The Women’s Health Podcast
053 - Dr Adam Culvenor and Dr Andrea Bruder - How do we prevent and manage ACL injuries in women and girls?

053 - Dr Adam Culvenor and Dr Andrea Bruder - How do we prevent and manage ACL injuries in women and girls?

March 12, 2021

We're excited that today we have a dynamic duo on the podcast: Dr Andrea Bruder and Dr Adam Culvenor.

Adam is a Physiotherapist and Research Fellow at the La Trobe University Sport and Exercise Medicine Research Centre, Australia. He has combined a clinical career in sports medicine together with research investigating prevention, management and long-term outcomes of sports-related injuries, and life-span osteoarthritis. He has a particular interest in anterior cruciate ligament (ACL) injuries; in optimising return to sport, identifying risk factors for poor long-term outcomes, and developing and testing novel osteoarthritis prevention strategies. Adam has written more than 50 publications on the subject of ACL injuries and osteoarthritis, has been invited to speak at numerous international conferences, and is\ currently leading the first clinical trial in the prevention of osteoarthritis in young adults following ACL injury.

Andrea is a physiotherapist, Lecturer in Physiotherapy at La Trobe University and Post Doctoral Research Fellow in the La Trobe Sport and Exercise Medicine Research Centre. Her research focuses on improving injury prevention and rehabilitation practices after musculoskeletal injuries. Andrea has a particular interest in reducing the risk of ACL injuries among women and girls playing Australian football, and for those who do sustain an ACL injury, how we can improve rehabilitation practices to reduce the long-term burden.

 

In this podcast we talked about:

- what the ACL is and how it can be injured

- some risk factors for ACL injury (in males and females)- including some of the social, environmental factors

- some of the current programs that exist that have been shown to reduce lower limb injuries...but how the uptake has been poor

- surgical versus non surgical (sexy, cutting-edge rehab) management

- why a trial period of this kind of rehabilitation may be of benefit, even if the client goes on to have surgery further down the track

- how the rates of arthritis are similar between the two treatment options

 

If you'd like to check out their blog, head to http://semrc.blogs.latrobe.edu.au/blog 

Their website details:

https://scholars.latrobe.edu.au/display/abruder 

https://scholars.latrobe.edu.au/display/a2culvenor 

 

Email addresses:

[email protected]

[email protected]

[email protected]

 

Twitter: @AndreaBruder

Twitter: @agculvenor

052 - Molly Galbraith - Strong Women Lift Each Other Up

052 - Molly Galbraith - Strong Women Lift Each Other Up

February 20, 2021

We are again blessed to have the amazing Molly Galbraith on the podcast!

Marika and Antony have both had the pleasure of getting to know Molly over the past 5 years and are thrilled to talk to her about her new book, Strong Women Lift Each Other Up.

Molly Galbraith, CSCS, is the cofounder of Girls Gone Strong (GGS), the world’s largest platform providing evidence-based, interdisciplinary health, fitness, nutrition, and pregnancy education for women and the health and fitness professionals who work with them—including industry-leading certification programs and coaching.

The “Strong Women Lift Each Other Up” philosophy is woven through the fabric of GGS, as Molly leads a team of women from the US, Canada, UK, Mexico, India, and Australia. From employing and educating, to featuring, collaborating with, and investing in women, GGS is dedicated to serving their community of women from 80+ countries around the world.

In the podcast we talked about soooo much great stuff, including:
- how this book came about and how women lifting each other up has helped Molly get to where she is today
- some of the statistics around representation of women in government and executive positions... and ways that we can help change this.
- why making the biggest difference with the least amount of harm is her highest value
- why the book is structured the way it is - to help the reader move through the stages of working on their own care first (eg on jealousy and the comparison trap) in order to feel able to truly support other women
- why understanding your values truly helps you a more fulfilling life and be true to yourself
- how helping lift other women up can be small, simple things such as a compliment or a recommendation
- how you can find your superpower and level up your support of other women!

