PELVIC HEALTH Physiotherapy

we meet you where you are. Helping you improve your pelvic health issues from pain, pregnancy, performance and beyond.

What is Pelvic health physiotherapy & how does it differ from traditional physiotherapy?

Let's start with the similarities! Like traditional physiotherapy, a pelvic health assessment will always approach your care by assessing how your whole body moves and functions. The pelvic, deep core, and pelvic floor are deeply integrated with the rest of your body and cannot be addressed in isolation. Both the assessment and treatment will directly address the pelvic floor  as well as explore movement and function in conjunction with other parts of the body. 

That being said, the pelvic floor muscles are more challenging to assess because we are unable to see or feel them externally. As such, one of the ways in which pelvic health physiotherapy differs from traditional physiotherapy is that there is an internal component to the assessment and treatment. Physiotherapists with the appropriate post-graduate training learn the skills needed to directly palpate the pelvic floor muscles vaginally and/or rectally. I know that this can sound daunting, but it is much more approachable than it sounds and it provides your therapist with invaluable information. Please keep in mind that this component is optional and your therapist can discuss this process in more detail with you prior to your appointment.

WHAT IS THE MOMENTUM DIFFERENCE that sets us apart?

Managing pelvic health dysfunction can be an exceptionally challenging time and we understand that sharing this information can be a vulnerable experience. Here at Momentum, we offer each and every person that we meet a comfortable, dependable, safe space - always. We are here to support you wholeheartedly and will work with you at every stage to build sustainable, healthy lifestyle changes that will lead to long-term results.

Our in-house pelvic health physiotherapist, Aislinn, has completed extensive post-graduate training in the assessment and treatment of pelvic health dysfunction. She has the skills and knowledge to help manage a wide variety of conditions experienced by both males and females. On top of her post-graduate training in the assessment and treatment of pelvic health conditions, Aislinn also offers these specialized skills:

●      Specialised training (InCORE Method) in the assessment and management of Diastasis Rectus Abdominus (abdominal separation) & the postpartum core

●      Oncology & the pelvic floor - specialised training in assisting with management of the secondary effects of cancer & cancer-related treatments on the pelvic floor and body as a whole

●      Trained ‘PfilAtes’ Instructor - evidence-based strength training program to effectively and efficiently strengthen the deep core and pelvic floor (https://www.pfilates.com/)

what can pelvic health physiotherapy help me with?

what is the pelvic floor?

The pelvic floor is a sling-shaped collection of tissue and muscles that sits in the space from your tailbone to your pubic bone as well as between both sit bones. These tissues have a number of functions including:

●      Support for abdominal contents such as bladder, uterus

●      Voluntary bowel and bladder control

●      Sexual function

●      Abdominal pressure control & breathing support

In pelvic health physiotherapy, we also focus closely on the deep core which includes:

●      The pelvic floor muscles at the bottom

●      Transverse abdominus muscle at the front around your lower abdomen

●      Multifidii muscles at the back along the spine

These three groups of muscles work very closely together. Pelvic floor dysfunction can affect both men and women. Please see below for more information when pelvic health physiotherapy may be indicated.

How can pelvic health physiotherapy help women?

●      Urinary and faecal leakage, frequency or urgency

●      Pelvic Organ Prolapse (uterine, bladder & rectal)

●      Chronic Pelvic Pain including that associated with menstruation & Endometriosis

●      Painful intercourse (Vaginismus or Dyspareunia)

●      Pre/Post-Natal Pelvic Girdle Pain, dysfunction, return to activity, birth preparation

●      Diastasis Rectus Abdominus or “ab separation”, abdominal hernias

●      Constipation

●      Persistent low-back, hip and groin pain that has not responded to traditional therapy

●      Return to activity after abdominal or pelvic surgeries

●      Ensuring appropriate deep core activation during daily life such as during exercise

●      Tailbone pain

●      Nocturia (night time urination)

How can pelvic health physiotherapy help men?

●      Urinary or faecal frequency, urgency or leakage

●      Chronic pelvic, hip or groin pain that has not responded to traditional therapy

●      Chronic constipation

●      Return to activity after abdominal or pelvic surgeries, such as post Prostatectomy

●      Painful intercourse

●      Difficulty initiating the urine stream or fully emptying

●      Chronic prostatitis (non-bacterial)

●      Diastasis rectus abdominus or abdominal hernias

●      Pudendal neuralgia

We also offer a complimentary 15-minute consult with our Health Coach, Sheffield, offering you some helpful tips on optimising your body’s recovery environment, and to introduce you to our 5 pillars of health. Just let us know when you contact us if you’d like to reserve your spot. For more information on our Health Coaching approach and benefits, please click here.

Why is pelvic health physiotherapy considered a specialty service?

Although very necessary and effective, pelvic health physiotherapy is a relatively new branch of the profession. As such, the knowledge and skills needed to practice in this specialty are generally not part of standard physiotherapy education. Physiotherapists who practice in this area have completed additional postgraduate training to offer this service. This also allows these therapists to offer services that others cannot - for example, pelvic health physiotherapists can offer internal assessments, in which the pelvic floor muscles are directly assessed vaginally and/or rectally. This type of assessment provides valuable insight into the function of the tissue in this region, which can facilitate faster resolution of symptoms.

Additionally, pelvic health physiotherapy encompasses all aspects of traditional physiotherapy plus more! Despite the name, we do not focus solely on the pelvis, but explore how your pelvis & deep core function as a unit with your body as a whole. As such, when you attend a pelvic health physiotherapy session we will be exploring and addressing aspects of how you feel, move and function holistically.

