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World Continence Awareness Week: Its all about the supervision of pelvic floor exercises!

16 June, 2019

If you follow my blog, you have heard the sad tale about me making the hard decision to close my pelvic floor inspired exercise studio (at Gladstone Road, Highgate Hill) at the end of 2018. This came about because in November 2017, there was a decree from the Australian Government that a number of complementary medicine categories would no longer be able to be covered by the Private Health Insurance companies. This is what the Government had decided as part of the linked advice above.

“Rules will be made to remove natural therapies from the definition of general treatment under section 121-10 of the Private Health Insurance Act 2007. Insurers will then not be able to offer benefits for these therapies as part of a complying health insurance policy.”

Three of these natural therapies included Pilates, Yoga and Tai Chi. There are many others but when I wrote the blog about this change, I was mostly addressing the restriction on Pilates. I wish to address this change again because I have just returned from a wonderfully inspiring weekend conference run by one of our leading Pelvic Health Educators, Taryn Hallum, updating the most recent research in all things Pelvic Health and some of the evidence has again got me all worked up about the changes implemented in just April 2019.

Jane Cannan, one of our Pelvic Health Physios

Pilates is one form of exercise. It is a name that the general public was familiar with and many physiotherapists had clinics with Pilates within the name of their practice, as they offered classes as an opportunity for patients to progress beyond just individual treatment. The word Pilates (named after Joseph Pilates who described the series of exercises) has a high recognition factor with the general public, who associate Pilates with strengthening exercises; understand that it helps with balance and coordination and that it is synonymous with perhaps posture, guided movements and set recognized exercises.

This dramatic decree from the government was quite incredible coming at a time when the slogan #exerciseismedicine was trending on Twitter and Instagram and that research was popping up everywhere saying exercise was the answer to most medical ailments!

And this dramatic decree was the nail in the coffin for my studio at Gladstone Road, Highgate Hill.

My studio was my dream – the opportunity to have a place where patients with pelvic floor ‘needs’ – maybe prolapse, urinary or faecal incontinence or pelvic pain – all things that can stop a conversation should one raise it over drinks at the bar in mixed company (in fact topics that are the focus of World Continence Awareness Week) could go and be supervised with their exercising and have their pelvic floor as the focus. The studio was definitely a wonderful add-on for our practice which is predominantly pelvic health-focused and one for which I had yearned for years.

I loved my studio. And that decree killed my dream. (Well until I created a small space at my rooms in Hampstead Road because my patients demanded we do something as they missed it so much.) The health funds would pay an amount towards the classes and this small subsidy would help the patients be able to afford to come regularly to the studio to exercise.

I really couldn’t understand the logic behind this decision.

Exercise is good for preventative health reasons. Bone density. Obesity. Diabetes. The Heart. The Lungs. The Brain. The Pelvic Floors (especially the pelvic floor). Really all the bits of our body are helped with exercise (but especially the pelvic floor and wait and see at the end of this blog about the evidence for supervision of pelvic floor muscle training in a class setting). Do government decision-makers not read Instagram or the Readers Digest? Of course the real medical literature is full of articles proclaiming the Wonder of Exercise, but I don’t expect public servants or the health department or the Health Minister to be all over research articles. But I would have thought some of them may have had a woman in their lives that loves their exercise. You see gyms, Pilates studios, yoga classes are all dominated by women. Women predominantly attend these health-promoting venues because they have read about the wondrous things that happen when you exercise.

Our yoga was loves at the studio

But what stirred up this hornet’s nest of annoyance again this weekend of learning and updating was the number of recent research papers that show that supervised training of the pelvic floor in classes and group sessions is better than assessing and teaching pelvic floor muscle training to a woman and then sending them home to do a home exercise programme. It appears that women need the supervision, the motivation, the inspiration, the dedication that a pelvic health physio supervised class gives them. Needless to say we will be looking at ways to increase the opportunity for women to attend more sessions in our Hampstead Road exercise space and ways to prompt them more in their home programme.

Now the good news is that very soon after the April introduction of this new decree – and after some dedicated lobbying from our professional organisation The Australian Physiotherapy Association– the Health Minister Greg Hunt reversed the decision as long as the P word is not mentioned – P doesn’t stand for preventative even though any exercise is preventative for so many things. P doesn’t stand for P*ssed off even though there’s a stack of physios, Pilates instructors and women who love their Pilates and have seen drastic declines in their numbers attending, who definitely are. P stands for Pilates – yes the actual word Pilates cannot be mentioned in any advertising, signage or handouts. And of course it must be a physio who is supervising the classes. There is unfortunately still one health fund who has refused to follow the decision of the health minister.

Enough whinging. Now the important message.

It’s World Continence Awareness Week. Ladies – do your pelvic floor exercises. Be motivated, be enthusiastic. Be regular in the initial phase and then integrate them into an exercise routine if you can. Make it count.

And what is your reward you ask?

Compared with no treatment or inactive control treatments, women with Stress Urinary Incontinence (SUI) who were in the Pelvic Floor Muscle Training (PFMT) groups were 6 times more likely to report being cured or improved. PFMT 72% Placebo/Control 11.4% (Doumoulin et al 2018)

The success rate for PFMT for SUI varies between 60-75% when performed in the outpatient setting under the supervision of a physiotherapist. (Fitz et al 2017).

In this World Continence Awareness Week, get yourself off to your nearest Pelvic Health Physio and be assessed and get in-training!

And below is our class space at Hampstead Rd with room for four people to the class. Ring (07) 38489601 if you want to try a one-on-one or group session.

 

Also for those ladies who used to come to dance, we are still doing dance every Thursday at 4pm at 194 Gladstone Road, Highgate Hill with Ash King. Again ring if you want to book in.

The thing I miss most about my little studio was it created a community – bureaucracy will never understand community though. 😦

The definition of Community: Our lovely dance ladies -we still congregate and chat, laugh and dance every Thursday at 4pm 

 

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