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Between Women’s Health Week and World Physiotherapy Day (September 8th) it is exhausting to keep up with all the spreading the word on these designated days/weeks.

But it is important especially when the theme for World Physiotherapy Day is Physiotherapy and Mental Health. 

Every day we Pelvic Health Physios see plenty of stressed out, anxious women who are coming to terms with their pelvic health issue/ diagnosis. Part of the difficulty with these pelvic health problems is you can’t unburden yourself to just anybody about your newly understood problem. There is shame; there is the fear you are the only thirty-something with these issues; and there is your own revulsion that your life has taken this shocking turn for the worst. The bottling up of these stories continues to place a strain on the mental health of women.

Women are so used to sharing EVERYTHING that is worrying them with their girlfriends, their sisters and mothers. But who can divulge to your mother/sister/husband/friends…even GPs about your faecal urgency that is causing your anxiety to sky rocket or your prolapse that makes you feel extremely unfeminine or your pelvic pain that is causing you to refuse any intimacy post-vaginal delivery? It’s never easy- but the knowledge that the stats are high for many women having pelvic floor dysfunction tells us you are certainly not alone and in these days of social media thankfully the word is getting out. However in my 27 years of just treating pelvic floor dysfunction alone I have seen the messaging change – from barely being able to get a line in an article about urinary incontinence to there now being multiple Facebook groups for every pelvic floor condition there is and lots and lots of conversations in the media for women to access. This is mostly a good thing.

But the down side of this is that so many women who actually don’t have prolapse are convinced they do and there is a certain level of catastrophising about pelvic floor dysfunction.

There are many odd sensations in the nether regions after you have a baby. Drag and ache, bumps and bulges. Sometimes you are right with your diagnosis from Dr Google and sometimes you are not. There can be normal post-natal swelling which is not a prolapse. Also whilst it’s good in theory to understand about your anatomy- looking with a mirror after childbirth can definitely escalate anxiety.

Schedule a 6 week post-natal check-up with a pelvic health physiotherapist who can tell you what is what but also remember prolapse can actually change through the day- it can start off with everything sitting inside the vagina early in the morning and as you have a heavy day on your feet with toddlers and babies and shopping and housework and washing the dog – things can drop by the afternoon. It is always handy for the GP to do an examination in standing to see what you are feeling rather than just in lying where everything is reduced.

You can see there is a common theme from the photos inserted in this blog -that keeping active is important for your mental health. We physiotherapists know and many women know that exercise is wonderful for improving your head-space. And yet so many women believe they can’t do anything after they have had a baby. Even if you have prolapse you can usually exercise with a pessary in – so get along to your pelvic health physio and start the conversation.

What can I do?

When can I do it?

Facilitate my rehab!

Be my pelvic health mentor!

Speaking of mental health for women here is a link to a great article about the mental load that women invariably carry once they become a mother. It is a long post (and a little unfriendly for reading when we are used to things that are fast and iPhone-friendly with reading) but I encourage you all to persevere to the end. It’s the “You should’ve asked” repeating at the end of each little cartoon that really resonates while you are reading it. This is what is exhausting for women. Not just doing the tasks but thinking about what needs to be done, when and by whom (which often ends up being by the woman because it’s just easier than coordinating another to do it) but then the answer comes back when they may crack “But you should’ve asked”.

And finally the mental health of mothers takes a downward plunge if the mental health of their children is not good. This link to an interview on the Today show has the full interview of Hugh van Cuylenburg from the Resilience project with some thoughts on building resilience in children and adolescents.

I encourage you to listen to the whole interview but if you don’t have time, a synopsis follows. Hugh talks about how to develop three key pillars that will help you and your kids develop resilience, which may lead to mental health improvements and you become happier. Hugh stated that recent research that studied 300,000 kids over last 3 years showed statistics that around 40% of high school kids and 24% of primary school kids have a mental health issue with anxiety being the primary one. Anxiety is a condition where obsessive, negative, worrying thoughts can’t switch off.

He commented that he recently heard someone say that with social media and iPhones “We have never been so connected and yet never so lonely”. And it is the omnipresent technology that can be so overwhelming for developing brains. Hugh reminded us that the 2018 adolescent and child brain will receive the same amount of information in a week that we older folk were exposed to in a year. Now that is mind-blowing.

Hugh tells us about how he got interested in resilience training. He was studying teaching in Australia and got access to a classroom when volunteering for a few weeks in India. In this village, there was no running water, no electricity- but these people were so unbelievably happy and so full of joy. One particular child slept on a dirt floor- he was happy, he was full of joy. Hugh couldn’t stop thinking about his own sister who was three years younger than him who was very unhappy, anxious and diagnosed with anorexia. She was desperately unwell and at a dangerously low body weight.

He wondered “How is this possible? This little boy is sleeping on a dirt floor with no running water, no electricity and yet he was so happy and yet his sister was so unhappy. What does this kid do, what do this community do every day that make them so happy?” He observed and watched them for years and he learnt about these 3 pillars- their key to life: Gratitude, Empathy and Mindfulness. He came back to Australia, went to uni and did post-grad studies to provide sound evidence that these strategies will help build resilience and found in fact there is over 30 years of research behind these strategies that if implemented our mental health improves and you become happier.

Pillar 1: Gratitude the ability to pay attention to what you’ve got and not to worry about what you don’t have (we have so much in Australia but we are not very good at paying attention to what we’ve got- we are always wanting for more and searching for a better life without really appreciating what we have got).

Pillar 2: Empathy put yourself in someone else’s shoes. This little boy – who had nothing, who sleeps on a dirt floor- was always exuding kindness and he loved giving compliments to people. Hugh pointed out that we often think nice things about people, but we never say them. He recommended thinking beyond yourself and the happier you are then the more likely you are to be kind to people. There is also strong neuroscience evidence that if you are kind to people your brain releases ocytocine – a feel-good hormone.

Mindfulness is about the ability to be calm and to be present. Mindfulness is not meditating but being in the present moment. Anxiety is the biggest problem- we are on edge and only present for 15% of our day. Screens are our biggest distraction. It is detrimental to children to feel you are not engaged fully with them. The answer is -get off your phone, be there for your kids, leave your device in the car.

To finish this blog I wanted to include more links from the wonderful articles and links that Jean Hailes for Women’s Health created for Women’s Health Week. Mostly this is so I can quickly access them for my patients because there is a wealth of information on the site but I commend them to you.

Here is the link to Day 3 of the Jean Hailes Women’s Health Week.

Here is the link to Day 4 of the Jean Hailes Women’s Health Week.

Here is the link to Day 5 of the Jean Hailes Women’s Health Week.

I hope you find lots of worthwhile information in this special blog celebrating World Physiotherapy Day and to all my Physiotherapy colleagues have a great day, great weekend and a great working year with your patients.

#startmoving #staymoving #bekind #bepresent #begrateful #bemindful #beempathetic