Our practitioners at Fertile Ground Health Group communicate regularly with many medical and allied health specialists for the shared care of patients and to ensure that the best outcomes are achieved. This collaborative approach has enabled us to get to know some fabulous specialists and we thought you might like to meet the “special” in your Specialist too!
In our second interview of the “Meet the special in your Specialist” series, we caught up with Libby Oldfield and Gen McGlashan, co-directors of Fitwise Physiotherapy whose practice is on level 4 of our building! We have been collaborating, referring and sharing patients with these two fabulous practitioners for the last 15 years and are so pleased to share with you more about their work and specifically, more about their speciality in pelvic health and continence.
What do you love about your work as a physiotherapist?
We love the interaction with our clients and the community we have, and the privilege of being a trusted part of the process of helping them to achieve their goals. Having the opportunity to work with amazing women and men, whatever age they are; enabling them to enjoy their lives fully – this is the reason we love what we do.
You specialise in pregnancy, post-natal and pelvic health. What inspired you to focus on these specialities?
We are 2 of 8 specialist women’s health physiotherapists in Australia. Women have many unique issues related to their bodies, hormones and the amazing capacity we make, grow and nurture a baby. Often a lot of issues that arise during our child bearing years have been dismissed as “minor discomforts of pregnancy’, however they don’t feel minor when they are happening to you! It is wonderful to have a growing body of research and evidence to be able to diagnose and manage these issues well.
This area of physiotherapy is very rewarding as there is the opportunity make big changes to people’s quality of life, and it is a wonderful population of clients to work with – often at very exciting or challenging times in their lives.
What kinds of ways can you help during pregnancy?
Pregnancy takes quite a mechanical toll on our bodies. Our pelvic floor has to hold an extra 12.5 kg on average, so this places stress on our bladder and bowel. The pregnancy hormones affect all our bones, muscles and joints so can lead to musculoskeletal problems and/or pain. Thorough assessment, manual therapy if appropriate, and correct and appropriate exercise are all part of an individualised management program for each of our pregnant clients. There are very many things that can be done to help you during your pregnancy –you just have to ask for help!
Post- natal? Having delivered a baby, our bodies need to revert to not being pregnant, restore our tissues to a non-pregnant state and allow us to achieve our fitness and exercise goals safely. We love helping a new mother recover and rehabilitate her body. Exercise has lots of research now to show that it has makes a significant positive difference to our physical and mental health. You need to be fit to be a mum, and the right exercise at the right time can make all the difference.
Pelvic health? Being female and being pregnant for the first time are the 2 biggest risk factors for pelvic floor and continence problems –however there is excellent evidence to show that being proactive and exercising your pelvic floor the right way during pregnancy can reduce your risk of issues after you have had your baby.
Pelvic health issues are not just restricted to women who are pregnant or have had a baby. Many women and men suffer from pelvic floor related issues that may effect their bladder or bowel function, and/or result in pain, and prevent them form enjoying the activities they would like to be doing. Men undergoing prostate surgery benefit from pelvic floor physiotherapy both pre and post operatively.
Continence and pelvic floor problems can be a sensitive topic for people to address. What reassuring tips can you offer for people experiencing difficulties with their pelvic health?
Continence and pelvic floor related problems can feel embarrassing to talk about, and often people feel like they are the only one with this problem. Pelvic pain, and pain or difficulty with intercourse are also common problems that we see frequently. You can be reassured that your physiotherapist is very confortable discussing all of these issues, and this is always done sensitively.
It is also often assumed that bladder or bowel leakage is normal after having had a baby. It is common, but not normal! The good news is that there is good evidence for pelvic floor rehabilitation following childbirth – vaginal or caesarean – pelvic floor problems are not just limited to vaginal deliveries.
Pelvic floor issues also include pelvic organ prolapse, too many trips to the toilet each day, or sudden strong urges to empty your bladder. Many of these problems are easily sorted with the correct assessment, diagnosis and treatment. It is important to have a post natal check-up, establish any history of your problems, and get a baseline for your pelvic floor function. You can then manage any issues you may have and discuss appropriate and SAFE exercise for each stage of your life.
Our Sporting Pelvic Floor clinic is designed to focus on goals of returning to sport and good pelvic floor function during sport, (from social to elite), and can provide pelvic floor rehabilitation at a higher level of to cope with the increased challenges this demands.
Can you share with us what’s involved with a pelvic floor examination and treatment?
A pelvic floor assessment and treatment involves listening to your story, taking a detailed history, finding out what’s normal for you in terms of bladder and bowel function, experience of pain, heaviness in the pelvis etc. With your consent, your physiotherapist would then assess your pelvic floor function. There are several ways this can be done, with different levels of information gained from each. We can use a Real Time Ultra Sound machine, which involves putting a probe with gel against your lower tummy. This shows us pictures of your bladder and we can see if your pelvic floor muscles can lift it. This assessment doesn’t tell us how good your pelvic floor is, but will give us an indication of whether you have the right action when you contract your pelvic floor. Another more thorough method of assessment is a vaginal examination. This allows us to assess the quality of your pelvic floor muscles, and to actually feel the muscles work, test their strength, endurance and timing. These options are discussed with you and the various pros and cons for you, and then you choose how you would like to be assessed if at all.
You help people improve their fitness at any life-stage, including pregnancy, motherhood and beyond. What services do you offer for this?
We offer individual assessments and exercise programs, as well as fully supervised individual or small group sessions in our clinical Pilates studio. We are happy to work in with your personal trainers with advice around exercise programming for you. We are also happy to write individual exercise programs for you to do at home or in your gym.
Onsite classes we offer are :
- fitness reformer pilates at our Armadale studio,
- P40 (a pre and post natal cardio- circuit class) at both practices.
- therapeutic yoga for all women
- Strengthwise classes for bone health and general fitness for older women
You have a birth preparation service called “Birthwise”- can you tell us about that?
Birthwise is a one-hour session that adds to your active birth preparation by personalising your goals and plans for birth. This session is done privately as an individual or couple with the physiotherapist, who teaches you to find coping skills from a physical view, breathing, positioning, touch, movement, TENS and effective pushing – all to help you manage the active parts of labour
What services do you offer that are specific to children?
Our Children’s Continence Clinic helps with children’s continence, bladder and bowel problems. Toilet training, bed-wetting, and constipation are common issues dealt with in the clinic.
How can people contact you if they would like to use your services?
People can ring the practice directly, or check out our website. This contains lots of information as well. Look at our Ebook section where a lot of these topics are covered in detail. Booking can be done online via the website www.fitwise.com.au . We are also on Instagram and Facebook
Any other comments you would like to make?
Fitwise offers holistic, client centred care. We help you achieve your goals. We are a group of highly trained, experienced physios headed by 2 of Australia’s specialists and pride ourselves on excellent, expert care.