Jo Gipson explains what it is and what she does in her sessions at Pro Health Physio.
Pelvic Health Physiotherapy is a type of physiotherapy that specialises in all of the muscles, organs and fascia around the pelvis in both men and women. It covers the treatment of the following conditions.
– Bladder and bowel dysfunction including incontinence
– Prolapse
– Pregnancy related musculoskeletal disorders and birth preparation
– Exercise during pregnancy and postpartum including running
– Postnatal recovery including the specialist management of scars
– Men’s health including post prostatectomy rehabilitation and hard flaccid syndrome management
– Sexual dysfunction including pain
– Pelvic Pain including that from endometriosis, bladder pain syndrome and pudendal neuralgia
Often part of treatment involves optimising the pelvic floor muscles which can contribute to these conditions.
The pelvic floor muscles
The pelvic floor muscles are a sling of muscles that extend from the pubic bone at the front to the tailbone at the back and out to both sit bones. They are like a hammock or sling which support your pelvic organs from the pressure above them. They need to be strong, coordinated and able to relax to allow the organs in the pelvis to work properly.
They play a role in
– Bladder and bowel function – they contract to stop things coming out when you don’t want to (incontinence), and relax to allow you to empty fully
– Sexual function – they play a key role in climax and in the function of erectile tissue in both men and women
– Organ support – they contract to support the pelvic organs during times of increased intrabdominal pressure such as running, coughing, laughing, sneezing etc.
– Hip and back movement – they rotate the hip and support the back within the core cannister
When these muscles aren’t working optimally they can contribute to symptoms of incontinence of the bladder and or bowel, difficulty emptying the bladder or bowel, an overactive bladder (meaning you frequently need to empty the bladder with a strong urge), pain within the pelvis or within the genitals, sexual dysfunction and prolapse (where one or more of the pelvic organs sits lower within the pelvis.
How common is pelvic floor dysfunction?
1 in 3 women experience urinary leaking, 1 in 2 experience prolapse and 1 in 10 experience anal incontinence, so it is much more common than you think. 1 in 5 women experience pelvic pain which can including persistent or generalised pain, or specific pain conditions including vulvodynia (pain around the vulva), vaginismus (a spasm of the muscles around the vaginal opening causing obstruction), dyspareunia (pain with penetration) and gynaecological pelvic pains from conditions such as endometriosis. Pelvic pain is also common in men and is often misdiagnosed as prostatitis.
Why might things go wrong?
The pelvic floor muscles are often discussed around the time of pregnancy and childbirth due to the hormonal changes, weight of the baby and the physical trauma of birth, however many individuals who have never had a baby experience problems within these muscles. Both men and women may have problems with these muscles, and this can be caused by multiple factors including your biomechanics, your past medical history and conditions such as a chronic cough or constipation, your stress levels, your hormone levels and different surgeries such as a hysterectomy or prostatectomy. There is no such thing as too young or too old to see a pelvic health physiotherapist.
What happens at pelvic health physiotherapy?
Seeing a pelvic health physiotherapy can feel intimidating if you are not sure what to expect. So what happens when you come to clinic?
– Your physiotherapist will ask you all about your story and what brought you to the clinic. They will likely have extra questions to help them understand your experience better and to help guide them on what treatments and further assessment might be needed.
– They will review your biomechanics (the way your body moves) by asking you to do a few simple movements like a squat, a lunge, or lifting your arms above your head.
– If you have had a baby they will check your abdominal muscles and any scars that you have around the abdomen.
– If it is indicated and if you feel comfortable they will offer you an internal examination (either vaginal or rectal). This is never compulsory and is only ever done with your consent. There are plenty of treatment options without doing an internal examination if you do not wish to have one.
– They will discuss with you a treatment plan.
A treatment plan may including things like bladder retraining, completing a bladder or bowel diary to help guide retraining, tibial nerve stimulation, scar massage, sensory work or mirror work, manual therapy, pelvic floor muscles optimisation, and most importantly rehabilitation back to your goals including the whole body rather than just the pelvic floor.
A bit more about Jo Gipson, our pelvic health physiotherapist at Pro Health NE
Since graduating from Birmingham University with a first class honours degree in 2016, Jo has gained extensive experience working in London’s top teaching hospitals including Guys and St Thomas’ Hospital, bespoke private practice settings including LETO Woman and running her own business offering bespoke pelvic health physiotherapy to clients across the UK. She is the North East representative of the pelvic pain network and has taught on multiple international physiotherapy platforms. She feels passionately about raising awareness of pelvic health having been on multiple TV appearances, magazine articles and podcasts (check her out on spotify!). Jo mentors extensively, helping other physios up skill their knowledge base in managing clients with pelvic floor issues, teaching therapists in both the UK/Ireland.
Outside of the clinic Jo enjoys triathlons, lifting weights in the gym and getting out of the city to explore the countryside. She has recently become a mother herself, so has first hand experience of the joys and challenges that come with this. She moved to the Toon, in Jan 2023 and has enjoyed settling into the North East .
Jo provides a truly holistic assessment, offering much more than kegels and breathing exercises! By looking at the whole body and addressing all the different factors that can contribute towards leaking, pain or pelvic symptoms, Jo can identify the right treatment to get you back to your goals whether that is lifting your baby out of the cot, completing a marathon or cycling LEJOG.
If you want to find out more about what treatment might look like, have a listen to the following podcasts where you can hear Jo talking about her work in this area.