WHAT YOU NEED;
WHAT TO DO;
This recipe was by Karina from cafe delights.
Becoming a mother is one of a woman’s biggest transformations in life, yet we can be so quick to hand over the experience and our trust to others. A care provider may have more knowledge and experience in the world of birth, however they are not qualified in knowing who we are, nor do they have an understanding of our personal foundations - what feels safe to us and what we define as feeling appropriately supported.
Formulating a birth plan can be seen as an exercise that can help you to get clear on what is important to you and can provide you with the clarity to make any decisions that may need to be made during birth feel much less overwhelming.
Why do I need a birth plan?
How do I create a birth plan?
Creating a birth plan is one of the minimal yet most impactful things you can do in preparation for your birth experience and it is never too early to begin.
Your birth plan should be:
Our personal experiences, health and personality will all contribute to how we birth.
There is no one person that can guarantee the birth we may want and we cannot have the chance of having the birth that we want if we do not take accountability to find out what that birth looks like for us.
To help you to get clear on what matters to you for your birth and for support creating your personalised birth plan, book a session with our Maternal Health Consultant, Vanessa Werner.
October is International Breast Cancer Awareness month so I thought I’d take this opportunity to raise awareness on something that many people don’t even realise exists in the cancer treatment space…
Physiotherapy
I’m sure we can all agree that seeing a physio after you’ve had any kind of orthopaedic surgery is almost a given. Similarly if you’re recovering from a neurological injury or illness (brain injury, stroke, Parkinsons) then a physio would probably be on your radar. And even those with respiratory or cardiac conditions will likely have seen a physio at some point.
In cancer treatment it isn’t yet an expected part of someone’s recovery journey. And this needs to change because we can have such a positive impact!
Cancer rehabilitation is a comprehensive treatment approach designed to help a person regain, maintain, or maximise their physical function and emotional wellbeing after a cancer diagnosis. The provision of physiotherapy; including health behaviour change interventions, hands-on treatment, and therapeutic exercise prescription is designed to empower a person back to function and activity. It can be appropriate at any stage of a person’s cancer journey - pre-treatment/surgery, during ongoing treatment and in the recovery and survivorship phases.
In New Zealand, there is currently no routine referral from cancer services to physiotherapy for rehabilitation. This is due to many factors, but ultimately, the current structure is difficult for health care professionals, patients and their whānau to navigate. This results in people with cancer needing to advocate for themselves in order to access cancer rehabilitation services.
The provision of cancer rehabilitation is almost entirely reliant on patient’s being able to pay for treatment themselves or through their insurance. Some financial support can be gained through charitable funding. Fortunately, a substantial number of the major cancer charities in New Zealand currently recognise and support oncology rehabilitation through funding via The Pinc & Steel Cancer Rehabilitation Foundation. Breast Cancer Foundation of New Zealand, Bowel Cancer New Zealand, Talk Peach (gynaecological cancers), Prostate Cancer Foundation and Leukaemia and Blood Cancer Foundation each commit funds to rehabilitation to be delivered by cancer physiotherapists who have undertaken additional, post- qualification, specialised training.
Table 1; below outlines many of the proven benefits of physiotherapy and physical activity on psychological, physical, and social outcomes in cancer. (Image from Physiotherapy in Cancer Care, PNZ 2024)
We know the research supports the involvement of physiotherapists in a person’s cancer journey but it’s also important to hear from those who have experienced it as well. I asked some of our recent clients to share their thoughts on how they came to know about physio, what impact it has had on them and what they would say to anyone who might be considering it:
“I had cording following lymph node removal and I was scared by the possibility of getting lymphedema. I sought out a hospital/community physio who took baseline measurements and gave information, including on The Pinc and Steel Foundation which I followed up. I was pleased to find that I could get funding for further sessions and I'm very grateful for that. I found my physio very easy to talk to. She seemed genuinely interested in me and my welfare. She was knowledgeable and helpful in coming up with short exercise and flexibility programmes that suited the phase of treatment I am in.I have the satisfaction of knowing that I'm doing what I need to for my best recovery. So, for other women, I could say that seeing a cancer rehab physio is a gentle way of actively promoting your own recovery.”
