Pelvic Health Melbourne

The Pelvic Floor and Sexual Function in Men

Mon, 20 Apr 2026 01:29:12 GMT

Sexual health is an important part of overall wellbeing, yet it is something many men find difficult to talk about. One factor that is often overlooked is the role of the pelvic floor in sexual function.

The pelvic floor is a group of muscles at the base of the pelvis. In men, these muscles help support the bladder and bowel, and they also play a key role in erections, ejaculation, and sexual sensation. When these muscles are not functioning well - whether they are too tight, too weak, or not coordinating properly - it can contribute to sexual difficulties.

Some men may experience erectile dysfunction, difficulty maintaining an erection, changes in ejaculation, reduced sensation, or discomfort during or after sex. These concerns can occur at any stage of life and are more common than many people realise.

There are a range of factors that can affect pelvic floor function. Stress and anxiety can increase muscle tension, while surgery (such as prostate surgery), prolonged sitting, or chronic pelvic pain can also play a role. Often, it is a combination of factors rather than a single cause.

It is also important to recognise the role of the mind-body connection. Stress, performance anxiety, and emotional wellbeing can all influence sexual function. Addressing both the physical and psychological aspects of health often leads to the best outcomes.

Pelvic health physiotherapy can help identify how the pelvic floor is functioning and guide treatment. This may include exercises to improve strength or relaxation, breathing techniques, and strategies to reduce tension and improve coordination. Education and small changes can often make a meaningful difference.

Sexual dysfunction in men is common, and support is available. Understanding the connection between the pelvic floor and sexual health can be an important step toward improving confidence, comfort, and overall wellbeing.

Pelvic Health Is For Everyone

Wed, 18 Mar 2026 22:36:42 GMT

Pelvic Health Is for Everyone

Pelvic health is often talked about as a women’s issue, but in reality it affects people of all genders across every stage of life. The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles also play a role in sexual function and everyday movements like lifting, bending, coughing, or laughing. Because they are involved in so many aspects of daily life, looking after pelvic health is important for everyone.

Pelvic health concerns can show up in many different ways. Some people experience bladder leakage, urgency, constipation, or changes in bowel habits. Others may experience pelvic girdle pain, including discomfort around the sacroiliac joints, pubic symphysis, or coccyx (tailbone). Pelvic pain can also occur in the lower abdomen or in the genitals and may affect comfort with sitting, exercise, or sexual activity. These symptoms can affect people of any gender, yet they are often not openly discussed.

Pelvic floor challenges can appear at different stages of life. Children may experience constipation, bedwetting, or daytime bladder accidents. Adolescents and adults may notice pelvic pain, bladder urgency, or bowel changes. Men may experience pelvic pain or bladder symptoms, including leakage, particularly after prostate surgery. Older adults may notice changes in bladder or bowel control or pelvic comfort as the body changes with age. While these experiences are common, many people are surprised to learn that help is available.

Hormones also play an important role in pelvic health for people of all genders. Changes in hormone levels; during puberty, pregnancy, menopause, or as part of gender-affirming hormone therapy, can influence tissue health, bladder control, sexual function, and comfort in the pelvic region. Understanding these changes and supporting the body with the right care can make a meaningful difference.

Pelvic health physiotherapy offers practical support, education, and treatment for many of these concerns. Physiotherapists can help people better understand their pelvic floor, improve bladder and bowel habits, manage pelvic girdle or pelvic pain, and support comfortable movement in daily life. Often, small changes can make a big difference to daily comfort and confidence.

Pelvic health isn’t limited to one gender or one stage of life. By talking about it more openly and recognising the many ways it can affect the body, we can make it easier for everyone to seek support and care for their pelvic health.

Understanding Lichen Sclerosis

Wed, 03 Dec 2025 22:28:50 GMT

Understanding Lichen Sclerosis: What You Need to Know

Lichen Sclerosis (LS) is a condition we see more often than people realise — yet many individuals go years without the right diagnosis. At Pelvic Health Melbourne, our goal is to make conversations about vulval, penile and anal health easy, accessible and stigma-free.

Here’s a clear guide to what LS is, how it’s treated, and how pelvic health physiotherapy can support you.

What Is Lichen Sclerosis (LS)?

Lichen Sclerosis is a long-term inflammatory skin condition that typically affects the vulva, penis, or the skin around the anus.

A few key facts:

It’s not contagious. You can’t pass LS on to a partner.
It may have a genetic or autoimmune link. People with other autoimmune conditions can be more prone to developing it.
It’s more commonly diagnosed in people in their 40s and 50s, though it can occur at any age.

Common Signs and Symptoms

LS can look and feel different for everyone, but some of the most common symptoms include:

Itching, burning or general soreness around the vulva, penis, or anus
Skin changes, such as pale or white patches, areas that appear thickened or “crinkled,” or skin that becomes thin and fragile over time
Dryness and loss of natural skin oils, leading to cracks, fissures, bruising or even blisters
Possible scarring or narrowing of the vaginal or anal openings in long-standing vulval or anal LS
In penile LS, symptoms often affect the foreskin and glans (head of penis)

If any of these symptoms sound familiar — especially if they’ve been going on for a while — it’s worth discussing LS with your GP or pelvic health clinician.

Typical Management & Treatment in Australia

The good news: with early diagnosis and treatment, LS can be well managed and long-term complications can be reduced.

Common treatments include:

Topical steroid ointments or creams to reduce inflammation
Topical oestrogen if thinning or hormone-related changes are present (for vulval LS)
Gentle skin care routines to restore moisture and protect fragile skin
Silicone-based lubricants for comfortable intimacy
Vaginal dilators or vibrators to help maintain stretch and comfort if the vaginal entrance has narrowed

Your GP or dermatologist will oversee the medical management — but pelvic health physio plays a big role too.

How Pelvic Health Physio Can Help

Our clinicians at Pelvic Health Melbourne are experienced in recognising LS and supporting you through the often-overlooked side effects of the condition.

We can help with:

Identifying symptoms early and guiding you to your GP for diagnosis and treatment
Addressing secondary pain, such as burning or discomfort caused by pelvic floor overactivity
Managing scarring or narrowing at the vaginal entrance using dilators, moisturises and tailored lubrication advice
Supporting intimacy goals, helping reduce muscle tightness and improve comfort during sexual activity
Easing nerve-related pelvic pain, which can develop from chronic irritation or inflammation

Managing LS isn’t just about treating the skin — it’s about restoring comfort, confidence and quality of life.

Why Awareness Matters

LS is not extremely common, and some practitioners may only encounter it rarely. This means it can sometimes be overlooked or mistaken for recurrent thrush, eczema or dermatitis.

Knowing the signs — and knowing to ask the question — can make a big difference.

Early treatment helps:

Control inflammation
Prevent or reduce scarring
Maintain skin health
Improve long-term comfort and function

If you suspect LS, trust your instincts and seek support. You're not alone — and there are effective treatments available.

If you’d like guidance, reassurance, or help managing symptoms, our pelvic health physiotherapy team is here to support you every step of the way.

Premature Ejaculation: The Causes, Treatment and Support

Wed, 12 Nov 2025 01:30:00 GMT

Understanding Premature Ejaculation: Causes, Treatment, and Support

Premature ejaculation (PE) is one of the most common sexual concerns in males, yet it is rarely talked about openly. Many males experience it at some point in their lives, but when it happens regularly, it can cause frustration, affect confidence, and even put strain on intimate relationships.

The good news? Premature ejaculation is very common and treatable. Let’s break down what it is, why it happens, and how it can be managed.

What is premature ejaculation?

Premature ejaculation is when ejaculation occurs sooner than you or your partner would like, often within a minute of penetration or even before penetration begins. For some males, it happens occasionally; for others, it’s a consistent pattern that impacts sexual satisfaction.

It’s important to know that there is no “perfect time” that sex should last. PE is usually defined not just by timing, but by whether it causes distress or difficulty in sexual relationships.

Why does premature ejaculation happen?

There isn’t just one cause — PE can result from a combination of physical, psychological, and behavioural factors.
Pelvic floor muscle involvement: Overactive or tense pelvic floor muscles can lead to reduced control and quicker ejaculation.
Psychological factors: Anxiety, stress, performance pressure, or even relationship concerns can all play a role.
Learned patterns: Rushing during sex or masturbation (for example, due to fear of being caught in adolescence) can become a habit that carries into adulthood.
Medical factors: Hormonal changes, nerve sensitivity, or underlying health conditions may contribute.

How can premature ejaculation be treated?

