Many people tend to both look forward to and dread the food that comes with the holidays. Here’s why you should just eat the cookies without feeling bad.

 

Foods we eat during holidays or family events are generally not foods we eat all the time. This is a special time with your family and friends and the food served tends to follow suit. It’s also special. The holidays can bring guilt and shame and other uncomfortable feelings for a variety of reasons, but food should not be one of them. Do these foods have more fat, sugar, and dreaded calories than your normal diet? Probably. Could you end up gaining a few pounds? That’s a possibility. If thinking about these things makes you nervous you need to ask yourself why. 

 

A cycle to break

A few weeks of eating special foods may lead to a few extra pounds, but a few weeks of getting back to your normal routine will have your weight back to normal. This may not be the case for everyone though, especially if you have an all-or-nothing mentality around diet, have a history of dieting or restricting foods, or are planning to lose weight in the new year. All of these reasons can lead to bingeing which can start, or continue, the cycle of restriction and bingeing which leaves people in worse health than when they started. 

 

If you are wondering if you are at risk for this kind of behaviour, consider how you feel about these special foods. Do they bring up more uncomfortable emotions than comfortable ones? Are you considering what actions you will have to take after eating this food, like skipping meals, severely increasing your movement, starting a new diet, or only eating low calorie foods after the holidays? If so, you may need to change your mentality around food, diet, and body size. This sounds like a lot of work and it is. Thankfully, there are a lot of resources to help.

Changing the status quo

Changing your mentality and doing all of that work has a lot of benefits. When it comes to the holidays, the negative feelings concerning all the special food you and your family and friends lovingly prepared will be heavily outweighed by nostalgia, joy, comfort, and pleasure. The food at these events may be culturally important, time consuming, or expensive to make but they are served because they represent something to the people present, something that often equates to love.

This holiday, just eat the cookies, the ham, the yams, the latkes, or the stollen.

 

 

 

Check out what I do in our previous blog for more information!

 

**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.

/by
, , , , ,

Physio for your… Behind?! Anorectal Disorders Explained!

Pelvic floor physiotherapists are physios who have had additional training to perform external and internal pelvic exams in order to treat a variety of pelvic floor disorders. Among those disorders include some that pertain to the dysfunction of the bowel – your behind. These anorectal disorders may include

  • Leaking of stool from the rectum (fecal incontinence)
  • Inability to control flatulence (being unable to hold back a fart)
  • Chronic constipation
  • OASIS (obstetric anal sphincter injuries) which include 3rd or 4th degree perineal tears sustained during labour and delivery, rectocele, rectal prolapse, and pain disorders of the anus
There is something we can do to help!

Fecal incontinence refers to the uncontrolled passage of fecal material (aka poop) in individuals who are 4 years old or older. There can be various reasons why fecal incontinence may be present. There may be damage to the internal or external anal sphincters during OASIS. Radiation therapy for certain pelvic cancers may have reduced the ability of the rectum to stretch contributing to incontinence, stool consistency may be too liquid making it difficult for the sphincters to stop the feces from exiting the anus (possibly due to partial bowel resection surgery due to various medical conditions. Food intolerances/poor diet may also cause stool consistency to be too loose. There may be some weakness in the external anal sphincter muscle or the puborectalis portion of the levator ani muscle (the main pelvic floor muscle group) contributing to leakage of stool.

Some leakage can be due to nerve disorders (example multiple sclerosis). Sometimes even chronic constipation can be a source of loose stools leading to fecal incontinence!

 

What does it mean to have a 3rd or 4th degree tear during labour and delivery?

A 3rd degree tear is a tear into the external anal sphincter and a 4th degree tear includes tearing into the internal anal sphincter. These two sphincters are what control the exit of the stool and gas out at the anus from the rectum. When there is a tear in the sphincters, the scar tissue that forms from the injury may cause problems. Common issues to these injuries include having pain during bowel movements and it can contribute to constipation. There can also be low tone of the IAS or EAS (internal or external sphincters) or weakness of the external anal sphincter that may cause fecal incontinence or difficulty with controlling an unwanted fart. Fecal urgency can also be a symptom following 3rd or 4th degree vaginal tears.

Even if there is no bowel dysfunction in the post partum period following labour and delivery with a 3rd or 4th degree tear, having a pelvic floor physiotherapist examine the pelvic floor and provide an individualized home exercise program to optimize the scar tissue mobility, pelvic floor mobility and strength, and provide education on optimization of defecation strategies. This can be very helpful as sometimes occult injuries (meaning those without obvious injury to the anal sphincters) are present. They could result in symptoms like fecal urgency and loss of control of farting or fecal incontinence later in life (post menopausal).

Proactive treatment can be beneficial in these cases!

Chronic constipation is often characterized by:

  • having a bowel movement less than 3 days/week
  • and/or a stool consistency on the Bristol Stool Chart of Type 1 or Type 2
  • history of very large bowel movements (plugging the toilet for instance)

A pelvic floor physiotherapist can be helpful in providing various strategies to assist with the evacuation of the bowels. Some basic recommendations may include:

  • general advice on fibre and fluid intake recommendations for optimal stool consistency
  • activity recommendations
  • manual therapy techniques to assist with motility of the stool through the rectum
  • education on various physical evacuation strategies
  • breathing techniques to assist with optimal bowel evacuation
  • minimization/elimination of straining

 

 

 

For those suffering from prolapse, a physiotherapist can help by teaching optimal defecation techniques to reduce strain to the area, thereby reducing strain to the tissues. There may also be too much tension in the pelvic floor muscles or there may be scar tissue present from obstetrical or other surgical injuries which can lead to pain in the pelvic floor or anus with or without having a poop.