“I came to physio a year after my Breast Cancer diagnosis. I was about 6 weeks post a bilateral mastectomy with reconstruction and my plastic surgeon recommended physio and Pinc and Steel classes. I was keen to start to increase my fitness again after chemo and surgery but I didn’t know where to start. My first visit to physio really highlighted that I needed to get back to basics and learn what my new limits were. I couldn’t even do an abdominal crunch without shaking. This was not only frustrating but eye opening. In subsequent sessions I was able to work on my flexibility and get to know my body better. Pinc and steel classes over 6 week gave me back my confidence and I was able to push myself to do more and more every week. I have felt so supported by my physio all the way. She has been able to develop a program of exercises to suit me and my situation and I don’t think I would be at this same point in my journey without her guidance. I would definitely recommend others seeking out treatment, it’s been an important part in my road to recovery and feeling like ‘me’ again.”
“I was an existing client at AP and found out about the cancer rehab service through my physio. I was looking to improve my overall flexibility and strength, plus build some resilience in my body again. My physio was gentle and measured, her advice was very personalised even though I was in a group class. My mental wellbeing has been the most marked improvement. I would definitely recommend the classes to others - enjoy the expertise, the banter and the supportive atmosphere.”
“My thoughts on the Cancer rehab Physio classes are that anyone offered the opportunity as I was should take it up, if not for the physical benefit which is well worth it but for the fact that they are great fun and it is beneficial to connect with people who have faced the same challenges.”
“After a partial mastectomy and radiotherapy, I had constant pain in my right chest and always sore in my underarm where lymph nodes were removed. I mentioned this to my oncologist on each 6 monthly visit and was told I need to learn to live with it. Sadly, at no stage was I ever offered or advised there was any help out there until one of the physios at AP mentioned the option of their cancer rehab service. My goal was to learn how to manage the pain, gain strength in my arm and be able to get more movement given it is my dominant arm. I was happy to try anything.I also became aware that it had affected my breathing considerably. Chest breathing had become a habit as a protection measure for pain.
Everyone I came into contact with to get set up for the programme were incredibly helpful and positive which was so encouraging and positive for your mental health. You were not alone.I am beyond grateful to be a part of this group. My personal journey has been mind blowing. The specialised exercises have given me a new lease on life, not only has the pain in my arm and chest improved 100% I have been given the tools to learn how to breathe more efficiently. It has given me so much confidence in my daily life.”
Hearing this from our clients makes me extremely proud of the cancer rehabilitation we can provide at AP. Our service is appropriate for anyone with a cancer diagnosis and at any stage in their journey. We have a range of 1-1 or group class options available and are able to link you up with the appropriate charities if you require financial assistance.
If you’d like to find out more you can read about the service on our website or book a complimentary cancer rehab information call with Kirsten to discuss your needs.
If you’d like to support someone you know or make a donation to The Pinc and Steel Foundation you can do so here
By Kirsten Rose, Physiotherapist & Health Coach.
This was the theme for Mental Health Awareness Week this year. It reminds us of the importance of social support and connection with others in order to foster not only our mental wellbeing, but our wellbeing as a whole. As a species, humans are wired for connection but in this modern age, despite the hyperconnectivity that technology allows, many people still feel lonely and isolated.
I was at a conference recently and one of the speakers presented on the theme that physical activity is like social glue. He talked about how we feel about exercise being more important than what we think about it (and hence the reason why just because we know it’s good for us doesn’t always translate into doing it!). We need to feel positively connected to that exercise to give us a compelling reason to do it. There is also mounting research that shows that people coming together to be active ramps up the benefits to their wellbeing, far exceeding the benefits of the exercise itself, and hence giving us that compelling reason to do it! For those of you who know me from the clinic, you’ll understand when I say I was just fizzing about this topic.