Treatment usually combines physical and psychological strategies. Here are some of the most effective approaches:

Pelvic floor physiotherapy
Learning to identify, relax, and retrain pelvic floor muscles can improve control. Many males with PE actually have an overactive pelvic floor rather than a weak one.
Breathing and body awareness
Deep breathing and mindfulness techniques can reduce muscle tension and help manage arousal levels.
Behavioural techniques
Methods such as the “stop-start” technique or “squeeze” technique, when practiced with guidance, can gradually improve control.
Psychological support
Addressing anxiety, stress, or negative thought patterns around sex can make a big difference. Sometimes, working with a psychologist or sex therapist alongside physiotherapy provides the best outcomes.
Medical options
In some cases, doctors may suggest medication (such as topical numbing creams or certain oral medications) if conservative strategies aren’t enough on their own.

Why seeing a professional helps

Many males try to manage PE on their own but don’t see lasting improvement. A pelvic floor physiotherapist can assess muscle activity, teach you how to use (and relax) your pelvic floor effectively, and guide you through strategies tailored to your body and situation.

If anxiety or relationship strain is part of the picture, working alongside a sexual health psychologist or counsellor can be very effective.

Conclusion

Premature ejaculation is common, treatable, and nothing to be ashamed of. If it’s causing frustration or stress in your life, know that help is available — and you don’t have to put up with it alone.

Taking the first step to speak with a professional can make all the difference in regaining control, confidence, and satisfaction in your sexual health.

Prostatitis: What You Need To Know

Wed, 05 Nov 2025 01:30:00 GMT

Understanding Prostatitis: What You Need to Know

Prostatitis is a common condition that affects the prostate gland, a small walnut-sized organ found in males just below the bladder. It can cause a range of uncomfortable symptoms, including pain, urinary issues, and sexual discomfort. While it can be distressing, it’s important to know that prostatitis is treatable and does not mean you have prostate cancer.

What Is Prostatitis?

Prostatitis refers to inflammation or irritation of the prostate gland. It is the most frequently diagnosed urological problem in males under 50 and can affect males of all ages. According to the Royal Australian College of General Practitioners (RACGP), up to 15% of Australian males will experience symptoms of prostatitis at some point in their lives. Despite its prevalence, many males feel unsure about what it means and how it’s managed.

Types of Prostatitis

Acute Bacterial Prostatitis (ABP)

ABP is a sudden and severe infection of the prostate caused by bacteria, most commonly Escherichia coli. Symptoms include fever, chills, dysuria, pelvic pain, urinary retention, and systemic illness. It is considered a medical emergency requiring prompt diagnosis and treatment with intravenous or oral antibiotics. Hospitalization may be necessary in severe cases.

Chronic Bacterial Prostatitis (CBP)

CBP involves recurrent bacterial infections of the prostate with similar but less intense symptoms than ABP. Patients may experience intermittent urinary tract infections, pelvic discomfort, and post-ejaculatory pain. Diagnosis is confirmed through culture of expressed prostatic secretions or post-prostatic massage urine samples. Treatment typically involves prolonged antibiotic therapy for four to six weeks, guided by culture and sensitivity results.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

CP/CPPS is the most prevalent form of prostatitis, accounting for over 90% of cases. It is characterized by pelvic pain lasting more than three months in the absence of detectable bacterial infection. Symptoms include pain in the perineum, suprapubic region, testicles or lower back, urinary frequency, urgency, dysuria, and painful ejaculation. The condition is multifactorial, with contributing elements such as pelvic floor muscle dysfunction, neurogenic inflammation, and psychosocial factors. Management is multidisciplinary and includes pelvic floor physiotherapy, pharmacological agents, and lifestyle modifications.

Asymptomatic Inflammatory Prostatitis

This form is diagnosed incidentally during evaluation for other conditions, such as infertility or prostate cancer screening. It is defined by the presence of inflammatory cells in prostate tissue or fluid without associated symptoms. No treatment is required as it does not impact health outcomes.

Clinical Presentation

Common symptoms across prostatitis subtypes include pelvic or perineal pain, urinary urgency and frequency, incomplete bladder emptying, and discomfort during or after ejaculation. In ABP and CBP, symptoms may be accompanied by signs of infection. In CP/CPPS, pain is the dominant feature and may be exacerbated by stress, prolonged sitting, or certain dietary factors.

Role of Pelvic Floor Physiotherapy

Pelvic floor physiotherapy is a cornerstone of treatment for CP/CPPS. Evidence supports the use of manual therapy, myofascial release, biofeedback, and pelvic floor muscle relaxation techniques to reduce muscle hypertonicity and alleviate pain. Patients are taught diaphragmatic breathing, stretching exercises, and behavioral strategies to manage flare-ups.

Comprehensive Management Approach
Treatment is tailored to the specific type of prostatitis. For ABP and CBP, antibiotics are the primary intervention. For CP/CPPS, a multimodal strategy is recommended. This includes alpha-blockers to improve urinary flow, anti-inflammatory medications, neuromodulators for nerve-related pain, and cognitive behavioral therapy for associated anxiety or stress. Dietary modifications such as reducing caffeine, alcohol, and spicy foods may reduce irritation. Regular physical activity and proper hydration support overall pelvic health.

Key Takeaways

Prostatitis is not associated with an increased risk of prostate cancer. While symptoms can be persistent, particularly in CP/CPPS, most patients experience significant improvement with appropriate care. Early diagnosis and a coordinated approach involving urology and pelvic health physiotherapy optimize outcomes. Patient education on the nature of the condition, realistic expectations for recovery, and self-management strategies are essential components of care.

Kids Daytime Wetting: What You Need To Know

Wed, 29 Oct 2025 01:00:01 GMT

Understanding Daytime Wetting in Children: The “Why” Behind It

Daytime bladder accidents, or daytime wetting, are surprisingly common in childhood. While many parents worry that something is “wrong” with their child, the truth is that bladder control is a complex process involving the bladder, pelvic floor muscles, bowel, nervous system, and even emotions.

When one part of this system is under pressure, immature, or not communicating well with the others, wetting can occur.

How Common Is Daytime Wetting?

Research shows that daytime wetting is more frequent than many parents realise:

Around 10% of children at age 5–6 experience daytime wetting.
By age 7, prevalence drops to about 5%.
At age 9, around 2–3% of children are still affected.

This means that while most children develop bladder control naturally, a significant number need extra support to achieve dryness.

1. The Developing Bladder-Brain Connection

To stay dry during the day, children need to:

Feel the bladder filling (sensory signal)
Recognise that signal as “I need to go”
Respond quickly by activating the pelvic floor and then relaxing it at the right time on the toilet.

In some children, this communication loop between the bladder and brain matures later. This can mean:

They don’t notice bladder fullness until the last moment.
This may result as a sudden strong urge and may present as them “dancing” or holding themselves.
Their bladder muscle (the detrusor) may contract involuntarily, pushing urine out before they are ready.

This explains why children often appear “fine one moment, bursting the next.”

2. Overactive or “Irritable” Bladder

Sometimes the bladder itself is the driver. An overactive detrusor muscle contracts too frequently, leading to urgency and accidents. This may be linked to:

Drinking bladder irritants (soft drink, caffeine, artificial colours/flavours).
Post-bladder infection sensitivity.
Constipation pressing on the bladder and reducing its capacity.

Children with overactive bladder often experience frequent small wees, urgency, and may show classic “holding manoeuvres” like squatting or crossing their legs.

3. Constipation and the Bladder-Bowel Link

Up to 30–50% of children with daytime wetting also have constipation. A constipated bowel takes up valuable space in the pelvis, which can reduce the bladder’s storage capacity.

Treating constipation is often the first and most effective step in resolving bladder problems.

4. Pelvic Floor Muscle Dysfunction

The pelvic floor muscles must hold on at the right time and relax at the right time. If these muscles are too tight or discoordinated, the child may not empty properly, which can lead to dribbling, urgency, or urinary tract infections.

This is where pelvic health physiotherapists use age-appropriate education and biofeedback to help children learn how their muscles work.

5. Neurodivergence and Bladder Control

Children who are autistic, ADHD, or have sensory processing differences often experience higher rates of bladder and bowel challenges. Studies suggest that children with ADHD are 2–3 times more likely to experience incontinence compared to neurotypical peers.

The pathophysiology here can involve:

Altered sensory processing: bladder fullness may not be felt until very late.
Executive function differences: difficulty shifting attention from play or schoolwork to respond to body cues.
Anxiety or rigidity: avoiding toilets outside the home due to sound, smell, or sensory overwhelm.
Medication effects: some ADHD medications may influence urinary frequency or urgency.

The key message: the bladder is working within the unique way that child’s nervous system processes information.

6. Behavioural and Emotional Factors

Stressful life events, school changes, bullying, or family transitions can all impact bladder control. In these cases, the child’s nervous system may be on “high alert,” influencing bladder muscle activity and pelvic floor responses.

