I’ve been a musculoskeletal physiotherapist for the last few years. Having over 20 years of dance expertise myself, I've always had a strong interest in treating dance related injuries (think lots of lower back, pelvis and hip.) This naturally exposed me to treating lots of fabulous females! As I continued to develop my skills in this area, I felt a growing gap in my knowledge with common re-occuring themes of incontinence, pelvic pains, urgency, pelvic floor dysfunction and much more. I wanted to know more! Could these issues be treated? How could I help empower more women to tackle these set backs? Why are these issues so common yet we don’t actively talk about them? I am hoping my blog posts can help shed light on these common, yet often complex issues and ultimately help more fabulous females regain control over their bodies and health.
I recently worked with Jane to help her manage her re-occurring lower back pain that has been affecting her since the birth of her son 3 years ago.
She had a natural birth and had a grade 2 tear of the vaginal tissue and peroneal muscles (These tears are common during a vaginal birth – imagine a 2-4KG baby exiting out of the vagina – ouch!).
She was distressed as she was unable to pick up and run after her young son and was struggling to sleep through the night. Even walking was uncomfortable.
After examining her, I ruled out anything sinister and reassured her of her concerns – we would get her back to carrying her son and loaded washing within the month. After 4 weeks of regular sessions, she had improved immensely from not being able to stand and walk upright to now having returned back to her day to day activities and caring for her little one without pain!! Jane finally felt like herself.
In the process of her rehabilitation, I had discovered she was unable to activate her deep core musculature. For those who don’t know what the deep core involves – it involves the muscles of transversus abdominus, multifidus, as well as your diaphragm and pelvic floor. Think of these muscles as the foundation in which a brick house is built on and is integral for supporting the house aka “remainder of the body” in anything you do! These muscles can often become dysfunctional after an episode of low back pain, so I wasn’t surprised that Jane had difficulty with these muscles. If you want further reading on it, and even some helpful ways to activate these muscles, here is a link below: http://www.dianelee.ca/article-training-deep-core-muscles.php
Understanding that the pelvic floor muscles is also important for providing closure to the vagina/anus so that we can choose to pass urine as needed, I had asked her if she had any trouble with leaking/controlling the bladder.
She leans in and whispers to me “That’s the reason why I don’t exercise anymore – I had an accident before when playing tennis”. She leans back and then brushes it off in a matter of fact way “But this is completely normal after having a baby, all my friends are like me”
This unfortunately is a response I normally get when questioning about post partum incontinence. I move on to my next question:
“Do you know it can be treated?”
And unfortunately a response I normally receive and I did receive from Jane is this instance was “What? No!”.
37% of Australian women experience incontinence but only 30% will actually seek help.
It breaks my heart that my female patients are silently suffering from incontinence and/or post natal traumas with little knowledge of the treatment strategies. Or in Janes and her friends case, they normalised incontinence and didn’t even know that treatment was an option! Rectus Abdominal separation, pelvic pains, wearing pads when exercising (or in Janes case – stopped her from exercising!)/leaving the house, fear of leaking when laughing, going to the toilet > 10 days a day is unfortunately common post natally but rest assured, it can be treated!
This is the reason why I furthered my physiotherapy studies in women health – to empower women to combat and take control of their health. Many women don’t know that help is out there. And when it is apart of my job to help my patients feel and live better, I love what I do (even if the day starts at 5.30AM!)
