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Ovulation Pain or Mittelschmerz

Posted: Thursday, December 19, 2013 at 8:00:22 AM EST by Alyssa Tait

 Can you feel when you're ovulating?

That niggling pain is back again, low down in the left of your lower abdomen. It’d be nice to just sit down and put your legs up, but you’ve got to keep working.  That time of month again – no, you’re not due for your period for another two weeks! This is mid-cycle pain. Not only do you get period pain, but you’re hassled in the middle of the month by more pain! Why?

That cyclic stabbing pain in one side of the lower abdomen that some women experience is known as ‘’Mittelschmerz’’ (meaning middle pain) or ovulation pain. It is typically described as occurring at mid-cycle. However, this is dependent on the length of the cycle. It would be more accurate to say it occurs approximately 2 weeks before the menstrual period – that is, at the time of ovulation.

Ovulation pain tends to switch sides from month to month (depending on which ovary you are ovulating from, obviously). For most women it lasts a few hours or less – just enough to let them know they are ovulating. For some women, it lasts for more days. And for some very unlucky women, it is severe and can be accompanied by other symptoms such as nausea or even vomiting.

The precise cause of Mittelschmerz is uncertain. It may be due to the enlargement of the follicle before the egg bursts forth in ovulation, or the rupture of the follicle itself, with the spilling of its contents into the surrounding tissue. Whatever it is, if it is anything more than a minor nuisance, you may want to have it looked into.

Severe Mittelschmerz is often due to endometriosis, a condition where the inner lining of the uterus (the endometrium) ends up implanted in places it shouldn’t be. Endometriosis can only be definitively diagnosed with a laparoscopy – a relatively invasive procedure. Women with endometriosis usually have painful and heavy periods as well, and sometimes pelvic or abdominal pain at other times of the month. This can imitate irritable bowel syndrome.

In my experience, cyclical abdominal or pelvic pain is more likely to occur when there are ‘’tissue restrictions’’ around the organs involved (in this case, the ovary, fallopian tube and uterus). For example, endometriosis causes adhesions (scarring) within the tissue which causes it to tighten up and be less flexible. As your pelvic organs contain smooth muscle and are designed to be very mobile, these restrictions can result in you feeling things you shouldn’t (such as pain) – or feeling sensations more strongly than necessary. Tissue restrictions that can be palpated by an experienced physiotherapist are certainly present where there is endometriosis, but many women I see with these problems do not have a diagnosis of endometriosis (yet, anyway).  In my experience, ovulation pain, period pain and other pelvic or abdominal pains can be successfully treated by gently easing these tissue restrictions. This involves a form of tissue release known as visceral manipulation, or visceral-specific myofascial release. Visceral manipulation is very gentle and performed through the abdomen by a physiotherapist who has trained specifically in this technique. It can provide relief within just a few sessions.

Contact us for an assessment using this approach and possible visceral manipulation treatment, or just to make an enquiry.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Minimising Pain Via Healthy Scars: How Nutrients Help

Posted: Thursday, July 17, 2014 at 4:34:24 PM EST by Alyssa Tait

Injury, trauma and surgery leave their mark.

It’s inevitable – scars are a normal part of the healing process.

Sometimes this is obvious – like Caesarean scars or the abdominal scar after a hysterectomy. These are easy to see (which doesn’t always make us happy! Scars that are painful are also obvious – like, for some women, episiotomy scars that make sex more painful.

Movement is an important part of healthy scar healing - you really need to play with your scars! However, an often-neglected factor in healthy tissue and scar healing is nutrition.

Why is nutrition relevant in scar healing?

Availability of certain nutrients has an impact on various aspects of healing and scar formation:

  • “Cleaning up” the initial inflammatory process
  • Preventing infection
  • Laying down healthy tissue
  • Manufacturing new blood vessels
  • Increasing the strength and flexibility of the scar

The “Clean-Up” and preventing infection

  • Vitamin A – immune effects for healthy inflammation
  • Vitamin C – acts as an antioxidant to “sweep up debris”; higher doses help counter constipation from pain medications
  • Zinc – deficiency results in poor healing
  • Bromelain – reduces swelling and pain, speeds up resolution of bruising
  • Protein – a deficiency results in prolonged inflammation and delayed healing
  • Glutamine – promotes healthy inflammation

