Check-Ups

Who do I recommend the Mom to be Check Up to?

Pregnancy leads to very big changes in the female body. The change in shape of the pelvis, for example, affects the hip joints, lower back, gait and the muscles of the pelvic floor. During the "Mom to be Check Up" we assess these areas for posture, strength, endurance and discuss any functional limitations and concerns.

As a pelvic floor physiotherapist, I specialize in the physical, hormonal and psychological changes that occur during and after pregnancy and can help you prepare your pelvic floor for vaginal birth, prevent incontinence and strengthen the muscles that support your baby bump. In addition, I treat pregnancy-specific complaints such as pelvic girdle pain, back pain or sciatica.

Studies show that exercise has a positive impact on pregnancy. Regular exercise reduces the risk of anxiety disorder or depression, lowers high blood pressure, reduces the risk of diabetes and thrombosis, and improves sleep quality.

The current guidelines of the American College of Obstetricians and Gynaecologists (Artal and O`Toole 2002) recommend at least 30 minutes of moderate-intensity exercise daily (walking, swimming, biking, hiking, light weight training).

If you are unsure when and how to start exercising and which exercises are safe and healthy for you and your baby, I will create a personalized exercise plan for you.

I recommend the Mom to be Check Up to pregnant women from the 3rd month of pregnancy and earlier if you are interested, as long as you are well during the first weeks of pregnancy.

What can I expect at the Mom to be Check Up?

The 90-minute session includes, among other things:

• Pelvic floor examination (UR choice questionnaire and optional
  vaginal examination)
• Examination of the core muscles (abdomen, back, diaphragm)
• Examination of the separation of the straight abdominal muscles (rectus diastasis)
• Assessment of pelvic statics and loading of the feet, knees, hips in stance and gait.
• Assessment of posture and joint mobility
• Discussion of specific exercises, sports adapted to your everyday life, sports hobbies and the week of pregnancy.

Afterwards you will receive, among other things:

• individualized training plan taking into account your lifestyle and goals
• individualized treatment plan for pregnancy-specific complaints
• Advice for independent perineal massage in preparation for childbirth

Who do I recommend the Mom Check Up to?

More than half of women experience weakness in their abdominal and pelvic floor muscles after having a baby. For example, they find it difficult to push the stroller uphill, walk longer distances or carry the baby. The feeling of "breaking through", "not being able to hold between the legs" and "looking pregnant" stresses them not only physically but also psychologically. Especially if there is also incontinence.

In up to one third of women, the gap on the anterior abdominal wall (rectus diastasis) does not close even 2 months after birth and there is a risk of back and pelvic pain and bladder, bowel and sexual dysfunctions. All this is treatable and does not have to be accepted!

I recommend to mothers the Mom Check Up after the gynecological 6 weeks follow-up. But we also treat any woman who gave birth years ago and still suffers from symptoms.

What can I expect at the Mom Check Up?

The 90-minute session includes, among other things:

• Examination of the pelvic floor
• Examination of the core muscles (abdomen, back, diaphragm) - Assessment of posture and joint mobility
• Screening for bladder, bowel, or sexual dysfunction.

Afterwards you will receive, among other things:

• Rehabilitation or training plan taking into account your lifestyle and goals.
• Advice on ergonomic behavior when breastfeeding, carrying, bathing, taking the baby out of the car.

To whom do I recommend the Menopause Check Up?

I recommend this check up to women who are interested in the physical changes and their impact on performance during the 4 phases of menopause.

Phase 1: Premenopause
The body gradually reduces production of the hormones estrogen and progesterone which can lead to irregularities in the menstrual cycle. Other signs of the change in hormonal balance may include:
- increased irritability, mood swings - sleep disturbances
- water retention

2nd phase: perimenopause
- Weight gain
- Joint pain
- Tightness in the breast
The actual period of "change" includes 1-2 years before and up to one year after the last menstrual period. The production of estrogen is reduced more and more and eventually stops completely. Usually this leads to an increase in complaints such as:
- Hot flashes, sweats
- concentration problems
- circulatory problems

3rd phase: menopause
- increased fatigue, listlessness
- increased need to urinate - joint pain
The time of the last bleeding (on average at the age of 51) marks the beginning of infertility and is called menopause.

