Author: Amanda Goodie, Women’s Health Physiotherapist at PhyxMe Physiotherapy & Rehabilitation
Pelvic health physiotherapy is a specialised area in the physiotherapy profession that has been gaining more public attention in the last few years. And with good reason too- up to 70% of women suffer from leaking of urine when they cough, sneeze or laugh, or are unable to hold on if they are rushing to the toilet. Pelvic floor physiotherapy is also useful during and after giving birth to help strengthen the pelvic floor muscles. But there are many other things that your pelvic health physiotherapist can help you with that you may not know about.
1. Urinary frequency
This is when you go to the toilet too often and it becomes bothersome. “Normal” frequency is between 5-7 times during the day, and 0-1 times at night. There are many reasons why you might be going to the toilet too often, including a having urinary tract infection (UTI), a small and tight bladder that can’t stretch properly to fill up, or an overactive bladder that sends incorrect messages to the brain so that you feel like you need to go even though your bladder isn’t full. Having a discussion with your pelvic health physiotherapist can help work out what may be contributing to the problem and help come up with a management plan.
2. Urinary urgency
This is when you all of a sudden feel like you are busting to go to the toilet. Our bladder is slowly and constantly filling all of the time, and you should get a gradual sensation of needing to wee, which increases slowly with time. In some cases, your bladder can become overactive or over sensitive and you will all of a sudden get a sensation that you are absolutely busting and need to go straight away. This is called urinary urgency. As with urinary frequency, there are many reasons why this may be happening, and your pelvic health physiotherapist can work with you to develop a management plan.
3. Pelvic organ prolapse
Pelvic organ prolapse is the descent of pelvic organs (bladder, uterus and/or bowel) into the vagina. Symptoms of this include a pressure, bulging or heaviness sensation around the entrance of the vagina, which is typically worse towards the end of the day or during/after exercise. Women who have had children, have a history of repeated heavy lifting, chronic cough or repeated heavy impact (such as involvement in elite sports) are at risk of developing a prolapse. Pelvic floor strengthening exercises are the best way to manage a prolapse, and a pelvic health physiotherapist can assist you to make sure you are doing your exercises correctly.
4. Painful sex
Sex is such an intimate act between ourselves and our partner, but for many people this can be a painful and dreaded experience. This may be referred to as dyspareunia or vaginismus, which are terms to describe pain with sex. Again, there are many reasons why a woman may experience pain. One simple solution may be ensuring that enough lubrication is used! Another reason may be that the pelvic floor muscles are too tight and are not able to relax enough to allow pain free penetration. Instead, on penetration they tighten and spasm and create a really unpleasant and painful experience. This is something that your pelvic health physiotherapist will be able to work through with you as well as teach you different strategies to help relax your pelvic floor muscles.
5. Painful periods
Growing up, we are taught that period pain is normal, and to just get on with our lives when we have our periods. Whilst for a lot of people this is the case, the reality is that up to a quarter of women and young girls experience significant period pain that stops them from participating in their normal daily activities, meaning that they miss work, school, sport or social events. When we are in pain, our muscles tend to tighten up, and often they can become shortened, contributing to the painful period. Whilst as a physiotherapist we cannot directly influence your hormones or periods, there are lots of different strategies that we can discuss to ensure that something like getting your period doesn’t stop you from getting out and living your best life.
Pelvic pain and dysfunction can be very personal and a lot of the time people suffer in silence thinking that they are the only ones with a particular problem or not knowing that there is a solution. The reality is that these are very common problems and often the treatment is simple and pain free. Pelvic health physiotherapists are highly experienced clinicians who work with people experiencing pelvic pain and dysfunction every day, so there is nothing to be embarrassed or ashamed about- I can almost guarantee that we have heard it all before!