Women’s Health

Introduction

The pelvic floor (PF) muscles exists in both men and women. The role of the PF is to keep your organs such as bowel and bladder in position especially on movements that cause an increase in intra-abdominal pressure like lifting, sneezing and carrying. The PF needs to be effective when passing urine or a bowel movement and in maintaining an erection or vaginal sensations. 1/3 of women experience issues with their PF during their lifetime.   

Other Functions

  • Keeping the bladder and bowel closed to stop ‘leaking’
  • Bladder and bowel emptying
  • Sexual function – maintaining an erection, preventing premature ejaculation in men and improving sensation and ‘grip’ in women

  

The pelvic floor muscles are also important in supporting postural and spine health and stability.  

Common Complaints with Pelvic Floor Dysfunction

  • Urinary dysfunction
  • Pelvic organ prolapse
  • Sexual dysfunction
  • Pain in the lower back, vagina or abdomen 

Common Contributing Factors

  • Pregnancy and childbirth – hormonal ligament laxity, vaginal delivery, episiotomy/tears
  • Obesity and being over-weight – extra downward pressure of the pelvic organs
  • Repetitive heavy lifting – this increases the intra-abdominal pressure on the pelvic organs
  • Strong family history – inherited weaker collagen type
  • Age –age related changes to muscle tissue composition
  • Menopause – hormonal changes can make symptoms worse
  • Chronic constipation – straining can increase intra-abdominal pressure  
  • Chronic cough – as above
  • Previous pelvic surgery – POP repair, hysterectomy, prostate surgery in men

Diagnosis

As you can see with the number of symptoms, contributing factors pelvic floor dysfunction need to consider other differential diagnosis. Pelvic Floor Dysfunction considerably impacts quality of life through reducing physical activity levels, pain and the possible impact on mental health.

 

At Pure Physiotherapy, our skilled clinicians will be able to help determine the factors contributing to your symptoms, pain and discomfort and work with you to develop a personalised and progressive management and exercise plan. Click here for more information on Pelvic Floor Muscle Dysfunction in our ‘Conditions’ section

Rehabilitation

Improving pelvic floor strength is a fantastic way to make steps towards improving your symptoms.  

Try these steps to help you find yours.  

  1. Get comfortable either sitting or standing.
  2. Imagine that you are trying to stop yourself from passing wind and urine at the same time. Draw the pelvic floor muscle upwards and forwards away from the bowel – as if your reaching them to the tip of your chin.  
  3. Try not to hold your breath or squeeze your buttocks or legs together.  
  4. Now fully relax your pelvic floor and tummy muscles before having another go.  

To improve your pelvic floor strength, try the above steps with 10 long squeezes (aim to hold for 10 seconds each) followed by 10 short squeezes. Make sure that you completely relax your pelvic floor and tummy muscles between each squeeze. Always go to your GP if you are concerned about urinary/bowel incontinence or if you get pain on trying these exercises.  

 

Introduction

Obstetrics is the name for the medical speciality of looking after women who are pregnant and shortly after giving birth. Ante-natal is the period before birth and Post-natal the period after giving birth. As well as the doctors and midwives, physiotherapists also play an important role in obstetrics.

Many women suffer with aches and pains during pregnancy, however, in some cases this is above the normal adaptation to changes in the body. Physios can assist you with this change and look at techniques and exercises which can ease the symptoms and allow you to be well prepared for progressing through pregnancy, labour and beyond.

At Pure Physiotherapy we have a number of physiotherapists who have undertaken additional training in obstetrics, particularly MSK conditions during pregnancy, so are well placed to be able to help.

Common Conditions Associated with Pregnancy & After

Ante-Natal

  • Pelvic Girdle Pain PGP (previously known as SPD symphysis pubis dysfunction).
  • Back Pain (upper and lower).
  • Sciatica.
  • Pudendal Neuralgia.
  • Cramp.

 

Post-Natal

  • Post C-section scarring, abdominal recovery.
  • Vaginal delivery recovery.
  • Pubic Symphysis pain.
  • Coccyx dislocation/pain.

Additional Things we can Assist with

  • General fitness advice during pregnancy.
  • Keeping “fit” for labour and birth.
  • Pelvic floor guidance.
  • Post-natal recovery and safe return to exercise.

 

Some great information leaflets for patients to read online are provided by the Pelvic, Obstetric and Gynaecological Physiotherapist Association, click here.

https://pogp.csp.org.uk/