After menopause, more than half of women may have vulvovaginal symptoms that can impact their lifestyle, emotional well being and sexual health. What’s more, the symptoms tend to co-exist with issues such as prolapse, urinary and/or bowel problems. But unfortunately many women aren’t getting the help they need, despite a growing body of evidence that skilled pelvic rehab interventions are effective in the management of bladder/bowel dysfunctions, POP, sexual health issues and pelvic pain. Continue reading “Pelvic Health at Menopause”
I’ve just come back from a gorgeous trip to Paris – the sun was shining but the leaves were turning and all the shops had signs up for ‘La Rentree’, that ‘re-entry’ period signalling the end of summer, time to think about school and a returning to learning.
Speaking of learning:
Did you know that September is Gynae Cancer Awareness month?
In October, everything seems to turn pink for Breast Cancer Awareness month, but there is much less of a conversation about gynaecological cancers, which is unfortunate as thousands of women are affected each year. Treatments have improved significantly over the past decade, so many more women are living with the after effects of cancer treatment – pelvic pain, urinary and bowel dysfunction, sexual health issues, bone health compromises and cardiovascular dysfunction. Despite a good and growing body of evidence on the benefits of pelvic rehab, the number of women sent for aftercare is just too small. Maybe its because of a lack of awareness on the benefits or a lack of providers in their area, because sometimes the oncology physiotherapists are worried about dealing with pelvic health and the pelvic health physios are worried about dealing with cancer issues?
One of the first steps towards improving this situation is talking about it and I’m delighted and honoured to be doing exactly that at this year’s International Pelvic Pain Society annual meeting in Chicago in October. The IPPS has been described as a giant pelvic floor high school reunion so if you are interested in taking your knowledge deeper in pelvic pain with some of the best international speakers out there – come and join us! There will also be the opportunity to join us for round table discussions over lunch – I’m honoured to be co-moderating one with Dr Jen Gunter! I was interviewed recently by The Pelvic Messenger radio show about this topic – you can have a preview of what I’ll be talking about in Chicago. I hope to see you there!
Of course, we want to not only spread awareness in the medical community about the benefits of pelvic rehab but also empower women with education about their own bodies. One of the earliest signs/ symptoms of vulvar or vaginal cancer can be skin changes in the genitals. Most women know the importance of regular self breast exams, but how many are doing regular vulvar self exams? (Are you? Do you know how?)
I’ve put together a handout on ‘How to do a Vulvar self-exam’ which you can access for free in the ‘Resources’ section on my website – let’s spread awareness of the importance of knowing what’s normal and encourage women to follow up when somethings not right.
If you’re interested in going a bit deeper into Oncology and the Pelvic Floor, I’ll be teaching Oncology and the Male Pelvic Floor in Salt Lake City in October and Oncology and the Female Pelvic Floor in Chicago next April through Herman & Wallace, The Pelvic Rehab Institute
Let’s keep the conversation going about spreading awareness of Gynae Cancer and its treatment – not just for September!
I hope I get to see you at one of my live events but if not, come and join the conversation on social media: you can follow my professional page on facebook Michelle Lyons Celebrate Muliebrity, where I curate news items on women’s health and if you are a physio, come and join our clinical group, Global Pelvic Physio. I’m a sporadic tweeter (but trying to get better!) – you can find me on Twitter as @mlyonspt
When I bring up the topic of pelvic floor dysfunction in athletes, stress incontinence is usually the first aspect of pelvic health that springs to mind – and rightly so, as professional sport is one of the risk factors for stress urinary incontinence. (Poswiata et al 2014). The majority of studies show that the average prevalence of UI across all sports is 50%, with SUI being the most common LUT symptom. Athletes are constantly subject to repeated sudden & considerable rises in IAP: eg heel striking, jumping, landing, dismounting and racquet loading. Continue reading “Taking care of the Female Athlete”
For Every Woman Who Needs to Know and Every Women’s Wellness Professional Serving the Hysterectomy Patient
At the most recent calculation, 1.2 million women a year underwent a Hysterectomy procedure worldwide. With a figure of 55,000 in the UK and just over 500,000 in the USA. Why women undergo this procedure is as varied as the woman to whom the procedure is being applied. From Ectopic pregnancies to Uterine Fibroids, Endometriosis to Cervical Cancer, the female ailments that precede the need for Hysterectomy are usually highly challenging in themselves and many women undergo Hysterectomy as a theoretical ‘final solution’ to chronic and life-disrupting issues only to find that there is also an additional toll to be paid during the recovery period and for many years after. For many women, although Hysterectomy alleviates their most pressing health issues, in the immediate and long-term recovery period, the removal the reproductive organs actually acts as a catalyst to range of, sometimes life-threatening conditions such as Osteoporosis, heart disease, pelvic organ prolapse, bowel dysfunction and Metabolic Syndrome.
