Pelvic Health Report &

Transcription

1 Pelvic Health Report & Pelvic Health Red Flag Questionnaire Helping you to pin down your symptoms, encouraging you to seek help. Burrell Education Page 1

2 Contents Being informed is a huge part of your CONTINENCE JOURNEY. Empower yourself through finding out more about your body, recognizing what doesn t feel right and learn to ask for help or a second opinion. Either way. This is your body. Take charge of your health. We hope this report full of useful information and of course our Pelvic Health Red Flag Questionnaire will help you understand your symptoms a lot better and guide you to make some healthful choices. 1. Your Core Explained Page 3 2. What Does My Pelvic Floor Look Like? Page Pelvic Floor Symptoms You Should Not Ignore! Page 7 4. The Types of Urinary Incontinence Explained Page Foods To Avoid If You Are Experiencing Urinary Incontinence P11 6. The Main Types of Prolapse Page Why ONLY Doing Kegels Doesn t Prepare You For REAL Life Page Red Flag Pelvic Health Questionnaire Page 26 Burrell Education Page 2

3 1. Your Core Explained They say a picture is worth a thousand words.so, here s a picture of what we re referring to when we say CORE and a brief explanation of its parts. So basically, the 4 labelled components of the Core are shown above in yellow and the dark grey line of the Abdominal Wall. Essentially, you need to be connected to all 4 components and they all need to be in good shape for the whole core to do its job properly which is to support and protect the organs and boney structures that it surrounds and attaches to. The Core also supports and gives power to the movement created by your arms and legs. Burrell Education Page 3

4 A few female-friendly facts 1. If you have poor posture and consequently, don t breathe properly, this affects the function of your Pelvic Floor. Great Pelvic Floor function is linked to your Diaphragm and Pelvic Floor lifting and lowering at the same time when you breathe. When you don t stand tall, your Diaphragm can t do its job and this essential action is thwarted. Cue a Sneeze/Pee! 2. Your deep tummy muscles TVA are linked to your Pelvic Floor! Give it a try, exhale and draw your belly button in. Eventually you should feel a tightening or change in the tension in your Pelvic Floor at the front (Vagina area). You might also feel your protective low back muscles tightening too. Now you know why your Trainer keeps telling you to breathe out when you lift your baby, the pram or yourself during an exercise class, she/he is trying to help you re-connect with what Mother Nature gave you. Exhaling on exertion reduces a build up of pressure and creates a stiffness in the Core that s both protective to your back, your weakened post baby tummy and turns your Pelvic Floor on! Result! So in short, sort your posture out your Pelvic Floor- depends on it and breathe out everytime you lift something including yourself! Burrell Education Page 4

5 2. What Does My Pelvic Floor Look Like? What does it look like?? See above. Why isn t it working as well as it used to? In the case of Genuine Stress Incontinence GSI (leaking when you cough, sneeze, jump etc) during Pregnancy and for some unfortunate women, way into the Post Natal period, the stretch/change in tension caused by carrying your baby, the birthing process (especially is you experienced tearing, Episiotomy, Forceps, Ventous or spent a long time pushing) all mean that your Pelvic Floor has experienced trauma. It needs time to heal (time, rest and great nutrition) and then a gradually progressed re-connection/exercise programme performed regularly (and at least in the beginning) guided by an experience professional to ensure you aren t just squeezing your butt cheeks. Get it right for life! Burrell Education Page 5

6 NB: Having a dysfunctional Pelvic Floor and experiencing any degree of incontinence or leaking, IS NOT AN INEVITABLE CONSEQUENCE OF BECOMING A MOTHER OR AGING! If something doesn t feel right or is giving you cause for concern.ask FOR HELP! Trust your female intuition. Burrell Education Page 6

7 3. 6 Pelvic Floor Symptoms You SHOULD NOT To Ignore! 1. You re not able to wear a Tampon comfortably anymore. 2. Sex has become painful. 3. There is a protrusion (tissue poking out of your Vagina or Anus) 4. You just feel different and uncomfortable down there! 5. You ve started to wear incontinence pads.just in case. Burrell Education Page 7

