Inhalers are essential to managing asthma, but did you know, taking your reliever inhaler more than two days a week, shows your asthma isn’t controlled.
Maybe the dose of your preventer is not right, or you’re not using your inhaler correctly. Smoking cessation, keeping active and weight loss are also recommended in the NZ Asthma Guidelines 2020.
What is often forgotten is HOW you are breathing. This isn’t doing some crazy technique where you jump in the snow in your underwear, but learning to breathe well and adaptably, all the time. Research shows that improving breathing in asthmatics reduces symptoms and inhaler use.
When we breathe, it should be silently through the nose and your upper belly should go gently outwards. The breath out should be relaxed and twice as long as the breath in. Asthmatics habitually try to get air in as easily as possible, leading to shallow mouth breathing and a short exhale. This is how we breathe when stressed and makes asthma worse.
Thinking about nose/belly breathing and a long-controlled exhale means the air you breathe in is clean, warm and moist (that’s the nose’s job), that you are relaxed and there is plenty of space to get the next breath in. Try humming, this helps keep the nose ready and active, it also gives you a long exhale!
The better you breathe at rest, the harder it is for your asthma symptoms to take hold.
Your nose is your first line of defense to allergens, pollens, viruses and the cold air. As air flows through your nose it goes to work filtering, warming and adding moisture to the air so by the time it reaches your lungs it’s clean and at body temperature. The moisture ensures the lungs function and can clear debris that does get through and inflate and function optimally.
The other amazing factor is the production of nitric oxide (NO) in our sinuses (laughing gas!). It doesn’t make you giggle but its effects are widespread and definitely promote wellness. NO works as a sterilizer (anti-fungal, antiviral and antibacterial), it promotes the beating of cilia – the cells that work like a Mexican wave to move your mucus around, reducing snotty noses and postnasal drip. It acts as a vasodilator (opens the blood vessels) and breathing against the increased resistance of small breathing tubes (compared to the mouth) opens up your air scass – this leads to an overall increase in the amount of oxygen you can absorb – up to 17-20% than through your mouth! NO also has anti-inflammatory effects.
This is all missed when you breathe through your mouth! You are more likely to feel calmer as you slow your breath down and tell your body it’s safe believe it or not breathing through your nose also improves your memory!! My favorite saying is it’s as silly to breathe through your mouth as it is to eat through your nose. People often tell me they can’t get enough air through their nose – this can be due to issues within your nasal structure and sinuses but often is actually due to chronic mouth breathing. The disuse leads to nasal stuffiness and a sensation of being blocked, so you continue to mouth breathe worsening the situation.
So….. tuck your chin in, close your lips, let your teeth sit slightly apart, your tongue floats to the roof of your mouth so it’s creating a small amount of suction, and is docked behind the top teeth. Breathe silently and feel your head, neck and shoulders relax and enjoy the calm and wellness.
Physiotherapy following childbirth is designed to assist with recovery of the pelvic floor and core, along with the rest of the body and health in general. The initial 3 months following childbirth is referred to as the ‘4th trimester’, and during this time it is essential to allow the body to recover from pregnancy and childbirth.
During pregnancy posture must change to accommodate for the beautiful wee baby growing inside. The ribs widen as the heart increases by 50% of its normal size and the ligaments soften to allow the body to stretch. The muscle activity around the pelvis changes as the pelvic position changes. This is a normal process and a clever way the body adapts to have a child. The pelvic floor is a group of muscles that sit like a trampoline in the base of the pelvis. With the increased weight of the baby resting on the pelvic floor it also undergoes some stretch throughout pregnancy.
Changes to the pelvic floor during birth.
During a vaginal delivery, or attempted vaginal delivery, the muscles and nerves stretch significantly to allow the passage of the baby from the inside to the outside. The pelvic floor is designed to stretch to 250% of its resting length, much more stretch than any other muscle of the body. However, depending on the circumstances of the delivery, that stretch to the tissues may be temporary but sometimes if there is a greater degree of stretch, a longer duration of stretch or the need to use instruments such as forceps, the tissues may be injured and not be able to return to their predelivery state. Due to the constantly changing circumstances of each mother’s labour and delivery it is possible to injure other structures around the pelvis during vaginal deliveries such as the pelvic bones, the tailbone, the nerves and the tissues that hold the pelvic organs inside the body.
For those who have a caesarean section delivery the pelvic floor has undergone the stress of the pregnancy. There may have been stress to the vaginal and pelvic floor tissues and muscles if a vaginal delivery was initially attempted, and then in order to access the baby for delivery the abdominal wall tissues and muscles are injured as they are cut to access the baby therefore also need time to heal and recover. We know the scar takes at least 3 months to heal to a reasonable strength when it can then start tolerating more stress and loading.
Due to these significant effects on the structures around the pelvic floor and pelvis it is very important to allow time for these injured tissues to recover follow childbirth, and to rehabilitate them in a safe manner. Pelvic health physios can help to guide women in this recovery, as well as check if there has been injury to the pelvic floor muscles or other structures during childbirth. Allowing the appropriate time to recover and rehabilitate from the normal adaptions from pregnancy, childbirth and the potential injuries that may have occurred is beneficial to optimize recovery and to address any symptoms or difficulties women may be having in the 4th trimester, but also to reduce the risk of pelvic health problems later in life. Pelvic floor physical therapy has been proven to reduce the risk of pelvic organ prolapse, urinary, bowel, and sexual dysfunction and pelvic pain.
