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Training and exercise therapy for the entire musculoskeletal system
- A baseball player's humerus is thicker than a soccer player's. Weightlifters' intervertebral discs are higher than those of swimmers. A high jumper's Achilles tendon is thicker than a marathon runner's. Training and exercise can do much more than just build muscle. Every structure in the body can change positively through targeted build-up of stress. Load shapes the structure. Adapted movement is the most effective form of therapy in physiotherapy and makes use of numerous adaptation mechanisms in the body. Training therapy in physiotherapy includes the structural improvement of movement processes and organ systems with the aim of strengthening coordination, strength, endurance and balance through systematic training, building on the stabilization of the primary disease and for the complementary treatment of secondary diseases. The overarching goal is to prevent the re-occurrence of diseases and the development of secondary diseases, maladaptations and chronic diseases. Die Bandscheiben von Gewichthebern sind höher als die von Schwimmern. Die Achillessehne eines Hochspringers ist dicker als die eines Marathonläufers. Training und Bewegung können viel mehr als nur Muskulatur aufbauen. Jede Struktur im Körper kann sich durch gezielten Belastungsaufbau positiv verändern. Belastung formt die Struktur. Angepasste Bewegung ist die wirksamste Therapieform in der Physiotherapie und macht sich zahlreiche Anpassungsmechanismen im Körper zu nutze. Die Trainingstherapie in der Physiotherapie umfasst die strukturelle Verbesserung der Bewegungsabläufe und der Organsysteme mit dem Ziel, die Koordination, Kraft, Ausdauer und das Gleichgewicht durch systematisches Training, aufbauend auf der Stabilisierung der Primärerkrankung und zur ergänzenden Behandlung von Sekundärerkrankungen, zu stärken. Übergeordnetes Ziel ist die Vermeidung des Wiedereintritts von Krankheiten sowie des Entstehens von Folgekrankheiten, Maladaptionen und Chronifizierungen.
Continence training for men
What is incontinence?
- Incontinence is the uncontrollable, involuntary loss of urine. Urinary incontinence is a form of incontinence and is known by various terms such as bladder weakness, weak bladder, involuntary urge to urinate or urine loss. Urinary incontinence doesn't just affect women - men can also struggle with the problem. A healthy person decides for themselves when and where they pass urine. People with incontinence, on the other hand, experience uncontrolled loss of urine - this can have various reasons.
- Incontinence is a problem that can affect both women and men.
Incontinence – these symptoms are typical
- Strictly speaking, urinary incontinence itself is the symptom; it suggests a weakening or injury to the pelvic floor or bladder dysfunction. Typical is uncontrolled loss of urine, which occurs suddenly depending on the form of incontinence and is accompanied by cramp-like pain, increased urge to urinate and an increased susceptibility to infections. Due to the constant moisture that accompanies urinary incontinence, the skin in the intimate area can also become irritated and red.
Types of urinary incontinence and causes of incontinence
- There are different forms of incontinence, all of which have different causes.
Stress incontinence
- With stress incontinence, pressure on the bladder causes involuntary loss of urine. This can be triggered by, among other things, sneezing, laughing, climbing stairs or lifting. This can be triggered by, among other things,sneezing, laughing, climbing stairs or lifting. With stress incontinence, the pelvic floor muscles are impaired, which means that continence is no longer guaranteed - this can have different causes. Stress incontinence can be caused by surgery, possible injuries to the pelvic floor muscles (such as the birth of a child) or a congenital tissue weakness that also affects the pelvic floor muscles.
Urge incontinence
- Urge incontinence involves an imperative need to urinate and, as a result, involuntary loss of urine. The bladder transmits the signal that it is full, reacts overactively and the urine escapes. Like the other forms of urinary incontinence, urge incontinence occurs primarily in older people.
- Depending on the underlying cause, a distinction can be made between a motor and a sensory form of urge incontinence. The former is usually due to a neurological disease such as multiple sclerosis, dementia, a stroke or Parkinson's disease, or it occurs due to medication side effects. In the sensory form of urge incontinence, involuntary loss of urine occurs due to external influences, for example due to excess weight pressing on the bladder, tumors or a change in the prostate.
Dribbling incontinence
- Dribbling occurs when a few drops of urine come out after going to the toilet. A possible cause of dribbling can be, for example, that the bladder is not completely emptied when urinating. Instead, urine collects in the urethra, which then has to be transported out of the bladder. A common reason for dribbling in women is weak pelvic floor muscles, and in men an enlarged prostate.
Mixed incontinence
- In this case there is a connection between urge and stress incontinence. This means that those affected lose urine when pressure is applied and feel a persistent urge to urinate. In most cases, one of the two forms is more pronounced than the other.
Overflow incontinence
- Here the bladder pressure is too high, the bladder should empty, but the urine cannot flow out due to a narrowing (obstruction) of the urethra. Obstruction can be caused by stones, tumors, foreign bodies, but also age-related enlargement of the prostate.
Reflex incontinence
- Due to nerve or spinal cord damage, there is a lack of control over the sphincter and bladder muscles. This form is also known as incontinence due to neurogenic detrusor hyperactivity (neurogenic bladder).
Nocturia
- Nocturia refers to the urge to urinate at night in adults. They are affected several times a night and have unbalanced sleep. A loss of urine does not necessarily have to occur.
Conservative forms of therapy for incontinence
- Lifestyle habits: Conservative therapy is the first step in treating incontinence and often consists of changing certain habits and other circumstances. For example, if being overweight is the reason for urge incontinence, losing weight and eating a balanced diet can help.