8 6. You now think McDonalds Restaurants are invaluable.for their toilets! DON T PUT UP or SHUT UP..SEEK HELP, YOU RE NOT ALONE! Burrell Education Page 8

9 4. The Various Types of Urinary Incontinence Explained Stress Incontinence Incontinence caused by an increase in abdominal pressure such as when one laughs, sneezes, jumps, or coughs. Causes of stress incontinence include pregnancy and childbirth, which cause stretching and weakening of the pelvic floor muscles. Other factors may also increase the risk for stress incontinence, such as being overweight, obesity and certain medications. Urge Incontinence Urge incontinence is often referred to as having an overactive bladder. This usually means that you have an urgent need to go to the bathroom and may not get there in time therefore leaking leaking urine. The causes of an overactive bladder may include damage to the nerves serving the bladder or the wider nervouse system and damage to the Pelvic Floor muscles, fascia and other connective tissue. Burrell Education Page 9

10 Conditions such as multiple sclerosis, Parkinson s disease, diabetes, and stroke can affect nerves, leading to urge incontinence. Other conditions such as bladder infections, bladder stones, and use of certain medications can also contribute to symptoms. It is possible to have a mixture of both Stress and Urge Incontinence and this is termed Mixed Urinary Incontinence. Overflow Incontinence You may be experiencing Overflow Incontinence if you are not able to empty your bladder appropriately. As a result, you may have leakage once the bladder is already full. This is more common in men with symptoms of frequent dribbling of urine. Causes of overflow incontinence include: Weak bladder muscles Blockage of the urethra, such as by prostate enlargement Medical conditions such as tumors causing obstruction of urine flow Constipation Functional Incontinence With functional incontinence, physical problems such as arthritis, or cognitive problems such as Dementia and Alzheimers prevent the sufferer from getting to the bathroom in time. Burrell Education Page 10

11 5. 7 Foods/Drinks To Avoid If You Are Experiencing Urinary Incontinence 1. Spicy Foods they can be irritating to a sensitive bladder. 2. Cranberry Juice paradoxically, Cranberry juice helps fight off bladder infections, but it can also increase the symptoms of an overactive bladder! 3. Coffee/Tea/Caffeine -it s both a diuretic and bladder irritant. Best replaced with a non-caffein alternative. Chocolate also contains caffeine so if your consumption if high, reducing this might also be helpful to alleviating your symptoms. 4. Carbonated Drinks the carbonation can irritate the bladder as can the caffeine thats included in many soft drinks. Burrell Education Page 11

12 5. Acidic Juices Highly acidic foods, fruits, vegetables and drinks, such as grapefruits, tomatoes and orange juice, can also irritatable to the bladder for some. 6. Sugar Real sugar or artificial can worsen the symptoms of overactive bladder for some people. Even honey can cause problems. If you find that you re susceptible to this, try to remove as much sugar from your diet as possible. 7. MSG Monosodium Glutamate has been found to be a trigger of overactive bladder symptoms. Burrell Education Page 12

13 6. The Main Types of Prolapse Urethrocele - Prolapse of the Urethra The urethra, the tube that takes urine from the bladder and/or the bladder neck descends into the roof of the vagina. Detachment of the urethropelvic ligaments from their attachments allows such a descent. This may lead to stress urinary incontinence that can occur with any activity that increases intra-abdominal pressure, typically sneezing, coughing, lifting, laughing, running, dancing, aerobics, etc. Cystocele - Bladder Prolapse Defined as a descent of the bladder through a weakness in its supporting tissues gives rise to a Cystocele. There are a variety of versions: a central-defect Cystocele occurs when the bladder falls into the roof of the vagina. A lateral-defect cystocele occurs when the attachment of the bladder to the pelvic side wall weakens. Burrell Education Page 13