Rebuilding the House: Laying down healthy tissue

  • Vitamin A and vitamin C – improves collagen production
  • Bromelain – speeds up healing
  • Glucosamine – leads to production of hyaluronic acid to hasten healing
  • Gotu Kola – a herb that increases collagen production

Getting the Plumbing In: Manufacturing new Blood vessels

  • Vitamin C and copper – help produce down blood vessels

Bouncing Back: Strength and flexibility of the scar

  • Vitamin A
  • Zinc – deficiency results in a weaker scar
  • Glucosamine – leads to production of hyaluronic acid for a stronger scar
  • Protein – a deficiency results in a weaker scar
  • Gotu Kola – a herb that improves strength of the scar

I was very aware of all of this when I recently had surgery for a broken ankle. This was a serious injury with a very decent scar. To cover my bases, I have taken all of the above nutrients each day in addition to a high protein, high vegetable diet. The body has amazing healing capacity – but it still appreciates a helping hand by having plenty of raw materials on-hand for rebuilding!

If you have had or are planning surgery, and want to really get off on the right foot, contact us at Equilibria for a tailored nutrient program.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Adhesions: Why You Need To Play With Your Caesarean Scar

Posted: Saturday, August 16, 2014 at 6:31:38 PM EST by Alyssa Tait

Does your scar move how it should?

Try this: pick up the skin on the back of your hand, lift it up and drop it. Notice how stretchy it is? Good, healthy tissue, like a healthy body in general, MOVES. That’s right, mobility is as important for skin is it is for the rest of the body.

Scars, on the other hand, don’t have good natural mobility. Scarring, or the formation of tissue adhesions after injury or surgery, is a healing process. The priority for healing tissue is to become strong quickly to protect the injured area and prevent re-injury. Unfortunately, as part of this process, tissue becomes tight, stiff and inflexible. Scars become stuck to the tissue below, whether this be muscles, tendons, ligaments or even organs. How stuck they get depends on a lot of things: the part of the body; how deep the cut was; how well your healing process occurred (including how good your nutrition for healing was); how early you start movement rehab; how well you stick to your program; how much stretching you do, and more.

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I can give a personal example here. Twelve weeks ago I broke my ankle on both sides and had surgery. There is a scar of several inches on the outside of my lower leg where they inserted a plate. I dutifully followed the surgeon’s instructions and kept my ankle completely immobilised for two weeks, then introduced controlled movement in one plane only. Despite following the correct protocol, by the time I was allowed to walk on the leg again (at six weeks) the ankle was incredibly stiff and horribly painful to take weight or to move or twist in any way. Now, at twelve weeks, I need to do painful stretches every day for around 2 minutes at a time in order to get the movement back. As in any orthopaedic rehabilitation, this is a slow and painful process.

Now take abdominal surgery. If you have had a Caesarean section, this is exactly the same process. The obstetrician cuts through many layers to get to your uterus: the skin, the fat, the fascia (tight connective tissue wrapping) of the muscle, the muscle itself, more fascial layers and finally the organ itself. So the scar you see in your lower tummy, neat as it is, is only the tip of the iceberg.

Try an experiment. Grasp your lower tummy in your hands – thumb above the scar, fingers below. Now pick up the skin and move it around. Stretch it, wiggle it, lift it, move it every which way. Does it move easily and painlessly? Can you even lift it?

When scarring is adhered to the underlying tissues, it’s hard or even impossible to lift. The edges of skin you try to lift collapse inwards into the crevasse that is the scar, tightly bound to the what’s underneath. It’s all gummed up under there, restricting circulation and compromising your range of motion; it can be responsible for underlying muscle tension and spasm and even pain. This is a common source I see of “unexplained” pain, where all medical investigations have come up with nothing. If your pain is new since your surgery, and other causes have been ruled out, you need to get your physiotherapist trained in connective tissue manipulation to check this.

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It doesn’t feel nice to stretch a scar. In fact, it can feel quite horrible: it can sting, give you strange hypersensitive sensation and feel sore after you stretch it. But it is essential to get it as mobile as you can – and as much of this as possible needs to occur between the six-week and the twelve-week mark post surgery, because after this, scar tissue gets tighter (or stronger).