Wetting in these cases is not deliberate — it’s the body’s way of responding to stress.

How Treatment Helps

When we understand why wetting occurs, treatment can be tailored to the child’s needs.

A collaborative approach between pelvic health physiotherapists, GPs, and sometimes paediatricians may include:

Bladder training: establishing healthy toileting routines.
Constipation management: diet, fluids, or medication if required.
Pelvic floor awareness: playful, child-friendly exercises to improve coordination.
Behavioural strategies: rewards, charts, or visual schedules.
Environmental changes: school toileting plans, sensory adjustments.

With the right support, most children improve significantly — and many achieve dryness within months.

The Takeaway

Daytime wetting is rarely about laziness or misbehaviour. It is the result of interacting bladder, bowel, muscle, and brain factors – all of which can be supported with the right guidance.

If your child experiences daytime wetting, know that you are not alone, and that early intervention can help prevent ongoing issues with confidence, social participation, and urinary health.

Our team at Pelvic Health Melbourne works closely with families, GPs, and other health professionals to provide child-friendly, evidence-based care.

Mastitis: How Ultrasound Therapy Can Help

Sun, 12 Oct 2025 22:59:46 GMT

Understanding Mastitis & How Physiotherapy Can Help

Mastitis is one of the most common challenges faced by breastfeeding women — and it can be incredibly painful and distressing. But the good news? With the right support and early intervention, recovery is usually quick, and breastfeeding can continue comfortably.

What Is Mastitis?

Mastitis is inflammation of the breast tissue, often caused by milk not draining properly (known as milk stasis). When milk remains trapped, it can irritate the tissue and lead to swelling, pain, and sometimes infection.

Common signs and symptoms include:

Localised breast pain, tenderness, or burning
A firm, red, or hot area on the breast
Swelling or lumpiness
Fever, chills, and flu-like symptoms
Feeling generally unwell or fatigued

It’s important to seek help early — untreated mastitis can worsen quickly and may require medical treatment such as antibiotics.

How Physiotherapy & Ultrasound Therapy Can Help

Many people are surprised to learn that women’s health physiotherapists can play an important role in managing mastitis. Alongside medical care and lactation support, physiotherapy can help reduce pain, inflammation, and improve milk flow — especially when using therapeutic ultrasound.

What Is Therapeutic Ultrasound?

Therapeutic ultrasound uses gentle sound waves to help soften and disperse blockages within the breast tissue. The treatment is non-invasive, painless, and supported by evidence for its role in improving symptoms and promoting recovery.

Ultrasound therapy can help to:

Break down blocked ducts
Reduce inflammation and swelling
Improve milk drainage and flow
Relieve pain and discomfort
Support faster healing

Sessions are typically short and safe to continue while breastfeeding.

Beyond Ultrasound: Comprehensive Care

At your physiotherapy appointment, we’ll do more than just treat the symptoms. We’ll look at the whole picture — what may have contributed to the blockage, and how to reduce the risk of it happening again.

This may include:

Reviewing your feeding or pumping techniques
Recommending gentle self-massage and drainage methods
Providing positioning advice for better milk flow
Teaching preventative strategies for future episodes

Every treatment plan is tailored individually — because every feeding journey is different.

When to See Your GP

If you experience fever, chills, or flu-like symptoms, or if your symptoms do not improve within 24–48 hours of treatment, it’s important to see your GP. Antibiotics may be needed alongside physiotherapy.

The Takeaway

Mastitis can be painful — both physically and emotionally — but it’s also very treatable. Early intervention and the right combination of care from your GP, lactation consultant, and women’s health physio can make a world of difference.

Ultrasound therapy is a safe, gentle, and effective part of that recovery — helping you get back to feeding comfortably, confidently, and pain-free.

Period Pain: What Is Normal and When to Seek Help

Tue, 07 Oct 2025 01:02:15 GMT

Period Pain: What Is Normal and When to Seek Help

Many people experience discomfort or cramping during their period. It’s often dismissed as “just part of being a woman,” but not all period pain is normal. In fact, period pain (also called dysmenorrhoea) can vary widely in intensity and impact, and in some cases it may signal an underlying issue that deserves proper attention.

As pelvic health physiotherapists, we see many people who are unsure whether their pain is something they should live with, or whether there are strategies to help. The good news is: support is available.

Why does period pain happen?

Each month, the uterus contracts to help shed its lining. These contractions can temporarily reduce blood flow and irritate nearby nerves, leading to cramping sensations in the lower abdomen. Pain may also radiate to the lower back or thighs.

For many, this pain is mild and lasts only 1–2 days at the start of the period. But for others, it can be more severe, long-lasting, and disruptive to daily life.

When is period pain not normal?

While some discomfort is expected, pain is not normal when it is:

Severe, sharp, or ongoing beyond the first couple of days
Preventing you from going to work, school, sport, or social activities
Not improving with simple strategies like heat, stretching, or gentle exercise
Associated with other symptoms, such as nausea, vomiting, bowel changes, heavy bleeding, or pain with intimacy

If this sounds familiar, it may be worth seeking further support. In some cases, conditions such as endometriosis or adenomyosis can cause significant pelvic pain, and these are best managed with a team approach.

How pelvic health physiotherapy can help?

A pelvic health physiotherapist looks at how your muscles, posture, and movement patterns may be contributing to pain. Pain often leads to protective tension in the pelvic floor muscles, which can create a cycle of ongoing discomfort.

Physiotherapy can help by:

Assessing pelvic floor function: checking for muscle overactivity or tension that may be amplifying pain
Teaching relaxation techniques: including breathing strategies, pelvic floor “drops,” and mindfulness-based approaches
Prescribing gentle exercise and stretches: to ease cramping and improve circulation
Lifestyle guidance: such as posture awareness, pacing strategies, and exercise modifications around your cycle
Collaborating with your GP or gynaecologist: ensuring that if further investigation or medical treatment is needed, you have the right support

Period pain is very common, but that doesn’t mean it should disrupt your quality of life or be brushed off as normal. If your periods are leaving you in bed, stopping you from enjoying daily activities, or not responding to simple strategies, it’s time to reach out for help.

A pelvic health physiotherapist can work with you to reduce pelvic tension, support your body with movement and lifestyle strategies, and guide you towards further medical input if necessary.

Pain is your body’s way of telling you something. Listening to it, and seeking the right support, is the first step towards feeling more in control of your cycle.

Perimenopause: Signs Your Period Is Ending

Fri, 19 Sep 2025 01:59:10 GMT

Perimenopause: The Chapter Before Menopause

Perimenopause is the transition phase before menopause, when the ovaries gradually slow their production of the hormones oestrogen and progesterone.

Unlike menopause, which is marked by the end of menstrual cycles, perimenopause is a shifting and fluctuating period of hormonal change.

This stage can begin earlier than many women expect. While the average onset is in the mid-40s, some women experience signs in their late 30s.

Perimenopause can last a few months, but for some, it stretches over several years — sometimes up to eight or more.

Because the changes happen gradually, early signs are often missed or dismissed as “just stress” or “getting older.” Recognising these changes is the first step in managing them effectively.

Common Signs and Symptoms

Hot flushes and night sweats
Sudden waves of heat, flushing of the skin, and sweating can appear during the day or interrupt sleep at night. These can range from mild to intense and may be triggered by factors such as stress, certain foods, or changes in room temperature.
Sleep disturbances
Falling asleep can become more difficult, and many women wake during the night without a clear reason. This can lead to fatigue and low energy during the day.
Mood changes
Shifts in mood, including irritability, anxiety, and sudden emotional reactions, can be linked to fluctuating hormones. For some, these changes can feel out of character and disruptive.
Irregular periods
Cycles may shorten, lengthen, or become heavier or lighter. Periods may also skip entirely before resuming again, adding to the unpredictability.
Cognitive changes (brain fog)
Some women report difficulty concentrating, forgetfulness, or losing their train of thought mid-sentence. These changes can be frustrating, especially in work or social situations.
Changes in libido and vaginal health
A decline in sexual desire, vaginal dryness, or discomfort during intimacy may occur due to reduced oestrogen levels.
Physical changes
Aches, joint stiffness, changes in skin texture, and pelvic floor symptoms such as urinary leaks, urgency, or a sensation of heaviness can develop.

Why This Stage Matters

Perimenopause is a natural stage of life, but it can have a significant impact on physical, emotional, and social wellbeing. Many women feel they have to “push through” without support, yet there are effective strategies to help.

