Before any physiotherapy, you will receive a full explanation about the treatment plan. With ample opportunity to ask questions, we aim to ensure all patients understand the aims of the treatment proposed. We are also guided by our professional standards of care and rules of professional conduct to support the delivery of a high quality service. The physiotherapy team, as is the case with all our clinical staff, is trained to assess and treat patients with courtesy, dignity and respect. All information is treated in strictest confidence.

Our values:

• We are passionate about Pelvic health and aim to treat the person not just the condition
• We aim to break the taboos about pelvic health.
• We strive to empower women and restore confidence
• We aim to collaborate with other health professionals and provide a holistic approach to  your treatment and care.

Our specialist Physiotherapists can help you with a range of conditions including:

• Bladder incontinence and/or urgency
• Leaking with exercise or coughing and sneezing
• Bowel incontinence / urgency and/or constipation.
• Pelvic pain including - vulvodynia/vaginismus/bladder pain syndrome
• Pelvic organ prolapse
• Sexual dysfunction or discomfort
• pregnancy-related pelvic girdle pain
• Perineal trauma

Physiotherapy can also address some of the many side effects of menopause, including physical aches and pains, vaginal symptoms, and pelvic floor muscle rehabilitation.

What happens during a pelvic health physiotherapy appointment?

A detailed history will be taken about the problems you are experiencing. Some of the questions may be of a personal nature to gain a full insight into the nature of your problems. You will also be given the opportunity to ask any questions you might have.

You may be offered an internal (vaginal) pelvic floor examination. This is not compulsory but forms a valuable part of the assessment and enables your physiotherapist to give you individualised treatment and ensure you can activate your pelvic floor muscles correctly. Your physiotherapist will discuss the examination in detail with you during your appointment and a chaperone can be arranged if you would like one.

What does pelvic health physiotherapy treatment involve?

Pelvic health physiotherapy treatments are based around exercise and advice, which is tailored to you following a detailed assessment. It may also involve some manual therapy, relaxation and breathing techniques. To ensure the best outcome, it is important that you take an active part in your rehabilitation and follow the advice of your specialist physiotherapist.

Is there anything I need to bring to my initial Pelvic Health physiotherapy appointment?

An up-to-date list of any medications you take is useful, plus details of any past or ongoing health conditions, investigations, or treatments, especially if they are related to your current symptoms.

You may also wish to note down any questions you have about the problem to ask your physiotherapist as well as thinking about the main problems you experience and how much they affect your day-to-day life.

Do I need to do anything at home for my pelvic health physiotherapy appointments?

You may be asked to complete a frequency volume chart for your bladder at home prior to attending your initial appointment or at some point during your treatment.

Do you inform my GP about my pelvic health physiotherapy?

Your GP is not routinely informed about details of your treatment but is informed if there are any concerns about your condition or if you require further investigations or referral to another health professional.

We provide antenatal outpatient appointments for women experiencing back or pelvic pain. At these appointments, women are taught self-help techniques and are given advice, including an information leaflet, about posture and about back and pelvic care. As well as being taught stability exercises, some pregnant women are fitted with a back support if necessary. Other physiotherapy treatment techniques are provided depending on individual needs. 

All women undergoing a major abdominal procedure are seen routinely by a physiotherapist. Other patients are referred to us for specific treatments. Working alongside the clinical teams, our therapy objectives are preventive and educational to reduce the risk of complications and speed recovery.  Sometimes treatment is required to aid recovery from complications such as reduced air entry, chest infections and poor mobility.

We see a range of patients in the outpatient department. Common outpatient conditions that are treated by our specialist Women’s Health

Physiotherapists include;

Urinary incontinence
Overactive bladder syndrome
Dyspareunia (pain during sexual intercourse)
Faecal incontinence
Obstructed defecation
Pelvic pain

You will find us on the ground floor of the Crown Street hospital site, within the antenatal clinic area. 

Pelvic Girdle Pain (PGP) is described as pain in the joints that make up your pelvic girdle, this includes the symphysis pubis (SPJ) at the front and/or the sacroiliac joints (SIJ) at the back. 

• Pain in the lower back, pelvic area and/or legs
• Can occur in any trimester - most common is 28-36 weeks.
• Can be debilitating and differ from one person to the next.
• It can impact on daily function and quality of life, and contributes to anxiety, depression and disability.
• Self managing condition with help & guidance from pelvic health Physiotherapists

• Postural Changes

• Functional Difficulties

• Adjustments at work

View this video in different languages below:

Portuguese - –https://youtu.be/6trV0i6dcPo 

Spanish - https://youtu.be/5nZ0gbO6b0w

Arabic - https://youtu.be/u5hBdxpqReo

Italian - https://youtu.be/mwAU_Kb-OMw

Perineal massage is a way of helping to prepare the perineum for childbirth, making it more flexible so it can stretch more easily during labour. 

