Urinary Incontinence and Pelvic Floor Strength

Urinary Incontinence and Pelvic Floor Strength

Urinary incontinence is a common problem, affecting approximately 25 percent of women at some point in their lives. Some of the most common times that women experience incontinence are during pregnancy, after childbirth or around menopause. Since incontinence is often caused by weakened pelvic floor muscles, building pelvic floor strength through exercise is typically the first line of treatment, and has proven very effective for many women. On the other hand, some women with severe urinary incontinence that hasn't been helped by less invasive measures may need corrective surgery.

Kegel Exercises
If you are one of the many women who suffer from urinary incontinence, chances are you've been instructed to do Kegel exercises to strengthen your pelvic floor muscles. Kegels are good. In fact, there is a lot of scientific evidence behind that recommendation, with many studies showing that they are an effective means of reducing the symptoms of incontinence, especially stress urinary incontinence, or SUI. However, studies have also shown that they must be done correctly to be effective, and that women who are guided by a physical therapist or fitness professional to ensure proper technique achieve much better results than those who do Kegels on their own.

However, Kegels probably aren't the only exercise you should be doing. There is an ongoing debate about Kegels. While they have long been the standard in the treatment of pelvic floor disorders, there are experts who feel that too much emphasis is placed on them, and that strengthening just the pelvic floor muscles in the treatment of pelvic floor disorders may be counterproductive. The pelvic floor muscles play a primary role in pelvic health, but there are other muscles that contribute, so some fitness and medical professionals advise that just working pelvic muscles and neglecting the rest creates an imbalance in the body that can be detrimental to pelvic health and the long-term management of urinary incontinence.

A Broader Approach
Some physical therapists are broadening their approach in the treatment of pelvic floor disorders like SUI. Many are working with patients to strengthen core muscles, gluteal muscles, hamstrings and others, rather than focusing exclusively on pelvic floor muscles. While it hasn't been proven that this more comprehensive approach to exercise is better for pelvic floor health than Kegels, it certainly can have benefits in weight management and overall health, both of which can help improve incontinence.

While non-invasive treatments help most women, surgery may be necessary for some. However, it is important to be aware that SUI surgeries that use transvaginal mesh implants, in the form of bladder slings, have been associated with serious complications. Common problems reported to the Food and Drug Administration (FDA) include mesh erosion, organ perforation, mesh contraction and infection. Many women have been affected by these dangerous complications and some have even filed bladder sling lawsuits. 

The FDA has issued safety alerts on these devices, warning that reports of serious complications with mesh procedures are rising dramatically. The agency advises that most cases of SUI can be treated successfully without transvaginal mesh and urges surgeons and patients to consider traditional SUI surgery as a safer alternative to bladder sling procedures. Even with all the complications the FDA has still not mandated a transvaginal mesh recall.

Guest blog written by Elizabeth Carrollton who writes about defective medical devices and dangerous drugs for Drugwatch.com.

Best Homemade Pancakes Ever! And They're Healthy Too!

My kids and I have established a tradition of Pancake Friday, making pancakes nearly every Friday for the past 5 years. I started out with your basic Bisquick box pancakes, which taste good though aren't necessarily the healthiest or cheapest way to go about eating pancakes every Friday. So I searched all over the web, experimented and concocted recipe after recipe of flat, stale, dry, chewy pancakes. Until...a friend of mine, Renee Samson, clued me in on a family recipe that included adding yogurt to the batter for the most moist, delicious fluffy pancakes I've ever tasted. My kids all loved them AND one of my biggest food critics (my husband) even prefers my pancakes to any other pancake out there now. I've modified a bit and this is the recipe I make every Friday, adding fruits, chocolate chips or even homemade granola to switch things up a bit.

