Pelvic Floor Physiotherapy is a special interest field of Physiotherapy, aimed at assisting those with pelvic floor dysfunction back to optimal pelvic health and continence. Physiotherapists use evidence-based practice and individualised assessment and treatment.
Pelvic floor dysfunctions include, but are not limited to:
- urinary or faecal incontinence – from leaking to full loss of control
- difficulty with bowel or bladder function
- sexual dysfunction such as painful intercourse or pain around the genitals
- pelvic organ prolapse
- painful scars after childbirth or surgery
- persistent pelvic pain conditions
Incontinence is NOT a normal part of ageing.
Incontinence is a common problem for an estimated 1.1 million New Zealanders. That's women and men. The two main types of incontinence are:
- Stress – where small amounts of urine leak during activities/effort
- Urge – a sudden strong urge to pass urine which can lead to a loss of urine
Women that have had a baby are more likely to experience incontinence. Research has shown that Physiotherapy is effective in treating stress incontinence in up to 80% of cases.
To evaluate the condition it may be necessary initially and periodically, for the therapist to perform an internal pelvic floor muscle examination. This examination is performed by observing and /or palpating the perineal region including the vagina and /or rectum. This evaluation will assess skin condition, reflexes, muscle tone, length, strength and endurance, scar mobility and function of the pelvic floor region. Such evaluation may include vaginal or rectal sensors for muscle biofeedback. It is, therefore advisable to aim to book your appointments outside of menstruation if possible.
Lisa Carnie is MetaMed's friendly and approachable Pelvic Floor Physiotherapist. She works with both women and men. A Pelvic Floor Physiotherapist can help correctly identify the pelvic floor muscles and make sure exercises are performed optimally to rehabilitate the integrated core and continence system. Pelvic floor exercises can also be very beneficial for both treating and preventing future problems. When these muscles and systems are strong we have more control over our bladder and bowels.
Many people with pelvic floor problems don’t seek help as they think nothing can be done or they are too embarrassed to talk about their ‘private' issues. Many women / mothers believe they are doomed to a life of painful sex, leaking bladders, and feelings of self-doubt. It's also common for men to experience urinary and bowel issues that may or may not be related to the prostate. Lisa also see's men post-prostectomy surgery. There are many treatment options available so it’s important to seek assistance.
Pelvic floor physical therapy – what to expect
Treatment may include, but are not be limited to the following:
- bladder retraining
- pelvic floor muscle training
- pelvic floor relaxation techniques
- core system rehabilitation
- healthy toilet habits
- use of vaginal weights
- vaginal dilators
- vaginal or rectal sensors for biofeedback and/or electrical stimulation
- ultrasound
- stretching and strengthening exercises
- soft tissue and/or joint mobilisation
- lifestyle modifications
- educational instruction
Physiotherapists are ACC accredited. No referral is required for an appointment. You can use an existing claim or lodge a new claim during your appointment (eg. Instrumental birthing injuries, pelvic fractures).
Conditions treated (both men and women):
- Urinary Incontinence: stress, urge or mixed incontinence, dysuria, overactive bladder, over-active pelvic floor, overflow incontinence, Hypotonicity (weak pelvic floor muscles) contributing to stress incontinence, urge incontinence and pelvic organ prolapse. Hypertonicity (tight pelvic floor muscles).
- Pregnancy: Birth preparation, incontinence, pelvic girdle pain, pregnancy pain, pubic symphysis pain, rib and upper back pain, swollen legs, anorectal pain, posture and back care.
- Post natal: Abdominal and pelvic muscles, scars (c-section, episiotomy, 3rd and 4th-degree perineal tears from instrumental delivery), diastasis recti, strength endurance and function of the pelvic floor, skeletal alignment, diaphragm and breathing, pelvic organ prolapse, pelvic pain, incontinence (stress and urge), trapped air in the vagina and mastitis.
- Post-prostectomy: urinary incontinence or bowel issues that may have been sustained after surgery.
- Bowel Problems: Faecal and flatal incontinence/soiling, difficulty emptying (including obstructive defaecation) and urgency.
- Pelvic organ prolapse: bowel, bladder, uterine and vaginal.
- Pre and post gynaecology surgery: hysterectomy, post-prostectomy and surgery for pelvic organ prolapse.
- Pelvic pain: Ano-rectal pain, sacral, coccyx thoraco-lumbar, abdominal-pelvic, perineum pains, Pudendal nerve pain, scarring, dyspareunia (difficult or painful sex), vaginismus (involuntary tightening of the muscles around the vagina).
- Constipation: pregnancy, scaring, haemorrhoids, overactive pelvic floor.
- Sexual dysfunction: erectile dysfunction, decreased sensation, vaginal dryness, painful sexual intercourse.
- Psychosomatic aspects of the above-mentioned conditions.
Please see the FAQ page for more information.
Wanaka, Queenstown, and Central Otago-based patients interested in consulting with a Pelvic Floor Physiotherapist can visit the MetaMed clinic near the Wanaka lakefront.