4. postmenopause
One year after the last bleeding, the phase of postmenopause begins, in which the hormone balance settles and complaints such as hot flashes decrease again. The low concentration of estrogen promotes
- a decrease in bone density
- the drying out of the mucous membranes
- a decrease in muscle strength (back and joint pain)
- development of diabetes and cardiovascular diseases

What can I expect during the menopause check-up?

The 90-minute session includes, among other things:

• detailed anamnesis interview about your symptoms, wishes and goals
• Pelvic floor examination (UR choice questionnaire and optional vaginal examination).
• Consultation for urinary incontinence (stress incontinence, urge incontinence, irritable bladder)
• Testing of the musculature (speed strength, endurance, coordination)
• Examination of the straight abdominal muscles (rectus diastasis due to pregnancies).
• Assessment of pelvic statics and loading of the feet, knees, hips in stance and gait.
• Assessment of posture and joint mobility
• Discussion of specific exercises, sports adapted to your everyday life, sports hobbies and physical condition.

Afterwards you will receive, among other things:

• individualized training plan taking into account your lifestyle and goals
• individualized treatment plan for specific complaints

To whom do I recommend the pelvic floor consultation?

Due to the specific anatomy of the female pelvis (3 openings for the urethra, vagina and anus), the extra strain caused by pregnancy and childbirth and the lack of oestrogen after the menopause, women are more often affected by urinary incontinence than men. In addition, many women suffer from their stressful everyday lives and find little time for themselves and to relax. This can also lead to painful tension in the pelvic floor.

A distinction is made between stress incontinence (pressure in the abdomen increases, e.g. when sneezing or jumping, sudden loss of urine without urge to urinate, tends to affect younger women), urge incontinence (sudden, unstoppable urge to urinate with loss of urine, irritable bladder, increases with age) and mixed incontinence (when symptoms of both forms of incontinence occur).

Vaginal births, weaknesses in the connective tissue and muscular holding apparatus and obesity can lead to subsidence of the pelvic organs (bladder, uterus, bowel). These become noticeable, among other things, by a feeling that something is pressing down, a foreign body sensation in the lower abdomen, bladder weakness with a frequent urge to urinate or difficulty urinating, pain during sexual intercourse, problems with bowel movements, back pain, or pressure ulcers and bleeding in the vagina.

I recommend the pelvic floor consultation to all women who suffer from the above symptoms.

What can I expect at the pelvic floor consultation?

The 90-minute session includes, among other things:

• Examination of the pelvic floor muscles
• Examination of the abdominal and respiratory muscles
• Assessment of the posture and function of the thorax
• Assessment of posture and joint mobility
• Screening for bladder, bowel, or sexual dysfunction.

Afterwards you will receive, among other things:

• Rehabilitation or training plan taking into account your lifestyle and goals.
• Advice on ergonomic carrying, sitting and toileting behavior
• Advice on how to behave during sports

The female pelvic floor consists of several flat muscle layers that are connected by connective tissue, so-called fasciae, and attach to the bones of the pelvis (pubic bone, ischium, coccyx), among others.

The pelvic floor muscles perform important tasks:

• carries the pelvic organs
• ensures urinary and fecal continence
• supports the pelvic movements
• stabilizes the upright posture
• Reflectively cushions pressure increases caused by sneezing, jumping, coughing
• provides important conditions for pleasurable sexual intercourse

The pelvic floor can be impaired in its function by diseases such as lichen sclerosis or neurological diseases such as multiple sclerosis, by injuries in vaginal births with perineal rupture or use of suction cups, by radiation in cancer diagnoses, because of a constant overload in obesity, constipation or diseases of the respiratory tract we chronic irritable cough. Psychological components have a great influence on the development of an irritable bladder or the chronification of pelvic pain syndromes.

I recommend the Pelvic Floor Check Up to all women who want to get to know their body better with its anatomy and functions and who are interested in tips to maintain pelvic floor health and prevent weakness, pain, incontinence, organ prolapse and dysfunction.

What can I expect during the pelvic floor check-up?

• Examination of the pelvic floor muscles
• Examination of the abdominal and respiratory muscles
• Assessment of the posture and function of the thorax
• Assessment of posture and joint mobility
• Screening for bladder, bowel, or sexual dysfunction.

Afterwards you will receive, among other things:

• Rehabilitation or training plan taking into account your lifestyle and goals.
• Self treatment guide
• Advice on ergonomic carrying, sitting and toileting behavior
• Advice on how to behave during sports