Physiotherapy’s part to play in pelvic health

Pelvic health, also known as pelvic floor, can be a daunting thing to discuss, and sometimes what we know is just based on hearsay from the people in our lives.

Habit Health Senior Physiotherapist, Heather Hickey, took a keen interest in pelvic floor physiotherapy after she got pregnant because it gave her the confidence to talk about the changes that can happen before and after pregnancy. Heather helps demystify the connection between physio and pelvic health from pregnancy to menopause.

What pelvic health issues do physios treat?

There are a few areas we can help with. We treat incontinence, which is the loss of bladder or bowel control. Most commonly, we treat urinary incontinence, which can happen because of weakness or damage to the pelvic floor muscles and/or connective tissues.

Some conditions or activities put people at a higher risk of pelvic floor dysfunction because they place a greater load or strain on the pelvic floor. Some of these are: pregnancy, multiple births, obesity, straining from constipation, chronic coughing or vomiting, high-impact physical activities, surgery, or trauma.

We also treat those with pelvic pain following trauma or from sporting conditions. Pelvic health physiotherapy can also be effective to address sexual dysfunction, including pain with sex or the inability to maintain an erection or achieve orgasm.

What are your tips for looking after pelvic health?

One great measure is to ensure you have good toileting habits and aren’t straining when passing a bowel movement.

Before giving birth, we also recommend seeing a pelvic physiotherapist.This can give you an opportunity to prepare yourself for the birth, consider the load that the child is putting on your pelvic floor and educate yourself on steps you can take to rehabilitate and re-engage in physical activity safely after giving birth.

For those nearing menopause, fluctuations in hormone levels can affect our pelvic floor function through changes in muscle and connective tissue, vaginal lining, and lubrication. Getting an internal pelvic exam gives insights into your strength, atrophy or drying. This gives a guide to possible treatments to help manage any concerns. 

Getting your routine smear checked also helps make sure any abnormalities are caught and addressed.

What do we need to know about the new maternal birth injuries ACC cover?

For those who gave birth on or after 1 October 2022, ACC provides support for the care of several maternal birth injuries: including a variety of perineal tissue tears, muscle detachments, injury from obstetric instruments, nerve injuries, uterine injuries, prolapses, bony fractures and joint or ligament tears. 

It all can sound a bit scary, but there are plenty of experts like us who can help you through these injuries. 

This includes care from a variety of medical and allied health providers, such as a pelvic health physiotherapist, a physiotherapist, a medical practitioner, a nurse practitioner, a nurse, a midwife, an osteopath, and a chiropractor.

What can someone expect if they see a physio for pelvic health issues?

We start by reviewing a person’s medical history and understanding their pelvic health concerns and any symptoms. We also conduct a visual and manual assessment of the pelvic floor where needed, and this may include an internal examination via either the vagina or anus. This helps make sure we create a thorough treatment plan. 

When we have all the information we need, we educate the client on the normal functioning and role of the various structures in the pelvic basin because, as with any part of the body, this can be pretty complex to understand. We make sure to break things down so they’re easy for our clients to understand. Then, we provide an explanation for the symptoms they’re experiencing. 

The rehabilitation programme always includes education and can also include home exercises, the use of a diary to monitor the person’s concerns, strategies to assist with toileting, mindfulness or urge control techniques, and if needed, a referral to a medical expert, dietician, or other health provider.

What should pregnant people or people who have given birth recently know?

If you are pregnant, we recommend pelvic floor muscle strengthening and perineal massage (stretching the exit of the birth canal) to prevent injury and aid in post-partum recovery.

If you’ve recently given birth, remember that with time and the right rehabilitation and support team, you can safely get back to physical activity and regain control of your bowel and bladder. While it’s common to have trouble with bladder and bowel control following childbirth, experts can help get this under control. 

How to access this service

Pelvic Health Physiotherapy is available to these clinics:

• PRG Cavendish Drive (Cavendish Drive, Auckland)
• Habit Health Centre Place (Hamilton Central)
• Habit Health Feilding (Feilding, Palmerston North)
• Habit Health Platinum (Wellington CBD)
• Habit Health Evans Bay (Evans Bay, Wellington)

Book your appointment

Urinary incontinence is no laughing matter. Talk to one of our pelvic health physiotherapists for information on our new femfit® by JUNOFEM pelvic floor training system.