Women's Pelvic Health

What is pelvic health physiotherapy?

A specialist area of physiotherapy aimed at assessing and treating symptoms relating to the area around the pelvis including pelvic pain, lower back and hip pain, problems relating to the pelvic floor area including incontinence and prolapse. These symptoms can happen at anytime across the lifespan, but for women, commonly can occur around pregnancy and postpartum and peri/menopause.

56-72% of pregnant women experience lower back or pelvic girdle pain
1/3 women will experience urinary incontinence in their lifetime
50% of women will have some level of pelvic organ prolapse in their lifetime

Women’s pelvic health physiotherapy includes

What to expect at your pelvic health appointment

A thorough history of your current symptoms including bladder, bowel, pregnancies and deliveries, pelvic or abdominal surgeries and medical history, current lifestyle including work and hobbies and your goals for treatment. An assessment of your posture, movement, breathing, abdominal muscles and opportunity for an internal vaginal assessment of the pelvic floor muscles to assess resting tone, strength and function. Discussion of the findings, education and advice on managing your symptoms and guidance on pelvic floor muscle lengthening and strengthening +/- any relevant adjuncts. Advice regarding onward referral if required such as your GP or urogynaecologist.

Pelvic floor muscle function can be assessed externally, if this is what you are comfortable with. However, the gold standard would be to complete an internal vaginal exam. This would involve a single gloved finger with lubrication, no speculum. This is the best way to assess your pelvic floor and guide you with rehabilitation.

As a single practitioner within a multi-profession shared working space I am unable to offer a formal chaperone for internal vaginal exams. However, if you would like to bring an informal chaperone with you for support (family or friend) you are most welcome to.

Pregnancy MOT

Pregnancy is a key time in a women’s lifespan, a time of great physical and psychological change. Whilst lower back pain and pelvic girdle pain, including pain around the pubic symphysis joint at the front of the pelvis, are common in pregnancy, support and specialist advice and treatment can help you to manage these symptoms (particularly when sought early on).

Designed from 12 weeks + to focus on conditions commonly seen in pregnancy including: lower back pain, pelvic girdle pain, hip pain, pubis symphysis pain and pelvic floor symptoms including incontinence and prolapse.

It can also be appropriate for women not experiencing pain or symptoms but wanting some reassurance throughout their pregnancy, for example advice on what exercise they can do antenatally, general tools and tips to care for their pelvic floor and body antenatally and postnatally, or for women that have previous history of pelvic girdle pain in pregnancy or sustained a previous tear or trauma during their first labour and are wanting tools to manage and mitigate this risk in subsequent pregnancy.

What the check includes:

Address and treat a range of conditions you are presenting with in pregnancy
Advise on minimising risk of pre-existing musculoskeletal issues worsening in pregnancy
Advise on safe abdominal exercises in pregnancy
Exercise tips-knowing what is safe/unsafe in pregnancy
Advice on labour positions, the risks and benefits of medical interventions to your pelvic floor and how to prepare your body for labour (including perineal massage for vaginal birth).
Helpful tips for the early postnatal period including: managing swelling and scar healing, using the toilet, commencing pelvic floor muscle strengthening and scar management.
Screen for any bowel, bladder or sexual dysfunction. Optional internal assessment to assess pelvic floor muscles and guide correctly doing pelvic floor muscle exercises.
An email to follow-up the appointment outlining the advice and information given.

Post-natal MOT

Whether you had a vaginal or c-section birth a post-natal examination can assess your posture, pelvic floor muscles and diastasis of the abdominal muscles as well as any ongoing lower back or pelvic girdle pain including symphysis pubis pain at the front of the pelvis and coccyx pain at the base of the spine. If needed, advice and exercises can be given to aid your recovery and get you returning to your activity safely.

Far from the ‘snap back’ images seen on social media and in the films our bodies need nurturing and a little care to help get back to full function, which as a new mum involves lots of bending, lifting, squatting movements with a fast growing baby. Treatment may involve advice on c-section or perineal massage, guidance on abdominal strengthening and pelvic floor muscle strengthening and/or guidance on return to exercise including return to running guidance so as to minimise the risk of incontinence and prolapse.

What the check includes:

Assess and treat any ongoing pain/discomfort in the pelvis, lower back, hips, perhaps also upper to mid back and neck.
Postural advice
Discuss postnatal return to exercise. What to start and when- exercise timeline.
Perineal or c-section massage
Check for excessive stretch on the abdominal muscles- diastasis rectus abdominis and guide abdominal strengthening exercises
Discuss your goals and what you would like to return e.g walking, yoga, pilates or higher impact activities such as those below.
Discuss and create a plan for returning to high impact exercise such as running, netball or CrossFit/gym.
Screen for bladder, bowel or sexual dysfunction. Optional internal vaginal assessment of the pelvic floor muscles and guide correct technique with strengthening.

Postnatal MOT package includes – 1 hour assessment and treatment + 3 x 30 min follow-ups £155.

Babies are welcome to attend the appointment along with you if needed!

Peri/menopause MOT

Coming soon April/May 2024…