We love Molly's book and would love everyone to get out and buy it and tell us what you think (no, we are not making commission!!). The book is not only filled with fabulous advice, interesting stories and  reflective questions, but also a ton of online resources.

You can buy her book at https://www.mollygalbraith.com/book2  

Check out Episodes 12, 24, 35 and 36 which also stars Molly!
http://www.womenshealthpodcast.com/uncategorized/012-molly-galbraith-feeling-fragile-uncomfortable-and-lack-confidence-in-your-post-baby-body/  
http://www.womenshealthpodcast.com/uncategorized/024-molly-galbraith-how-can-i-heal-my-relationship-with-my-body/ 
http://www.womenshealthpodcast.com/uncategorized/035-molly-galbraith-ask-me-anything-part-1/ 
http://www.womenshealthpodcast.com/uncategorized/036-molly-galbraith-ask-me-anything-part-2/ 

051 - Marika and Antony - Catching Up and Kicking Off 2021

051 - Marika and Antony - Catching Up and Kicking Off 2021

February 15, 2021

A quick chat between Marika and Antony just catching up.

Antony's courses can be found at
www.mypteducation.com 

The Peak Simplicity Masterclass - www.physiodetective.com/masterclass 

050 - Dr Clare Minahan (PhD) - What Are The Unique Physiological Differences Of Female Athletes?

050 - Dr Clare Minahan (PhD) - What Are The Unique Physiological Differences Of Female Athletes?

December 17, 2020

FIFTIETH EPISODE SPECIAL!!

Antony and I were thrilled to talk to Clare Minahan, PhD Scientist and champion for women in sport.

Clare Minahan is an Associate Professor at Griffith University, Queensland Australia, and has led the Griffith Sports Science group since 2002. Clare’s interests are in the advancement of human performance with a key focus on the determinants of performance in female athletes. She has documented unique responses to exercise in female athletes including muscle damage, thermoregulation and immune function. Clare is a founding member of the Australian Institute of Sport’s Female Performance and Health Initiative.

Some of the topics we cover in this episode include:

  • some of the differences between male and female athletes in terms of how they respond to training and recovery
  • how the oral contraceptive pill (OCP) influences things like thermoregulation, immune function and recovery from acute bouts of intense exercise
  • how the hormones fluctuate over the menstrual cycle and how this may influence training choices
  • why training needs to be individualised and based on tracking of the athlete's cycle
  • that around 50% of athletes are on the OCP, so we need to understand better the effects. Clare also discusses the different generations of OCP and acknowledges that these will have different effects on the athlete (there are at least 35 different types of OCP just in Australia!)
  • how female athletes are at a 3x increased risk of ACL injuries. Studies showing that landing strategies seem to changes during teenage years for girls. This could also be related to hormonal changes - there are some studies showing increased risk during late follicular phase- but there is still much more to learn on this. Could also be related to changes in body composition through the teenage years
  • females with higher circulating levels of testosterone. Do they have a competitive advantage?
  • the advantage of having a regular menstrual cycle in terms of giving us a picture of our health. Withdrawal bleed while on OCP is not the same thing.
  • if not able to properly track menstrual cycle due to OCP use, Clare talks about other ways that we can monitor for RED-S (hint: performance, fatigue, mood, immune function)
  • why it's important to get the basics right (sleep, nutrition, stress etc) before manipulating your training around the menstrual cycle

If you would like to get in touch with Clare, you can best contact her on twitter @clareMINAHAN or via the Griffin University website [email protected]

049 - Amanda Thebe - The Menopocalypse Is Coming For You!

049 - Amanda Thebe - The Menopocalypse Is Coming For You!

December 10, 2020

On this podcast, we chat to Amanda Thebe, fitness professional and author of the book Menopocalypse: How I Learned to Thrive During Menopause and How You Can Too!

Amanda has over twenty years of experience in the fitness industry. She is a popular guest on podcasts and online summits, and her health and fitness tips have been featured in media outlets like Shape, Prevention, Healthline, and Global News. She lives in Houston, Texas.

