Inside the Box

Jo is a well experienced physiotherapist and Director of The Physiotherapy Clinic. She has spent the better part of 10 years learning and working in the pelvic floor, pelvic health and childbirth arena which has lead to her post grad cert in continence and women's health and a masters in women's health medicine. Now Jo has moved into studying medicine and is a PhD student looking into pelvic floor assessment in pregnancy. Jo also heads a birth education platform, Born Ready, and hosts a yearly conference for health professionals working in Women’s Health . Fun fact Jo’s grandmother had 18 children. 

In this episode we cover:

• How Jo’s personal and professional experience have shaped the work she is doing in birth preparation 
• Juggling clinical work, motherhood, business ownership, studying medicine and deep diving into research work
• Jo’s current work in the research field on pelvic floor outcome measures in pregnancy, and their relationship to birth outcomes
• What is the role of the physio in birth preparation?
• What are the most important parts of birth prep to reduce birth trauma 
• How to push effectively
• Birth education and Born Ready 

Links: Born Ready https://www.bornready.com.au/ 

Marc is a colorectal surgeon with over 25 years experience in the medical field. He has a career-long passion for preventing, treating, and curing problems related to the bowels, pelvic floor and their function. Marc is a specialist with expertise in abdominal and pelvic pain, bloating, constipation (difficulties emptying the bowel), bowel leakage (incontinence) and bleeding from the back passage. 

Marc is passionate about giving holistic, conservative management strategies to his clients where he can and dives into some very practical and useful tips to keep your bum healthy and happy. In this episode we cover:

• What are the most common bowel disorders seen by a colorectal specialist? How many of these have a pelvic floor dysfunction component?
• The journey to becoming a colorectal specialists and why Marc is so passionate about it
• When would you consider a caesarean section for subsequent births after experiencing a 3rd or 4th degree perineal tear in your first birth? Marc describes 3 key factors required for decision making.
• Missed 3rd or 4th degree anal sphincter tears after having a baby, what are the treatment options? Is surgery able to help this? How late is too late?
• The use of sacral neuromodulation in the treatment of faecal incontinence 
• Fecal urgency and difficulty holding poo after a cesarian section - when will this get better? Whats normal? What can you do a bout it?
• Stool bulking (fibre) vs stool softners - how do you know which one?
• Haemorrhoids, fissures and painful poos - what’s normal, what’s not and what can you do about it
• How long is too long to do a poo (this one will surprise you!)
• Marc finishes with his mantra for optimal bowel health “Eat well, keep moving and don’t rush”

Links: https://www.thebowel.clinic/about

Dr Dean Conrad is a specialist obstetrician and gynaecologist based in Sydney. 

Dean is staff specialist at The Sutherland Hospital and a conjoint lecturer with the University of New South Wales. He has a special interest in minimally invasive laparoscopic and robotic pelvic surgery and specialises in the treatment of fertility and pelvic floor dysfunction, including non-mesh treatments for urinary incontinence. His passion for education has taken him across the country as an educator, proctor and surgical mentor for doctors, advancing the knowledge and awareness of endometriosis and pelvic floor dysfunction.  

In this episode we cover:

• What is stress urinary incontinence (SUI)?
• What are the two main causes of stress incontinence and how do we assess it in clinic?
• Measuring mid urethral closure pressure in urodynamics 
• What surgical options are currently available (Mesh and non mesh options) for treating SUI and how effective are they?
• A deep dive into the Birch Colposuspension for surgical management of SUI
• Is there a place for urethral bulking? And how effective is it?
• How has Fatherhood shaped his outlook in his professional life

Links: Instagram @drdeanconrad

Website www.anaria.com.au/dr-dean-conrad

Jess is a 3x Olympian, 2022 Commonwealth Games Marathon champion and 2x com games bronze medalist. She is also a mum of 2 and a qualified physiotherapist.

Jess birthed her 2nd Baby, Ellie, just 10 months before she finished 13th in the Paris olympics in the Women’s Marathon. In this episode we discuss:

• Ellie’s birth story (Planned Cesarean Section) 
• Post partum recovery timelines after a c-section and return to running 
• Training for her first marathon after birth (South Korea)
• The lead up to the Paris olympics, her training, sleep schedules and diet 
• Juggling multiple night wakes, breastfeeding and the demands of olympic training 
• Mindset and physical training in the lead up to Paris 
• What’s next in store for Jess

Links: You can follow Jess’s journey online @jess_tren

Zali is a dedicated and compassionate physiotherapist in Women’s Health with a special clinical interest in the sporting pelvic floor.  Zali has worked with many elite athletes and sporting clubs including Essendon AFLW/VFLW, Hawthorn AFLW and VIS Women’s Hockey. 