Recipe 
2 c flour (I've used bleached, unbleached, whole wheat....all work well)
2T baking powder
2T raw sugar
pinch sea salt (for an extra boost of trace minerals-magnesium, potassium, calcium)
2 eggs beaten
1c milk (I use 1%)
1c yogurt (homemade yogurt is best though store bought will work)
2T melted coconut oil

Wisk together the dry ingredients.
Mix wet ingredients together, I warm the mixture a bit to keep the coconut oil from solidifying when added to the cold milk/yogurt/egg.
Pour wet ingredients into the dry ingredients and mix well, smoothing out the lumps but not over wisking.
Ladle pancake batter into a med-low heated griddle, pan or skillet.  The temp may vary depending on your stovetop, we use gas and I find that keeping the heat at medium-low is perfect.  I love to use a cast iron skillet because it provides just a tad extra iron to our diets and evenly cooks the pancakes. Watch for the bubbles on the top of the pancake to pop and the sides of the pancake start to dry. Flip and cook for just a bit longer on the other side to make sure the pancake is cooked all of the way through.
Can freeze excess pancakes and reheat them in the toaster or microwave!

Strawberry Mango Paradise Smoothie-Why Coconut?

Why coconut? Coconut meat, milk and oil have been shown to:

• Provides a nutritional source of quick energy
• Improves insulin secretion and utilization of blood glucose.
• Improves digestion and bowel function.
• Reduces inflammation.
• Supports tissue healing and repair.
• Supports and aids immune system function.
• Functions as a protective antioxidant.
• Helps to protect the body from harmful free radicals that promote premature aging and degenerative disease.

That is just to name a few of the health benefits of coconut! Check out the latest from the Coconut Research Center on the health benefits and medicinal uses of the coconut!

Strawberry Mango Paradise Smoothie Recipe

In your blender add:

1/2c canned coconut milk (I like Thai kitchen) OR for thinner smoothie use prepared coconut milk

1/2c plain yogurt

1/2c chopped zucchini-raw

1c frozen strawberries

1c frozen mango

raw sugar or honey to taste (optional, my kids like it a bit sweeter)

Pulse to get the smoothie going and blend until you've reached your desired consistency. We like ours really smooth, so I'll let it blend for a minute or so. You can also throw in raw spinach in place of or addition to the zucchini. For an additional  boost of omega 3 fatty acids, lignans and fiber add a few sprinkles of flax meal into your smoothie. This recipe makes 4-5 smoothies.

Make "Healthy" a Habit: Challenge!

I'm re-introducing my Baby Steps, Big Changes challenge. I challenge you to make a small change to your health and well-being and to make it a habit. 1 small change. We all want to be healthy, fit individuals though getting there is daunting when you think about diets, nutrition, vitamins/supplements, stretching, exercising, sleep, low stress, good food, bad food, moderation etc etc. It's a LOT to think about and it's hard to put the right foot forward when trying to achieve so many goals in so many different places. However, while difficult, it's not impossible. it takes dedication, accountability, strength, knowledge, perseverance, hope, flexibility, a goal and a plan.

According to Florida International University, and various other research sources out there, it takes 21 days to form a habit (or in our situation, a lifestyle change) and conversely 21 days to break a habit. So, with this in mind, knowing that if we can dedicate ourselves to one part of our health...we can form a healthy lifestyle habit in just 21 days, 3 weeks.

How it will happen:

1) What 1 thing would you like to change (don't worry, if there's more than one, the rest will fall into place as you start to build a healthier lifestyle)

2) What is your goal? Start small.

3) Make a plan, write it down. Share it with others. Encourage others to join you. Accountability and team/group motivation is hugely successful.

4) Educate yourself on how to make the change, find a way that makes it happen for you. Empowered Wellness 'Healthy~You~Can Do" Workshops are a great way to gain the knowledge you need to fill your health toolbox with the tools you need in making healthier choices.  Be flexible to make it suit your lifestyle, do what works for you and be consistent in making it happen.  Educate yourselves on how to do it, what's worked for others, what will work for you.

5) Mark your calendar and journal-check in with friends who are on board with getting healthy

6) Continue to seek out resources, the more you know the more successful you can be.

7) Don't beat yourself up if you have an off day, we all do. It's ok to fall off the health wagon from time to time, just don't let it become a habit. A  Failure is feedback, learn something from your off days.

