When to see a pelvic health physio?

Pelvic health physiotherapy
Previously all things “down below”, or to do with one’s “private parts”, or “fanny” have been taboo - certainly not a topic openly discussed among peers or even family. Thankfully this is slowly changing. Women are talking about their vaginas and various related complaints with friends and family. We have a long way to go, but it’s a start. 

We often come across people who have no idea what pelvic health physiotherapy is, and once we explain are quite surprised that this area of physio exists. While we're happy to spread the word and sing of the benefits far and wide, we're also looking forward to the day where most people know what it is and what we do - I think then we’ll have reached a point where the issues women face are no longer hush-hush. 

What is Pelvic Health Physiotherapy? 
Pelvic Health Physiotherapy encompasses care for issues such as pelvic pain, pelvic organ prolapse, urinary/faecal incontinence, sexual dysfunction, pre/postnatal injuries/advice/recovery. 

With women’s health concerns slowly making their way into the mainstream, you might be thinking “should I be seeing a pelvic health physiotherapist??” 

In an attempt to simplify things, the short answer is if you have any pelvic health related concerns then yes!

Pelvic health related concerns include:
Pelvic pain (e.g. vaginismus, vulvodynia)
Painful sex (or pain after sex) 
Pain / difficulty using tampons 
Pregnancy
Childbirth (particularly if you’ve had any tears, or a baby > 4kg, or a long active/pushing phase)
Any urinary incontinence
Bladder pain syndrome / interstitial cystitis 
Constipation (particularly if chronic) 
Pelvic organ prolapse (usually in women who have had babies, but can happen in those who haven’t); this is characterised by a bulging/heavy/dragging sensation inside your vagina
Persistent low back or hip pain that has not responded to conventional physiotherapy management

We can assess you appropriately and advise on the best treatment options - whether that is referring you to a specialist (e.g. gynaecologist), a pelvic floor assessment/treatment, bladder retraining etc.

Pelvic health conditions can be confusing, and more often than we like people are passed between various medical professionals before they even hear about pelvic health physiotherapy or a pelvic health diagnosis. If you have any symptoms which you are unsure about, book in and get seen. 

What does an appointment involve? 
All appointments involve taking a detailed history about your concerns and birth history, bladder/bowel history, gynae history, and any other relevant information.
 
Assessment and treatment depends on the issues that need addressing. If you are presenting with complaints of pelvic floor weakness or injury (e.g. from childbirth) then the assessment may involve an internal vaginal assessment, although this is not compulsory.

These assessments can give valuable information about the function of your pelvic floor muscles, whether there is prolapse present, and guide us to develop an effective rehabilitation plan. 
If you are presenting with bladder urge or urge urinary incontinence, without evidence of pelvic floor weakness, then often a vaginal examination is not necessary. 

If you are pregnant, without any particular concerns, appointments involve teaching you proper pelvic floor exercises, discussing how to best look after yourself during pregnancy, labour, and post birth, and informing you about all things related to pregnancy/childbirth - knowledge is power!

If you are postnatal, Jen likes to see you around 6 weeks - and this involves checking in on your recovery, addressing any particular concerns, and guiding you in returning to full function (and beyond).

All appointments involve detailed education about your condition and the recommended treatment approach. 

What if I'm not sure whether this appointment would be appropriate for me? 
If you have a concern that isn't mentioned above and you are wondering whether you would benefit from an appointment, please feel free to get in touch.

jen@urbanathlete.co.nz

Jen is more than happy to have a brief phone call or quick email to discuss (always in complete confidence) whether she would be the right person for you to see, and if not can provide alternative pelvic health physiotherapist recommendations for you.

Will I be able to access ACC for my appointment?
ACC now provide cover for Maternal Birth Injuries. Births occurring on or after 1st October 2022 qualify. 

If you sustained an injury (e.g. tear, avulsion, prolapse) as a result of your birth, then we can lodge an ACC claim (or may already have had one lodged for you). 

If your injury happened during a birth prior to 1st October 2022 unfortunately this will not be covered. 

If you sustained an injury but not during childbirth - then you may be able to access ACC, but will likely need this to be lodged through your GP. If needed, Jen can discuss this with you.

Meet Jen, our Pelvic health physio guru

Incase you haven't met her, here’s a little bit about Jen:

Jen has worked both in Auckland and London in the musculoskeletal and sports physio sphere, including a couple of seasons with Superleague Netball in the UK and travelling with NZ Athletics to Oceania's 2022. She has also started to specialise in pelvic health, and you'll find her talking about bladders, bowels, and the lack of pre/postnatal education without too much encouragement.

She's always been keen on sports, but more of a social all-rounder than a master of any one. You're most likely to find her involved if there's a cold drink after the final whistle.

She has a particular passion for treating the individual - finding out what makes people tick, and getting to the root of the issue to get them back to their best. 

Jen is always empathetic, ready for a laugh, and eager to push you to improve. 

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