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Pelvic Health 101: Assessment, Treatment, and Resources for Better Well-being

Join Mairead Hughes, Specialist Physiotherapist, as she discusses various topics related to pelvic health and raises awareness about assessment protocols, treatment options, and resources for education and self-management. Improve your general health and well-being by understanding the importance of holistic care for Aspergillus-related illnesses.

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Pelvic Health 101: Assessment, Treatment, and Resources for Better Well-being

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  1. Pelvic Health 101 Mairead Hughes Specialist Physiotherapist The National Aspergillus Centre Wythenshawe Hospital Manchester University NHS Foundation Trust

  2. Aims of todays talk… • Introduce topics related to pelvic health • Raise awareness of assessment protocols and treatment options • Signpost patients to resources for education and self management • Improve general health and well being: important in holistic care of aspergillus related illnesses

  3. Why…? Having poor control of bodily functions quietly disempowers people by interfering with every single aspect of their lives; planning trips around rest room locations and breaks, fluid intake around planned activities or not going out at all. May is Pelvic Pain Awareness Month

  4. True or False… • Urinary incontinence is normal in females… • Urinary incontinence can only be fixed by surgical procedures…

  5. Role of the Pelvis Structural Support: primary role is to support the weight of the upper body when sitting and to transfer this weight to the lower limbs when standing. It serves as an attachment point for trunk and lower limb muscles, and also protects the internal pelvic organs. Excretion of waste products: urine, menstruation, faeces Reproduction and Sexual Well Being

  6. The World Health Organization stated… • incontinence is a largely preventable and treatable condition • and “certainly not an inevitable consequence of ageing” World Health Organization Calls First International Consultation on Incontinence. Press Release WHO/49, 1 July 1998. 

  7. Pelvic Diaphragm • Deepest Layer • Levator Ani Muscles • Pubococcygeus • Pubovaginalis • Puborectalis • Iliococcygeus • Coccygeus • Function: • Support the pelvis • Support the organs • Assist abdominals • Sphinteric • Sexual appreciation • Muscle Fibers • 30% fast twitch • 70% slow twitch

  8. Mobility vs. Stability • Pelvic floor- function • Supportive • Sphinteric • Sexual • Too much mobility-prolapse or incontinence • Too much fixation-pain

  9. The Male Pelvic Floor

  10. Female Pelvic Floor

  11. True or false • It is normal to leak when you cough or sneeze • Only females get stress incontinence

  12. Incontinence in Respiratory Conditions hyperinflation  BMD(osteoporosis) infection exacerbation kyphosis  inflammatory markers abnormal posture Coughing  muscle strength pain  LBM Incontinence autonomic control constipation

  13. Urinary Incontinence: Post Prostatectomy 99% Glina 2009, 1 year occasional 90% Peterson 2012 Stress incontinence Urge Incontinence Passive Incontinence Frequency/low capacity Nocturia Post void retention Post void dribble 80% Milios Climacturia70% Milios unpublished

  14. Pelvic Floor “The Knack” (Bracing Techniques) Brace with your pelvic floor and deep abdominal muscles when you cough, sneeze, lift or exercise Need to master in controlled environment, cortical before anticipatory subconscious

  15. Treatment Strategies-Incontinence • Stress and Urge • Scheduled voiding • Bladder retraining • Relaxation techniques • Type and amount of fluid intake

  16. How long and how many? • To strengthen a muscle you need to find the isolated muscle then gradually fatigue a muscle • Must be individualised: - How long can YOU hold for? • How many can YOU do? • How fast- time 10 quick lifts • At the righ time- c/sn/lift bucket

  17. Urinary Incontinence Summary • Prevalence of UI is higher than ‘healthy’ population • Patients often more tolerant of UI symptoms as have significant other symptoms or functional issues • Major cause is coughing • Likely to impact on spirometry and ACT • Unlikely to ask for help • Big problem when severely affected • Reluctant to be assessed McVean 2002

  18. Bowel Health

  19. True or False • You should chew your food 20 times before swallowing • ‘Al Dente’ vegetables are the best for your digestive health • Digestion begins in the stomach

  20. True or False • It is normal to have your bowels open once every three days…. • It is normal to have your bowels open three times per day…

  21. Good Bowel Habits • Optimal stool consistency- Ensure Adequate Fluids, movicol v metamucil • Eat sufficient Fibre ** • Light pressure to initiate evacuation • Perineum drops, puborectalis relax, EAS open • Use Optimum Defecation Position- stool, knees • Very high priority for all pelvic floor conditions • KISS – balloon expulsion

  22. True or False It is normal to pass wind 10 times per day

  23. Wind

  24. Fight or Flight vs Rest and Digest • Over stimulation in current lifestyle vs ‘caveman days’ of fight or flight • Sit to eat and take time to rest following food, allows your body to focus on digestion

  25. Relaxation, mindfulness… • Can help general well being as well as digestive and respiratory health • Mindfulness can help manage symptoms of breathlessness and panic https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/

  26. www.bladderandbowel.org • www.eric.org.uk • https://www.nhs.uk/conditions/

  27. References • Schussler B, Laycock J, Norton P: Pelvic Floor Re-education: Principles and Practice, New York, Springer-Verlag, 1994 • Wallace K: Female pelvic floor functions, dysfunctions, and behavioral approaches to treatment. Clinics in Sports Med, 13:2:459-480, 1994 • Gray, H : Gray’s Anatomy of the Human Body. Philadelphia, Lea & Febiger, 1918 • Moore, K: Clinically Oriented Anatomy (ed 2) Baltimore, Williams & Wilkins, 1985 • Wall LL, Norton PA, DeLancey JO: Practical Urogynecology. Baltimore, Williams & Wilkins, 1993 • Pastore, E. A., & Katzman, W. B. (2012). Recognizing Myofascial Pelvic Pain in the Female Patient with Chronic Pelvic Pain. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 41(5), 680-691 • Gentilcore-Saulnier, E., McLean, L., Goldfinger, C., Pukall, C. F., & Chamberlain, S. (2010). Pelvic Floor Muscle Assessment Outcomes in Women With and Without Provoked Vestibulodynia and the Impact of a Physical Therapy Program. Journal Of Sexual Medicine, 7(2), 1003-1022. • Schussler B, Laycock J, Norton P: Pelvic Floor Re-education: Principles and Practice. New York, Springer-Verlag, 1994

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