Pelvic Physiotherapy

Pelvic Physiotherapy is more than just about your pelvic floor muscles.

It can help with:

  • Stress Urinary Incontinence
  • Urge incontinence or overactive bladder
  • Chronic pelvic pain
  • Pain with sexual intercourse
  • Postural issues
  • Pelvic organ prolapse
  • Bowel incontinence

Although often a forgotten or ignored area, the pelvic floor is crucial for posture, bladder control and sexual satisfaction. Problems can result from weak, damaged or overactive pelvic floor muscles. Treatment may include exercises, biofeedback or muscle stimulation, postural advice, core stability and manual techniques. The aim is to improve your pelvic floor to cure, or greatly reduce symptoms. This is done by improving muscle function, not just in isolation but so the pelvic floor works  as it should during your daily functional activities.

Pelvic floor or bladder problems are often accepted as ‘a woman’s lot’ or the natural consequence of childbirth. Women are frequently too embarrassed to seek advice or treatment.

Research shows that, in many cases, physiotherapy can cure or dramatically improve pelvic floor problems. It is the recommended first line treatment for incontinence and recommended for the treatment of chronic pelvic pain by:

  • The National Institute for Health and Care Excellence (NICE),
  • The European Association of Urology Guidelines on Chronic Pelvic Pain.

Stress Urinary Incontinence (SUI)
This is when urine leaks on exertion such as during a cough or sneeze, or when playing sport. It is due to weak pelvic floor muscles, but postural problems and breathing pattern can also play a role. Physiotherapy is very effective for this type of problem.

Breathing assessment and re-education is an important element of retraining the core and pelvic floor.

Urge Incontinence or Overactive Bladder (OAB)
This is when urine leaks following an urgent desire to empty the bladder. It can be provoked by running water, putting your key in the door or on the way to the toilet. It is due to an overactive bladder. Retraining the bladder, pelvic floor exercises and lifestyle advice can cure or greatly improve this problem.

Overactive Pelvic Floor Muscles
Pelvic floor muscles can become overactive or tight resulting in symptoms such as pelvic pain, pain on sexual intercourse or pain referred into the back, groin, pubic area or vagina. Physiotherapy can help reduce spasm and retrain the pelvic floor muscles.

Prolapse
A prolapse occurs due to weak or damaged pelvic floor muscles. The pelvic organs (bladder, bowel or uterus) push down into the vagina. You may feel a heaviness ‘down below’ or feel as though something is always in the vagina or bulges out. Physiotherapy can often greatly improve mild or moderate prolapse or prevent it from becoming worse.

Chronic Pelvic Pain
Physiotherapists take an holistic approach to chronic pelvic pain. Treatment will look at your posture, how you move your body, your breathing pattern and your pelvic floor. We also look at the mechanisms that perpetuate pain and help to break the cycle.

Gynaecological Surgery
Physiotherapy is useful to train the pelvic floor muscles prior to hysterectomy or pelvic floor surgery. Following surgery it can aid recovery and help improve pelvic floor function to prevent recurring problems.

Bowel Incontinence
In cases where bowel incontinence is due to weak pelvic floor muscles physiotherapy can often cure or greatly improve symptoms and bowel retraining can help with urgency.

What happens at the first appointment? I will take a case history to explore the causes and impact of your pelvic floor problem. This will include asking information about your bladder and bowel habits. In most cases a vaginal examination will be helpful to fully assess the pelvic floor muscles and tailor the treatment. However let me know if you would prefer not to have this, as there are other methods we can use to assess your muscles. I will make and agree a treatment plan with you and help you work towards your goals.