Struggling? Book online with a physiotherapist today in Warman at Warman Physiotherapy & Wellness or Saskatoon, at Warman Physio Saskatoon. Don’t see a spot that works? Add yourself to the waitlist! You can even select if you have a therapist, location, and day/time preferences!

 

 

This post was created by Maja Stroh MPT and pelvic health physiotherapist at Warman Physiotherapy & Wellness

/by

What does the dietitian at Warman Physio do?

Jessica Braun Dietitian

Hi, I’m Jessica the dietitian. I’m a private practice dietitian which means I don’t work for the Saskatchewan Health Authority (SHA). I see clients both in-person at the clinic and virtually. Clients are usually looking for a private practice dietitian because their doctor told them to see a dietitian and the SHA dietitians are all booked up or not accessible to them. They often feel like they have no idea what to eat. Or they are sick of trying to lose weight and want to find an alternative to improve or maintain their health.

My appointments generally run from 45-60 minutes. This may seem long but we go over so much information and get into a lot of detail to find the best path for you. Don’t worry about trying to remember everything though! I send post-appointment summary emails along with any resources you may need. 

I see clients of all ages for a wide variety of reasons:
  • type 2 diabetes
  • heart health
  • digestive conditions and gut health
  • disordered eating
  • food allergies and intolerances
  • reducing disease risk
  • learning how to meal plan and incorporate new foods into your diet
  • introduction to solids
  • picky eating

After all of that you might be wondering, “but, what don’t you do”? I’m glad you asked. There are a couple things: weight loss, diagnosed eating disorders, and type 1 diabetes. I also don’t create meal plans but I can teach you how to make your own.

Telling people I can’t help them lose weight often leaves them confused. That doesn’t mean we can’t reach your health or eating goals! I’m a weight neutral dietitian meaning weight is not a factor in our discussions or goals. I won’t ask you how much you weigh, we won’t talk about BMI, and I won’t ask you to track your weight. We brainstorm strategies that have nothing to do with weight loss, creating goals that are tailored just for you and sustainable for the long-term

 

Check out this blog on Halloween candy for a little more information about how I work, or check out my social media on Facebook, or IG (@jessicabraunrd)

 

 

**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.

/by

Halloween Candy & Cravings

Since it is the beginning of November, it’s likely your kids have acquired large quantities of candy. Or, if you’re like me, you only had four trick or treaters this year and now have a lot of candy hanging around. Either way, this situation can bring up some uncertainty, fear, and shame for kids and parents alike.

Adult Cravings

Let’s start with discussing cravings as an adult. Cravings are a normal part of our appetites and I promise they don’t occur because you are addicted to sugar. What causes cravings depends on a couple things like: your emotional state, hunger level, mentality towards “junk food”, and if you follow a restrictive eating pattern.

Looking more closely at these possible causes will give us an idea of where your cravings are coming from. If you routinely skip meals or wait long periods between eating for whatever reason your brain is going to start craving simple carbohydrates. For example candy because they are the quickest source of energy for your brain. Eating more regularly, every 3-4 hours for example, can help curb “hangry” sugar cravings.

If you are experiencing emotional turmoil or stress and your main coping mechanism is eating to help deal with those feelings Halloween candy may be exactly what you start reaching for. “Emotional eating” or using food to cope with difficult emotions or stress; is not necessarily a bad thing but it may not be serving you well. If your only coping mechanism is food you may want to practice additional strategies to help you get through these feelings.

Lastly, if you follow a diet or meal plan that only allows for limited carbohydrates or sweet foods or if you avoid candy and other carbohydrates in general these restrictions are going to increase the frequency and intensity of cravings. Additionally, if you mentally restrict yourself, meaning you eat these foods but feel shame or guilt when doing so this can have the same effect as physical restriction. This cause for cravings is complicated and difficult to resolve but it can be done. Using tools like Intuitive Eating, Body Neutrality, and Body Trust can help you stop dieting and restricting which will improve the cravings.

As I said already, cravings are normal and not always avoidable. But the best way to get rid of cravings is to eat that food you are craving! That doesn’t mean you avoid it until your cravings become too strong so that you can’t stop yourself anymore, it means you add this food to your regular diet without restriction. This is one of the main principles of Intuitive Eating and it is not easy and takes some work but having a healthy relationship with food is worth it.

Child Cravings

Now let’s move on to the kiddos. As a parent we face a dilemma when it comes to kids and candy, how much should I let them? Kids will have the same cravings and reactions to their Halloween candy that adults do, so how do we solve this? We use something called the division of responsibility. As a parent it is your job to choose what, when, and where your child eats. It is your child’s job to decide how much of each food offered they eat. Depending on the age of your child, you should either offer them their Halloween candy at each snack or meal (or both) without restriction. Remember, they get to decide how much. Or, give them free access to their Halloween candy. Lastly, making sure candy and similar goodies are available year round.

The goal here, for both you and your kids, is to make Halloween candy not a big deal. This might mean your family eats nothing but Halloween candy for three (or more) days but the novelty won’t last too long. Once everyone gets used to having free access to candy, both physically and mentally, it doesn’t become a special treat anymore. It just becomes food! By next Halloween the candy dilemma will be long gone.

 

Resources:

Intuitive Eating: https://www.intuitiveeating.org/

Division of Responsibility: https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding/

Body Trust: https://centerforbodytrust.com/about-us/

Body Neutrality: https://www.facebook.com/watch/?v=652417292047818

 

**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.

 

/by