In this episode we talked about:

  • Amanda’s recent experience with COVID-19 and how it knocked her for six for a few months. The post-viral syndrome left Amanda with a lot of fatigue and she struggled with daily activities for a long time, but is thankfully now on the mend!
  • her story about when she first started experiencing symptoms of menopause (ie migraines, vertigo and depressions) and how it took two years and several health practitioners to find the answers she was looking for
  • how surprised she was to find out that she was perimenopausal at the age of 42 and how so few people were talking about the subject! This led Amanda on a journey of discovery - she dived deep into the literature to learn more about menopause so that she could help herself and others. This led to her writing a book on it!
  • the frustration that Amanda felt when she couldn’t find the answers to what was going on. She felt so much despair and thought that she was going to be feeling like that forever.
  • how little medical professionals get trained on the topic of menopause -including the management. But this seems to be changing in the UK with new guidelines and mandatory training
  • some of the common symptoms that women experience through the perimenopausal period (that no-one talks about!), such as vaginal dryness, urinary incontinence and sexual dysfunction.
  • what happens to oestrogen and progesterone during the perimenopausal period. Amanda also talks about leptin and ghrelin and how these hormones can impact our hunger and satiety cues.
  • some of the physiological and psychological changes that occur through the perimenopausal period and how we can become more susceptible to things like cardiovascular disease, Alzheimers disease and osteoporosis
  • the controversy around hormone therapy, how the medication has changed over time and how incredible helpful it is for so many women
  • how physical and emotional stress can impact on symptoms during perimenopause - and some things that you can do to reduce these!
  • why women tend to put on weight around menopause and how there is often a change in body shape around this time.
  • how perimenopause can be a tough time for many women as they are often not only working and raising children, but also looking after elderly parents too. She discusses how useful it can be for women to spend some time exploring their values (see website below) and learn to make values-based decisions. And say no!

Resources
Menopocalypse book! (BUY HERE: https://www.fitnchips.com/books/)
Oestrogen matters - Dr Blooming and Dr Tavris
XX Brain book - Dr Lisa Mosconi
www.viacharacter.org
www.valuescentre.com

You can find Amanda at
fitnchips.com

[email protected]

048 - Dr Julie Granger - Are Teenagers Children or Adults?

048 - Dr Julie Granger - Are Teenagers Children or Adults?

November 2, 2020

In this episode we have a fantastic conversation with Dr Julie Granger all about adolescent health and well being.

You may remember Julie from our previous episode (#20 "Do you have a hormonal teenager?")

Julie educates and mentors physical therapists and health professionals to eliminate the awkwardness that comes with helping teens — to instead confidently and expertly guide them and their families toward healthy lives in adolescence and adulthood. She also helps entrepreneurial physical therapists and health professionals who are feeling stuck, confused, or overwhelmed about how to start or grow a practice to tap into their intuition and discover a personalized life and business plan that’s both inspiring and reflects what they truly love in life.

In this podcast, we talk about
- how teens often slip through the cracks as they don't fit into either the adult or paediatric models of care
- how some teenage boys can bottle up their emotions and minimise their injuries - and how we can open up dialogue with them
- the importance of allowing children to experience the consequences of their decisions in the process of transitioning to independent adults
- why some injuries and pains are more common at different age points (think: bony changes)
- why it is essential for health professionals working with teens to know the growth charts and to have good links with radiologists that understand growth plates
- some tips for communicating with parents of teens
- how to help navigate the rehabilitation timeline with teens (when a week feels like a year!)
- how to set up your working environment to make it more "teen friendly"

You can learn more about Dr Granger here:
Facebook: @drjuliegranger
Instagram: @drjuliegranger
Twitter: @drjuliegranger

If you would like to join her FB group and learn more about working with this population head to

https://www.facebook.com/groups/healthproshealthyteens 

And for those who want to deep dive and become the go-to expert in working with teens, then definitely check out her online course (commencing November 16th):
http://bit.ly/healthprosforhealthyteens (using this code will help support our podcast by giving us a small commission).

