The pelvic floor is a group of muscles in the pelvic which support the abdominal organs and – when working efficiently – help to maintain continence.
Men, women and children have pelvic floor muscles, and all can be impacted by symptoms of pelvic floor dysfunction.
Pelvic floor dysfunction occurs in patients with pelvic health issues such as incontinence, pelvic pain, or pelvic organ prolapse.
Other contributing factors may be the passive pelvic support structures (ligaments), bladder and bowel habits, and lifestyle factors.
A thorough assessment and individualised treatment program from a suitably trained therapist is crucial for effective treatment of pelvic health conditions, and fulfilling of patient goals.
The pelvic floor can be assessed while fully clothed by using a real-time ultrasound machine. Or a more comprehensive assessment – via vaginal or rectal examination – allows for accurate assessment of pelvic floor muscle tone, strength and activation technique. Your PhysioPro will thoroughly explain both assessment techniques, and you may choose the assessment technique you prefer.
Real time ultrasound
At PhysioPro we are able to complete a noninvasive assessment of your pelvic floor function using our real-time ultrasound machine. You can be fully clothed for this assessment.
To visualise the bladder and pelvic floor, it is important you have some fluid in your bladder; please ensure to drink a large glass of water in the lead up to your appointment, and – if able – avoid going to the toilet to empty your bladder.
A more comprehensive assessment method is via a vaginal or rectal examination; which allows for accurate assessment of pelvic floor muscle tone, strength and activation technique.
The choice of assessment technique is entirely the patient’s. Your PhysioPro can thoroughly explain both assessment techniques, and the patient consent’s to whichever they choose.
Incontinence is the involuntary loss of urine, wind or stool. Loss of bladder or bowel control occurs in 30-40% of women and 10% of men, and can have a negative impact on an individual’s quality of life.
These issues tend to increase in incidence and/or severity with age, but whilst incontinence is common, it should never be accepted as normal, and treatment should always be sought early.
Pelvic floor physiotherapy is recommended as a first line treatment for incontinence. 80% of patients can improve their symptoms with conservative treatment including education on correct pelvic floor activation, an individualised pelvic floor muscle training program and implementation of good bladder and bowel habits.
Common incontinence presentations include stress urinary incontinence, which involves leaking with coughing, sneezing, lifting, or exercise, and overactive bladder, where there is a sudden, urgent need to use the toilet with or without leakage.
Blocked ducts & mastitis
Mastitis is when a milk duct becomes blocked and results in cellulitis of the surrounding breast tissue. Part of the breast becomes inflamed, red, swollen, hard and very painful.
Mastitis can be contributed to by:
- Trauma to the breast
- Damaged nipples
- Poor attachment, positioning or sucking of baby
- Incomplete draining of the breast
- Abrupt weaning or unresolved engorgement
- Restrictive bra or clothing
Anti-biotic treatment should be commenced immediately when signs of mastitis appear, it is often necessary to test the breast milk to determine which specific anti-biotic is appropriate.
Management may also include anti-inflammatory or pain relieving medication.
Your PhysioPro can provide education on effective feeding practices, and relaxation techniques to aid the “let down” reflex. Your PhysioPro will also use massage and ultrasound treatment to help reduce the inflammation and pain, and unblock the milk duct.
Please let our receptionist know if you have mastitis at the time of booking.
Prostate cancer is the most commonly diagnosed cancer among Australian men, with many subsequently undergoing surgery to remove their prostate (radical prostatectomy).
Due to the close proximity of the prostate to the bladder neck and internal urethral sphincter, majority of men (up to 95%) experience leakage of urine as a side effect of the surgery.
While most men will be fully continent by 12 months post-op, evidence supports the use of pelvic physiotherapy both before and after surgery as a means of speeding up this recovery.
Pelvic physiotherapy incorporates pre-operative education, real-time ultrasound assessment (a non-invasive technique), and prescription of individualised pelvic floor exercises.
Sacroiliac joint dysfunction and back pain in pregnancy
Back pain is a common complaint for women during pregnancy, pain may present in the lower back, in the sacroiliac joint (where the spine and pelvis meet), or pubic symphysis (where the front two halves of your pelvic meet).
