Pelvic Floor Physiotherapy Assessment and Treatment

The Pelvic Floor is a large hammock of muscle that lines the outlet of our pelvis, it has a role in;

• Supporting your abdominal organs such as the bladder and bowel, and the womb (uterus) in ladies
• Continence: allowing you to decide when you want to go to the toilet and when isn’t appropriate
• Sexual Function: Parts of the pelvic floor form the muscles for orgasm in women and erection in men
• Stability: Assists in the stability and load transfer through the pelvic joints such as the sacroiliac joints, pubic symphysis, and the lower back.

The Pelvic floor can have issues with being either underactive (weak) or overactive (working too hard!) causing interference with the above functions. As the pelvic floor is an internal muscle it is very difficult to establish yourself how well it is working. An assessment of the Pelvic Floor is undertaken by experienced Women’s and Men’s Health Physiotherapist Jenna Sweeney and involves taking a detailed history of your bladder and bowel function in both women and men, in addition to obstetric and gynaecology history for women, and surgical and prostate history for men. To accurately assess the pelvic floor itself, a vaginal and or back passage examination is completed in women, and a back passage exam in men.

From this assessment you will be provided feedback on the condition of your pelvic floor, and have the opportunity to discuss recommended advice and treatment for any continence, prolapse, sexual function or musculoskeletal symptoms that maybe related to the Pelvic Floor.

Jenna Sweeney is a Chartered Physiotherapist with 10 years experience, who has specialised into the area of Women’s and Men’s Health, undertaking postgraduate training into Obstetrics, Gynaecology, Urology and Pelvic Health.

She has completed competencies and education to be able to perform detailed musculoskeletal, vaginal and anorectal (back passage) examinations in order to assess the spine, pelvis, pelvic floor and anal sphincter muscles in both Men and Women in order to diagnose and treat common Urology and Gynaecology conditions related to the functioning of the Musculoskeletal system of the Pelvis.

• Urinary Incontinence is reported to affect 1 in 3 ladies in their lifetime, with childbirth being one of the largest predictors of this. If there is dysfunction of the Pelvic Floor it can have a large part to play in the development of the three different forms of urinary incontinence; Stress Incontinence, Urge Incontinence and Mixed Incontinence.
In men who have undergone treatment for Prostate problems, such as swelling of the prostate (Benign Prostatic Hyperplasia) or Prostate cancer, urinary incontinence can commonly be a side effect.

• Pelvic Organ Prolapse can occur in women if weakening of the supporting ligaments and pelvic floor muscle occurs causing the bladder, bowel or uterus to bulge from their natural position into the vagina. Sometimes a prolapse can be large enough to protrude out of the vagina. Prolapse can be very common, those with mild prolapse can be symptom free. A mild to moderate prolapse can be reduced with pelvic floor retraining and various lifestyle interventions under the supervision of a Women’s Health Physiotherapist.

• Faecal Incontinence can occur when there is weakness in the Pelvic Floor in addition to the Anal Sphincter muscles. The Anal Sphincter muscles have a role to play in providing feedback to you when you need to open your bowels, allowing you time to access a toilet. Unfortunately when these are weak the warning signals may be absent or delayed resulting in faecal urgency or incontinence.

• Pelvic Pain can occur In many different forms, such as Sacroiliac Joint or Lower Back Pain which can be related to weakness in the Pelvic Floor, or Dyspareunia (Pain during sexual intercourse) and Vulvodynia (vaginal pain which can be either provoked by a stimulus or not) in women, which can sometimes be associated with overactivity of the Pelvic Floor Muscles. A skilled Women’s and Men’s Health Physiotherapist can assess and provide advice treatment to address the above issues, via ‘up’ or ‘down’ training the pelvic floor to encourage it to work optimally.

An hour is provided for the assessment to enable an in depth look into the signs and symptoms you may be suffering with.

Any follow up sessions subsequently booked for treatment are 30 minutes long.

This varies as the physiotherapy intervention you receive will be individually based upon the assessment findings identified. However, for muscle retraining and improvement of symptoms, it can be realistic to expect maximum recovery to occur over a 3-6 month period and so appointments will be planned accordingly.

  • £75 for the assessment
  • £45 for follow up

Practitioners

Jenna Sweeney