047 - Dr Jo Milios - The Nuts and Bolts of Men’s Health

047 - Dr Jo Milios - The Nuts and Bolts of Men’s Health

October 12, 2020

In this episode, we finally manage to grab Dr Jo Milios back on the podcast. We spoke to Jo for over an hour this time last year...and sadly the technology let us down. Yes...it all got wiped.

So thankfully Jo does not hate us and she kindly agreed to come back on the podcast!

Dr Jo Milios is a physiotherapist based in Perth, Western Australia. She is passionate about helping men with urinary incontinence, Peyronie's disease and pelvic pain.

Here are some of the topics that we discussed in the podcast
- Jo's journey in physiotherapy and how she came to be working in men's health through a connection with her brother who is a urologist
- how Jo became so passionate in helping men after radical prostatectomy (RP) regain their continence and sexual function, culminating in her completing her PhD in 2019.
- the story of how she learnt about Peyronie's Disease through the experience of a young client and wanted to be able to help him. This led to her reaching out to international colleagues and trying therapeutic ultrasound to great effect
- Jo then added yet another project to her PhD, demonstrating the efficacy of ultrasound on Peyronie's disease
-she discusses the physiological changes that occur during prostate surgery and why there are changes in continence and sexual function.
- how penile length changes can occur after surgery and some of the things that can be done to help maintain length
- hard-flaccid syndrome - how some young men are suffering from too much vigorous self stimulation while watching porn. Can lead to hypersensitivity, pain, Peyronie's disease, depression/ anxiety etc
- how it can take 2 years for the nerves to recover after RP, so during that time we want to maintain length and function but take the pressure away from sexual function. Only 22% of men regain sexual function after two years and in men over 60 - only 4% will regain sexual function if don't do penile rehabilitation
-  ultrasound treatment for Peyronie's disease - how she performed her research study and some of the amazing results found. We may need to pull these machines out of the cupboard and dust them off!
- why it's important for men to check their penis regularly (eg in the shower) and feel for any changes such as lumps and bumps. 
- the importance of screening for erectile dysfunction (think: cardiovascular disease), urinary /bowel function and pelvic pain. We as health and fitness professionals need to be more proactive in this!
- the importance of screening the spine in clients with urinary symptoms and how treatment of the spine (eg through manual therapy and/or exercise) could help relieve symptoms esp in those who seem to have good PFM function

You can learn more from Jo by listening to her podcast with Melissa Hadley-Barrett
- https://thepenisproject.org/ 
https://thepenisproject.podbean.com/ 

In that podcast, Jo and Melissa talk to everyday men about their experiences post RP. 

You can also find Jo here:
www.menshealthphysiotherapy.com.au 
[email protected] 

046 - Amy Dawes - Birth Trauma Awareness Week

046 - Amy Dawes - Birth Trauma Awareness Week

October 12, 2020

****Apologies - this episode was released quickly on social media but Antony forgot to release it here. Enjoy!****

This is just a super quick episode to give you the heads up about Birth Trauma Awareness Week (6th-12th September 2020).

You can help by:
- donating money or buying a t-shirt 
- raising money while doing a 5km walk
- sharing your story
- signing the petition to help women around Australia get access to postnatal pelvic health physiotherapy care

Please see the links below for more information about how you can support this valuable cause.

https://www.redbubble.com/i/t-shirt/The-ABTA-Start-the-Conversation-White-by-TheABTA/54578433.YIZYC?asc=u 

https://www.birthtrauma.org.au/birth-trauma-awareness-week/ 

https://www.birthtrauma.org.au/change-org-campaign/ 

https://www.sbs.com.au/news/insight/prolapse-muscle-tears-and-trauma-why-women-need-better-support-post-birth?fbclid=IwAR10w6TxIMPN4hIRs9h_ZH3J0xeBQzYKX97t6T1fRLPdOgvRIrD3FYDPoFA 

045 - Dr Jane Foster - What Does It Mean To “Take Emotional Responsibility Now”?

