Welcome to Claire!
Prolapse Incontinence Pain during Sex Pregnancy Difficult Labour Post Gynaecological Surgery
We have a new Physiotherapist joining our Tilehurst Clinic - Welcome to MSK and Specialist Womens Health and Pelvic Physio, Claire Stevens. Claire, who has a post graduate certification in Womens Health Physiotherapy (POGP) joins our female pelvic health therapy team along with Sports Therapist, Rachel, who works at the Reading site. Both clinicians provide a service for treating women suffering from pelvic girdle dysfunction, pain during intercourse, post surgery and have interst in the athletic pelvic floor. Rachel and Claire can treat using trgger point therapy or pelvic massage. Their unique skill set allows them to look at patients in a holistic manner with assessment of both the pelvis and the musculoskeletal system.
Women's health is a branch of healthcare treating problems affecting the pelvic girdle. It is very specialised because of the unique nature of the various problmes affecting the structures inside the pelvis, and the highly sensitive parameters for discussion relating to the bladder, bowel and sexual organs.
sshhhhhh! Dont tell anyone and dont laugh too hard, but 1 in three Women are affected!
EXPERTISE AND KNOWLEDGE
The pelvis has three pain functions for men and women. Bowel function, bladder and reproduction. For women, there is a greater propensity for pelvic girdle pain and dysfunction owing to differences in anatomy and function. Men dont have baby's and the very structure of the pelvic floor makes it inherently stronger in a man. Of course, things can weaken and problems relating to bladder and bowel can occur in men with an incidence accounting for a 1 in 7 (see our Men's Health section for more dtails). For women it is 1 in 3.
What do we treat in Women's Health?
- Difficulty openinng bowels or incontinent of bowels
- Endometriosis and pain associated with this conditon
- Pelvic Pain
- Pain and abdominal cramps during periods
- Pelvic floor weakness
- Pudendal Neuralgia
- Diastasis Recti
- Pregnancy related Pelvic Girdle Pain
- Chronic Pelvic Pain
- Intersitial Cystitis
- Post surgery rehabilitation
- We can also help with pain and discomfort during and after pregnancy. We regularly treat pelvic girdle pain both before and after brith (SPD or symphysis pubis dysfunction now called pelvic girdle pain).
- Seeing a physio can help you reduce the gap in the tummy after having a baby (rectus diastasis) by reducing a weak core and strengthening abdominal muscles.
- Prolapses can happen even when you are not pregnant and our service allows us to assess and in a lot of cases successfully treat the problem with pelvic therapy.
- Nerve pain like Pudendal Neuralgia can occur in the pelvis and requires delicate assessment. It can affect both men and women.
- No one likes to talk about leaking and incontinence. We see many women affected by incontinence and there appears to be a general acceptance that the normal after childbirth is some leakage - its not and in a lot of cases pelvic Physiotherapy can help this. The problem? We dont talk about it and so there is a large scale problem. Imagine leaking when you run or exercise? Some just avoid exercise. Imagine the knock on effect to your general health.
- Here is a comedy yet hard hitting video about pelvic floor physiotherapy - Click VIDEO
What to expect on assessment?
Our pelvic health assessment program uses a comprehensive subjective examination where we will encourage dialogue from the patient to discuss their problem in as much detail as possible. We will use differential questioning to hone in on the possible causes of your problem. The history of any condition as told by the patient reveals much more (in many cases) than any test or examination. Therefore, this phase may take a little time to ensure we get all the important information down on paper. Some questions may be of a sensitive nature considering the nature of the pelvic problem. We will always explain why we need to ask such questions and will use our knowledge of pelvic anatomy and skeletal models/diagrams to help with our explanation.
We may also use a questionnaire which helps to diagnose your problem and also to identify an objective marker so that we can accurately identify progress.
Examination may include the lumbar spine, pelvis, hips and pelvic muscles. If you are pregnant DONT WORRY! the therapist will know exactly how to handle the patient so not to cause worry to the mother and certainly not to bring any harm to the baby. Women’s health and pregnancy physiotherapists are experts in the handling of pregnant women. Your assessment may be very different if you are pregnant and depending how far along you are.
Most of the examination will be external and may include palpation of the abdomen, gluteal and lumbar spine. It may include direct palpation of the perineum or instruction to the patient to palpate their own perineum (saddle region between the anus and scrotum). We may also palpate on the inside of the pelvis. Gaining access requires palpation through the vagina or the anus. This is by no means an absolute necessity but is helpful in the assessment of the pelvic floor. Total understanding and a complete explanation, and only after consent in a written format are any form of internal examinations conducted. Dynamic ultrasound may also be used to visualise the pelvis. Internal examination, while useful, is not tolerated by all patients and is never forced upon a patient.
Once we have completed both phases of the examination we will then formulate an action plan with the patient and begin treatment.
The examination will last at least an hour. In some cases 1hr 30 minutes is necessary.
Muscles can be rehabilitated and retrained and at the Reading Pelvic Health Clinic we are specifically trained to identify pelvic floor dysfunction and apply a bespoke regime of motor control exercises to remedy such dysfunction. Specialised manual therapy techniques for the pelvic floor can be incorporated to reduce muscle sensitivity and facilitate appropriate muscle activation.
Treatment (might include):
· Hands on manual therapy treatment to your low back and pelvis, getting the joints moving correctly
· Trigger point therapy: Getting the muscles working properly and rid of the overactive parts in both the low back muscles, hip muscles and pelvic floor muscles. You will also be taught how to do this yourself. (Please note, only Rachel (our Sports Therapist) carries our trigger therapy)
· Pelvic floor exercises to release your pelvic floor
· Specific hip, spine and pelvis exercises to get you and your pelvic floor moving better, think yoga poses and squatting
· Specialised Breathing and relaxation work
· Re-education of the pelvic floor, hip and abdominal musculature
· General exercise
· Pain management education (essential to understanding WHY the pelvis hurts).
· Advice re sexual and toileting practices
If you want to speak to Claire or Rachel before booking please call or email the clinic
or Call 01189310053