14 Cystoceles are graded as follows: GRADE 1= mild GRADE 2= bladder to vaginal opening with strain GRADE 3= bladder outside vaginal opening with strain GRADE 4= bladder outside vaginal opening at all times The symptoms of a cystocele are typically one or more of the following: Sufferers complain of a bulge or lump protruding from the vagina, an increased need to urinate or the opposite a slow weak stream that stops and starts, recurring urinary tract infections and pain during vaginal intercourse. Burrell Education Page 14

15 Rectocele - Rectal Prolapse Ascent of the rectum through a weakness in its supporting tissues gives rise to a Rectocele. The rectum protrudes through the floor of the vagina because the levator muscles of the Pelvic Floor and associated fascia have become lax and dysfunctional. As a rectocele progresses, the amount of ascent into the vaginal floor increases. Rectoceles are graded as follows: GRADE 1= mild GRADE 2= rectum to vaginal opening with strain GRADE 3= rectum outside vaginal opening with strain GRADE 4= rectum outside vaginal opening at all times Burrell Education Page 15

16 The symptoms of a Rectocele are typically one or more of the following: A bulge or lump protruding from the vagina, especially noticeable during bowel movements. Kinking of the normally straight rectum creating a relative obstruction and thus: o o o o o difficulty with bowel movements the need for splinting (holding the rectocele down with your fingers) to empty the bowels fecal soiling incomplete emptying of the rectum vaginal pain or painful intercourse Perineal Floor Relaxation Perineal muscle laxity, a condition in which the muscles of the perineum (the anatomical region between the vagina and anus) become lax causing the following anatomical changes: a wide and lax vaginal opening decreased distance between the vagina and anus Women with perineal relaxation who are sexually active may complain of a very loose or gaping vagina, making intercourse less satisfying for themselves and their partners. Burrell Education Page 16

17 Enterocele - Small Intestine Prolapse The Peritoneum is the thin sac that contains the abdominal organs, including the small intestine. Descent of the peritoneal contents through a weakness in the supporting tissues at the apex of the vagina gives rise to an Enterocele, a.k.a. dropped small intestine, small intestine prolapse, or small intestine hernia. As an enterocele progresses, the amount of descent into the vagina increases. Enteroceles are graded as follows: GRADE 1= mild GRADE 2= peritoneal sac to vaginal opening with strain GRADE 3= peritoneal sac outside vaginal opening with strain GRADE 4= peritoneal sac outside vaginal opening at all times The symptoms of an enterocele are typically one or more of the following: a bulge or lump protruding through the vagina intestinal cramping due to small intestine trapped within the entrocele vaginal pain or painful intercourse Burrell Education Page 17

18 Vaginal Vault Prolapse The most advanced stage of pelvic relaxation occurs when the support structures of the vagina (cardinal and uterosacral ligaments) are damaged by hysterectomy or other pelvic surgery such that the vaginal turns inwards. For illustrative purposes, if the vagina can be thought of as a sock, vaginal vault prolapse is a condition in which the sock is turned inside out. Burrell Education Page 18

19 Uterine Prolapse Descent of the uterus and cervix because of weakness of their supporting structures. Normally the cervix is located in the deepest third of the vagina. As uterine prolapse progresses, the amount of descent into the vaginal canal will increase. Uterine prolapse is graded as follows: GRADE 1= mild descent of the cervix towards the vaginal opening with strain GRADE 2= cervix to vaginal opening with strain GRADE 3= cervix outside vaginal opening with strain GRADE 4= procidentia, complete prolapse in which the cervix and uterus are outside the vaginal opening at all times The symptoms of uterine prolapse are typically one or more of the following: bulge or lump protruding from the vagina a sense of dropping out and lack of pelvic support urinary symptoms: obstructive voiding symptoms, the need to manually reduce (push back) the uterus in order to initiate voiding, irritative voiding symptoms, incontinence, urinary tract infections Burrell Education Page 19

20 kidney obstruction because of descent of bladder and ureters (tubes that drain urine from the kidney to the bladder) vaginal pain with sitting and walking painful intercourse spotting or bloody vaginal discharge Burrell Education Page 20

