Carina Siracusa: "Now’s the time to figure out how we can get our names out there"

It’s time for pelvic floor physios to stand up and shout

Pelvic floor physical therapists need to highlight everything they can do to help people of all ages, according to specialist Carina Siracusa.

A lack of awareness around treatments offered by pelvic floor physical therapists can leave patients suffering in silence when it comes to bladder and bowel dysfunction – and in the case of children the issue may not be identified at all.

“With children, a lot of paediatricians tell parents that it’s something they’ll grow out of,” says Carina Siracusa, who leads Monday's focused symposium on paediatrics and pelvic health.

“But multiple studies have really shown that children who have bowel and bladder issues are much more likely to have bowel and bladder issues as adults. They can then become more severe, and develop into even more difficult issues to treat.”

Siracusa is joined by Els Bakker, Dawn Scandalcidi and Wendy Bower in a session which aims to widen the discussion around motor control in bladder and bowel dysfunction, and highlight treatments that move beyond well-known pelvic floor exercises. One part of the discussion will focus on screening, in a bid to make sure physios are asking the right questions about a subject that is sometimes difficult to raise.

“It’s something people are reluctant to talk about,” says Siracusa. “It’s a bit of taboo subject – it’s not something that anybody wants to admit to, even to a healthcare provider. When I have patients in my office one of the first questions they ask is, ‘Why am I seeing a physio for this?’

“The biggest contributor to both faecal and urinary incontinence is a loss of muscle strength. Sure, we talk a lot about our pelvic floor muscles and kegel exercises – but it’s not just about kegel exercises. It’s really making sure that the entire core stability system is balanced, that all of those muscles are strong, and that they’re working together properly. Physios are the musculoskeletal experts, and this can be a musculoskeletal problem.”

In addition to shyness, Siracusa says that there’s a lack of education on the links between poor muscle strength and bowel and bladder dysfunction. There are also comparatively few pelvic floor specialists around the world.

“People don’t know that there is a fairly easy treatment,” she says. “We’re just starting to get more people aware of what we can actually do. Physiotherapists are not great marketers all of the time. We’re getting better, and now’s the time to figure out how we can get our names out there.”

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