Pelvic Floor Dysfunction

1 in 3 women will suffer with pelvic floor muscle dysfunction at some point. It can result in continence problems, prolapse, pelvic pain and sexual dysfunction. Symptoms could occur at any life stage but certain factors can increase the chances, including:
•Menopause
•Pregnancy and Childbirth
•Surgery – gynaecological or abdominal surgery
•Chronic constipation
•Injury.

Stress Incontinence

Involuntary loss of urine during any physical stress or exertion. This could range from minor exertion like standing from a chair to a major stress like performing a star jump. It is caused by an increase in pressure in the tummy which then pushes on the bladder. Although it is a common complaint and you may often hear people saying they have a little leak when they laugh or cough, it is not normal.

How I can help...

After assessing your pelvic floor muscle and individual needs I can devise a treatment program. These treatments may include:

  • Pelvic floor muscle exercises and re-education

  • Advice on breathing patterns

  • Modification of general exercises and activities

  • Abdominal muscle re-training.

Urgency/Overactive Bladder

An overwhelming urgency to reach the toilet which may cause you to leak before you get there. You may notice an increase in the number of times you visit the toilet (more than 8 times a day) and your bladder may wake you more than once at night time.

How I can help...

After an assessment of your specific symptoms, habits and pelvic floor muscle control, I will devise a treatment program. These treatments may include:

  • Pelvic floor muscle reeducation

  • Bladder retraining

  • Fluid management

  • Dietary advice.

Prolapse

A pressure or dragging sensation can indicate pelvic organ prolapse. At times a prolapse can be more obvious and you may notice a bulge in the vaginal opening, this can be quite uncomfortable. It is nothing serious but, physio can help you to reduce the discomfort and improve quality of life.

How I can help...

After an assessment of your symptoms and a physical exam I will devise a treatment program. These treatments may include:

  • Pelvic floor muscle re-education

  • Advice on breathing patterns

  • Techniques to help open your bowels

  • Activity modification (lifting and exercise)

  • Abdominal muscle training.

Bowel

Although less common than bladder symptoms, it is a problem for some women and understandably can be very distressing. You may notice an uncontrollable urge to pass a bowel movement and you may not make it to the toilet in time. You may leak from the bowel but be unaware of this happening. It could also happen during physical activity. You may find it difficult to clean after a bowel movement and could get staining in your underwear. You may notice the opposite and struggle to empty your bowels.

How I can help...

After an assessment of your needs/lifestyle habits and pelvic floor muscle I can devise a treatment program. These treatments may include:

  • Pelvic floor muscle re-education and exercises

  • Advice on techniques to improve constipation

  • Breathing patterns

  • Anal sphincter exercises.

Pelvic Pain

Pelvic pain can have a significant impact on quality of life. It relates to pain in the pelvic floor, lower abdomen, pelvic region including urethral, buttocks, bladder and anal pain.

The muscles around the pelvis can become over active, particularly the pelvic floor. This will then contribute to the pain in the pelvic area. Release of these muscles through manual techniques and breathing exercises helps to reduce the tension in the muscles.

How I can help...

After an assessment of your symptoms and full physical examination of your pelvic area, I will devise a treatment program. Treatments may include:

  • Pelvic floor muscle down training

  • Breathing pattern re-education

  • Techniques to help you open your bowels

  • Fluid and dietary advice

  • Stretching and strengthening exercises

  • Activity modification

  • Soft tissue release

  • Joint mobilisation

  • Desensitisation techniques.

Sexual Dysfunction

You may notice pain during sex (dyspareunia). This may prevent you from having sex altogether. This is often the result of an overactive pelvic floor muscle (vaginismus) or scar tissue following surgery/childbirth.

How I can help...

After an assessment of your symptoms and a physical assessment of your pelvis and pelvic floor muscle, I will devise a treatment program. Treatments may include:

  • Pelvic floor muscle down training

  • Breathing pattern re-education

  • Techniques to help you open your bowels

  • Stretching and strengthening exercises

  • Soft tissue release

  • Use of dilators

  • Desensitisation techniques.

Post Surgery

Surgery for gynaecological problems can increase the risk of pelvic floor dysfunction due to the elective trauma that surgery causes.

Such surgeries might include a hysterectomy, prolapse repair and bladder neck surgery.

How I can help...

After an assessment of your symptoms, discussion of your previous surgery and an assessment of your pelvic floor muscle I will devise a treatment program. These treatments may include:

  • Pelvic floor muscle re-education

  • Bladder re-training

  • Fluid management

  • Activity modification

  • Soft tissue release

  • Techniques to help open your bowels.

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