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Pelvic Floor
Physiotherapy

Lidder Therapies offers a range of treatments for Women’s Pelvic Floor Physiotherapy in Hitchin and Hertford

As many as 1 in 3 women will experience pelvic health problems during their lifetime with symptoms including urinary incontinence, faecal incontinence, constipation, pelvic organ prolapse and pain. However, many tolerate these problems, either too embarrassed to seek help or unaware that there are treatments available.

 

In a recent survery of 2000 women by the Royal College of Obstetrics and Gynaecology (February 2023) it was found that

  • 20% will experience urinary incontinence

  • 25% will have a frequent urge to wee

  • 55% do not or have never done pelvic floor exercises

  • 23% do not know how to do them

 

Furthermore, 

  • 69% of women had not spoken to anyone in the NHS about their pelvic health

  • 53% did not seek help, because of these

  • 39% thought their symptoms were normal and

  • 21% were embarrassed

In cases of incontinence and pelvic organ prolapse the pelvic floor muscles are often weak and research has shown that pelvic floor exercises could prevent surgery and reduce symptoms. Conservative management is recommended for 3 months by the National Institute for Health and Care Excellence (NICE 2019).

 

The pelvic floor has been described as a hammock or sling that extends from the pubic bone at the front to the coccyx at the back. Normal pelvic organ alignment and function relies on the integrity of the pelvic floor muscles and the internal pelvic and abdominal connective tissue. The pelvic floor can be damaged commonly by childbirth, pelvic surgery, chronic coughing, chronic constipation or obesity. 

Core function relies on a synergistic action between the pelvic floor below, the diaphragm above, the abdominal muscles at the front and the deep spinal muscles behind. Any damage to one will affect the function of the others. Treatment is aimed at optimising the function of the core canister. 

The pelvic floor muscles can also be tight or overactive and can present as chronic pelvic pain and may cause sexual discomfort. Treatment is aimed at releasing these muscles and restrictions before appropriate strengthening.

Lidder Therapies, Physiotherapy, Hitchin

Who is pelvic floor physiotherapy for?

Pelvic Floor physiotherapy can be helpful if you are experiencing the following. ​​

  • Stress urinary incontinence - leakage when coughing / sneezing or undertaking physical activities

  • Urge incontinence -  leaking when you get a sudden and uncontrollable urge to urinate and you don’t make it in time  

  • Frequency – having to go more often during the day or night, or always ‘checking to see where the nearest toilet is’

  • Pelvic organ prolapse- a feeling of vaginal pressure or a visible bulge 

  • Pelvic pain / pain with intercourse/ vulvodynia/ vaginismus

  • Pelvic pain - including pain in the pelvic floor, lower abdominal or pelvic region including urethral, bladder and anal pain.

  • Constipation

  • Weak pelvic floor muscles following birth trauma

  • Post-natal treatment of rectus abdominis divarication (split tummy muscles)

  • Rehabilitation pre / post gynaecological surgery

  • Endometriosis / Adenomyosis

  • Menopausal symptoms

​​

The Pelvic, Obstetric and Gynaecological Physiotherapy group (POGP) and The International Urogynecological Association (IUGA) have many informative booklets which can be downloaded. 

How do we assess the pelvic floor? 

A specialist pelvic floor physiotherapist will most often assess your pelvic floor with a digital vaginal examination. If this is not possible we can also perform an ano-rectal examination. In some instances, such as early pregnancy or early post surgery when an internal examination is not appropriate we can also assess externally by feeling through the gluts, although this will not be as accurate or give us as much information. 

 

Do we use biofeedback devices? 

A biofeedback device is anything that gives information about the strength and / or quality of the muscle contraction that you can feel or see. This is so valuable as the pelvic floor muscles are inside the pelvis and we cannot see them contracting or relaxing. 

A biofeedback device can be 

  • A finger

  • A real time ultrasound scan, which shows in real time the pelvic floor squeezing or relaxing (this is like the ultrasound scan you have in pregnancy, which shows the movement of the muscles, bladder or bowel)

  • An electronic device such as an Elvie, Pericoach, Pelvifly

 

How can pelvic floor physiotherapy help you?

 

Pelvic Floor Physiotherapy is an hours’ thorough assessment of your core system and pelvic floor muscles. We will then advise on bespoke exercises appropriate for you, be that pelvic floor strengthening or pelvic floor release, and advise on general exercises to complement your rehabilitation. Research has shown that doing pelvic floor exercises along with general full body strengthening to be the most effective. 

 

We can also advise on other devices that may be able to help you, such as vaginal support pessaries, vaginal weights, dilators, biofeedback, stimulation and exercise devices such as The Elvie. 

 

Your treatment could also include manual therapy and release of the abdominal visceral fascia or the pelvic floor. As well as lifestyle advice including correct toileting and bladder retraining. 

If you are unsure how we can help or what treatment you require please get in touch

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TESTIMONIALS ABOUT PELVIC FLOOR PHYSIOTHERAPY

Really lovely and professional service. I saw Bally because I was anxious about hysterectomy surgery and wanted to make sure I was ready and everything was ok before surgery. Bally was very reassuring and covered everything I needed to know about women's pelvic health, my pre surgery position, what surgery would entail and what I needed to know about post surgery recovery. I would highly recommend Bally to anyone who needs support with women's health.

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