From the two-to-six-week mark, I massaged my strange-looking, bruised, hypersensitive leg with caution, trying to both remove swelling and get my nerves used to the sensation. From six weeks, when I tried “picking up” the scar, I realised how tight it had become – it was so “gummed up” I had almost no inward movement of my ankle. While this restriction is often less obvious in a Caesarean scar, it is absolutely an issue. I have seen many patients whose tight scar tissue is restricting their movement and promoting pain; in some, it’s even promoting dysfunction of the underlying organs.

Movement is essential for good health! And this goes for scars as well. If you are before the six-week point post-surgery, ask your physiotherapist for specific, safe mobilisation exercises for your scar. If you are past the six-week point post-surgery, get your scar moving vigorously. Pull it and stretch it every which way. Just play with it! For help with getting your tissue healthy and moving again, contact me at Equilibria.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Adhesions: A Cry For Help From Your Episiotomy Scar

Posted: Saturday, August 16, 2014 at 5:27:31 PM EST by Alyssa Tait

I suspect we underrate the negative impact of episiotomy scars.

My last post was about scar tissue after surgery and how it can cause real problems, both in the short and long term. I used the examples of an orthopaedic surgery scar and a Caesarean scar. Both of these are considered major surgery, and when you really stop to think about it, it makes sense that they require some rehabilitation. (As an aside, nutrition has a big impact on healing of scars, and should be a major focus in the first three months after any surgery).

But what about perineal scars from childbirth injury? These include scars from episiotomy, OASIS (obstetric anal sphincter injuries), and all types of tears to the vagina and perineum, whether first-, second-, third- or fourth-degree. Won’t these types of scars benefit from rehabilitation too? Of course they will – in fact, I think we need to be much more proactive about this.

When the obstetrician gives you your six-week postnatal “clearance”, this is just the beginning. In fact, many women see their GP and have no perineal or vaginal examination at their six-week check-up. If they do have an examination, the aim is to ensure healing is adequate and there are no signs of infection. This quick check is not designed to confirm your tissue is back to its fighting best!

Many women I see, when they see their doctor for their six-week check, have not started having penetrative intercourse again yet. This is perfectly natural; not everyone feels ready by this point. However, when they are given the “all-clear” by the doctor, it comes as a rude shock when they first try to have intercourse two, four or six weeks later – to find that it’s horribly painful and not at all what they were expecting.

For some women, this initial pain with penetrative intercourse eases up quickly; for others it is mild or not significant in the first place. However, for a significant number of women, this pain is severe, persistent and very disruptive of their intimate relationships.

Pain with sex after childbirth is quite common, and in a way should come as no surprise. Think about this: you break your ankle and it is immobilised for six weeks in a cast or moonboot. Finally the day comes when it can be taken off. With joy and enthusiasm you throw your weight onto it – in fact, you don’t just try to walk, but jump off a high step and throw yourself into an exuberant set of dance moves. OUCH! It’s excruciatingly painful, isn’t it? Of course it is. Your body is not designed to go from zero to a hundred in the blink of an eye after a significant injury.

Well, an episiotomy or perineal tear is a significant injury to your vulva. While it might be mild and you get away with token, short-lived discomfort, you may be like many women I see for whom it is actually quite a hard road back to enjoyable, pain-free intercourse.  I often describe penetrative sex to women as being what a marathon run is to an ankle sprain. You wouldn’t jump straight into a marathon once your ankle sprain heals! But for some reason, women expect (or society expects us!) to be straight up for sex after the perineum heals postpartum. As I mentioned, some women have no ongoing problems. But if you find that the low-level discomfort (or strong pain) doesn’t get better and better each time you try, you need to get going with some perineal rehab!

The longer you leave this, the harder it is. A number of women I have seen with post-partum vulval pain and painful sex were so sensitive in the area of the scar they could barely stand light touch, let alone entry of their partner’s penis. This is more likely to occur the longer you leave it, and may involve sensitisation of the nervous system (where the brain, spinal cord and nerves become hypersensitive to touch and normal sensations become interpreted as pain: this is called central sensitisation).  The pelvic floor muscles become both tight/overactive and weak – not a good combination!

