International Women's Day Special

Don't suffer in silence - speak up this International Women's Day!

Let our Women's Health specialists help you with your problems and fears in a comfortable environment. We provide evidence-based solutions for common problems such as:

*Terms & Conditions:

Book an Appointment with Our Women's Health Specialists

Call: 6258 5602 (Camden Medical Centre)

6438 0162 (Raffles)

6443 4591 (East Coast)

6258 5602 (Jurong)

6734 4707 (Novena)

Email: info@physioactive.sg

Pelvic Floor - You Should Be Able to Sneeze!

These muscles are a bit like car tyres. We know over time they wear out but we don’t really want to know… and like tyres they CANNOT be ignored!

Are you at risk? How do you fix it? Leakage can be avoided… here’s how!

Video Credit: On the Couch with Nici

Michelle Lyons Tour Down Under 2018

The PhysioActive team welcomed world-renowned Women's Health lecturer - Michelle Lyons last July as she shared with us her integrative approach right here in Singapore.

In collaboration with Pelvic Floor Exercise, we hosted a two-day Post-natal Rehabilitation course for registered physiotherapists in Singapore.

The course included essential content and delved deeper into the role of physio in preparing women for labour and delivery, and then through recovery and beyond.

It was a jam-packed weekend but the participants certainly had an enriching time learning how to better offer the best possible care for their patients.

Course Content

Planning an international course/conference?

From local sporting events to international tours and conferences, our expertise makes us the team of choice to manage your specific event requirements!

Contact or drop us an email today at info@physioactive.sg to find out more.

The Top 5 Health Myths Every Women Should Know

Too many women suffer needlessly in silence from women’s health conditions. Studies show that they tend to avoid bringing the subject up with their doctors.

In actual fact, there are many highly effective treatments for managing women-specific conditions such as DRAM, incontinence, pelvic girdle pain and pre & post-natal issues. The solutions are often simple, ranging from lifestyle changes and medications to physiotherapy.

Let us debunk the most common myths surrounding women’s health this International Women’s Day. We hope this article will help you to understand more about your body and keep the misconceptions away.

Don’t forget to also share this article with your family and friends to initiate these unspoken conversations – it’s time to talk!

Myth: Urinary incontinence is a normal part of childbearing and aging.

Fact: It is common but it is definitely not normal.

While the occurrence of incontinence is common among mothers and seniors, it must not be regarded as “normal”.

In Singapore, more than 15% of women suffer from stress urinary incontinence. Yet few women are talking about it and adapt by altering their lifestyles so as to avoid embarrassment.

Incontinence is a problem that can be successfully addressed and treated. Once you have made that important first step to get a consultation, you will be well on your way to regaining a more active and confident life!

Myth: Kegels are for everyone.

Fact: Kegels can do more harm than good in certain cases.

These pelvic floor exercises have become very popular but you might want to hold off and consult a professional first.

Kegels can make it worse if you already have an undiagnosed pelvic pain or tight pelvic floor muscles. It is like having pulled your bicep and then doing lots of bicep curls! During labour and delivery, your goal is also to relax the pelvic floor muscles and not to tense it up more.

Myth: Pelvic floor issues will not affect me as I had a C-section.

Fact: Your pelvic floor is not spared even if you had a C-section.

Vaginal delivery may be associated with a two-fold increase in your risk of contracting stress urinary incontinence. However, the weight and pressure of your foetus can trigger pelvic floor disorders regardless of the method of delivery.

Hormonal shifts and anatomical changes can affect your pelvic floor health from the start of your pregnancy. This brings us to the next point.

Myth: Pelvic floor physiotherapy is only for postpartum recovery.

Fact: Pelvic floor physiotherapy can be beneficial for you during pregnancy and postpartum.

Not many women know about this but pelvic floor physiotherapy can be extremely beneficial for pain relief and prevention of any complications that may occur after delivery.

In addition, pelvic floor physiotherapy can also help to ease the delivery process. Together with your physiotherapist, you can learn how to best relax your pelvic floor and review the optimal positions for pushing.

Myth: Postpartum sex will be uncomfortable and there is nothing I can do about it.

Fact: It need not be with some tips and tricks.

If sex feels uncomfortable after childbirth, it can be an indication that something else is going on in your body. Active infection, tight pelvic floor muscles, scar tissue and hormone imbalances can be the cause.

Sex should not be painful and if it is, you should consult a women’s health physiotherapist on returning to sex after pregnancy and childbirth.