So, unlike other surgical procedures, the expected short-term recovery issues are generally compounded by the unexpected and confusing long-term physical and emotional fallout due to gross endocrine disruption. Unfortunately, this imbalance and the sometimes debilitating accompanying negative symptoms can easily last for many years and even decades into the rest of woman’s life.
[su_expand more_text=”Read more” link_color=”#ff009e” link_style=”button” more_icon=”icon: plus-circle”]Hysterectomy is, of course, one of many female health taboo subjects….it traditionally happens to older women who historically have been ‘non-complainers’ and not been strong advocates for their later-life health. For many, Hysterectomy is something that is ‘done’ to them without a clear understanding of the actual procedure or the short and long term implications for their ongoing health.
There is, however, a sea change, women are finding their voice, asking questions and insisting on answers. And thanks to the internet and the democratisation of information regarding the procedure, women are starting to become their own health advocates. BUT, there is still work to be done to improve education on the procedures themselves and how best to recover plus clear directions on the potential for ongoing health challenges that women may experience due to the procedure, sometimes for the rest of their lives. Information regarding Hormone Therapy, bone health, sexual function and so many other issues also need to be clearly explained so that women are prepared and indeed can take steps to offset these health issues through specific nutrition and lifestyle protocols. Ultimately, women need to know that there is life, hope, and wellness after Hysterectomy and that there are great information and sources of support for their onward journey.
The sole purpose of this course is to provide a 1-stop portal for evidence-based, heavily researched up-to-date, woman-centered information and education on all the key ‘big rocks’ of Hysterectomy before the procedure, in the short-term post the procedure and way into their futures so that no woman who has access to this information need ever go to a consultation, into a surgery or suffer symptoms under-prepared, under-educated and feeling disempowered.[/su_expand]
In this course, you will learn:
[su_spoiler title=”Part 1″ style=”fancy” open=”yes”]
1. The Anatomy and Physiology of Hysterectomy
2. Current Global Statistics
3. The various types of Hysterectomy surgeries and the implications for recover and complications
4. The reasons for Hysterectomy
5. The alternatives to Hysterectomy
6. How to prepare for and what to ask you doctor at your ‘exploring having Hysterectomy’ meeting
7. How to prepare for and what to ask you doctor at the ‘deciding to have a Hysterectomy’ meeting
8. Hysterectomy and ‘forced’ Menopause – The potential fallout (short and long term) and implications for about pelvic, bone and heart health
9. Becoming your own Hysterectomy Heroine and Midlife Health Advocate
10. Heart and soul preparation for the surgery and the ‘new version’ of you
[su_spoiler title=”Part 2″ style=”fancy”]
1. Supportive nutrition and lifestyle before and healing nutrition and lifestyle after surgery
2. Nutrition to support your connective tissue health in the short and long term
3. Preparing for your procedure and hospital stay
4. Offsetting potential post Hysterectomy alignment changes especially the effects on Diaphragm function because of peri-operative positioning
5. Early days post procedure self-care strategies for lifting, sleeping, bowel health, constipation and surgery gas
6. Leaving the hospital, removal of stitches and beginning your healing journey at home
7. Your post procedure support system – asking and getting help at home
[su_spoiler title=”Part 3″ style=”fancy”]
1. Offsetting potential post Hysterectomy alignment changes especially the effects on Diaphragm function because of peri-operative positioning
2. Simple soft tissue/self-massage and stretches to relieve post operative aches and pains
3. Early days return to movement/exercise with suitable progressions
4. The short and long term impact of scar tissue and adhesions caused by surgery and how to optimize lymphatic and visceral function
5. Choosing the best style of exercise to support your new pelvic health status. Pelvic floor safe, bone strengthening, cardio-protective, alignment focussed movement for life.
6. Restoring ‘Intrinsic Core Synergy’ and releasing scar tissue to optimise core function.
[su_spoiler title=”Part 4″ style=”fancy”]
Hysterectomy Stories + Vital Resources
Real life testimonials of women’s Hysterectomy stories, their no holds barred journies to and through Hysterectomy. One of the greatest gifts we can give each other as women is the gift of community and sharing during this process. In many cases, many of the fears and concerns about this procedure can be lessened by simply knowing that we’re not alone and this part of the education hopes to give you a insight into the journey of real women in a bid to bring hope and clarity to those with questions. Ultimately, you are NEVER alone in this procedure and it is exactly that, a procedure…..it need not become your identity.
Our top online listing of ESSENTIAL websites, blogs, clinical information, books and support groups.
