Reading and Tilehurst's Physiotherapy, Spinal, Sports and Pelvic Specialists

 

Tilehurst Clinic4 Chapel Hill, RG31 5DG
Reading Clinic Sports Park, University of Reading, RG6 6UR

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0118 9310053

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email: info@corebodyclinic.co.uk

 

 

Men's & Women's Health Physiotherapy

Pelvic Girdle Pain

Pelvic Girdle Pain is a generic term to describe pain in the pelvis.  It is common to see this term used when talking about women who are pregnant. 

 

If we talk first about pelvic girdle pain during pregnancy.  To read about other conditions related to Pelvic Pain that are not pregnancy related please click here and for any pelvic pain or prostatitis related to men, please click here

 

 

 

When a women is pregnant, the hormone relaxin is secreted to allow ligaments to soften and enable the sacoiliac bones to move. The body is preparing for the growing baby and the eventual delivery.  For the baby to enter and exit from the birth canal the pelvis must move and as the baby grows the natural weight of the baby moves the pelvis.  During birth there is additional movement and the bones rotate to allow the baby to exit.  This phenomenal process is largely pain free.  It is the ONLY time the pelvis moves under normal circumstances.  There can be trauma caused to the pelvic girdle.  However, the bones rarely move.  

The sacroiliac joint (SIJ) is composed of 3 main bones: Sacrum and 2 iliac bones.  To the front of the pelvic is the symphysis pubis and during pregnancy women can suffer from symphysis pubis dysfunction (SPD).  PGP and  SPD are often used interchangeably when referring to pain in the pelvis.  Pain during pregnancy is common and rarely anything related to the progress of your pregnancy.  PGP and SPD is very common.  Should you be feeling pain in the lower abdomen and your baby is moving we would still recommend an examination by your GP and Midwife before seeing a physiotherapy specialist. 

Keeping the muscles strong and active during pregnancy is essential.  The muscles are key to maintaining a strong pelvic supportive ring drawing in the pelvic bones and compensating for the slight loss in pelvic ring stability.  Pain causes the muscles to spasm and inhibit.  Movement is therefore painful, uncoordinated and patients become incapacitated. 

 

 

We find that women present with specific features when asking for help with PGP:

  • Pain at the front of the pelvis (Lower abdomen and under the baby bump)
  • Pain in the inner thighs and up into  the pelvis and sometimes genitalia
  • Pain in the lower back
  • Pain in the SIJ themselves
  • Pain in the buttocks
  • Pain inside the pelvis

 

Pain is often felt with:

  • Rolling in bed
  • Sit to stand
  • Sudden movements
  • Walking and weight bearing through the legs

 

What can a physiotherapist or sports therapist do to help?

  • Use gentle pain releiving manipulation      
  • Apply a supportive belt
  • Use massage techniques
  • Use exercise therapy to engage the pelvic muscles.  
  • Teach and evaluate the pelvic floor muscles and reduce the liklihood of continence problems. 

 

Physiotherapy techniques are among the safest to use during pregnancy and physiotherapists are certified to look after pregnant women.  Massage is especially helpful for these patients 

Male Pelvic Pain & Men's Health Physiotherapy

Male Pelvic pain and Men’s Health physiotherapy is a specialist branch of physiotherapy that deals with male pelvic pain (chronic prostatitis) and pelvic organ dysfunction.  At Core Body Clinic we are trained both in musculoskeletal physiotherapy, chronic pelvic pain therapy and men’s health physiotherapy combining a unique skill set to comprehensively assess and diagnose problems affecting the pelvis.

Hard Flaccid

Hard Flaccid Syndrome is a condition affecting the penis and is of unknown aetiology among men.  However, hard flaccid syndrome is believed to be more prevalent between the ages of 18 and 35.  It is characterised by a change in penis size, shape and feel.  Penile stiffness or swelling when the penis is in a flaccid state and flaccid size is a common characteristic.  The penis is sometimes firmer to the touch, it is engorged and rubber in texture, and is often accompanied by a change in size or shape of erection.  There may be a loss in nocturnal erections, and it may require a greater degree of stimulation to achieve an erection.  There is often a loss in libido and a shattering of confidence.  However, the most common reason for someone seeking help when suffering from hard flaccid is because of alarming changes in penile shape and size.  Patients often self-diagnose hard flaccid from reading online forums.  It is different from peyronnie’s disease because there are no visible signs of tissue scarring and plaque formation. Nevertheless, hard flaccid is a distressing and poorly understood condition.  At Core Body clinic, our pelvic physiotherapists are experts in the treatment of Hard Flaccid syndrome. 