These may include:

Adjusting exercise and nutrition to support hormonal health and bone strength.
Learning pelvic floor exercises to address or prevent leaks and discomfort.
Using medical treatments such as hormone replacement therapy (HRT) or other symptom-management options under guidance from a healthcare professional.
Exploring lifestyle changes like stress management, consistent sleep routines, and reducing trigger foods.

Tracking and Seeking Support

One of the most useful steps you can take is to track your symptoms. Keeping a simple diary for two to three months can help identify patterns and make discussions with your GP or women’s health physiotherapist more productive.

If symptoms are disrupting your daily life — whether that means poor sleep, ongoing discomfort, or emotional strain — professional help is available. The sooner support is sought, the smoother this transition can be.

Perimenopause may be a natural phase, but with the right knowledge, tools, and care, it doesn’t have to be a time of uncertainty or struggle.

Hysterectomy: Removing The Uterus

Wed, 17 Sep 2025 02:39:21 GMT

The Role of Pelvic Floor Physiotherapy After a Hysterectomy

A hysterectomy is a significant surgical procedure, and while it can be necessary for a range of medical conditions, recovery requires careful consideration. The pelvic floor and core do not automatically restore their previous function following surgery. Regardless of whether the procedure was performed via an abdominal, vaginal, or laparoscopic approach, targeted rehabilitation is often essential.

Pelvic floor physiotherapy provides evidence-based strategies to optimise healing, restore function, and support long-term pelvic health. Below is an outline of how a physiotherapist may assist across the different stages of recovery.

Early Recovery (0–6 Weeks)

Focus: Education, Protection, Gentle Awareness

During the initial post-operative phase, the priority is to protect healing tissues and establish safe movement patterns. A physiotherapist may provide:

Pelvic floor education — guidance on how surgery has altered pelvic support, biomechanics, and bladder/bowel function.
Breathing and core coordination — gentle diaphragmatic breathing techniques to reduce tension, support circulation, and minimise swelling.
Safe movement and postural strategies — instruction on bed mobility, transfers, and walking to avoid unnecessary strain.
Scar and tissue healing advice — information to optimise scar recovery, reduce the risk of adhesions, and monitor for signs of complications.

Mid Recovery (6–12 Weeks)

Focus: Activation, Strengthening, Confidence

Once surgical healing is established, rehabilitation progresses to restoring muscle activation and movement control. This may include:

Pelvic floor muscle retraining — graded internal or external exercises focusing on coordination, endurance, and strength.
Core muscle activation — re-education of deep abdominal muscles, particularly the transversus abdominis, in synchrony with the pelvic floor.
Postural alignment and movement retraining — addressing compensatory patterns or protective guarding to optimise pelvic loading.
Scar mobilisation — manual therapy to improve tissue mobility, circulation, and sensitivity.

Later Recovery (3+ Months)

Focus: Return to Function, Fitness, and Lifestyle

The longer-term phase of rehabilitation supports a safe return to higher levels of activity and addresses ongoing pelvic health needs. This may involve:

Exercise progression and return-to-sport planning — individualised advice for safely resuming walking, lifting, gym training, Pilates, or sport while minimising risk of prolapse or core dysfunction.
Bladder and bowel retraining — management of urgency, leakage, or constipation, which may present post-surgery.
Support for intimacy and pelvic pain — rehabilitation for dyspareunia, vaginal tightness, or scar-related discomfort.
Prolapse prevention and long-term pelvic health — strategies to manage intra-abdominal pressure and maintain pelvic organ support.

Why Consult a Pelvic Floor Physiotherapist?

Pelvic floor physiotherapists are trained to assess not only the muscles, but the integration of breath, core, scars, posture, and daily movement patterns following surgery. This holistic assessment allows for a tailored rehabilitation plan to support both short- and long-term recovery.

Importantly, it is never too late to commence pelvic floor physiotherapy. Whether a patient is six weeks or six years post-hysterectomy, physiotherapy can assist in improving function, comfort, and quality of life.

Prolapse: What Raises Your Risk?

Mon, 15 Sep 2025 04:15:49 GMT

Understanding the Risk Factors for Pelvic Organ Prolapse (POP)

Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs (such as the bladder, uterus, or rectum) shift downward and push into the vaginal wall due to weakened support from the pelvic floor. It’s more common than many realise, and while it can feel overwhelming, knowing the risk factors can help you take steps to protect your pelvic health.

Key Risk Factors

1. Vaginal Birth

Childbirth is one of the most significant contributors to POP. Vaginal deliveries, particularly when forceps are used, when the baby is large, or after multiple births, can place considerable strain on the pelvic floor muscles and connective tissues.

2. Age

As we age, our muscles and tissues naturally weaken. This includes the pelvic floor, which means the likelihood of prolapse increases over time.

3. Obesity

Carrying extra body weight increases pressure on the pelvic floor. Over time, this added strain can contribute to the development of POP.

4. Genetics

Sometimes, pelvic health challenges run in families. If you have a close relative with POP or connective tissue disorders, you may be more predisposed to experiencing prolapse yourself.

5. Menopause

Hormonal changes associated with menopause—particularly lower oestrogen levels—can lead to thinning and weakening of pelvic tissues, making them less supportive.

6. Prior Pelvic Surgery

Procedures like a hysterectomy can affect pelvic support structures and increase the risk of prolapse later on.

7. Chronic Strain

Repetitive straining from chronic constipation, persistent coughing (such as from smoking or lung disease), or frequent heavy lifting can all place continuous pressure on the pelvic floor, increasing the risk of POP.

8. Connective Tissue Disorders

Some people have naturally weaker connective tissues due to genetic factors. Conditions like hypermobility can make the pelvic floor less resilient and more prone to prolapse.

What Can You Do?

While not all risk factors can be avoided, there are proactive steps you can take to support your pelvic health:

Maintain a healthy weight to reduce pressure on the pelvic floor.
Address chronic straining by managing constipation, cough, or lifestyle factors that increase abdominal pressure.
Strengthen your pelvic floor muscles through targeted exercises. A pelvic health physiotherapist can guide you in learning the right techniques.

Final Thoughts

POP is influenced by many factors—some you can’t control, like age and genetics, and others you can actively address. By understanding your risk profile and making supportive lifestyle changes, you can strengthen your pelvic health and reduce the likelihood or severity of prolapse.

If you’re concerned about your pelvic floor or would like personalised guidance, our team at Pelvic Health Melbourne is here to help.

Perimenopause: Bladder and Bowel

Wed, 03 Sep 2025 03:15:15 GMT

The Perimenopausal Changes No One Warns You About

Perimenopause — the transition period leading up to menopause — is a natural phase in every woman’s life. While symptoms like hot flushes and mood swings are widely discussed, there are other, less talked-about changes that can have just as much of an impact on daily life.

Let’s explore some of the more surprising changes to your bladder, bowel, and periods — and what you can do to manage them.

Bladder: “Why Do I Always Feel Like I Need to Go?”

If you've noticed you're heading to the toilet more often — or feeling an intense need to go, only to pass a small amount — you're not alone. As oestrogen levels decline, the tissues supporting the bladder and urethra can become thinner and less elastic, leading to:

Increased bladder urgency
More frequent urination
A lingering sensation of not quite emptying

What You Can Do

Try not to respond to every urge straight away. Bladder retraining can help your body adjust and reduce the frequency of urgency over time.
Avoid common bladder irritants that can make urgency worse. These may include:
Coffee
Alcohol
Artificial sweeteners
Fizzy drinks
Spicy or acidic foods (depending on your individual sensitivity)

Bowel: Slower, Smellier, and More Sensitive

Digestive changes are also common during perimenopause. Hormonal fluctuations can slow gut motility, which may result in:

Increased constipation
New food sensitivities
More noticeable (and often smellier) wind

These changes are often unexpected but entirely normal. Supporting your gut health with fibre-rich foods, hydration, and regular physical activity can make a significant difference.

Periods: Heavier, Irregular, and Less Predictable

For many women, perimenopause brings changes to menstrual cycles well before periods stop altogether. You may experience:

Heavier bleeding than usual
Irregular cycles — sometimes longer, sometimes shorter
Spotting or bleeding between periods

Important: Any new spotting or unusual bleeding should be checked by your GP. While often harmless, it’s important to rule out any underlying issues.

You Don’t Have to Just “Put Up With It”

These changes are common, but that doesn’t mean you have to live with discomfort or uncertainty. At Pelvic Health Melbourne, we specialise in supporting women through perimenopause and beyond.

We provide expert care to help you:

Manage bladder urgency
Reduce or eliminate after-dribble
Improve bowel function
Strengthen pelvic floor health

What We Offer

Personalised pelvic health assessments
Evidence-based treatment plans tailored to your needs
Compassionate, confidential care at every stage of menopause

Book your pelvic health consultation today and take the first step toward feeling more in control of your body — and your life.

