Pelvic floor and continence physiotherapy
Problems related to the pelvic floor and pelvic organs are incredibly common, can present at any life stage and affect different women in different ways. Some of the conditions we commonly see include:
- Stress urinary incontinence - leakage of urine with activities such as sneezing, coughing, running and jumping.
- Overactive bladder or urge incontinence - a sudden and intense desire to urinate which may come on without reason or during circumstances such as hearing running water or putting a key in the front door.
- Prolapse of the pelvic organs (uterus/cervix, bladder and bowel).
- Bowel dysfunction - difficulties with constipation, emptying bowels, faecal urgency/leakage and difficulty controlling wind.
- Pelvic pain - this may be superficial pain in the perineum or deep pelvic pain. Includes pain related to sexual intercourse.
- Childbirth - treatment for childbirth related pelvic floor and continence problems such as tears to the pelvic floor, weak pelvic floor muscles, overactive/tight pelvic floor muscles, difficulties with bladder and bowel control, pain with sexual intercourse, advice on safe return to exercise post-natally.
- Coccyx (tailbone) pain
- Surgery - physiotherapy pre and post pelvic surgery such as hysterectomy.
If you would like treatment for any of the conditions listed above, please call the clinic and ask to book a Pelvic Floor Physiotherapy Consultation. Alternatively, you can click on the Appointment Bookings button at the top of the page to book a consultation with one of our Women's Health Physiotherapists online.
Pregnancy and post-natal care
Pregnancy, childbirth and the post-natal period can be an incredibly exciting time but also a time where significant physical demands (and let's not forget emotional and social demands) are imposed on pregnant women and new mums.
All of our pregnancy and post natal services have been developed in line with our knowledge and training in the specific changes that happen to the body during the childbearing years and management of common problems that may affect women. We aim to help you maintain optimal physical function throughout your pregnancy, to assist with safe return to your pre-pregnancy exercise/activities and to help treat and prevent problems such as pelvic pain, back pain, abdominal muscle separation, incontinence and prolapse.
Physiotherapy in pregnancy
During pregnancy women will experience changes to their posture, weight distribution and increased joint laxity, and significant demands are placed on the abdominal and pelvic floor muscles.
Pregnancy related conditions that our physiotherapists commonly see include pelvic girdle pain (sacroiliac joint pain at the back of the pelvis and pubic symphysis pain at the front), back pain, wrist pain and carpal tunnel syndrome.
We use a variety of treatment techniques to address your individual problem. This may include hands-on techniques, specific exercises and prescription of support garments/braces where needed. We are focused on education and empowering our patients to manage their condition. We can give advice on preparing the pelvic floor for birth (activation and relaxation and perineal massage) and helpful infomation on how to assist recovery immediately after your baby's delivery.
Physiotherapy after delivering your baby
Being pregnant and delivering a baby is hard work! It's important to listen to your body and remember that all women recover differently. Some women seem to bounce back to their pre baby physical condition and exercise. Other women struggle with problems such as pelvic floor pain and dysfunction, incontinence, abdominal muscle seperation, back pain and mastitis. Some conditions we commonly see in new mums include:
- Abdominal muscle separation (rectus diastasis or DRAM).
- Pelvic floor problems following birth related trauma to the pelvic floor, pelvic and sexual pain, incontinence and prolapse.
- Wrist pain and "Mummy thumb"
- Back and pelvic pain
- Physiotherapy for breast conditions in lactating mums (including blocked ducts and inflammatory mastitis).
Physiotherapy post natal check
We have developed our Physiotherapy Post Natal Check to focus in on all aspects of a new mum's physical wellbeing. We aim to help women avoid common new mum aches and pains, advise them on how to progress back into their normal exercise/activities safely and ensure they get their abdominal and pelvic floor muscles activating correctly to treat or PREVENT future problems.
Depending on your individual needs, the comprehensive physiotherapy consultation may include:
- Pelvic floor muscle assessment
- Prolapse assessment, treatment and prevention advice
- Incontinence assessment, treatment and prevention advice
- Bowel care advice
- Musculoskeletal assessment
- Assessment of abdominal muscle separation (rectus diastasis) and the ability to activate the deep abdominal or "core" muscles using real time ultrasound.