Chronic Prostatitis and Chronic Pelvic Pain Syndrome (CPPS)

Chronic Prostatitis (or prostatitis 3b) or Chronic Pelvic Pain Syndome (CPPS) are often considered synonymous where pain in the pelvis is of a persistent nature.  

In Prostatitis, there is often as an infection affecting the prostate gland.  However, only about 5-10% are actually bacteria related with the vast majority related to inflammation or non-specific pain syndromes. Prostatitis can affect all men at any age and accounts for about ¼ of all pelvic pain conditions, genital or urinary conditions in young to middle aged men.  Where pain persists after a period of time and after medicine has failed to resolve pain, by process of elimination, CPPS or Chronic Prostatitis type 3b is a diagnosis often assigned.   

Incontinence

Our pelvic therapists at Core Body Clinic are experts in treating Incontinence. We understand it and we really care about helping you.   

Erectile Dysfunction and Physiotherapy

Erectile dysfunction is a deeply personal and distressing problem that describes a condition where an erection is either not possible or is not sufficient for the desired task of sexual activity.  It is a condition that can have multiple causes and therefore you must discuss it with the GP. 

 

They will look for all medical reasons for this problem and advise you accordingly, conducting tests where necessary.  We know that smoking, alcohol, a poor diet and lack of exercise can have an impact (for some) on erectile function.  Physiotherapy can be very helpful where the pelvic floor is implicated.  We can also advise on exercise, diet and general wellbeing.   

Diastasis Recti

Diastasis Recti - This is a term describing the separation of the abdominal muscles. The abdominal muscles consist of the rectus abdominus, the deeper transversus abdominus, and then the internal and external oblique muscles.

Prostate Cancer: Physiotherapy and Rehabilitation

Prostate Cancer touches one in eight men and many opt for surgery to the remove the prostate (radical prostatectomy).  Other treatments include hormone therapy, radiotherapy and in some instances chemotherapy.  It largely depends on the stage and grade of cancer.  It is accepted that if we live long enough all men will develop prostate cancer cells (you might have to live to 180!).  However, they are slow growing and often people die of other causes before the cancer is diagnosed.  Radical surgery has a 15 year survival rate of almost 90%.  The effects of having surgery can leave a man suffereing incontinence and erectile dysfunction.  

Women's Health Physiotherapy

What is Women’s Health physiotherapy and how can it help me?

Women's Health Physiotherapy is a specialist branch of physiotherapy where the physiotherapist has undergone specialist training and competencies in pelvic anatomy, pathology, diagnosis and treatment. They are trained to assess and treat women suffering from pelvic floor weakness, problems with bowel and bladder, pain in the pelvis and women who have had a baby or who are pregnant and having problems.  At Core Body Clinic our physiotherapists are dual trained in musculoskeletal physiotherapy and Women's Health Physiotherapy.  They have a detailed understanding of pelvic anatomy and pelvic floor function and they are skilled in many techniques to treat pain and rehabilitate function. 

Pudendal Neuralgia

 

Pudendal Neuralgia can affect both women and men.  It is not a common condition, though patients often present with the diagnosis.  The pudendal nerve is a major nerve (like the sciatic nerve) arising from the sacral plexus.  It is an important nerve for differential diagnosis in cases of CPP (Chronic pelvic pain). The difference between pain arising from somatic structures (muscle, bladder, bowel etc) are that they are often achey or deep.  Nerve pain is different and will behave in a manner where manifestations of lancinating, sharp, throbbing or stabbing sensations are experienced. This is what we call neuropathic pain.  Pain is often felt along the pathway of the nerve.  However, it is not a common diagnosis and is often over diagnosed. 

Sporting Pelvis and Groin Pain

Troubling groin or hip pain, unresolved by medical and surgical intervention, can be helped by evaluating the function of the pelvic girdle.  Our Sports Pelvis service is specifically designed to consider the sporting population with the pelvic girdle in mind.  With a background in elite football, we are all too familiar with niggling groin strains, unnecessary surgical procedures and post-surgical complications or pain that can ruin an athlete’s career.