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When I was a practicing personal trainer, I was often made to feel that my skills and services were inferior to that of a physiotherapist.

Coupled with this, is a genuine fear among some Fit Pro’s that referring clients to an allied health professional will somehow deem them as responsible for the injuries of their clients and / or shine a light on their own knowledge inadequacies. And there is also a lingering perception that referring will then equate to losing a client.

It is hard to build relationships when:

  • there is not a full understanding of what another does
  • mutual respect is lacking, and when
  • people react out of a scarcity mindset

And while it is true that the qualifications of a person who has Cert III or IV in fitness is significantly less than that of an Exercise Physiotherapists or physiotherapists – fitness professionals still have a valid role in the health equation.

A person who is on a mission to get fit are most likely to seek out the services of a fitness professional. This might be at their local gym, or it may be finding a more smaller boutique option. Even if they have injuries, there can be apprehension about cost and time and may skip seeing a phyiotherapist… when all they want to do is just get in shape.

This is even more true, when an injury can not be readily seen and either the client (or their trainer) does not probe the possibility. Such is the case for pelvic health issues, when leaking can be seen as normal, rather than as it should be seen which is common.

Leaking does not have to be you (or your clients’) normal. Having a service that you offer as a Fit Pro for women who are experiencing pelvic floor dysfunction (pain, leaking, prolapse… anything that does not feel right) can really set you apart and make you stand out as a true professional!

Creating a WIN WIN WIN situation

One of the key reasons that my personal training business mishfit® won several awards from Fitness Australia, was the formal relationships that we had with other allied health professionals. Namely pelvic health physiotherapists and dietitians.

This was a win, win, win relationship between the Allied health practitioner, the client and the mishfit® franchisee.

A win for the client because they had their pelvic floor assessed and knew exactly how to contract their pelvic floor and deep abdominal muscles. This was achieved with the help of ultrasound. Many of our clients did not even know that such a service existed. Or were reluctant as they thought such a visit was unnecessary. We sold them the benefits – as trainers we could not see if they were contracting their pelvic floor correctly and to train them approrpiately and importantly, we needed the diagnois from a professional. In the 10 + years I ran mishfit®,  I never had one client who took up the money back guarantee.

We don’t know what we don’t know!

Here is a video that I made showing the experience of having the pelvic floor ultrasounded. An ultra sound is a very unobtrusive way to get visual feedback to ensure you are correctly contracting your pelvic floor. It is also a good opportunity for women to ask questions or the pelvic health physio to ask questions to see if there are any other issues.

And of course, as the Fit Pro – we benefitted greatly. Pelvic health issues have no outward signs – it is not something that you can peg on how someone walks, what they wear, or how they look. Pelvic floor dysfunction comes in all shapes sizes. However, there is such a thing as exercise induced incontinence or exercise induced prolapse. This was the best diagnostic way to have the “inside knowledge” of just how at risk a client was. A report sent back to me from the physio to the trainer with all the relevant information on how to best support each individual client.

It was also a WIN for the Allied Health professional. They were introduced to new clients, who were more likely to return to them when and if they had other issues in the future – as they were a trusted and known professional. As well as knowing that they had a team of fitness professionals who were supporting the mutual client with monitoring the exercise prescription and execution.

mishfit® Care Package

I called this arrangement the mishfit® Care Package. And it also included options with a registered dietician for those clients who were also wanting weight loss.

This system not only boosted our professionalism, but it also gave the business an additional revenue stream.

Terry Wesselink

Terry Wesselink was one of our original pelvic health physiotherapist partners. Terry has not only been a great source of wisdom and knowledge, but she was also one of the first pelvic health physiotherapists who was genuinely excited about the benefits of a partnership, like that of the mishfit® Care Package could represent in holistic health for women. Terry promoted this idea amongst many of her collegues and together we have broken down stereotypes and the outdated women’s health models.

Terry now leads the team at the Continence Foundation Victorian Branch and is responsible of the full operation of this peak body organisation. This includes pelvic health education, resource development, health promotion and managing a busy NDIS continence clinic. 

I asked Terry to put her pelvic health physio hat on and tell us about:

Why do you think it is important that fitness and physio work together?

Health is something that needs to be actively pursued and pelvic health is no exception. I have learnt through experience that we cannot sit by passively and expect optimum health to be delivered to us. Quick fixes on their own, often have short lived results. In order to have good pelvic health in the long term, we need to understand how to exercise our pelvic floor and core muscles safely and effectively and then do that exercise regularly.

