COVID19: we are now offering telehealth consultations!

It is crucial for Physio Borealis to continue supporting women through their pregnancy and postnatal journey despite the COVID19 outbreak.

In a time where you need support more than ever to maintain a healthy pregnancy or heal after Baby, social distancing can feel extremely stressful due to the lack of access to health care resources.

By providing our clients with the telehealth option, we will ensure to support them via recommendations for symptoms management, education and sharing appropriate resources.

PRENATAL TELEHEALTH CONSULTATION
Get recommendations about symptoms management such as:

  • Urine leakage
  • Vaginal heaviness
  • Constipation, hemorrhoids
  • Back, pelvic or hip pain
  • Diastasis recti / abdominal separation

Receive education about how to best prepare your body for birth:

  • Which core and pelvic floor exercises to do during pregnancy?
  • How to stretch your perineum to decrease risk of tearing and pain during the pushing stage?
  • Best positions to protect your pelvic floor during pushing?
  • Things that can help to decrease pain during labour?
  • How to push safely and effectively?

POSTNATAL TELEHEALTH CONSULTATION

Get recommendations about symptoms management such as

  • Urine leakage
  • Bowel issues / constipation management
  • Vaginal heaviness / prolapse
  • Back, pelvic or hip pain
  • Diastasis recti / abdominal separation
  • Vaginal tear & painful sex
  • Csection scar sensitivity / massage techniques

Get an early start on your recovery

  • Which core and pelvic floor exercises to do?
  • How to heal your diastasis recti / abdominal separation?
  • How to safely return to activities post partum?

Learn about resources to help your post partum journey

  • Referrals to health care providers who offer online services (ex: lactation/sleep consultants, naturopaths, etc…)

ONLINE FOLLOW UP (available for all of our clients)

Check in with me about

  • How to progress your home exercise program
  • How to manage your symptoms

WHAT MATERIAL DO I NEED FOR A TELEHEALTH SESSION?
A desktop computer with a camera and microphone
An internet connection of 15 Mbps or more (check out your internet speed at fast.com)
Firefox or Chrome browser

HOW DOES IT WORK?
1. Book your Telehealth session through my online booking system
2. You will receive a confirmation email with a link to access your video call
3. At the time of your appointment, click on the link and log into your account.
4. That’s it! Your video session will start 🙂

More info about the process can be found here

IS TELEHEALTH COVERED BY INSURANCE?

We encourage you to contact your insurance provider and ask them if they cover telehealth physiotherapy services.

A communicate released last week by the BC College of Physiotherapy has listed a few insurance providers and their response as to whether or not they cover telehealth physiotherapy services (see p.3)

However, in light of the situation constantly evolving, we still recommend to double check with your insurer prior to booking.

Self-massage with balls during & after pregnancy

Low back, hip & pelvic pain during & after pregnancy can restrict mobility and limit moms in their daily activities. Having some self-management techniques to alleviate the pain can be a life saver for a better sleep, improved mobility & remaining active.

How about using massage balls for self-treatment? You can do it anywhere, anytime, for as long as you want! Isn’t it the best?

WHO IS THIS FOR?

  • Pregnant or post partum women who experience low back, hip, sacrum or pelvic pain (**an assessment by a pelvic health PT is highly recommended prior to do these techniques, to make sure they are appropriate for you**)
  • Pregnant women who are closer to labour (>36 weeks) and want to improve their pelvic mobility in order to ease labour and birth
  • Pregnant women in labour who want to reduce pain during the contractions

First watch the warm-up video to help your tissues get in the mood and ease into the release. Then, move on to the next video for more in depth massage techniques.

**The Yoga Tune up massage balls are available at my clinic for purchase, or online :)**

2 self-release techniques for your guts!

If you have abdominal discomfort from bloating or constipation,
this video for you!

Or if you came to see me and I mentioned that you had tension around your intestines, this video is for you too! 

Here below is a video with two techniques you can do at home to release your small intestine and colon.
This is a quite powerful health tool that you can use for yourself or your kids to help with digestion!

Why do we have tensions in our guts? 
Stress, intense core workouts, habit of clenching the belly to “look flat”, poor diet, and trauma (ex: car accident, falls) can all lead to tensions in the fascias and connective tissues around our guts.

