Urinary incontinence (leaking urine) can affect up to 1 in 3 women/people at some point in their life.  Symptoms can be distressing and affect your quality of life. On average it can take up to 10 years to seek help.  Adverts on TV show smiling women wearing incontinence pads promote the idea that is a normal part of ageing or a to-be-expected result of pregnancy and child birth – it's not!  But it is common and you can get help.

 

Urinary incontinence can be split into different groups:

• Stress incontinence (leaking when you cough, sneeze, jump, laugh) is the most common, and accounts for over half of reported urinary leaking.

• Urge incontinence (leaking when you need to go to the toilet or for example when you put the key in the door or hear running water)

• Mixed incontinence (a combination of the 2 above)

 

How can we at Sunnydale physiotherapy help?

• research shows that pelvic health physiotherapy can help improve or cure symptoms in over 70% of women/people

• clinical guidelines recommend 3 months of supervised pelvic health physiotherapy as a first line of treatment.

• pelvic health physiotherapy treatment for urinary incontinence is suitable for women/people of all ages, not just (as is often thought) in the immediate postnatal period.

 

What to expect in your assessment/treatment?

• diagnosis of the type of incontinence you are experiencing

• pelvic floor function assessment (vaginal examination if appropriate and appropriate consent gained see consent section)

• bladder function assessment

• identifying other contributing factors:

  • other pelvic health dysfunction (e.g. prolapse, pelvic pain)

  • lifestyle (work, exercise, home/care commitments)

  • other medical conditions (including previous urogynaecological conditions)

  • menopause/menstrual cycle

• we then provide you with a clear treatment plan with email/WhatsApp support along the way.

Pelvic organ prolapse (or vaginal prolapse) is where the vaginal wall either at the front (bladder prolapse, previously called cystocele), back (bowel prolapse previously called rectocele) or top (vaginal vault or uterine prolapse) moves downwards causing a bulging, heaviness or discomfort in the vagina.  A prolapse can be quite mild or large and can vary from intermittent symptoms (good days and bad days) to affecting your quality of life.  

 

Prolapse can happen to any woman/person even if you haven’t had children.  It is however common post vaginal delivery, 1 in 2 women/people post partum have some degree of prolapse.  Other risk factors can be ageing (particularly peri/post menopause), genetics, obesity, along with some occupations/activities.

 

Common symptoms of pelvic organ prolapse are:

• heaviness/dragging/discomfort in the vagina (sometimes a feeling of something e.g. a tampon inside the vagina)

• urinary leakage

• difficulty fully emptying your bladder, or increase/decrease in the number of times you empty your bladder

• difficulty fully emptying your bowel

• discomfort during penetrative intercourse 

• back pain

• pelvic pain

 

How can we at Sunnydale physiotherapy help?

• clinical guidelines recommend pelvic health physiotherapy as the first line of treatment for women/people with mild to moderate pelvic organ prolapse.

  • to improve symptoms and quality of life

  • to change the severity of the prolapse in some people

 

What to expect in your assessment/treatment?

• vaginal and pelvic floor examination (if appropriate, and gained appropriate consent (see consent section)

• bladder/bowel functional assessment

• identifying other contributing factors:

  • other pelvic health dysfunction (e.g. incontinence, pelvic pain)

  • lifestyle (work, exercise, home/care commitments)

  • other medical conditions (including previous urogynaecological conditions) menopause/menstrual cycle

• we then provide you with a clear treatment plan with email/WhatsApp support along the way.

Tummy muscle separation or diastasis recti abdominis (DRA/DRAM) is typically associated with pregnancy or postnatally, however it can affect anyone, including men.  It’s when the 2 sides of the rectus abdominus (the 6 pack muscles) move apart as the muscles stretch to accommodate a growing baby, or have repetitive overload.

 

Common symptoms:

• doming or tenting of the tummy during loading e.g. sitting up, turning in bed

• a visible gap or feeling of a gap in your tummy

• lower back pain

• can be accompanied by symptoms of prolapse or incontinence.

 

How can we at Sunnydale physiotherapy help?

We can help you to reduce the gap change the appearance, together with reducing the pain you may experience

 

What to expect in your assessment/treatment?

• We will assess your tummy during active tasks and feel your tummy to assess for any gap/separation in your tummy muscles.

