Pelvic health rehabilitation

Up to a third of women experience issues with their pelvic floor at some during their life. Some of the most common pelvic issues include leaking urine through sneezing or coughing (known as stress urinary incontinence) and pelvic organ prolapse (which happens when one or more of the organs in your pelvis slip down and bulge into your vagina). Many pelvic issues cause pain and discomfort, which can significantly impact your mobility, relationships, social life and mental health.

Fortunately, women’s health physiotherapy is a highly effective form of treatment for pelvic issues, helping reduce pelvic pain and restore the proper function of your pelvic floor.

We offer fast access to a network of dedicated Women’s Health Physiotherapists experienced in the treatment and management of many pelvic pain conditions. You can book an appointment with one of our Physiotherapists today by calling us directly on 0141 300 6026.

Women’s health physiotherapy describes the therapeutic treatment of conditions that affect your pelvic floor. Magdalena Grabek, one of our Physiotherapists at The London Independent Hospital, says: “Pelvic health physiotherapy is established as a first-line of defence against incontinence and pelvic pain.”

Women’s health physiotherapy treats many pelvic issues, including incontinence, pelvic pain, vaginal pain, pelvic organ prolapses and more. Pelvic floor dysfunction, which happens when your pelvic floor does not function properly, can be caused by:

Hypotonicity (weak pelvic floor muscles): This causes stress incontinence, urge incontinence and pelvic organ prolapse. 

Hypertonicity (tight pelvic floor muscles): This causes urinary and faecal urgency, urge incontinence, chronic pelvic pain, dyspareunia, vaginismus, vulvodynia, interstitial cystitis and chronic prostatitis.

Women’s Health Physiotherapists will tailor a specialist exercise plan to suit your needs. These exercises help relax your muscles if they are tight or strengthen them if they are weak. This will help reduce your symptoms and restore function in your pelvic floor.

Pelvic floor physiotherapy also helps manage pregnancy-related issues and postpartum recovery, as well as recovery for women after undergoing certain procedures (pelvic floor repair surgery, myomectomy, or hysterectomy).

Your Physiotherapist will begin by taking a detailed account of your medical history. They will want to know more about the nature of your symptoms and how they impact you.

They will often ask about your pelvic functions (your bladder, bowel and sexual functions), as well as any other medical concerns you might have. This is to ensure they take a holistic approach to your care, which considers many individualised factors in your treatment plan.

This conversation is followed by a movement exam. This is to examine the movement of your body and whether this could be contributing to your pelvic problems.

A tailored pelvic floor muscle exam will also be performed. This can include an internal vaginal or rectal examination to examine your muscles and how they function. Our Physiotherapists will ensure you feel relaxed and safe throughout your examination.

You will also undergo a posture and breathing assessment. This is because your posture and breathing can impact the function of your pelvic floor.

After these examinations, you and your Physiotherapist will work together to build a plan to manage your symptoms. Sometimes, this includes referring you to another clinician to help with pain management or further medical evaluation. However, this always includes specialist exercises you can start immediately, as well as more information about how best to manage your condition.

It is useful to note that managing chronic pain conditions requires more physiotherapy sessions due to the complexity of the condition. Pelvic floor dysfunction caused by incontinence or pelvic prolapse usually involves less physiotherapy appointments. 

There are many pelvic floor devices commonly used during physiotherapy sessions. These include:

Electrical stimulation devices: this is a therapeutic treatment that applies electrical stimulation to your pelvic floor muscles. This form of therapy is helpful for those who cannot actively contract their pelvic floor muscles or have suffered nerve damage.

Biofeedback devices: this device uses sensors to provide visual feedback of the function of your pelvic floor. It helps you better connect with your pelvic floor and understand how to plan your treatment accordingly.

Other forms of equipment often used include pelvic floor trainers (small dilators inserted into your vagina to help treat vaginal tightness and sensitivity) and Kegel balls (inserted into the vagina to exercise your pelvic muscles).

It is important to work with your Physiotherapist during your sessions to decide which device is best for you to use. Your Physiotherapist will incorporate this device into your treatment plan alongside other specialist exercises.

Pelvic floor devices are great for:

• Motivation to support your wellbeing;
• Training your muscles and helping restore pelvic function, and
• Those who like to track their progress.

The exercises you will be assigned depend on your condition and related symptoms.

Pelvic floor dysfunction caused by hypotonicity (weak pelvic floor muscles) require pelvic floor strengthening exercises, known as Kegel exercises. Your Physiotherapist will guide you through these.

Hypertonic muscles (tight muscles) require relaxing exercises called reverse Kegels or down-training.

If your pelvic floor muscles are tight and weak (which is possible), any tension is treated before weakness. After your muscles have reached a normal resting tone and are able to relax fully, their strength is reassessed and strengthening exercises are prescribed, if appropriate.

Regular home exercises can also be supported by breathing or core strengthening exercises.

It is important to remember that exercises can be both internal and external. Your Physiotherapist will ensure you understand how to carry out each exercise (whichever type), in a relaxed and efficient manner.

There are many benefits of pelvic health physiotherapy. It improves pelvic function and helps you find the best exercise regime for you. It also treats:

• Chronic pelvic pain;
• Urinary symptoms (leaking urine, urgency, interstitial cystitis and frequency);
• Bowel symptoms (leaking faeces, gas, constipation or haemorrhoids);
• Scar pain (pain from tears, an episiotomy, or Caesarean section;
• Pelvic organ prolapse (vaginal pressure, heaviness, or a pain or dragging feeling);
• Abdominal muscle separation (a visible bulge or indent in the midline of your abdomen, and
• Pain during penetration (vaginismus, which describes pain during and after intercourse or insertion of menstrual products).

Pelvic health physiotherapy treats many conditions and symptoms, helping women feel more confident and comfortable in themselves again. Most importantly, pelvic health physiotherapy helps women experience relief from pain.

To find out more about our pelvic floor physiotherapy services, you can call us directly on 0141 300 6026 to book an appointment with one of our Physiotherapists today.

To find out more about it, you can speak with one of our advisors directly or call us on 0141 300 6026.

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