Category Archives: Women’s Health

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Urinary incontinence: why aren’t women talking about it?


“With one in three women affected after childbirth, it’s surprising to find that female incontinence is rarely spoken about”

A great piece in Monday’s Irish Times documenting patient experiences and also offering some advice from our Specialist Women’s Health physiotherapist and practice partner Maeve Whelan.

http://www.irishtimes.com/life-and-style/health-family/urinary-incontinence-why-aren-t-women-talking-about-it-1.2835293

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Call us now for Ante & Postnatal Pilates Classes

Pictured here is our physiotherapist Elaine with a few of the younger members of her popular Postnatal pilates class! Elaine has a special interest in women’s health and a wealth of experience in women’s health conditions.

Are you pregnant or have just given birth? To be eligible to join the ante natal class you must be at least 16 weeks pregnant and 6-8 weeks following delivery for the postnatal class.

All ante and postnatal Pilates classes are led by Chartered Physiotherapists who are experienced in the rehabilitation of women’s health conditions such as pelvic girdle pain and pelvic floor dysfunction.

Tara Murtagh

Welcome to the clinic – Tara

We are delighted to welcome Tara Murtagh to the clinic due to increasing demand. Tara has a wealth of experience, and also expert post graduate training in Pelvic Floor rehab and continence.

Tara is passionate about treating prenatal and post natal musculoskeletal conditions, pelvic floor and continence rehab, clinical Pilates, dry needling as well as exercise prescription and rehabilitation.
Welcome on board Tara!

Milltown Physiotherapy on the Radio

Our specialist Women’s Health physiotherapist Maeve Whelan was asked on the radio to give her expert advice during World Continence Week to discuss overactive bladder (OAB). A surprisingly common condition effecting 15% of the population.
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A lot of great advice from Maeve here and worth a listen for both clinicians and patients alike.

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World Continence Week and Overactive Bladder (OAB)

One in three women experience urinary leakage.

Just under 60% of women who never had a baby have had some sort of pelvic floor symptoms – this may be bladder or bowel control, pelvic organ prolapse or sexual pain.

15% of Irish people experience overactive bladder (OAB) symptoms.

Half of Irish people don’t understand OAB.

90% avoid visiting their doctor for help when the condition first occurs.

Irish research shows that 22% of Irish people claim they would either do nothing or are unsure of what to do if they experience OAB symptoms – and almost 1 in 3 report embarrassment as the key barrier to seeking help for OAB.

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To mark World Continence Week 2016 Irish experts shared tips on improving bladder control encouraging the public to take action and improve their bladder control.

Specialist Chartered Physiotherapist In Womens’s Health & Continence Maeve Whelan went to Jumpzone and with a group talked about the pros and cons of pelvic floor exercising on a trampoline!

 

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Trampolining is not for the feint hearted! The problem is that those who have real problems wouldn’t dare. The majority of women would think that they could n’t get up on a trampoline for even a minute, let alone stay there long enough to strenghten the pelvic floor.

 

WHAT HAPPENS WHEN IT GOES WRONG?

Every time you land on the trampoline, your pelvic floor has to contract to keep everything in place. Yes – if you have problems with bladder leakage, it might increase your symptoms. . The bounce generates a lot of intra-abdominal pressure, and if your muscles are too weak – you’ll leak.

 

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Think of a ship in dry dock: the organs (bladder, uterus and bowel) keep going down and the support (the muscles or in this analogy the water) is not there to counteract that force. The neck of the bladder opens.

 

However – you are up there with the highly trained:

  • 80% of elite trampolinists have pelvic floor leakage
  • 28% of all athletes have pelvic floor leakage

 

WHAT DO I DO ?

Learn how to do a  CORRECT PELVIC FLOOR CONTRACTION:

  • Squeeze engaging from the back as well and up to the front across the vagina and towards bladder
  • Lift up and in as if trying to stop passing wind and stop passing urine
  • Don’t lift your chest & don’t squeeze buttocks
  • Start by holding for 5 and drop completely
  • Then progress to hold for longer and introduce breathing at the same time
  • Do 10 reps x 3 times per day
  • Do some in lying some in sitting and some in standing

 

Engage your core muscles

 

  • Zip up lower tummy as if away from knicker elastic or tummy button to spine
  • DON’T brace the tummy – that means you shouldn’t feel a popping out of the muscles under the ribs
  • DON’T lift your chest
  • Engage the pelvic floor muscles
  • Practice with the pelvic floor 10 reps x 3 times per day

 

Posture

 

  • Lift the chest – make sure you are not rounded at the middle back
  • Use the buttocks to stand– don’t sag down at the pelvis
  • Don’t brace the upper tummy

 

HOLD while bouncing – Some gentle rebounding – your feet don’t even have to leave the surface at first and build up impact all the time working on contracting the pelvic floor at impact.

