The Pelvic Health Podcast
The Glottis and Pelvic Floor

The Glottis and Pelvic Floor

November 6, 2020

We know holding our breath can influence pressure onto the #pelvicfloor, but did you ever think about how this happens, or why, or that our vocal cords can influence this pressure?

Physical therapist and academic, Aliza Rudavsky, joins me to discuss her research in this area and some very cool facts about how the #glottis works and how this can influence the pelvic floor.

Bio from her website:

A native of Pittsburgh, Aliza grew up as a dancer.  She studied modern dance in college and performed professionally for several years before going to graduate school for her Doctorate in Physical Therapy at the University of Washington in Seattle.  As a physical therapist, Aliza has specialized training in pelvic floor dysfunction and women's health PT through the Herman and Wallace Institute.  She trained as a dance PT through the Harkness Center for Dance Injuries and the Australian Ballet.  She also has unique training in physical therapy for voice dysfunction and treats both performing artists and other occupational voice users. 

Aliza completed her PhD in 2018 through the University of Copenhagen (in collaboration with Monash and Latrobe Universities in Melbourne, Australia) under the supervision of Dr. Jill Cook.  Her research involved studying tendon development in adolescent ballet dancers. She has published this research in several sports journals as well as the International Association of Dance Medicine and Science.

Currently, Aliza is an assistant professor at Penn State University where she has a split appointment in the department of Kinesiology and the School of Theatre.  In Kinesiology she teaches the athletic training students and does research, and in the School of Theatre she runs an on-site PT clinic for the musical theatre and acting students. Her current research involves connecting the pelvic floor to the vocal folds to study how they coordinate to regulate pressures in the trunk. This research is currently funded by the Foundation for PT Research-Pelvic Health Research.

Aliza is the mother of two delightful young boys with a third baby on the way.  She enjoys biking, hiking and exploring central PA with her family. 

 

Listen and enjoy and a big thanks to Always Discreet for sponsoring this episode of The Pelvic Health Podcast. Head to Always Discreet to learn more about bladder leak tips, management and incredible bladder leakage protection!

Sexual activity and Low Back Pain

Sexual activity and Low Back Pain

October 23, 2020
APA Titled Sports and Exercise #Physiotherapist, Indianna Franke, who also holds a Grad. Cert in #PelvicFloor Physiotherapy, joins the podcast today to talk about sex in the context of low back pain.
 
As low back pain is one of the most common musculoskeletal types of pain, and sex is part of life but often becomes difficult when you have #backpain, why aren't all of us as professionals asking our patients about this? We ask about pain with bending, lifting, #exercise, #sports, and other daily activities, but often we are too embarrassed or ill-equipped to talk about how to help our patients when they are quite possibly having #back #pain during #sex.
 
Thank you to @alwaysdiscreet for sponsoring this episode
 
Below are some useful links from our chat. Enjoy!
 
 
Cognitive Hypnotherapy and Pelvic Pain with Sheren Gaulbert

Cognitive Hypnotherapy and Pelvic Pain with Sheren Gaulbert

October 1, 2020

This episode will blow your mind! I admit the word "hypnotherapy" really threw me but you have to listen - especially if you are a #pain #science nerd, have #pelvicpain, or treat those with pelvic pain. Sheren Gaulbert has extensive knowledge in the pain science field and brings a very large piece to this puzzle.

Sheren Gaulbert was diagnosed with unprovoked vulvodynia in 1999 after a lifetime of intermittent pain and comorbid conditions. With frequent episodes of fainting as the pain worsened, and mobility affected, she stopped working altogether.

10 years on from diagnosis and unsuccessfully trialling different treatments, she stumbled across self-hypnosis and later Quest Cognitive Hypnotherapy (QCH), starting her on her journey toward freedom. Her curiosity to find out why it was working and how she could help others, led her to seek out further training for a better grounding in pain neurophysiology, and to understand best practice models from current, up-to-date treatment methodologies and pain science.

Sheren has a specialist interest in female and male pelvic pain and is now a Trustee of the Vulval Pain Society, She hosts VPS webinars with specialist vulval pain clinicians, and you will find a selection on YouTube.

Sheren is currently working on the Pelvic Pain Toolkit, which includes short information videos, with Pain Toolkit founder Pete Moore. This will be released later in 2020.

