postnatal therapy

Let’s talk about incontinence! - Karin Goldschmidt

Pelvic Floor Exercises

Pelvic Floor Exercises

Yes that’s right... It may not be perceived as the most glamourous subject and sadly many choose to suffer in silence due to the stigma attached to bladder leakage. However, we do need to speak about it – loud and clear. In the UK today there are around six million people who experience symptoms of incontinence. Do a quick Google search on the subject and you will find an array of companies selling incontinence products. As amazing as it is that these products are available for those who really are in need and as a short term solution, it also poses the risk of people thinking that incontinence is “just something one has to live with and accept”, without actually being proactive in taking steps to become continent.

Incontinence may be very common, however it is NOT normal, meaning it’s is NOT something you have to live with. The symptoms can often be treated, either with professional help or on your own by doing a combination of specific Pelvic floor exercises and by implementing lifestyle changes.

Although the incidence of incontinence and bladder weakness does increase with age, surveys show that 6% of women aged 15-44 have the condition so it is far more common, than one might think.

Urinary incontinence is often considered a female problem, but this is only partly true. Although in younger age groups, more women than men do experience this condition, the differences are equalized around the age of 70, so in later life, almost as many men as women suffer from incontinence. However, we should not view as part of normal aging- it is never too late to seek help.

There are two main types of urinary incontinence – Stress Incontinence and Urge Incontinence. 

Stress incontinence: Leaking of urine with coughing, sneezing, sex, or impact exercise, like running and jumping.This is related to damaged and/or weak pelvic floor muscles, and is common in younger women who have given birth vaginally.

Urge incontinence: Sudden and unpredictable overwhelming urge to urinate, with leaking of small to large amounts of urine. This sometimes also goes along with needing to go often that can occur day and night. It is more common in people who are overweight, or have diabetes or other neurological issues such as dementia or stroke. The problem is thought to be due to spasms of the bladder. A lot of things can aggravate symptoms, such as caffeine, diuretics (“water pills” used for high blood pressure), drinking too much fluid, and bladder infections.

The most common form of incontinence, called “mixed”, has symptoms of both of these categories. But the kind of incontinence really doesn’t matter. What people need to know is that there are solutions.

So what are the ways of treating incontinence?

First of all, you need to be assessed thoroughly by your health professional to understand the cause of your problem. In the case of this being done by a Pelvic floor Physio, they may observe your breathing, posture and how your muscles are functioning. You will be asked about your lifestyle choices such as hydration, nutrition, exercise and stress levels.

Specific Pelvic floor exercises (often prescribed by a Pelvic health professional) are in many cases the simplest and best way to start with, often leading to good results. These should be done in conjunction with implementing the necessary adaptions to your lifestyle. The importance of treating the patient with an holistic view is something we learned about in the last 25 years — before then, most doctors believed that most stress incontinence required surgery.

Your health professional may also ask you to keep a “bladder diary,” in which you record two days and nights of activity.

Finally, were there events that triggered it? Laughing? Coughing? Sex? Drinking coffee? This can help with diagnosis and treatment, especially for people who have to go frequently during the day or have to get up several times a night to urinate (a problem called nocturia).

For otherwise healthy people, the next step is to look at your lifestyle choices. If you are overweight, losing weight is essential. Stop smoking (for this and many other reasons). Limit your caffeine. If you have trouble with nocturia, avoid drinking liquids after 7 p.m. If constipation is a problem, treat it.

Another treatment method is behavioural therapy, which means a combination of two techniques, bladder and pelvic muscle exercises and bladder training. Strengthening or down training the muscles of your pelvic floor (these are called Kegel exercises, often recommended to pregnant women).

For those with urge problems, the strategy is slightly different. Bladder training involves going on a regular schedule and learning how to retrain the central nervous system to control strong urges (“mind over bladder”).

Instead of running to the bathroom as quickly as possible, be still. Do pelvic muscle exercises and focus on feeling the urgency to wane (like a decreasing wave). Hopefully the urgency will lessen so you can get to the bathroom in  time.

Urinary Incontinence

Interview with Ana Seymenska - Physiotherapist and Thai Yoga Masseuse

How would you describe yourself and the way you work to some-one that has never meet you before?

Thai Yoga Massage - Stretching

I am a qualified physiotherapist who specialized in Thai Yoga Massage, which is an ancient form of therapy from East Asia involving acupressure and applied Yoga-like stretching. Through my therapy sessions, I hope to remind others,  “There’s more to life than increasing its speed.” as Mahatma Gandhi said, encourage them to allow themselves to slow down and stop more often, and to practice less doing and more allowing. My aim is to help people to feel more comfortable and well in their bodies.

What exactly is a Thai Massage?

Thai Yoga Massage is a unique and powerful massage therapy that combines acupressure and gentle applied yoga-like stretching. Traditional Thai massage also called “Ancient Massage” in Thailand, can look back at the long history of therapeutic healing, the earliest roots of which lie in Northern India dating back 2,500 years ago. 

What is the difference from a deep tissue, Swedish or from an aromatherapy massage?

Traditionally Thai massage is done on the floor on a mat and not on a table like in the other forms of massage; the receiver is wearing comfortable stretchy clothes and no oils are used. 

The theoretical principles behind Thai massage and the approach to the body are also different. While in the West the treatment is based mostly on anatomy and physiology knowledge, in Thai massage (as well as other East Asian practices) the practitioner is concerned mainly with balancing the energy system of the body by working on energy lines and points; that approach allows the practitioner to develop a way of work that is more intuitive, mindful and centred. 

What are the benefits from a Thai Massage?

Thai Yoga Massage Positions

Some of the benefits of Thai Yoga massage include - encouraging healing and recovery through the stillness of the body and mind. Increased one’s own body awareness, calm or invigorate the Central nervous system. Quieten and calm the mind. Increase general and local circulation. Improve the flexibility of the muscles and joints. Stimulate the work of the internal organs. Improve breathing and help the body to detoxify.

Thai Yoga massage, as a complementary therapy, is invaluable for promoting health and well-being and is recommended in combination with nutritious food and physical activity as part of a balanced healthy lifestyle.

Is a Thai Massage appropriate for any age?

There is no age limit for receiving Thai massage. Although there is no minimum age as such, it is recommended that anyone under 16 should receive consent from an adult who has parental rights and have them to attend the session.

What can I expect to feel after my Thai Massage?

There are several reactions one can expect after receiving a massage. Most common are - being tired or energized, both of which are associated with the energy balancing effects of the massage. Other common effects reported after Thai massage are - a feeling of relaxation, tranquillity, lightness, freshness, calmness, peace, centeredness. After a Thai Yoga Massage I personally feel more relaxed physically and in my thoughts about things and at the same time I notice myself more alert; I am more tuned in to myself and to the outside world.