Women’s Health Physiotherapy is the specialist treatment of any symptoms that arise from the pelvis and the pelvic floor. From incontinence to prolapse, pelvic pain or constipation, there is evidence that physiotherapy can alleviate, and in may cases cure these symptoms. Whether you’ve had a vaginal delivery or a C-section recently, whether you’ve had a baby years before or whether you’ve never had one, whether you’re entering menopause, undertake a lot of high-intensity exercise or spend much of your day sat at a desk; all these things impact your pelvic floor! And pelvic floor health is something that all women should be familiar with.

Your pelvic floor is the web of muscles found at the base of your pelvis. They are shaped like a sling and hold your pelvic organs (uterus, vagina, bowel and bladder) in place.

Everybody has a pelvic floor and you mostly hear about issues in women and mainly after childbirth. Actually, having a baby is only one of the many factors which can result in pelvic floor problems. Other factors which can lead to symptoms include age, high intensity exercises, sitting, posture, hormones, menopause or surgery

Women’s Health Physiotherapy is the specialist treatment for;

• • stress incontinence
• • UFaecal incontinence
• • urinary leaking
• • Pelvic pain during or after pregnancy
• • Prolapse
• • Weak pelvic floor
• • Antenatal care
• • Postnatal care
• • Return to sport after pregnancy
• • Recovery from gynaecological surgery and post operative care
• • Rectus abdominus divarication (a separation of the abdominal muscles)
• • Bladder problems
• • Urinary urgency
• • Urge incontinence
• • Dyspareunia (painful or difficult intercourse)
• • Constipation
• • Irritable bowel syndrome (IBS)

No, maintaining pelvic floor strength and function is relevant whether you have or haven't had a baby. There are many factors which effect the strength and stability of your pelvic floor muscles. These factors include age, genetics, posture, daily activities, hormones (peri-menopause and menopause itself), sport, training and surgery.

Your assessment appointment starts with your medical history, questions about your symptoms, how long you have had your symptoms for and how they affect you day to day, Sarah will start with assessing your low back, pelvic and hips to check for any postural issues that are contributing to your symptoms. The next part of the assessment is the (optional) internal examination. All female health practitioners will start by internally assessing you with their fingers. Yes it's intrusive, no it's not painful. It is necessary for Sarah to get a view of the internal vaginal walls and internal structures. Using touch allows Sarah to assess the tension or lack of it in these areas. It takes a few minutes. Sarah can also use a probe which is inserted and then sends signals back to a computer. The probe can sense electrical impulses within a muscle - in this case, the pelvic floor muscles. These measurements show up on the screen and beep so you as the patient can see and hear what is happening. (The screen and sound is also something else to look at and focus on!). Sarah will insert the probe or you have the option to do it yourself. Sarah will talk you through everything, what you need to ask your body to do and when.

There is nothing special you need to wear to your assessment appointment. When it is time to have your examination, Sarah will step out of the room to give you a moment to get changed. You’ll be asked to remove your trousers and underwear and put on a patient gown. When Sarah comes back in, she’ll ask you to get onto the examination couch, you’ll be on your back in a semi sat up position.

During you assessment and any treatment sessions it will be yourself and Sarah in the treatment room. You are welcome to bring someone with you to any treatment sessions and you will be offered a chaperone if that would make you feel more comfortable.

Know that feeling embarrassed is completely normal. However, for women’s health physiotherapists, assessing pelvic floor muscles is no different to assessing shoulder muscles. For professionals, it is just anatomy.

You should leave it 6 weeks following a vaginal delivery or C-Section before having a women’s health assessment.

No matter how long ago you had your baby, you can always make changes to your pelvic floor. It is like any other muscle in the human body, with the right diagnosis and the proper exercises you can make vast changes to your symptoms.

It is very common to have some sort of urinary leaking after having had a baby. For some women this resolves naturally within weeks, for some it takes months and a third of women will have long term symptoms. 80% of women who have women’s health specialist physiotherapy will have their symptoms cured.

Leaking when you jump, sneeze, cough, laugh, walk or run is called stress incontinence. No matter how small the amount of leaking, it still means there is a dysfunction with your pelvic floor muscles. 14. You can have treatment at any stage of pregnancy. For an internal women’s health assessment you need to be into your second or third trimester.

Yes! Pelvic pain during pregnancy is very common, and can often be simply fixed with manual therapy and lifestyle advice.

• • Manual therapy to tight joints and muscles (this can include internal work such as trigger point release, stretches and scar tissue release).
• • Massage to tight achy muscles
• • Exercises to help strengthen the supporting muscles around the tummy and pelvis
• • Pelvic pain retraining
• • Education and advice about what to avoid, and what to do when the problems arise
• • Pilates based stability exercises
• • Provision of belts and any other supportive tools
• • Relaxation and breathing exercises

No, although it can be helpful in certain situations, it is always you choice, and not always necessary. Our women’s health professionals will always explain each of your options to you, so you can make a fully informed decision.

One in 3 women aged between 30-55 currently has an issue with urinary leaking when they strain, and 55% or women over 55!

80% of urinary incontinence cases can be resolved in 4 months!! So that almost half the women you know have some form of leaking, and most of them can be cured!