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Endometriosis

Endometriosis Awareness Month

What is Endometriosis?

Endometriosis is a condition where endometrial tissue (tissue similar to the lining of the womb) starts to grow in other places, such as the ovaries and fallopian tubes. It is one of the most common gynaecological diseases needing treatment (NG73 September 2017). It can affect women at any age however it is mainly a disease of the reproductive years. Whilst the exact cause is not known, it is associated with menstruation and hormonal changes.

What are the symptoms?

enometriosis-diagramThe main symptoms include pelvic pain, painful periods, pain during or after sex, pain with passing urine or bowel movements during your period, feeling sick, constipation, diarrhoea, blood in your urine during your period and infertility.

As a result, endometriosis can have a significant impact on quality of life and in some cases lead to feelings of low mood or depression.

How can it be treated?

Treatments include painkillers, hormone medicines and contraceptives, surgery to cut away patches of endometriosis tissue or in some cases hysterectomy. The current NICE guidelines (NG73 September 2017) note in their recommendations that there should also be access to a multidisciplinary pain management service with expertise in pelvic pain as well as other things.

Physiotherapists can play a role in the management of pelvic pain by helping to strengthen the pelvic floor, which can improve sexual function as well as prevent unwanted leakage or continence issues.

HerPelvipower_magnetic_field_training_EJPhysioe at Emma James Physio we can provide expertise and insight into the management of pelvic pain. Emma herself has a special interest in Women’s Health and has been working hard to develop a service that is accessible for all, in the diagnosis, management and treatment of pelvic pain.

We can provide assessment and treatment using the Pelvipower chair, or perhaps why not try some acupuncture for pain relief. Why not book in for an assessment and find out more about the range of tools we have available to help manage your symptoms?

floatation-therapy-at-ejphysioNot quite ready to tackle it yet?……………..no problem, book in for a session in our floatation tank and take some time out for you. Looking after yourself with some ‘me time’ can do the world of good for your state of mind. Our therapists are ready and waiting to help to when you are.

 

maryMary
🙂
Blog Post by Mary
Senior Physiotherapist MSc, BSc (Hons), MHCPC, MCSP
Emma James Physiotherapy

For all new mums that love to run!

In this blog, I am going to talk through a recent publication which is rare its in context; providing guidelines for women wanting to return to or begin running after giving birth. It aims to serve as a guide for all new mums that love exercise or want to start after having a new-born.

Let’s dive in!

There is little guidance provided to healthcare professionals on how to transition runners back to activity postpartum; so, it’s easily understandable why new mums themselves may run into trouble (pun intended; apologies). There are three stages within the postpartum phase; lasting up to 6 months, but there are still intrinsic factors such as hormone level changes that are still adjusting even longer than this – so we need to be considerate for a significant period of time when returning to exercise.

Barriers that may affect women when returning to running postpartum may include;

  • new-muminadequate quality and quantity of sleep
  • fatigue
  • learning to care for a new-born
  • a changing schedule
  • physical changes

During pregnancy and postpartum the pelvic floor muscles (PFM) undergo significant change, including stretch from the increased weight gain and postural changes, increased muscular demand because of these changes, possible tearing during childbirth and then ultimately recovery through the pregnancy and postpartum period.

These changes may lead to decreased core stability, pelvic floor weakness, urinary incontinence, stress urinary incontinence (SUI) while running, lower back and hip pain and other musculoskeletal injuries.

See more info on PFM and the affects of pelvic floor weakness in our previous blog here.

There is an association with the intrinsic changes above and altered running gait post-partum. Therefore, it may be important to modify frequency and intensity of running with the guidance of a healthcare professional.

So, when is it safe to return to running?

new-mum-running

There is currently no guidance available for women who want to return to running or begin to run postpartum.

There are some recommendations for exercise in general. Return to exercise gradually when it is medically safe, when physical stress is tolerable.

The recommendations outlined in the aforementioned study are as follows;

  1. Clearance to exercise by physician
  2. Evaluation by healthcare professional specialising in pelvic health
  3. Comprehensive assessment of physical function and biomechanics
  4. Initiation of running and strength programme

Walking is a great way to begin safely exercising immediately postpartum. It provides many of the psychological benefits of exercise while preparing the body for running. Despite the overwhelming changes that occur postpartum, many women progress or start with running much sooner than their bodies are ready to.

If you do suffer from incontinence, diastasis recti abdominis (DRA) or any other associated post-partum issues; it doesn’t mean you cannot return to running, it may just mean modifying activity and completing specific exercises to address any issues. Many women are under the misconception that leakage while running is normal and it is not.

To summarise

Many women return to running between 6-8 weeks post-partum, without guidelines or instruction from a healthcare professional, with biomechanical and physiological changes that occur during pregnancy and remain postpartum potentially increasing risk of injury.