A good way to start to help this is some nice perineal massage daily with olive oil, apricot kernel oil or jojoba oil. You can do this yourself, and if you like, progress to allow your partner to do it. (You may need to have an agreement that nothing sexual proceeds from this, unless you yourself wish to initiate it.) If this does the trick, that’s fine. However, often more specific therapeutic input is required. A physiotherapist trained in connective tissue mobilisation and myofascial release can help your vulva and vagina restore its natural movement, flexibility and sensation. This requires specific training, and it’s worth enquiring of your physiotherapist whether they have this specific set of skills. With the right type of therapy, you can get back your good health in this area, get rid of pain, and restore the quality to your sexual experience. Contact me to get help for this.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

The Five Sources of Painful Sex (And Not One of Them Starts With "V")

Posted: Thursday, December 11, 2014 at 12:21:26 PM EST by Alyssa Tait

Vaginismus, vulvodynia, vestibulodynia, vaginitis, vulvar lichen sclerosus, vaginal atrophy, vulvitis…

Any of these might be names that your “painful sex” has been given, but they don’t tell you much about the root cause. Painful sex itself is medically termed “dyspareunia”- but again, if a doctor tells you that you have dyspareunia, it doesn’t leave you any wiser.

Even after you have been given a diagnosis (and many women never are), it is more important to understand the cause of your pain. While there is rarely one source of the pain, these are five areas that can contribute to the cycle of pain to ask your health professional about.

Skin.

vaginalepithelium_sm_sm

The external skin of the vulva or the internal skin of the vagina is an often overlooked source of pain. Raw, chafed, inflamed skin is painful to rub on your arm, so why would it be any different in the vulva or vagina? Sore, vulnerable and fragile vaginal or vulval skin can be due to many causes, including hormones, allergies, mucosal inflammation from other sources or nutrient deficiencies. Vaginal dryness can be a contributing factor, but is often not the only cause (or even the most important cause). Tight scar tissue in the skin from episiotomies is another source of pain with sex. Has your health professional ruled all of these out?

Nerves.

Nerves convey information about sensation to your brain. Sometimes, though, the nerves themselves get “caught up in the action” creating a type of nerve inflammation called neurogenic inflammation. This creates over-sensitive nerves, technically known as “peripheral sensitisation”.

Organs.

uterusandcervix

Tender or inflamed organs can be painful when pressure is applied to them. A problem with your bladder can give you pain with sex, especially in specific positions. Possibilities include urinary tract infection, urethritis or interstitial cystitis/painful bladder syndrome. Irritable bowel syndrome can also cause pain with sex, as there is often significant pressure on the rectum and the small intestine through the walls of the vagina. Endometriosis is an inflammatory condition leading to formation of adhesions or internal scars, and a common cause of painful sex.

Muscles.

It is rare that I see a woman with painful sex who does not have some muscular cause as part of the picture. Stinging after sex can be an issue with the skin - but it can also be an early sign of problems with the muscles. It is important that all parts of the pelvic floor muscles, from the surface to the deep muscles, are assessed, as well as the deep internal hip muscles (obturator internus).  More commonly, it is assumed that muscles are the sole cause when there are other causes that need to be addressed as well. While muscular problems are important to address, it is rarely sufficient to work only on the muscular causes of painful sex.

Brain.

brainonfire

The brain causes of painful sex fall into two categories: the over-blamed brain and the under-blamed brain. In the over-blamed brain, it is assumed that stress, relationship problems and psychological problems are to blame for most of the painful sex. This is rarely the case. In the under-blamed brain, the contribution of the central nervous system to the maintenance of your pain is undervalued. Central sensitisation is the medical term for when your brain and nervous system are actually helping to drive your pain - and it does not mean you are being a hypochondriac! Your health professional should be able to describe the ways in which the brain acts to perpetuate pain. In this situation it is a must to retrain your brain. My e-book Outsmart Your Pain describes the brain’s role in your pain and how to break the cycle.  It can be ordered here.

Ask your health professional if they have ticked off all five sources of pain in your assessment.

They should be able to give you a rough percentage that each is likely to be contributing to your pain.

If identifying potential sources of the pain is important, it’s even more important to identify the processes causing your continuing pelvic pain – but that’s the topic for another blog post.

Now that you know what areas are involved, you may be interested in a brief summary of ten reasons why sex hurts. There may also be special considerations for pain with sex in the older woman. And let's face it, sometimes it can just be a challenge to track down that elusive libido!

If you would like to solve your painful sex – whatever “V-Word” it might have been called - contact us to make an appointment.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain

Posted: Thursday, July 24, 2014 at 5:17:27 PM EST by Alyssa Tait

Your vulva hurts. Your vagina hurts. You’ve been told you have vulvodynia.