045 - Dr Jane Foster - What Does It Mean To “Take Emotional Responsibility Now”?

July 30, 2020

In this interview, we talk to Dr Jane Foster, educator and creator of MYTERN - a program designed to help people change their language around emotion and regain control!

TERN = Take Emotional Responsibility Now.

As an educator, she was concerned about the false narratives that were, and still are, embedded in our culture, disrupting people's lives and even ending them. She wanted to create a simple, every day language that could be used by everyone to build new positive narratives, eradicating stigma and judgement, enabling people to regain control of their mental and emotional state. A language that could replace blame, judgement and retaliation with empathy, compassion and responsibility. The culture of having to be happy and positive all the time is unrealistic and almost impossible to maintain - especially now.

In this interview, Dr Foster talks about
- her PhD project where she sent one text message per day to university students over a ten week period. She had astonishingly positive results in the test group, including increased psychological well-being, life satisfaction and purpose. They also had decreased psychological distress levels and there were several students who said that the program prevented them from committing suicide.
- how MYTERN can be used in schools, homes and occupational settings.
- how the program revolves around metaphors such as roads- you can be on a red (rough road) or a green (smooth road) in terms of your emotions. They are not necessarily "bad" and "good" roads- and we don't want aim for always being on those smooth roads. The red roads can help us with our resilience, as we will always come up against challenges in life. The idea is to be in control - whether we are on the red or the smooth roads.
- how you can be out of control on red OR green roads. You can be on a green road and out of control - eg taking alcohol / drugs. You can also be in control on a red road - eg angry but responding in a calm way.
- how being out of control in MYTERN means that you are hurting yourself, hurting someone else or hurting something else.
- how the language can be simplified to - "are you on a red or green road? Are you in or out of control?"
- how the analogy of the steering wheel works - YOU are in control of the car (your emotions) and how you respond. Other people can not make you feel a certain way. "YOU made me feel this way" is giving the other person all the power. and making yourself a victim.
- MYTERN teaches you how to empty your glass - how little stresses build up over time and fill our glass. Minor stresses can help build health and resilience.
- how people of different ages can use the MYTERN model - from young children and adolescents to adults (even corporations)
- how sign language can be used to indicate when you're feeling out of control (extending the fingers, flexing the thumb across the palm)
- the acronyms of PETs and TEPs. 
- PETs are Personal Emotional Tools that help us regain control esp when we are on red roads. A PET could be going for a walk, taking some deep breaths, patting a pet, reading a book, cooking a nice meal, dancing etc. Adults will often choose alcohol, exercise or eating chocolate - which are fine in moderation, but in excess can become a TEP.
- TEPs are Triggers for Extra Precaution - ie the events/situations that cause someone to feel out of control. For example - parents are fighting, losing a computer game, bad drivers, feeling unwell or going to school/ work. Calling it a "TEP' rather than a "trigger" means that there is no judgement. It's a made up word so that there is no connotation associated with it. Understanding your own TEPs (and what PETs can help in that particular situation) gives you skills to help bring yourself back into control.
- how these tools can help lay down new neural pathways and some of the changes that Jane has seen over time within groups using the MYTERN model.
- the different packages available on the MYTERN website - eg therapist pack, teenager pack, family pack, adult pack. Each pack consists of short education videos and handouts (including maps and activities). The packs for individuals are only $AU19.99 and the therapist/family packs are $AU49.95. (Prices as of 21st July 2020). There are also a phone app (the emoji app) and the SMS messaging service.

 

You can find Dr Foster:

Email: [email protected] 
Website: https://mytern.com.au 
Facebook: https://www.facebook.com/myterncity/ 
Instagram: https://www.instagram.com/myterncity/ 
Twitter: https://twitter.com/myterncity 

044 - Dr Sallie Sarrell - What is Endometriosis and What Is The Gold Standard Of Care For It?

