Pelvic Health

Oak Flats Physiotherapy and Pelvic Health treat a range of Pelvic Health and Women’s Health complaints.

Urinary Incontinence

Urinary incontinence is the accidental loss of urine. There are several types of urinary incontinence including:

• Stress incontinence- loss of urine when there is an increased pressure on the pelvic floor in activities such as coughing, sneezing, laughing and exercise.

• Urge incontinence- a strong and sudden desire to void in which you leak before you reach the toilet.

• Mixed incontinence- a mixture of stress and urge incontinence.

Although 1 in 3 women who have ever had a baby wet themselves; incontinence is not normal and pelvic health physiotherapy can help. Treatments may include advice, reassurance, bladder retraining, lifestyle advice, pelvic floor muscle training and appropriate advice/referral for further intervention.

Urgency and frequency

Bladder urgency is the strong, sudden desire to void. Some people may also experience incontinence with urgency. This urgency may be caused by an overactive bladder- where for many possible reasons, your bladder spasms when it should be relaxed and gives you a sudden urge. Urgency can also contribute to high frequency of trips to the bathroom which can be quite bothersome for some.

There are many reasons why these symptoms can be occurring. Pelvic floor physiotherapy can help with lifestyle advice, pelvic floor muscle retraining and bladder retraining.

Pelvic Organ Prolapse

Pelvic organ prolapse is when the bladder, uterus or rectum (or a combination of the three) drop into the vagina.  This may cause discomfort; a sensation of bulging, dragging or heaviness; difficulty emptying your bladder or bowel; incontinence; and lower back pain.  Pelvic floor physiotherapy can help in many ways including pelvic floor muscle training, advice and exercise modification.  Your physiotherapist will also advise you if she feels you would benefit from a pessary or consultation with a gynaecologist.

 Faecal incontinence/ urgency

As well as bladder incontinence, some people may also experience faecal urgency and or incontinence.  This may occur for many reasons.  Pelvic floor physiotherapy can help with education, lifestyle modification, fluid and diet modification, and pelvic floor exercise prescription. 

Constipation

 Constipation is a common complaint and can occur for a number of reasons.  A pelvic health physiotherapy can help. After a thorough subjective and objective assessment your pelvic health physiotherapist can determine the possible cause of your constipation and give appropriate treatment.  Treatment may include fluid and dietary advice, education on good bowel habits, pelvic floor muscle training/ coordination/ relaxation and reassurance. 

Pelvic pain and dyspareunia (Pain with sexual intercourse)   

There are several pelvic pain conditions that pelvic floor physiotherapy can assist with, including:

• Dyspareunia (pain with intercourse)

• Vaginismus (tightening of the superficial muscles of the pelvic floor, making intercourse very painful and difficult)

• Vulvodynia (pain, burning, irritation around the vulva)

• Pudendal Neuralgia (chronic pain related to the pudendal nerve which results in pain between the anus and clitoris in females and or anus and penis in males)

• Pelvic pain associated with chronic conditions such as endometriosis. 

In these conditions, it is very common to see overactivity of the pelvic floor muscles.  This means that the patient finds it difficult to relax the pelvic floor (often without realising) much like how we hold tension in our neck and shoulders. Pelvic floor physiotherapy can help in many ways including education and reassurance, breathing exercises, pelvic floor down training, manual therapy and in some cases TENs. 

Pre- and post-natal care:

Pelvic girdle pain (pain around your pelvis) is commonly seen throughout pregnancy.  Pelvic health physiotherapy can help with advice, reassurance, manual therapy, exercise prescription and advice on appropriate braces and supports.

At 6 weeks post-natal, whether you have had a vaginal birth or caesarean, it is very important to have a thorough assessment with a pelvic health physiotherapist.  In this assessment your physiotherapist will examine your pelvic floor in regards to strength, endurance and coordination; prolapse, scar tissue, pain; and measurements that give guidance on advice to a safe return to exercise. Your physiotherapist will also perform a general musculoskeletal assessment, assess for any abdominal separation; and assess your deep abdominal strength and coordination.

After a thorough assessment, you will be prescribed a tailored and safe exercise program and be given advice to returning to the activities you love, without putting your body at risk of injury. 

Pre and Post-operative care:

After gynaecological or urological surgery such as prolapse repair and hysterectomy; it is important to have an assessment with a pelvic health physiotherapist to ensure your pelvic floor is functioning optimally for the best long-term results.  Bladder training in some patients and advice on good toileting habits is also important. 

 Mens Health

Incontinence isn’t just a women’s problem.  Men can also experience incontinence.  A common time we see this is after a prostatectomy which is surgery to remove the prostate due to cancer.  Often, men will experience some degree of incontinence.  Pelvic health physiotherapy can help with pelvic floor muscle training, lifestyle advice, bladder retraining, ed.