One doctor says the problem is in your nerves. Another says the problem is in your muscles.

But has anyone checked your connective tissue?

There is no doubt that in most cases of vulvodynia there is a problem with the nerves – either the local nerves of the vulva, or the central nervous system (the nerves that travel through your spinal cord and brain). In fact, some cases of vulvodynia are more accurately termed pudendal neuralgia (a problem with the pudendal nerve, which goes to the vulva).

Equally, most women with vulvodynia have a problem with the pelvic floor muscles – either as a cause (they were tight first, and caused dysfunction) or an effect (sex hurts so much it makes muscles tense up). Sometimes this is called vaginismus – confusing!

But the connective tissue is an often overlooked area that can contribute to vulvodynia as well.

So, what exactly is connective tissue, and what does it have to do with vulvodynia?

Connective tissue is the wrapping that covers your muscles and organs, and separates them from each other. It separates different layers of the body – skin from fat, fat from muscle, muscle from deeper muscle, and organs from muscle. It is everywhere in your body, connecting and holding everything together.

Connective tissue wraps around your blood vessels (veins and arteries), your lymphatic vessels (which carry fluid) and around your nerves. It is even wrapped around individual strands of your nerves, and individual fibres of muscle!

With this connective tissue surrounding and connecting all parts of your anatomy, can you imagine some of the effects if it’s tight or inflexible?

That’s right: pressure, tension, pulling, tugging, squashing and restriction of muscles, nerves and blood vessels. This can lead to pain that feels like burning, tugging, pinching, grabbing, swelling and “something getting stuck”.

Part 2 in this series will help you understand your connective tissue further - including how to get it healthy and flexible.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Connective Tissue Dysfunction in Vulvodynia and Chronic Pelvic Pain Part 2: Evaluation and Treatment

Posted: Saturday, August 16, 2014 at 6:30:48 PM EST by Alyssa Tait

Connective tissue dysfunction in vulvodynia is often missed, and needs to be treated.

Confused about connective tissue? Picture a whole lot of fruit in a plastic bag, sitting in a bowl of jelly.

apricots, plums, grapes and so on. The fruit can be moved and jiggled around within the jelly, even within the plastic bag.

Now imagine a several layers of cling wrap around each piece of fruit. The wrinkles of the cling wrap stick to each other. The fruit doesn’t move so well. The jelly doesn’t get swished around so much, and hardens up.

Your muscles and organs are the fruit, and the connective tissue is the cling wrap.

If it gets tight and thick, it restricts movement. Any restriction of movement in your body, whether in muscles, skin, nerves or organs, can create dysfunction and pain. (The jelly is what is called the interstitial fluid of your body – the fluid you never noticed unless it increases, causing swelling and possibly pain and even abdominal bloating).

The connective tissue around the organs is called visceral connective tissue. Treatment of this connective tissue is known as visceral manipulation, and can be a very useful component of treatment of vulvodynia and chronic pelvic pain.

A specific type of connective tissue restriction will be very familiar to you:

The most common type of connective tissue restriction is a scar.

When scars are deeper in the body, they are often called adhesions (but they are the same thing by a fancier name). Connective tissue mobilisation is a brilliantly effective technique for tight scars and adhesions, which are sometimes playing a part in vulvodynia (especially when there has been surgery, such as an episiotomy or Caesarean scar, or endometriosis).

What does connective tissue mobilisation (CTM) feel like?

CTM feels like a skin-rolling type of massage. It can be very relaxing and soothing. It can also be quite uncomfortable, especially when there is dysfunction. In fact, if CTM doesn’t feel that comfortable, it’s probably a good sign you’ll benefit from it! Sometimes one side of your body will feel fine and the other uncomfortable – guess which one needs the treatment?

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However, slow and gentle is the key. Too much CTM too soon can stir you up – irritate local nerves, irritate the skin, even cause bruising. But the right kind and amount of CTM is wonderful for freeing up tight tissues and helping them move the way they should, improving circulation and skin condition and helping to desensitise your nervous system. The health professional treating your connective tissue should therefore be very familiar with your condition – and especially with central sensitisation – and plenty of experience in treating it.

Getting treatment for vulvodynia?

