copper’s have a show of hands if you’ve
ever had low back pain before awesome
and what about havoc floor issues and by
this I might mean leaking from your
bowel or bladder or pelvic organ
prolapse where your organs are falling
outside of your body or a Rick Dale
dysfunction this conversation just got a
bit uncomfortable than that we hear
about back pain all the time so we know
it’s a considerable problem affecting a
large proportion of the population there
are at least a dozen teeth talks on the
subject but if you have even heard about
perfect flourishes at all you probably
think this to fix just a small
proportion of the population namely
pregnant woman or the very elderly who
have lost all control of their bodily
functions but pavatt floor issues are as
prevalent as low back pain affecting up
to eighty percent of the population an
effect the most of the time when you’re
Becker saw your pelvic floor is likely
to be involved but if you’re not one of
these eighty percent you can be forgiven
for thinking it’s just doesn’t true I
don’t know anyone affected by this well
I’m here to tell you that you do but
they’re just not talking about it
because when you’ve got issues with your
back it’s highly likely you’ll tell
someone about your pain and you’ll get
tons of advice like which practitioners
you could see or what stretches or back
rubs you might try but you are far less
likely this year over coffee how your
vulva pain is really playing up today
or how yeah I’d love to play netball but
I’m worried my uterus is going to fall
out
well how premature ejaculation is
ruining your relationship pose wheeze
and sex they are fundamental parts of
life and yet we don’t like to speak
about such things when they’re going
well we certainly don’t like to talk
about them when they’re not we kept it
so used to keeping our private parts so
private we don’t even know about our own
I’m a physiotherapist and I have a
master’s degree in musculoskeletal
physiotherapy so I thought I had a
pretty good grasp on human and enemy but
it was like I used to keep this little
black box over the pelvis and genitals
and no-go zone that I would skip around
for fear of embarrassing myself or my
clients I’d had to attend a few lectures
which covered this area of anatomy in a
subject that used to be called Women’s
Health physiotherapy but I had no
interest in it whatsoever at 18 years
old when I entered physio school I
dreamed of perhaps heading to the
Olympics with a team or getting the
chance to rub down the All Blacks
I couldn’t even say the word vagina
without blushing I did not intend on
including them in my career but then I
had children
and I discovered the true importance of
this structure literally holding our
bodies together a part of you that you
take very much for granted until it’s
not functioning properly and a part that
due to the sensitive awkward even
downright embarrassing nature is
underreported and it’s undertreated it’s
the pelvic floor now pelvic floors not
just a clever name it’s literally the
floor of our pelvis which is pretty
useful because it stops all our insights
falling out it’s made up of a group of
muscles but also a fresher and
connective tissue which holds everything
in its place so much easier for me to
stand up here and teach you about your
biceps for example because I could say
here it is and this is what it does I’m
not showing you my pelvic floor but if I
can get you all to sit up nice and tall
in your chairs I want you to imagine
you’re walking into really cold water so
as that icy cold water gets higher up
your thighs I want you to try and lift
your most sensitive bits up and out the
way
that’s your pelvic floor your pelvic
floor is a rock star of a muscle group
that we all want working optimally
because it has some really useful
functions like it stops you a leaking
urine and feces it also helps you
eliminate these when it’s convenient it
keeps your pelvic organs inside your
body and has a role in the functioning
of both your bowel and bladder and it is
essential in a satisfying sex life but
on top of all that it’s also responsible
for holding our bodies together it is
the floor of the so called core muscle
group you’ve all probably heard this
term core muscles bandied about and most
people think this is their abdominal
muscles but your core muscles are
transversus abdominus at the front
multifidus at the back your respiratory
diaphragm at the top and your pelvic
floor at the base now when we have
children the pavatt floor muscle can
stretch up to three hundred and fifty
percent of its resting length and this
is incredible because no other muscle on
the body could do that they would wrap
sure if it was stretched beyond 150 so
when I had my babies I knew
giving birth would be no walk in the
park but I guess I thought that once all
was said and done I’ll just be pre-baby
clear but with the baby how quickly I
learnt becoming a mother is a complete
identity shift one of the most
significant physical and psychological
changes a woman will ever experience
becoming a mum can feel like the rug has
been pulled out from under your feet and
in my case I felt like the floor was