[su_spoiler title=”Pre-Requisites: Who is this Course For?” style=”fancy” ]
- ANY WOMAN who is considering or has undergone a Hysterectomy and wants/needs to know more, be in a community of others who are also seeking to empower themselves through education about Hysterectomy. The content is presented in a manner that’s suitable for both professionals and non-professionals. The aim was/is to reach WOMEN who desperately need supportive and clear information from a reliable and evidence-based source!
- Fitness Professions
- Women’s Health Educators
- Professionals working with Peri to Post-Menopausal women
[su_spoiler title=”Who has accredited this Advanced CPD?” style=”fancy” ]We are just awaiting accreditation but like all Burrell Education courses, this course will be accredited by Skills Active in the UK and candidates will receive CPD points. (Burrell Education is a Licensed Education Provider). And we await NASM Accreditation in the US also in order to grant candidates CEU points.
There is a 30 question multiple choice exam for professionals taking this course who wish to gain continuing education points but lay persons can simply view the content and course materials and use the course for personal education.[/su_spoiler][su_spoiler title=”How is this course delivered? What kit do I need?” style=”fancy” ]
You need a computer and internet connection. The course content, totalling 4 Modules will go live within the membership site on Monday 2nd May and the 4 Modules be delivered fortnightly after initial launch. Thereafter, the full course contents will be available in full for candidates to access whenever they desire wherever they are on the planet.[/su_spoiler][su_spoiler title=”Will I be well supported on this course even though it is delivered on-line? ” style=”fancy” ]
YES, you will, 100%. There will be an associated Facebook Support Group which will give you directly daily access to the tutors/authors and all of the other course participants.[/su_spoiler][su_spoiler title=”How much time do I need to put aside for study?” style=”fancy” ]
I feel that this depends on your study style but 3-4 hours maximum for each module should be sufficient. But you have eternal access so may wish to return to the content and go over again.[/su_spoiler][su_spoiler title=”How Do I Secure My Place For The Next Course?” style=”fancy” ]
Your first payment, whether in full or by instalments, secures your spot![/su_spoiler][su_spoiler title=”How Long Can I Access The Course Content On-Line?” style=”fancy”]
Forever and ever! Access to both the course materials, videos, PDF downloads and the Facebook Support Group are open to you forever.[/su_spoiler][/su_accordion]
[su_tabs vertical=”yes”][su_tab title=”Michelle Lyons”]
Michelle Lyons is a Global Women’s Health Physiotherapist and Physiotherapy Educator based in Ireland that EVERYONE should know if they are working in the world of Women’s Wellness. The term Women’s Health Physiotherapist although wonderful doesn’t actually cover even a 10th of Michelle’s scope of practice, knowledge, and teaching which includes Female Cancers, Menopause, Bone Health, Herbalism, Pelvic Health, Aromatherapy, Mindfulness, Integrative Nutrition…..and the list goes on. Her knowledge base is both extremely wide and deep and her contribution to this certification, quite simply elevates it to being ESSENTIAL INFORMATION FOR THE LIFE OF EVERY WOMAN! You can find out more about Michelle here.
[/su_tab] [su_tab title=”Jenny Burrell”]
Jenny Burrell is the Head of Burrell Education and with nearly 20 years dedicated to the fitness, soft-tissue therapy, nutrition of and wellness of the Ante Post Natal woman, Jenny reached out to Michelle Lyons with her extensive knowledge of Mid-Life women’s wellness to see if a collaboration educate both the woman considering and experiencing Hysterectomy would be possible. As Hysterectomized woman, Jenny experienced first hand the lack or information prior to and after the procedure and dedicated herself to one day creating education for other women so that they would have vital and empowering information that was easy to access in order for them to become better advocates for their own health at such a pivitol time in their life. You can find out more about Jenny here.
This Course Launches – Tuesday 3rd May, 2016
It is ACCESS ANYTIME which means once you purchase you get access to the Modules and the Facebook Support Group hosted by Jenny Burrell and Michelle Lyons immediately (from May 2nd onwards) and you complete the contents and exam (if you want certification) in your own time.
Happy New Year!
I hope that 2015 was good to you and 2016 will be even better. This is going to be a year of #radicalselfcare for me – I stepped off the whirlwind of work and travel about three weeks ago and today is my first day back at proper work. What a change to be well rested! You know, sometimes I don’t realise how tired and empty I’ve become until I have a chance to re-charge and I realise that this (happy! energetic! enthusiastic!) is how I’m supposed to feel. So this will be the year of self care. Of practising what I preach! Of yoga, and rest, and meditation and great food. I spend a lot of time travelling for work and before the plane takes off, they always tell me to put my own mask on first.
Message (finally) received
In other news….