• We will teach you how to activate your core muscles safely and work on a graded program to improve your core strength and tension.

• We will identify and address any other factors influencing your tummy separation e.g. other pelvic health dysfunction (e.g. incontinence, pelvic pain) lifestyle (work, exercise, home/care commitments) other medical conditions (including previous urogynaecological conditions)

This is defined as pain in the structures related to the pelvis.  For pregnancy related pelvic pain, see the dedicated section below

 

Symptoms include:

• vaginismus (involuntary spasm of the vaginal muscles on penetration, can sometimes be painful)

• dyspareunia (painful sex)

• vulvodynia (pain in the vulva region)

• bladder pain syndrome (pain in the bladder region often related to bladder filling, and combined with increased urinary frequency)

• dysmenorrhoea (pain with menstruation)

• coccydynia (pain in the coccyx region)

• pelvic pain relating to chronic conditions such as endometriosis

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How can we at Sunnydale physiotherapy help?

Often people with pelvic pain have seen many healthcare practitioners and are unaware that pelvic health physiotherapy is an option.  We aim to manage your pain holistically, no two people are the same, and that goes for your treatment as well.  We look at you as an individual, working together to understand what is driving your symptoms and the best approach to give you back control.  We will use a combination of the following to achieve long lasting results:

• manual therapy (soft tissue release, joint mobilisations)

• movement (whether that be stretching/relaxation/strength)

• breath (as strange as it sounds, breath mechanics can play a vital role in pain management)

• acupuncture

• pain science education (understanding how pain works can give you control over it)

• lifestyle (working out what in your lifestyle may be affecting your symptoms)

Are you struggling to get back to exercise? Experiencing changes in your bladder or bowels? Just not feeling right? Or just needing reassurance that you are ready to return to activity this is the assessment for you.

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A Mummy MOT is a specialist postnatal examination for women following both vaginal and C-section deliveries (any time 6 weeks after birth).  We will provide you with gentle exercises and treatment to help with your recovery; getting you back on track with your goals.

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www.mummymot.com 

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What is included:

• postural and functional assessment

• pelvic floor function check

• bladder, bowel and sexual dysfunction assessment

• abdominal separation assessment

• c-section scar check (if appropriate)

• written report of findings and recommendations for exercises/actions

There can be many effects on our bodies during the peri menopause (the period of transition to menopause) and menopause (12 months following your last period and beyond).  These include musculoskeletal and genitourinary symptoms:

• joint aches and pains

• loss of muscles mass and reduced flexibility

• increased risk of osteoporosis

• increased risk of prolapse, and incontinence

• pelvic pain or pain during intercourse

• vaginal dryness/irritation

• recurrent UTI/infections

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Here at Sunnydale Physiotherapy we can help you make sense of the changes happening to your body and provide expert advice and guidance to support you in improving your symptoms.

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What is included:

• a check of your medical history and bladder, bowel and sexual function screen

• a full postural and functional assessment as well as an exercise and activity review to provide you with the best advice for the right activities for you now and in the future.

• a pelvic floor and core function check 

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Pain during pregnancy can be common.  It may flare up a pre-existing condition (e.g. hyper mobility, arthritis, or an old injury), or the onset of new pain (e.g. lower back pain, pelvic girdle pain, hip pain, rib pain, carpal tunnel syndrome).

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At Sunnydale Physiotherapy we are specially trained to identify underlying causes for your pain and provide treatment and advice to support you at any stage during your pregnancy.

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Treatment may include:

• manual therapy: soft tissue massage/release, joint mobilisations

• exercises e.g. for flexibility, safe core strength, as well as guidance on general exercise during and after pregnancy

• acupuncture (precautions are taken by avoiding contraindicated points during pregnancy, acupuncture is safe to use during pregnancy).

• advice on activity modifications

• advice on birthing positions and preparing for labour

We are experienced in supporting women recovering from gynaecological surgery including:

• hysterectomy (laparoscopic/abdominal)

• prolapse repair

• autologous sling (for urinary incontinence)

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We can provide the reassurance and guidance that you need to support you in your recovery, getting you back to doing the things you love.

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Assessment and treatment may include:

• screening and problem solving bladder/bowel/sexual dysfunction

• posture and functional movement assessment

• advice on returning to exercise/activity now and in the future

• pelvic floor and core function check