Sheren also runs CPD courses for health professionals and one-to-one mentoring for clinicians ready to learn from different modalities to provide better care. She encourages a multidisciplinary approach to pain management (and for some complete relief), and an effective treatment plan which treats the individual – the whole complex person, considering their values, beliefs, expectations, cognitive evaluations, contextual, cultural factors and more.

She is also founder of the Break Through Pain Programme: a tailored, collaborative and action-orientated approach which utilises the Cognitive Hypnotherapy framework to help each unique individual experiencing persistent pain, start living a better quality of life, more comfortably doing more of the things that give them joy.

 

  

Practical tips for Diastasis Rectus Abdominis with physical therapist Lashonda Jones

Practical tips for Diastasis Rectus Abdominis with physical therapist Lashonda Jones

September 15, 2020
It's time to talk about the practical side of abdominal separation, or DRA - diastasis rectus abdominis, after discussing the lack of research on a recent episode. How should we assess it? What kind of exercises should we try? What if we can't physically see a physiotherapist because of location or isolation? Who better than Lashonda Jones.
 
Lashonda is a licensed physical therapist, certified personal trainer & pre/postnatal corrective #exercise specialist. She's has 14 years of exercise in outpatient orthopedics with a more recent transition into women's health once she became a mom of two. She loves educating & empowering women on Postpartum rehab, fitness & Diastasis Recti healing journeys. After working hard to heal her own #Diastasis & seeing the lack of education moms were given about their postpartum healing she developed an online program that allows women to work 1 on 1 with her online to receive the individualized education & exercises they need to heal
 
Education: Masters Physical Therapy
Bachelor's Exercise Sports Science Sports Medicine concentration
NSCA Certified Personal Trainer
Certified Pre & Post natal exercise specialist 
 
 
 
Listen and enjoy and a big thanks to Always Discreet for sponsoring this episode of The Pelvic Health Podcast. Head to Always Discreet to learn more about bladder leak tips, management and incredible bladder leakage protection!
Returning to CrossFit 6 weeks after having a baby with physio and coach Candice Lamb

Returning to CrossFit 6 weeks after having a baby with physio and coach Candice Lamb

August 15, 2020

Physiotherapist and coach, Candice Lamb, and I are back to talk about what first sessions, weeks and first few months might look like when returning to CrossFit-brand training and high-intensity exercise after having a baby. This episode, as a continuation from our last one on CrossFit in Pregnancy, focuses on women who were doing this activity before and during their pregnancy - not women who are new to this activity after having a baby. Pelvic health considerations and modifications for certain specific exercises, much needed discussion around bracing (which will continue in episodes to come), returning to intensity, and more. 

Enjoy, subscribe and keep moving :)

Big thanks to this episode's sponsor Always Discreet. Learn more about bladder leak tips, management and incredible bladder leak protection by checking out Always Discreet.

Diastasis Rectus Abdominis with Dr. David Larson

Diastasis Rectus Abdominis with Dr. David Larson

July 12, 2020

DRA, the separation of the abdominal muscles most often associated in women with pregnancy, is very close to my heart and I am so excited to bring you this AMAZING conversation on the research on #exercise for #diastasisrecti with David Larson @dmlarson31 dmlarson@asu.edu

 

Aside from discussing what research we do have , the drawbacks of this limited data, and the physiology behind the effects of adequate load on connective tissue, he talks about his research into patient satisfaction with exercise programs. Just because as professionals we think someone is better, doesn't mean they feel that way. 

 

Bio from Arizona State University website: (see below for reference list)

David is a Lecturer and Coordinator for CHS100/300 in the College of Health Solutions at Arizona State University.  David earned a Doctoral degree in Health Science from A. T. Still University, Masters degree in Kinesiology from A. T. Still University, and a Bachelors degree Kinesiology from Arizona State University.  His research is primarily focused on conservative treatment modalities such as abdominal strength training for the postpartum condition diastasis recti.  David is a Certified Strength and Conditioning Specialist (CSCS), a Certified Pre- and Postnatal Coach (CPPC), and Certified Level 2 Nutrition Coach through Precision Nutrition (PN2).  He specializes in pre- and post-natal training, youth athletic performance, and strength and conditioning and has over 10 years of experience in the fitness and sport performance industry. 