- Prescription of individualised home exercises based on the physical assessment results
- Advice regarding safe return to exercise
- Posture and positioning advice in relation to new mum demands such as breast/bottle feeding and lifting/carrying
- Advice regarding prevention of common post-natal conditions such as "mummy's thumb"
- Fitting of SRC recovery shorts or an abdominal binder (as required)
We recommend that you book in for this consultation following your 6 week check with your GP or Obstetrician, however it would still be relevant and beneficial up to one year following the birth of your baby.
When you speak to our receptionist, please ensure you specifically ask to be booked in for a "Post Natal Check". This will ensure you are booked in with the correct therapist.
Physiotherapy for inflammatory breast conditions/ mastitis
Blocked ducts, engorgement, inflammation and mastitis are common problems affecting breast feeding women. Symptoms may include swelling, redness, lumps and pain in one or both breasts
Physiotherapy treatment is aimed at reducing inflammation and clearing blocked ducts. Depending on your specific problem, treatment techniques that may be used include:
- Ultrasound
- Lymphatic massage/drainage techniques
- Lymphatic taping
Physiotherapy may help with the resolution of symptoms during an acute episode, but it may also help prevent recurrence if you have experienced repeated bouts of blocked ducts or mastitis.
Some important notes...
- The key to success is early intervention. When you call the clinic please ensure that you explain to our receptionist that you need treatment for blocked ducts/mastitis. We will fit you in for an appointment with one of our women's health physiotherapists ASAP. If caught early enough, physiotherapy treatment may help clear blockages, reduce inflammation and prevent the development of an infection.
- If you think you have developed an infection, for example you have a fever, rigors or you feel generally unwell, please make an appointment to see your GP. Even if you are diagnosed with infective mastitis and require antibiotic treatment, Physiotherapy can still be effective as an adjunct to this in is facilitating recovery and preventing recurrence.
Labour TENS consultation and unit hire
What is TENS?
Transcutaneous Electrical Nerve Stimulation (TENS) uses electrical impulses (felt as a tingling sensation) applied to the skin using electrodes and a small battery-operated machine to relieve pain.
TENS has been used for many years as a non-pharmaceutical method of pain relief and it works via the following physiological mechanisms:
- The pain gate mechanism - the electrical tingling sensation that the TENS provides overrides pain signals being sent to the brain.
- By releasing our bodies natural pain killers - such as endorphins.
How is it used in Labour?
TENS is a drug free option to help control labour pain.
In clinical practice TENS is used in the initial stages of labour to reduce contraction pain and labour induced back pain.
Four long electrodes are placed over the lower back. These are connected to the labour TENS machine which is small and light and can be clipped on to clothing so as not to interfere with an active labour.
Our labour TENS units have a hand held boost button to easily increase the intensity of tingling during each contraction.
Does it work?
Santana et al (2016) showed that TENS “reduces pain and postpones the need for pharmacological analgesia in labour”.
Is it safe?
No adverse effects have been shown for mum or baby.
Our service
At Pinnacle Physio we have Obstetric TENS units that you can hire to use during your labour.
We recommend you come in for an appointment at around 37 weeks gestation. If your partner or labour support person is able to attend the session with you this is helpful as they will need to help you apply the electrodes when you are in labour.
During your appointment your Physio will show you how to use the TENS machine (including the contraction boost button) and give you specific advice on how you can use the TENS machine to maximum benefit.
The TENS machine comes in a carry case and we make sure that you have everything you need to use it in labour including electrodes, spare batteries and instructions.
Useful links
Offers information and support for people experiencing bladder and bowel control issues.
Provides guidance on protecting and strengthening your pelvic floor, especially during exercise.
Supports women and families affected by physical or psychological birth trauma.
Shares reliable information and resources for those living with endometriosis.
Delivers evidence-based information and support for managing chronic pelvic pain.
Supports new and expecting parents experiencing anxiety or depression.
Provides mental health services and resources for expectant and new parents.
Offers support, education and resources to help parents with breastfeeding and infant feeding.
