Comprehensive Women’s Health Physiotherapy: Addressing Pelvic Floor Dysfunction
Many women face the challenges of pelvic floor dysfunction, often believing mistakenly that it is a normal condition. It’s important to recognise that while common, it is not something one has to accept as standard. At Grosvenor Gardens Healthcare, located in the heart of London, our skilled pelvic floor physiotherapists offer effective treatment solutions.
We provide expert care for conditions including incontinence, bladder issues, neck and lower back pain, pelvic discomfort, and complications arising during pregnancy and postpartum. Our approach is tailored to address the unique musculoskeletal conditions women may encounter at different stages of life, serving patients from Chelsea to Mayfair with the latest techniques and compassionate care.
Various factors can contribute to pelvic floor dysfunctions, including lifestyle and life stage:
Pregnancy: Especially in the later trimesters, the pressure exerted on the pelvic floor due to the growing abdomen can lead to urinary stress incontinence. Prioritising pelvic floor exercises, engaging the abdominal muscles, and maintaining proper posture during pregnancy can mitigate these issues.
Ageing: While urine leaks are often associated with ageing, it’s important to note that urinary incontinence does not have to be an inevitable part of the ageing process. As women enter perimenopause and menopause, hormonal changes can weaken pelvic floor tissues. During this phase, adopting a healthy lifestyle and diligently strengthening the pelvic floor and its surrounding structures can significantly improve urinary control.
Childbirth: Both vaginal and C-section deliveries, as well as pelvic surgeries or radiation, can have adverse effects on the pelvic floor and abdominal wall. Postnatal physiotherapy can be instrumental in addressing these issues.
Neurological Diseases: For some women with neurological diseases, physiotherapy can play a pivotal role in alleviating symptoms and enhancing quality of life.
Additionally, it’s worth noting that even women of childbearing age who have not experienced pregnancy or obstetric surgeries may suffer from urinary incontinence. High-impact athletes, such as runners and sportswomen who engage in traditional sit-ups, can experience increased intra-abdominal pressure. If their pelvic floor cannot adequately support these pressures, they may experience urine leaks.
At Grosvenor Gardens Healthcare, we understand the unique challenges women face throughout their lives. Our expert team is here to provide tailored physiotherapy solutions that empower women to regain control over their pelvic health and overall well-being. Don’t hesitate to reach out to us for guidance and support on your journey to improved pelvic health.
Musculoskeletal and Sport Physiotherapy: Expert Care for Injuries and Pain
Musculoskeletal physiotherapy is a specialised field dedicated to treating injuries and conditions affecting muscles, joints, and soft tissues.
Our experienced physiotherapist combines a deep understanding of human anatomy with extensive knowledge of human movement. This allows us to identify the precise issues contributing to pain and dysfunction, enabling us to establish tailored goals aimed at optimising functional movements and facilitating a return to normal daily activities.
We provide comprehensive treatment for a wide range of conditions, including:
- Back, neck, and shoulder pain.
- Hip, knee, and ankle injuries.
- Postural problems.
- Pain management.
- Post-surgical rehabilitation for the spine, shoulder, abdominal-pelvis, hip, knee, ankle, and foot.
- Hip and knee replacement rehabilitation.
- Sports injuries.
Our physiotherapy treatments encompass:
- Thorough assessment of your condition, followed by the development of customised programs designed to correct body alignment, enhance muscle coordination, and improve posture.
- Manual therapy, soft tissue massage, and muscle energetic techniques.
- Clinical pilates and therapeutic exercises.
- Muscle strengthening, flexibility enhancement, and joint mobility exercises.
- Effective pain management strategies.
At our clinic, we’re dedicated to helping you recover from musculoskeletal issues and sports injuries. Our tailored approach ensures that you receive the personalised care needed to regain your optimal physical well-being. Contact us today to begin your journey toward improved health and functionality.
Pregnancy Physiotherapy: Relieving Pain and Enhancing Mobility
Pain in the neck, middle back, lower back, and pelvic regions is a common experience during pregnancy. It’s crucial to understand that physical therapy can play a significant role in reducing pain and improving mobility during this special time.
Maintaining proper posture, enhancing pelvic mobility, and strengthening the pelvic floor and its surrounding structures can alleviate discomfort and pain throughout pregnancy, aid in a smoother delivery, and expedite postpartum recovery.
