TWHP – 058 – Dr Jenny Kruger – Can Incontinence Be Improved Using a Device Like femfit®?

This is the episode that has been 6 years in the making! We are thrilled to be able to chat to Dr Jennifer Kruger, who is the CEO and co-founder of JUNOFEM, a medtech company spun out of the University of Auckland.  Jennifer’s background is clinical, but has been an academic for most of her career, so her name is probably familiar to most who are listening!  She still heads the pelvic floor research group at the Auckland Bioengineering Institute, but is now commercialising her research for greater reach, to more women who need it!

Here are some of the things we discussed:

  • Dr Kruger’s clinical background as a midwife, and how her interest in birth outcomes and postnatal recovery led her to doing extensive research into pelvic floor function during and after childbirth. She pursued graduate degrees to study pelvic floor muscle function using ultrasound, MRI and computational modeling, with a long term goal of improving birth outcomes and helping with postnatal recovery. She completed her PhD looking at pelvic floor morphology and function in elite athletes.
  • Over the past 8 years, she has been working with the team at University of Auckland, including some very clever bioengineers to develop the femfit®, which is a flexible vaginal pressure sensor array that measures pelvic floor muscle activation and intra-abdominal pressure during functional activities
  • Initial prototypes used a single pressure sensor, but the final version has 8 pressure sensors along the vaginal length. Therefore it can produce a pressure profile showing pelvic floor vs. intra-abdominal pressure and ensure clients are doing a correct pelvic floor contraction, rather than bearing down
  • The tool has been validated against trans-perineal ultrasound and manometry to ensure that the information regarding movement of the pelvic floor muscles is correct.

Dr Kruger is passionate about removing some of the stigma associated with urinary incontinence and help provide practical options for women wanting to improve their pelvic floor strength and function. Her team are performing ongoing research with the femfit® device, which includes looking at PFM function during functional activities.

To learn more about the femfit® or to become a registered affiliate for the device, please go to the website for details.

To support The Women’s Health Podcast, please use the code “femfit+WHP” to get 10% off the femfit® and in doing so, you will help keep The Women’s Health Podcast on air!. Follow this URL https://shop.junofem.com/discount/femfit+WHP or use the QR Code below!

https://www.junofem.com

Or contact Jenny at j.kruger@junofem.com

You can follow Jenny and JUNOFEM on social media:

https://www.instagram.com/junofemhealth

https://www.linkedin.com/company/junofemhealth

057 – Nina Theodorsen – Is Whole-Body, Functional Exercise During Pregnancy Going To Make Diastasis Worse

In this episode, we talk to Nina Theodorsen, a Norwegian women’s health and pelvic floor physiotherapist, who works in a private clinic and is doing a PhD at University of Bergen. Nina has done extensive research on the effect of exercises on DRA during pregnancy and the postpartum period. Her long clinical experience affects her approach to research and dissemination of the results. She also holds a degree in health management and further education in sexual health and education, teaches women’s health on the bachelor physiotherapy program, holds courses and talks, and tries to influence politicians to prioritize and improve women’s health.
 
Nina begins the episode by discussing her background working with women around the perinatal period and how her clinical observations led to her desire to perform more research on the effect of exercise on DRA. She felt that there was a lot of messaging that was fear-based and could potentially reduce participation in exercise.

With Kari Bø and others in the team at University of Bergen, Nina has published research studies on the effect of pelvic floor and transversus abdominis contraction on the inter-recti distance in both pregnancy and post-partum populations. She also conducted a randomised controlled trial (during covid lockdowns!!) on the effect of a 12-week full body strengthening program (including abdominal exercises) during pregnancy on the inter-recti distance at late stage pregnancy and at 6 weeks postpartum.

You can access her research articles here:
https://doi.org/10.1016/j.jphys.2024.02.002 
https://doi.org/10.1016/j.physio.2023.08.001 
https://doi.org/10.1016/j.physio.2018.08.009

Nina is happy for people to get in touch with her with any questions or comments.
We thoroughly enjoyed this interview with Nina and hope you do too! Please feel free to leave a comment below about your thoughts on the topic!

nina-margrethe.theodorsen@uib.no
@diastaseprosjektet

056 – Dr Tracy Sher – Pudendal Neuralgia – What Health Professionals Really Need to Know to Provide Care and Hope

Yes it has been over 2 years since our last episode, but we’re back and full of excitement about the guests to come!

And what a great episode to kick off the re-boot. On this podcast we interview Dr Tracy Sher about all things related to Pudendal Neuralgia. Dr Sher is the Founder/CEO of the global platform, Pelvic Guru, LLC/Pelvic Global and the Global Pelvic Health Alliance Membership (GPHAM). She is also the Owner/Clinical Director of the private practice, Sher Pelvic Health and Healing in Orlando, Florida. 