8) Reward yourself, don't deprive yourself of things that make the world a happier place. If chocolate brings you to a happy place, why deprive yourself of that small pleasure. Find a special time to indulge yourself. Find enjoyment and control over your indulgence to avoid over-doing it.

9) Pass it on, spread the word. A healthy world is a happier world

10) Smile, it releases endorphins

So....who's in? You can do this!

Why Fermented/Cultured Foods? Intro to Kombucha

Did you know that this food preservation method from times past produces foods that are more easily digestible, creates new nutrients including folic acid, riboflavin, niacin, thiamin, biotin, omega-3 fatty acids, superoxide dimustase, GTF chromium, glutathione, phospholipids and beta 1,3 glucans as a by-product of the microbial culture life cycle? (Katz 6-7) Let's not mention the digestive health benefits of live fermented foods, by helping to create and sustain thriving microflora in the gut that help prevent digestive related disease and illnesses.

Kombucha, referred to as "Immortal Health Elixir" in ancient Chinese times,  is just one of the variety of the live fermented foods/beverages you can enjoy and benefit from. Kombucha is produced by the fermentation of sugar sweetened black tea plus a symbiotic culture often referred to as the "mother" or "scoby". The "mother" is a culture of acetic bacteria and fungi and aids in the fermentation of the sweetened black tea to produce a powerfully nutritious and delicious cultured beverage.

Russian research at the beginning of the century, indicate that Kombucha has healthful properties that help improve resistance to cancer, prevent cardiovascular disease, promote efficient digestion, boost the immune system and reduce inflammation. As found by Santos and colleagues, Kombucha can help aid in the prevention of digestive disease caused by E.Coli and Staph typhi by inhibiting growth of these bacteria, seen in the presence of a significant inhibition halo zone (or presence of inhibited growth) between 20-25mm for E. Coli and 21mm for Staph typhi.  For more resources on a century full of research visit Gaia Organics Research.

Basic Kombucha Recipe (as per Sandor Katz)
1qt/1liter water
1/4c suga/60mililiters sugar
1TBSP/15mililiters loose black tea or 2 tea bags
1/2c/125 mililiters mature acidic Kombucha
Kombucha Mother or Scoby

1. Find a scoby-try local health food stores, friends, wellness centers
2. Bring water and sugar to a boil, turn off heat and add tea (I put mine in a tea infuser and rigged it up to float in the pan). Steep ~15min.
3. Pour liquid into a wide glass container or crock, to allow adequate surface area of scoby to grow. Cool liquid
4. Add mature acidic kombucha, keep a portion of subsequent batches on hand for this purpose.
5. Place kombucha mother or scoby in the liquid with the firm opaque side up.
6. Cover with a cloth and store in a warm spot (ideally 70-85 degrees F). Let sit for a week or so, the longer it sits the more acidic it will become.
7. Store liquid in the refrigerator.
8. You will now have 2 mothers (the one you started with and a new one-the skin that formed on top of your new batch of kombucha). Use either to start a new batch, pass the unused mother down to a friend or compost it.
9. Drink, enjoy and be healthy!



Sources:
Katz, S. (2003). Wild fermentation: The flavor nutrition and craft of live-cultured foods. (1 ed.). White River Junction: Chelsea Green Publishing Company. DOI: www.chelseagreen.com

Santos Junior, R., Batista, R., Rodrigues, S., Filho, L., & Lima, A. (2009). Antimicrobial activity of broth fermented with kombucha colonies. Journal of Microbial and Biochemical Technology, 1(1), 72-78.

Cardio Training Intensity and Your Fitness Goals

What is "cardio"? In the fitness industry, cardiorespiratory training is activity that puts demand on the cardiovascular and respiratory systems in order to produce, sustain and recover from the activity. Basically if you are getting your blood pumping, you are cardiorespiratory training on some level.

