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Women’s Health Physiotherapy in Norwich

Women’s Health Physiotherapy, or pelvic, obstetric and gynaecological physiotherapy, is the treatment of all disorders and problems related to the pelvis area, the pelvic floor and within the OB-GYN sphere.

DabbourPhysio can offer help with bowel and bladder problems, all forms of pelvic pain as well as antenatal and postnatal problems.

Bladder and Bowel

Bladder and bowel problems are a present in men, women and children of all ages. It is also a common occurrence, with at least 1 in 10 being affected at some point throughout their life.

Physiotherapy treatment can help effectively treat and manage a wide variety of problems related the bladder and bowel, such as:

Bladder weakness

  • Symptoms include increased urgency, frequency, waking up in the middle of the night (nocturia) and urge incontinence.
  • Treatments include pelvic floor muscle training, bladder training and advice/education on how to manage and prevent the issue.

Stress urinary incontinence and urinary retention

  • Symptoms include urine leakage when coughing, sneezing, laughing, standing up, getting in and out of a car or similar, lifting heavy, exercise or when having sex.
  • Treatments include pelvic floor muscle training, bladder training and advice/education on how to manage and reduce the problem.

Urge urinary incontinence

  • Symptoms include increased urgency and frequency of needing to use the toilet as well as not managing to make it to the bathroom in time.
  • Treatments include pelvic floor muscle training, bladder training and advice/education on how to manage and prevent the issue.

Menopause related bladder and bowel problems

  • Symptoms include stress and urge incontinence, noctoria, pain on urination as well as possible bowel urgency.
  • Treatment includes bladder and bowel training, exercise programmes and advice/education on how to manage and prevent the issue.

Bowel urgency

  • Symptoms include a sudden need to have a bowel movement or the inability to hold stool during the bowel urgency. Pain when excreting stool or during general bowel movements can also be a symptom.
  • Treatments usually focus on bowel training helping to strengthen muscles involved in bowel movements such as the pelvic floor muscles, the abdominal muscles and the anal sphincter. This can be done using exercise programmes and advice/education on how to manage and prevent the issue.

Faecal Incontinence

  • Symptoms include the inability to hold stool with or without urgency as well as leakage during daily activities.
  • Treatments include bowel training to strengthen muscles involved in bowel movements such as the pelvic floor muscles, the abdominal muscles and the anal sphincter. This can be done using exercise programmes and advice/education on how to manage and prevent the issue.

Defecation dyssynergia (Anismus)

  • Symptoms include problems to pass faecal material, including excessive straining when defecating. Other symptoms could be tenesmus (a feeling of incompleteness when passing stool) or a feeling of obstruction and/or blockage after visiting the bathroom.
  • Treatments include advice on aggravating factors, defecation management, training programmes such as related to toilet diaries and effective straining methods.

Prolapse

  • Symptoms include vaginal bulging, aching or heaviness leading to problems emptying bower or bladder. Various forms of incontinence may also be caused by a prolapse.
  • Treatments include a supervised pelvic floor muscle training programme, lifestyle advice and modifications, exercise prescription or the use of a vaginal pessary.

Pelvic Pain

Pelvic pain can be caused by dysfunction in your pelvic joints (e.g. sacroiliac or pubic symphysis) or due to the muscles on the inside or your pelvis such as your pelvic floor muscles.

Women’s Health physiotherapy can help with the assessment and management of a wide variety of such problems.

This includes:

Pelvic Girdle Pain (PGP)

  • PGP can include sacroiliac pain, pubic symphysis pain, coccyx pain or a combination or any of these. Symptoms include pain in the lower back, the ground area, front and back or the thighs, back of lower leg, around your hips as well as any pain around your pelvic floor and around the vagina, perineum or anus.
  • Treatments include advice and education on the management and rehabilitation of the pain as well as exercises and training programmes focused on strengthening the muscles helping to improve the stability of your pelvic and back. Physiotherapy treatment can also include the use of equipment such as pelvic support belts or massage and gentle manipulation of the relevant areas.

Internal Pelvic Pain (such as during sex, pain using tampons etc.)

  • Causes of internal pelvic pain that physiotherapists are trained to diagnose include overactive pelvic floor muscles, vulvodynia, vaginismus, hormonal changes and skin irritation.
  • Treatments include advice/education on how to manage and prevent the issue as well as training of the pelvic floor muscles. It can also include manual therapy to help relax the pelvic floor muscles as well as trigger point release, myo-fascial stretches and scar massage.

Vulvodynia

  • Symptoms include any combination of burning, stinging, aching or throbbing sensations as well as soreness and itching. It is often triggered by touch, such as during sex or when using tampons or other similar products. It can be located in both smaller parts of the vulva such as the opening to the vagina or be more generalised in the region, including pain in the inner thighs and surrounding areas.
  • Treatments include pelvic floor exercises, muscle relaxing techniques or use of vaginal trainers.

Endometriosis

  • Endometriosis has a wide variety of symptoms, with the most common being painful and/or heavy periods as well as pain in the lower abdomen, pelvic or lower back. Other symptoms include pain during and after intercourse, bleeding between periods, exhaustion and tiredness or discomfort during bladder and bower movements.
  • Treatments include pelvic floor training and exercise programmes, advice and education around sexual intimacy with endometriosis, diagnosis of other related problems contributing to pain. Physiotherapy can also help by treating connective tissue dysfunction, using myofascial trigger points and treating hypertonus within the pelvic floor.

