What is pelvic health physio and why doesn’t everyone know about this?

Are you leaking urine when you laugh, sneeze or go for a run?

It is normal after a pregnancy and usually treatable with pelvic floor physiotherapy.

Don’t be embarrassed. It’s high time for women to be mindful of this pelvic health concern.

You are not alone, it is distressing to know that 1 in 3 women suffer from incontinence.

There is help and hope with the correct treatment options. It’s never too late to regain control of your life.

Many women with pelvic floor dysfunctions do not seek help as they feel nothing can be done or they are shy to talk about their privacy issues. There are many treatment options available and usually they are treatable with pelvic floor physiotherapy. A pelvic floor physio can help you to treat these conditions with dignity and privacy. Most women feel relieved after discussing these issues with an understanding health care provider.

Let’s see how it works

  • What is pelvic floor?

    The pelvic floor is like a hammock stretching from your pubic bone to your tailbone and a collection of muscles, fascia, ligaments, tendons that supports your pelvic organs.

    Pelvic floor is part of our core musculature.

    The pelvic floor has many functions including:

    • Sphincteric control for normal bladder and bowel emptying
    • Pelvic organ support
    • Sexual function
    • Able to relax and open to allow physiological child birth
    • Counteracting downward forces generated from activities that increase abdominal pressure (ex: lifting, coughing)
    • Lumbo-pelvic stability

    Just like any other muscle in the body, your pelvic floor muscles can tighten, have poor endurance and/or poor coordination, scar adhesions, lack strength, cause pain or function poorly.

  • Risk factors for pelvic floor muscle dysfunction:

    Pregnancy

    Chronic Constipation

    Vaginal delivery with forceps/Vacuum

    Episiotomies/Perineal tears

    C section/scar adhesions

    Unhealthy bladder and bowel habits

    Menopause

    Breast feeding

    Hypermobile joints

    Chronic coughing (e.g. Cystic fibrosis, Bronchiectasis)

    Pelvic surgeries

    Joint malalignment/habitual postures

    Strenuous physical activity

    Family history

    Smoking

    Obesity

  • Symptoms of pelvic floor dysfunctions

    Leaking urine when you cough, laugh, run, sneeze or exercise

    Feeling heaviness, pressure or a dragging sensation in the pelvis or vagina

    Having to rush to restroom and leaking before you can get there

    Waking up to use the restroom often at night

    Incomplete emptying of the bladder and bowel including constipation

    Decreased sensation with sexual intercourse

    Pain during sexual intercourse or difficulty with penetration

    Pain in the lower abdomen, vagina, pelvic girdle, tail bone

  • What can a pelvic floor physio do about my bladder, bowel or pelvic pain?

    We focus on assessing the pelvic floor muscles and associated areas, identify the causative factor and help strengthen the pelvic floor muscles and transition to your daily functional activities or athletic goals later. More often than not, the instructions given by your midwife, GP, obstetrician, gynaecologist are too vague or not specific enough to treat the actual problem. Moreover, some people with pelvic pain should not do pelvic floor exercises as it might make the pain worse.

    Research shows physiotherapy in the form of pelvic floor muscle retraining can improve and resolve incontinence.

    Seeing your pelvic floor physio who specializes in the pelvic area is very important to get right instructions. Exercises prescribed is individualized to the patient. A triathlete should and will have a different program compared to someone who has never really exercised.

    Pregnancy, child birth via vaginal delivery or c section is physically demanding and also stressful and damages the pelvic floor, abdominal muscles and nerves. All postnatal mums recover differently. Some new mums can run quite soon and some only after one year.

    Rehabilitation of a sprained ankle takes six months to recover. Childbirth is like a sporting injury to the body. Any injury, the stages of recovery and time frames must be considered to optimise full function and to avoid future problems.

    If you are at risk of pelvic floor problems make sure you avoid exercises that put too much stress on it such as heavy lifting, running, jumping, deep lunges and high impact sports. Abdominal exercises such as planks, sit-ups, crunches and double leg lifts really push down on the pelvic floor.

    There are many safe pelvic floor exercises which put less stress and downward pressure on the pelvic floor like low impact cardiovascular exercises such as walking, swimming, cycling, postnatal exercises, pilates and yoga. Sometimes you might have to modify the exercise, position, weights, intensity and frequency according to your progress.

    If you are at risk of pelvic floor dysfunction don’t put up with it, seek help and advice from your pelvic floor physio. In addition, we can advise on safe exercises which will return you to your sports and discuss treatment options, if required. Address all the factors contributing to the patient’s dysfunction. Educate and provide home program for symptom management.

  • Physiotherapy can help with

    Pelvic floor muscle training

    Education about healthy bladder and bowel function

    Urge management strategies

    Bladder training

    Toileting techniques

    Bracing techniques

    Biofeedback training for pelvic floor

    Realtime ultrasounds for pelvic floor training

    Assessment and treatment of painful scar tissue, mastitis/blocked milk ducts and painful intercourse.

  • Pelvic floor exercises and prevention

    Pelvic floor exercises can also be very beneficial for treating current problems as well as prevention of future issues. When pelvic muscles are strong, we have more control over our bladder and bowel movements. Before you start doing your pelvic floor exercises, it is important that you are aware of their location. Research shows that many women have difficulty in identifying these muscles and in fact some women do them incorrectly which worsens the problem. A pelvic floor physio can help you identify these muscles and make sure you are performing the exercises correctly.

  • Does it really work?

    Yes, research has shown pelvic floor physiotherapy can be very effective in treating stress incontinence in up to 80% of cases. So, there is no need to suffer in silence.