On a personal level this resonates so deeply with me. Team sports have been a huge part of my life since I was a kid. As an adult, Crossfit has truly been my social glue for the past decade. Being a part of that community has helped me ride through many a storm - moving back to Auckland after many years away, helping me to maintain both my physical and mental health through the wild ride of becoming a parent, those ridiculous covid years, and all the other curveballs that life regularly throws at our way. Yes I love it as a form of exercise, but it’s the people that make it extra special and have helped me to stay consistent over all this time. I’d also say that over the years I’ve recognised it’s importance for my mental health and fitness, not just for the physical or aesthetic gains.
Amongst the team here at AP, it’s a common theme. Whether it’s running, triathlons, multisport, pilates, yoga, tramping, dancing, team sports…we all value the social connection and headspace that our chosen form of exercise gives us. It’s why we can relate to our clients when pain, illness or injury gets in the way of taking part in these activities. Because it’s not just exercise buzz that we miss is it?
What we miss is something that’s called “collective effervescence” - the energy that comes from being in a group with a shared purpose. The feeling that you get from the supportive scaffolding that those people provide, so even on a bad day, you know you can turn up and 99% of the time leave feeling so much better!
So what do you do when you can’t be part of your chosen community for a while?
Especially if you notice that you’re starting to feel the negative mental effects of less regular exercise and social connection then we need to be proactive…
Firstly let’s talk about that word “can’t” cos as humans we’re pretty good at black and white thinking. I know I’m not alone with the “if I can’t do it in the way that I want then I won’t do it at all” story. Yep I see you nodding as you read this. Is there another version of that story that might actually be more true? Perhaps a reframe like this might be more helpful… “I could go and I’ll be slower/need to ask for help/have to modify a few things but I could still be there”.
If you really can’t do it then there’s two things we need to consider:
Firstly, you’re allowed to feel like that sucks, make some room for those emotions. Being unwell and/or injured often isn’t fun. It can be frustrating, stressful and for sure it can rob you of some of the joys of life for a while. You don’t need to pretend like that’s not happening. However, ruminating and getting stuck in those negative thought loops isn’t helpful so onto the next consideration…
What are the opportunities that this injury/illness might be providing you? Not in a toxic positivity way, but in a realistic and optimistic way, as there is often room for growth in times of adversity.
Maybe if your injury is only in one part of your body, you can focus your training elsewhere to tidy up that technique or strength difference you’ve been meaning to address for ages. Maybe there’s now time available to learn something new - for many of us exercise is our best tool to manage stress, but could this be a chance to learn more about what breathwork, mindfulness or a creative pursuit could do for your stress as well?
Here at AP, we‘re passionate about ensuring that our clients can be supported along their whole recovery journey. We can be your community when you need us.
That might look like starting with one of our physiotherapists and progressing to one of our physio-led group classes to get you back on track, then working with our Health Collective team of pilates instructors, personal trainers and massage therapists to keep you well. And there’s the option of Health Coaching anywhere along that journey to support you with making those mindset shifts so your new routines and habits are both successful and sustainable.
I’d like to leave you with this wonderful quote from Vivek Murthy, the US Surgeon General…
“We succeed and thrive best when we work together and support each other.
When we struggle alone, that’s when the struggle can seem impossible”
So don’t go it alone. Reach out and let us help you. We’re experts in making better lives possible.
If you would like to learn more click on our Health Coaching page or book a complimentary call with Kirsten HERE.
INGREDIENTS:
INSTRUCTIONS:
This recipe was taken from Rachel Conners.
How is personalised prenatal support an investment to my birth experience (and long term health)?
“As long as I am healthy and my baby is healthy”
I have heard almost every mother say this when we discuss their expectations for birth and usually my response is; “Define healthy. What does healthy mean for you? Mentally, emotionally, spiritually and physically?"