Make sure you ask whether your connective tissue has been checked, and if it would benefit from treatment. Treating your muscles, nervous system and connective tissue together and restoring their normal movement and function will get you the best results.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Alkaline Diet for Good Health: Myth or Reality?

Posted: Wednesday, August 20, 2014 at 10:45:44 AM EST by Alyssa Tait

There is a lot of talk about the balance between acidity and alkalinity for good health – at least in the natural health world.

“Alkalinity” is often equated with good health, and “acidity” something to avoid. The world of chronic pelvic pain occasionally enters the debate as well, especially websites and forums devoted to interstitial cystitis or painful bladder syndrome.

lemon

So is “becoming more alkaline” really a goal we should have in mind – and is it more important if there is chronic pelvic pain? And if it is, how to we go about achieving it?

While this is a pretty big topic, my aim in this blog post is to make this concept as simple as possible, in order to make a “murky” kind of topic more clear.

This first post will cover the alkaline-acid theory in general. My next post will relate it to chronic pelvic pain and interstitial cystitis.

So let’s start with the first question.

Is alkalinity-acidity a genuine concept, or something that some strange naturopaths have inherited from folk wisdom with no basis in fact?

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That one is easy. Acidity/alkalinity are concepts accepted by mainstream medicine as well as the natural health world. In mainstream medicine, being on the end of either spectrum is usually linked with fairly serious diseases. The blood pH (acidity level) is kept in a fairly narrow range in good health (7.35-7.45).  Based on blood test findings, it is possible to be placed in one of five categories:

Normal – most of the general population. No excessive alkalinity or acidity.

Metabolic acidosis – the blood is too acidic, and the reason is something to do with the metabolism (such as uncontrolled diabetes)

Respiratory acidosis – the blood is too acidic, and the cause is something to do with the respiratory system, such as hypoventilation

Metabolic alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism

Respiratory alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism.

The great thing about this system is that it is nice and obvious, and can lead to a medical diagnosis of a serious illness. However, it is important to note that there is a difference between blood acidity and tissue acidity, and this test specifically measures blood acidity. Naturopaths often argue for the benefits of measuring tissue acidity, to see what is really happening inside the body tissues. This is a good point, as things need to be really out of balance in order to show up on this test. It is a reasonable argument to look for more subtle problems in the tissue itself to help reach optimal health. However, the measures often suggested to achieve this, such as testing the pH of the saliva, have no research support whatsoever and are not reliable. So even if measuring tissue acidity is the ideal, we lack reliable measures for it.

What influences acidity or alkalinity level of the tissue?

Although we can’t measure it, there are known influences on tissue alkalinity. One major one is mineral level. Another is the general composition of the diet. A third is digestive function. A fourth is level of inflammation in the body.

Composition of the diet

Traditional naturopathics often recommends a high vegetable, low animal diet to achieve an ideal level of alkalinity of the body. Sometimes there is an 80:20 ratio described: 80% of the diet should be vegetables, especially leafy greens. Meat is often demonised as being “acidifying” and discouraged if good health is desired. However, there are much stronger food influences on tissue acidity than meat. Sugar and refined carbohydrates are the major one, as well as coffee, alcohol and dairy products. It is sometimes assumed that food that is acidic in nature causes acidity, but this is not necessarily the case. Lemon and orange are high-acid fruits, but do not have a significant effect on the body’s acidity.

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Influence of minerals on alkalinity

A number of essential minerals have an effect of increasing alkalinity level. These include potassium (the major alkalising mineral of the body), iodine (a major alkalising mineral), calcium and magnesium level. If levels of these are low, it doesn’t matter whether you  have the “cleanest” of  raw food vegan diets – your system will still tend towards acidity.

The converse of this is the role of heavy metals. Heavy metals, such as mercury, lead and cadmium, have an extremely acidifying effect on the tissues. Mercury, for example, is a metal that is toxic to the body's cells. In order to deal with mercury, a high amount of acidic hydrogen atoms are produced. Additionally, by blocking zinc, mercury also blocks the enzyme carbonic anhydrase, which leads to increased acidity as well.

Digestion

There is often confusion, when discussing the relative merits of “alkalinity”, between tissue alkalinity and alkalinity of the digestive system. It is important to distinguish between the two. In fact, when the digestive system is functioning well, it is very acidic: the stomach has a high level of acid to digest effectively, and to absorb alkaline minerals effectively, which – you guessed it – are important for tissue alkalinity.