When to begin Pelvic Health Physiotherapy;
It is highly recommended to start pelvic floor physiotherapy around 6 weeks following delivery. This is to screen for any potential injuries, and to help to guide recovery including exercise and return to sports and fitness whether your goal is circus performing, running 5km or 50km. Having said that, it is never too late to see a pelvic floor physio. Many pelvic health symptoms that occur after having children and are often thought to be a ‘normal’ consequence are in fact common but not normal. They are a sign of pelvic floor dysfunction and often respond very well to pelvic health physiotherapy. A good example of this is leaking when you cough, sneeze or jump on a trampoline- this is common but not normal!
Postpartum physio can also help with:
Difficulty peeing or emptying the bladder, leakage of urine, and bladder urgency or frequency
Constipation, difficulty with bowel movements, and leakage of bowels
Painful sex, diminished or absent orgasm
Separation of the abdominal muscles
Restoring core function and strength of the abdominals and pelvic floor
Pelvic floor and pelvic girdle, low back, and hip pain
Caesarean section and episiotomy scar tissue and pain
Pelvic organ prolapse prevention and/or treatment
Eliminate pain from trauma to the pelvic floor and muscles
Reduce pain from nerve damage in the pelvic and pelvic floor
Postnatal physiotherapy helps with this and really should be a standard part of our healthcare as it is in France! As a profession we are excited that the upcoming ACC Maternal Birth Injury coverage will improve access for many new mothers to undergo postnatal rehabilitation- more on that in our next post.
Our Pelvic Health Physiotherapy team at Active Health are here to help you recover and live your best life! Call us at 03-383-6290 to see one of our team.
Active Health Canterbury and Rangiora are excited to introduce you to our new look Pelvic Health Physiotherapy team who bring a wealth of education and experience to this exciting and expanding area of physiotherapy.
With the range of experience of our pelvic health physios we are proud to offer quality care in all aspects of Women’s, Men’s and Pelvic Health from care during pregnancy and the postnatal period, to management for bladder, bowel, prolapse and sexual concerns, through to more complex conditions such as pelvic pain, pelvic cancer and pessary fittings.
All of our Pelvic Health physios have a solid background in musculoskeletal physiotherapy and have completed specific training in pelvic health physiotherapy. Our team are all passionate at enabling women and men to safely return to activities and sports they love following events or conditions that may have limited their ability such as childbirth, surgery, or the onset of pelvic health symptoms.
Meet our team…..
Jo Dowle;
Jo joins the team with a wealth of experience and education in the area of pelvic health, both in the private setting and from within the public system. With her solid background in musculoskeletal physio, Jo is able to thoroughly investigate symptomatic dysfunctions from both inside and outside the pelvis and apply education, manual therapy and exercise to address her patients’ symptoms and functional limitations. Jo has had much experience working with pregnant and post-natal ladies and has a special interest in helping women return to exercise or higher-level sports after childbirth. Jo has also undergone training to fit a range of pessaries for both prolapse and stress incontinence and works with the patient’s healthcare provider to ensure this is done safely.
Fun fact about Jo: Jo lived in Nepal for 2 years and worked with leprosy patients.
Jacqui Bath;
Jacqui Bath has wide ranging experience as a physio and has treated a range of clients from high level athletes playing contact sports to physical facilitation rehabilitation programs with the more elderly. She has extensive experience as a musculoskeletal physio and since having her own children, she has also completed further training to become a Womens’ and Pelvic Health physiotherapist. Jacqui has a special interest in core stability and strengthening, including Pilates and incorporates this into preparing her patients to return to exercise and sports. Jacqui has completed a Postgraduate Diploma in Public Health, focusing on health promotion and prevention, Hauora Māori and promoting healthy active lifestyles.
Fun fact about Jacqui: Jacqui was one of the first women in New Zealand to referee rugby.
Ashley Briscoe;
Ashley Briscoe has recently moved back to her hometown of Christchurch after working in private practice in Auckland. Ashley has done multiple pelvic health courses and enjoys combining her pelvic health and musculoskeletal skills to empower and motivate her clients back into doing those things they enjoy after childbirth or pelvic injuries. At Birthcare in Auckland Ashley worked with women soon after childbirth educating and guiding women on postpartum recovery and safe return to exercise. Ashley is currently studying towards a Diploma in Pain Management with a focus on pelvic pain at the University of Otago. She particularly enjoys working with lower back, pelvic, glute and hip pain, again utilizing her pelvic health and musculoskeletal skills.
Fun fact: Ashley has three schnauzers aged 3 months, 6 years and 7 years.
Susan Larson;
Susan Larson is Active Health’s team lead for Pelvic Health and Cancer Rehab, with a Postgraduate Certificate in Pelvic Health and is a Certified Cancer rehabilitation Physio. She enjoys sharing knowledge gained from her extensive experience and education in pelvic health, cancer rehab and musculoskeletal physiotherapy with her team and enjoys working in a close team environment with others who share her passion for pelvic health. Susan’s area of special interest is rehabilitation of pelvic cancers, including gynecologic, prostate and colorectal cancers.
Fun fact: Susan has jumped off 3 bridges, out of 2 planes, and climbed 21 14,000ft mountain peaks.
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