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

Yes it has been over 2 years since our last episode, but we’re back and full of excitement about the guests to come!

And what a great episode to kick off the re-boot. On this podcast we interview Dr Tracy Sher about all things related to Pudendal Neuralgia. Dr Sher is the Founder/CEO of the global platform, Pelvic Guru, LLC/Pelvic Global and the Global Pelvic Health Alliance Membership (GPHAM). She is also the Owner/Clinical Director of the private practice, Sher Pelvic Health and Healing in Orlando, Florida.

In this podcast we cover:

• Pudendal neuralgia versus pudendal nerve entrapment.
• Some basic anatomy including the pathway of the pudendal nerve and where it might become irritated or entrapped
• The “Pudendal Tour” - ie the challenging journeys that some patients will go on, including multiple scans, nerve conduction tests, injections and surgery.
• Some of the signs and symptoms that clients might present with
• What a physiotherapy assessment might look like and how to prioritise what to look at on day one
• The importance of a multidisciplinary team in the management of pudendal neuralgia and some of the specialties you might want to include in your team
• Some interesting case studies including patients who have been diagnosed with pudendal entrapment but there was something ELSE was going on…
• Acute onset pain that often gets missed (think post-surgical!)
• How we as health professionals need to be careful with our language (avoid nocebic language!) and can provide hope for these patients
• What might conservative Mx might look like for someone with pudendal neuralgia

Correction: Tracy wanted to add after the conversation:

“Numbness can end up being part of pudendal nerve entrapment. The Nantes criteria actually lists: “no objective sensory defects” but those who treat this clinically will see sensory changes. This was the original Nantes criteria - but we see many more nuances to this: pain limited to the territory of innervation of the pudendal nerve, pain predominant during sitting, pain does not awaken the patient from sleep, no objective sensory defects, a positive effect of anaesthetic infiltration of the pudendal nerve.The key is to do all differentials as it isn't a typical symptom.

I also stated S1-3 in the beginning and meant to say S2,3,4.”

As always, we felt like we could have picked Tracy’s brains for hours, so might have to get her to come back again in the future (or encourage her to come to Australia!).

You can reach Tracy at: Website: www.pelvicglobal.com Email: Tracy@pelvicguru.com Instagram: @pelvicguru1 Twitter: pelvicguru1 Free Facebook Group: Pelvic Guru Academy