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Bladder training/urotherapy: Special toilet and bladder training can be used to relearn continence. With coordinated bladder training you can improve the performance of your bladder and make it less irritable over time.
When training your bladder (urotherapy), make sure not to reduce the amount of fluid you drink, but rather to avoid certain drinks such as alcohol or coffee. It's best to train your bladder at home, because that's where you feel most comfortable and relaxed. You should still drink up to 2 liters a day, but only a little after 7 p.m. After observing the habits, visit the toilet regularly during bladder training. Maintain these intervals between toilet visits and avoid prophylactic toilet trips in which only a small amount of urine is passed. The micturition log will help to monitor and extend the intervals between toilet trips - whatever seems most comfortable. - Physiotherapy: If the sphincters and pelvic floor are the problem, these muscle groups can be specifically trained and strengthened under physiotherapist instructions. The exercises to treat incontinence are primarily intended for use at home but can also be done on the go and at work. Medications can also help treat urge incontinence.
Treatment of erectile dysfunction
- Impotence (erectile dysfunction) means that when an erection occurs, the penis becomes flaccid after a short time or does not become stiff at all. Satisfactory sex is often no longer possible, although sexual desire (libido) is often still present. Potency problems increase with increasing age. There can be psychological causes, but also illnesses such as vascular calcification or diabetes.
What is impotence?
- Impotence (erectile dysfunction) means that the penis does not stiffen sufficiently or the erection cannot be maintained long enough for a satisfactory sexual act. Doctors characterize the term impotence even more broadly, namely as the "inability to perform sexual intercourse satisfactorily."
- Men with impotence are not isolated cases. There are no exact figures because the number of unreported cases is very high. However, it is estimated that around five percent of men in the general population are affected. With increasing age, the risk of erectile dysfunction increases.
- The extent of impotence can vary greatly from man to man. Some sufferers only complain about occasional potency problems ("It doesn't work sometimes"), others report a total loss of erectile function.
Physiotherapy for erectile dysfunction
- The pelvic floor muscles are spontaneously active in healthy male erectile function and support vascular congestion and penile rigidity. Selective practice and training of the male pelvic floor muscles is possible. Physical therapists can take advantage of this when treating ED.
- The aim of the therapy is to promote blood circulation with targeted exercises so that the erectile tissue is preserved and to strengthen the muscles necessary for an erection. In addition, you will receive information and advice about alternative options for producing an erection - either for the desire to have sexual intercourse or to keep the erectile tissue functioning, as an unused erectile tissue can lead to atrophy(tissue loss) (vacuum therapy, drug therapy,...).
Follow-up care for men after prostatectomy
- When the prostate is surgically removed (radical prostatectomy), an attempt is made to preserve the adjacent nerves that are responsible for erectile function. However, impotence is one of the possible side effects, as are urinary incontinence and other urinary problems.
- See also continence training for men and/or treatment of erectile dysfunction
Manual therapy
- Manual therapy treats dysfunctions of the musculoskeletal system - the focus is on muscles and joints and their interaction. This form of treatment uses special maneuvers and mobilization techniques that help increase mobility and reduce pain. Read everything you need to know about manual therapy and its techniques here.
What is manual therapy?
- Manual therapy is a method of physical movement therapy. It is carried out by specially trained physiotherapists and aims to improve the mobility of muscles and joints and relieve pain. Manual therapy is characterized by certain mobilization techniques, for example stretching or stretching limbs and joints using pulling stimuli (traction treatment, extension treatment).
- Manual therapy is based on the knowledge that vertebrae that shift due to unusual stress, for example, can irritate the surrounding nerves and thus trigger painful blockages. Manual therapy techniques aim to remove these blockages.
When do you use manual therapy?
Manual therapy can help with a wide variety of functional disorders in the musculoskeletal system. Common areas of application are:
- Spinal problems (including herniated disc)
- Back pain
- Joint pain
- Muscle aches
- Special indications for extension therapy: Rheumatic diseases, sciatica (irritation of the sciatic nerve) and joint osteoarthritis
How is manual therapy used?
There are many different techniques. An experienced therapist selects the appropriate method based on the individual symptoms.
What do I have to consider before and after manual therapy?
If the symptoms have subsided through manual therapy, you should actively do something to ensure that they do not return. Doctors and physiotherapists recommend regular training to strengthen the musculoskeletal system and avoid future functional disorders. In this way, the effect of manual therapy can be preserved permanently.
Visceral therapy
Visceral therapy is the merging of the musculoskeletal system with the organ system. Our organs are attached to the musculoskeletal system and thus get their support and place in the body. They therefore have a strong connection to the spine, pelvis, ribs, shoulder girdle, bones, muscles and fascia.
Organ dysfunction can occur for many reasons: infections, operations, malnutrition, poor posture, scoliosis or emotional stress. The consequence of this is that the stressed organs build up tension and subsequently transfer it to the musculoskeletal system. For example, constipation or cystitis can lead to problems in the hip joint or lumbar spine (pain, intervertebral disc problems, sliding vertebrae, etc.).
The integrative manual treatment concept of visceral therapy is based on a well-founded anamnesis of the patient, which is verified by findings and aims to treat the chain of lesions. This consists of interrelated sectors and is treated using a targeted treatment process based on anatomical, topographical, physiological/functional, sympathetic and parasympathetic connections.
Scope of application
- General complaints in the chest, stomach and pelvic area, inflammation, menstrual problems, reflux
- Diseases of the respiratory and cardiovascular systems
- Pain in the musculoskeletal system, spinal problems
- Metabolic disorders
- After operations
- Digestive problems of all kinds
- Unfulfilled desire to have children
- Psychosomatic complaints