 

Reference list:

Acharry, N., & Kutty, R. K. (2015). Abdominal exercise with bracing, a therapeutic efficacy in reducing diastasis-recti among postpartal females. International Journal of Physiotherapy and Research, 3(2), 999-1005. doi:10.16965/ijpr.2015.122

Awad, M. A., Mahmoud, A. M., El-Ghazaly, H. M., & Tawfeek, R. M. (2017). Effect of Kinesio Taping on Diastasis Recti. Med. J. Cairo Univ., 85(6), 2289-2296.

Benjamin, D., Van de Water, A., & Peiris, C. (2014). Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy, 100(1), 1-8. doi:https://doi.org/10.1016/j.physio.2013.08.005

Bo, K., Hilde, G., Tennfjord, M. K., Sperstad, J. B., & Engh, M. E. (2017). Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn, 36(3), 716-721. doi:10.1002/nau.23005

Boissonnault, J. S., & Blaschak, M. J. (1988). Incidence of diastasis recti abdominis during the childbearing year. Phys Ther, 68(7), 1082-1086.

Chiarello, C. M., McAuley, J. A., & Hartigan, E. H. (2016). Immediate Effect of Active Abdominal Contraction on Inter-recti Distance. J Orthop Sports Phys Ther, 46(3), 177-183. doi:10.2519/jospt.2016.6102

da Mota, P. G. F., Pascoal, A. G. B. A., Carita, A. I. A. D., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual therapy, 20(1), 200-205.

El-Kosery, S. M., El-Aziz, A. A., & Farouk, A. (2007). Abdominal muscles exercise program and/or electrical stimulation in postnatal diastasis recti. Bull. Fac. Ph. Th. Cairo Univ, 12(2).

El-Mekawy, H. S., Eldeeb, A. M., El-Lythy, M. A., & El-Begawy, A. F. (2013). Effect of Abdominal Exercises versus Abdominal Supporting Belt on Post-Partum Abdominal Efficiency and Rectus Separation. International Journal of Medical and Health Sciences, 7(1), 75-79.

Gallus, K. M., Golberg, K. F., & Field, R. (2016). Functional Improvement Following Diastasis Rectus Abdominus Repair in an Active Duty Navy Female. Military Medicine, 181(8), e952-e954. doi:10.7205/MILMED-D-15-00387

Gluppe, S. L., Hilde, G., Tennfjord, M. K., Engh, M. E., & Bo, K. (2018). Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial. Phys Ther, 98(4), 260-268. doi:10.1093/ptj/pzy008

Gluppe, S. L., Hilde, G., Tennfjord, M. K., Engh, M. E., & Bø, K. (2018). Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial [Article]. Physical Therapy, 98(4), 260-268. doi:10.1093/ptj/pzy008. (Accession No. 128847946)

Grgic, J., Schoenfeld, B. J., & Latella, C. (2019). Resistance training frequency and skeletal muscle hypertrophy: A review of available evidence. Journal of Science and Medicine in Sport, 22(3), 361-370. doi:https://doi.org/10.1016/j.jsams.2018.09.223

Gunnarsson, U., Stark, B., Dahlstrand, U., & Strigård, K. (2015). Correlation between Abdominal Rectus Diastasis Width and Abdominal Muscle Strength. Digestive Surgery, 32(2), 112-116. doi:10.1159/000371859

Gürşen, C., İnanoğlu, D., Kaya, S., Akbayrak, T., & Baltacı, G. (2016). Effects of exercise and Kinesio taping on abdominal recovery in women with cesarean section: A pilot randomized controlled trial. Archives of gynecology and obstetrics, 293(3), 557-565. doi:10.1007/s00404-015-3862-3

Hills, N. F., Graham, R. B., & McLean, L. (2018). Comparison of Trunk Muscle Function Between Women With and Without Diastasis Recti Abdominis at 1 Year Postpartum. Phys Ther, 98(10), 891-901. doi:10.1093/ptj/pzy083

Kamel, D. M., & Yousif, A. M. (2017). Neuromuscular Electrical Stimulation and Strength Recovery of Postnatal Diastasis Recti Abdominis Muscles [Article]. Annals of Rehabilitation Medicine, 41(3), 465-474. doi:10.5535/arm.2017.41.3.465. (Accession No. 124103784)

Keeler, J., Albrecht, M., Eberhardt, L., Horn, L., Donnelly, C., & Lowe, D. (2012). Diastasis recti abdominis: a survey of women's health specialists for current physical therapy clinical practice for postpartum women. Journal of women’s health physical therapy, 36(3), 131-142.

