​Chronic pain is pain that persists beyond the expected healing time of an injury. It differs to acute pain, that is caused by tissue damage, as chronic pain is less about the structural damage and more about the sensitivity of the nervous system.

​When pain is chronic, both the mind and body play important roles in winding down the nervous system and modifying the brains interpretation of danger.
 
The best approach to treating chronic pain is a holistic and broad perspective that reviews and considers:
 

• Medical treatments including medication and surgery.
• Emotional well-being as thoughts and emotions impact on the nervous system.
• Connections with people places and purpose.
• Activity levels that impact both the physical and nervous systems.
• Diet and nutrition to nourish both mind and body.

 
Taking this whole person approach retrains the nervous system and restores tissue health.

​Getting moving again at comfortable levels, from the brains perspective, allows the body and brain to move without fear or danger signals and gradually restores the bodies tissues.
 
It is important to pace the activity levels, finding the right balance, and to gradually build activity, to overcome the fear that there may be something dangerous and structurally wrong with the body.
 
Learning to “reprogram” activity is an important part of the overall brain retraining strategy. Regular activity also reverses the downward cycle of the condition of the body and tissues which contributes to worsening pain overtime.

​Want to know more? Here is some more information around the management of chronic pain.

• Pain explained in 5 minutes – watch the video here.
• Understanding Pain from NSW Health – read the fact sheet.
• Self-managing chronic pain tips from Pain Australia – check out the tips

 
Please don’t hesitate to contact Pear Exercise Physiology and discuss any further questions you have around the treatment of chronic pain.

A hysterectomy is the surgical removal of the uterus and/or the cervix and is used to treat several conditions, therefore the recovery from the surgery depends heavily on the type of procedure performed.

​Following a hysterectomy some women develop pelvic organ prolapse. Before a hysterectomy the bladder, urethra, vagina and uterus are all attached to the pelvic walls by a system of connective tissue, fascia and ligaments. When the uterus is removed an element of this supportive structure is also removed which can cause some women to experience a pelvic organ prolapse.

A prolapse is where one or more of the pelvic organs, or the vagina itself falls into the vaginal opening. Common signs and symptoms of a prolapse can include:
 

• A feeling of heaviness around the lower tummy, pelvis and genitals.
• A dragging discomfort inside the vagina.
• A feeling of sitting on a small ball like there is something coming down into the vagina.
• Feeling or seeing a bulge or lump in or coming out of the vagina.
• Discomfort or numbness during sex.
• Problems weeing such as feeling like the bladder isn't emptying fully, needing to go to the toilet more often or leaking a small amount of pee when coughing, sneezing or exercising.

​A strong pelvic floor is key to avoiding a prolapse. As a start try these two exercises that are gentle on the pelvis post hysterectomy.
 

• Core Breaths – breathe deep into the back of your rib cage, then as you exhale lift your pelvic floor as if you were drawing a tampon inside you. You can also think of it as the same muscles you would use to stop gas or cut off urine. Don’t strain and if your pelvic floor is particularly week after a hysterectomy it may take some time to build up to doing a lot of the exercises.

 

• Pelvic Tilts – lying on the floor curl your tail bone up and flatten your back into the floor taking the curve out of your spine, then untuck your pelvis and lower your tailbone so there is a small arch at the bottom of your back and repeat. If lying on the floor is too much you can also do the exercise standing against a wall.

 
It is also important to support your pelvic floor in your everyday activities following a hysterectomy. Using your core breath always exhale on effort, no matter the activity, to protect and stabilise the pelvic floor and abdominal walls.