Guest Blog with Women’s Health Physiotherapist, Vivienne Byrne

We'll be discussing Women’s Pelvic Health and why Vivienne believes Hypopressives will soon be used within the Clinical Practise of every Pelvic Floor Physiotherapist.

Hi Vivienne, welcome! I’m really excited to have you here. Could you introduce yourself, to those who don’t know you? 

Yes, Hi everyone, I’m Vivienne and I’ve been working as a Physiotherapist for 19 years and Specialising in Pelvic Health for the last 7 years. I’ve always had an interest in the Pelvic Floor (PF) and my Dissertation, back in 2001 was on Pelvic Floor Muscle (PFM) contraction. I’m also currently finishing my training as a Women’s Health Coach with The Integrative Women’s Health Institute.

I’ve always been passionate about movement and empowering women. I have a special interest in Pelvic Organ Prolapse (POP), and I see it as my duty to have as big a toolbox as I can as a Health Professional. I currently use manual techniques including visceral work, brain science, mindfulness, exercise & functional rehab; a psychosexual approach, Real Time US, health coaching, support of pessaries and education as part of prolapse care within clinical practise. I aim to empower women so that they can manage their condition and ultimately be the expert of their own bodies.

I am also a qualified Fit Pro, and Yoga and Pilates Teacher. In my personal life I am a mother of 2 young boys and enjoy all activities including music and Crossfit.

And of course, I’ve recently trained in the Hyopressives Technique, with UK Hypopressives.

It’s so great to have the opportunity to talk to an experienced Women’s Health Physiotherapist about pelvic health and Hypopressives.

What’s your opinion on the overall value of practising standard Pelvic Floor Exercises (PFEs), three times a day?

Yes, so this is the recommended daily amount that Women’s Health Physiotherapist’s (WHPs) prescribe. The research supports this amount to maintain strength gains achieved after a period of training, so therefore this will often be our starting point.

When learning a new skill, we know the brain initially is only trying to get the connection to the action / muscle in question, so small frequent attempts are what embeds that activity, and it becomes easier. 

However, my own clinical practice has changed in the last few years.

Like with any muscle that has deconditioned or weakened we isolate to train it to catch up, BUT then we use global functional exercises, because the PF does not work in isolation, but functionally like all muscles.

the Pelvic Floor does not work in isolation, but functionally like all muscles.

As a Health Coach (and human being!) I’ve also learned that if I ask someone to do something 3 times a day and it’s unrealistic, they are less likely to do it at all, and then you have the added guilt of ‘I failed at that’, which is not helpful to anyone.

The other issue with this prescription is if the woman has a lack of range in the PF (not full movement) in therapy terms described as tight/short with or without pain. In this case it would not be appropriate and could actually worsen some symptoms. That’s where a physical pelvic floor examination can give women a starting point and knowledge about what’s going on with their body.

So these are just some of the ways that expert knowledge has progressed since the 1940s, when targeted PFEs were invented?

Yes, I think for years Pelvic Floor Therapists were Pelvic Floor-centric and it was all about the Pelvic Floor and not what it worked with, etc. Our assumptions about HOW it worked were also not questioned.

Previously there was a poor crossover between WHPs and MSK Physio’s and you need a background in both for the best overall approach. Purely because the body works as one unit.

Also, our Toolbox was quite limited years ago. It was all about the exercises which are very important - but it’s ALL the education, understanding and rehab around this, that gets the best results.

We are acknowledging now that every issue is not about ‘Weakness’ which is really important, and are also exploring our biases as WHPs. This is being helped by some great clinicians getting involved in asking questions, interpreting research and looking outside the box. We want our Pelvic Floor to be 'Reactive'. Forget about focusing solely on strength.

We want our Pelvic Floor to be ‘Reactive’. Forget about focusing solely on strength.

So what do you think Hypopressives can add to this, and Women’s Health in general?

I think Hypopressives primarily re-activate, mobilise and ‘switch on’ the pelvic floor by stimulating it through movement. 

Everything is governed by the brain, and I think the technique reminds the brain what full function of the Diaphragm and Pelvic Floor should be, moving the organs with it and thus promotes more REFLEX activity. I think Hypopressives primarily re-activate, mobilise and 'switch on' the pelvic floor by stimulating it through movement.

The inhale in Hypopressives is very directed and gets results in terms of increasing the Diaphragm’s range of movement. Most people have some lateral stiffness of their ribcage, so it's a quicker way to get things activated rather than relying on lots of sessions of practicing gentle ‘belly breathing for several minutes a day.

I think the Apnea encourages the diaphragm to go into its most elevated position in the chest cavity due to the negative pressure built in the chest cavity and the pelvic floor therefore follows due to its fascial connections. As the body always follows the path of least resistance, in terms of soft tissue tension, it’s more pro-active as a breathing technique.