Keshwani, N., Mathur, S., & McLean, L. (2018). Relationship Between Interrectus Distance and Symptom Severity in Women With Diastasis Recti Abdominis in the Early Postpartum Period. Physical Therapy, 98(3), 182-190. doi:10.1093/ptj/pzx117

Khandale, S. R., & Hande, D. (2016). Effects of abdominal exercises on reduction of diastasis recti in postnatal women. IJHSR, 6(6), 182-191.

Lee, D., & Hodges, P. W. (2016). Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: an observational study. journal of orthopaedic & sports physical therapy, 46(7), 580-589.

Lee, H., Kim, I.-G., Sung, C., & Kim, J.-S. (2017). The Effect of 12-Week Resistance Training on Muscular Strength and Body Composition in Untrained Young Women: Implications of Exercise Frequency. Journal of Exercise Physiology Online, 20, 88+.

Liaw, L. J., Hsu, M. J., Liao, C. F., Liu, M. F., & Hsu, A. T. (2011). The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. J Orthop Sports Phys Ther, 41(6), 435-443. doi:10.2519/jospt.2011.3507

Litos, K. (2014). Progressive therapeutic exercise program for successful treatment of a postpartum woman with a severe diastasis recti abdominis. Journal of Women’s Health Physical Therapy, 38(2), 58-73. doi:10.1097/JWH.0000000000000013

Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., & Kaczmarczyk, K. (2018). Diastasis recti abdominis - a review of treatment methods. Ginekol Pol, 89(2), 97-101. doi:10.5603/GP.a2018.0016

Mota, P., Pascoal, A., Carita, A., & Bø, K. (2015). Inter-recti distance at rest, during abdominal crunch and drawing in exercises during pregnancy and postpartum. Physiotherapy, 101, e1050-e1051.

Newman-Beinart, N. A., Norton, S., Dowling, D., Gavriloff, D., Vari, C., Weinman, J. A., & Godfrey, E. L. (2017). The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS). Physiotherapy, 103(2), 180-185. doi:10.1016/j.physio.2016.11.001

Parker, M. A., Millar, L. A., & Dugan, S. A. (2009). Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction-are they related? Journal of Women’s Health Physical Therapy, 33(2), 15-22.

Thabet, A., & Alshehri, M. A. (2019). Efficacy of Deep Core Stability Exercise Program in Postpartum Women with Diastasis Recti Abdominis: A Randomised Controlled Trial (Vol. 19).

Tuttle, L. J., Fasching, J., Keller, A., Patel, M., Saville, C., Schlaff, R., . . . Gombatto, S. P. (2018). Noninvasive Treatment of Postpartum Diastasis Recti Abdominis: A Pilot Study. Journal of Women’s Health Physical Therapy, 42(2), 65-75. doi:10.1097/JWH.0000000000000101

Walton, L. M., Costa, A., LaVanture, D., McIlrath, S., & Stebbins, B. (2016). The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, Oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). Physical Therapy and Rehabilitation, 3(1), 3. doi:http://dx.doi.org/10.7243/2055-2386-3-3

Youssef, A. M., Sabbour, A. A., & Kamel, R. M. (2003). Muscle Activity in Upper and Lower Portions of Rectus Abdominis During Abdominal Exercises in Postnatal Women Having Diastasis Recti. Bull. Fac. Ph. Th. Cairo Univ, 8(1).

 

Listen and enjoy and a big thanks to Always Discreet for sponsoring this episode of The Pelvic Health Podcast. Head to Always Discreet to learn more about bladder leak tips, management and incredible bladder leakage protection!

Electrical Stimulation for the Pelvic Floor with Fiona Rogers

Electrical Stimulation for the Pelvic Floor with Fiona Rogers

June 24, 2020

Fiona Rogers is baaackkk! I bugged her to join me to talk about using electrical stimulation for the #pelvicfloor because I do not know enough about it (my brain can only hold so much information!). I have watched her dive deep into the research behind this for years and develop her course "Electrical Stimulation for Pelvic Health: An advanced course for health professionals" - which is now online! Click on the name of that course to find out more.

Listening to her has made me excited to use this option more for those who may need it, and understand so much more about parameters AND why all probes will not work for all women!