As well as this, a healthy colon is characterised by high levels of short chain fatty acids, such as butyrate, which are protective against bowel cancer.

So in short, an acidic digestive system is a requirement of tissue alkalinity. Taking bicarbonate-based supplements will have the short-term effect of alkalising the system – including the urine, helpful at times in painful bladder syndrome or interstitial cystitis – but if consumed close to eating, will actually counteract the normal gastric acidity and can have a counterproductive effect on tissue alkalinity.

Inflammation

A key concept of good health to understand is that inflammation, by virtue of the underlying tissue biochemistry, always tends to promote acidity in the tissue. The cause of the inflammation doesn’t matter: it can be inflammatory bowel disease or obesity – but there is always associated acidity.

Read my next blog post to find out what, if anything, acidity/alkalinity has to do with chronic pain in general, and pelvic pain, vulvodynia and interstitial cystitis in particular.
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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Annoying Abdominal Adhesions: Start Here

Posted: Monday, July 25, 2016 at 1:34:11 PM EST by Alyssa Tait

Abdominal Adhesions: when pain after surgery persists and a technique to resolve it

You’ve had abdominal surgery.

Now you’ve got persistent abdominal pain.

Not the result you were after.

Well, don’t look back now – most likely, you had to have the surgery – it was the best or only choice available to you. And you can’t go back, only forward!

So how to move forward with this abdominal pain after surgery when you’ve had all the medical checks, and they tell you it’s “just” adhesions?

Well, first things first.

What are adhesions? “Adhesions” is really just a fancy name for scar tissue, but doctors often use it to refer to scar tissue they assume is more extensive or more restrictive as a way of explaining your pain. Occasionally, they’ll use the word “adhesions” because they actually found them when doing your surgery, as in

Boy, everything was a mess in there!” or

Gosh, everything was stuck to everything else!

(These comments don’t do anything for your confidence, and may actually play a role in worsening the pain you experience via some complicated brain mechanisms. For more about that, see my post on chronic pain in the pelvis and the brain. But back to the story.)

Adhesions form in an estimated 50-100% of cases of surgery (I know, a pretty broad statistic.) They start forming within hours of the surgery. When they become a problem (i.e. are assumed to be responsible for ongoing abdominal pain after surgery) – the suggested treatment is: surgery. (Yes, strange but true.)

But there is another technique that works.

(And whether or not you need to have surgery for adhesions or not, it is always a good idea to have this technique done after to maximise recovery).

Visceral manipulation is the technique.

It’s a mouthful to say but very easy to have done, providing you can find an appropriately-trained therapist.

Visceral manipulation is something I do a lot of in clinical practice in Brisbane, Australia. More to come on this wonderful technique, but in the meantime, make an appointment with us or track down a therapist trained in visceral manipulation closer to you.

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An Interview with Alyssa Tait - Adhesions, Chronic Pain, and the Nervous System

Posted: Tuesday, September 13, 2016 at 1:14:04 PM EST by Alyssa Tait

It's not often someone gives me the floor for 45 minutes to talk about the web of connections linking adhesions, pain, visceral manipulation, the gut and the nervous system...

Stephen Anderson's questions were so thought-provoking, I just kept talking!

Here's the interview: Alyssa Tait on Pelvic Pain, Adhesions, and SIBO

This interview will either be a great cure for insomnia, or a useful insight into how my brain sees this broad and fascinating field.

We traversed the physical, the emotional and even the metaphysical!

Listen here.

We covered all sorts of topics...

...the curious pathway of my career and how it led me to visceral manipulation

...the emotions and your organs

...chronic abdominal and pelvic pain and visceral manipulation

...adhesions, and how they are more than just structural, but neurological as well

...endometriosis and how these adhesions differ from surgical adhesions

...central sensitisation in chronic pain and its links to visceral hypersensitivity in irritable bowel syndrome

....the power of the words "let's see" in therapy

Have a listen now!

Stephen's highlights and insights include...

....the power of the nervous system to increase neurological tone as a means of self-protection, and how this might impact the function of the organs

...the importance of engaging in fun, nurturing and nervous-system relaxing activities to take care of ourselves

....the need as practitioners to be careful with our language with our patients and not be "part of the problem".

Please listen, and give your rating or review on itunes!

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter
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