Strength training for beginners

Strength training – printable information sheet Quick links What is strength training? What are the benefits of strength training? Why […]

Challenging your muscles with strength training exercises 2 or 3 times each week can improve the strength and tone of your muscles.

Regular weight-bearing exercise and strength (resistance) training can help improve your bone density and decrease your risk of osteoporosis.

Exercise helps build and maintain bone mass through mechanical loading, resistance and impact which stimulate bone-forming cells. Strength training and balance work reduce the risk of falls and fractures, particularly in older adults or those with low bone density. For people with joint pain or arthritis, regular movement can reduce stiffness, improve function and slow the progression of disability.

Download: Decreasing the risk of falls and fractures | Fact Sheet MAIN POINTSFalls and fractures can happen at any age, but the risk increases as women age.Falls in older people are more likely to cause more severe injuries.Low bone density, low muscle strength and poor balance are more likely as women age and increase the risk of falls.Improving your bone health can also help decrease the risk of falls and decrease the severity of any injuries or other consequences if you do fall.Appropriate physical activity can help decrease several fall risk factors.Speak with your doctor, assess your overall health and make changes to decrease your risk of a fall.You can reduce your risk of having a fall. The years before, during and after menopause are great times to speak with your doctor, assess your overall health and make changes to decrease your risk of a fall.By the numbers – falls and fractures in women after the age of 40Between the ages of 40 and 60 years, women begin to experience a decrease in the ability to balance and a decrease in bone density. Both of these changes contribute to the likelihood of both a fall and more severe outcomes after a fall. Here are some statistics showing the increase in the risk of falls as women age:After the age of 50, one in two women will break a bone at some stage during the rest of her life because of a fall.One in five women will fall each year before she reaches the age of 60.One in three women will fall each year after the age of 65.One in two women will fall each year after the age of 80.In older people, 30 per cent of falls result in more severe injuries such as head trauma, hip fracture, other fractures and dislocations. Of the hip fractures in older people, more than 90 per cent are caused by a fall – 25 per cent of people with hip fractures die within 12 months and 25 per cent never regain full mobility. After a fall, older people can also lose confidence and become less physically and socially active.Factors increasing the risk of falls and fracturesA proper review of your risk of falls and bone fractures can be performed by healthcare professionals. Self-assessment tools are also available to help you to uncover any risk factors. Your risk of having a fall increases if you have:low bone density / osteoporosis – women 60 years or older with osteoporosis have twice the risk of fallingdecreased strength in your lower bodydecreased balance, reaction time and postural stabilitya history of previous fallsother medical conditions including (but not limited to) – hearing and vision problems, heart disease, incontinence or dementia.Decreasing your risk of falls and fracturesYour doctor can suggest steps you can take to decrease your risk of falls. These include:increasing muscle strength through physical activitymaintaining or improving your bone density (see section below)improving your mobility through physical activityimproving balance through physical activityhaving your vision and hearing checkedmaking sure your footwear is appropriatereviewing your environment for tripping hazardsspeaking with your doctor if you have a fear of falling or feel physically or socially restricted.Maintaining or improving your bone health decreases the risk of falls and fractures and may decrease the severity of injuries or other consequences if you do fall.You can improve your bone health with:physical activity to improve bone density, muscle strength, mobility and balance – weight-bearing activities or strength training can improve your muscle strength, bone density and mobility, while activities such as Tai Chi, yoga or Pilates can improve balanceadequate calcium intake – a minimum of 1200g per day, preferably from dietary sourcesVitamin D – helps calcium absorption and maintains bones. Low vitamin D blood levels are common in Australia and you may need supplements if your blood levels are lowanti-osteoporosis medications, including menopausal hormone therapy (MHT), can reduce the risk of a first fracture and especially further fractures by up to 70%.Where can I find more information?Lifestyle and behaviour changes for menopausal symptoms (See AMS fact sheet Lifestyle and behaviour changes for menopausal symptoms)Osteoporosis (healthybonesaustralia.org.au)Calcium Supplements (See AMS information sheet Calcium supplements)Self-assessment tool: Are you at risk of osteoporotic fracture?Self-assessment tool: Know your bonesIf you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Doctor service on the AMS website.

