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Physiotherapy

One sneeze too many?

incontinence The Body Refinery New Farm

Recently, actress Kate Winslet was being interviewed on the Graham Norton show. She was talking about how having babies had affected her and specifically her ability to remain continent when sneezing. “I can’t jump on trampolines anymore, I wet myself,” Winslet, 42, said on the show. “It’s awful, especially if you’re wearing a skirt.”

The mother of three attributes her incontinence to childbirth. “When you’ve had a few children you know, it’s just what happens,” she says. “It’s amazing, two sneezes, I’m fine. Three, it’s game over.”

 

So, is childbirth responsible?

While many people think that incontinence is a condition that only affects the elderly, it can affect men and women of all ages. Urinary incontinence, and in particular Stress Urinary Incontinence (SUI), is a significant health problem which can have a considerable impact on an individual’s quality of life.

SUI is defined as the involuntary loss of urine on effort or physical exertion, such as sneezing or coughing. Current evidence indicates that stress incontinence affects 4% to 14% of younger women and 12% to 35% of older women, with a peak incidence in midlife around the time of menopause.

Many women with urinary incontinence do not seek help for their condition. Some women have SUI of a mild nature and do not feel that treatment of the condition is warranted; others are embarrassed to speak with a healthcare provider about their condition or fear that treatment will require surgery.

 

incontinence The Body Refinery New Farm
 

What if we told you that simple Physiotherapy can help?

Whilst the cause of SUI is often multifactorial and may involve muscle, nerve or sphincter issues… research provides overwhelming support that pelvic floor physiotherapy is effective at reducing SUI. Furthermore, there is widespread recommendation that pelvic floor muscle training should be included in first-line management programmes for women with stress, urge or mixed urinary incontinence.

So if you, like Kate, experience symptoms from ‘’one sneeze too many”, there is help available! The Body Refinery offers women’s health physiotherapy, which involves assessment by specifically-trained, female Women’s Health Physiotherapists, who can then help with the management of stress urinary incontinence.

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Book an appointment with a Women’s Health Physiotherapist today on 07 3358 3915 or at info@thebodyrefinery.com.au

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What is your posture like at your desk?

posture tips the body refinery

It is very common to find people with back and neck problems that are related to their work setting and posture. As physiotherapists, we seek to understand the underlying factors that are responsible for each patient’s ailment. For this reason, we always ask our clients: “What makes the pain worse?” The most common answer we hear is “When I sit at my desk at work”.

Obviously, avoiding sitting at a desk isn’t usually a viable option, however, we can teach you some strategies for working at a desk that will minimise the likeliness of further injury or pain. It may sound strange that just sitting can cause injury, but that’s exactly what can result from poor static posture when sitting at the desk!

There are many reasons for this: Firstly, the human body is not designed to be seated in a chair for 8 hours a day. Stress, poor workstation ergonomics, and bad posture are the main cause of this sort of injury or pain. To remedy these, it is important to position your arms, legs and spine in the appropriate alignment, to distribute the appropriate load on your joints and muscles. Doing so avoids excessive overactivity or overstrain.

 

Here are 5 tips for a good posture in order to prevent ergonomic injuries:

 

1. Find your natural posture

  • Move your chair away from your desk and sit down comfortably. For most people, it would look a lot like sitting in a car. Your feet are on the floor in front of you; your hands are in your lap, and your shoulders relax as you lean back just a bit.
  • This is called your “natural posture.” In it, your vertebrae are stacked, your entire back moves as you breathe, and your pelvis is positioned so that your spine is stacked properly.
  • Memorise this natural posture.

posture desk tips the body refinery

2. Keyboard and mouse placement

  • Building around the natural posture, the keyboard and mouse should be positioned in a way that keeps your elbows to your sides, and your arms at or below a 90-degree angle. This way, the muscle load is reduced and you’re not straining.
  • Position your keyboard 1 to 2 inches above your thighs. For most people, that probably means employing a pull-out keyboard tray. Alternatively, you can lower your desk, but the keyboard tray is a preferred method. Here’s why…
  • Tilt. The keyboard should ideally be positioned with a negative tilt — down and away from you so that your arms and hand follow the downward slope of your thighs. That being said, you should never use the kickstand that is incorporated underneath most keyboards.
  • Position. Ideally, your keyboard and mouse should be shoulder-distance apart and as level as possible.

 

3. Position your screen(s)

  • Distance. If your screen is too far away, you’ll start doing something called ‘turtling’, or craning your neck, and you’ll find yourself extending your neck to see it.
  • To find the right screen position, sit back and extend your arm. The tips of your middle finger should land on your screen. That’s the spot.
  • If you have two monitors, set them up side by side (no gap), and place the secondary monitor off-centre. Those who use both monitors equally should centre them both. Now, sit back and extend your arm and pan in an arch. As you pan your arm, your fingertip should almost always touch the monitors. Use the same logic when placing other items, like a document holder or a phone.
  • Height. To adjust the height: close your eyes. When you open them, your eyes should land on the address bar. If not, lower or raise the monitors using the built-in option, with risers, or with other items (as long as the monitor is safe and stable).

