Physiotherapy following a tummy tuck

A tummy tuck, or abdominoplasty, is the surgical removal of excess skin, fat and a tightening of the underlying tummy (abdominal) muscles.

This is designed to help improve the shape and tone of your stomach region when other options (such as diet and exercise) have failed to work. This can immediately make you look and feel better. However, it does not strengthen your abdominal muscles or ensure your muscles are working optimally.

 

Following surgery, it is important to ensure your core (this includes your deep abdominal muscles and pelvic floor) is working properly. Physiotherapy helps you learn to use these muscles correctly again.Many plastic surgeons will recommend physiotherapy prior to and after surgery.

After a tummy tuck, physiotherapy is important to:

  • Teach your muscles how to work correctly, to prevent problems such as back, pelvis or hip pain.
  • Help you achieve optimal results following your surgery.
  • Help you reach your goals, such as returning to work, gardening, exercise or sport in a timely manner.

At Better Health our physiotherapist Janette, has completed specialised training in Pelvic Floor and Women’s Health Physiotherapy.

On the initial visit, a thorough assessment will be completed. Any risk factors for pelvic floor weakness will be addressed. This will include your obstetric, surgical and medical history, as well as an evaluation of your bladder and bowel health. The physical examination will include an assessment of your pelvis, spine and abdomen.

Additional assessment will include:

  • Real-time ultrasound. This is a non-invasive procedure useful for evaluating muscle activity in the back, abdomen and pelvic floor. It is useful for both diagnosis, assessment, and rehabilitation.
  • For women, a more detailed assessment of your pelvic floor function can be achieved with a vaginal examination. This option can be discussed with Janette at your initial consultation.

Following your initial visit you will receive individual, tailored advice. You will be given a safe, supervised exercise program to help you recover from your surgery.

Private health rebates are available (this will vary depending on your individual cover). Medicare rebates are available if referred by your G.P under a chronic disease management care plan. Contact Janette for more information at janette@betterhealthpractice.com.au or call reception to make an appointment on 9518 0722

Janette O’Toole Pelvic Floor/ Women’s Health Physiotherapist

Janette has over 15 years’ experience in the field of Women’s Health and Pelvic Floor Physiotherapy. She has gained extensive experience in the assessment and management of incontinence, pelvic organ prolapse, bowel disorders, sexual dysfunction, pelvic pain and antenatal and postnatal care. She has completed postgraduate studies in Continence & Pelvic Floor Dysfunction, Women’s Health and Acupuncture.

Poor sleep? Five tips to help stop your bladder waking you up at night  

Both men and women can develop problems with waking up at night to go to the toilet. This can affect the quality of our sleep. Some may leak before they get to the toilet at night, even if they do not have any problems during the day. Bladder problems are more common as we get older, but for some people they may have had this problem since childhood.

If you are having any bladder problems, here are some steps that you can try that might help.

Step 1:

You are what you drink

We should aim to drink 1.5-2L per day in total.

Some things that we drink really do irritate the bladder. Alcohol, all caffeinated drinks (including tea, coffee, energy drinks and green tea), fizzy drinks (this includes sparking water) and diet drinks that contain artificial sweeteners (such as aspartame and acesulfame) can aggravate bladder symptoms. It’s best to limit these things as much as possible. It is not always possible to cut these things out completely, but cutting them down will often help. Water IS best.

Step 2:

Teach your bladder who is boss!

It is possible to train your bladder to learn to hold more, reduce the feeling of rushing to the toilet and reduce leaking. This is done by holding off going to the toilet and increasing the time between trips to the bathroom. However, it is also important that you don’t put it off too long and still go to the toilet every 3-4 hours during the day!

Step 3:

Stop drinking late at night

Be aware of how much you drink in the last two or three hours before you go to bed. Instead, try to drink little and often during the day.

Step 4:

Feeling stressed?

We know that stress has an impact on our body in many different ways. Stress can also affect the bladder. Finding ways to relax and reduce the stress in your life may help. This might be yoga, meditation or practicing mindfulness. Simple, regular exercise, such as going for a walk may also help.

Step 5:

Infection- don’t ignore!

A urinary tract infection (UTI) can also cause bladder symptoms at night. There are many reasons why someone may develop an infection. Symptoms can vary from a strong and frequent need to pee, passing strong smelling or discoloured urine, pain in the lower tummy or a burning sensation when going to the toilet. It is important to get this checked by your doctor as you may need medication to clear it.

