I refer patients to certain blogs over and over during their treatment session and so have created this Articles section for patients to access easily.
I have included a link today to a Radio National Life Matters show on a silent epidemic-Persistent Pelvic Pain. Bettina Arndt, Dr Susan Evans, a pain survivor-Vanessa and the host of Life Matters, Natasha Mitchell, had a 38 minute discussion on the topic of persistent pelvic pain (PPP)- literally bringing PPP out of the cupboard! Persistent pelvic pain is a debilitating scourge on society and as Susan said the causes can be multi-factorial and quite divergent but the end result is the same – a miserable, stressed and despondent woman (or man).
Quite a few listeners phoned in with their story, and the story is the same – a run-around to many different doctors and therapists, invasive tests and surgeries and not many answers. But there is tremendous hope for these patients. Because of work by the Adelaide pain researchers Lorimer Moseley and David Butler which has shed a new light on how to manage chronic pain, great improvements are happening for pelvic pain disorders. By adapting their wonderful principles of the central sensitization of pain rather than only focusing on the end organ (in the periphery such as the endometriosis, the vagina, the bladder etc) we are now looking at a multi-factorial approach to treatment, which importantly, includes the brain.
Understanding about this new way of treating persistent pelvic pain:
- that the brain decides whether there is going to be pain or not
- identifying stressors that might be releasing stress hormones such as cortisol and adrenaline which further sensitizes the already hypersensitive nervous system
- dilators to massage the tight pelvic floor muscles and to desensitize the painful vagina
- pelvic floor muscle training but focusing on the relaxation of the muscles rather than over-tightening them
- relaxation and breath awareness by using general body and pelvic floor relaxation CDs, perhaps meditation, pelvic floor safe yoga
- release of endorphins (the body’s own pain killer rather than high dose and sometimes addictive medications) through general exercise – doing it in a paced and graded way
- a medication (which is in fact a low dose old-fashioned antidepressant which turns down the messages from the pelvic nerves)
All of these strategies plus a few more will change the outcome for these patients.
Thanks to Bettina for raising the profile of this condition and may our progress forward with treating PPP be a fast and furious to get these patients back to a productive, enjoyable life again.
Sue Croft graduated from the University of Queensland with a Bachelor of Physiotherapy in 1977 and initially practised general physiotherapy at Princess Alexandra Hospital – then moving to the Spinal Injuries Unit. She then worked in the Mater Hospital Intensive Care Unit for 4 years. Following the birth of her children she tutored at the University of Queensland developing an interest in Women’s Health. Since 1988, Sue has worked continuously in Women’s Health and Continence promotion and Pelvic Health Physiotherapy.
Jane Cannan Jane completed her Masters in Physiotherapy Studies at the University of Queensland in 2009. (She originally graduated from Queensland University of Technology with a Bachelor of Applied Science and a Bachelor of Education in 1999 and initially worked as a Primary School Health and Physical Education teacher and Secondary School Health, Physical Education, Maths and Science teacher. It is both her passion for teaching and the health sciences that led her into physiotherapy.)
Martine Lange is a Pelvic Health and musculo-skeletal physiotherapist and is an accredited Pilates instructor through the Queensland Pilates Institute. Martine has undertaken many courses from the Women’s Health Training Institute to further her continence and prolapse skills.
Megan Bergman graduated from the University of Queensland in 1996. Initially she worked and ran a busy sports practice in Cairns, including providing physiotherapy services for state and national level hockey and basketball teams. Megan then spent two years working throughout England and a 2 year period in Asia raising her two sons. She has now returned to Brisbane with her family, where her passion for Women’s Health has led to continued ongoing education and training undertaking many courses at the Women’s Health Training Institute and other APA led courses. She is an experienced Pilates instructor and conducts one-on-one, two-on-one and three-on-one classes at our Hampstead Road clinic. Megan fits pessaries and treats our male clients. She is currently undertaking extra training to be able to see children for bed-wetting and other continence issues. Megan is an avid bush walker and has two teenagers who are keeping her active and engaged. Megan loves to help clients achieve their goals and take control of their bodies.
Amanda Waldock graduated from the University of Sydney with her Masters of Physiotherapy in 2014 following the completion of her Bachelor of Health Sciences in 2012 also from the University of Sydney. She spent the first few years of her career working in public and private hospitals in Sydney. In 2017 she moved to Brisbane and commenced working at the Royal Brisbane and Women’s Hospital. It was here that Amanda started to work in Women’s Health Physiotherapy after completing her training with the Women’s Health Training Association. She has recently returned from the UK where she was working at The Chelsea and Westminster Hospital within the Pelvic Health Team. Amanda has completed training in many areas relating to Women’s Health including the WHTA 5 day introduction to women’s health, Stress urinary incontinence and Prolapse management, The Female Athlete with Antony Lo, Visceral Mobilisation Level 1 and POGP Pregnancy related Physiotherapy assessment and management of musculoskeletal conditions (lumbar spine and pelvis). Amanda has had experience seeing women in a hospital setting post-delivery and gynaecological surgery. She has also has experience running exercise classes and education classes for antenatal and postnatal women.