Male Pelvic Pain

Wed, 27 Aug 2025 03:27:58 GMT

Male Pelvic Pain: Understanding the Many Faces of Discomfort

Pelvic pain in men is a complex issue involving various muscles, nerves, organs, and psychological factors. Since the pelvic region houses key structures such as the bladder, prostate, urethra, bowel, and the pelvic floor muscles, pain may present differently depending on the underlying cause. Recognising the specific types of pelvic pain and related symptoms can help men seek appropriate care early and improve outcomes.

Common Types and Examples of Male Pelvic Pain

Prostatitis and Chronic Pelvic Pain Syndrome (CPPS)

Pain Types: Dull aching in the lower abdomen, sharp stabbing pain in the perineum (the area between the scrotum and anus), burning during urination, and discomfort after ejaculation.
Additional Symptoms: Urinary frequency and urgency, weak or interrupted urine stream, and sometimes flu-like symptoms in bacterial prostatitis.
CPPS, a non-bacterial form, often features muscle tightness and nerve irritation causing persistent discomfort without infection.

Pelvic Floor Muscle Tension and Spasms

Pain Types: Intermittent or constant burning sensation deep in the pelvis, a "stuck" feeling during urination, testicular or penile pain not explained by infection.
Often worsened by sitting for long periods, sexual activity, or stress.
May also cause referred pain to the lower back, hips, or thighs.

Pudendal Neuralgia (Nerve Entrapment)

Pain Types: Sharp, burning, or electric shock-like pain primarily localised to the perineum and genital area.
Pain often worsens when sitting on hard surfaces and improves when standing or lying down.
May include numbness, tingling, or altered sensation around the genitals and anus.

Urethral Pain Syndrome and Urethritis (Non-infective)

Pain Types: Burning or raw sensation at the urethral opening, pain with urination, or persistent pelvic discomfort.
This can happen without bacterial infection and is sometimes related to pelvic floor dysfunction or inflammation.

Testicular Pain and Epididymitis

Pain Types: Sharp or aching pain localised to one or both testicles, sometimes radiating to the groin or lower abdomen.
May be associated with swelling, tenderness, or warmth.
Causes include infection, trauma, or referred pain from pelvic floor muscles.

Bladder Pain Syndrome / Interstitial Cystitis

Pain Types: Persistent pressure, discomfort, or burning in the bladder and perineal region.
Symptoms often worsen with bladder filling and improve after urination.
May be accompanied by urinary urgency and frequency.

Hernia-Related Pelvic Pain

Pain Types: Dull aching or sharp pain in the lower abdomen, groin, or pelvic area, especially when coughing, lifting, or standing.
Often associated with a noticeable bulge or lump in the groin.

Irritable Bowel Syndrome (IBS) and Gastrointestinal Pain

Pain Types: Cramping, bloating, and lower abdominal discomfort that can refer to pelvic areas.
May be associated with bowel changes such as diarrhea or constipation.
Bowel problems often coexist with pelvic floor dysfunction, complicating pain presentation.

Musculoskeletal Pelvic Pain

Pain Types: Aching or sharp pain stemming from muscles, ligaments, or joints of the pelvis and lower back.
Causes include poor posture, pelvic instability, trauma, or overuse injuries.
Pain may radiate into the groin, perineum, or thighs and can worsen with sitting, standing, or movement.

Sexual Dysfunction-Related Pelvic Pain

Pain Types: Pain during or after ejaculation, penile or perineal burning, and pain associated with erectile dysfunction.
Often linked with pelvic floor muscle tension or nerve irritation.

When to Seek Help

Men experiencing any of the following should consult a pelvic health physiotherapist or healthcare provider:

Persistent or worsening pelvic, perineal, testicular, or genital pain
Pain worsened by urination, ejaculation, sexual activity, bowel movements, or sitting
Difficulty starting or maintaining urine flow, weak or split stream
Urinary urgency, frequency, dribbling, or incontinence
Numbness, tingling, or unusual sensations in the pelvic or genital area
Visible lumps, swelling, or signs of infection (fever, chills, burning urination)

How Pelvic Floor Physiotherapy Can Help

Pelvic floor physiotherapists specialize in diagnosing and treating pelvic pain related to muscle dysfunction, nerve entrapment, and biomechanical issues. They use techniques such as:

Manual therapy to release muscle tension and trigger points
Tailored exercises to strengthen or relax pelvic muscles
Education on bladder, bowel, and posture habits
Neuromodulation techniques like TENS or biofeedback
Collaborative care with urologists, gastroenterologists, and pain specialists

Early assessment and intervention can greatly improve pain relief, bladder and sexual function, and quality of life.

Expert Tips for Managing Pelvic Pain at Home

Maintain regular bowel habits to prevent constipation and straining
Practice relaxation techniques and mindfulness to reduce pelvic muscle tension
Avoid prolonged sitting or pressure on the perineum; use cushions and take breaks
Stay hydrated and avoid bladder irritants like caffeine and alcohol
Use warm baths or heat packs to relax muscles and improve circulation
Engage in gentle stretching and low-impact exercise as advised by your physiotherapist

At Pelvic Health Melbourne, all our physiotherapists are trained to help manage all types of pelvic pain men encounter. You don’t have to live with pelvic pain—help is available.

Pregnancy and Varicosities

Thu, 21 Aug 2025 03:52:49 GMT

Varicosities During Pregnancy: What You Need to Know

Pregnancy is an exciting time, but it also brings a number of changes to the body. One of the common issues many women experience is varicosities — swollen, twisted veins that develop just under the skin. While they can be uncomfortable, they are generally harmless and can often be managed with simple strategies.

In this blog, we’ll break down what varicosities are, why they happen during pregnancy, the signs to look for, and what you can do to relieve symptoms.

What Are Varicosities?

Varicosities are veins that become enlarged and visible under the skin. They most often occur in the legs, but pregnancy can also lead to vulvar varicosities and rectal varicosities (commonly known as hemorrhoids).

These veins can appear blue or purple and may bulge above the surface of the skin. Some women experience discomfort, while others may simply notice the cosmetic changes.

Why Do They Happen in Pregnancy?

Several factors during pregnancy contribute to the development of varicosities:

Increased blood volume: During pregnancy, your body produces more blood to support your growing baby. This extra volume puts added pressure on your veins.
Hormonal changes: The hormone progesterone relaxes the walls of your veins, making them more likely to swell.
Pressure from the uterus: As your uterus grows, it presses on the pelvic veins, slowing circulation and increasing pressure in the lower body.
Genetics: If your family members experienced varicose veins, you may be more likely to develop them as well.

Common Types of Varicosities in Pregnancy

Leg varicose veins – swollen, bulging veins that often appear on the calves or thighs.
Vulvar varicosities – swelling and visible veins in the vulvar area, which can cause heaviness or discomfort.
Hemorrhoids – varicosities in the rectal area, often made worse by constipation and straining.

Signs and Symptoms

Varicosities may present with:

Blue or purple bulging veins
Aching or heaviness in the legs or groin
Itching, throbbing, or tenderness
Swelling around the affected area
Discomfort that worsens after standing or sitting for long periods

Prevention and Relief Tips

While varicosities can’t always be prevented, there are many ways to relieve discomfort and stop them from worsening:

Move regularly: Avoid sitting or standing still for long stretches. Get up and walk around every hour.
Elevate your legs : Resting with your legs propped up helps improve circulation and reduce swelling.
Wear compression stockings: These provide support and assist blood flow back toward the heart.
Stay active: Daily walks and gentle exercise promote circulation.
Hydrate well: Adequate water intake helps prevent constipation, reducing the risk of hemorrhoids.
Eat a high-fibre diet: Fibre-rich foods keep your bowels regular and prevent straining.

When to Call Your Doctor

Most varicosities are harmless, but it’s important to seek medical advice if you notice:

Sudden pain or swelling in the leg
Skin discoloration or ulcers around a vein
Bleeding from a varicosity
Signs of a blood clot (deep vein thrombosis), such as warmth, redness, or severe pain in the calf

The Good News

The reassuring news is that most varicosities improve significantly after delivery as blood volume and hormonal levels return to normal. Conservative measures are usually very effective, and in most cases, varicosities don’t cause complications during pregnancy or labor.

Final Thoughts

Varicosities are a normal and common part of pregnancy for many women. While they can be uncomfortable, they are usually temporary and manageable with lifestyle strategies.

If you’re experiencing varicosities, talk with your physiotherapist or healthcare provider. They can help guide you with safe management strategies to keep you comfortable and reduce symptoms throughout your pregnancy.

