In this interview, Antony interviews his co-host Marika about some of the lessons she has learnt along her journey as a physiotherapist (including sharing some of her big mistakes!).

Marika Hart is an APA-titled Musculoskeletal and Continence and Pelvic Health Physiotherapist. She started her journey in Perth, before heading to London, Melbourne and finally back home. Despite declaring no interest in working in pelvic health, she found herself falling into the field after having 2 children and realising she was ignorant about this area! She currently works as the senior urogynaecology physiotherapist at King Edward Memorial Hospital, where she continues to learn from her colleagues and patients.

In this episode you will hear Marika share

• some of her a-ha moments when working as a physiotherapist
• some of the different ways in which she has advanced her knowledge and skills over the years (courses, mentors etc)
• her vulnerability as a new-grad physiotherapist, feeling like she should know more
• how changes in her mindset led to less stress and anxiety at work
• how working with Girls Gone Strong helped her develop new skillsets to help her clients
• how diversifying early in her career has helped enormously in her work as a pelvic health physiotherapist
• how her musculoskeletal masters clinics helped her develop her clinical reasoning skills and start asking herself “why” more.
• some of the difficulties in working with complex conditions and why self care is so important

Would you like to hear Antony share his top tips and a-ha moments?

Let us know in the socials!

This is the episode that has been 6 years in the making! We are thrilled to be able to chat to Dr Jennifer Kruger, who is the CEO and co-founder of JUNOFEM, a medtech company spun out of the University of Auckland. Jennifer's background is clinical, but has been an academic for most of her career, so her name is probably familiar to most who are listening! She still heads the pelvic floor research group at the Auckland Bioengineering Institute, but is now commercialising her research for greater reach, to more women who need it!

Here are some of the things we discussed:

• Dr Kruger’s clinical background as a midwife, and how her interest in birth outcomes and postnatal recovery led her to doing extensive research into pelvic floor function during and after childbirth. She pursued graduate degrees to study pelvic floor muscle function using ultrasound, MRI and computational modeling, with a long term goal of improving birth outcomes and helping with postnatal recovery. She completed her PhD looking at pelvic floor morphology and function in elite athletes.
• Over the past 8 years, she has been working with the team at University of Auckland, including some very clever bioengineers to develop the femfit®, which is a flexible vaginal pressure sensor array that measures pelvic floor muscle activation and intra-abdominal pressure during functional activities
• Initial prototypes used a single pressure sensor, but the final version has 8 pressure sensors along the vaginal length. Therefore it can produce a pressure profile showing pelvic floor vs. intra-abdominal pressure and ensure clients are doing a correct pelvic floor contraction, rather than bearing down
• The tool has been validated against trans-perineal ultrasound and manometry to ensure that the information regarding movement of the pelvic floor muscles is correct.

Dr Kruger is passionate about removing some of the stigma associated with urinary incontinence and help provide practical options for women wanting to improve their pelvic floor strength and function. Her team are performing ongoing research with the femfit® device, which includes looking at PFM function during functional activities.

To learn more about the femfit® or to become a registered affiliate for the device, please go to the website for details.

To support The Women’s Health Podcast, please use the code “femfit+WHP” to get 10% off the femfit® and in doing so, you will help keep The Women’s Health Podcast on air!. Follow this URL https://shop.junofem.com/discount/femfit+WHP or use the QR Code below!

https://www.junofem.com/

Or contact Jenny at j.kruger@junofem.com

You can follow Jenny and JUNOFEM on social media:

https://www.instagram.com/junofemhealth

https://www.linkedin.com/company/junofemhealth

In this episode, we talk to Nina Theodorsen, a Norwegian women's health and pelvic floor physiotherapist, who works in a private clinic and is doing a PhD at University of Bergen. Nina has done extensive research on the effect of exercises on DRA during pregnancy and the postpartum period. Her long clinical experience affects her approach to research and dissemination of the results. She also holds a degree in health management and further education in sexual health and education, teaches women's health on the bachelor physiotherapy program, holds courses and talks, and tries to influence politicians to prioritize and improve women's health

Nina begins the episode by discussing her background working with women around the perinatal period and how her clinical observations led to her desire to perform more research on the effect of exercise on DRA. She felt that there was a lot of messaging that was fear-based and could potentially reduce participation in exercise.

With Kari Bø and others in the team at University of Bergen, Nina has published research studies on the effect of pelvic floor and transversus abdominis contraction on the inter-recti distance in both pregnancy and post-partum populations. She also conducted a randomised controlled trial (during covid lockdowns!!) on the effect of a 12-week full body strengthening program (including abdominal exercises) during pregnancy on the inter-recti distance at late stage pregnancy and at 6 weeks post-partum.

You can access her research articles here:

https://doi.org/10.1016/j.jphys.2024.02.002

https://doi.org/10.1016/j.physio.2023.08.001

https://doi.org/10.1016/j.physio.2018.08.009

Nina is happy for people to get in touch with her with any questions or comments.

We thoroughly enjoyed this interview with Nina and hope you do too! Please feel free to leave a comment below about your thoughts on the topic!

nina-margrethe.theodorsen@uib.no

@diastaseprosjektet