More than two thirds of elite female athletes in sports like soccer, gymnastics and weight lifting leak urine. In this episode we cover:

• What types of pelvic floor dysfunction we see in the athletic population (including stress incontinence, pelvic pain and constipation) 
• Educating Female athletes on pelvic floor, what they should know 
• The stats on pelvic floor dysfunction in female athletic populations 
• A deep dive into theories around why our top athletes might leak urine (it’s not a weak pelvic floor!) 
• The stigma around pelvic floor dysfunction amongst elite athletes 
• Treatment options for stress incontinence in sport and how quickly athletes can see improvements in symptoms 

Links: You can follow Zali’s professional and personal journey online @zali.rayment.physio 

Kate Ivey is the founder and a trainer at DediKate, the online fitness community for rural and regional women, mums and those that don't have time for the gym. She lives on a farm in New Zealand with her husband and 3 kids. Kate and her DediKate team help women all over NZ and Australia to look after themselves and exercise for the physical and mental health benefits. Their short and effective online workouts enable women to fit exercise into their busy lives! 

In this episode we cover:

• Kate’s story of putting on 30kgs in her pregnancies and overcoming road blocks in her return to exercise after having her 3 babies 
• Kate’s birth stories and why she is passionate about advocating in this space 
• How Kate turned a dissatisfaction / road block in her 30’s into a thriving online business 
• Words of wisdom and encouragement for Mum’s trying to get back into fitness after having children 
• Therapy and mindset training in your 30’s and key takeaways for Kate after more than a year of working on her mental fitness
• Kate finishes by answering this questions: “What legacy do you hope to leave on the Women’s fitness industry?”

You can find Kate’s online programs here www.kateiveyfitness.com and follow her journey on instagram @kateiveyfitness.

About Liv: 
My name is Liv, and I am a qualified physiotherapist and clinical Pilates instructor who is passionate about all things movement. I have been working in the industry for 6 years now, and have a special interest in Women's health. I love educating and sharing what I have learnt about the body with others. Whether you are a weekend sports warrior, Pilates enthusiast, newbie mover or returning to movement after injury or some time off, nothing brings me more joy than seeing others achieve their movement goals!

In this episode we cover:

• Liv’s passion for pilates and how she got to clinical pilates instructor and physiotherapist
• Is pilates worth the hype for pregnant and post partum women?
• Is pilates a prolapse safe workout?
• Can pilates help pelvic floor dysfunction?
• Whats the difference between clinical pilates and standard pilates?
• Liv finishes by answering this questions: “If you could only pick 2 pilates exercises to do for the rest of your life what would they be and why?”

Links: You can find Liv’s professional Pilates journey on instagram @pilateswithlivv 

In this episode you’ll hear from us; Kat, Caitlin and Tash. We unpack life lately:

• 2 of us are pregnant (we’ll let you listen to find out who)
• The comparison of pelvic floor rehab and return to sport after a second vaginal birth Vs a first 
• The little things we implement (and stuff we dont do so well) when navigating our marriages with smalls kids, businesses and a busy work schedule
• Exciting new projects for Ivoryrose and The Hills Physio leading into 2024 

You can follow our journeys: @ivoryrose_physiotherapy @pelvicfloorwithcaitlin @insidethebox_pod @katwarr

In this QandA episode Kat, Caitlin and Tash answer some of your questions about pelvic pain. 

Some of the questions we cover:

• “Ive had painful intercourse my entire life and I tried physio who recommended dilators, but I had no improvement. Do dilators work? Should I try again?”
• “TENS for period pain, are they as effective as they are made out to be?”
• “How can I talk to my partner about painful intercourse?”
• “Are there specific exercises to help vaginismus?”

If you have more questions, slide on into our DM’s @insidethebox_pod

In this patient story we are joined by Hiral, a 39 year old Social Worker who shares her story of living with endometriosis. Hiral openly discusses the challenging fertility journey she went on that ended with a hysterectomy, which ultimately changed her mental and physical health for the better. 

In this episode we cover:

• Navigating a new healthcare system after migrating to Australia at 23 years old
• Hiral’s symptoms that lead to a diagnosis of endometriosis 
• Treatment options she tried in attempt to overcome her symptoms 
• Hiral’s trying fertility journey and the mental and physical toll that this long journey took on her and her partner 
• The decision to have a hysterectomy 
• Life after a hysterectomy