Don’t suffer in silence – PhysioActive can help

Let our women’s health specialists help you with your problems and fears in a comfortable environment. We provide evidence-based solutions for common problems such as DRAM, incontinence, pelvic girdle pain and pre & post-natal issues.

Also, don’t miss out on our special discount offered in conjunction with the International Women’s Day!

Book an Appointment with Our Women’s Health Specialists

Call: 6258 5602 (Camden Medical Centre)

Email: info@physioactive.sg

Pelvic Floor Exercises For Women

Top Tips For Strengthening Your Pelvic Floor

The aim of this post is to provide information about pelvic floor exercises for women.

Pelvic Floor Exercises

What are the Pelvic Floor Muscles?

A group of muscles that are attached to the pubic bone at the front of the pelvis and go to the base of the spine at the back.

Theses muscles are very important as if they are working properly they provide support for the pelvic organs. They also help us to control the bladder and bowel. They can increase pleasure during sexual activity.

There are many ways in which these muscles may become weak such as:-

Exercising The Pelvic Floor Muscles

1. Sitting or lying comfortably, concentrate on the pelvic floor muscle. Try to lift and squeeze at the front as if you are trying to stop the passage of urine. At the same time lift and squeeze at the back as if you are stopping the passage of wind. Try not to hold your breath or use muscles such as the buttocks or thighs.

2. Hold this tightening as long as you can (aim to hold for 6-8 seconds ). Rest for the same amount of time.

3. Repeat 3 sets of 8-12 repetitions every day for 5-6 months (Bo 2004).

Try to give yourself a reminder, such as doing them every time you have emptied your bladder or when making a drink.
It is important that you do not stop the flow of urine mid-stream as this can be bad for your bladder.

The ‘Knack’

It is very important that you can work these muscles quickly at times when they are put under strain. Every time that you cough, laugh or sneeze, tighten your pelvic floor. It is also a good idea to tighten these muscles before and while you are doing any activity that may cause you to leak urine, such as lifting.

Helpful Hints

Need further assistance? Please click to find out more about our treatment options for incontinence and pelvic floor disorders, or book an appointment with our specialist team today.

Thanks for reading!

This post has been written by PhysioActive physiotherapist, manual therapist and women’s health specialist, Gail Craig (Grad Dip Phys, MCSP, HPC registered).

Thoughts or questions?

Leave a comment below, say hello on Twitter (@physioactivesg) or visit us on Facebook (facebook.com/physioactivesg).

The Pelvic Floor & The Effects Of Pregnancy

The Pelvic Floor During Pregnancy

Women gain an average of 2 stone (12-13kg) in weight during pregnancy. Therefore, during pregnancy, your muscles have to work harder than usual. Your posture also changes and adapts during pregnancy. Regular post-natal exercises will help to regain your fitness and muscle tone/strength and help you regain your posture.

The pelvis consists of 3 bones and 3 joints, one of these joints is at the front of the pelvis (the symphysis pubis joint) and two are at the back of the pelvis (the right and left sacro-iliac joints). These bones form a protective basin for your bladder, womb and bowel. The spine consists of many small bones (vertebrae). The joints of the spine and pelvis are supported by ligaments and muscles, which provide stability and allow you to maintain a good posture.

Hormonal changes during pregnancy results in laxity of the ligaments and during this time your joints can become less stable. This can result in aches and pains in your back and/or pelvis, during, and for some time after pregnancy. The changes in your posture during pregnancy may also place further strain on your back.

Effects Of Pregnancy & Delivery On Bladder Function

For the pelvic floor, delivery is probably the most “stressful” period in a woman’s lifetime. However very little is known about the relationship between delivery, pelvic floor changes and stress urinary incontinence (SUI). It is widely recognized that stress urinary incontinence may be a consequence of pregnancy/delivery and that pregnancy usually worsens any pre-existing SUI (Hojberg et al 1999).

According to Koebel et al (2002), vaginal delivery might lead to Stress Urinary Incontinence (SUI) via four major mechanisms:

  1. Injury to “connective tissue supports” by the mechanical process of vaginal delivery.
  2. Vascular damage to the pelvic structures as a result of compression by the presenting part of the foetus during labour.
  3. Damage to the pelvic nerves and /or muscles from trauma during the birthing process.
  4. Direct injury to the urinary tract during labour and delivery.

Pelvic floor muscle strength decreases immediately after delivery. For some mothers it returns to within the normal range a few weeks after delivery (Peschers et al 1997), for other mothers there is persistent weakness (Dumoulin et al 2004).