So often we underestimate that if a birth goes physically well then all else will be well, however, how a mother and her newborn are treated and supported will hugely determine the impact it has on a mother’s overall birth experience, wellbeing and recovery.
Birth is likely to be the biggest, most significant event of your life and it is also likely to be one that will continue to influence you in many ways, for the rest of your life.
Though we place our trust in external resources and the expertise of medical professionals, our boundaries, expectations of safety and feeling well will be assumed differently by everyone who is involved in our pregnancy, birth and postpartum journey. We can be so quick to assume that our care provider knows or understands what we may want or need and this is where the risk of experiencing trauma, depression, confusion and disappointment increases.
No one can guarantee us a perfect birth and we cannot have the chance of having the birth we want if we do not do not accept the responsibility to find out what that birth looks and feels like for us.
We need to be able to recognise our own needs before we can voice them to others.
Top reasons to invest in prenatal care:
How we invest in our pregnancy through prenatal support will ultimately be revealed during birth and our postpartum recovery. Hold yourself accountable to gain clarity of your needs, learn about birth, build confidence in your decisions and speak to the importance of what matters to you.
Birth is not outside of us, it comes from within us.
To invest in your prenatal health and to feel foundationally supported in preparing for your birth, book a session with our Maternal Health Consultant, Vanessa Werner
Though the most recognised part of our C-section birth is the incision scar, a lot of us can be surprised to see the development of what is called the C-section shelf.
What is a C-section Shelf?
A C-section shelf is the section of the lower abdomen that ‘hangs’ over the scar where the incision was made and its appearance can look different for each of us. It may be raised, puffy scar tissue, skin puckering, excess skin overlap or low hanging belly. A C-section shelf may also appear more exaggerated if you develop diastasis recti.
How does a C-section shelf develop?
When a C-section incision is stitched back together, the skin becomes more taught than before, leading it to look like a piece of string being held against the tummy. This means the skin above, which has been stretched from pregnancy will appear to hang over your scar line.
Not merely cosmetic - scar adhesions that contribute to the development of a C-section shelf can result in physical feelings of discomfort, including numbness, pain, tingling, and itchiness. When these sensations occur in the deeper tissue layers, the surrounding muscles and organs can be affected, causing functional problems including:
How can I heal my C-section shelf?
With proper guidance and patience you can prevent and relieve new and even decades-old scar adhesions associated with your C-section shelf. These long term remedies should help to reduce the appearance of your C-section shelf:
Scar Massage
Scar adhesions usually develop in the area underneath and around your C-section incision where one layer of tissue may be stuck to another layer when it should usually glide freely.
Scar mobilisation is to massage the scar tissue which increases blood flow to the area and helps to gradually break up adhesions and free the surrounding tissues. The idea is to loosen the scar from the tissue, so it doesn’t get “stuck” to the layers below. Helping to break up adhesions will improve the function of your core/abdomen and appearance of your c-section shelf.
You can perform a c-section scar massage yourself and/or a pelvic floor physical therapist can help. Begin with small circular massages (using a moisturiser or oil for your skin) to promote blood flow, support the healing process, and reduce discomfort.
Remember to wait until your incision is completely healed, (usually after 6 weeks postpartum) and you feel ready to begin developing a healing relationship with your scar.
Skin Care
A consistent skin routine can help to visibly reduce the appearance of the incision scarring, stretch marks, and the laxity of your skin.
Can exercise help to improve my C-section Shelf?
A therapeutic exercise routine may help with excess fat and help to heal your postpartum core and pelvic floor, however no form of exercise will completely ‘fix’ your postpartum skin. Improve a C-section shelf and heal diastasis recti by focusing on deep core training while factoring in total body workouts to build strength and stamina.
Is it too late to start ‘treat’ my C-Section Shelf?
A lot of preventative healing happens in the first six months postpartum, but it is never too late to begin personal rehabilitation.
