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originally published: July, 2015

birmingham health physiotherapy
Dangly Things and Lady Bits

Two students, one conference, lots of lessons

Two students, one conference, lots of lessons.

Physiotherapy students Helen Owen and Ella Jennings share their very different days and key messages gleaned at the inaugural Women’s Health Physiotherapy Summit. As an area with little student interest, both students share candidly their first experience of pelvic physiotherapy.

Helen’s Day
Having been part of the Women’s health physiotherapy group on Facebook for some time now, I was in no way inclined to do a women’s health placement or pursue an interest in women’s health. To be frank (and I know I’m not the only student that thinks this) but dealing with other people’s bikini and mankini zones is gross. So when Gerard Greene asked me and a few other students to attend the Women’s Health Physiotherapy Summit, I was still very unsure – did I really want to spend a whole day talking about THAT?

I said yes – and I’m glad I did! Each speaker mentioned one key phrase that I had neglected to realise was so important previously because of my own mind-set around women’s and men’s health – quality of life. Holistic, patient centred care is taught at university and something that many of us pride ourselves in trying to deliver, but getting a better understanding of psychological and social issues surrounding individuals. But this is a medical problem – just because it’s not always seemingly connected with the same part of the anatomy that we are treating, doesn’t mean that we should disregard it. And even if it’s not at all related to the problem the patient presents with, it’s still part of their history and their body.

We’re pushed at university, throughout placement, and through our clinical time to treat the whole person and be holistic in our approach, so how can we ignore something that might have such an immense impact on quality of life? Just like we treat other muscles to improve quality of life (think falls prevention, stroke rehab and so on) Michelle Lyons made the apt statement that the pelvic floor is a muscle, like any other muscle and there are different ways of assessing it and treating it. She continued saying that basic bread and butter MSk skills can be used, like teaching the patient to contract and see if it improves symptoms. If it’s weak, strengthen it. Like any other muscle.

Thinking back three years to the start of my physio degree, it all felt a bit gross having to get that close to people, palpate feet and arm pits, facilitating pelvic tilts, and trying to get sputum cleared from patients. No, normal people don’t go around doing these but we are not normal people: we are extraordinary because we are physios and we care about the patient. We get used to dealing with close touch, feet, armpits, sputum, vomit, and so on because we know it helps the patient. We need to get over the stigma surrounding ‘private’ bits, because this can affect a person’s life as much (if not more because of the associated cognitive and emotional impact) as anything else going on in their body.

Ella’s Day
I was delighted to be invited to the #WHPTSummit2015 conference as it is an area I have not really covered in detail as a student, and with pregnant best friend I have become extra interested in the subject!

Although it meant a 4.30 start to get to Walsall on time, arriving at the conference I was welcomed with an information pack, and quickly got settled in for a day of learning. Even though pelvic health seems a little alien to me at the moment, the resounding messages I got are applicable to all areas of physiotherapy:
• Knowing the underlying anatomy and musculoskeletal principles is extremely important, as this is the ‘bread and butter’ of physiotherapy practice
• It is easy to identify dysfunction, but important to consider whether this relates to the presenting condition
• Explaining the pain is just as important as any other condition, and it is important to consider central sensitisation in cases of chronic pain

Things I learned
Obviously there was a lot of information on the day, which I think would be impossible to summarise fully, but here are some points that were interesting to me:
• Probably the number one point to stress is that men can have pelvic floor issues too!
• One thing I didn’t realise is that not only can the muscles of the pelvic floor be weak; they can be tight and overactive, meaning that further contraction and thus control is not possible.
• It was also thought provoking to hear people’s perspectives when examining and treating the pelvic floor. On one hand, it is just another muscle and we know the principles of stretching and strengthening. However due to the associated issues such as incontinence, and that pelvic floor examination is obviously a private area and there can be associated psychosocial issues to consider.
• In other countries, assessment of the pelvic floor post-pregnancy is routine. This seems like a great place where physiotherapy can be used in prevention and reduce future care costs. This is already being done privately, with a mummy MOT (http://www.simplywomenshealth.co.uk/pages/the-mummy-mot.php)

As with all recent physiotherapy events I have attended, it was great to hear the enthusiasm of the speakers and attendees. This especially related to how beneficial exercise is and how as physiotherapists, we need to shout about what we can deliver!
Impact of technology

The conference was a great introduction to some of the latest technology in pelvic health and the science behind it. It definitely seems like technology will continue to be hugely influential in healthcare, particularly when used to combat issues of adherence. For example, the squeezy pelvic floor app exists for individuals to track their exercise and provides a visual stimulus to help when completing the program.

https://itunes.apple.com/gb/app/squeezy-nhs-physiotherapy/id700740791?mt=8

Technology also has a huge impact in terms of social media. The women’s health physiotherapy facebook group (https://www.facebook.com/groups/1424514604444439/?fref=ts) has provided a great resource for information sharing. This is particularly important in women’s health as it seemed that a lot of people only worked in small groups or individually rather than big teams. There is huge value in connecting with others and sharing evidence and information, and a community ready to answer any questions. Furthermore, twitter and periscope were used to share what was going on at the conference. These online resources and can be a good way to connect with other students (and professionals). In fact, I got to meet Gerard Greene and Helen Owen, both of whom I’ve talked to on twitter but not in person.

Overall, attending the #WHPTSummit2015 was a fantastic experience and I would thoroughly recommend it.

I’m a student interested in women’s health, what can I do?

Asking the expert panel how students can get involved, they suggested joining the facebook group in the first instance. Attending this conference was a fantastic opportunity to network, through challenging yourself to speak to people you don’t know in the breaks means you find out about lots of different career routes, interesting jobs, and forge new connections. Ask questions, they open up doors and share your enthusiasm. Attending events in areas you are interested in is definitely a good idea.

Helen Owens is a final year Physiotherapy student at Coventry University and set up the CUPhysio Blog, twitter feed and is part of WE AHPS. Ella Jennings is a final year Physio student at Manchester Metropolitan University and is Chair of the CSP Students.

Follow them on twitter

Ella

https://twitter.com/aPhysioStudent

Helen

@HelenOwen3

 


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