Conditions & Injuries: Women's Health

Antenatal support

During pregnancy, our bodies change significantly and fast. Hormonal changes and changes in our gait and posture as the baby grows impact our muscles, ligaments and joints. Working with a physiotherapist during pregnancy can help avoid and address pain and imbalances resulting from these changes. It can also help you to build up muscles to ease your labour and improve your recovery time.

How we support women during pregnancy

Our physios can work with you from the earliest stages of pregnancy, providing you with information about the changes you can expect to your body and advice on how to deal with them to prevent unnecessary stress, pain or loss of sleep.

We’ll work with you to develop a tailored strength and exercise programme and ensure your pelvic floor is functioning well. Having strong pelvic floor muscles, and improved tone and muscle strength in general, can help you to push the baby out more efficiently during labour. We’ll adapt your exercises as the pregnancy progresses, constantly assessing the impact of the pregnancy on your musculoskeletal system.

We can also provide perineal massage, which reduces the chance of tears to the perineum during vaginal births, and show you how to do this for yourself.

Postnatal support

After you’ve given birth, your body will need some time to recover before you return to your pre-pregnancy activities, or even to every-day activities. This is normal.

We usually recommend you leave it at least 6 to 8 weeks after you've had your baby before coming to see us for a general Mummy MOT, to address scarring and strength issues as a result of a c-section, or any problems such as diastais recti (sometimes called ‘mummy pooch’ or ‘FUPA’).

If you are experiencing numbness, partial temporary paralysis or unmanageable pain or discomfort please contact us sooner.

How we support postnatal women

A specialist physiotherapist will assess the condition of your pelvic floor and other muscle groups, as well as any specific concerns you may have. This will include a gentle, single-finger internal examination to assess the strength and the endurance of your pelvic floor muscles.

Based on what you are experiencing, whether you had a c-section or a vaginal birth, and our assessment, we’ll create a tailored and progressive exercise programme to slowly bring you back to full strength.

We‘ll make sure you understand and can feel for yourself what you’re trying to achieve with the pelvic floor exercises, and if you have any trouble with them, we can provide you with an internal device that can either stimulate the muscles for you or provide you with biofeedback on how successfully you are doing the exercises. We can arrange for you to trial one of these devices.

If you enjoy sport and exercise, we can also advise you on when and how to return to different sporting activities and tailor your exercise programme for those specific sports.

If you have diastasis recti (sometimes called a ‘mummy pooch’ or ‘FUPA’) – a very common result of a pregnancy where the abdominal muscles separate down the middle of your stomach – our physio will advise you on when and how to start exercising safely again. If it’s severe and doesn’t appear to be reducing, we can refer you to a specialist for surgery if you aren’t planning on having any more children.

Urinary incontinence

Urinary incontinence in women can occur at any age. There are four types: urgency incontinence (when you suddenly need to wee and can’t hold it in), stress incontinence (when you leak due to increased pressure on the bladder from movement, coughing or sneezing), functional incontinence (when other health conditions prevent you from getting to a bathroom in time) and overflow incontinence (when your bladder can’t hold any more urine).

Common causes

A weak, damaged or dysfunctional pelvic floor is one of the principal causes of stress and urgency incontinence. A dysfunctional pelvic floor can be caused by many things, including giving birth, constipation, urinary tract infections, hormonal changes during menopause, or long-term coughing which puts strain on the pelvic floor muscles. Anxiety can also cause incontinence, as can various bladder conditions and organ prolapse.

How we treat urinary incontinence

A specialist physiotherapist will assess the condition of your pelvic floor and other muscle groups, as well as any specific concerns you may have. This assessment includes a gentle, single-finger internal examination to assess the strength and the endurance of your pelvic floor muscles. In some cases, it may be that not being able to relax your pelvic floor muscles is the cause of your incontinence, rather than muscle weakness. Either way, we can provide you with a programme to improve the function of your pelvic floor.

We’ll make sure you understand and can feel for yourself what you’re trying to achieve with the pelvic floor exercises, and if you have any trouble with them, we can provide you with an internal device that can either stimulate the muscles for you or provide you with biofeedback on how successfully you are doing the exercises. We can arrange for you to trial one of these devices.

Our physio can also support you in better understanding other possible psychological and physical causes of your incontinence and give you strategies to address these. And if strengthening the pelvic floor is not an option or does not help we can advise you on alternative approaches and refer you to a specialist who can provide you with a suitable pessary or discuss your surgical options.

Pelvic organ prolapse

A prolapse is when one or more organs in the pelvic region (the uterus, bowel, bladder or the upper part of the vagina itself) bulge down into the vagina and the vaginal passage. This causes a feeling of heaviness and discomfort and can result in the organ bulging outside of the vagina. It can also affect you going to the toilet.

Common causes

A weak or damaged pelvic floor is the main cause of pelvic organ prolapse. A weakened pelvic floor can be caused by many things, including giving birth, constipation, hormonal changes during menopause, the ageing process, or long-term coughing which puts strain on the pelvic floor muscles.

How we treat prolapse

A specialist physiotherapist will assess your prolapse and the condition of your pelvic floor and other muscle groups. This assessment includes a gentle, single-finger internal examination to assess the vaginal wall, the degree of the prolapse, and the strength and the endurance of your pelvic floor muscles.

We’ll then provide you with a programme to improve the function of your pelvic floor, and make sure you understand and can feel for yourself what you’re trying to achieve with the pelvic floor exercises. If you have any trouble with them and it is suitable, we can provide you with an internal device that can either stimulate the muscles for you or provide you with biofeedback on how successfully you are doing the exercises. We can arrange for you to trial one of these devices.

If strengthening the pelvic floor is not an option or does not help we can advise you on alternative approaches and refer you to a specialist who can provide you with a suitable pessary or discuss your surgical options.

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