Bottom Surgery and Physiotherapy

Wed, 06 Aug 2025 03:48:10 GMT

Supporting Transmasculine and Transfeminine Clients Through Bottom Surgery: The Role of Physiotherapy

Bottom surgery is a powerful and deeply affirming step for many both transmasculine and transfeminine individuals. Whether someone is preparing for vaginoplasty, vulvoplasty or phalloplasty, the journey is not just surgical—it’s physical, emotional, and functional. Physiotherapy can play a key role in optimising outcomes and supporting a safe, confident return to daily life.

At our clinic, we work closely with clients before and after gender-affirming surgeries to ensure their pelvic and overall health is considered throughout their surgical journey.

Pre-Surgery Preparation: Laying the Foundation

Before surgery, our physiotherapy sessions focus on building a strong foundation. This includes:

Understanding Your Body’s Baseline

We begin by gaining a thorough understanding of your current:

Bladder and bowel function – Are there any concerns with urgency, leakage, constipation, or straining?
Pelvic floor tone and coordination – We assess whether your muscles are overactive, weak, or uncoordinated, which can impact recovery.
Intimate or sexual function – If relevant and comfortable for the client, we explore areas of sensitivity, pain, or tension that may influence post-op outcomes.

These baseline assessments guide us in creating a tailored prehabilitation program that optimises your function and supports a smoother recovery.

Optimising Pelvic Health

Pelvic health plays a crucial role in:

Managing urination and bowel habits post-surgery
Supporting circulation and tissue healing
Reducing pelvic pain or tightness
Preparing muscles for dilation (if applicable)

We also look at core strength, breathing, posture , and general mobility —especially important for improving blood flow, wound healing, and reducing post-op complications.

Post-Surgery Recovery: Gentle, Guided Support

After surgery, our work shifts to supporting your healing and helping you return to your life with comfort and confidence.

Wound Care & Scar Management

We guide you through:

Gentle scar tissue mobilisations (when appropriate)
Promoting circulation to reduce swelling
Supporting healing around graft or donor sites (e.g., arm, thigh)

Dilation & Tissue Care

For clients undergoing phalloplasty or metoidioplasty involving a urethral lengthening or neo-vaginal closure, pelvic physiotherapy may include:

Education around dilation (where applicable)
Pain management strategies
Breathwork and relaxation techniques to reduce muscle tension

Returning to Life and Movement

We support:

Safe return to walking, lifting, cycling, gym or sports
Managing fatigue and pacing during recovery
Addressing any bladder, bowel or sexual function changes

We also hold space for the emotional aspects of recovery. This is a major life transition, and our approach is compassionate, gender-affirming, and always client-led.

We Are With You All the Way

Our goal is to make your body feel more like home. Whether you're months away from surgery or already on the other side, we’re here to walk beside you with skilled hands, open minds, and affirming care.

If you’re considering bottom surgery or in the recovery phase, get in touch to see how pelvic physiotherapy can support your goals and wellbeing.

Understanding Clitorodynia

Wed, 30 Jul 2025 02:46:45 GMT

Understanding Clitorodynia: Yes, It’s Real—And Yes, There’s Help

Let’s talk about something that doesn’t get talked about enough: Clitorodynia .

Clitorodynia is a condition involving chronic clitoral pain , and for many, it can feel isolating, confusing, and incredibly frustrating. If you’ve experienced burning, aching, or stabbing sensations around the clitoris—especially during everyday activities like sitting, walking, or even showering—you’re not alone. And more importantly, you're not imagining it.

What Does Clitorodynia Feel Like?

Clitorodynia can show up in a variety of ways, including:

Burning or stinging sensations
Sharp, stabbing pain
Itching, irritation, or rawness
Throbbing or tenderness
Pain during movement, sexual activity, or even at rest
Sometimes numbness or tingling that spreads to the pelvis

For some, symptoms may come and go. For others, they’re persistent. Even things like urination or using certain soaps can trigger discomfort. If you ever experience severe pain along with symptoms like a fever or rapid heart rate, it’s important to seek urgent medical attention.

The Good News: You Don’t Have to Suffer in Silence

At Pelvic Health Melbourne , we understand how deeply clitorodynia can impact daily life—and how often it's misunderstood or dismissed. That’s why our approach is rooted in empathy, education, and evidence-based care. Our team works with you to tailor a plan that supports healing and comfort.

Some of the tools and techniques we use include:

Mindfulness and breathwork to soothe the nervous system
TENS therapy (gentle electrical stimulation) for pain relief
Gentle stretching and pelvic floor downtraining
Internal muscle release techniques , when appropriate
Personalised advice on skincare, pain triggers, and referrals for further support, including medications or imaging if needed

You’re Not Alone—and You’re Not Making It Up

If you’ve ever been told “it’s all in your head” or felt dismissed by healthcare providers, we want you to know: we see you . Clitorodynia is real, and help is available. You deserve answers. You deserve relief. And at Pelvic Health Melbourne, we’re here to help you find both.

Toilet Training and Neurodivergence

Wed, 23 Jul 2025 02:47:13 GMT

Potty Training Isn’t One-Size-Fits-All

Toilet training is a significant milestone for children and their families. However, for neurodivergent children, including those with autism, ADHD, or sensory processing differences, this journey can present unique challenges.

Understanding the Challenges

Neurodivergent children may face several obstacles during toilet training:

Sensory Sensitivities: Discomfort with the feel of toilet paper, coldness , the sound of flushing or poo/ wee hitting the water, or the brightness of bathroom lighting.
Communication Differences: Challenges in expressing the need to use the toilet or recognising bodily cues can lead to accidents
Routine Resistance: A preference for sameness and resistance to change can make adapting to new routines difficult.
Gastrointestinal Issues: Conditions like constipation or diarrhea can complicate the process and cause discomfort and withholding.

Strategies for Success

Implementing tailored strategies can make toilet training more manageable:

Visual Schedules: Use clear, step-by-step visual aids or routine boards to outline the toileting process, helping children understand expectations
Positive Reinforcement: Celebrate small successes with praise or rewards to encourage continued progress. Instead of giving a reward each time a step is completed, agree on a certain number of ticks or stickers needed to get the reward. Rewards can be toys, food, family time or praise; make it meaningful for your child!
Sensory-Friendly Environments: Modify the bathroom setting to reduce sensory overload, such as using soft lighting, noise-cancelling headphones or a heater.
Consistent Routines: Establish regular toileting times to build predictability and reduce anxiety.
Professional Support: Engage with specialists, such as pelvic health physiotherapists, to address specific concerns and help you along this journey.

You're Not Alone

Remember, every child's journey is unique, and progress may be gradual. Patience, understanding, and tailored support are key to navigating the challenges of toilet training. If you need assistance or have concerns about your child's toileting journey so far, don't hesitate to reach out. Together, we can work towards a positive and successful toileting experience.

Perimenopause & Menopause

Wed, 09 Jul 2025 03:16:29 GMT

Understanding Menopause: How a Pelvic Health Physiotherapist Can Help You Thrive Through the Change

At Pelvic Health Melbourne, we know that menopause isn't just a stage of life—it’s a deeply personal transition that can impact your body, confidence, and quality of life in ways you may not expect. As pelvic health physiotherapists, we’re here to support and empower you with respectful, evidence-based care tailored to your needs.

What Is Menopause and Perimenopause?

Menopause marks the end of your menstrual cycle, officially diagnosed when you haven’t had a period for 12 consecutive months. The years leading up to this, known as perimenopause, are when many of the most noticeable symptoms begin normally from 40 years old

During this time, fluctuating hormone levels—particularly a drop in oestrogen—can lead to a range of physical and emotional changes. Some are widely known, others less talked about, but all are valid and worthy of care.

Common Symptoms of Perimenopause and Menopause

Increased blood loss during periods
Weight gain and bloating - especially new weight deposits around the stomach
Low libido or sexual discomfort - our vagina shrinks both in length and width
Bladder urgency, frequency, or leakage
Vaginal dryness or pelvic discomfort - use silicon based lubes as water based just absorb in too easily
Pelvic organ prolapse or heaviness
Hot flushes and night sweats
Mood swings, anxiety, and low mood
Fatigue and disrupted sleep - waking for a few hours in middle of night then exhausted in morning
Brain fog and memory changes

These symptoms can feel overwhelming, but you are not alone—and you don’t need to suffer through them in silence.

How Pelvic Health Physiotherapy Can Support You

At Pelvic Health Melbourne, our experienced physiotherapists work with you holistically to address the physical changes of menopause that affect your pelvic floor, bladder, bowel, and sexual health.

Here’s how we can help:

1. Pelvic Floor Rehabilitation

We assess and treat pelvic floor muscle weakness, overactivity, or incoordination. This helps reduce urinary urgency, incontinence, heaviness, and discomfort.

