Specific Conditions

 

Incontinence (leakage or urine) is a very common condition especially in women.  You might have heard that one in three women who has given birth will end up with some form of urinary incontinence.  However, incontinence can affect people of all ages and there are several different types of incontinence. The most common type is called Stress Incontinence.  This occurs when there is an increased pressure (such as when exercising, coughing, laughing, sneezing) in the abdominal cavity and the pelvic floor muscles aren’t strong enough to counteract that pressure. 

 

Many women believe that nothing can be done and that they just need to wear a pad and get on with it.   This is simply not the case! Research has shown that around 80% of women can expect significant improvement with pelvic floor physiotherapy.

 

Another common form of urinary leakage is Urge Incontinence. This is when you leak urine associated with an urgent desire to go to the toilet.  This is often associated with triggers such as anxiety, putting the key in the door or running water. Sometimes patients don't actually leak urine, but they suffer with constant urgency and can spend their lives worrying about their bladder.  Frequently people will suffer from both urge and stress incontinence at the same time.

 

 

Prolapse or a “dropping down” of the pelvic organs (the bladder, uterus or bowel) occurs when the ligaments and fascia (connective tissue) supporting them is stretched or damaged.  Women often complain of a heaviness or dragging sensation in their vagina.  Sometimes they have difficulty emptying their bladder or bowels. You may be surprised to learn that this is actually very common – around 50% of women whom have ever had a baby will develop prolapse at some point in their lives.  Many people think that nothing can be done or that surgery is their only option, however, recent research has shown excellent evidence that pelvic floor physiotherapy can help decrease your symptoms and should be the first treatment offered

 

 

Persistent Pelvic Pain, is chronic (or long-standing) pain in the pelvic region and occurs in both men and women. It is often very complex in its presentation and sometimes poorly understood. 

Symptoms in men may include:

  •      Discomfort during or after passing urine

  •      Pain in the rectum, penis or testicles

  •      Pain in the pelvic floor area when sitting or standing

  •     Pain with an erection or ejaculation

  •     Pain in the buttock area or pelvic joints

 

Symptoms in women may include:

  •     Discomfort in the bladder

  •     Pain passing urine

  •     Pain with sex (dyspareunia)

  •     Pain in the pelvic floor when sitting or standing

  •     Pain in the rectum or when passing a bowel motion

  •     Pain in the buttocks, pelvic joints or lower abdominal region

 

If you’ve seen your GP and been cleared from any obvious medical issues, then seeing a pelvic floor physiotherapist may be the next step you need to take on your road to recovery.

A thorough assessment and history is always vital when assessing any type of pelvic pain.  Many of these symptoms can be related to tight or overactive pelvic floor muscles, which (in women) can cause pain and distress during intercourse (dyspareunia), or even make it impossible for intercourse to occur (vaginismus).  Sometimes this can be related to vulvodynia (pain in the vulval region) or provoked vestibulodynia (pain in the vulvar with touch or pressure).

 

Painful Bladder syndrome (previously called interstitial cystitis) can occur in men and women and causes symptoms of urgency and frequency of urination as well as pain in the bladder  (even though urine testing is clear).  Often patients will have several of these conditions at the same time and be quite frustrated and confused by their symptoms.  We will always take the time to hear your individual story and have many different treatment strategies to help restore your health and well-being.

 

 

Bowel Problems. While most of us feel embarrassed talking about urinary leakage, discussing a  “bowel” problem seems to cause an even higher level of anxiety.  Thus, bowel issues are often endured in silence and not treated. Yet bowel problems are surprisingly common.  If you are suffering in silence with a bowel issue you are definitely not alone. 

 

Common bowel complaints include:

  • decreased flatus control (accidentally farting or passing wind)

  • rectal soiling (noticing a small amount of poo on your undies)

  • feacal incontinence (leaking stool from the bowel)

  • constipation (infrequent stools, slow transist or straining to pass a motion)

  • feeling of incomplete bowel emptying

  • Irritable bowel syndrome

 

Patients often report huge relief at having finally discussed their concerns with an understanding and knowledgeable health professional.  At the same time many patients convey their surprise and amazement at how simple lifestyle advice and specific exercises often dramatically improve their symptoms.

 

 

Pelvic girdle and low back pain in pregnancy  At Lisa Yates Physiotherapy we believe that pregnancy is a special time in which women should be nurtured.  While a certain amount of discomfort in pregnancy is to be expected, women should not have to suffer in silence or with debilitating pain.  Usually the earlier a problems addressed, then the less likely it is to become severe or disabling. Pelvic girdle pain was once termed “pelvic instability” or pubic symphysis dysfunction and studies reveal it occurs in about 20% of all pregnancies.  Women may experience pain or tenderness in the groin (pubic symphysis) that can extend down the inner thighs. This may occur on its own or simultaneously with pain over sacroiliac joints (lower back) which can extend into the buttocks. . Occasionally there is a “clicking” or grinding noise or a feeling of things “giving way”.  Symptoms are often aggravated by walking, using stairs or standing on one leg.

Likewise, low back pain is common in pregnancy and can often be debilitating if left unchecked.  A Physiotherapy examination will look at posture, joint testing, regions of tenderness, muscle strength and length.  Treatment always includes education, postural correction and may also include massage, mobilization of the joints and exercises to strengthen the body and prepare you for birth and beyond.

 


 

© 2015 by Lisa Yates, Continence & Women's Health Physiotherapy