 

4. Adjust your chair

Your chair is your best ergonomic friend. It supports your back, bottom, and posture. Here are some things to look for in a good chair:

  • Shape. Think back to your natural posture. With your tailbone sticking out just a bit, and your vertebrae in their slight curve, the lumbar portion of your spine points in toward your belly. To help you sustain this posture, find a chair that offers good lumbar support.
  • Length. When you sit down, there should be a little space between the edge of the chair and the back of your knees, about the size of your fist. Depending on the chair, you might be able to adjust the seat depth accordingly.
  • Height. When you sit, your feet should be on the floor (not dangling) in front of you, and your thighs should be slightly below your hips. Shorter people may need to use a footrest, while extra-tall people may need to adjust the height of the desk.
  • If you ever find yourself tucking your feet behind you, sitting on one leg, or in another irregular position, your chair needs to be adjusted.

 

5. Move every hour (minimum)

  • Take a break at least once an hour to walk around the office or stretch. If it helps, set an hourly alarm as a reminder.
  • No matter how ergonomic your workstation is, stretching your body is the only thing that can combat the health issues that arise from prolonged sitting.

 

If you have any questions or concerns about any pain or discomfort you are experiencing, do not hesitate and consult one of our physiotherapists. With Pilates, we can improve the endurance and strength of the postural muscles, so that sitting in the appropriate posture is eventually something that comes naturally.

We have also developed an online 4-week Low Back Pain Pilates program. Take your Physiotherapist with you!

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Physio and Pilates – the ultimate combination

Pilates Physiotherapy Combination

A combination of Physiotherapy and specific exercise protocols in a Pilates program are the key to a successful Pilates workout.

Why change something if it’s not broken?

Pilates has been around since the early 1920’s. Recently, physiotherapists have started returning to exercise-based therapy and in particular, the Pilates method, which can provide a number of benefits, according to evidence-based studies (3).

The first Pilates teaching courses for physiotherapists in Australia started in the early 1990s, with an aim that Pilates would be another tool for physiotherapists to use. Postgraduate training (by teachers such as Butler, McKenzie, Sahrmann and Janda) along with spinal stability training and muscle energy techniques all had a part to play in adapting Pilates to a clinical setting (4).

Physiotherapists in Australia have traditionally used a “hands-on” approach in the acute stages of injury, which provides excellent outcomes to a point, beyond which exercise is a logical progression. Unfortunately, most patients progress to a gym setting that is often not appropriate or specific enough to address the underlying biomechanical causes, and all too often this aggravates the original problem.

Combination Pilates Physiotherapy

Research over the last two decades has shown that the most effective way to manage spinal instability is with specific exercise programmes that are designed, and supervised, by a physiotherapist. Improving activity of the core group of muscles is now accepted as being more effective than other training regimes that focus on strengthening periphery muscles (4). Motor re-learning strategies that look more at muscle and movement efficiency are replacing strength and power regimes (3).

“The success of the Pilates system in managing pain, inhibiting pathology and training coordinated movements, is that it gives the physiotherapist a tool to be able to address the motor control specifics of dysfunction and more importantly problem solve the reason or pathology behind the situation” (4)

The value of Pilates to physiotherapists now extends beyond rehabilitation exercises, which act as an adjunct to treatment, to being a very effective treatment tool in itself.  It can be employed as an alternative to “hands-on” management, helping the clinician to confidently progress to a more pathology-specific exercise regime rather than a programme of generic exercises (2).

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Join our Clinical Pilates classes and focus on your health and mind-body connection. Call us on 07 3358 3915 or download our app.

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References

  1. Lim E et al (2011) Effects of Pilates Based Exercises on Pain and Disability in individuals with persistent Nonspecific Low Back Pain: A Systematic review with Meta-analysis. J Orthop Sports Phys ther Vol 21 (2)
  2. Tulloch E, Phillips C, Soles G, Carman A, Abbott H (2012) DMA Clinical Pilates Directional Bias Assessment: Reliability and Predictive Validity JOSPT: 42(8):676-687
  3. Wajswelner H, Metcalf B, Bennell K (2012) Clinical Pilates versus General Exercise for Chronic Low Back Pain: A Randomised Trial. Med. Sci. Sports Exerc, Vol.44 No 7, PP1197-1205
  4. Phillips C (2003) Pilates, the clinical changes are key. Musculoskeletal Physiotherapy Australia Newsletter IN TOUCH issue 2/3 2003
  5. Rydeard R, Leger A, Smith D (2006) Pilates-Based therapeutic Exercise: Effect on subject with nonspecific chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial.  JOSPT 2006;36(7): 472-484