Why is it bad to have tensions in our intestines? 
It can lead to many problems, including:
– Decreased flow and mobility in the digestive system, leading to bloating/constipation and discomfort along the digestive track in some cases

– Increasing pressure on the pelvic organs such as the bladder, uterine and rectum, and can lead to urine leakage, urinary urgency, painful menses

How to prevent tensions to build up in my guts? 
By…
– Decreasing your stress level as much as possible
– Having a healthy diet that includes adequate fibre & water intake
– Avoiding to clench your core to look like you have a “flat belly” through your daily activities- let it go instead, let it breath 🙂
– Once in awhile, massaging your intestine with the techniques demonstrated in my video to keep things moving!

Top 3 tips for hemorrhoids & anal fissures

(If you rather watch my video summarizing these things, click link above!)

Hemorrhoids and anal fissures are a real pain in the butt to deal with. And when you just gave birth and you have a newborn to take care of, the last thing you want is to cry out of pain on the toilet every time you have a bowel movement. So let’s make things easier for you mammas.

First, you may have hemorrhoids or anal fissures, or the whole package deal (both).

What is the difference between hemorrhoids and anal fissures?

Hemorrhoids are basically swollen veins that are bulging out of the rectum lining. They can be located internally (inside the rectum) and/or externally (outside of the anus). Some people have them and are not symptomatic (inactive hemorrhoids). A flared-up or active hemorrhoid is normally caused by recent increased of pressure in the pelvic area. For example, childbirth, pregnancy and severe constipation are common causes.

An anal fissure is a small cut in the lining of the anus. It can be caused by childbirth, constipation, straining, passing large stool, and anal sex.

What are the symptoms? 

Both hemorrhoids and anal fissures can present the following symptoms:

  • Pain with bowel movement often describes as if “you were passing sharp glass through your rectum”
  • Blood on the toilet paper after bowel movement

If you do not have these symptoms but you have had them in the past, that means that your condition is under control (hemorrhoids are not active, or fissure is healed). That’s awesome!!! Keep it that way by following tips #1 et #3 below 🙂

What to do? 

#1 Keep your stool soft! 

The first thing to look at is the quality of your stool. Keep it as soft as you can – you do not want a hard stool to go through these painful spots, believe me! Target a #4 type stool on the Bristol Stool chart, like a snake or a soft sausage. Drink plenty of water and check your fibre intake – if you need more info, read my blog post about bowel health.

#2 Decrease inflammation 

My number one to achieve this is a very natural way to decrease swelling: good ol’ ice! But how do you ice your butt hole? Using this wonderful device called the ANUREX which you keep in your freezer. It literally saves lives (according to my clients…!) – the best investment you will ever make to sooth the area. It comes with a little bottle of lube that you can put around it to make insertion easier. You basically insert the anurex in your rectum for a few minutes to help decreasing pain and swelling. I recommend using it 2-3x/day when things are flared-up.

There are other ways to decrease inflammation such as using topical prescription drugs. Some of my clients found lots of relief in Proctofoam which is a numbing foam with cortisone. It is used with an applicator that you gently insert in the anus. Ask your doctor 🙂

The other thing you should consider to decrease inflammation and pressure is to sit on a donut cushion (a cushion with a hole in the middle). This way, your anus will be free of pressure and it will be better for the healing process. You can find those cushions pretty much anywhere in health care stores or even Walmart.

#3 Squat to poo!

I cannot put more emphasis on the importance of the squat position during bowel movement!! I told you about it in my post about bowel health, and this was more as a preventative recommendation. But here my friends, I am telling you: you don’t have the choice anymore!! You need to get a Squatty Potty!!! Squatting during bowel movement relaxes the tension from your pelvic floor muscles around the rectum, and makes it easier to release stool without straining. Since avoiding to strain is huge in healing hemorrhoids and anal fissures, you really want to put all the chances on your side. The Squatty Potty is available at Canadian Tire (in the bathroom items aisle) or you can also purchase it online. Or else you use whatever you have at home to elevate your feet while you poop – however make sure it is high enough so your knees are higher than your hips!

 

I followed all these tips but I am still struggling….

OK – do not panic. You are not a lost cause, there are still a few things you could consider. First, go see a Pelvic Health PT to see if there is any tension in your pelvic floor that could make your stool more difficult to pass, thus restricting the healing of your condition. I learned a super powerful technique at the Institute for Birth Healing called the “anal sphincter release” and it has been working like a charm to reduce tensions around the anus and make more space for the stool to go through. It is a super gentle technique to relax the anal sphincter.