You may be wondering how we achieve this. Our treatments encompass:
- Manual Therapy: Hands-on techniques tailored to your specific needs.
- Soft Tissue Massage: Targeted massage to relieve tension and discomfort.
- Pelvic Mobility and Muscle Strengthening: Focus on enhancing pelvic mobility and strengthening muscles, particularly the pelvic floor.
- Posture Re-education: Guidance on maintaining proper posture and increasing perineal and breathing awareness.
- Perineal Massage: Techniques to prevent injuries during labor.
- Toning and Relaxation: Exercises to promote body and perineal muscle toning and relaxation.
- Advice and Exercises: Comprehensive guidance to enhance well-being during labor and in the postpartum period.
Our pregnancy physiotherapy is designed to empower you to navigate pregnancy with less pain, greater comfort, and improved overall well-being. Contact us to discover how our specialized care can support you throughout your pregnancy journey.
A Comprehensive Postnatal Check-Up: PrioritiSing Your Well-Being (The Mummy MOT)
During pregnancy and childbirth, the muscles, fascia, and ligaments in the lower part of your pelvis, responsible for supporting pelvic organs like the bladder, uterus, and rectum, undergo significant stress and strain to accommodate the baby’s arrival.
Therefore, after giving birth, there are two essential appointments on your schedule that should not be missed:
First, a review with your gynaecologist, and second, an assessment by a physiotherapist specialising in obstetrics and urogynaecology. This assessment encompasses:
Full Posture Screen: Our physiotherapist carefully evaluates the alignment of your pelvis with respect to your spine, as proper alignment forms the foundation for effective abdominal-pelvic recovery.
Abdominal Muscle Examination and Diaphragm Assessment: We ensure there’s no diastasis (separation) of the rectus muscles or restrictions in the diaphragm, a crucial breathing muscle.
Pelvic Floor Muscle Assessment: We assess the condition of your pelvic floor muscles and any scars, addressing adhesions or imbalances that may affect their functionality. Our physiotherapist also evaluates pelvic floor tone and provides you with a personalised exercise guide to support your recovery.
Prolapse Screening: We check for any signs of visceral prolapse.
In some cases, additional sessions may be necessary to address specific issues, such as:
- Poor posture contributing to intra-abdominal pressure and pelvic floor dysfunctions.
- Pelvic misalignment.
- Muscle strains.
- Painful scars.
- Rehabilitation following a caesarean section.
- Diastasis rectus.
- Urinary incontinence and bladder dysfunctions.
- Bowel incontinence.
- Sexual dysfunctions.
- Potential back discomfort resulting from breastfeeding postures.
Our comprehensive postnatal check-up, known as The Mummy MOT, prioritises your well-being by addressing these issues and tailoring a plan to support your postpartum recovery journey. Don’t hesitate to schedule your assessment for a healthier, more comfortable postnatal experience.
Paediatric (Children’s) Physiotherapy: Expert Care for Young Ones
Our skilled paediatric physiotherapist, Carla, specialises in providing treatment for a range of conditions affecting children, including:
- Plagiocephaly/Flat Head Syndrome
- Lower Limb/Leg & Foot Issues
- General Baby MOT
- Gait Issues/Delay
- General Motor Development Delay
- Sports Injuries
- General Pain & Issues Related to Growth Process
With Carla’s expertise, your child can receive personalised care to address their specific needs and promote their optimal physical development. We are committed to ensuring the well-being of your little ones.
Urinary Incontinence: Understanding and Conquering It
Urinary incontinence, characterised by the involuntary loss of urine, can significantly affect one’s quality of life. It results from the inability to retain urine in the bladder due to the loss of voluntary control over the urinary sphincters, leading to the involuntary passage of urine.
The reassuring news is that most cases of urinary incontinence can be effectively treated with physiotherapy. There is a solution, and this condition does not have to limit an individual’s daily activities or social life.
