Women's Health

Antenatal Care

Our chartered physiotherapists are trained in treating pain during pregnancy. Neck and shoulder tension can be relieved by treatments in alternate side lying. We use bio oil for treatments during pregnancy. We can alleviate pelvis, hip and spinal pain as tension increases on ligaments and joints throughout pregnancy. An exercise program can be designed to address individual needs.

Post Natal

Much physiotherapy work can be done soon after birth. Lower back and pelvic pain can be treated using many of our techniques. Pilates classes are a great way on gently mobilising the spine and pelvis. Pilates will also gradually strengthen weakened tummy muscles following pregnancy. Postural advice and footwear is also essential during this time. Many new mothers benefit from massage of spinal muscles to reduce tension and pain.

Pelvic Floor

The pelvic floor is a diaphragm compound of muscles from tail bone to pubic bone interiorly. During pregnancy these muscles are lengthened and weakened with increasing baby weight. Physiotherapy can help you identify and locate these muscles. New mothers can be instructed in specific pelvic floor exercises to strengthen these muscles.

  1. Identify Muscles

First, you need to find your pelvic floor muscles.

Try to tighten your muscles around your vagina and back passage and lift up, as if you’re stopping yourself passing water and wind at the same time.

A quick way of finding the right muscles is by trying to stop the flow of urine when you’re on the toilet. Don’t do this regularly because you may start retaining urine.

Once you’ve found the muscles, make sure you relax and empty your bladder completely.

If you’re not sure you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise.

Stress Incontinence

If you develop stress incontinence there is a good chance that it can be cured with pelvic floor exercises. Stress incontinence is when urine leaks when there is sudden extra pressure. Urine tends to leak when you cough, laugh or exercise.

Urge Incontinence

Urge incontinence is often referred to as overactive bladder. You have an urgent need to go to the bathroom and may not get there in time, leaking urine.

Causes of overactive bladder include:

  • Damage to the bladder nerves
  • Damage to the nervous systems
  • Damage to muscles

Mixed Urinary Incontinence: Some women have both of these types of urinary incontinence.

How can physiotherapy help with incontinence?

Individuals can be educated in pelvic floor anatomy. We can isolate the pelvic floor muscles and begin a specific set of pelvic floor exercises to strengthen this muscle.

  1. Identify the muscle

First you need to find the pelvic floor muscles.

Try to tighten your muscles around your vagina and lift up as if you’re stopping yourself passing water and wind at the same time.

A quick way of finding the right muscles is by trying to stop the flow of urine when you’re in the toilet. Don’t do this regularly because you may start retaining urine.

Once you’ve found the muscles, make sure you relax and empty your bladder completely.

If you’re not sure you are exercising the right muscles, put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise.

  1. Contract the muscles correctly

The movement is an upward and inward contraction, not a bearing down effort.

When you first start the exercises, check that you are doing them correctly. Put your hands on your abdomen and buttocks to make sure you can’t feel your belly, thighs or buttocks moving.

  • Don’t hold your breath. You should be able to hold a conversation at the same time or try counting aloud while you’re doing the exercises.
  • Don’t tighten the tummy, thigh or buttock muscles- you’ll be exercising the wrong muscle groups.
  • Don’t squeeze your legs together.
  1. Fast and Slow Contractions

You need to train your pelvic floor muscles through repetition, in the same way as you would train a muscle group at the gym.

Slow Contractions

Slow contractions help to increase the strength of your pelvic floor. They help your muscles to hold back the urine.

  • Lift your pelvic floor muscles to a count of ten
  • Hold the muscles tight for 10 seconds
  • You may find at first that you can only hold the contraction for one or two seconds, so concentrate on lifting your muscles and holding the contraction for as long as you can
  • Gradually increase the time until you reach 1 seconds
  • Relax your muscles and rest for 1 seconds
  • Repeat the contractions up to 10 times

Fast Contractions

Fast contractions help your pelvic floor to cope with pressure, for example when you sneeze, cough or laugh. This works the muscles that quickly shut off the flow of urine.

  • Lift your pelvic floor muscles quickly
  • Hold the contraction for one second
  • Relax the muscles and rest for one second
  • Repeat the contractions 10 times

How Often Should I Do The Exercises?

Try to do one set of slow exercises and one set of fast contractions six times a day.

The Chartered Society of Physiotherapists also recommends that you do a quick contraction just before you cough, sneeze or laugh.

You may also find it useful to do a fast contraction just before you get out of a chair. This is because the movement of getting up puts pressure on your bladder and pelvic floor.

How Do I Know They Are Working?

You can test your muscle strength with the stop-start test. When you urinate, partially empty your bladder and then try to stop the flow of urine.

If you can’t stop it completely, slowing it is a good start. Try the test every two weeks or so to see if your muscles are getting stronger. Don’t do the test more often than this.

The Pros of the Pelvic Floor Exercises

  • They’re simple
  • They’re cheap
  • They’re effective
  • You can do them when sitting, standing or lying down
  • You don’t need any special equipment, but until you get into the habit of doing them, you may find that a tick chart helps to remind you to do your exercises
  • You can do them with or without vaginal cones

The Downside of Pelvic Floor Exercises

  • You have to keep doing them for the rest of your life
  • It can take up to 15 weeks before you see any difference
  • If you haven’t noticed a difference after three months, see your continence adviser again to check whether you’re doing them correctly or if there’s another problem