The last resort option is to consult your doctor and see if you would be a candidate for surgery. I would not recommend this option if your symptoms are still recent (<3 months), and you have not tried all of the above. Hemorrhoids can be removed through different procedures. But they are only removed if they are causing extreme pain and difficulty with bowel movement (that means – they won’t remove them for aesthetic reasons just because you don’t “like how they look” – anyway I swear you do not want to go through this surgery if you do not have symptoms, because the recovery is quite painful!)

 

I hope this gives you a few tools to manage your symptoms.

Sophie

Tips for a peaceful bladder during the holiday travels

The holiday travels can be a source of anxiety for folks who experience bladder control issues. Long travels, flights, airports, being in places where you don’t know the location of the bathrooms, can indeed make things stressful. 

Here are a few tips to go through the holiday travels with a bladder at peace!

#1 – Avoid bladder irritants before and during your travel time

Coffee, tea, alcohol, carbonated drinks, acidic, spicy & sugary food can all be triggers for those who experience bladder urgency & incontinence. Avoiding them the day before and during your travel time may just be what you need to keep yourself out of trouble.

#2 – Keep the bowels moving

I know this can be a challenge when you are away from home and you eat things that you don’t normally eat, drink more alcohol than usual, perhaps eat less fruits and veggies than what you are used to. But remind yourself that constipation is one of the #1 causes of pelvic disorders. When your rectum is full, it can press on your bladder and cause urinary urgency and incontinence. Straining on the toilet can also worsen a prolapse, so you really want to keep things moving while you are away and don’t let it go too long.

One good way to manage it is to carry dried fruits with you so you get your fibre intake, as well as a water bottle to keep those fibres wet & moving along the intestinal track. Fibre supplement caps such as Metamucil can also be a good way to get your fibre intake without carrying too much food on you. However, be aware that increasing your fibre intake without increasing your water intake at the same time can actually make your constipation worse by bulking your stool too much! So make sure that both water & fibre intake go hand in hand! 

If you have not had a bowel movement for more than 2 days, try my intestinal massage to get things started.

#3 Select an aisle seat if possible

There is no point in stressing yourself out while travelling on the plane by having a window seat and not being able to access the bathroom on time if you need to. Sometimes, paying the extra few bucks and buy some peace of mind is the way to go, this way you don’t end up having to wake your neighbours up every time you have to use the washroom. One less thing to worry about!

#4 Exception to “no just in case” rule

I know I have told you in the past that going to the bathroom “just in case” is not a good strategy to work on your bladder capacity. However, when it comes to air travel where you may have to wait in line for security or other things, you can make exception to the rule. This is not the time to work on bladder capacity that day, you can work on it while you are in a more familiar environment. Emptying your bladder before security & boarding could be a good solution to avoid distress associated with bladder urgency while you are waiting in line and cannot use the washroom.

#5 Wear protection in case

There is nothing worse than feeling uncomfortable from urine leakage in your underwear and pants, especially in public when you can’t change right away. Wearing a liner or incontinence pad during your travels can be a good way to keep your mind at peace, knowing that you have protection just in case, and that you can change it if you have an accident. I highly discourage you from using menstrual pads for that purpose, as they do not breath well and may create some irritation around the vulva. Go for pads that are specifically made for incontinence (ex: Poise) and will be much more comfortable for you. Carry a few in your purse in case you need to change them over the course of the day, and maybe a change of underwear as well.

#6 Urgency: stop, breath, distract, kegels

If you are on the plane and have sudden bladder urgency but there is a line up to the bathroom, use the “stop and breath” technique. As you are waiting, try to distract yourself from your bladder by bringing your attention to your breath, and count up to 10 nice breaths in & out, feeling the air coming in through the nose, out through the mouth.

You can also use mental distraction: counting backward from 1000, mentally listing the American states, find the names of all the people you know whose names start with an “A”, or whichever silly task you may find. You can download games on your phone before taking off which you can use for distraction during the bathroom line up. The less you think of your bladder, the more control you will regain over the urgency. Your bladder literally feeds on your thoughts, it WANTS YOU to think of it. Do not let your bladder control your mind!

You can also do a few kegels (pelvic floor contraction / release) to distract yourself from the sensation of your bladder. Squeeze for a few seconds, release, squeeze, release… Do this 5-10 times. Normally, the urgency will decrease as you do this.