Types of Urinary Incontinence
Urinary incontinence comes in different forms, each with its unique underlying causes. Hence, an accurate physiotherapeutic diagnosis is crucial to customise the treatment effectively. Symptoms may overlap among the types of urinary incontinence:
Stress Urinary Incontinence: This type involves the involuntary loss of urine during physical activities such as coughing, sneezing, laughing, walking, running, exercising, and lifting weights, among others. It typically occurs when intra-abdominal pressure increases during exertion, and weakened abdominal and pelvic floor muscles cannot adequately support the bladder. Consequently, urine may involuntarily leak through the urethra, especially when the urethral support is compromised.
Urge Incontinence: Marked by a sudden, intense urge to urinate, followed by an involuntary loss of urine. Many individuals with urinary urgency struggle to retain urine until reaching a restroom. This symptom often coincides with increased urinary frequency. The origins of urge incontinence involve a combination of poor bladder control (due to bad habits), weakened pelvic floor muscles, and transverse abdominal muscles.
Mixed Incontinence: Some individuals experience a combination of stress and urge urinary symptoms, making diagnosis and treatment especially vital to address both aspects effectively.
Understanding the type of urinary incontinence you or a loved one is experiencing is a crucial step towards finding the right physiotherapeutic solution. We are here to provide the support and guidance needed to help you regain control over your urinary health and enjoy a fuller, more comfortable life.
Bowel Incontinence: Understanding and Managing It
Bowel incontinence, also known as faecal incontinence, refers to the inability to control bowel movements, resulting in the involuntary loss of solid or liquid stool, or the inability to control gas (wind).
The origin of bowel incontinence can be traced to issues at the anal or rectal levels, including:
- Anal hypotonia.
- Hypotonia of the pelvic floor muscles.
- Alterations in the reflexes responsible for maintaining anal continence (such as the recto-anal inhibitory reflex).
- Changes in anal-rectal compliance and sensitivity.
The most common causes of faecal incontinence include:
- Obstetric and gynaecological trauma.
- Weakness of the pelvic floor.
- Retroverted uterine positioning.
- Direct trauma.
- Rectal surgery.
- Central neurological factors.
Treatment for faecal incontinence typically takes a conservative approach, involving techniques like biofeedback, electrostimulation, the use of a rectal balloon, and a series of exercises aimed at enhancing the patient’s control over anal continence. In addition to these methods, it is crucial to follow hygienic and dietary guidelines to ensure thorough rectal emptying and minimize gas production. Correcting any problematic defecation techniques that may further weaken the pelvic floor and contribute to uro-genital prolapse is also essential.
Pelvic Organ Prolapse: Understanding the Condition
Pelvic organ prolapse occurs when one or more of the organs in the pelvis, such as the bladder, uterus, or rectum, descend from their normal position. This condition is categorized into two types, depending on the prolapsed organ:
Prolapse of the Anterior Wall: In this case, the bladder, urethra, or uterus descends.
Posterior Wall Prolapse: Here, the rectum or intestines are the organs that have descended.
Pelvic organ prolapse can manifest in various degrees of severity. Without timely treatment, it can progress to the point of complete exteriorization of these organs. The progression is typically categorized into four degrees:
- Grade 1: The organs have descended slightly.
- Grade 2: The organs have descended to the level of the vaginal opening.
- Grade 3: The vagina or womb has dropped significantly, with up to 1 cm bulging out of the vaginal opening.
- Grade 4: More than 1 cm of the vagina or womb protrudes from the vaginal opening.
Common symptoms of pelvic organ prolapse include:
- Sensation of heaviness or pressure in the pelvic and genital area.
- Feeling like there is something descending into the vagina, often noticeable in a sitting position.
- Perception of a vaginal lump or a visible lump that was not present before, sometimes requiring manual adjustment for urination.
- Discomfort or pain during sexual intercourse.
- Sensation of incomplete bladder emptying, increased urinary frequency, or minor urine leakage during activities like coughing, sneezing, or exercising.
- Pelvic or lower back pain.
- Recurrent bladder infections.
Understanding pelvic organ prolapse and its symptoms is essential for early diagnosis and appropriate management. We are here to provide the support and guidance needed to address this condition effectively.
Chronic Pelvic Pain: Understanding and Managing Persistent Discomfort
Chronic pelvic pain is a condition that can affect individuals of all ages, both men and women, and it can be highly debilitating. This type of pain is typically felt in the lower abdomen but often radiates to areas such as the vulva, lower limbs, and buttocks due to the intricate connections within the pelvic region. Chronic pelvic pain is defined by pain persisting for a duration exceeding six months.