Incontinence seems to be linked to several things:

Helpful Incontinence & Pelvic Floor Hints

Women tend to have a peak of progesterone mid-cycle. If you have some incontinence you may find that you leak a bit more at this time in your cycle, as the muscles will be a bit weaker.

Learn “The Knack”

Pelvic floor exercises are very important during pregnancy and after giving birth. You can exercise these muscles to regain their strength by doing regular 'invisible' exercises.

Strengthen Your Pelvic Floor Muscles During & After Pregnancy

The floor of your pelvis is formed by very elastic muscles, which act like a small trampoline to support your baby during pregnancy. These muscles also support the bladder, uterus and bowel. Pregnancy and childbirth put pressure on the pelvic floor, and it is common for many women to experience that they lose a few drops of urine when sneezing or coughing - this is called 'stress urinary incontinence' (SUI). Many women have this problem during pregnancy and/or after delivery.

Female Anatomy

How To Do Pelvic Floor Exercises

• Sit with your knees apart
• Don’t hold your breath
• Don’t clench your buttocks

Tighten your back passage as if you were trying to stop passing wind. Now tighten the muscles you would use to stop a flow of urine. Do both together and you should feel your back passage, vagina and front passage all lift and close at the same time. Now you know what to do, you can do this exercise while standing, sitting or lying down.

Each day you need to do:

Slow exercises – tighten, hold (aim for up to 10 seconds) and relax, repeat 10 times.
Fast exercises – tighten and relax quickly. Repeat up to 10 times.
How often? – Always do a mixture of fast and slow exercises while seated on the toilet after you have emptied your bladder. Make this a lifetime habit. You can exercise in the shower, as you wash your hands, while ironing, etc.

Protect your pelvic floor: Make a habit now of always pulling up your pelvic floor before you lift, carry, push or pull light to moderate weights.

When you laugh, cough, lift or sneeze tighten your pelvic floor!

All information is based on up-to-date evidence based clinical practice.

The Chartered Society of Physiotherapy (UK) Association of Chartered Physiotherapists in Women’s Health.
The American College of Obstetricians and Gynaecologists (ACOG). Evidence Based Physical Therapy for the Pelvic Floor. Kari Bo, Bary Berghmans, Siv Morkved, Marijke Van Kampen. Koebel et al (2002).

Thanks for reading!

This post has been written by PhysioActive physiotherapist, manual therapist and women’s health specialist, Gail Craig (Grad Dip Phys, MCSP, HPC registered).

Thoughts or questions?

Leave a comment below, say hello on Twitter (@physioactivesg) or visit us on Facebook (facebook.com/physioactivesg).

Returning To Sex After Pregnancy & Birth

Top Tips For Sex After Birth & Pregnancy

Returning to sexual intercourse after giving birth often creates a lot of anxiety for many woman. Your baby is up often during the night meaning you are exhausted, your body hasn’t returned to it’s pre-pregnancy state and either you might have had some perineal stitches from a vaginal birth or abdominal stitches from a caesarian.

It is completely normal to feel apprehensive about returning to sexual intercourse so here are a few pointers to help combat those nerves:

Here at PhysioActive we offer a range of women's health services, from pre- and post-natal care to treatment for incontinence and pelvic floor disorders. Please get in touch and book an appointment today if you feel we can help.

Thanks for reading!

This post has been written by PhysioActive physiotherapist and women's health specialist, Tamara Gerdis (Physiotherapist B.Sc, Women’s Health).

Thoughts or questions?

Leave a comment below, say hello on Twitter (@physioactivesg) or visit us on Facebook (facebook.com/physioactivesg).

Tamara Gerdis Joins The Team

Here at PhysioActive we are pleased to announce the addition of Tamara Gerdis (Physiotherapist B.Sc, Women's Health) to our dedicated Women's Health team.

Tamara graduated with a Bachelor of Science Physiotherapy Degree from the University of Cape Town, South Africa, in 1999. After working as a general physiotherapist for the NHS in London for over 3 years, Tamara began her specialisation in women’s health physiotherapy when she moved to Sydney, Australia in 2004.

She began working at The Royal Hospital for Women, which is a specialist mother and baby teaching hospital with 4000 births per year. There, Tamara worked on the postnatal, antenatal, gynaecology, oncology wards and the outpatient department.

After moving to Singapore with her husband and 2 young children at the end of 2011, Tamara furthered her studies by completing her Graduate Certificate in Continence and Women's Health Physiotherapy through the Curtin University in Perth, Australia.

This has given Tamara a unique set of skills, specific to women’s health and continence conditions. Tamara is registered with the physiotherapy councils in Australia, the UK, South Africa and Singapore.

