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Emma James Physio Blog

Chartered Physiotherapy and Clinical Pilates

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November 2019

Treat your Pelvic Floor to more!

Pelvipower_bio-feedback_training_EJPhysioThere is a new Swiss technology-driven treatment for increasingly common issues such as incontinence, pelvic girdle pain, sexual health/dysfunction, and back pain.

The treatment (called PelviPower) is conducted in the form of a customised therapy chair, where specific impulses (Magnetic Field Therapy, PFT) and high-accuracy sensors (Biofeedback Training, BFT) can target an individual’s particular issues whilst producing results that are measurable and can be replicated.

Conventional Approach

Until very recently, both clinicians and patients have been limited to abstract descriptions and poorly located/defined areas of symptoms, relying heavily on vague and subjective instructions to address various pelvic girdle complications; while most of these issues are often sensitive topics to discuss, and the physical assessment itself being quite intimidating as well. Understandably this has led to a general reluctance for both men and women discuss/seek treatment for their pelvic issues. The PelviPower system addresses these obstacles by providing precise real-time data to the clinician without any invasive procedures, and it also gives the patient a much better information and direction throughout the treatment process.

Incontinence

At least 30% of woman experience some degree of urinary leakage in their lifetime especially during and after pregnancy and soon after menopause as oestrogen levels decline. 1 in 4 women will avoid activities such as sports, going to the gym or daily social activities as a result. There is common misunderstanding that it is a normal or inevitable consequence of childbirth or ageing, when in fact it is an issue that needs to be addressed. Common forms of Incontinence include:

  • Stress incontinence: This is urinary leakage due to weakened pelvic floor muscles and tissues. It generally occurs when pressure on your bladder increases — such as when you exercise, laugh, sneeze, or cough.
  • Urge incontinence: You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
  • Bowel Incontinence: Bowel (or faecal) incontinence is the inability to control bowel movements. Severity can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control. Some people have recurring or chronic faecal incontinence.

Mens Health

A healthy pelvic floor muscle(s) can prevent incontinence, erectile dysfunction/premature ejaculation, complex pelvic girdle pain, and lower the incidence of back pain. Amongst men who require a prostatectomy, it is also imperative to optimise the pelvic floor muscle before and after the surgery to prevent these unwanted leakage and/or incontinence.

PelviPower Treatment

Pelvipower_magnetic_field_training_EJPhysioThe PelviPower treatment chair is currently utilised globally, and receiving excellent feedback from expert pelvic floor clinicians in leading-research areas such as Ireland, Australia, and New Zealand.

Your clinician will conduct a thorough non-invasive examination with you, noting the subjective history, symptoms, and your particular goals/expectations from the treatment. You will then be asked to sit in the PelviPower chair so that your pelvic floor contractions can be assessed, and your clinician being provided with specific data about your contraction patterns. From there the clinician will be able to tailor an individualised treatment plan for your needs, which would typically involve 2-5 sessions per week of no more than 20 minutes in the chair per chair (depending on your situation). The entire process is conducted whilst fully-clothed, and is complete non-invasive.

My Conclusion

  • Convention/past diagnosis and treatment of pelvic floor issues can be inaccurate, lacing specific focus
  • Can be a daunting and embarrassing process for the patient
  • A lack of awareness and support
  • PelviPower is non-invasive, relatively easy to use
  • The treatment is measured and can be replicated
  • Noticeable improvement within a short space of time
  • Guided by a trained clinician throughout the entire process

Exciting News!

You will have the opportunity to try PelviPower for yourself as this service will be available at our Hemel Hempstead practice from December 2019.

For more information please visit our PelviPower page, visit the PelviPower website or contact us for more information and how to book.

kelvin

Kelvin
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Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

 

Tendon Pain Treatment and Management

The best part about tendon rehab is you need to facilitate your load to optimal levels, so it doesn’t mean complete cessation of exercise! Tendon rehab is fundamentally based around loading the affected musculotendon unit, so strengthening exercises are key. Research shows best outcomes are associated with a long term (average 12 weeks), progressive and individualised loading programme. So as long as you put the hard graft into your rehab; you’ll go the extra mile!

There are other significant factors that will contribute to your management; such as foot and ankle biomechanics, BMI, psychosocial factors as well as other co-morbidities. As Kelvin stated in our previous blog post, each case of tendon pain is unique and is tailored to you as the individual.

So, what is the norm for Tendon Pain?