044 - Dr Sallie Sarrell - What is Endometriosis and What Is The Gold Standard Of Care For It?

July 8, 2020

Wow, this episode is a doozy!

We think EVERYONE should listen to this episode, whether you are a medical /fitness professional or general public....this information is so important.

After 23 years of misdiagnosis, Sallie embraced her struggles with endometriosis to forge a new pathway for all who suffer from the disease and its associated conditions. She is a practicing pelvic physical therapist specialising in endometriosis and subsequently occult hernia who has gone on to found The Endometriosis Summit - the largest patient and practitioner gathering for endometriosis in the United States with Dr Andrea Vidali and is a driving force behind iCareBetter, a new endometriosis education portal and video vetting system for endometriosis excisionists in North and South America. Sallie is currently weathering the USA's Covid life with her two poodles, and parents while doing telehealth to the endometriosis world.

In this interview we discuss:
- what endometriosis is and how common it is (one in ten women!!).
- how those lesions make their own oestrogen (and progesterone) and nerve/blood supply.
- why hysterectomies don't cure endometriosis
- the history of diagnosis of endometriosis and some of the theories that have existed over time
- how in endometriosis, the tissue can extend as far as the lungs and pericardium. The only organ in the body that hasn't been shown to have endo is the spleen!
- how birth control can modulate the period but not the disease
- how you can get endo in the skin - typically iatrogenic such as being dragged by a surgical scalpel
- how diagnosis is made. Typically imaging is not helpful. Gold standard = laparoscopy.
- Staging of the disease is not well correlated with pain experienced
- the common symptoms associated with endo - including cramps, painful periods, IBS-like symptoms, pain with deep penetration, back pain, leg pain, tailbone pain, rib pain, leaking for no reason, increased urinary frequency, issues with fertility, nose bleeds with periods, neck pain and reflux, symptoms at ovulation (bowel problems worse with periods and ovulation)
- how girls/women are often taught to be warriors and put up with pain. The message is often that period pain is normal and needs to be put up with.
- some of the changes that are happening around the world to educate high school girls about periods (see resources below)
- that symptoms may be there early in life such as inflammatory issues in the gut, but not diagnosed until older age when having fertility issues.
- how early menstruation is associated with higher risk of endometriosis
- teens don't always need to rush in for surgery. Birth control can modulate symptoms in some people. It does not treat the disease.
- some of the conversations to be had around providing contraceptive pills in children.
- how endometriosis itself can impact ovarian reserve
- the receptor site sensitivity for progesterone can be down-regulated in some women with endo. Some docs will throw more progesterone into the system, which may not do anything. So different pills need to be considered
- how the type of surgery is important - ablation just burns off the top, you need excision surgery to remove the roots
- the current limitations in the medical system - in terms of education of doctors and gynaecologists.
- how health and fitness professionals can help women with endo - by being aware of the different symptoms that can be related to endo and screen further. How exercise can help improve mobility around the scar. Try and meet your clients where they are at and tap into the activities that they enjoy.
- some of the questions that you can ask if you suspect a client has endometriosis
- how every woman deserves treatment and some of the gaslighting that still goes on within the medical system
- how as physiotherapists we can support our clients with endometriosis - through connecting with our clients and teaching them that they will need to advocate for themselves. Educate re: central nervous system sensitisation and teach the client tips to help them regulate this such as meditation/ breathing exercises and some cardiovascular exercise.
- the Endometriosis Summit - usually every March. This year was over 700 people! In October there will be an Endometriosis Reproductive Immunology conference online.
- how iCareBetter is putting together a list of excisionists and doing blinded studies on the surgeons

Resources:
https://www.theendometriosissummit.com/ 
https://www.endowhat.org/ 
https://nzendo.org.nz/education-in-schools/ 

You can find Sallie here:
Facebook: https://www.facebook.com/sallie.sarrel 
Website: https://salliesarrel.com 
Email: [email protected] 

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