#7 Trust yourself

In a new environment, this is so easy to lose your confidence in your bladder control, as you may not know where the bathrooms are. Reminding yourself that there is a huge psychological component to bladder control, and the more thoughts you put into your bladder or are worried about it, the more you are giving material for your bladder to feed on and take control over your mind.

Finding a positive and empowering mantra that you can repeat mentally when you feel about to lose control may be a great way to work around this. Something around the lines of:

“I am calm, in control, and I know I can do this.”

Close your eyes and try to picture yourself in an environment that is familiar to you where you would be in control (ex: in your own house). Or picture yourself on the beach, on the top of a mountain, or any environment that brings calm & quiet into your mind. Take 10 breaths here.

 

Alright – that’s it for my little tips!!! I know you can do this!! 

Happy holidays everyone and see you back in January 🙂 

Sophie

Vaginal scar tissue: 3 techniques to release it

Vaginal tears from childbirth can heal in different ways, and many people are not aware that sometimes they need a little help in the healing process. In fact, vaginal scar tissue can often heal “tight” and not super flexible, and can cause pain with sex.

If this is your case, these techniques can help with releasing the scar tissue and make it softer. I recommend doing them every day or other day until there is no discomfort anymore with any of the techniques and that sex feels comfortable.

Painful sex: how to use vaginal dilators to stretch your vagina

There is this myth going around in our society that it is “good to have a tight vagina” – but good for who exactly?! I’m asking you.

What if I was telling you that most of my clients consulting for painful sex issues present, in fact, a tight vagina, and it sure makes their sex life not pleasurable at all! Is that good? It sure ain’t.

There is a difference between having a healthy muscle tone in your vagina so you can have good sensation during sex, versus having a high tone and tight pelvic floor. Hypertonic pelvic floors are NEVER good and healthy – they can cause pain, incontinence, overactive bladders and so on. We want those tissues to breath, to allow stretch, to be dynamic, to move!

BUT HEY – that was not the point of my post actually. I wanted to tell you that if you feel like your vagina is so tight that penetration feels like sandpaper in your lady bits or like trying to fit a banana in a toothpaste tube, this video is for you.

This is for you, post partum mom who had vaginal tearing or episiotomy, or simply a challenging healing time, and now feels like sex is no longer the same and that there is not enough space down there.

This is for you, menopausal women who had no sex for years and just met a new partner, and discovers the sad reality of “use it or lose it”. Indeed, after a certain age, if we do not have sex very often, the vagina can actually shrink…! But hey, you can get it back!

This is for you, young woman in your 20s who has never been able to insert a tampon without pain, or never been able to have painfree sex ever since you became sexually active. You are actually starting to think that this may be how sex is supposed to be, and may start wondering why people even have sex.

PLEASE DO NOT ACCEPT PAINFUL SEX AS YOUR REALITY!

Return to running after birth: do you make the cut?

When should you return to running after delivery? There is so much controversy about this topic, and I thought I would share the updated 2019 guidelines to enlighten your decision making. Remember that these tests are only one part of the puzzle, and that a Pelvic Health PT assessment should also be part of it to make sure that you core and pelvic floor are ready for it too.

What’s the risk of going back to running without meeting those criterias?

You may put yourself at risk for permanent damage/injuries such as vaginal prolapse (when your bladder is descending into the vagina), or even pelvic/low back pain. Or you may get lucky and nothing will happen. But do you want to take that chance?

I have had clients who regretted not having been informed about holding off on high impact after birth, as they dealt with low back pain or vaginal heaviness for years after the fact… until they finally consulted with a pelvic health PT to address it. Believe me ladies, it is not worth the risk, especially if a few weeks of adequate exercises prescribed by a Pelvic Health PT can prevent those injuries.

Watch my 10-min video below to test where you’re at 🙂 

Also, if after going through these tests you feel like you make the cut, please ensure to go back to running very progressively – starting with some walk/run, flat course, short distances, slower speed, etc.  A pelvic health PT can guide you in the progression. You can find the updated guidelines at p.5 here for more details 🙂

Leaking urine: weak or tight pelvic floor?

Many people think that if they are leaking urine, they must necessarily have a weak pelvic floor. Starting from this assumption, they start doing Kegel exercises, and sometimes make their problems worse! Why is that?

In this video, I am drawing the distinction between a weak and a tight pelvic floor, and why Kegels can be harmful in some cases!