2. Bladder & Bowel Retraining

Menopause can alter bladder sensitivity and bowel regularity. We provide personalised strategies to restore control and confidence.

3. Sexual Wellness Support

Painful intimacy or decreased sensation are common but treatable. We use gentle, respectful approaches including pelvic floor therapy, education, and support for vaginal tissue health including discussions about topical oestrogen therapy, vaginal dilation (if required), vibrators to assist blood supply and appropriate lubrication for stage of life.

4. Movement & Strength Programs

Specific exercise program for you respecting non restorative sleep, need for more stretch and cardio allowing for adequate body recovery.

5. Education & Empowerment

We take the time to explain what’s happening in your body, and why, so you feel more in control. Our goal is to help you make informed decisions about your health and wellbeing.

Why Choose Pelvic Health Melbourne?

At Pelvic Health Melbourne, we do more than treat symptoms—we care for the whole person.

We offer:

Longer, unrushed appointments
Private, purpose-designed rooms
Highly skilled and specialised clinicians
An inclusive space and point of mond
Care that respects your lived experience

We believe every woman deserves dignity, support, and solutions—not dismissal or shame.

Take the Next Step

If you’re navigating perimenopause or menopause and feeling unsure where to turn, we invite you to start with us. Whether you’ve just started noticing changes or have been putting up with symptoms for years, now is the right time to seek support.

Book an appointment with one of our experienced pelvic health physiotherapists today. Let’s work together to help you feel strong, supported, and at home in your body again.

Pelvic Organ Prolapse

Wed, 04 Jun 2025 23:38:10 GMT

Pelvic Organ Prolapse, or POP, is a symptom that affects many people but is not always openly discussed. It occurs when one or more pelvic organs—such as the bladder, bowel, or uterus—shift from their normal position and descend, often resting against the vaginal wall. While some degree of movement is considered normal, a prolapse is diagnosed when symptoms are present.

What Does POP Feel Like?

People with POP often describe a sense of heaviness or dragging in the pelvis. Others may notice a bulge in or outside the vagina, discomfort during daily activities, or a feeling that something is “coming down.” POP can also affect bladder and bowel function, leading to symptoms like incomplete emptying or frequent urgency.

What Increases the Risk of POP?

The most significant risk factor for developing POP is vaginal childbirth. However, it's not just childbirth itself, but certain factors around the delivery that play a role:

Birth weight over 4kg
Pushing for less than 20 minutes or more than 2 hours
Obstructed labour or instrumental delivery (forceps, vacuum)

Other contributing lifestyle factors include:

Chronic constipation or long-term straining
Persistent coughing (e.g., due to asthma or smoking)
Heavy lifting over extended periods
Family history of prolapse
Menopause, due to hormonal changes affecting tissue support

Conservative Treatment Options

For many people, POP can be managed conservatively without surgery. Treatment may include:

Pelvic Floor Muscle Training : Strengthening these muscles improves the support they provide to pelvic organs.
Horizontal Rest : Lying down throughout the day can help reduce the sensation of heaviness and give your body time to recover.
Hormonal Therapies : Your doctor may prescribe topical oestrogen to help strengthen vaginal tissues, particularly after menopause.
Pessary Use : A pessary is a small silicone device inserted into the vagina to provide internal support for the organs.
Lifestyle Modifications : Addressing chronic constipation or cough and avoiding unsafe repetitive heavy lifting can reduce strain on the pelvic floor.

For personalised guidance, it’s important to consult a qualified pelvic health physiotherapist who can tailor your treatment to your specific needs and goals.

When Is Surgery Considered?

In more severe cases of prolapse, or when conservative measures do not relieve symptoms, surgery may be recommended. If this is the case, your healthcare provider will refer you to a specialist for a comprehensive assessment and to discuss your surgical options.

Conclusion

Pelvic Organ Prolapse is common, but with the right support and management strategies, it doesn’t have to limit your quality of life. Early intervention through physiotherapy and lifestyle changes can significantly improve symptoms and help you feel confident in your body again.

If you're experiencing symptoms or want to know more, reach out to a pelvic health physiotherapist to explore your options.

Overactive Pelvic Floor

Wed, 28 May 2025 02:46:50 GMT

The pelvic floor muscles play a crucial role in supporting your bladder, bowel, and reproductive organs. While much attention is given to strengthening these muscles, it’s just as important to understand when they are overactive —meaning they have difficulty relaxing or letting go. Overactivity in the pelvic floor can contribute to a wide range of symptoms, often overlooked or misdiagnosed.

What Are Overactive Pelvic Floor Muscles?

Overactive pelvic floor muscles are muscles that remain tense or tight when they should be able to relax. This tension may be constant or triggered by certain activities, positions, or stressors.

Some common causes include:

Ongoing pelvic, hip, or lower back pain
Chronic conditions like endometriosis, adenomyosis, or bladder/urethral pain
Recurrent vaginal infections (e.g., thrush or UTIs) or vulval skin disorders
Holding stress or anxiety in the abdomen or pelvis
High-intensity or repetitive exercise
Past trauma, including childbirth or emotional/sexual experiences

Even athletes or those who do frequent pelvic floor exercises may develop tightness—sometimes without realizing it.

Signs and Symptoms of Overactivity

Symptoms can vary, but people with overactive pelvic floor muscles often report:
Bladder symptoms:

Difficulty starting urination
Slow or interrupted urine stream
A feeling of incomplete emptying

Bowel symptoms:

Thin or pellet-like stools
Incomplete evacuation
Difficulty releasing wind

Intimacy-related symptoms:

Pain with penetration or deep intercourse
Discomfort or pain during tampon use or pap smears
Vaginal burning, aching, spasms, or tenderness
Difficulty achieving orgasm

These symptoms are not “just in your head”—they are often signs that your pelvic floor may be holding more tension than it should.

Treatment Options

If you suspect your pelvic floor muscles may be overactive, a pelvic health physiotherapist can help. At Pelvic Health Melbourne , our team is trained to assess your pelvic floor function and tailor a treatment plan specific to your needs.

Treatment may include:

Manual therapy to release tight pelvic floor muscles
Pelvic floor downtraining and stretches to improve relaxation
Relaxation techniques like deep breathing, mindfulness, gentle movement, or listening to calming music
Use of heat packs to reduce muscle tension and pain

We’ll also help you explore lifestyle changes and emotional support to address any underlying contributors to pelvic tension.

You Don’t Have to Live With Discomfort.

If you’re experiencing any of these symptoms, don’t hesitate to seek support. Many people live with pelvic floor dysfunction for years without realising the cause of their discomfort. Early assessment and treatment can make a significant difference.

Book an appointment with our team at Pelvic Health Melbourne and take the first step toward feeling better in your body.

Prostate Cancer

Wed, 21 May 2025 03:15:10 GMT

Prostate cancer is a significant health concern, particularly for men over 50, arising when abnormal cells in the prostate gland grow uncontrollably, forming malignant tumors. It is the most commonly diagnosed cancer in Australia , with over 26,000 cases in 2024 and a lifetime risk of 1 in 6 by age 85 . Early-stage prostate cancer often has no symptoms, but advanced cases may involve urinary frequency, pain during urination, blood in urine/semen, or bone pain. Risk factors include age, family history (especially BRCA gene mutations), and elevated testosterone levels.

How Is Prostate Cancer Diagnosed?

There’s no single test for prostate cancer. Diagnosis usually involves:

PSA Blood Test: Measures a protein made by the prostate. High PSA can mean cancer, but also other prostate issues. PSA testing can help catch cancer early, but it’s not perfect-sometimes it leads to unnecessary worry or treatment. Talk to your GP about the pros and cons for you.
Digital Rectal Exam (DRE) : Your doctor feels the prostate for lumps. This is quick and safe, but not always needed-especially if your PSA is normal.
Imaging & Biopsy: If cancer is suspected, scans and a biopsy (removal of a small tissue sample) confirm the diagnosis.

Your Role in Care Decisions

A prostate cancer diagnosis can be overwhelming, but you’re not alone. At Pelvic Health Melbourne, we encourage you to:

Ask questions and take notes. Bring a support person to appointments.

Discuss all your options. Your treatment will depend on several factors, including the stage of the cancer, your overall health, and what matters most to you. Options may include:

Active surveillance (monitoring the cancer closely)
Surgery to remove the prostate
Radiation therapy
Hormone therapy
Chemotherapy or participation in clinical trials

Take your time. Most prostate cancers grow slowly. You usually have time to consider, seek a second opinion, and decide what’s right for you.

Access support . Emotional and practical support-through family, friends, counsellors, or support groups-can make a big difference.