 

Be careful – don’t over brace the core or the pelvic floor – you might leak more.

 

BUT Conscious, active “zipping” of the core is only required when you are increasing your activity levels – bouncing, lifting, running, pushing, bending, weight training etc.

 

DON’T FALL IN TO THE TRAP

 

  • Oh well I have had a baby – that’s the way it is now
  • I thought it was the menopause – it’s the hormones
  • Oh well I am too old – its too late for me

70-80% of women will do well with bladder retraining and pelvic floor exercises – have a look at http://www.oab.ie .

 

FINALLY – TRY EVB SPORT SHORTS FOR EXTRA SUPPORT http://evbsport.com  !

 

 

 

EM

Welcoming Eimear To Milltown Physiotherapy

We are delighted to welcome Eimear Murphy to the staff at Milltown Physiotherapy. Eimear is a chartered physiotherapist graduating from UCD in 2002. She also holds a Masters from the prestigious University of Western Australia.
Eimear has worked as a senior physiotherapist in ‘Burns and Plastics’ and ‘Women’s Health and Continence’ in St James’s Hospital before specialising in musculoskeletal physiotherapy. Alongside Women’s Health and continence, Eimear has a special interest in the treatment of neck and low back pain.

Sarah, Steph Helen Diane

Physiotherapists travel to UK for Diane Lee course

Three of the Chartered Women’s Health physiotherapists from Milltown Physiotherapy (practice partner Helen MacDevitt, Stephanie Crossland and Sarah Mullins) travelled to England for four days to attend a course given by Diane Lee from Canada.

Diane is a world renowned physiotherapist who is internationally recognised for her clinical work on the thorax and pelvic girdle. She is the author of two books on these topics along with contributing chapters in many highly regarded publications for physiotherapists. We were very lucky to be able to attend this course as Diane is not over on this side of the water very often!

She is currently undertaking research on the behaviour of the muscles of the abdominal wall in women with diastasis recti abdominis (DRA). The course title was “New perspectives from the Integrated Systems Model for Treating Women with Pelvic Girdle Pain, Pelvic Organ Prolapse, Stress Urinary Incontinence and / or Diastasis Rectus Abdominis”.

 

Why am I still having pain or experiencing dysfunction after having my baby?
It is well known that the abdominal wall and pelvic floor muscles play key roles in function of the trunk and that pregnancy and delivery can have a significant and long lasting impact on their activation patterns. Muscle imbalances can arise postnatally, thereby compromising the ability to transfer load through the trunk. This may create pain in a multitude of areas as well as affect the urinary continence mechanism and support of the pelvic organs.

 

What is Diastasis Recti Abdominis (DRA)?
It is a widening of the midline tissue known as the linea alba and separation of the recti muscles of the abdomen. It occurs to some extent in 100% of women in the third trimester of pregnancy (Gilleard and Brown 1996). Following pregnancy, DRA may prevent restoration of both the appearance and function of the trunk. Many women with DRA remain abnormally widened at 8 weeks postpartum and this distance remains unchanged at 1 year without any intervention (Coldron et al 2008, Liaw et al 2011). 66% of women with a DRA also have at least one support-related pelvic floor dysfunction (Spitznagle et al 2007).

 

What is the Integrated Systems Model for Disability and Pain?
It is a framework developed to help clinicians determine the primary cause of symptoms when multiple sites of impairment are noted during any single task and helps formulate prescriptive treatment programmes that are unique to each individual.

Milltown Physiotherapy lecturing internationally

Maeve was recently for the very first time over in the USA teaching. It was a great pleasure to be with a lovely group of Women’s Health physiotherapists in Milwaukee Wisconsin, organised by Nina Olson of Freedom PT, Fox Point.

Two days of hard work by all concerned flew by and was rewarded half way by a fantastic seafood dinner on Friday evening in Lake Michigan’s Harbour House. Thank you Nina, Emily and Tracey of Freedompt for looking after me so well!

 

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