21 7. Why ONLY Doing Kegels Doesn t Prepare You For Real Life! Just for the record.i DO NOT think Kegels are a waste of time. They are just not enough! They have a vital role as an entry-level activity especially after birthing or any gynaecological intervention. This post is about applying Kegels as restorative strength work to people who are able to move and have some degree of fitness. Quite some time ago I came to realize that MOVEMENT has a better effect on improving the strength and function of the Pelvic Floor compared to KEGELS! FACT! I didn t like it either! I was in my comfort-zone talking about Kegels, giving people my lovely handout and vaugely reinforcing this prescription. It was a truly hand in the cookiejar moment where if I wanted to retrieve my hand I had drop the cookie! I had to delete a whole load of poor information that I d taken in over the years via my equally poor fitness education. I had to start rebuilding my foundation principles, thought processes and my repertoir Burrell Education Page 21

22 of restorative exercise for my clients (mainly Pregnant and Post Baby exercisers) so that I could actually do a major part of my job stop them leaking everytime they sneezed and laughed hard! So I could write forever on my journey to this point but I won t because these things I know and I know for sure and other people who are much more experienced, educated and learned than I also know for sure. 1. Your Pelvic Floor muscles don t sit between your legs in splendid isolation! They are a fundamental part of the totally interconnected sum of YOU! They are connected via fascia and other connected tissue to the bones of the pelvis and more distally even to movements of the femur. Burrell Education Page 22

23 2. When you bend at the waist (either forwards or backwards) this affects your Pelvic Floor. In the most basic terms, your tummy is connected to your Pelvic Floor and your back is connected to your Pelvic Floor and changes in either of these two areas is reflected back to the Pelvic Floor. (See the diagram below). Burrell Education Page 23

24 3. When you take your legs wide (think Plie Squat and lateral squat) or take your leg into abduction and return or step into the transverse plane and return, these movements also challenge the Pelvic Floor musculature and Obturator Internus (part of the support system of the bladder) in an eccentric/concentric manner. Incidentally, eccentric/concentric work is what you are doing when you lower and lift your arm performing a bicep curl. We stretch to strengthen. 4. When you squeeze your legs together, this too activates your Pelvic Floor, your inner thigh muscles (adductors) are (fascially) linked to you Pelvic Floor. Add some resistance such as a Pilates Ball or Pilates Rings and you increase your bang for buck. Burrell Education Page 24

25 6. Lastly, mother nature had this nailed right from the start before we started fiddling around and contextualizing and actually if we just MOVE & BREATHE (with intention and mindfully) guess what? This thing we call THE CORE and its reflection elsewhere in our system.works just fine. As we exhale, our God-given corset is activated. Lifting and tensioning our Pelvic Floor, activating our lumbar and thoracic muscles (lower and upper back) and the protective/stabilizing fascia there too. Our deep abdominal muscles tissue also are activated by the out-breath and the Diaphragm lifts all components activated, happy and doing their job because we exhaled! 7. Try it for yourself, exhale for an 8 count and listen too/feel what happens. Burrell Education Page 25

26 Red Flag Pelvic Floor Dysfunction Questionnaire (Females) Pelvic Floor Dysfunction (PFD) may present via a wide variety of symptoms and in order to help you understand why your Pelvic Floor isn t working as well as it used to, you ll need to take some time to process and answer the following questions as fully as possible. The answers to the following questions will give you a clearer picture of how to move forward, possibly get help and get you back to great core and pelvic health and function. 1. Are you experiencing difficulty with your bowel, wind or urinary urges? If YES, please state which. Yes? No? 2. Do you lose urinary control when laughing, sneezing, coughing or jumping or moving quickly? Or leak without warning? Yes? No? 3. Are your bowel movements or urination painful? Is there any blood present in either your stools or urine? If YES, please give further details: Yes? No? 4. Do you experience a sensation of pressure or increased weight in your vagina or rectum or noticed any protrusions from your orifices? Has anyone ever said you may have a prolapse? If YES, please give further details: Yes? No? 5. Do you experience pain with intercourse or sexual stimulation? If YES, please give details. Yes? No? 6. Do you currently or have you ever needed to wear incontinence pads? If YES, how many would you wear in a day? Yes? No? 7. Do you experience pain in your genitals with or without sexual intercourse? If YES, please give details. Yes? No? 8. Do you experience pain within or at the joints of your pelvis? If YES, please give details. Yes? No? 9. Are you incontinent overnight? Yes? No? 10. Do you suffer from constipation or regularly strain on the toilet? Do you need to assist your own voiding or feel that when you pass faeces, you never feel like you ve managed a full movement? Yes? No? Burrell Education Page 26