In this podcast we cover:

  • Pudendal neuralgia versus pudendal nerve entrapment. 
  • Some basic anatomy including the pathway of the pudendal nerve and where it might become irritated or entrapped
  • The “Pudendal Tour” – ie the challenging journeys that some patients will go on, including multiple scans, nerve conduction tests, injections and surgery.
  • Some of the signs and symptoms that clients might present with
  • What a physiotherapy assessment might look like and how to prioritise what to look at on day one
  • The importance of a multidisciplinary team in the management of pudendal neuralgia and some of the specialties you might want to include in your team
  • Some interesting case studies including patients who have been diagnosed with pudendal entrapment but there was something ELSE was going on…
  • Acute onset pain that often gets missed (think post-surgical!)
  • How we as health professionals need to be careful with our language (avoid nocebic language!) and can provide hope for these patients
  • What might conservative Mx might look like for someone with pudendal neuralgia

Correction: Tracy wanted to add after the conversation:

“Numbness can end up being part of pudendal nerve entrapment. The Nantes criteria actually lists: “no objective sensory defects” but those who treat this clinically will see sensory changes. This was the original Nantes criteria – but we see many more nuances to this: pain limited to the territory of innervation of the pudendal nerve, pain predominant during sitting, pain does not awaken the patient from sleep, no objective sensory defects, a positive effect of anaesthetic infiltration of the pudendal nerve.The key is to do all differentials as it isn’t a typical symptom. 

 I also stated S1-3 in the beginning and meant to say S2,3,4.”

As always, we felt like we could have picked Tracy’s brains for hours, so might have to get her to come back again in the future (or encourage her to come to Australia!).

You can reach Tracy at:
Website:  www.pelvicglobal.com  
Email: Tracy@pelvicguru.com
Instagram: @pelvicguru1
Twitter: pelvicguru1
Free Facebook Group: Pelvic Guru Academy 

055 – Antony and Marika – We’re Back! Antony and Marika Catch Up!

And…we’re back!

After a two-year hiatus, we’ve decided to kick off
the Women’s Health Podcast again. We’re excited to interview some incredible guests on the show in the months to come and would love to hear your suggestions!

In this chat, we discuss what we’ve been up to over the past two years (and all the places Antony has been to!). We have a bit of a chat about principals rather than protocols when treating pelvic health conditions and the importance of personal experience as a motivator for change. We also talk about collaboration between health and fitness professionals and how this can benefit women.
It’s a bit of a random chat, but hopefully you enjoy it!

We’ll see you soon with our first guest for 2023.

054 – Kieran Richardson – What Is The Future Of Physical Therapy and Evidence-Based Practice?

Today we have the pleasure of speaking to Kieran Richardson.

Kieran is a Specialist Physiotherapist and the Director of Global Specialist Physiotherapy, a consultancy company providing Professional Development, Formal Mentoring and Non-surgical opinions for patients. 

Kieran and his team of academics, expert clinicians and researchers consult to multiple clinics and health care professionals in Perth, Western Australia, and well as nationally and internationally via online platforms such as Zoom. 

He also has various online courses for both clinicians and patients, specifically covering non-surgical management of ACL tears. 

He also has successfully overseen 100’s of full thickness ACL tears of patients both in Australia and internationally via the Telehealth method.

Today we talked about:
– Kieran’s career journey – from considering a life as an accountant, doctor or lawyer to choosing to be a physiotherapist
– how the specialisation process helped – in particular the mentoring/peer review
– how applying evidence-based practice can be a tricky balance 
– how ACL management is VERY surgical focussed in Australia and how this has been very slow to change in spite of the current research
– how healthcare is very medically dominant – we (physiotherapists) would need to be a combined force to have a strong say
– the evidence for and against manual therapy – are we throwing the baby out with the bathwater?
– communicating with colleagues online. Could we do better?
– the business of healthcare and how profits can impact on management.
– ACL pathways. What is considered best management? How is ACL surgery/rehab funded in Australia?
– whether or not physiotherapists could play a bigger role in musculoskeletal pain in primary health care settings to help reduce medical burden
– why important intra- and interdisciplinary collaboration is so important
– his top tips for new graduate physiotherapists

You can find Kieran at:
kieran@globalspecialistphysio.com 
https://www.instagram.com/global_specialist_physio/    
https://www.facebook.com/globalspecialistphysio 

Check out his references at: www.globalspecialistphysio.com/acl  

053 – Dr Adam Culvenor and Dr Andrea Bruder – How Do We Prevent and Manage ACL Injuries In Women and Girls?

We’re excited that today we have a dynamic duo on the podcast: Dr Andrea Bruder and Dr Adam Culvenor.