also taken from my pelvis
I had a relatively enviable birth story
a fast water birth of no pain relief and
no instrumentation needed and yet I was
torn from front to back and part of my
pelvic floor muscle was ripped right off
the bone so it’s devastating because I
had no idea that was even possible I
hadn’t yet learned that 90% of woman
will receive some degree of tearing
during the delivery and for most woman
after the birth the focus becomes solely
on the well-being of their child their
pelvic health doesn’t get a second
thought so despite the fact I sustained
significant injury during my delivery I
was actually one of the lucky ones
because although I knew nothing about
public health myself at that time I knew
there are people who did so I didn’t
wait to see what issues of heaven future
I took myself to see a public health
physiotherapist and I learned that while
things have most differently changed I
could retrain and reconnect with what
was left of my pelvic floor and like
with any other significant injury with a
period of rehabilitation and some hard
work it’s possible to return to good
health
but pelvic floor issues aren’t just due
to pregnancy and childbirth though it
can be affected by constipation heavy
lifting chronic coughing obesity surgery
pain aging stress so all men or women
and children anybody with a body can
have pavatt floor issues so if these
issues are so common and is so
problematic why don’t we hear anything
about it
embarrassing some of the first issues
that something’s not right with your
pelvic floor is leaking from your bowel
and bladder and who wants to admit to
that I’d bet you be shocked to learn
that the number of people who suffer
from fecal incontinence that’s leaking
poos is one and eight so in this room of
approximately 800 people that means is
up to a hundred who have issues with
soiling their pens at least once a month
that’s more than the number of people in
here who have diabetes osteoporosis and
cancer combined
that is it’s also what motivates me
to do this because these people aren’t
this these numbers don’t even clued
those people living in care facilities
where the numbers are even higher this
is people like you and I in our
community who tell nobody about this not
their nearest and dearest and not their
GPS they feel an overwhelming sense of
shame and embarrassment and because no
one talks about it and they don’t tell
anyone
they’ll assume that they’re the only
ones suffering from such issues everyone
else seems to believe in their Facebook
really lives I believe that pelvic
health is a key missing link in our
approach to wellness we have so much
access information on well-being these
days and yet we keep our Public Health
taboo and people suffering from poverty
law issues will slowly withdraw from
their own lives they withdraw from
exercise from travel from sex because
you can imagine it’s really hard to
motivate yourself to exercise if you
can’t make it around the mountain
without wetting your pants or you don’t
take up the opportunities to go on your
child’s school trips or overseas
holidays or starting your relationships
because of embarrassment over your
toileting habits this might not be
life-threatening in the short term but a
certainly life diminishing the only time
we hear anything about public health is
in advertising for say incontinence pads
but I try to minimize the impact and
make it almost popular in funky LBL
light bladder leakage just
we problem affects one in three women
therefore it’s normal seriously no
amount of leaking urine is normal it is
really common yes but it is not normal
and in the majority of the time it’s
treatable if you just satisfied to wear
pads without investigating the reason
it’s like taking a pen adult everyday
for a headache without looking into the
cause so if you’re getting home and
putting the key in the door and getting
a really sudden difficult to defer urge
to pee or you leak on cough sneeze
laughs and exercise this is super common
it’s not normal if you’re struggling and
straining to pass a bowel motion and
having to wipe hundreds of times to feel
clean it’s really common it’s not normal
if you’ve got painless sex loss of
sensation and ability to achieve orgasm
or erectile dysfunction these are all
really common not normal if you’ve got a
heavy dragging pain feeling like you’re
pavatt organs are sitting lower than
they should this is surprisingly common
it’s not normal you do not need to put
up with it you do not need to accept it
as your lot in life and seeking
treatment for this you can get benefits
and all aspects of your well-being as
I’m speaking I can sense you’re all
still madly trying to contract and those
pelvic floors because everyone assumes
when a physio talks about pelvic health
we’ll just be encouraging you to do your
kegels all day every day and doctor at
dr. Arnold Kegel was a legend he did the
world a great service from back in the
1940s after 18 years of researched he
discovered the pelvic floor muscles like
any other muscle able to return to
function with an appropriate exercise
regime he described the pelvic floor