During pregnancy your body produces a hormone called relaxin, which causes the ligaments holding the joints in your spine and pelvis together to loosen. This creates room for your growing baby, and prepares you for the birth process, but it also results in instability of your joints, which may cause pain.
As your baby grows you will gain weight will is added load for your spine and pelvis. In addition to this, your centre of gravity shifts which may alter your normal posture.
With the change of centre of gravity and especially during stressful times in your pregnancy you may also experience increased muscle tension and spasm.
Your PhysioPro will assess and diagnose the source of your back or pelvic pain. Treatment may involve massage, joint mobilization, taping or bracing, and heat or ice therapy. Your PhysioPro will also educate you on how best to manage your pain at home, improve your posture, and may prescribe exercises to strengthen and stabilize.
Diastasis of rectus abdominis prevention and treatment
During pregnancy as your baby grows and uterus expands the two parallel sheets of muscle in your abdomen (rectus abdominis, your six pack muscles) may separate down the centre seam (the linea alba).
This condition is known as rectus diastasis and can contribute to back and pelvic pain during and after your pregnancy. In this state your abdominal muscles are unable to provide the required stability to your trunk and pelvis. There is also a strong correlation between rectus diastasis and incontinence.
Your PhysioPro will assess your abdominal muscles for signs of rectus diastasis by sight, palpation and specific diastasis stress tests.
Many women commence exercises such as sit ups after delivery in an attempt to strengthen and tone their abdominal muscles. However these exercises are a poor way of improving abdominal muscle function after pregnancy and often further compromise the rectus diastasis.
Your PhysioPro will teach you how to safely activate your abdominal muscles – often with Pilates type exercises – to help prevent a diastasis forming, or to optimize tension across the linea alba and narrow your diastasis to a normal width.
Please let our receptionist know if you have rectus diastasis at the time of booking.
Your “core” is made up of three main muscle groups
Transverse abdominis – your deepest abdominal muscle, provides a “corset” of support
Pelvic floor – sits like a hammock within your pelvis, control bladder and bowel function, as well as stabilizing the lower back and pelvis
Multifidis – short muscles spanning from the transverse process (at the side) of one vertebra to the spinous process (in the centre) of the vertebra above, produce small “fine-tuning” postural movements throughout the day
At PhysioPro we will assess your core muscle function using palpation and functional tests, educate you on how to better activate your core muscle groups, and prescribe specific (often Pilates-based) exercises to improve your core strength and endurance.
You may benefit from core muscle strengthening or retraining if:
- you have experienced episodes of back pain
- you notice a reduction or plateauing of your sporting performance
- you have poor balance or difficulty with activities of daily living
- you struggle to maintain good poor posture throughout the day
- you want to prevent incontinence of bladder and/or bowel
TENS use during labour
TENS (Transcutaneous Electrical Nerve Stimulation) can be a great way to control pain and it is non-invasive and drug-free which makes it helpful during labour. It is run with a battery and electrodes which makes it transportable and easy to apply. It distributes a mild current which gives you a tingling sensation where it is applied. The intensity can be adjusted depending on the intensity of the pain and the threshold of the patient. It doesn’t have any harmful affects on the mother or the baby however it is advised not to use it before 37 weeks pregnancy. You can still move with the TENS on and you can put it on at home before you attend hospital and whilst in hospital it can be used in conjunction with other pain relief.
TENS works by blocking or short circuiting the pain messages as they travel from the site of pain to the brain. Research has also shown that it can boost production of endorphins which can help pain control.
It is important with all pain to control it before it controls you. It is therefore best to use early in labour. It is also recommended to use it in conjunction with other pain relieving strategies and not to have it as your only strategy.
To apply you place the electrodes on either side of the spine in the lower back and then incrementally turn up the intensity on the spine as the labour pains progress. It is however advisable to book in with your PhysioPro for a demonstration.
There are some considerations of using TENS. It shouldn’t be used as your only strategy but as a piece of the birth plan puzzle. It shouldn’t be used in or near water nor if you have metal implants from a prevous fracture or a pacemaker. The eletrodes should aways be zeroed before you switch it on and the skin should be alcohol swabbed and a trial should be done pre application to make sure there are no allergic reactions.
Please book in with your PhysioPro today for your demonstration.
Contact our friendly staff
to make an appointment
that works with your schedule.
PhysioPro have three locations
in the Perth metro area.