Adam is a Physiotherapist and Research Fellow at the La Trobe University Sport and Exercise Medicine Research Centre, Australia. He has combined a clinical career in sports medicine together with research investigating prevention, management and long-term outcomes of sports-related injuries, and life-span osteoarthritis. He has a particular interest in anterior cruciate ligament (ACL) injuries; in optimising return to sport, identifying risk factors for poor long-term outcomes, and developing and testing novel osteoarthritis prevention strategies. Adam has written more than 50 publications on the subject of ACL injuries and osteoarthritis, has been invited to speak at numerous international conferences, and is\ currently leading the first clinical trial in the prevention of osteoarthritis in young adults following ACL injury.

Andrea is a physiotherapist, Lecturer in Physiotherapy at La Trobe University and Post Doctoral Research Fellow in the La Trobe Sport and Exercise Medicine Research Centre. Her research focuses on improving injury prevention and rehabilitation practices after musculoskeletal injuries. Andrea has a particular interest in reducing the risk of ACL injuries among women and girls playing Australian football, and for those who do sustain an ACL injury, how we can improve rehabilitation practices to reduce the long-term burden.

In this podcast we talked about:

  • what the ACL is and how it can be injured
  • some risk factors for ACL injury (in males and females)- including some of the social, environmental factors
  • some of the current programs that exist that have been shown to reduce lower limb injuries…but how the uptake has been poor
  • surgical versus non surgical (sexy, cutting-edge rehab) management
  • why a trial period of this kind of rehabilitation may be of benefit, even if the client goes on to have surgery further down the track
  • how the rates of arthritis are similar between the two treatment options

If you’d like to check out their blog, head to http://semrc.blogs.latrobe.edu.au/blog

Their website details:
https://scholars.latrobe.edu.au/display/abruder
https://scholars.latrobe.edu.au/display/a2culvenor

Email addresses:
a.bruder@latrobe.edu.au
a.culvenor@latrobe.edu.au
aclstudy@latrobe.edu.au

Twitter: @AndreaBruder
Twitter: @agculvenor

052 – Molly Galbraith – Strong Women Lift Each Other Up

We are again blessed to have the amazing Molly Galbraith on the podcast!

Marika and Antony have both had the pleasure of getting to know Molly over the past 5 years and are thrilled to talk to her about her new book, Strong Women Lift Each Other Up.

Molly Galbraith, CSCS, is the cofounder of Girls Gone Strong (GGS), the world’s largest platform providing evidence-based, interdisciplinary health, fitness, nutrition, and pregnancy education for women and the health and fitness professionals who work with them—including industry-leading certification programs and coaching.

The “Strong Women Lift Each Other Up” philosophy is woven through the fabric of GGS, as Molly leads a team of women from the US, Canada, UK, Mexico, India, and Australia. From employing and educating, to featuring, collaborating with, and investing in women, GGS is dedicated to serving their community of women from 80+ countries around the world.

In the podcast we talked about soooo much great stuff, including:

  • how this book came about and how women lifting each other up has helped Molly get to where she is today
  • some of the statistics around representation of women in government and executive positions… and ways that we can help change this.
  • why making the biggest difference with the least amount of harm is her highest value
  • why the book is structured the way it is – to help the reader move through the stages of working on their own care first (eg on jealousy and the comparison trap) in order to feel able to truly support other women
  • why understanding your values truly helps you a more fulfilling life and be true to yourself
  • how helping lift other women up can be small, simple things such as a compliment or a recommendation
  • how you can find your superpower and level up your support of other women!

We love Molly’s book and would love everyone to get out and buy it and tell us what you think (no, we are not making commission!!). The book is not only filled with fabulous advice, interesting stories and reflective questions, but also a ton of online resources.

You can buy her book at https://www.mollygalbraith.com/book2

Check out Episodes 12, 24, 35 and 36 which also stars Molly!
http://womenshealthpodcast.com/uncategorized/012-molly-galbraith-feeling-fragile-uncomfortable-and-lack-confidence-in-your-post-baby-body/
http://womenshealthpodcast.com/uncategorized/024-molly-galbraith-how-can-i-heal-my-relationship-with-my-body/
http://womenshealthpodcast.com/uncategorized/035-molly-galbraith-ask-me-anything-part-1/
http://womenshealthpodcast.com/uncategorized/036-molly-galbraith-ask-me-anything-part-2/

https://www.podbean.com/media/player/uak35-fb43f5?from=pb6admin&download=1&version=1&auto=0&share=1&download=1&rtl=0&fonts=Helvetica&skin=1&pfauth=&btn-skin=107

050 – Dr Clare Minahan (PhD) – What Are The Unique Physiological Differences Of Female Athletes?