What is intensity? Intensity in any kind of exercise training is, basically how much effort you are putting into your workout as compared to your maximum efforts. This can be measured in many ways, some ways are more appropriate than others depending on the training concept. For today, we're talking about "cardio" and a good indicator of your intensity during a cardiorespiratory workout is perceived exertion. Perceived exertion scales usually follow the Borg Rating of Perceived Exertion Scale which is a 6-20 scale (6 being no effort 20 being maximum effort), however are scaled down to a 1-10 scale for ease of use (1 being no effort at all 10 being maximum effort).

The Borg Rating finds a high correlation between perceived exertion multiplied by 10 and actual the heart rate during activity of that intensity level. (Borg, 1998). This, of course, is just a generalization and doesn't take into account all of the variables that affect heart rate (fitness level, medication, conditions that affect the cardiorespiratory system etc). For instance if you are exercising at intensity level 10 on the Borg Scale, your heart rate would be roughly 10x9 or 90beats per minute. This exercising heart rate is very light and your efforts "relatively" low, again this number is relative depending on the above variables. Perceived exertion comes in handy when you a) don't have a heart rate monitor handy or b) don't feel like stopping your activity to check your pulse rate. How well your body is conditioned will determine your perceived exertion for each activity.

From weeding the garden to running a race the possibilities of activities that challenge our cardiorespiratory systems are endless and you have the power to get the most (or least) out of your efforts by changing your intensity level during your activities. By increasing your intensity level during activity, you are telling your body to recruit more motor units (nerves stimulating muscle fibers to work). More motor unit recruitment means more muscle fibers working which also means more energy required to produce and sustain those contractions. More energy required can mean more calories expended during that particular exercise effort. If your fitness goal, for instance, is weight loss increasing your intensity level to maximize the amount of energy expended works to your advantage! It can mean a difference of hundreds of calories burned during one bout of exercise.

How can you increase your intensity? It all depends on the exercise

• Involving more muscle groups per activity is usually a good start. A jumping jack for instance, intensity is increased when you add arms movement to the leg movement. Starting with just legs is a great place to start add arms when you're feeling ready to take things up a notch. 
• Intentional movement, making those movements count...flopping arms around will require less muscle work than intentional, defined arm movement. Small movements will require less energy than large movements. Squatting and standing up without focusing on muscle contraction will require less energy than squatting and squeezing the quads and glutes when you come back up. As founder of the willPower Method®, Stacy Lei Krauss says "defined movement produces defined muscles", I couldn't agree more. Make those movements count!
• Add a jump or a kick to your step
• During slower tempo exercise, create fuller range of motion (this is also good for joint mobility)
• Contract muscles when you can both concentrically (shortening the muscle) and eccentrically (elongating the muscle from shortened state).
• Smile (a smile produced by the contraction of 17 muscles, burn extra calories just by smiling:)-my personal favorite!   

Empowering You and Your Growing Baby

Inside you is an innate wisdom that intuitively understands about the very natural process of birth. We help you reconnect with this wisdom, guiding you through a class specifically designed for the journey of pregnancy.  Linking yoga postures with the breath will lead you to new discoveries, bringing awareness to the mind, body and spirit, and also the spirit of your baby. The program, conducted in a calm, peaceful environment will help strengthen the uterus and pelvic muscles, improve circulation, aid in digestion, exercise the spine, relieve fatigue and tension and increase overall comfort. 

Yoga can also alleviate many of the discomforts of pregnancy such as nausea, constipation, swelling, back pain and sciatica. Breathing techniques will be practiced. This allows the chest to open and helps to improve circulation in both mother and baby, ensuring a better supply of oxygen to the blood.  It also calms the nerves and gives the mother greater control of her breathing during labor.  Prenatal yoga keeps the body healthy and flexible.  A safe, open community allows you to freely discuss any issues, from discomforts and concerns, to the wonderful new changes your body and baby are experiencing.

~Nicole Cummings Prenatal Yoga Instructor at Empowered Wellness Rochester MN

 

Safety Guidelines
All pregnant women are welcome to attend the class, whether you have a regular practice or want to start yoga during pregnancy. No prior yoga experience is required.  It is very important to inform the teacher of any complications (current or past) or any treatment that you are receiving.