FEMALE PELVIC HEALTH PHYSIOTHERAPY SERVICE IN MOSSEL BAY AND SURROUNDS

I will collaborate with the female patient to compose a suitable exercise routine and body-alignment / physiotherapy treatment package (that may include electrotherapy and other modalities together with the pelvic floor exercises), that utilise behavioural / lifestyle change strategies, dietary and fluid intake adjustments and onwards referral and collaboration as needed with other local practitioners who focus on women’s health. Practitioners can include a dietician, psychologist, councillor, life coach, homeopathy consultant, general practitioner, gynaecologist or other specialists, fitness instructor, biokineticist and other social networks or group classes.

PELVIC HEALTH PHYSIOTHERAPISTS CAN ASSIST IN THE TREATMENT OF:

Being and staying active

Specific strengthening and stretching exercises or adaptation of exercises
Relaxation and breathing / stress management strategies
Sport specific challenges and injury rehabilitation
Osteopenia and osteoporosis exercise, balance training and mobility especially during and after menopause
Managing menopause strategies
Physical and exercise strategies for chronic conditions

Pelvic floor dysfunction

Pelvic floor weakness (leaking / incontinence of bladder / bowel or prolapse)
Functional Constipation
Bladder problems (urge and urgency)
Sexual health related to pelvic floor function
Pelvic pain syndromes and management

Antenatal strategies

Protecting the pelvic floor strategies
Back, neck pain and aches
Pelvic pain
Maintaining or starting exercise
Manual handling strategies
Choice of Orthotics

Post natal care

Returning to exercise / sport
Infant care and mental well-being
Pelvic floor weakness (leaking / incontinence)
Pelvic pain
Back and neck pain (body aches)

Post surgery rehabilitation

Scar management (all areas) after surgery
Returning to sport / exercise
Manual lymph drainage and compression care (complete decongestive therapy) incl. post mastectomy care as part of complementary therapy in the management of cancer.
Fascia and connective tissue mobilisation as part of connective tissue integrated care

MORE ABOUT PELVIC FLOOR PHYSIOTHERAPY TRAINING:

I provide complete pelvic floor physiotherapy training where the focus is on the education (preventative / promotion), evaluation, treatment and support of females with symptoms of pelvic floor dysfunction, including pelvic organ prolapse, urinary and faecal incontinence, peripartum and post-partum pelvic floor dysfunction, including sexual dysfunction and chronic pelvic pain, in conjunction with other challenges unique to the female body.

Pelvic floor physiotherapy training (PFPT) includes the use of manual manipulation (of joint, fascia and muscles), in conjunction with a step-wise, individualised exercise, breathing and flexibility programme to restore functional muscle synergy.

Depending on the female patient’s symptoms and current pelvic function, other modalities such as electrostimulation (electrical stimulation provides a small electrical current to contract the pelvic floor and assist the patient in isolating the correct muscles to exercise), biofeedback machines (biofeedback machines use a vaginal or rectal pressure sensor to provide visual feedback of the strength of the muscle contraction), and other aids such as vaginal dilators or vaginal weighted cones (Vaginal cones are a weighted cone that is inserted into the vagina and held in place during activity by pelvic floor contractions) may also be used to assist with optimal recovery and exercise.

PFPT examination and treatment includes both internal pelvic and external components.

Pelvic floor exercises are specific and needs to be exercised routinely. Studies show that a significant improvement in pelvic floor function are observed usually around 6 months after the start of regular pelvic floor exercises. Therefore, the women’s health physio will assemble with the patient the most appropriate follow-up strategy to encourage continuation of exercises and behavioural changes, as well as suitable and timely monitoring/ motivational strategies and progression of the exercises / treatment package. A suitable exit strategy and end goals will be established at the start and reviewed as set out in the treatment plan.

Quick Pelvic floor checklist:

(Reference: Emma Brockwell. Women’s health Physiotherapist. UK)

If you experience one or more of these physical symptoms, the chances are that you have pelvic floor dyssynergy/ dysfunction and will benefit from pelvic floor physiotherapy treatment.

• Do you leak urine when you cough, sneeze, jump or move
• Do you leak urine if you cannot get to the toilet quickly?
• Do you get to the toilet on time to pass urine or stools?
• Do you struggle to hold your urine for a long (4 hours) time?
• Do you feel heaviness, dragging or bulging in your vagina?
• Do you notice a gap or doming around your tummy?
• Do you have pain in your lower back, pelvis and / or hips?
• Do you have pain in your vagina during sex?
• Do you have faecal incontinence (poo leak) and or difficulty controlling wind?
• Do you have any questions or concerns about recovery from C-section / episiotomy (surgical incision) or 3rd and 4th degree tears?

You do not need a referral to see a physiotherapist for treatment, however best enhance care focus on a multidisciplinary team and includes discussion with your gynae, mid-wife and any other role-players in your recovery.

Many of the physical changes and challenges of the pelvis that women face throughout their stages of life are addressable and manageable and, in many instances, surgery can be avoided if changes and challenges are addressed early on.

PFPT (pelvic floor physiotherapy training) is a program of exercises to improve pelvic floor muscle strength, endurance, power, relaxation or a combination of these.  PFPT is performed by physiotherapists who has a special interest in Women and Pelvic Health and has completed the compulsive further training through the South African Society of Physiotherapy and are recognised by the Health Profession’s Council of South Africa and the South African Society of Physiotherapy as female pelvic health physiotherapists.

Robust evidence-based support recommends PFPT with or without supplemental modalities for the treatment of urinary incontinence, pelvic organ prolapse, faecal incontinence, peripartum and postpartum pelvic floor dysfunction, and hypertonic pelvic floor disorders, including pelvic floor myofascial pain, dyspareunia and vaginismus, and vulvodynia.