Due to the makeup of the tendon fibres and what their role is, it takes either a dramatic change in your load or a build up in load that exceeds your capacity over time to elicit a painful response. This may cause an inflammatory response for an acute change and/or structural change in a more chronic period of excessive loading. Either way, there will be an element of pain that is overriding in either your day-day activities or exercise-based activities.

So, What do we do?

You stop doing what hurts, dur? Well, with tendon pain it isn’t as straight forward, and that’s good news for you! Why? Because it doesn’t mean you have to completely stop all forms of activity. Our aim is to keep the healthy or injured part of the tendon active within our desirable limits and with suitable progressions in activity and exercise; our tolerance will improve over time!

So now we come onto the million-dollar question, what is the right amount of pain?

The criteria for tendon related acceptable pain is really straight forward, we take a subjective interpretation of your pain and provide scores of optimal, acceptable and undesirable intensities of pain. The presence and/or duration of symptoms after a reaction are also monitored and fall into the same categories. Remember, your pain is unique to you, as well as your exercise tolerance – this is all considered when your therapist constructs your rehabilitation programme.

adamSo don’t panic, tendon pain isn’t as debilitating as it seems. With patience and commitment, we will get you back to your goals, and back even stronger than before!

Adam

Blog post by Adam
Senior Physiotherapist at Emma James Physio

The upward surge in sports injuries around this time of the year

As the winter months slowly start to take over our skies, the balmy holidays in July and August already feel like a distant memory; what that also means for a lot of us is that we’re back in full swing with our gym routines, running trails, contact sport training and games – casual and professional athletes alike – and perhaps preparing for our next marathon/half-marathon.

Interestingly, we as Sports Physios tend to see an upward surge in sports injuries around this time of the year. And sometimes, as a figure of speech, we can even predict certain months being more “hip/knee/ankle injury dominant”, depending on whether there is a prominent sports events coming up e.g. London Marathon, or a finals series. In those months, we are bound to see and treat a few people with sore ankle tendons or painful knee tendons.

…but why is that?

Today I’m hoping to provide you with a little insight to how we as physios answer that question.

Tendons mostly are the thick, fibrous connective tissue that links a particular muscle to a bone, and is the main structure that converts a muscle contraction into an actual body movement. It is primarily made up of collagen tissue, and this tissue can be an incredibly robust, “workhorse” structure – being able to absorb impact, withstand multi-directional forces, convert muscle energy into movement, and generate power + velocity pertaining to our chosen sport.

However, tendons do have a major character flaw: they are very, very sensitive to change. Which means any drastic changes to one’s training routine – simply termed as Load in Sports Science – can have an irritating effect on the tendon structure, eventually leading to pain. Load, as we know, can be measured in a few ways:

  • Frequency: How often the training takes place e.g. How many runs per week?
  • Intensity: How hard the training session(s) is, e.g. How fast you’re running
  • Volume: How much the person is doing in a particular session, e.g. How far you’re running

When there is a sudden, drastic increase in load – or an “upward spike” – the collagen structure of the tendon is unable to cope with these changes, and can often begin an inflammatory process, leading to collagen/tendon breakdown, and in severe cases, loss of structural integrity. Broadly speaking, this is when the person begins to feel a persistent pain during and/or after the training, and the performance/output is no longer as well as before. Conversely, tendons also adapt to a decrease in load – or we refer to as “deloading” – whereby the collagen structure adapts to a lesser training load/regime, and in time is no longer at the capacity of its previous training intensity. So if we were to put two and two together: a deloading phase during our summer holidays/off-season followed by an upward spike around this time of the year…it’s not hard to see why some of us are getting aches and pains!

Luckily, most of the time these changes are not permanent, and tendons generally do respond well to treatment and rehabilitation. This is where the expertise of your physio comes in – we can determine the extent/severity of your presenting tendon injury, provide any immediate treatment that is necessary, but more importantly go through the details of your training routine and carefully making adjustments to it. This ensures that we are gradually rebuilding your tendon strength properly, as well as preventing it from further irritation and breakdown. Such is the nature of tendon injuries, there is no one-size-fits-all, and each case is treated in accordance to its specific needs.

All the physios at Emma James have had the privilege to work with (and currently so) athletes at various levels, and therefore are very experienced in dealing with tendon injuries.

kelvinShould you have any doubts about your training, be sure to contact us as we would love to help. Just imagine: us making your marathon training (actually) enjoyable!

Kelvin
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Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

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