Currently, there is no gold standard for the management and care of women returning to running postpartum. The reviewed article highlights changes that occur during pregnancy that may alter the way women walk, run, lift and move postpartum.

Following the 4 stages of returning to running above should reduce the risk of complications and increased injury risk, whilst being under the guidance and care of a healthcare professional.

mummy-mot-certified-logoAt Emma James Physio we pride ourselves in offering specialist women’s health, biomechanical and strength and conditioning services. So, come and see us and we will get you back to where you want to be, or for you new mums; help you take those first steps after your new-born!

Adam 😊adam

 

Blog post by Adam
Senior Physiotherapist at Emma James Physio

Reference: Edwards, Kate. (2019). Considerations for the Postpartum Runner. Strength and Conditioning Journal. Publish Ahead of Print. 1. 10.1519/SSC.0000000000000453.

The importance of pelvic floor health in a sporting population

What is your Pelvic Floor?

Your pelvic floor is the group of muscles and ligaments in your pelvic region. The pelvic floor acts like a sling to support the organs in your pelvis – including the bladder, rectum and uterus or prostate.

Contracting and relaxing these muscles allows you to control your bowel movements, urination and for women particularly, sexual intercourse.

The importance of Pelvic floor health

What issues can you face with a dysfunctional pelvic floor?

Pelvic floor dysfunction is the inability to control the muscles of your pelvic floor. This term refers to a range of issues such as:

  • urinary issues, such as the urge to urinate or painful urination
  • constipation or bowel strains
  • lower back pain
  • hip pain
  • pain in the pelvic region, genitals, or rectum
  • discomfort during sexual intercourse for women
  • adductor pain

The importance of pelvic floor health in a sporting population

weight-lifting-womanAthletes are at greater risk of stress urinary incontinence due to their continued exposure to increases in intra-abdominal pressure throughout training.

What does this mean? Well, most sports involve one of two exercise forms; jumping and landing (eg. running, athletics) or the Valsalva maneuver (eg. weight lifting).

These two activities exert different deformations upon the pelvic floor due to their distinct direction and type of pressure loads.

Hip & Adductor injuries in a sporting population

hip-pain
Did you know that your pelvic floor muscles are directly attached you your hip muscles?

That’s right, the hip bone is connected to the pelvic bone and the pelvic floor muscles are connected to the one of your hip muscles: the obturator internus (OI)! It is reported that 64-72% of patients with hip dysfunction also experience pelvic floor dysfunction. This is largely due to weak lateral rotators and tight adductors.

 

How can we help you?

Personal Training
A personal trainer can help you to strengthen your lateral rotator muscles to help prevent hip dysfunction.

Sports Massage
A deep tissue massage of the adductor muscles can help to relieve muscle pain and tension, as well as overloading the pelvic floor.Pelvipower_magnetic_field_training_EJPhysio

The PelviPower Chair
This non-invasive method involves sitting on a chair as the pelvic floor muscles contract up to 25,000 times by the magnetic waves in the seat. One to two training sessions per week are adequate to effectively strengthen the pelvic floor.

Pelvic Floor Trainers & Toners

pelviva-logo-ejphysio
My Pelviva

Pelvic Floor muscle trainer with reactive pulse technology

Pelviva is an award winning, life changing, Pelvic Floor muscle re-trainer that uses a specially developed stimulation programme to treat the symptoms of bladder leakage in women.

Receive 10% off purchase price when you use the code EmmaJames at checkout when you purchase online.

Visit the Pelviva Website for more details and how to buy.

Secret Whispers

secret-whispers-logo-web

Secret Whispers ™ is a pelvic floor toner for women. Its 6 Step Pelvic Floor Exercise Strengthen & Tighten Your Pelvic Floor Fast. It helps with – pregnancy, childbirth, incontinence and bladder control.

Secret Whispers ™ pelvic floor packs are available to purchase from our main Emma James Physio clinic or online:

Click here to Purchase Secret Whispers Products

india-wayland
Bye for now 😉
India
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Blog Post by India
Sports Therapist at Emma James Physio

Pelvic Floor and the Menopause

The menopause and perimenopause can bring with it problems associated with pelvic floor dysfunction. The menopausal years can span any time from 45-55 years. The perimenopause can occur for many years before this while women are still having their monthly cycles. Some women who go through an early menopause could experience symptoms at a much younger age.

Reduced levels of oestrogen starting around menopause can cause thinning of the lining of the urethra, the short tube that passes urine from the bladder out of the body. In addition, the surrounding pelvic muscles also may weaken with aging, a process known as “pelvic relaxation.” As a result, women at midlife and beyond are at increased risk, or an exacerbation of pre-existing, stress and urge incontinence.

What is your pelvic floor?

