Pelvic Floor & Musculoskeletal Physiotherapy

The pelvic floor is a muscular and fascial support sling in the base of the pelvis. These tissues help to provide the continence mechanism by closing off the urethra (i.e wee tube) and anus (i.e rectum) as well as provide additional support to the pelvic organs (the bladder, bowel and uterus). The pelvic floor muscles also form part of your core muscles, along with your diaphragm, deep tummy muscles and the deep spinal muscles. 

When there is an imbalance or weakness in these tissues, pelvic floor dysfunction can occur. Pelvic floor physiotherapy works to treat any imbalances in the pelvis (both externally and internally if indicated) and is suitable for all life stages.

Click on the arrows below for more information.

Includes pre/post natal care, peri-menopause and menopause, bladder dysfunction, bowel dysfunction, pelvic organ prolapse, pelvic pain, sexual dysfunction and exercise rehab. Click on the arrows below for more information on each of these services.

Research shows that pregnant women should undertake supervised pelvic floor muscle training throughout their pregnancy however clinically we see many women do not know how to correctly contract and relax these muscles. In a pregnancy physiotherapy appointment, we can assess these muscles and teach you how to strengthen them correctly.

Regardless of whether you have any unwanted symptoms, prenatal pelvic floor physiotherapy focuses on prevention of symptoms of pelvic floor dysfunction, preparation for birth and recovery during the early postnatal stages (i.e the fourth trimester).

Physiotherapy can also help manage common complaints in pregnancy including:

• Pelvic Floor symptoms such as leakage, constipation, pelvic pain and vulvar varicosities

• Pelvic Girdle Pain and ‘lightening crotch’

• Low Back Pain

• Hip Pain

• Diastasis Recti ‘abdominal separation’

• Rib Pain

• Carpal Tunnel Syndrome

• Exercise Guidelines in Pregnancy

• Birth Preparation

• Caesarean sections preparation and recovery

• Preparation for the Postpartum period

If you have any concerns we recommend booking an appointment as soon as you are able. If you do not have any concerns and would like a general pregnancy assessment, we recommend this appointment from the start of your second trimester (i.e after your 13/40 scan).

Postnatal physiotherapy includes a comprehensive assessment and management plan to facilitate your recovery, reduce any symptoms of pain or pelvic floor dysfunction and allow a safe return to exercise after having your baby.

Conditions/concerns include:

• Pelvic Floor symptoms such as bladder and bowel leakage, urgency, prolapse symptoms, return to intimacy, perineum pain

• Diastasis Recti i.e ‘abdominal separation’ and ‘weak core’

• Breastfeeding concerns

• Return to exercise in the postpartum stages

• Return to running and high intensity training guidelines

• Postural related pain such as neck pain, shoulder pain

• Hand and wrist issues such as ‘mummy’s thumb’

Recommended appointments:

• If you have any pelvic health concerns in the postnatal period, we recommend booking an appointment as soon as you are able. If you do not have any current concerns we recommend a review at 3-6 postnatal.

• If you are specifically seeking a pelvic floor assessment please book this for 6 weeks postnatal.

• If you would like to attend for return to exercise, core strengthening, abdominal separation and doming (DRAM) management, or back/hip/pelvic pain, please book this appointment from 3-4 weeks postnatal.

• Great than 3 months postnatal? Don’t worry, it is never too late for a postnatal check!

Persistent pelvic pain or female pelvic pain commonly affects the pelvic region, ranging anywhere between the navel and the thighs. It might follow a quite consistent pattern such as cyclical pain (i.e ovulation pain, period pain) and pain with intimacy or it might be quite unpredictable and debilitating.

Regardless of how your symptoms manifest, at Flow Pelvic Physio we understand how distressing pelvic pain can be and strongly believe that no woman should have to put up with such symptoms.

We hold a supportive, non-judgemental space where you can feel comfortable to address your concerns and get a clear management plan. Where appropriate, we will work closely with the rest of your health care team to facilitate holistic, person centred care.

Conditions we can assist with include;

• Sexual pain

• Vaginismus

• Vulvodynia

• Vaginal dryness

• Endometriosis

• PCOS

• Painful periods

• Pain related to symptoms of perimenopause and menopause

• Bladder pain syndrome/interstitial cystitis

• Coccydynia (tailbone pain)

Pelvic organ prolapse or ‘POP’ occurs when one or more of the pelvic organs sits low in the pelvis, often creating a sensation of bulging, dragging or heaviness. POP can be graded by the vaginal wall that is most affected;

• Anterior wall/bladder POP (previously cystocele)

• Posterior wall/rectum POP (previously rectocele)

• Apical/Vault POP (previously uterine)

Symptoms may include:

• Vaginal heaviness or feeling of something slipping down in the vagina

• Dragging sensation

• Low back pain

• Difficulty emptying your bladder

• Difficulty emptying your bowel

Treatment may include;

• Pelvic floor muscle training

• Global strengthening

• Activity modification

• Vaginal support pessary

• In more severe cases surgery may be indicated which would involve a specialist referral

If you are experiencing symptoms of POP the team at Flow Pelvic Physio will provide you with an individualised management plan to help you to improve your symptoms and get you back to doing the things you love, without fear of worsening your symptoms.

Bladder dysfunction such as leakage, is a common but not normal complaint. Symptoms of bladder dysfunction include;

• Urinary incontinence (stress and urge)

• Urinary urgency (sudden sensation that you are busting)

• Overactive bladder

• Bladder pain syndrome/interstitial cystitis

• Incomplete emptying/difficulty emptying

• Nocturia (frequent urination overnight)

• Post Void Dribble

• Dysuria (painful emptying)

• Nocturnal enuresis (bed wetting)

• Bladder concerns related to perimenopause and menopause

If you are experiencing symptoms of bladder dysfunction, the team at Flow Pelvic Physio will provide you with a specific management plan to help you to improve your bladder habits and function. We hold a supportive, non-judgemental space where you can feel comfortable to address your concerns. Management may include pelvic floor muscle training, bladder training, urge deferral strategies, bladder emptying techniques and bowel management strategies.

Bowel dysfunction can be a very personal and at times embarrassing concern which, more often than not, is not openly spoken about.

Symptoms of bowel dysfunction include;

• Faecal incontinence

• Faecal urgency

• Faecal smearing

• Uncontrolled flatus (wind)

• Difficulty or painful emptying including constipation

• Haemorrhoids & anal fissures

• Obstetric Anal Sphincter Injuries (OASI)

If you are experiencing symptoms of bowel dysfunction, the team at Flow Pelvic Physio will provide you with a specific management plan to help you to improve your bowel habits and function. We hold a supportive, non-judgemental space where you can feel comfortable to address your concerns.

Pelvic floor muscle dysfunction including urinary frequency, urinary urgency and incontinence, pelvic pain

Common conditions we manage include:

• Neck pain

• Upper back, shoulder and rib pain

• Low back pain

• Hip pain

• Pelvic Girdle Pain

• Hand and wrist complaints

• Carpal tunnel, dequervains ‘mothers thumb’

• Individualised home exercise programs