If you have any specific concerns or are experiencing any bladder problems, such as urinary frequency, urgency, waking up several times a night needing to void, incontinence or difficulty emptying your bladder, a pelvic floor physiotherapist may help you with this. This is a physiotherapist who has undertaken specialised training in this area and is able to provide specific advice to help. They can also assess your pelvic floor and may give you exercises which can help with this problem.

Contact Janette for more information at janette@betterhealthpractice.com.au or call reception to make an appointment on 9518 0722

Janette O’Toole

Pelvic Floor Physiotherapist

Better Health Practice Stanmore

Vaginismus- a common cause of painful sex

Vaginismus is an involuntary tightening of the pelvic floor muscles and affects a woman’s ability to engage in any form of vaginal penetration.  This is a very common problem. However, many women don’t seek help because they are embarrassed or because they don’t know help is available.

Vaginismus can occur when attempting to insert a tampon, during a gynaecological examination or during sexual intercourse. Some women suffering from vaginismus will be able to achieve partial or full penetration, however this will usually be painful. Others find they cannot achieve penetration at all. Women and their partners often describe attempts to have intercourse as ‘hitting a brick wall’ or feeling ‘too small’ or ‘tight’.

Common symptoms of vaginismus

  • Pain at the entrance of the vagina with penetration
  • Difficulty inserting tampons or undergoing a pelvic exam e.g. papsmear
  • Burning or stinging with tightness during sex
  • Avoidance of sex due to pain and/or failure
  • Difficult or impossible penetration

Causes of vaginimus

There are several reasons why someone may experience vaginismus. These include physical and psychological factors such as:

  • childbirth
  • medical conditions like UTIs, yeast infections (thrush), chronic pain syndromes
  • rape, sexual abuse or assault in the past
  • a painful examination in the past
  • unpleasant sexual intercourse
  • fear of getting pregnant
  • fear the vagina may be too small for any penetration
  • for many women there may be no obvious cause

Physiotherapy is recommended as first-line treatment for vaginismus with high success rates. If you have any specific concerns, we would recommend you contact our physiotherapist Janette, for further information. Janette is a physiotherapist who has completed specialised training in this area. She can confirm the diagnosis, provide you with treatment and advice to help, or refer you to the appropriate provider if required.

 

Contact Janette for more information at janette@betterhealthpractice.com.au or call reception to make an appointment on 9518 0722

Janette O’Toole Pelvic Floor Physiotherapist

Better Health Practice Stanmore

Pelvic floor safe exercise

Pelvic floor safe exercises are exercises designed to protect your pelvic floor. Certain exercises can overload the pelvic floor, weakening it over time and increasing the risk of developing problems, such as incontinence or prolapse.

Although most women have some knowledge about the pelvic floor, often it is only considered during pregnancy and following childbirth. However, research has shown that people who engage in high impact exercises and sport are at risk of developing pelvic floor problems. In fact, the incidence of urinary incontinence is higher in active people compared to the normal population.

 

Am I at risk?

Throughout our lifetime, there are several life changes, which put us more at risk. These include:

  • Pregnancy and for at least than 6 months postnatally
  • Breastfeeding
  • Following continence or prolapse surgery or following a hysterectomy (women)
  • Prostrate problems or following prostrate surgery (men)
  • Menopause and ageing
  • Being overweight or under weight
  • If you experience symptoms of prolapse (heaviness, pressure or bulging down below) or urinary leakage (such as leaking with coughing, sneezing or with exercise)

How can I protect my pelvic floor?

  • Use your pelvic floor during exercise
  • Maintain good posture during exercise
  • Breathe out with effort to avoid straining
  • Avoid heavy lifting and strong abdominal exercises
  • Be aware of your pelvic floor…can you feel any downward pressure on the pelvic floor during exercise?

What exercises are pelvic floor safe?

Although all exercise will cause an increase in abdominal pressure, and therefore put some load on the pelvic floor, the following exercises are considered ‘safe’.

  • Walking
  • Swimming
  • Cycling (seated)
  • Walking in the water
  • Water aerobics (low intensity)
  • Low impact exercise classes
  • Cross trainer (low resistance)
  • Seated weights (low resistance)

What exercises should I avoid?

The following is a list of exercises which cause an increased load on your pelvic floor. If you are experiencing any symptoms, or have several risk factors, it is important to limit these exercises.