Healing from a c-section takes patience and the acceptance of your birth story and the way you feel about yourself can have a huge effect on the relationship you have with your body and your self-esteem. If you are preparing for or recovering from a C-Section birth, our Maternal Health Consultant, Vanessa Werner can help to address any emotional challenges and provide you with personalised information and support.
Book a session with Vanessa Werner.
INGREDIENTS
Author: Cookie and Kate and Adapted from The Southern Vegetarian Cookbook.
HEALTH TIP FROM HEALTH COACH, KIRSTEN ROSE
As we head further into winter many of us find ourselves drawn to starchy comfort food. However, eating fewer carbohydrates can be a helpful way to regulate blood glucose levels and support metabolic health. Eating too many on a regular basis can lead to frequent blood sugar spikes and falls. This pattern can make your odds of developing metabolic syndrome and its related conditions (including insulin resistance, diabetes, and heart disease) more likely over time.
Carbs are present in some form in many foods such as fruits, vegetables, dairy and grain based products to name a few. They can also be a rich source of vitamins and minerals in our diet, so for most people we don't want to eliminate them completely. What we mostly want to avoid is refined carbs, like sugar and wheat flours. Pairing carbs with essential nutrients like protein, fibre, and healthy fats, will help create a more balanced blood sugar response.
What happens in pregnancy, labour and birth all impact how a woman becomes a mother and cares for her babies. These are the years that are formative, creating ripples that can affect generations of family to come.
I’ve come to realise that women aren’t able to entirely "recover” from each chapter of motherhood. Instead, we only continue to build upon the many tiers of our journey.
Pregnancy, on into Birth, on into Postpartum. Each tier morphing and merging into the next.
Healing is a cyclical experience, as is the impact of trauma and what happens to us during the transformative trimesters of pregnancy, birth and postpartum (the changes of our bodies, the shifts in our identity), will ultimately shape HOW we mother and WHO we are as mothers.
We are transformed permanently, psychologically and physically.
There is a shift of our root perspective and a restructuring of our internal consciousness so that we are never going to be able to see life as we saw it before. We may outgrow friendships, reassess priorities and start to grieve the deep knowing that we are leaving behind a way of life that we so independently worked hard to create.
Once our babies are born, we view postpartum as the opportunity to heal, but there is no going back to who we were before birth, or even before pregnancy. Yes, who we were lives within us, stored in our nervous system and memories, even surfacing with emotional and behavioural patterns, but we cannot turn back the clock.
What can we do to bring a sense of closure to each chapter of your motherhood journey? (Pregnancy, birth and postpartum
By always playing a proactive part in our journey we can work to understand and to feel into the stages and layers of change, not only in our body but also the shifts in our thought patterns and experienced emotions.
To feel prepared for your birth and supported during your postpartum recovery, Vanessa is available at Auckland Physiotherapy for appointments on Fridays and Saturdays.
'Click here' to book.
Having worked within high performance sport in the UK, the pressures on young, promising athletes to reach their full potential is immense. That pressure comes from a variety of different sources, parents, peers, coaches, performance staff and the player themselves. That pressure is a double edged sword. On one hand it helps to drive the athlete to raise the bar in terms of improvements in performance, but on the other it may hinder development and lead to extra physical as well as emotional stress, especially where injury is concerned.
Nowadays, young athletes are training more often each week, for longer durations and often with additional strength and conditioning demands. Couple that cocktail with the fact that these same players may be playing for school and local clubs and you can see a very hectic training schedule.
A typical week may look like 3 training sessions a week for Club, alongside 1-2 training sessions a week for school, leading up to 2 games on the weekend. The strength and conditioning sessions would be a minimum of 1 x week. That week doesn’t even take into account that these young athletes are still studying at school with additional academic, social and emotional demands. Physical and psychological load is very high.
Often when that load is not managed correctly, it is when the risk of injury is generally higher. If you would like advice on load management or ensuring your body (or your child's) has the strength, flexibility and endurance to cope with that load, talk to David.
Injury prevention tip:
For more advice, book a session with David Bahadoor HERE