WHY DO CLIENTS CHOOSE MOMENTUM AS THEIR Pelvic health physiotherapy provider?

"I recently had a baby and was in need of postpartum-focused physiotherapy. Aislinn was the perfect practitioner for my needs. She is incredibly knowledgeable in pelvic health and was able to alleviate my pain, improve my strength and overall well-being. Her patience, kindness and ability to clearly explain everything made my healing journey much easier. I highly recommend Aislinn to any woman seeking pelvic-focused physiotherapy."

Cathy B.

FREQUENTLY ASKED QUESTIONS

What can I expect from the first pelvic health physiotherapy visit?

Your first (and all subsequent) pelvic health session will last 60 minutes in length. It will involve a brief discussion around your concerns, past medical history, and goals. This will be followed by a holistic orthopaedic assessment exploring the function and movement capabilities of the body including the spine, ribcage, hips and pelvis. Finally, we will perform a more focused assessment of the deep core, including the pelvic floor through observation and palpation - including internal assessment vaginally and/or rectally at your comfort level.

A session of pelvic health physiotherapy includes, but is not limited to:

• A full comprehensive internal (if recommended) examination/assessment of your pelvic floor

• A full functional assessment of your pelvis and deep core muscles, with an evaluation of findings provided to you with a clinically effective care plan

• Implementation of a personalised treatment plan to optimise your recovery. This will include recommendations for self-management. Your treatment plan can include massage, acupuncture/dry needling, exercise prescription, or strength & conditioning.

Why is an internal pelvic health assessment necessary? Is it mandatory?

The internal portion of a pelvic health assessment provides valuable information to the therapist such as:

●      Muscular and tissue tension in the pelvic floor

●      Pelvic floor muscle strength and function

●      Points of tenderness

●      Presence of conditions such as pelvic organ prolapse

Having access to this information allows for more efficient diagnosis of pelvic floor dysfunction as well as more effective treatment prescription.

However, please keep in mind that pelvic health physiotherapy can still be very effective without the internal component and this aspect of the assessment is not mandatory. We will always work with you within your comfort level, and you should never feel pressured to participate in any aspect of assessment or treatment that you are not 100% comfortable with.

Can I still come to my appointment if I have my period?

Yes! There is no problem with attending your pelvic health appointment during your menses. At times, this can be helpful, such as if you have noticed a correlation between your menses and your symptoms.

However, if you are uncomfortable attending the session during your period - that is no problem & we would be happy to reschedule your appointment.

Can I have an internal assessment when I am pregnant?

Yes - having an internal assessment during your pregnancy is safe and can be beneficial! However, there are some situations in which we do not proceed with an internal assessment during a pregnancy:

●      No internal assessments during the first trimester

●      No internal assessments if you have been instructed to avoid intercourse during your pregnancy

When is it unsafe to complete an internal assessment:

There are some select situations in which we will not proceed with an internal assessment due to safety:

●      Less than 6 weeks postpartum

●      Less than 6 weeks post-operative abdominal or pelvic surgery

●      Less than 12 weeks postoperative pelvic organ prolapse repair

●      Active hemorrhoids

●      Active pelvic infection (such as urinary tract infection)

●      Radiation injuries less than 12 weeks old

●      Radiation seed implants in the pelvis

●      Direct instruction or avoid insertion of tampons, menstrual cups etc. or to avoid intercourse

When should I start pelvic health physiotherapy?

Pelvic health physiotherapy can be beneficial at many times, including:

●      At any time to check on your pelvic health as a whole

●      Anytime you have symptoms of pelvic floor dysfunction such as urinary leakage, constipation, or pelvic pain

●      After clearance by your physician/surgeon after abdominal or pelvic surgeries

Specific recommendations in regard to pregnancy:

●      Prior to pregnancy to gain baseline information on your deep core function

●      Any time after the first trimester of pregnancy

●      After your 6-week check up with your physician postpartum

DO I NEED TO SEE A GENERAL PRACTITIONER (GP) OR SPECIALIST FIRST BEFORE COMING IN?

Put simply, No (unless your medical insurance requires you to for claiming purposes only). With regards to who is best to see first, we do recommend you see our physiotherapists as we are considered ‘first line’ providers when it comes to musculoskeletal and neuromuscular injuries and conditions. Especially when it comes to acute injuries (e.g. ankle sprains, suspected muscle tears, or joint pain), you are better off contacting us for some advice to reduce the initial stress and worry. It also gives us an opportunity to provide you with some professional advice without needing to necessarily see us in person.

IS pelvic health PHYSIOTHERAPY COVERED UNDER HEALTH INSURANCE in hong kong?

This depends on the type of medical/health insurance you have as different policies offer varying levels of coverage. Some insurance providers require you to visit a GP first so that your physiotherapy sessions can be covered by your insurance, while others do not. Please check with your insurance provider before coming in. If you are in need of a GP (whether more family-focused or sports-specialised), please ask us for a recommendation.

WHEN SHOULD I BE BOOKING A CONSULTATION?

If you are experiencing any musculoskeletal pain or injury, or you have long-term mobility and movement restrictions, then you will benefit from our Discovery Consult. Symptoms you may be experiencing might include pain (after an injury), a niggling issue that has been impacting the life you want to live, or a long-term diagnosed or undiagnosed condition that you want to overcome. If you’re not quite sure, please give us a call or send us a message (+852 9339 3202) and find out how we can help you. Our PhysioCare consults are medically-insurable.