muscles as these most versatile muscle
group in the entire human body and
before his work these muscles in their
role in supporting the pelvis were
largely ignored but it seems as though
public perception of poverty for
rehabilitation stopped with his
techniques published in the 1940s and
there are no areas of medicine or
Exercise Science that have remained calm
for the last 70 plus years so please
don’t think this of public health kegels
are not your only option and they’re not
a blanket treatment for anything to do
with pelvic health so if you’ve tried a
few squeezes before perhaps following a
pamphlet or dr. Google if this hasn’t
changed what’s happening for you well
maybe you weren’t doing it right or
maybe it wasn’t what you needed in the
first place because dr. kegels work
focused on what he called pavatt floor
relaxation where the muscles were
stretched and week week usually
following vaginal birth but more than
half the woman and the majority the men
I see in my clinic they don’t suffer
from pelvic floor relaxation but rather
an overactive pelvic floor one that’s
too tight an inability to relax your
pelvic floor and tight does not equal
strong this causes its own set of
problems but a lot of pain pain in your
hips back pelvis and genitals painless
sex worsening menstrual pain but also
frequency and urgency the way and
difficulty evacuating your bowels if we
use our biceps again to show this
example if I get you all to squeeze your
biceps as tight as you can squeeze it as
tight as you can
it only takes a couple of seconds before
that starts to feel a bit uncomfortable
right and you’re probably not feeling as
strong of this position is compared to
as if you’re in a more mid-range
position where you can both contract
relax and extend muscles like to hang
out in a mid-range position and so too
with a perfect floor it doesn’t wanna be
stuck in a short type position where it
can’t work well with those other pelvic
floor muscles it hurts and it’s not as
strong and coordinated so if you leak
please don’t assume you must be leak
weak this is a much harder concept for
people to grasp because everything we
thought we knew about public health was
that it must be weak and lengthened how
does it get too tight there are so many
ways in our modern life but trying to
suck your tummy in all the time being
told we have to engage our core and also
some high load repetitive sports there’s
a study that looked at 300 elite female
college athletes competing in a variety
of sports from basketball to
leigh sees a strong fit young girls and
only 13 had previously had a child and
yet 52 percent reported leakage of some
kind and only 3% had discussed it with a
medical provider there’s also a strong
correlation between our emotional
well-being and our public health
depending on your thoughts around
evolution we like many other mammals may
have had a tail at some stage and now
we’ve just got a tail bone and these
pavatt floor muscles all attached to our
tail bone so when you’re stressed or
anxious or upset or hurt it’s like we’re
trying to tuck our tail in see what
happens next time someone pisses you off
at work or cuts you off at traffic does
your body feel all open and relaxed or
short and tight so when we’re looking at
treating pelvic floor issues we need to
treat take a holistic approach meaning
we take the whole body we can’t now that
we’ve taken that black box of the pelvis
we can’t focus all our attention there
pervert floor exercises might be
included in step one to reacquaint
yourselves with this part of our body we
can be completely dissociated from but
then we need to look at posture at
breathing how these muscles work with
the rest of the core muscles and indeed
with the whole body look at stress
management you’ll exercise and movement
of choice what you’re eating and
drinking in your toileting habits there
are so many pieces to the puzzle and so
many tips and tricks you can learn to
regain control over your situation one
of my most favorite things to teach is
how to properly you don’t even know that
you don’t know how to do it but if you
think about the lifespan of your pelvic
floor so having a baby is a pretty big
event but if you do that at all you’re
likely to only do this two to four times
maybe more if you’re really keen but
opening your bowels we don’t get a
choice in that you all need to do that
hopefully in most days until you die so
you biscuit that right so there’s no
one-size-fits-all prescription every
person is tough
the demands they place on their pelvic
floor is different and the integrity of
their pelvic floor is different accurate
assessment is essential in determining
the best treatment so I urge any of you
if you’re having any issues with your
pelvic floor don’t hide in shame seek
help
don’t let embarrassment stand in the way
of good health going Google Public
Health physiotherapy in your region and
get yourself booked in today because
while ignorant may be bliss knowledge is
power
get to know all of your ever-changing
body and don’t ignore the signs that
sending you and remember you’re not
alone in this is super common but it’s
not normal
you