Tamara enjoys, cooking, reading, and spending time with her family.

Stay tuned for Tamara's valuable contributions to our blog, starting off with an informative post on the topic of 'Returning To Sexual Intercourse After Pregnancy & Birth'.

Preparing Your Body For Pregnancy- The Benefits Of Pre and Post-Natal Classes For You & Your Baby

Women gain an average of 2 stone (12-13kg) in weight during pregnancy. Your muscles and posture are affected during pregnancy and for several months after giving birth. Specific pre and post-natal classes and exercises will help you to prepare for giving birth and will also help you to regain your muscle tone/strength and fitness levels after delivery.

Exercise helps:

• To strengthen your pelvic floor
• Avoid constipation
• To reduce low back pain
• You cope with fatigue
• To prevent varicose veins
• Improve circulation

Another benefit of attending pre and post-natal classes is that it gives you a chance to meet other new mums, which is a good way to make new friends and share experiences.

Taking care when exercising:

Anything that puts strain on your joints or ligaments, such as high impact aerobics, difficult yoga positions or jogging on the road should be done more gently when you are pregnant and for several months after giving birth due to on-going hormonal changes.

Enjoyable activities:

Brisk walking, swimming, cycling and gentle toning and stretching classes are beneficial before and after pregnancy.

Your abdominal muscles - “Natures perfect corset”:

You have 4 pairs of muscles arranged in 4 layers. From the most superficial to the deepest these muscles are:

• The rectus abdominis muscles run vertically up and down the centre of your tummy
• The external oblique muscles crisscross diagonally on your sides
• The internal oblique muscles crisscross diagonally on your sides
• The transversus abdominis muscles are the deepest horizontal muscles encircling your waist

These muscles work together to firmly support your spine, tilt your pelvis upward and to pull your tummy tight. These muscles bend and twist your spine.

Muscle Layers of the Abdomen:

Rectus Abdominis

• Rectus abdominis
• External oblique
• Internal oblique
• Transverse abdominis

The Rectus Abdominis

Also known as the "six pack", the rectus abdominis runs vertically from the sternum (breast bone) to pubic bone (the front of the pelvis). The function of this muscle is to flex the spine (bend the spine forwards). Exercises, such as crunches flex the upper spine, which moves the ribcage closer to pelvis. Pelvic tilts and reverse rolls, flex the lower spine, which moves the pelvis closer to the ribcage. A narrow band of connective tissue (the linea alba) runs down the body's midline between the rectus abdominis.

During pregnancy, the linea alba widens and becomes thinner in response to hormonal effects and the growth of the expanding uterus.

Abdominal separation, (diastasis recti abdominis muscle DRAM) is a fairly common occurrence during the latter part of pregnancy and the postpartum period. It causes the right and left sides of the rectus abdominis to separate along the linea alba.

The External Oblique and Internal Oblique

External & Internal Oblique

The external oblique is the most exterior layer of the abdominal wall and runs diagonally from the ribs toward the midline. The internal oblique lies underneath the external oblique and has diagonal fibres that run in the opposite direction. Together, they form an X shape across your torso. You can think of the top half of the X as the external oblique and the bottom half of the X as the internal oblique. These two muscles always work together and perform lateral spine flexion (side bends) and assist in spine rotation.

The Transverse Abdominis

Transverse Abdominis

The deepest layer of the abdominal wall, and the most important in postnatal exercise, is the transverse abdominis. Its fibres run across the abdomen and perform abdominal compression, which draws the belly inward, and narrows the waist. Fitness trainers refer to this muscle as the body's "internal girdle.

Pre and Post-Natal classes will also include instruction on:

1. Pelvic floor exercises
2. Specific exercises for your abdominals
3. Specific exercises for your legs and upper body strengthening
4. Posture and exercises using the Swiss ball
5. Some cario work
6. Relaxation

Come along to our Pre-Natal classes to ensure that you are fit and ready to give birth.

Return to our Post-Natal classes to help your body regain your muscle tone/strength and fitness levels after delivery.

All information in this leaflet is based on up-to-date evidence based clinical practice. Information was obtained from:
The Chartered Society of Physiotherapy (UK) Association of Chartered Physiotherapists in Women’s Health.
The American College of Obstetricians and Gynaecologists (ACOG)

Thanks for reading!

This article has been written by Gail Craig, Grad Dip Phys, MCSP, Physiotherapist & Manual/Spinal Therapist

<strong?Thoughts of questions?

Leave a comment below, say hello on Twitter (@physioactivesg) or visit us on Facebook (facebook.com/physioactivesg).