Toilet Training

Download: Urinary Incontinence in Women | Fact Sheet MAIN POINTSUrinary incontinence is common in womenWomen can have stress or urge incontinence or a mixture of bothLearning how to contract pelvic floor muscles correctly can help treat stress incontinence. Some women may need surgeryBladder training and vaginal oestrogen can assist with urge incontinenceWhat is incontinence?Urinary incontinence is the involuntary loss of urine.It is a common problem for women, getting worse with advancing age. 1 in 2 women over the age of 70 has some form of urinary incontinence. Not everyone who has had a baby has incontinence, and women who have not had children may still suffer from incontinence.Urinary incontinence can be also associated with vaginal prolapse, chronic lower back pain, or bowel issues, including faecal incontinence. Children may also suffer from incontinence but this often has a different cause. What are the different types of incontinence? There are two main types of urinary incontinence:Stress incontinenceUrge incontinenceStress Urinary Incontinence (SUI) is more common, affecting 1 in every 5 women. Women who have not had a baby have a 1 in 10 chance of developing SUI, while for those who have had a baby, the chance rises to approximately 1 in 3.Urge Urinary Incontinence (UUI) is less common in younger women, affecting approximately 1 in 30 women, but becomes more common with advancing age.The difference between managing these two types of incontinence are discussed below.In some instances, both types of incontinence can occur in one person, though the cause for each type is different. This is known as mixed incontinence. Mixed incontinence affects approximately 1 in 10 women.What is considered normal bladder function?Passing urine 4-6 times per dayPassing urine no more than once per nightPassing 1-2 cups of urine (250-500mls) each timePassing urine in a steady stream until the bladder is emptyBeing able to delay passing urine until convenient, andHaving no leakage of urine between visits to the toiletIn a woman with normal bladder function, the muscles of the pelvic floor contract when she is doing any physical activities. These activities may include sneezing, coughing, sports or any other physical effort which can cause the pressure in the abdomen to rise.When the pressure in the abdomen rises, the muscles of the pelvic floor contract, compressing the urethra (the tube which connects the bladder to the outside) and triggering contraction of the sphincter (the muscle that wraps around the urethra to keep it closed). This prevents any leakage of urine.What causes stress urinary incontinence?Stress incontinence is the involuntary loss of urine often related to physical exertion. This is caused by either:loss of the support of the urethra by the muscles and ligaments of the pelvic floor, orloss of the strength of the sphincterWhen the pressure in the abdomen rises, insufficient contraction of the pelvic floor means the compression of the urethra will also be insufficient. This in turn leads to insufficient contraction of the sphincter, resulting in the loss of urine and “stress incontinence”.What causes urge urinary incontinence?Urge urinary incontinence is the involuntary loss of urine associated with urgency (having to rush to the toilet), or being unable to delay passing urine until a convenient time.The uncontrollable need to pass urine occurs due to overactivity of the muscle of the bladder wall. It is associated with increased urinary frequency, urgency and needing to wake up multiple times during the night in order to pass urine. Typically, the feeling of urgency can be associated with daily activities, such as when you put the key in the front door, or when water is running. This is also known as overactive bladder syndrome. Some people with overactive bladder syndrome can feel urgency, but not actually leak any urine.Mixed urinary incontinence is the involuntary loss of urine associated with both urgency and any physical exertion, or when sneezing or coughing.Management of Stress IncontinenceStrengthening the pelvic floor muscles and learning how to contract them correctly is an important step in managing SUI. About one in two women are unable to contract their pelvic floor correctly. Nurse Continence Advisors or physiotherapists specialised in pelvic floor management can assist you with a personalised training program of pelvic floor muscle contractions. They will also teach you "the knack”. “The knack” is contracting your pelvic floor before coughing, sneezing, or doing anything that raises the pressure in your abdomen. The training can also help you learn how to isolate the muscles of your pelvic floor around the anal area, to help control any anal incontinence and the passage of wind.Other