ever had low back pain before awesome
and what about havoc floor issues and by
this I might mean leaking from your
bowel or bladder or pelvic organ
prolapse where your organs are falling
outside of your body or a Rick Dale
dysfunction this conversation just got a
bit uncomfortable than that we hear
about back pain all the time so we know
it’s a considerable problem affecting a
large proportion of the population there
are at least a dozen teeth talks on the
subject but if you have even heard about
perfect flourishes at all you probably
think this to fix just a small
proportion of the population namely
pregnant woman or the very elderly who
have lost all control of their bodily
functions but pavatt floor issues are as
prevalent as low back pain affecting up
to eighty percent of the population an
effect the most of the time when you’re
Becker saw your pelvic floor is likely
to be involved but if you’re not one of
these eighty percent you can be forgiven
for thinking it’s just doesn’t true I
don’t know anyone affected by this well
I’m here to tell you that you do but
they’re just not talking about it
because when you’ve got issues with your
back it’s highly likely you’ll tell
someone about your pain and you’ll get
tons of advice like which practitioners
you could see or what stretches or back
rubs you might try but you are far less
likely this year over coffee how your
vulva pain is really playing up today
or how yeah I’d love to play netball but
I’m worried my uterus is going to fall
out
well how premature ejaculation is
ruining your relationship pose wheeze
and sex they are fundamental parts of
life and yet we don’t like to speak
about such things when they’re going
well we certainly don’t like to talk
about them when they’re not we kept it
so used to keeping our private parts so
private we don’t even know about our own
I’m a physiotherapist and I have a
master’s degree in musculoskeletal
physiotherapy so I thought I had a
pretty good grasp on human and enemy but
it was like I used to keep this little
black box over the pelvis and genitals
and no-go zone that I would skip around
for fear of embarrassing myself or my
clients I’d had to attend a few lectures
which covered this area of anatomy in a
subject that used to be called Women’s
Health physiotherapy but I had no
interest in it whatsoever at 18 years
old when I entered physio school I
dreamed of perhaps heading to the
Olympics with a team or getting the
chance to rub down the All Blacks
I couldn’t even say the word vagina
without blushing I did not intend on
including them in my career but then I
had children
and I discovered the true importance of
this structure literally holding our
bodies together a part of you that you
take very much for granted until it’s
not functioning properly and a part that
due to the sensitive awkward even
downright embarrassing nature is
underreported and it’s undertreated it’s
the pelvic floor now pelvic floors not
just a clever name it’s literally the
floor of our pelvis which is pretty
useful because it stops all our insights
falling out it’s made up of a group of
muscles but also a fresher and
connective tissue which holds everything
in its place so much easier for me to
stand up here and teach you about your
biceps for example because I could say
here it is and this is what it does I’m
not showing you my pelvic floor but if I
can get you all to sit up nice and tall
in your chairs I want you to imagine
you’re walking into really cold water so
as that icy cold water gets higher up
your thighs I want you to try and lift
your most sensitive bits up and out the
way
that’s your pelvic floor your pelvic
floor is a rock star of a muscle group
that we all want working optimally
because it has some really useful
functions like it stops you a leaking
urine and feces it also helps you
eliminate these when it’s convenient it
keeps your pelvic organs inside your
body and has a role in the functioning
of both your bowel and bladder and it is
essential in a satisfying sex life but
on top of all that it’s also responsible
for holding our bodies together it is
the floor of the so called core muscle
group you’ve all probably heard this
term core muscles bandied about and most
people think this is their abdominal
muscles but your core muscles are
transversus abdominus at the front
multifidus at the back your respiratory
diaphragm at the top and your pelvic
floor at the base now when we have
children the pavatt floor muscle can
stretch up to three hundred and fifty
percent of its resting length and this
is incredible because no other muscle on
the body could do that they would wrap
sure if it was stretched beyond 150 so
when I had my babies I knew
giving birth would be no walk in the
park but I guess I thought that once all
was said and done I’ll just be pre-baby
clear but with the baby how quickly I
learnt becoming a mother is a complete
identity shift one of the most
significant physical and psychological
changes a woman will ever experience
becoming a mum can feel like the rug has
been pulled out from under your feet and
in my case I felt like the floor was
also taken from my pelvis