Your perineum spans from the rear of your vagina through your anus and rectum and it includes the back part of the birth canal. 

View the video below for further advice

Our top tips!

Here is a selection of exercise videos you may find useful when suffering from pregnancy related pelvic girdle pain.

When purchasing your exercise ball, please make sure you purchase an anti-burst ball and a size that is suitable for your height.

Here below is the recommended sizes:

Pelvic tilts

Side Flexion

Childs pose

Thoracic Rotations

Pelvic Circles

Seated adduction with ball or towel

Glute activation

Leg lifts

Clam

Baby Hugs

Pelvic floor muscle exercises
The pelvic floor muscles (PFM) are at the bottom of
your pelvis, and support the pelvic organs.

When to start?

• Now's a great time to start these exercises if you haven't been doing them.
• Try to get into the habit of doing these exercises every day. To make it easier, try to link them with something you do regularly, such as brushing your teeth or watching TV.
• If you find them difficult or you need advice, speak to your midwife or watch the video below for verbal cues. 

Pelvic floor muscle exercises are needed to:

• Improve muscle strength so that you can control your bladder and bowel
• Support your pelvic organs
• Support your growing baby during your pregnancy

All women are at risk of postpartum urinary retention. Should you experience any issues with your bladder or voiding problems please speak to your GP and Midwife. 

Make sure you are emptying your bladder regularly (5-8x per day), particularly if you have had an epidural.

 If you can’t pass urine, inform your midwife immediately.
If you are unable to control and pass urine as usual, ask to see the specialist physiotherapist or talk to your midwife.

Our top bladder tips:

• Do not ‘stop and start’ the flow of urine.
  • Do not get into the habit of going to the toilet ‘just in case’.
  • Breathing out slowly as you pass urine
  may also help.
  • Drink 1.5-2 litres (3-4 pints) of fluids per day to include water/squash.

View the video below for further information:

It can be common to experience pain and discomfort following a vaginal delivery post birth. 

Should you experience ongoing symptoms of discomfort or pain please speak to your GP or midwife. 

View the video below for more information and advice:

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle. This muscle covers the front surface of the belly area. All women will experience changes in their tummy muscles during the 3rd trimester period. It is normal for these changes to be present in the early stages post delivery. 

These changes can be: 

• Separation of the abdominal wall 
• Doming 
• Coning 
• Elasticity changes to the skin 
• Belly button changes 
•  Abdominal hernias 

Generally most of these changes improve over time. Intervention such has exercise can help to improve the strength and tension within the tummy muscles. Please speak to a postnatal fitness professional or Pelvic Health Physiotherapist for further guidance. 

View the video below for further information:

Our top 5 tips to help with Constipation following birth: 

• Drink plenty of water 
• The use of stool softeners  
• Aim to open your bowels soon as you feel comfortable to do so following birth
• Some women experience constipation - sitting in the right position on the toilet helps your muscles to relax, and makes it easier to open your bowels. You can use the position in the diagram on the right to help you empty your bowels more easily.
  • When having a bowel movement, you may find some extra support will make you more comfortable. Try holding a wad of toilet paper or a sanitary pad firmly in front of the back passage. If you have had a Caesarean section operation, supporting your wound with a folded towel may also help.
  DO NOT STRAIN and DO NOT RUSH.

If unsure speak your GP or Midwife for support. 

View the video below for further information:

Returning to exercise after delivery is recommended but it should be gradual and should not involve high impact exercise too quickly. It is advised to wait until at least 6weeks after your delivery to ensure healing and vaginal discharge and bleeding have stopped.

For C-section deliveries it is recommended women wait until 12 weeks postnatal before commencing any exercise. 

If you are unsure please speak to a medical professional or your Pelvic Health Physiotherapist. 

View the video below for more information:

Pelvic floor muscle exercises
The pelvic floor muscles (PFM) are at the bottom of
your pelvis, and support the pelvic organs.

When to start?
• If you have a urinary catheter, wait until it is removed and you are passing urine normally before starting these exercises.

Pelvic floor muscle exercises are needed to:
• improve muscle strength so that you can control your bladder and bowel
• support your pelvic organs, helping to prevent prolapse

Remember to:
• Start the pelvic floor muscle exercises as soon as possible, after any catheter has been removed.
• Do the exercises in varying positions, but if you are sore in the early days, lying on your side might be most comfortable.
• Do gentle, rhythmic tightening and relaxing of the muscles, which will help ease discomfort, pain and swelling, and will aid healing if you have stitches following an episiotomy or tear, on your perineum.

View the video below for further information:

Clink on the images below to view our care and advice following a C-section delivery.