PELVIC HEALTH
ABOUT PELVIC HEALTH PHYSIO
Your body, our priority
Our pelvic health physiotherapy service offers specialist assessment and rehabilitation for pelvic, bladder and bowel pain, and pelvic floor dysfunction.
STATISTICS
Many women tolerate pelvic related issues for years thinking they are a normal part of being a woman. Embarrassment often prevents women seeking help and many women are unaware that there are effective treatments available.
1 in 3
1 in 3 women will experience urinary incontinence in their lifetime.
Up to 50%
Pelvic organ or vaginal prolapse is experienced in up to 50% of women who have had children.
18-50 year olds
Approximately 20% of women between the ages of 18-50 will have chronic pelvic pain.
Up to 70%
Following prostate surgery, up to 70% of men will suffer from urinary incontinence.
SPECIALISTS IN PELVIC HEALTH FOR WOMEN & MEN
Choose From One of the Eight Specialist Services
During pregnancy your body has the incredible ability to transform in order to allow for the growth of your baby. These changes can last up to 12 months or longer after childbirth. These changes include:
- changes in posture
- increased weight around the abdominal region
- hormonal changes including increased levels of Relaxin
- changes in muscular function
- changes to your bladder and bowels
Pelvic Girdle Pain (PGP) is the umbrella term for pain associated with these changes.
This includes pain in the anterior pelvis (pubic symphysis), hip pain, lower back pain, coccyx pain and sacroiliac joint pain.
Physiotherapy can be very beneficial to assess and treat symptoms from very early in your pregnancy.
The treatment includes:
- Using hands-on manual therapy
- Developing an individualised exercise and strengthening programme
- Advice and education on pacing and managing everyday activities
- Pelvic floor muscle assessment and rehabilitation if required
- Post-natal advice on how to prepare for your birth and the arrival of your baby
Postpartum Care
After childbirth it is very important that you rehabilitate your body using research-based guidance and by listening to your body. Whether you have had a caesarean section or vaginal delivery, it is important that you allow your body time to rest and recover.
Symptoms that you may experience post-natal include:
- Muscular aches and pains
- Diastasis recti abdominis (DRA)
- Urinary incontinence
- Bowel issues- incontinence or constipation
- Prolapse
- Painful sexual intercourse
If you are concerned regarding your body’s recovery postpartum it can be beneficial to have a physiotherapy appointment to reassure you and to ensure you are receiving the input that you need.
Postpartum treatment includes:
- A musculoskeletal assessment
- Abdominal assessment and treatment for DRA
- Pelvic floor assessment (after 6 weeks)
- Prolapse management
- Bladder and bowel retraining
- Scar tissue management including massage
- Development of a bespoke exercise programme based on your goals
- Returning to sexual intercourse
Bladder Incontinence
The bladder is a complex organ that can develop a range of problems in both women and men. Urinary incontinence is the most common presentation and is the involuntary leaking of urine that is thought to effect up to 7 million people in the UK. The following are a list of bladder related issues:
- Stress urinary incontinence
- Urge urinary incontinence
- Mixed urinary incontinence
- Overactive bladder
- Bladder retention
- Bladder pain syndrome or ICS
- Post-prostatectomy incontinence
A physiotherapy assessment can prove vital in the treatment of your bladder symptoms.
Bladder treatment includes:
- Fluid/bladder diary
- Pelvic floor muscle assessment and retraining
- Advice on use of continence aids
- Bladder retraining
- Onward referral for appropriate assessments with specialist consultants
- Evidence based holistic approach to treating bladder pain syndrome
- Post-prostatectomy pelvic floor assessment and rehabilitation
Bowel Incontinence
Bowel incontinence can prove very distressing and affects up to 1 in 10 people. The bowels can also present with issues of constipation.
The following are common bowel issues that may benefit from a physiotherapy assessment and treatment:
- Faecal incontinence
- Flatus/wind incontinence
- Faecal urgency
- Staining of underwear
- Constipation or incomplete emptying
- Pain on emptying bowels
- Anal sphincter dyssynergia
Prolapse
Prolapse is the decent or lowering of the bladder, bowel or uterus. It is described as an anterior, uterine or posterior prolapse and can present for a combination of reasons including the following:
- Pregnancy and post childbirth
- Chronic constipation causing strain over the pelvic floor muscles
- High load over pelvic floor including high impact exercise
- Increased weight
- Chronic chest infections
The signs and symptoms of a prolapse may include:
- Heaviness or dragging in vagina
- A feeling of something coming down or lump in the vagina
- A feeling of incomplete emptying of bladder or bowels
- Pain during sexual intercourse
Research shows that physiotherapy for up to 4 months can prove beneficial in the management of prolapse. This treatment includes:
- Pelvic floor muscle and prolapse assessment and rehabilitation
- Management of bladder and bowel symptoms
- Weight management
- Exercise modification and monitored progression
- Onward referral to specialist consultant if required
Menopause Care
As your body transitions into menopause, it is not uncommon to experience pain and issues of the pelvis. These can include:
- pelvic pain
- hip issues
- swelling of the pelvis and the lower limbs
- lower back issues
- leaking
During the course of your treatment you can expect open discussions about your bladder and bowel function, sexual function, sleep quality and mood. You will build joint goals for you to achieve.
As part of your treatment you can expect:
- specialist manual treatment to alleviate your symptoms
- a pelvic health program
- clinical advice on exercise and lifestyle advice, this will take into account your hormonal balance, bone and cardiac health
Should you need specialist help we have a network of gynaecologists, endocrinologists, nutritionist and private GP’s that we can assist with onward referral.
Sexual Dysfunction Clinic
Discussing your pelvic and sexual health can be challenging, we can assure you of our discretion and will make you feel at ease.
There are numerous reasons why women may experience pain either before, during or after intercourse. Some reasons are overactivity of the pelvic floor musculature, medical reasons and/or psychological reasons. Such a condition may include vulvodynia where this can be present as burning or stinging, increased sensitivity to the touch and sitting. Another conditions vaginismus which may result in the spasms of the pelvic floor musculature.
If you experience pain or discomfort with deep penetration or certain sexual positions this may be the result of certain medical conditions. These may include cystitis, endometriosis, pelvic inflammatory disease (PID), fibroids, interstitial cystitis, ovarian cysts, or even prolapse.
Men's Health
Men’s Health Physiotherapy encompasses a wide range of conditions including incontinence, overactive bladder, bowel dysfunction, post prostate surgery, pelvic pain and erectile or other sexual dysfunction. These conditions can affect those in their youth, sporting activities and are also quite common post-surgery.
Did you know that 1 in 10 men may experience pelvic floor continence issues during their lifetime. Also, 1 in 5 men suffer from erectile dysfunction. Furthermore, 16% of men over 18 years of age have a overactive bladder condition.
You can expect in your assessment for your physiotherapist to take a detailed history about the problems you are experiencing. As part of your physical assessment you may be offered an internal pelvic floor examination. This is not compulsory but may be useful as part of your assessment.
Once your assessment is complete, treatments may include:
- Pelvic floor exercise program
- Exercise and lifestyle advice
- Manual therapy
- Shockwave Therapy for erectile dysfunction (ED)
Meet Our Team
Bayley is the clinical lead for the Pelvic Health Clinic at Physio On The Green. She offers a highly specialist assessment and rehabilitation for pelvic, bladder and bowel pain, and pelvic floor dysfunction.
Bayley is a member of the Chartered Society of Physiotherapy CSP, The Pelvic Obstetric and Gynaecological Physiotherapy (POGP).
Bayley Robson
Pelvic Health Specialist | Physiotherapist