Your pelvic floor muscles are a broad sling of muscles, like a trampoline, stretching from your pubic bone at the front of your pelvis to your coccyx (tail bone) at the back. They form the floor of your pelvis and are responsible for:

  • Supporting your pelvic organs – your bladder, bowel and womb
  • Controlling your bladder, bowel and sexual functions

Experiencing urinary incontinence (leakage) should not be accepted as normal at any point in a woman’s life. Below are the different types of incontinence.

exercise-and-pelvic-floorStress Incontinence

Stress incontinence is the most common type of incontinence and is when urine leaks during activities such as coughing, sneezing, lifting and during exercise. It occurs because the pelvic floor muscles become weak and are unable to cope with the rise in abdominal pressure associated with these activities. Weakness of these muscles can happen because of childbirth, chronic constipation, persistent coughing and around the menopause and perimenopause.

Urgency and Urge Incontinence

Urgency arises when your bladder needs to be emptied in a great hurry. Sometimes the urge to pass water is so strong that leakage happens before you get to the toilet. This is called urge incontinence. This relates to the size of your bladder, how much it holds, and how it is trained to respond. Mixed bladder leaking describes a combination of stress incontinence and urge incontinence.

Heres just a few ways we can help here at Emma James Physio:

Pelvipower_magnetic_field_training_EJPhysio

 


Special offers:

pelviva-logo-ejphysio
My Pelviva

Pelvic Floor muscle trainer with reactive pulse technology

Pelviva is an award winning, life changing, Pelvic Floor muscle re-trainer that uses a specially developed stimulation programme to treat the symptoms of bladder leakage in women.

The Pelviva treatment programme exercises your Pelvic Floor muscles to prevent bladder leaks when you laugh, sneeze, cough or exercise and to help you hold on when you urgently need the toilet.

Receive 10% off purchase price when you use the code EmmaJames at checkout when you purchase online.

Visit the Pelviva Website for more details and how to buy.

Secret Whispers

secret-whispers-logo-webSecret Whispers ™ was born after its founder Julie discovered that there were no adequate products available to help improve her pelvic floor and a lack of information available. The importance of pelvic floor exercises is often not discussed and crucially women are not given enough information about it.

Secret Whispers ™ is a pelvic floor toner for women. Its 6 Step Pelvic Floor Exercise Strengthen & Tighten Your Pelvic Floor Fast. It helps with – pregnancy, childbirth, incontinence and bladder control.

Secret Whispers ™ pelvic floor packs are available to purchase from our main Emma James Physio clinic. Please ask at reception for details. You can also purchase online,

Click here to Purchase Secret Whispers Products


Heres a useful guide to the pelvic floor, supported by wellbeingofwomen.org.uk

lisaAsk our friendly staff for more information and how to book your place.

Lisa

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

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

 

Pilates in pregnancy

PREGNANT? Sleepless nights? Tense?

Why Pilates? How will Pilates help in pregnancy?. Here is the answer.

 

Pilates is a slow but effective form of exercise.

pregnancy-exerciseThere are many benefits to joining a class:

  1. Relaxation: Pilates exercise helps to reduce stress and relieves unwanted tension, aiding sleep
  2. Concentration: It allows you to put your day worries aside and concentrate on your baby
  3. Co-ordination: Utilising moves that coordinate different muscle groups, ensuring there is a functional focus on exercises allowing you to benefit not only in pregnancy and labour, but also beyond
  4. Posture: It improves posture and body alignment to relieve pain and aches
  5. Strengthening and stretching: Pilates helps in stretching tired achy muscles and strengthening muscles helps stabilise your pelvis during pregnancy
  6. Breathing: Breathlessness and shortness of breath is one of the most common problems in pregnancy. Pilates exercises improves efficiency of breathing and oxygen delivery to your baby, breathing techniques learned can help contribute to a smoother delivery
  7. Core-strength: strengthens muscles which create a solid protective base, to stabilise the spine and support your back

More Information:

 

No reason to delay. Join our friendly classes at Emma James Physio
emma-james-2014Emma
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Blog Post by Emma
MD, Owner & Senior Clinical Director
Emma James Physio

Post Pregnancy exercise

Hi,

Being a mum I know the importance of exercise after having kids so heres my Top Tips on why Post Pregnancy exercise is so important to your wellbeing.

Regular exercise after pregnancy can:

  • Promote Weight loss, especially when combined with reduced calorie intake
  • Improve your cardiovascular fitness
  • Strengthen and tone abdominal muscles
  • Help enhance your mood
  • Improve flexibility
  • Reduce the heavy postnatal depression with a healthy mind

 

Why not try our Post Pregnancy exercise classes at Emma James Physio:

  • Bespoke luxury personal training and physio studio
  • Specialist care for hypermobility, bladder issues, complicated biomechanics
  • Fitness studio for every women and people wanting to get back into exercise, we are almost the luxury stepping stone back to the gym
  • Rehab gym
  • You are not just a number in a class, our studio has a more personal feel
  • Exercise in a friendly and fun environment
  • Small group classes

Further Information:

Post by Emma James – October 2018

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