In many instances, chronic pelvic pain syndrome poses a diagnostic challenge, as the root cause of the pain remains unidentified. This can lead individuals on a frustrating journey from one specialist to another, causing delays in diagnosis and treatment. When the primary cause cannot be pinpointed, physicians often resort to prescribing medications, hormonal treatments, or even surgery.
The origins of chronic pelvic pain are diverse, stemming from the digestive, urinary, genital, or neuromuscular systems. Consequently, it is frequently associated with sexual, behavioural, emotional, and cognitive repercussions, significantly impacting the daily lives of those affected.
In a significant number of cases, the initial cause of the problem may have been effectively treated by a specialist doctor, yet it left behind lingering effects on the pelvic muscles and their reflexes, resulting in persistent pain.
As physiotherapists, conducting a thorough and tailored assessment of the patient’s condition is essential to comprehend the complexity of the situation and identify the structures that require attention or treatment.
If the pain is rooted in muscular issues or has affected the pelvic region, physiotherapy can play a crucial role in significantly alleviating discomfort or facilitating the complete recovery of the patient. Through physiotherapy, we address the entire abdominal-pelvic structure, aiming to enhance the quality of life for those experiencing chronic pelvic pain.
Physiosexology: Bridging Physiotherapy and Sexual Health
Physiosexology is a specialised branch of physiotherapy dedicated to the rehabilitation of the pelvic floor and the treatment of sexual dysfunction. This field encompasses various conditions, with some of the most common being dyspareunia, vaginismus, and anorgasmia.
According to the World Health Organization (WHO, 2006a), sexual health is defined as a state of overall well-being that includes physical, emotional, mental, and social aspects related to sexuality. It emphasises the importance of maintaining a positive and respectful approach to sexuality and sexual relationships, along with the ability to have pleasurable and safe sexual experiences free from coercion, discrimination, and violence. To achieve and sustain sexual health, the sexual rights of all individuals must be respected, protected, and fulfilled.
Dyspareunia and Vaginismus:
Dyspareunia: This condition involves pain during or after sexual intercourse or when inserting a tampon. Although pain during intercourse is not uncommon, it is not considered normal. Dyspareunia can result from various causes, many of which are treatable. Pain experiences can range from burning sensations to itching, cutting pain, stinging, or tightness, often preventing women from reaching orgasm. Dyspareunia can be categorised as either superficial (pain at the vaginal entrance) or deep (deeper pain in the vagina or lower abdomen during penetration). Regardless of its origin, women with dyspareunia often exhibit varying degrees of pelvic floor muscle tension due to painful sexual experiences and other pelvic floor dysfunctions.
Vaginismus: This condition manifests as the inability to tolerate vaginal penetration, such as inserting a finger, tampon, or engaging in sexual intercourse. It is characterised by spasms in the pubovaginal and perineal muscles. Vaginismus may have primary origins (present from the beginning) or secondary origins (developing later in life due to factors like childbirth, surgery, trauma, or emotional events). The physiotherapeutic treatment of vaginismus involves sexual and anatomical education, beginning with external structures and progressing to intracavitary treatment. The objective is to achieve muscle relaxation through myofascial techniques, manual therapy, vaginal dilators, and biofeedback to correct involuntary muscle contractions.
Addressing Orgasm Disorders in Women (Anorgasmia):
Anorgasmia is a type of sexual dysfunction characterised by the inability to achieve orgasm despite adequate stimulation. The physiotherapeutic approach to anorgasmia involves sex education, self-exploration, relaxation techniques, external and intracavitary techniques for normalising pelvic floor muscle tone, strengthening exercises, and improving motor control. It is important to identify the underlying causes of anorgasmia, which can range from sexual education deficits and trauma to pelvic floor issues like pain during intercourse, muscle weakness, urinary incontinence, and chronic pelvic pain. A multidisciplinary approach, including collaboration with a psychologist specialising in sexuality, is often crucial to achieving successful outcomes.
In summary, physiosexology offers a holistic approach to sexual health and well-being by addressing pelvic floor issues and sexual dysfunctions, helping individuals achieve fulfilling and pleasurable sexual experiences.
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