FIFTIETH EPISODE SPECIAL!!

Antony and I were thrilled to talk to Clare Minahan, PhD Scientist and champion for women in sport.

Clare Minahan is an Associate Professor at Griffith University, Queensland Australia, and has led the Griffith Sports Science group since 2002. Clare’s interests are in the advancement of human performance with a key focus on the determinants of performance in female athletes. She has documented unique responses to exercise in female athletes including muscle damage, thermoregulation and immune function. Clare is a founding member of the Australian Institute of Sport’s Female Performance and Health Initiative.

Some of the topics we cover in this episode include:

  • some of the differences between male and female athletes in terms of how they respond to training and recovery
  • how the oral contraceptive pill (OCP) influences things like thermoregulation, immune function and recovery from acute bouts of intense exercise
  • how the hormones fluctuate over the menstrual cycle and how this may influence training choices
  • why training needs to be individualised and based on tracking of the athlete’s cycle
  • that around 50% of athletes are on the OCP, so we need to understand better the effects. Clare also discusses the different generations of OCP and acknowledges that these will have different effects on the athlete (there are at least 35 different types of OCP just in Australia!)
  • how female athletes are at a 3x increased risk of ACL injuries. Studies showing that landing strategies seem to changes during teenage years for girls. This could also be related to hormonal changes – there are some studies showing increased risk during late follicular phase- but there is still much more to learn on this. Could also be related to changes in body composition through the teenage years
  • females with higher circulating levels of testosterone. Do they have a competitive advantage?
  • the advantage of having a regular menstrual cycle in terms of giving us a picture of our health. Withdrawal bleed while on OCP is not the same thing.
  • if not able to properly track menstrual cycle due to OCP use, Clare talks about other ways that we can monitor for RED-S (hint: performance, fatigue, mood, immune function)
  • why it’s important to get the basics right (sleep, nutrition, stress etc) before manipulating your training around the menstrual cycle

If you would like to get in touch with Clare, you can best contact her on twitter @clareMINAHAN
or via the Griffin University website.
c.minahan@griffith.edu.au

049 – Amanda Thebe – The Menopocalypse Is Coming For You!

On this podcast, we chat to Amanda Thebe, fitness professional and author of the book Menopocalypse: How I Learned to Thrive During Menopause and How You Can Too!

Amanda has over twenty years of experience in the fitness industry. She is a popular guest on podcasts and online summits, and her health and fitness tips have been featured in media outlets like Shape, Prevention, Healthline, and Global News. She lives in Houston, Texas.

In this episode we talked about:

  • Amanda’s recent experience with COVID-19 and how it knocked her for six for a few months. The post-viral syndrome left Amanda with a lot of fatigue and she struggled with daily activities for a long time, but is thankfully now on the mend!
  • her story about when she first started experiencing symptoms of menopause (ie migraines, vertigo and depressions) and how it took two years and several health practitioners to find the answers she was looking for
  • how surprised she was to find out that she was perimenopausal at the age of 42 and how so few people were talking about the subject! This led Amanda on a journey of discovery – she dived deep into the literature to learn more about menopause so that she could help herself and others. This led to her writing a book on it!
  • the frustration that Amanda felt when she couldn’t find the answers to what was going on. She felt so much despair and thought that she was going to be feeling like that forever.
  • how little medical professionals get trained on the topic of menopause -including the management. But this seems to be changing in the UK with new guidelines and mandatory training
  • some of the common symptoms that women experience through the perimenopausal period (that no-one talks about!), such as vaginal dryness, urinary incontinence and sexual dysfunction.
  • what happens to oestrogen and progesterone during the perimenopausal period. Amanda also talks about leptin and ghrelin and how these hormones can impact our hunger and satiety cues.
  • some of the physiological and psychological changes that occur through the perimenopausal period and how we can become more susceptible to things like cardiovascular disease, Alzheimers disease and osteoporosis
  • the controversy around hormone therapy, how the medication has changed over time and how incredible helpful it is for so many women
  • how physical and emotional stress can impact on symptoms during perimenopause – and some things that you can do to reduce these!
  • why women tend to put on weight around menopause and how there is often a change in body shape around this time.
  • how perimenopause can be a tough time for many women as they are often not only working and raising children, but also looking after elderly parents too. She discusses how useful it can be for women to spend some time exploring their values (see website below) and learn to make values-based decisions. And say no!

Resources
Menopocalypse book! (BUY HERE: https://www.fitnchips.com/books/)
Oestrogen matters – Dr Blooming and Dr Tavris
XX Brain book – Dr Lisa Mosconi
www.viacharacter.org
www.valuescentre.com

You can find Amanda at
fitnchips.com

amanda@fitnchips.com