What is a Pelvic Physiotherapist?
A pelvic physiotherapist is a specialized type of physiotherapist in treating conditions related to the pelvic region. The pelvic area is responsible for a number of important functions of the body. The bones of the region include the ilium, ischium, and pubis which fuse together to form the hip bones, and lastly the sacrum and coccyx. The muscles include the pelvic floor muscles which control the bowel and bladder, while providing support for other pelvic organs. The organs that reside in that region include the uterus and ovaries in women, the prostate in men and also includes the bladder for both sexes.
Naturally, the pelvic region is very important in regulating our digestive, reproductive system and supporting our overall health. There are several conditions that arise from age, injury, and inflammation which requires the services of a pelvic physiotherapist.
Pelvic organ prolapse is a condition in which one or more of the pelvic organs (such as the bladder, uterus, or rectum) drop down from their normal position and press against the walls of the vagina in women. This can happen when the muscles and tissues that support the pelvic organs become weakened or damaged, which can occur due to pregnancy, childbirth, surgery, menopause, and other factors. Prolapse is less common in men and impacts the bladder area. Symptoms of pelvic organ prolapse can include a feeling of fullness or pressure in the pelvic area, discomfort during sex, or difficulty with bowel movements. Some people may also experience urinary or fecal incontinence.
Pelvic physiotherapy can be an effective treatment for pelvic organ prolapse. A pelvic physiotherapist can work with you to strengthen the pelvic floor muscles which helps support the surrounding organs. They will also work to improve posture and alignment through strengthening as this can help take pressure off the pelvic organs and reduce symptoms. Your pelvic physiotherapist will educate you on these exercises that strengthen and reduce discomfort. They may also use manual therapy techniques such as soft tissue mobilization, joint mobilization, or myofascial release to help to improve the mobility and function of the pelvic area.
Overall, the physiotherapist will educate you about the condition, how to manage symptoms and how to prevent it from recurring. It’s worth noting that there are different types of pelvic organ prolapse, and the specific treatment plan will depend on the type and severity of your condition. At physiomobility, our qualified pelvic physiotherapists can ensure that you get the right treatment for your specific condition.
Urinary incontinence is a condition that involves the involuntary loss of urine in men and women. It primarily impacts the elderly demographic but may also impact other age groups and women after giving birth. Urinary incontinence arises from a weakness in the pelvic floor muscles or can be a symptom of other conditions. This weakness results in several common symptoms which include the leakage of urine, difficulty holding in urine, incontinence during strenuous activity such as coughing or lifting, frequent urinations and incontinence at night. Some individuals may be unable to control the urge to leak or cannot control the frequency in which they urinate. In addition, this muscle weakness can cause bowel related dysfunctions such as pain and constipation.
Pelvic physiotherapist can work with patients to strengthen the pelvic floor muscles with correct form in order to enhance its support of the bladder, the uterus and the rectum. They stimulate electrical stimulation to excite the pelvic floor muscles to improve strength and force output. Biofeedback may also be used to help monitor the activity of those muscles to ensure proper technique is used. A pelvic physiotherapist will also help you create a diary or log of the time of urinations with the intention of gradually increasing the time between them.
Symptoms of urinary incontinence may not necessarily be from pelvic floor weakness. There is a possibility of other underlying conditions such as bladder stones, urinary tract infections (UTIs) or nerve related disorders. Contact us at Physiomobility to rule out other conditions to be sure pelvic physiotherapy is good for you.
The 9-month process of conceiving and giving birth to a child can be very taxing on the physical and mental health of a young mother. After the first few weeks of pregnancy, a woman’s body undergoes many anatomically related changes involving their bladder, vagina, core muscles, postural muscles, breasts, weight fluctuations and hormone change. These structural changes also impact the body’s center of gravity which can overwork and overstretch certain muscle groups and can also stress ligaments and joints. This may lead to pregnancy-related back pains, muscle spasms, SI joint pain, constipation and bladder control problems. A pelvic physiotherapist assists a pregnant woman with a tailored program to provide them a complication-free pregnancy. This would include pelvic floor muscle training and stretching, as it has shown to lower the rate of pain and second-stage labor. Gaining control and awareness of your pelvic floor muscles allows one to be best prepared for delivery.
There are a number of conditions that may arise postpartum such as diastasis recti, pelvic muscle or ligament injury, perineal pain, bowel movement dysfunction and more. A pelvic physiotherapist can help by providing exercises to help strengthen and stabilize the abdominal and pelvic floor muscles. They will also be instructed to improve proper posture, alignment and body mechanics and/or provide manual therapy to help alleviate pain and discomfort. Lastly, they can educate women on diet, accessibility and lifestyle modifications they can make.
The prostate is a male gland located in the pelvic region that can cause various symptoms, such as difficulty with urination, pain or discomfort in the pelvic area, or sexual dysfunction. Prostate pain or dysfunction due to enlargement, injury or surgery can seriously impair one’s quality of life and it is essential they seek out adequate treatment. Your pelvic physiotherapist would start with relieving muscle tension and promoting circulation to the area. If there is an underlying nerve issue, they may use nerve mobilization techniques to improve function and reduce pain. Next, strengthening the pelvic floor muscles help support the function of the prostate gland and bladder control.
Overall, pelvic physiotherapy can help individuals with prostate dysfunction or pain to improve their symptoms and quality of life. It is important to consult with a healthcare professional to determine the best treatment approach for your specific situation.
Pelvic Fractures
Pelvic fractures can take place in a variety of ways throughout the pelvic bones. Stress fractures in a pelvic bone usually develop due to repetitive, high-impact activity that puts stress on the pelvis, such as long-distance running or ballet. It often affects people who quickly increase the duration and intensity of a physical activity without gradually building up endurance. Pelvic fractures may also be due to motor vehicle accidents or falls. In people with osteoporosis, fractures in the pelvis may develop as the result of everyday movements and elderly postmenopausal women are most susceptible.
A pelvic physiotherapist will be able to help alleviate pain and provide education on how to appropriately load it to help rehabilitate the fracture. In addition, they will provide exercises and therapies to strengthen the surrounding muscles, improve circulation, range of motion and enhance balance. Hip fractures may also be coupled with soft tissue complications, tendon issues, or nerve damage. Regardless of the condition, your pelvic physiotherapist will be able to assess and provide a personalized plan to provide pain relief and facilitate healing.
Written by Sagar Dama, BSc Kinesiology
References:
Alouini, S., Memic, S., & Couillandre, A. (2022). Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: A systematic review. International Journal of Environmental Research and Public Health, 19(5), 2789. https://doi.org/10.3390/ijerph19052789
Piccione, F., Maccarone, M. C., Cortese, A. M., Rocca, G., Sansubrino, U., Piran, G., & Masiero, S. (2021). Rehabilitative management of pelvic fractures: A literature-based update. European Journal of Translational Myology, 31(3). https://doi.org/10.4081/ejtm.2021.9933
Özengin, N., Yıldırım, N. Ü., & Duran, B. (2015). A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse. Journal of Turkish Society of Obstetric and Gynecology, 12(1), 11–17. https://doi.org/10.4274/tjod.74317
Salvesen, K. Å., & Mørkved, S. (2004). Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ, 329(7462), 378–380. https://doi.org/10.1136/bmj.38163.724306.3a
Szczygielska, D., Knapik, A., Pop, T., Rottermund, J., & Saulicz, E. (2022). The effectiveness of pelvic floor muscle training in men after radical prostatectomy measured with the insert test. International Journal of Environmental Research and Public Health, 19(5), 2890. https://doi.org/10.3390/ijerph19052890
