Conditions Treated

Pelvic Health Physiotherapists treat a wide range of conditions affecting both men and women. 

A summary of some of the conditions we can help can be found here. This is by no means an exhaustive list. 

Please do not hesitate to get in touch if you are unsure as to whether Physiotherapy could help you.

Pelvic Organ Prolapse

Pelvic organ prolapse is very common, with 1 in 10 women having at least one surgical procedure for it in their lifetime. Physiotherapy can help with all types of pelvic organ prolapse, whether it's the bladder, rectum or uterus that are affected, and is recommended as the first line of treatment. Strong pelvic floor muscles can help to compensate for the lack of support in the vaginal walls, and practical lifestyle advice can make an enormous difference. Pelvic organ prolapse is often associated with childbirth, but sometimes does not become a problem until menopause when hormone levels change. Prolapse is usually described as mild, moderate or severe (1st, 2nd or 3rd degree), and by the affected compartment.

Bladder Dysfunction

Bladder issues in women and men can be helped by Physiotherapy treatment, and again, are recommended as first line treatment. Urinary stress incontinence (leakage associated with coughing, sneezing, laughing or exercising) is incredibly common, affecting 1 in 3 adult women. Physiotherapy can cure this sort of leakage for somewhere in the region of 75% of women. Bladder urgency and urge incontinence are also very common, and again Physiotherapy can be a huge help - pelvic floor exercises, bladder re-training, acupuncture can all have a role. Men will sometimes have issues with bladder control associated with enlarged prostates or post prostate cancer surgery.

Bowel Dysfunction

Between 1 and 10% of adults struggle with bowel incontinence, and 0.5-1% of adults will find their quality of life is affected by this distressing condition. Bowel incontinence is often a hidden condition, with people finding it difficult to discuss even with close family and friends. This can be a huge barrier to seeking help. Bowel incontinence can be associated with childbirth (particularly 3rd and 4th degree perineal tears), pelvic organ prolapse and often exists alongside bladder problems. Constipation is also an incredibly common problem affecting up to 20% of the UK population. Issues with bowel function can also often be successfully helped by Physiotherapy treatment.  

Pelvic Floor Muscle Weakness

Pelvic floor muscle weakness is incredibly common in women, and perhaps more surprisingly, common in men too. These muscles can become weak as a result lack of exercise, carrying excess weight, chronic coughs, chronic constipation, heavy lifting, and most significantly as a result of the affects of pregnancy and childbirth, and the hormonal changes that occur around menopause in women. The muscles will gradually weaken with age too if they are not used (exercises regularly). Pelvic Physiotherapists are ideally placed to educate and assist with pelvic floor muscle training. Up to 50% of people will do pelvic floor exercises incorrectly - this is where specialist assessment and advice are invaluable. 

Vulval Pain Syndromes

Vulval pain (only affects women) is a much more common problem than you might think affecting around 16% of UK women for 3 months or more. Vulval pain can be intermittent or constant, provoked or unprovoked, and can sometimes be caused by infection, skin conditions or other conditions. It is commonly associated with pelvic floor muscle overactivity, and this is where Physiotherapy  treatment comes in, alongside treatment of any other conditions which may be contributing. Manual therapy, soft tissue release, acupuncture, breath work, relaxation and mindfulness are all possibilities to be included in your Physiotherapy treatment for these distressing conditions.  

Bladder Pain Syndrome

Bladder pain syndrome (BPS) is sometimes known as Interstitial Cystitis. It is between 2 and 5x more common in women than in men, and may affect up to 6.5% of the population. BPS can be incredibly persistent and distressing in nature. 90% of bladder pain sufferers are in their 50's and 60's. BPS is a chronic bladder condition characterised by pain, urinary urgency, frequency and nocturia. Symptoms often resemble those of patients with  an overactive bladder, as well as symptoms suggestive of lower urinary tract dysfunction. It is not clear what causes bladder pain syndrome. It is often associated with overactive pelvic floor muscles though, and this is where Physio can help. 

Pelvic Floor Muscle Overactivity

Pelvic floor muscle overactivity (or hypertonicity to give it it's proper term), is when the pelvic floor muscles are shorter and tighter than they should be at rest. It is much more common than you think, and can sometimes occur alongside weakness in other parts of the pelvic floor muscles and symptoms of prolapse, and bladder or bowel issues. It is often associated with chronic back and pelvic pain, vulval pain, and bladder pain syndrome. Physiotherapy techniques to release, lengthen and re-educate the pelvic floor muscles can be incredibly helpful. Vaginismus is a type of pelvic floor muscle overactivity, where the pelvic floor goes into spasm on attempting to insert anything into the vagina.

Chronic Pelvic Pain

Chronic Pelvic Pain Syndrome (CPPS) in any pelvic pain that has been present for more than 6 months or longer, even it comes and goes, rather than being present continuously. Common causes of CPPS are endometriosis, pelvic inflammatory disease and irritable bowel syndrome, but the pain can be musculoskeletal in nature and related to long term lower back, hip or sacroiliac joint issues. If other causes of pelvic pain have been ruled out, and the pain persists it is certainly worth seeing a Physiotherapist in order to assess the relevant structures that may be implicated. I often find that pelvic floor muscle overactivity is a cause of chronic pelvic pain, and this is something that can be effectively treated with physio.

Pregnancy Related Pelvic Girdle Pain

Pelvic Girdle Pain or PGP (previously known as Symphysis Pubis Dysfunction and sacroiliac joint pain) are very common pregnancy complaints. They affect somewhere in the region of 1 in 5 pregnant women. PGP can cause pain and difficulty walking, problems turning over in bed, difficulty climbing stairs and pain or difficulty taking your legs apart. I am able to provide assessment, treatment and advice regarding the management of these troublesome conditions, to help you to enjoy your pregnancy and the postnatal period more fully. Don't suffer in silence. These conditions may be common, but that does not mean that nothing can be done about them, so please do seek help. 

Rectus Abdominus Divarication

A Rectus Abdominus Divarication or "tummy gap" is a very common postnatal complaint. Around 2/3 pregnant women develop a tummy gap, and for some these persist for several months postnatally, leading to lower back pain. A tummy gap can also contribute to problems that we more commonly associate with pelvic floor muscle dysfunction, due to the way that these muscle work together. A tummy gap check forms an integral part of a Mummy MOT, and I will often use my ultrasound scanner when assessing these, and when teaching correct exercise technique for recovery. An individualised exercise programme is the best approach for treatment, and postnatal Pilates classes are helpful. 

Pregnancy Related Back Pain

According to the literature between 50 and 90% of pregnant women will have back pain at some point in their pregnancy, and at least half of these will have pain that is significant enough to affect their quality of life. Commonly in pregnancy the lower back is achey as a result of the postural changes that occur, and the stretch to the abdominal muscles. The thoracic spine (mid back) and ribs often become stiff and uncomfortable too, again due to changes in posture, and  certainly with rib pain - the position of the baby can be a cause. It is also not unusual to have neck pain in pregnancy, again due to posture and centre of gravity changes. Although these issues are common, they are treatable.

Caesarean or Perineal Scar Issues

Sometimes postnatal women will have issues with either a caesarean section scar or a scar from a perineal tear or episiotomy. Scars can become tight, bobbly and uncomfortable, and can often benefit from massage and soft tissue release work around them to improve comfort and the appearance of the scar. Sometimes issues with scars can be contributing to problems with ongoing back pain or a tummy gap, and so it can certainly be helpful to get these looked at if you suspect they may be contributing to any problems you may have. These will always be assessed as part of a Mummy MOT, and a treatment plan formulated - this will often include techniques you can use at home to help.

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