Pelvic health physiotherapy
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Pregnancy is a great time to get to know your pelvic health a bit better. We use a 1 hour pregnancy appointment to check your hips/pelvic joints and more importantly your pelvic floor muscles. We can assess how you are at connecting to those muscles. If you know how to relax them, how to “push” to optimise childbirth and hopefully make pelvic floor issues in the future less likely.
We also discuss positioning and breathing for birth which are key for giving birth. Learning this information is also helpful for early days c section recovery and beyond, as pelvic floor muscles are the cornerstone to good core health in the future.
Pelvic Girdle Pain is also our Speciality. It is a common condition in pregnancy but certainly something you just have to put up with. We use hands on therapy as well as the right advice and exercises to help improve your pain.
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Pelvic Organ Prolapse is a common condition amongst women and does not have to be life-limiting. We are skilled in the assessment of pelvic organ prolapse and getting to the root source of the issue. We listen to your symptoms and plan to reduce those, so you can get on with the day to day, without bother or a lack of confidence about making things worse. Our management options can include getting your pelvic floor working optimally to provide the right support, reducing downward pressures, hypopressives and pessary fitting.
We can also use the point of care ultrasound via the perienum, to give us and you a real-time visual of the vaginal walls and your pelvic floor which can be useful information.
Niamh also fits pessaries for pelvic organ prolapse. This may be done in the initial appointment or on follow up if we run out of time etc.
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Bladder issues are common especially after pregnancy and with increasing age. However, symptoms can often be improved with Pelvic Health Physio. We carry out a thorough assessment via dialogue and a pelvic examination to see what is causing the bladder issue. Stress urinary incontinence and urge urinary incontinence are treated in different ways. We are also skilled in assessing and treating bladder prolapse and symptoms associated with recurrent UTIs/Bladder pain.
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Many people will find us in the Postnatal Period. The popular Mummy MOT postnatal check is a 1 stop appointment to thoroughly assess your abdominals and pelvic floor muscles following delivery. We screen for any bladder, bowel, sexual dysfunction and pelvic organ prolapse at this appointment too.
We specialise in some of the common postnatal conditions such as diastasis, postnatal pelvic pain, pelvic organ prolapse, pelvic floor dysfunction and incontinence . Pelvic floor problems can affect everyday life and dominate your day to day. We are here to help and empower you to prevent or overcome whatever issue is holding you back from living the life you want to live. Postnatal Physio is also great for women who want to return to exercise post-baby in a safe and effective way.
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Many women suffer with dyspareunia (pain with sexual activity) and usually there is a straightforward reason, and that is why we use are assessment techniques to see what is the most likely reason. In clinic we treat Vaginismus. This is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted.
The symptoms include burning or stinging pain upon penetration, as well as intense fear or loss of desire when penetration is attempted.
Vaginismus isn't "only" about sex, it's about life. Penetrative sex is not the only thing its victims lose . It can painfully interfere with regular gynecological examinations, the use of tampons and period cups, or even childbirth.
It is extremely treatable and pelvic health physio can help you get there. We work through your history, thoughts and fears about treatment and take it step by step according to your goals.
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Bowel issues encompass anal fissures, bowel urgency, leakage, prolapse or difficulty emptying.
The anal opening sits within the pelvic floor muscle sling and pelvic floor physio can assess the dysfunction and help you to manage it.
your pelvic health physios..
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Niamh burn MSCP
Pelvic Health Physio MSCP
Director
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Sangita Patel MSCP
Pelvic Health Physio MSCP
What to expect….
Prior to your appointment, you may be asked to complete some questionnaires via your confirmation email to give us some background information. Your questionnaires and treatment notes are secure documents and can only be viewed by your treating Physiotherapist.
You will have a sit down with your Physiotherapist in a private treatment room to discuss your needs or issues and what you would like to establish following the session. The assessment is individual and based on your needs.
If your problems are pelvic floor related an internal vaginal examination is often advised to establish your pelvic floor function and this is usually done within your first appointment (or subsequent appointment is you wish). This type of examination is optional and will only be carried out if you are comfortable with it and this can be discussed further at your appointment.
The assessment will often involve checking other parts of your body, often including your alignment, abdominal muscles, joints(pelvic/hips/spine) and point of care real-time ultrasound.
Treatment will often follow on from the assessment, this can include soft tissue techniques, exercise, pelvic floor rehab, pelvic floor manual therapy and home exercise program.
How many sessions will I need?
The number of sessions you will require can vary. Some clients will have a 1-2 session. some clients will benefit from some regular sessions over a short period of time to get rehab established. Other clients may attend sporadically every few months to have a check in and ensure that there symptoms ares being well managed with some support from your pelvic health physio. Sometimes we will recommend seeing another health professional for a specific issue or within our clinic (strengthening, massage or acupuncture).
Privacy
We understand the highly sensitive nature of many of the conditions that people may have. All of our clinic rooms are private and all the information is kept confidential. Only the treating Physiotherapist has access to your notes, unless we gain your permission to share with another practitioner.
new feature
new feature
Point of Care Ultrasound Scanning (POCUS)
POCUS is the use of mobile ultrasound scanning (external via the perineum) to provide us with a window into your pelvis. In a way, It allows the internal to become external. POCUS can show us in real time your pelvic floor muscles, how they are functioning and give you some live visual feedback on how to engage/relax them in lying and standing. Often a barrier for people to training their pelvic floor muscles is a lack of awareness of the correct technique- POCUS can help overcome that barrier.
It is also a great way to check for pelvic organ prolapse in in a functional everyday position like, standing.
POCUS has been shown to be a safe medical technique. It is also a great way to assess the pelvic floor for those who do not feel comfortable with an internal pelvic examination. POCUS is usually offered within your pelvic health initial appointment or a subsequent follow up if we run out of time.
overactive bladder?
overactive bladder?
Treatment of Overactive Bladder Syndrome (OAB)
OAB is when the bladder contracts at inappropriate times (and usually when it is not full) This means you have to urinate more refquently or you may not make it on time to the toilet as the bladder muscle contract prematurely and you will leak (urge incontinence). You may also have to wake more frequently at night to pee (nocturia).
Clinical guidelines advise assessment and tratment of the pelvic floor muscles, bladder re-training, lifestyle changes alsonside a pelvic health Physiotherapist. However, for those people who symptoms persist, we need to explore other management options.
Medications (anti muscarinics) for OAB have mixed success and can carry unpleasant side effects such as dry eyes, mouth and constipation.
Recently research has suggested that acupuncture can be a useful tool in calming the bladder nerves and reducing OAB symptoms. At the pelvic academy, our acupuncturist offers elector acupuncture sessions which target the percutaneous tibial nerve via the lower leg. similar to PTNS. It is a simple, minimally invasive technique with no known side effects.
We suggest 6 x 30 min sessions over 4-6 weeks to feel the benefit and advise that you have seen a Pelvic Health Physio prior to this to confirm that you are a suitable candidate for the treatment.