Great Health Guide - - CONTENTS - Mar­garita Gure­vich

Learn about this di­ag­nos­tic tool in women’s health

Have you ever been told that you need to strengthen your core or your pelvic floor mus­cles? Per­haps you have even tried to en­gage those mus­cles but found the ac­ti­va­tion hard to achieve due to not hav­ing a clear un­der­stand­ing of how to do it. Real Time Ultrasound solves this is­sue by pro­vid­ing in­stant feed­back to en­sure that you are ac­ti­vat­ing the mus­cles cor­rectly. While it is a di­ag­nos­tic tool rather than a treat­ment, im­proved pelvic floor health for women, can help to re­duce back pain, aid in the man­age­ment of in­con­ti­nence and en­sure that you get the most out of your Clin­i­cal Pi­lates pro­gram. The aim of Clin­i­cal Pi­lates is to strengthen the core mus­cles. Many peo­ple, how­ever, find the term ‘core’ a bit am­bigu­ous and strug­gle to achieve cor­rect ac­ti­va­tion. This is where Real Time Ultrasound can make the job much eas­ier.


• You and your phys­io­ther­a­pist can see on the screen how you are en­gag­ing the mus­cles. As phys­io­ther­a­pists we of­ten see pa­tients en­gag­ing not only the core mus­cles (the deep mus­cles of the stom­ach and lower back) but also the su­per­fi­cial ab­dom­i­nal mus­cles. While those mus­cles are also im­por­tant they are not go­ing to help when it comes to core strength­en­ing. • Your phys­io­ther­a­pist can teach you how to iso­late the core mus­cles. This will then be­come the ba­sis of your

Clin­i­cal Pi­lates pro­gram as you will be con­fi­dent that you are switch­ing on those mus­cles cor­rectly dur­ing each ex­er­cise. Your phys­io­ther­a­pist would then re­assess you at reg­u­lar in­ter­vals

to track your progress and up­date your pro­gram ac­cord­ingly. Gen­er­ally, this should be done ev­ery seven weeks, es­pe­cially when you are just start­ing your Clin­i­cal Pi­lates pro­gram. BACK PAIN: REAL TIME ULTRASOUND: • It is im­por­tant that the cor­rect tech­nique is used when it comes to treat­ing back pain. When the core is strong, any load sus­tained while lift­ing, twist­ing or bend­ing will go through the core mus­cles, rather than the spine. It is also manda­tory that the ex­er­cises are cor­rect for you. Once again, Real Time Ultrasound can as­sist with this. By see­ing on the screen how well the mus­cles work, your phys­io­ther­a­pist will know at which level they should work your core.

• Us­ing the 12-point scale as an ex­am­ple, dur­ing the Real Time

Ultrasound as­sess­ment, it may be­come ap­par­ent that your core mus­cle strength and en­durance is on the lower spec­trum and that the mus­cles switch off as you go up the scale. In this case it’s im­por­tant that you are given only low-level core ex­er­cises as dur­ing high level ex­er­cises, the load will start go­ing through the spine, con­se­quently hurt­ing your back. On the sub­se­quent re­assess­ments you should see your core get­ting stronger, at which stage your phys­io­ther­a­pist will ad­just both your Clin­i­cal Pi­lates and home ex­er­cise pro­grams. MAN­AG­ING IN­CON­TI­NENCE: REAL TIME ULTRASOUND: • An ar­ti­cle on the man­age­ment of uri­nary in­con­ti­nence pub­lished in the Amer­i­can Fam­ily Physi­cian showed that: “Blad­der re­train­ing and pelvic floor mus­cle ex­er­cises are first­line treat­ments for per­sons with­out cog­ni­tive im­pair­ment who present with urge in­con­ti­nence… Pelvic floor mus­cle ex­er­cises are con­sid­ered first­line treat­ment for stress in­con­ti­nence”. • To ben­e­fit from the ex­er­cises, how­ever, it’s im­por­tant that you are en­gag­ing the rel­e­vant mus­cles cor­rectly. When it comes to man­ag­ing in­con­ti­nence, the main mus­cles which need to be strength­ened are the core and the pelvic floor mus­cles. As men­tioned above, us­ing Real Time Ultrasound in women’s health, will en­sure cor­rect ac­ti­va­tion of the cor­rect mus­cles and im­prove pelvic floor health for women.

Real Time Ultrasound is an in­dis­pens­able tool for Clin­i­cal Pi­lates, back pain, man­ag­ing in­con­ti­nence and women’s health. Your phys­io­ther­a­pist will tell you how it can help you im­prove your pelvic floor health.

Mar­garita Gure­vich is Se­nior Phys­io­ther­a­pist and uses Clin­i­cal Pi­lates, SCENAR Ther­apy & other ev­i­dence-based tech­niques, in­clud­ing Real Time Ultrasound and McKen­zie Treat­ment. Mar­garita spe­cialises in sports in­juries, women’s health (in­clud­ing in­con­ti­nence) and gas­troin­testi­nal is­sues. Mar­garita may be con­tacted via her web­site.

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