In my mothers era, women didn’t know they had pelvic floor muscles and even today the majority of women need some guidance in learning how to exercise their pelvic floors (and the rest of their body) safely and effectively.

Even if every physiotherapist who ever qualified, switched to women’s health there would not be enough of us to help every woman out there with a problem.

To give you some idea of the scale of the problem, take a look at these statistics:
1 in 3 women has a problem with incontinence,
Some women have overactive pelvic floors or pelvic pain, and
50% of women over 50 years have some degree of Pelvic Organ Prolapse.

I believe:

  • While some symptomatic women really should have a physiotherapy (or medical) assessment and treatment, not every woman who is uncertain about how to exercise safely needs pelvic floor physiotherapy.
  • Fitness instructors are already in the business of teaching correct and safe exercise, it makes perfect sense for them to also be involved in helping clients with correct pelvic floor activation.
  • Fitness instructors are also at the frontline of health and can easily screen their clients for pelvic floor issues.
  • Fitness instructors have their client’s trust and can encourage those who need extra help to seek it in the right place.

And as I mentioned earlier, exercise is really important in the pursuit of health. I also need to be able to refer my patients to fitness instructors who understand how to help my patients exercise safely and in a way that is appropriate for their particular pelvic floor issue.

I need fitness instructors I can talk to about my patient’s needs.

How do you see a service like the mishfit® Care Package helping women, regardless of whether they are symptomatic or not?

The mishfit® care package was a great way for women to have a brief session with a Women’s Health Physiotherapist and find out how well their pelvic floor is working. Being able to see how their pelvic floor is working on Real Time Ultrasound is a real eye-opener for many women. Many women gain extra confidence in their ability to activate (or relax) their pelvic floor muscles and some women learn the right action for the first time. Incorrect pelvic floor technique is more common in women who have symptoms, but can occur is asymptomatic women too. Getting the technique right can prevent problems developing in future.

After the Real Time Ultrasound, I could give the mishfit® instructor clear objective information to help her chose the right level of exercise and progression for each woman.

I believe it’s really important for everyone involved in your health to have access to the right information.

What are your top tips for women who need pelvic floor support?

Learning to use your pelvic floor muscles correctly is both learning a new skill and establishing a new habit and the first step in learning any new skill is to get the right instructions and instructor.

  1. Make sure you understand the instructions and aim to perform the new skill correctly from the start.
  2. Learn to self check or ask your instructor to check that you are performing the new skill properly.
  3. Practice your new skill often to gain confidence in your ability.
  4. Apply your new skill in lots of different situations to become a master.
  5. Once you have mastered the skill, then work on your strength, coordination, speed etc.

It’s easier to establish a new habit if you associate it with an existing habit.
I work with my clients to identify appropriate habits to associate with their new pelvic floor muscle habit.
It is a true advantage if you have an instructor (fitness professional) that helps women to establish their new pelvic floor muscle habit as part of the exercise classes.

Where can people find a pelvic health physiotherapist?

The National Continence Helpline  has a directory with suitably trained  physiotherapists from all over Australia. Or alternatively you could ring the National Helpline 1300 33 00 66 which is staffed by continence nurses, that can help you trouble shoot any sort of pelvic floor / continence queries.

People don’t need a referral to make an appointment with a physiotherapist, but if they have symptoms, then they can speak to their GP to see if they are eligible for an Enhanced Primary Care Package which entitles them to a Medicare rebate for some of the costs.
If they have private health cover, they can check with their insurer what cover they have for Physiotherapy treatment.

Pelvic Floor education is important for everyone… what can you recommend?

The Victorian Continence Resource Centre has a great resource called Reclaim your Core – which I highly recommend:

Click on the image to purchase

 

 

And I am sure Mish, you might remember helping me with the many edits of my own book – WeeFree Women!

From Mish:

Terry is caring and funny and what is more – loves promoting Fit Pro’s who share our vision of working collaboratively to get women moving, and keep them moving – safely! 

If you are a Fit Pro and especially if you are working with women, I strongly recommend that you connect and build a relationship with a pelvic health physiotherapist near your practice, to enhance the services you provide. Although this can be a WIN WIN WIN situation, don’t be disheartened if you meet an Allied Health Professional who does not seize this opportunity… keep looking – because connection, my friend, is the way of future proofing your business!

Can you find a Terry in your community?

 


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