I had a relatively enviable birth story
a fast water birth of no pain relief and
no instrumentation needed and yet I was
torn from front to back and part of my
pelvic floor muscle was ripped right off
the bone so it’s devastating because I
had no idea that was even possible I
hadn’t yet learned that 90% of woman
will receive some degree of tearing
during the delivery and for most woman
after the birth the focus becomes solely
on the well-being of their child their
pelvic health doesn’t get a second
thought so despite the fact I sustained
significant injury during my delivery I
was actually one of the lucky ones
because although I knew nothing about
public health myself at that time I knew
there are people who did so I didn’t
wait to see what issues of heaven future
I took myself to see a public health
physiotherapist and I learned that while
things have most differently changed I
could retrain and reconnect with what
was left of my pelvic floor and like
with any other significant injury with a
period of rehabilitation and some hard
work it’s possible to return to good
health
but pelvic floor issues aren’t just due
to pregnancy and childbirth though it
can be affected by constipation heavy
lifting chronic coughing obesity surgery
pain aging stress so all men or women
and children anybody with a body can
have pavatt floor issues so if these
issues are so common and is so
problematic why don’t we hear anything
about it
embarrassing some of the first issues
that something’s not right with your
pelvic floor is leaking from your bowel
and bladder and who wants to admit to
that I’d bet you be shocked to learn
that the number of people who suffer
from fecal incontinence that’s leaking
poos is one and eight so in this room of
approximately 800 people that means is
up to a hundred who have issues with
soiling their pens at least once a month
that’s more than the number of people in
here who have diabetes osteoporosis and
cancer combined
that is it’s also what motivates me
to do this because these people aren’t
this these numbers don’t even clued
those people living in care facilities
where the numbers are even higher this
is people like you and I in our
community who tell nobody about this not
their nearest and dearest and not their
GPS they feel an overwhelming sense of
shame and embarrassment and because no
one talks about it and they don’t tell
anyone
they’ll assume that they’re the only
ones suffering from such issues everyone
else seems to believe in their Facebook
really lives I believe that pelvic
health is a key missing link in our
approach to wellness we have so much
access information on well-being these
days and yet we keep our Public Health
taboo and people suffering from poverty
law issues will slowly withdraw from
their own lives they withdraw from
exercise from travel from sex because
you can imagine it’s really hard to
motivate yourself to exercise if you
can’t make it around the mountain
without wetting your pants or you don’t
take up the opportunities to go on your
child’s school trips or overseas
holidays or starting your relationships
because of embarrassment over your
toileting habits this might not be
life-threatening in the short term but a
certainly life diminishing the only time
we hear anything about public health is
in advertising for say incontinence pads
but I try to minimize the impact and
make it almost popular in funky LBL
light bladder leakage just
we problem affects one in three women
therefore it’s normal seriously no
amount of leaking urine is normal it is
really common yes but it is not normal
and in the majority of the time it’s
treatable if you just satisfied to wear
pads without investigating the reason
it’s like taking a pen adult everyday
for a headache without looking into the
cause so if you’re getting home and
putting the key in the door and getting
a really sudden difficult to defer urge
to pee or you leak on cough sneeze
laughs and exercise this is super common
it’s not normal if you’re struggling and
straining to pass a bowel motion and
having to wipe hundreds of times to feel
clean it’s really common it’s not normal
if you’ve got painless sex loss of
sensation and ability to achieve orgasm
or erectile dysfunction these are all
really common not normal if you’ve got a
heavy dragging pain feeling like you’re
pavatt organs are sitting lower than
they should this is surprisingly common
it’s not normal you do not need to put
up with it you do not need to accept it
as your lot in life and seeking
treatment for this you can get benefits
and all aspects of your well-being as
I’m speaking I can sense you’re all
still madly trying to contract and those
pelvic floors because everyone assumes
when a physio talks about pelvic health
we’ll just be encouraging you to do your
kegels all day every day and doctor at
dr. Arnold Kegel was a legend he did the
world a great service from back in the
1940s after 18 years of researched he
discovered the pelvic floor muscles like
any other muscle able to return to
function with an appropriate exercise
regime he described the pelvic floor
muscles as these most versatile muscle