Dysmenorrhoea (painful periods)

  • The classical symptom of dysmenorrhoea is cramp and abdominal pain, sometimes spreading to the lower back and thighs, before or during the early part of your period. Other symptoms include tiredness, nausea and vomiting, diarrhoea, back pain, headaches and bloating. Dysmenorrhoea may also present as heavy and/or irregular periods, bleeding in between periods and vaginal discharge.
  • Physiotherapy treatments include advice/education on how to manage and prevent the pain as well as training of the pelvic floor muscles. General exercise prescriptions have also been found to help with dysmenorrhoea.

Sexual Pain (Dyspareunia)

  • Symptoms include pain at sexual penetration or simply at any penetration of the vagina (tampons, birth control etc) or the sudden onset of pain after previously pain-free sex. It can also present as a deep and heavy pain during thrusting, general throbbing, burning or aching that remains after intercourse.
  • Patients with dyspareunia often present with musculoskeletal issues that can be helped by physiotherapy. Treatments include advice/education on intercourse and sexual activity in addition to training of the pelvic floor muscles. It can also include manual therapy to help relax the pelvic floor muscles as well as trigger point release, myo-fascial stretches and scar massage.

Overactive pelvic floor muscles

  • Overactive pelvic floor muscles can be a contributing cause to a number of pelvic pain related disorders. Symptoms can include external and internal pain of various forms, as well as sensitivity of general or specific regions of the pelvis.
  • Treatment includes training of the pelvic floor as well as advice and education on how to control the muscles. Manual therapy can also be used as well as other relaxation techniques focuses on the pelvis.

Prolapse

  • Symptoms include vaginal bulging, aching or heaviness leading to pelvic pain. Various forms of co-complexities causing pelvic pain may also be caused by a prolapse.
  • Treatments include a supervised pelvic floor muscle training programme, lifestyle advice and modifications, exercise prescription or the use of a vaginal pessary.

Antenatal and Postnatal

During the antenatal and postnatal period the body undergoes a significant amount of musculoskeletal and hormonal changes.

These changes can affect the body by weakening and stretching the abdominal, back and pelvic floor muscles. This results in an increased risk of joint and ligament injuries within the body or suffering from general pain and dysfunction. Physiotherapy can help with a number of issues related to the antenatal and postnatal periods.

Common conditions treated include:

Pregnant with Pelvic Girdle Pain (sacroiliac pain, pubic symphysis pain, coccyx pain)

  • PGP can include sacroiliac pain, pubic symphysis pain, coccyx pain or a combination or any of these. Symptoms include pain in the lower back, the ground area, front and back or the thighs, back of lower leg, around your hips as well as any pain around your pelvic floor and around the vagina, perineum or anus.
  • Treatments include advice and education on the management and rehabilitation of the pain as well as exercises and training programmes focused on strengthening the muscles helping to improve the stability of your pelvic and back. Physiotherapy treatment can also include the use of equipment such as pelvic support belts or massage and gentle manipulation of the relevant areas.

Postnatal treatment for tears, scars and C-sections

  • Physiotherapy can help manage and rehabilitate any pain caused by tears or scars from the birth such as from a C-section (Caesarean) or episiotomy. Physiotherapy can also help with advice and education on how to minimise scar tissue and ensure the best possible healing from tears and incisions.

Postnatal spinal problems

  • Post-pregnancy many women can suffer from pain in the spinal area. Women’s Health Physiotherapists are trained to diagnose and treat any issues related to this as well as any musculoskeletal lower back pain.
  • Treatments include advice and education on the management and rehabilitation of the problem as well as exercises and training programmes focused on strengthening the muscles helping to improve the stability of your back.

Return to exercise and normal activity

  • Physiotherapy can help to ensure that you are perfectly placed to return to exercise and other daily activities after your pregnancy. Physiotherapy can help to minimise the risk of common problems caused by too early return such as prolapse, back pain and injuries due to weak abdominal and pelvic floor muscles.
  • DabbourPhysio is particularly well-placed to help if you wish to return to high-level activities with its extensive experience in strength and conditioning training of antenatal and postnatal women.

Weak abdominal and pelvic floor muscles

  • Treatment includes a personalised training programme designed to help improve any weakness in your core and pelvis due to the pregnancy. The exercise prescription can also be adjusted towards your goals and your preferred activities, allowing you to incorporate your treatment into your daily life.

Pelvic Pain (vulvodynia, endometriosis, dysmenorrhoea etc.)

  • Causes of internal pelvic pain that physiotherapists are trained to diagnose include overactive pelvic floor muscles, vulvodynia, endometriosis, vaginismus, dyspareunia, hormonal changes and skin irritation.
  • Depending on your type of pelvic pain, there are a large variety of treatments. This can include advice/education on how to manage and prevent the pain as well as exercise programmes and manual therapy. It can also include manual therapy to help relax the pelvic floor muscles as well as trigger point release, myofascial stretches and scar massage.

Sexual Pain (Dyspareunia)

  • Symptoms include pain at sexual penetration or simply at any penetration of the vagina (tampons, birth control etc) or the sudden onset of pain after previously pain-free sex. It can also present as a deep and heavy pain during thrusting, general throbbing, burning or aching that remains after intercourse.
  • Patients with dyspareunia often present with musculoskeletal issues that can be helped by physiotherapy. Treatments include advice/education on intercourse and sexual activity in addition to training of the pelvic floor muscles. It can also include manual therapy to help relax the pelvic floor muscles as well as trigger point release, myofascial stretches and scar massage.

Stomach Recovery

  • During pregnancy, your rectus abdominis muscle may separate as your baby grows. This muscle is in the midline of your stomach and has a major role in providing stability to your lower back and your core.
  • Separation of the rectus abdominis heals normally during the first three to four months postnatal. After this period, progressive abdominal exercises are required to help ensure the muscle regains its strength and will be able to help prevent you having an increased risk of lower back pain, pelvic floor dysfunction and abdominal hernias.

If you would like to find out more about how I can help you get in touch today.