Pelvic Floor Physiotherapy

WHY SEE A PELVIC FLOOR PHYSIOTHERAPIST?

Pelvic Floor Physiotherapists have completed further postgraduate studies in Pelvic Floor Function. This is very detailed as should be your initial assessment. This is a specialist area that you need appropriate physiotherapy for.

At your first visit our pelvic floor physiotherapist will ask you many questions about your pelvic floor function –this is important as it helps her work out how to help you. She will assess other factors that may affect your function.

In either the 1st or 2nd physiotherapy appointment you will have either an ultrasound or vaginal pelvic floor assessment of your pelvic floor depending on your preference, condition and doctor’s instruction. If your preference is a pelvic floor ultrasound please drink 1-2cups of fluid 1-2 hours prior to your appointment so you can have the scan.

THE BIGGEST HURDLES to OVERCOME ARE:
Embarrassment
Misconception that it’s normal to leak
Finding time to treat yourself
Compliance to pelvic floor and other exercise
This is why it’s important to have the right person treating YOU!

PELVIC FLOOR PHYSIOTHERAPY CONDITIONS TREATED

Incontinence - This may include stress (eg. Cough, sneeze, jump), urge (bladder overactivity)–urgency to get to the toilet or Mixed (both of these Incontinence. There is level 1A evidence (this is the highest) that correct pelvic floor strengthening can cure or help manage these conditions.

Urgency- Not necessarily with incontinence- urgency can still have a huge impact on an individual’s life. Bladder retraining techniques, education and pelvic floor strengthening will help manage this condition. TENS may assist.

Pelvic Organ Prolapse –Level 1 evidence reports pelvic floor strengthening should be first line treatment for this condition. A gynaecologist may use a pessary to assist with support whilst you are strengthening these muscles. Surgery may be the best option for you however pre-strengthening may improve function prior and will assist with surgical outcomes. So whilst waiting for your gynaecologist appointment see our pelvic floor physiotherapist! Incontinence can be a complication of surgery and strengthening is the treatment for this so start now! Associated pelvic dragging or heaviness may reduce with strengthening. Prolapses feel worse at the end of day as you are upright and the pelvic organs descend with gravity. An easy strategy to reduce symptoms is to lie down for 20 minutes during the day and rest the area.

Pre & Post- prostectomy –Any pre-strengthening will assist the motor connection between the brain and pelvic floor muscles postprostectomy. So if you have a chance attend physiotherapy prior to learn this and learn other strategies that will help.

Pregnancy–The increasing weight of the uterus, increasing laxity of connective tissue due to the hormone relaxin and vaginal delivery can all weaken the pelvic floor. Prolapse(50% first time mums!) and Incontinence (40%) can result. Pelvic floor Strengthening during pregnancy reduces the chance of this. It is also known to reduce the length of 2nd stage labour and assist with rotating baby’s head. Learning ‘motor’ control of these muscles is important so you are in control during labour!

Sexual Dysfunction–Overly tight pelvic floor muscles can cause pain during intercourse. This condition does not necessarily mean the muscles are strong. Physiotherapy treatment includes education, strategies for self-management, pelvic floor exercises for control, muscle releases and stretches.

Spinal Strengthening- Back treatment - The pelvic floor muscles are the base muscles of your spine. They interconnect via fascial connective tissue to our transversus muscle which supports the trunk. Correct pelvic floor contraction is an important part of spinal strengthening. The beauty of seeing our pelvic floor physiotherapist is that she is also trained in spinal treatment so we can check it's all functioning properly.