Listen and enjoy and a big thanks to Always Discreet for sponsoring this episode of The Pelvic Health Podcast. Head to Always Discreet to learn more about bladder leak tips, management and incredible bladder leakage protection!

Please rate and leave a review on the Apple Podcast app so more people can find it! 

 

Debunking Desire with Dr Lori Brotto

Debunking Desire with Dr Lori Brotto

June 2, 2020

#debunkingdesire aims to educate women, their partners, health care providers, and the media about low sexual #desire in #women.

Who better to talk to about this than Dr. Lori Brotto, not just because she has THE best name but because she has a brilliant mind and has worked in this area for years. In this episode, Dr. Brotto discusses sexual desire, this #debunkingdesire campaign as well as some of her work in #sexual #pain, such as provoked vestibulodynia (#PVD). 

Dr. Lori Brotto is a Professor in the UBC Department of Obstetrics and Gynaecology, and a Registered Psychologist. She is the Executive Director of the Women's Health Research Institute at BC Women’s Hospital. Dr. Brotto holds a Canada Research Chair in Women's Sexual Health. She is the director of the UBC Sexual Health Laboratory where research primarily focuses on advancing the science of psychological and mindfulness-based interventions for women’s sexual health. Dr. Brotto is an Associate Editor for the Archives of Sexual Behavior, has over 150 peer-reviewed publications, is passionate about knowledge translation, and as such, is frequently featured in the media on sexual health topics. Her book, Better Sex Through Mindfulness: How Women Can Cultivate Desire (Greystone Publishing) is a knowledge translation of her research over the past 15 years demonstrating the benefits of mindfulness for women’s sexual concerns and genital pain.

*Click on links above and below for more information!

Australian Booktopia for Better Sex Through Mindfunless

Assessing the Impact of Male Pelvic Pain with Tom Astill

Assessing the Impact of Male Pelvic Pain with Tom Astill

May 11, 2020

I love to highlight the people in the research trenches and asked Tom Astill to chat with me about the research he has been working on with Jane Chalmers and Rocco Caveleri regarding a new questionnaire directed at assessing the impact pelvic pain has on men, called The Male Pelvic Pain Impact Questionnaire (links below). The focus of this episode was this assessment questionnaire, but as usual, I took him off course and ventured into in a few other places. I hope you enjoy!

A bit more about Tom:

Originally born in England, Tom moved to Australia 15 years ago. Initially he studied audio engineering and worked in various fields of technical support and training before meeting his wife and embarking on a physiotherapy degree.

He is a newly graduated physiotherapist. As part of his undergrad he conducted an honours project where they developed a questionnaire to assess the impact of chronic pelvic pain in men. This project has sparked a passion for research, chronic pain, and men’s health. He is currently deciding on PhD topics in those areas and working on expanding his clinical skills to support his future research. He enjoys reading, cooking, and spending time with his twin daughters Kate and Lily.

Links:

mPPIQ preprint on Research Gate

Abstract presentation through the Australian Pain Society

New research on urinary incontinence, weight and physical activity with Tayla Lamerton

New research on urinary incontinence, weight and physical activity with Tayla Lamerton

April 12, 2020

Tayla Lamerton, a PhD candidate at The University of Queensland, joins the podcast to discuss her research exploring urinary incontinence in young to middle age women who are overweight and obese, as well as some other cool studies she has up her sleeve.

I love highlighting the work of up and coming researchers and Tayla Lamerton is a name you should keep in mind. She is in her last year as a PHD Candidate at the University of Queensland, Human Movement and Nutrition Sciences. Prior to commencing her PhD, she graduated with a Masters in Psychology from the University of Otago, NZ. She also trained as a group fitness instructor in 2013 and is now a Level 1 CrossFit trainer. Her research interests focus on understanding female pelvic floor health in young women. Specifically, how weight and physical activity are related to urinary incontinence in this demographic, and exploring methods to improve management and return or adhere to regular physical activity.

Papers:

Lamerton, T. J., Torquati, L., & Brown, W. J. (2018). Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis. Obesity Reviews19(12), 1735–1745. https://doi.org/10.1111/obr.12756

Haakstad, L. A. H., Gjestvang, C., Lamerton, T., & Bø, K. (2020). Urinary incontinence in a fitness club setting-is it a workout problem? International Urogynecology Journal. https://doi.org/10.1007/s00192-020-04253-0

Play this podcast on Podbean App