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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Male Pelvic Health Physiotherapy is a specialist service that treats pelvic pain and pelvic floor dysfunction in men. A pelvic Health Physio can help with conditions such as bladder and bowel issues, sexual pain and prostate cancer.
How does a male pelvic health initial session work?
It starts with a sit down to go through your symptoms and how it is affecting your day to day life. We will work out what your goals are for that session.
The physical exam involves checking your pelvic and hip joints and some of their associated muscles and ligaments in standing and lying down.
We can use our palpation skills to assess your pelvic floor muscles. We can also use real-time ultrasound to view the pelvic floor inside the body.
This assessment is pain-free and accurate. We can assess the strength, responsiveness and tension in the pelvic floor and provide tailored treatment, as well as monitor your progress.
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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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Endometriosis affects 1 in 10 women and can take an average of 7-10 years to diagnose. It can range from superficial to deep. It's not uncommon for it to affect the bladder, bowel and rectovaginal tissue. Many women will come to clinic with symptoms including pelvic pain and issues with bladder and bowel function. We also have women visit us after laproscopic surgery for endometriosis or post-hysterectomy. They are often feeling ill-equipped on how to become active again and fearful of movement.
Physio can include:
Gathering a full background history and goals for moving forward.
Hands-on treatment
Pelvic floor muscle release
Breathing
Movement and exercise
Pain management advice
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A total hysterectomy is removal of the uterus and cervix and is often carried out for various reasons including:
Heavy periods
Fibroids
Endometriosis
Carcinoma
Uterine Prolapse
Its major surgery performed through the abdomen or vagina. To reduce the risk of a pelvic organ prolapse occurring, you may also undergo a sacrospinous fixation surgery (sacrocolpopexy)
Post surgery Pelvic health physiotherapy can help you to get back on track with management including:
Help with back, abdominal or pelvic pain
Scar massage
Pelvic floor muscle release work
Screening for prolapse
Pelvic floor muscle training
Advice on getting back to exercise and activity effectively.
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Many people will find us in the Postnatal Period. The popular MOT postnatal check is a 1 stop appointment to thoroughly assess your abdominal 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. We also offer caesarean scar massage and post C-section rehab.
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Hormonal changes associated with this life transition can impact the bladder, pelvic floor muscles and vaginal tissues. These changes are normal but the symptoms associated with them are treatable.
We can help you to resolve issues like bladder urgency, incontinence and painful sex. So that you can have the pelvic health that you deserve, moving forward.
We also offer strength training sessions with an experienced coach within our small private gym. Strength training has been shown to be a valuable way to optimise health through and beyond menopause.
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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 our 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
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Emily Potter MSCP
Pelvic Health Physiotherapist
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.
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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.