approaches to treating stress incontinenceUsing stool bulking agents or softeners will help avoid constipation and having to strain when opening your bowels. When emptying the bowels and bladder, it may also help to use a low stool to elevate the knees slightly higher than hips, relaxing the pelvic floor and the abdomen. Additionally, avoiding heavy lifting can help avoid raised intra-abdominal pressure leading to SUI.Some women may be able to use a continence pessary, which is inserted into the vagina and supports the bladder neck, helping to reduce leakage.Another non-surgical option is duloxetine, an antidepressant medication known as a serotonin and noradrenaline reuptake inhibitor (SNRI). It may help some women but its use is not approved for this purpose in Australia or New Zealand.Your doctor may recommend surgery if other treatments have not helped. You may be referred to a specialist urogynaecologist to discuss the benefits and risks of surgery for SUI. The types of surgery available for SUI include urethral bulking agents, midurethral slings, colposuspension, or an autologous fascial sling.None of the types of surgery currently available have a 100% cure rate, however for 80-90% of women, their surgery will provide significant improvement at 12 months post-surgery.For incontinence caused by neurological disorders, such as multiple sclerosis or spinal cord injury, management should be tailored to the individual woman's needs.It’s very important to have an accurate diagnosis of SUI before considering surgical treatment because it can make overactive bladder symptoms worse. The diagnosis of SUI can be established with a special test called urodynamic studies. This test is essential before surgery is undertaken.Management of Urge IncontinenceThis usually starts with simple measures, such as using vaginal oestrogen and seeing a physiotherapist to help with pelvic floor rehabilitation. Learning how to retrain your bladder to hold larger amounts of urine can help reduce the urge to pass urine.Retraining the bladder includes learning how to contract pelvic floor muscles repeatedly and practising how to hold the contraction for a specific period of time. Wiggling your toes can also help reduce urge incontinence as this sends a signal to the bladder to relax.If you are overweight, even 5% weight loss can improve urinary urgency significantly. Removing bladder irritants can also help reduce the urge symptoms. Common bladder irritants include alcohol, caffeine (especially tea & coffee) and fizzy drinks. If you are postmenopausal, vaginal oestrogen may be prescribed to use as a vaginal cream or tablet. Oestrogen can plump up the lining of the vagina, which thins out once you go through menopause, and may provide some improvement in incontinence. However, the effect wears off once you stop using the treatment. The amount of oestrogen that gets absorbed into the body is very small and considered safe. Women who have had breast cancer should consult with their doctor to discuss whether or not they can use vaginal oestrogen.Adding in anticholinergic medications can help in addition to bladder training and weight loss. These medications aim to decrease the contractions of the detrusor (bladder wall muscle). Another available medication is called mirabegron. Some of these medications can be quite expensive as not all of them are available on the Pharmaceutical Benefits Scheme (PBS).If a trial of two or more medications has not helped, you may need to see a specialist who will talk to you about other treatment options, including injections of Botulinum toxin (Botox) into the bladder wall. Percutaneous tibial nerve stimulation (PTNS), or sacral nerve stimulator implants can also help by interfering the urge signals from the bladder through the process known as neurological modulation.Where to seek further help/ information:Your GP can start management, and if necessary, refer you onto a Gynaecology or Urogynaecology clinic.Helpful online resources include: Australian Physiotherapy Association website: http://physiotherapy.asn.au  then click “Find a Physio” and choose a Women's Health & Continence physio in your areawww.UGSA.com.au  then click “Patient Information”www.yourpelvicfloor.org If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find a Practitioner service on the AMS website.

The aim of bladder training is to help you gain better control over your bladder. Bladder training should be done under the supervision of a continence health professional.

Learn how to toilet train your child. Discover signs of readiness, practical tips, hygiene habits and how early childhood services support toilet training in partnership with families.

Guide to a simple breathing technique that can help you remain calm during times of anxiety or stress.