group in the entire human body and
before his work these muscles in their
role in supporting the pelvis were
largely ignored but it seems as though
public perception of poverty for
rehabilitation stopped with his
techniques published in the 1940s and
there are no areas of medicine or
Exercise Science that have remained calm
for the last 70 plus years so please
don’t think this of public health kegels
are not your only option and they’re not
a blanket treatment for anything to do
with pelvic health so if you’ve tried a
few squeezes before perhaps following a
pamphlet or dr. Google if this hasn’t
changed what’s happening for you well
maybe you weren’t doing it right or
maybe it wasn’t what you needed in the
first place because dr. kegels work
focused on what he called pavatt floor
relaxation where the muscles were
stretched and week week usually
following vaginal birth but more than
half the woman and the majority the men
I see in my clinic they don’t suffer
from pelvic floor relaxation but rather
an overactive pelvic floor one that’s
too tight an inability to relax your
pelvic floor and tight does not equal
strong this causes its own set of
problems but a lot of pain pain in your
hips back pelvis and genitals painless
sex worsening menstrual pain but also
frequency and urgency the way and
difficulty evacuating your bowels if we
use our biceps again to show this
example if I get you all to squeeze your
biceps as tight as you can squeeze it as
tight as you can
it only takes a couple of seconds before
that starts to feel a bit uncomfortable
right and you’re probably not feeling as
strong of this position is compared to
as if you’re in a more mid-range
position where you can both contract
relax and extend muscles like to hang
out in a mid-range position and so too
with a perfect floor it doesn’t wanna be
stuck in a short type position where it
can’t work well with those other pelvic
floor muscles it hurts and it’s not as
strong and coordinated so if you leak
please don’t assume you must be leak
weak this is a much harder concept for
people to grasp because everything we
thought we knew about public health was
that it must be weak and lengthened how
does it get too tight there are so many
ways in our modern life but trying to
suck your tummy in all the time being
told we have to engage our core and also
some high load repetitive sports there’s
a study that looked at 300 elite female
college athletes competing in a variety
of sports from basketball to
leigh sees a strong fit young girls and
only 13 had previously had a child and
yet 52 percent reported leakage of some
kind and only 3% had discussed it with a
medical provider there’s also a strong
correlation between our emotional
well-being and our public health
depending on your thoughts around
evolution we like many other mammals may
have had a tail at some stage and now
we’ve just got a tail bone and these
pavatt floor muscles all attached to our
tail bone so when you’re stressed or
anxious or upset or hurt it’s like we’re
trying to tuck our tail in see what
happens next time someone pisses you off
at work or cuts you off at traffic does
your body feel all open and relaxed or
short and tight so when we’re looking at
treating pelvic floor issues we need to
treat take a holistic approach meaning
we take the whole body we can’t now that
we’ve taken that black box of the pelvis
we can’t focus all our attention there
pervert floor exercises might be
included in step one to reacquaint
yourselves with this part of our body we
can be completely dissociated from but
then we need to look at posture at
breathing how these muscles work with
the rest of the core muscles and indeed
with the whole body look at stress
management you’ll exercise and movement
of choice what you’re eating and
drinking in your toileting habits there
are so many pieces to the puzzle and so
many tips and tricks you can learn to
regain control over your situation one
of my most favorite things to teach is
how to properly you don’t even know that
you don’t know how to do it but if you
think about the lifespan of your pelvic
floor so having a baby is a pretty big
event but if you do that at all you’re
likely to only do this two to four times
maybe more if you’re really keen but
opening your bowels we don’t get a
choice in that you all need to do that
hopefully in most days until you die so
you biscuit that right so there’s no
one-size-fits-all prescription every
person is tough
the demands they place on their pelvic
floor is different and the integrity of
their pelvic floor is different accurate
assessment is essential in determining
the best treatment so I urge any of you
if you’re having any issues with your
pelvic floor don’t hide in shame seek
help
don’t let embarrassment stand in the way
of good health going Google Public
Health physiotherapy in your region and
get yourself booked in today because
while ignorant may be bliss knowledge is
power
get to know all of your ever-changing
body and don’t ignore the signs that
sending you and remember you’re not
alone in this is super common but it’s
not normal
you
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