27 11. Have you recently (or ever) had a baby? Do you have a separation of your abdominal muscles at the midline? If YES, please give details. Yes? No? 12. Have you ever undergone any gynaecological surgery (eg.,a hysterectomy, fibroids removal?) If YES, please give details. Yes? No? 13. Are you or have you ever been an elite athlete? Runner, gymnast, trampolining or any sport that involved regular contact? Yes? No? 14. Do currently, or have you in the past experienced back pain? Yes? No? 15. Have you ever sustained an injury to your pelvic region (fracture, radiotherapy or injury to your coccyx?) Yes? No? 16. Are you going through or have been through the menopause? If YES, please give details, Yes? No? 17. Do you or have you ever had a chronic cough or a condition that affected your breathing (smoking, hayfever, asthma?) If YES, please give details. Yes? No? 18. Are you or have you ever been overweight? If YES, please give details. Yes? No? 19. Do you frequently lift heavy weights? (Gym, work, children, caring for disabled or elders?) Yes? No? 20. Are you pregnant? If YES, please give details. Yes? No? 21. Have you ever undergone any abdominal surgery? If YES, please give details. Yes? No? 22. Have you ever undergone any back surgery? Or been given an Epidural? If YES, please give details. Yes? No? 23. Do you suffer from hypermobility? Yes? No? Any other information you d like to give about your health/symptoms? Burrell Education Page 27

28 In your own words, why do you feel you need a Pelvic Health programme? How long have you been aware of or concerned by a change in your continence and Pelvic Floor function? Please detail any previous attempts to improve your continence. What liquids to you drink during the course of your day and how much of each type? (Both coffee, tea, plus other sources of caffeine alcohol consumption can have a negative impact on urinary incontinence). Are you on any special kind of medication? On a scale of 1-10, how much are you troubled by your Pelvic/Continence issues? A Little Very Concerned Answering YES to any of the first 10 questions and marking anywhere on the scale or being a little to very concerned about your Pelvic Health means that your pelvic health and function isn t what it should be or what you d like it to be. If you have downloaded this questionnaire from the website and you re not local to an Ambassador, our advice is to take this answered questionnaire to a recommended specialist in Women s Pelvic Health and seek help for your symptoms. If you are planning on attending a FooFooFunClub, please return your completed questionnaire to the Ambassador and he/she will help and advise you further. Burrell Education Page 28

29 If your symptoms are light bladder leakage urine when your pelvic floor is under pressure, during running, coughing, sneezing, laughing or jumping etc., and a NO ANSWER TO QUESTIONS 3,4,5,6, 7 and 9 then either the FooFooFunClub or the FooFooFunBox programme will help you establish a great workout for your Pelvic Floor and entire core to improve your continence. If you re at all unsure, please get in touch with us via the website or speak to your Ambassador. Take time to complete the above questions too so that when you visit your Pelvic Health Specialist or your Ambassador, they will immediately have a clearer picture of your issues. Remember... Be brave & good luck. I sincerely hope all this information has helped and informed you. Yours in health, Jenny Burrell, Creator of FooFooFunBox & FooFooFunClub Burrell Education Page 29

30 Connect With Us On We have the Public Page and a Private Group Called: TheFOOFOOFUNBOXCommunity...simply ask to join and get supported! With huge thanks to Helen Keeble, Women s Health Physiotherapist, London, who kindly helped us create this Red Flag Questionnaire. helenkeeble@hotmail.co.uk Burrell Education Page 30