Pelvic floor health is vital for maintaining a full and active life. People can be affected by pelvic floor concerns at any stage of life, however it is commonly experienced by women when pregnant, antenatally and then again during/after menopause. Lara is trained in pelvic floor internal examination and treatment and uses a non-intimidating approach to her sessions. Pelvic floor issues are common, however many people do not need to suffer with symptoms such as:
- Leakage with coughing, sneezing, laughing
- Leakage with exercise such as jumping, squatting, running.
- Things “just not feeling right” or “feeling a bit lower/heavier/bulgey” post childbirth.
- Uncertainty on how to activate or relax their pelvic floor muscles.
- Wanting advice on readiness to return to exercise post childbirth and guidance on how to do so.
- Suddenly beginning to leak in middle age after never doing so previously.
- Pain from penetration either sexually or for using tampons etc.
- Chronic lower abdominal pain, common in people with endometriosis.
- Preparation for birth with those who feel their pelvic floor is “a bit tight”.
More information on the prevalence and types of pelvic floor issues are found in this fantastic TED talk below:
What is a pelvic floor muscle squeeze or kegel exercise?
Our pelvic floor muscles are the lowest muscles in our pelvis or “the floor”. They help to support the pelvic organs (bladder, bowel and sexual organs). When we squeeze these muscles, we are lifting these organs up towards our head. These muscles also help to close off some of the openings we have in our pelvis; such as the urethra and rectum. It is important for our health and the control of bladder, bowel and sexual function, that we know how to squeeze and relax these muscles.
What is Vaginismus?
Vaginismus is tightening of the connective and muscular tissue surrounding the vaginal canal. When this tissue is too restrictive, it becomes increasingly difficult/impossible to get anything inside the vagina e.g. fingers, tampons, a speculum for vaginal examination. Pelvic floor physio is one of the major treatments for this condition.
What is Vulvodynia?
Vulvodynia is pain around the vulval area from an unknown cause (e.g. not due to injury, dermal conditions or cancer). Vulvodynia is caused by “excessive neural activity” e.g. the nerves are relaying too many messages about the vulva back to the brain. Vulvodynia can be constant or in response to a stimulus (e.g. tight clothing, washing yourself etc.). Pelvic floor physio is useful to help the nerves to learn how to correctly fire information back to the brain.
What is Vestibulodynia?
Vestibulodynia is similar to vulvodynia, except that the area of pain is concentrated in the vaginal skin closest to the vaginal entrance and on the very inside of the labia minora.
How do pelvic floor physiotherapists assist with endometriosis pain?
Physiotherapists cannot change the pain from endometriosis itself, however we can help with managing some of the side-effects endometriosis can have on your bladder, bowel and pelvic floor muscles. This may include treating overactive pelvic floor muscles, helping to teach you techniques to ease pain and difficulty passing bowel motions etc, reducing pains when being intimate, explaining some of the confusion around endometriosis, treatment options and how it is individually affecting your body.
What does an internal examination involve if I need one?
Pelvic Floor Physio’s are trained to do internal vaginal examinations when required. An internal examination involves visualising the vulval area, inserting a gloved finger or tool into the vagina and asking the patient to do a series of squeezes/bearing down/coughing etc., throughout this process we are feeling for the integrity of the connective tissue in the pelvis as well as the quality of muscle movement. This gives us invaluable information to assist us to diagnose pelvic organ prolapse, pelvic floor muscle tightness/weakness or reduced muscle coordination. From here, we are able to give you a specialised treatment protocol tailored to your needs. Whatever we find will be explained to you in full following the assessment. Your comfort is always 100% of our focus, therefore you are in total control throughout the assessment and are able to ask us to stop, have a break, try again next time, whatever you need to feel comfortable throughout. Our physio will talk to you throughout the assessment to constantly monitor how you feel.