I have some great courses coming up in the UK and US over the next few months:
In the UK: I shall be teaching a refresher day in RUH Bath on Feb 6 for previous attendees of my Advanced Clinical Skills in WH, and I’ll be back in Bath in April to teach my new course ‘The Obstetric Pelvis’ where we will be integrating advanced techniques to treat pregnant and post natal women: details to follow! I’ll be teaching a one day Masterclass in Breast Cancer Survivorship in Worthing on February 26 – I’ve just posted the details for that in the fb group, but do contact me if you’d like any other info. One of the highlights of my year is teaching at the Woman on Fire conference in London, March 12/13. I get to present alongside some of my best friends and learned colleagues – Jenny Burrell, Maria Elliott, Jessica Drummond and some new friends too.
Here’s a taster of what I’ll be talking about….
In the US, I’ll be heading to Colorado at the end of the month to teach my Special Topics: Endometriosis, Fertility & Hysterectomy course: here’s a link to that info, and I’m excited to be going to Atlanta in March to teach about all things Menopausal: here’s that info!
Today (January 6th) is Nollaig na mBan in Ireland, which roughly translates to Women’s Christmas – traditionally it is a day to mark the end of the festive season, where the women of the house are feted and celebrated and get to relax! (#radicalself care begins here!) A big part of that is creating ‘dainties’ – small and delicious things to eat, so I used a recipe from Susan Jane White’s book ‘The Virtuous Tart’ for Chocolate Seed Soldiers. I do have to warn you though – they are full of good things like dates and cashew butter and cocoa nibs and goji berries but they are SERIOUSLY addictive! Why not make some to share and celebrate the women in your world?
Of course, another new year’s resolution is to become a more regular blogger, so I hope to be popping up more regularly with #radicalselfcare ideas, good food to make, eat and share and how to move your body in a happy and healthy way – after all, we are here to celebrate muliebrity!
Happy New Year to you all
Onwards & Upwards
How can it be nearly the end of September already? But it is…the light is changing as it comes in lower, its a little bit darker every morning when I open the curtains, and I am loving having a fire lit in the evenings.
The French have a wonderful word for this time of year – La Rentree. It conjures up the end of looser summer routines and a return to learning and school schedules and after school activities, the start of the build up to the festive season (don’t you feel like it gets earlier every year?)
I secretly loved September as a child – that new book smell! new pens and pencils! And now, I love that feeling of new starts and new beginnings – as my friend Jessica Drummond says – ‘September is the new January’. I am very happy to have collaborated with Jessica and another of my good physio friends Julie Granger Jesse on our new Female Athlete Wellness course – which you can do at home beside your own fireplace in your pj’s if you want!
Have a look at this free video training series that Jessica has put together and come and join the conversation with us!
Until next time, onwards & upwards!
While it can initially be very useful to find and activate/relax your pelvic floor muscles in supine or side lying (have you seen the free download about this on the Resources page?!), it’s really not a good long term or functional strategy – the pelvic floor needs to actively work in a number of different positions and in a number of different activities and in coordination with the breath.
Once you have mastered the art of contracting, relaxing, lengthening and relaxing the pelvic floor muscles in a supine or side lying position, try it in sitting (on a firm chair to start with – you can try sitting close to the edge so that when you contract your pelvic floor you can feel it lift up and in and away from the surface of the chair & then relaxing back down again)
In standing, try and keep even weight on both feet and really bring your attention to the movement of the breath as you close the openings, lift up and in and then relax the pf muscles back down again.
Progressing to Movement:
The Knack: Ashton Miller et al first described this pre-emptive tightening of the pelvic floor before a sudden increase in intra abdominal pressure (such as a cough or a sneeze) back in 1998 and it was reviewed again in 2008
Essentially it involves bracing the pelvic floor for a sudden increase in pressure – as stated above, perhaps a cough or a sneeze, but also applicable for going from sitting to standing. Incorporating ‘The Knack’ into every transfer from sit to stand with emphasis on breathing and pf coordination can really enhance the efficiency of the lumbo-pelvic stability system
Try this: Sit close to the edge of your chair. Fold your arms (this way you won’t be tempted to push down on the arms of the chair!)
Take a deep breath in, as you exhale, relax your pelvic floor
Take another breath in, this time with the exhale, close the opening of your pelvic floor and lift up and in as you stand up (Don’t forget to keep breathing!)
Once you are standing, relax the pelvic floor (and again, don’t forget to breathe!). Many women (especially those who do have some incontinence problems, are concerned they will leak if they fully relax their pelvic floors. This is an important mis-conception to address. By being able to fully relax their pelvic floors, they will actually gain a greater spectrum of movement when they contract their pf muscles, promoting a faster return to continence and control than simply
‘Tighten! Tighten! Tighten!)
We need to be able to have a full spectrum range of motion and control with our pelvic floor muscles – for continence control, for sexual health and for avoiding problems with back pain or even pelvic organ prolapse
In my next blog post we will look at how we can incorporate more dynamic and challenging movements into our pelvic floor training programmes.
See you then!