New at Trimetrics!
Pfilates! Pelvic Floor Conditioning Program.
A specially designed, Pilates based program to target pelvic floor weakness, and to improve the symptoms of incontinence.
The issue of incontinence in women is a silent epidemic.
With stats that tell us that one in three women suffer from some form of incontinence or other pelvic floor (PF) dysfunction from athletes to residents of care facilities, new, and not so new mums, and those who have never had children, it’s the unmentionable issue. Its not easily discussed among women themselves and not with a doctor until they are really desperate. Considering the effect that any form of incontinence or pelvic floor issue can have on close personal relationships, it’s shocking that it does not receive more attention.
While not a direct killer in itself, compared to other chronic medical conditions overactive bladder (an umbrella term) is ranked as # 2, after depression in terms of impact on quality of life. For moms aged 30 and over the risk of postpartum urinary incontinence is 34 %. The issue of the economic costs of incontinence is an article in itself when we start to account for lost workplace productivity, medications, and surgeries up to 50 % of which fail.
With new research, we as physiotherapists have a much clearer understanding of the causes. We understand that most pelvic floor issues are primarily problems of the tone of the pelvic floor. These issues fall into 2 broad categories:
1 Hypertonic PF muscles (muscles that are too tight)
We understand that the PF muscles undergo trauma with childbirth regardless of delivery method. With vaginal deliveries, nerves within the vaginal muscles are bruised, compressed and over stretched. Think, for example, of how nerves that are overstretched in a whiplash accident, affect the neck muscles: they respond by tightening up leading to pain and weakness.. The pelvic floor muscles behave the same way. Deep muscle tightness does not necessarily relax automatically. Long-term tension leads to weakness, painful intercourse, constipation and bladder issues. While many of these cases need exercise therapy, the muscles FIRST need to be released using targeted internal myofascial release techniques by a specially trained physiotherapist. Generally, anywhere from 2-6 treatment sessions is all it takes to release tension patterns that may have existed for years. Then the muscles are ready for a progressive re training program.
2 Hypotonic PF muscles (muscles weak, and deconditioned ).
There is still a prevailing view that the PF muscles somehow magically self strengthen after childbirth or surgery. It’s common for patients to be told to wait 6 weeks before exercising after delivery of a baby. This makes no sense when we know that muscles regardless of where in the body need to be strengthened as soon as possible after injury or surgery…why do we have such a blind spot about the pelvic floor? No one tells an athlete to wait 6 weeks after ligament repair….. rehabilitation begins immediately if not pre-surgical! While new mothers may be given a brief exercise sheet referring to Kegel exercises, these instructions are no where near as precise as they should be in order to get the PF system back to full strength and endurance. Many women are actually practicing Kegels incorrectly, by pushing down, or not doing both fast and slow exercises. The PF is a strong neuromuscular system which needs to be conditioned with a progressive exercise program taking into account the needs for both endurance and strength, same as any other muscle system.
Thanks to Dr Bruce Crawford ‘s research, we now have a smart effective pelvic floor exercise program ( Pfilates ,pronounced “ filates “) to up train the pelvic floor system and seek full recovery. Using electromyography Dr Crawford selected the 10 best Pilates exercises, which most efficiently work the PF. The program applies the same training principals to the PF as we would apply to any body part needing rehabilitation. This has not traditionally been the case with PF retraining.
Trimetrics physiotherapists and Pilates instructors are certified by Dr Crawford to teach his program. We will launch the first one in March and plan to offer them on a continual basis as a component of our Women’s Health physiotherapy program.
We recommend that prior to registering for the 3 week Pflates program, you have a 60 minute one to one screening appointment with Kirsten Stalberg, Registered Physiotherapist. Kirsten, trained in Melbourne Australia, has worked at the Royal Women’s hospital Melbourne and lectured in women’s health to physiotherapy students at Latrobe University. Kirsten is certified to perform internal techniques, and has specific training to assess whether the pelvic floor is hypertonic or hypotonic, or requires a different treatment approach. She will take a detailed history and provide any treatment as needed prior to the program so that you will receive the best results possible.
We are grateful to our clients Maria and Helena who are keen to help us spread the word about our treatment program. Here are their testimonials.
– My family doctor referred me to Kirsten Stalberg at Trimetics because I was suffering from extreme urinary incontinence and he could not help
me (I was up several times at night to urinate, as well as numerous times throughout the day, ALWAYS felt that I had to urinate, and had severe leakage).
-My treatment, which included various techniques, was easy, educational and produced results very quickly
– The RESULTS ! I now sleep through the night or get up just once to urinate, have leakage VERY seldom (only if I eat or drink something that i’ve learned aggravates my bladder), and I urinate infrequently.
– Today I have sanity (as am getting more sleep) and joy back in my life, thanks to the life changing treatment I received from Kirsten at Trimetics.
“ I saw Kirsten Stalberg 3 times for assessment and treatment of incontinence /urge of urination after my second pregnancy and c/section.
The treatment was very effective and homework easy to do. As a result I rarely have incontinence, which provides me with more freedom in life. I am way less anxious looking for a bathroom!