  • Abdominal exercises e.g. sit ups or crunches
  • Jogging/ running
  • Skipping
  • High impact exercise classes e.g. star jumps
  • Sports that involve a lot of stop-start running or changes in direction e.g. tennis, netball
  • Lifting heavy weights
  • Any exercise where you experience downward pressure on the pelvic floor

You can modify your exercise by:

  • Lowering the weight you use and increasing the number of repetitions gradually.
  • Interval training (alternate between low and high impact exercise) e.g. walking and running
  • Choose supported positions e.g. sitting when using upper body weights

For information on pelvic floor exercises read…

https://betterhealthpractice.com.au/pelvic-floor-what/

If you have any specific concerns, we would recommend you could see a pelvic floor physiotherapist. This is a physiotherapist who has undertaken specialised training in this area, is able to assess your pelvic floor and give you specific guidance with what exercises are safe for you.

 

Contact Janette for more information at janette@betterhealthpractice.com.au or call reception to make an appointment on 9518 0722

Janette O’Toole Pelvic Floor Physiotherapist

Better Health Practice Stanmore

Is it OK to pee just-in-case?? Tips to keep your bladder healthy!

Up to 4.8 million Australian experience bladder problems. This is more than the incidence of heart disease, diabetes and epilepsy combined. Although usually not life threatening, this can enormously affect on someone’s quality of life.

Men and women, young and old can be affected. Despite being so common it is still not as openly talked about and many people don’t get the help they need.

Understanding how the bladder works is an important step in keeping it healthy.

 

How does the bladder work?

The bladder is a storage organ that sits within your pelvis. Urine is made by your kidneys and is stored in your bladder. Nerves carry messages from the bladder to your brain to tell it when it is beginning to feel full. In response, your brain will let you know that you need to consider going to the toilet and at the same time it will tell the muscles to remain closed until you get there. When you decide to go to the toilet your bladder outlet muscles (urethral sphincter and pelvic floor) relax and your bladder contracts (squeezes) emptying your bladder of urine.

What are the signs of a healthy bladder?

  • passing urine every 3-4 hours (4-7 times each day) depending on how much you drink
  • can hold between 400-600ml of urine when it is full
  • will first tell you that you may need to go when it is about half full (200-300ml)
  • may wake you up once at night and twice if you are over 65 years old
  • tells you when it is full but gives you enough time to find a toilet
  • empties completely each time you pass urine
  • does not leak

Good toilet habits

  • empty the bladder 4-7 times a day
  • avoid getting into the habit of going ‘just in case’
  • in women- it is important to sit down on the toilet and not ‘hover’
  • take your time to empty. Relax. Don’t strain.
  • drink at least 1.5L of fluid per day, and more in hot weather or when you are exercising. Fluid counts as everything you drink, but water is best.
  • reduce things which may ‘irritate’ your bladder. This includes any caffeinated drinks (such as tea, coffee, cola), alcohol, fizzy drinks and drinks containing artificial sweeteners.
  • keep a healthy weight
  • avoid constipation, eating a healthy diet with plenty of fruit, vegetables and dietary fibre.
  • practice pelvic floor exercises. For information on pelvic floor exercises read…

https://betterhealthpractice.com.au/pelvic-floor-what/

If you have any specific concerns or are experiencing any symptoms, such as urinary frequency, urgency, waking up several times a night needing to void, incontinence or difficulty emptying your bladder, a pelvic floor physiotherapist may help you with this. This is a physiotherapist who has undertaken specialised training in this area and is able to provide specific advice to help you. They can also assess your pelvic floor and may give you exercises which can help with this problem.

 

Contact Janette for more information at janette@betterhealthpractice.com.au or call reception to make an appointment on 9518 0722

Janette O’Toole

Pelvic Floor Physiotherapist

Better Health Practice Stanmore

The pelvic floor- the who, what, when, where and how? by Janette O‘toole Women’s Health Physiotherapist

1- What is the Pelvic Floor?  The pelvic floor is a sling that spans the bottom of the pelvis, much like a trampoline. It is comprised of muscle, ligaments, connective tissue and nerves.

knee pain in runners

Runner’s knee is a general term for knee pain felt around the kneecap. Physiotherapists often refer to runner’s knee as “patellofemoral pain”.  The patellofemoral joint is composed of the kneecap (patella) and the thigh bone (femur).  The patella should fit snugly into a groove on the femur and track smoothly in this groove when the knee […]

Hamstring Strain: a common sporting injury

One of the most common injuries in sport is the hamstring strain, as these muscles are very susceptible to injury. The hamstrings are a group of muscles on the back of the thigh.  The upper part of these muscles attach to the lower part of the pelvis and the lower part attaches just below the […]