The Importance of Pelvic Health Physiotherapy

Physiotherapy is a key part of prostate cancer care-before and after treatment . Our team at Pelvic Health Melbourne works closely with you and your doctors and specialists to help you achieve the best possible recovery.

Goals of Physiotherapy in Prostate Cancer Care

Restore and Maintain Bladder Control: Regain continence and reduce urinary leakage with targeted pelvic floor muscle training and education.
Enhance Pelvic Floor and Sexual Function: Strengthen and retrain pelvic floor muscles to support continence and sexual health, especially after surgery.
Reduce and Manage Pain: Ease pelvic or post-surgical pain with evidence-based techniques.
Support Physical Recovery: Improve strength, flexibility, and stamina to help you return to daily life.
Promote Safe, Effective Exercise: Tailored activity helps manage fatigue and maintain muscle and bone health.
Educate and Empower: Learn correct pelvic floor activation, self-management strategies, and lifestyle tips to support your recovery.
Support Emotional Well-being: Address psychological impacts and help you return to the activities you value.
Prevent and Manage Complications: Reduce risks like falls or bone loss, especially if you’re on hormone therapy.
Coordinate Care: We work with your broader medical team and refer to other specialists as needed.

What Can You Expect from Pelvic Health Physiotherapy?

Faster recovery of bladder control and reduced urinary leakage
Improved pelvic floor strength and function, supporting continence and sexual health
Reduced pelvic pain and discomfort
Better understanding of your body and how to manage symptoms
Support in returning to daily activities, work, and exercise
Improved confidence and quality of life

Early referral to physiotherapy-ideally before surgery-can maximize your recovery. Research shows up to 94% of men regain bladder control within three to six months after prostate surgery with physiotherapy support.

At Pelvic Health Melbourne, we’re here to help you take an active role in your prostate cancer journey. If you have questions about pelvic health, continence, or recovery, our team is ready to support you every step of the way.

For more information or to book an appointment, contact us today.

The Pelvic Floor

Wed, 14 May 2025 03:14:31 GMT

Understanding the Pelvic Floor: What It Is and Why It Matters

The pelvic floor is a vital yet often overlooked part of our body. It plays a significant role in supporting several important functions, from bladder control to sexual health. In this blog, we’ll explore what the pelvic floor is, its functions, and why it’s essential for overall well-being.

What is the Pelvic Floor?

The pelvic floor refers to a group of muscles, ligaments, and tissues that stretch like a hammock across the bottom of the pelvis. It forms the base of the abdomen and supports the bladder, uterus, rectum, and small intestine. Think of it as a supportive structure that holds these organs in place, ensuring that they function properly.

These muscles are responsible for several key functions, including:

Supporting pelvic organs: The pelvic floor muscles help keep the bladder, uterus, rectum, and small intestine from sagging or shifting.
Controlling urination and bowel movements: The pelvic floor muscles help control the release of urine and feces. When the muscles are healthy, they can help you hold and release waste at appropriate times.
Sexual health: These muscles play a role in sexual arousal and orgasm. In both men and women, a strong pelvic floor can enhance sexual experience and satisfaction.
Childbirth support: In women, the pelvic floor muscles help during childbirth by assisting in the delivery process.

Why is the Pelvic Floor Important?

The pelvic floor is crucial for maintaining proper function in several areas of life. When these muscles weaken or become damaged, it can lead to a variety of issues, such as:

Urinary Incontinence: Weak pelvic floor muscles can lead to difficulty controlling urination, causing leakage, especially when coughing, laughing, or exercising.
Pelvic Organ Prolapse (POP): If the pelvic floor muscles are too weak to support the pelvic organs, they can slip out of place, leading to conditions like bladder prolapse or uterine prolapse.
Constipation: A weak pelvic floor can make it harder to control bowel movements, potentially leading to constipation.
Pain During Sex: A tense or weak pelvic floor can cause discomfort or pain during intercourse.
Postpartum Recovery: After childbirth, the pelvic floor may be weakened, leading to issues with incontinence or prolapse symptoms.

How to Keep Your Pelvic Floor Healthy

Maintaining pelvic floor health is essential for both men and women, and there are several ways to strengthen and care for these muscles:

Pelvic Floor Exercises (Kegel Exercises): Kegels are exercises that target and strengthen the pelvic floor muscles. To perform them, simply contract the muscles you would use to stop urination and hold for a few seconds, then release. Regular practice can help improve muscle tone and control.
Avoid Straining: Straining during bowel movements or lifting heavy objects can weaken the pelvic floor muscles. Ensure you use proper technique when lifting, and try to prevent constipation by eating fiber-rich foods and drinking plenty of water.
Maintain a Healthy Weight: Excess weight puts added pressure on the pelvic floor, so maintaining a healthy weight can reduce strain and prevent weakening of the muscles.
Stay Active: Regular exercise, including pelvic floor exercises, helps improve circulation and muscle tone. Yoga and Pilates can also be beneficial in strengthening these muscles.
Posture Awareness: Maintaining good posture throughout daily activities can reduce strain on the pelvic floor and support proper muscle function.

When to Seek Help

If you experience any of the following symptoms, it may be time to consult a healthcare provider for an assessment of your pelvic floor health:

Uncontrolled leakage of urine or feces
A feeling of heaviness or bulging in the pelvic area
Pain or discomfort during sex
Difficulty with bowel movements
Frequent urges to urinate, especially at night

At Pelvic Health Melbourne, we can provide personalized exercises and treatment options to address your pelvic floor dysfunction.

Conclusion

The pelvic floor is a powerful yet delicate system that plays a key role in daily life, from maintaining organ function to supporting sexual health. By understanding its importance and taking steps to strengthen and care for these muscles, you can prevent and manage issues like incontinence, prolapse, and discomfort. Whether through pelvic floor exercises, weight management, or posture awareness, maintaining pelvic health is essential for overall well-being.

If you’re experiencing symptoms of pelvic floor dysfunction, don’t hesitate to contact us —early intervention can make a significant difference in managing these conditions and improving quality of life.

Pudendal Neuralgia

Wed, 07 May 2025 05:53:18 GMT

Pelvic pain can be a distressing and often misunderstood condition, affecting both men and women. One lesser-known cause of chronic pelvic pain is pudendal neuralgia, a condition that occurs when the pudendal nerve, which supplies sensation and function to the pelvic area, becomes compressed or irritated. This can lead to debilitating symptoms that impact daily life, from sitting comfortably to engaging in intimate activities. Despite its significant impact, pudendal neuralgia is frequently underdiagnosed.

In this blog, we’ll explore what pudendal neuralgia is, its symptoms, potential causes, and how pelvic health physiotherapy can play a crucial role in managing and alleviating symptoms.

What is Pudendal Neuralgia?

Pudendal neuralgia is a chronic pain condition that results from irritation, compression, or damage to the pudendal nerve. This nerve runs from the lower back through the pelvic floor and is responsible for sensation and function in the genitals, perineum, and anus. When compressed or irritated, it can lead to persistent and often severe pain.

Common Symptoms of Pudendal Neuralgia

Symptoms of pudendal neuralgia can vary from person to person, but common signs include:

Burning, stabbing, or aching pain in the pelvic region
Pain that worsens when sitting and improves when standing or lying down
Numbness, tingling, or a “foreign object” sensation in the rectum or genitals
Pain during or after sexual activity
Bladder or bowel dysfunction , such as urgency, frequency, or difficulty emptying

These symptoms can be frustrating and debilitating, often leading to emotional distress, anxiety, and a decreased quality of life.

What Causes Pudendal Neuralgia?

There are several potential causes of pudendal neuralgia, including:

Prolonged sitting (especially on hard surfaces or during cycling)
Pelvic trauma or surgery that affects the nerve
Muscle tension or tightness in the pelvic floor
Childbirth injuries
Nerve entrapment or compression from scar tissue or inflammation
Medical conditions such as endometriosis or interstitial cystitis

Since pudendal neuralgia can have multiple contributing factors, proper diagnosis by a healthcare professional is essential for effective treatment.

How Can Pelvic Health Physiotherapy Help?

Pelvic health physiotherapy is a non-invasive and effective approach to managing pudendal neuralgia.

A trained pelvic health physiotherapist can assess your symptoms and develop a personalized treatment plan that may include:

Manual Therapy & Myofascial Release – Helps release muscle tension and improve blood flow to the affected area.
Pelvic Floor Relaxation Techniques – Since tight pelvic muscles can contribute to nerve irritation, learning how to properly relax these muscles is key.
Postural & Movement Retraining – Poor posture or movement patterns can put extra strain on the pudendal nerve. Physiotherapy can help correct these imbalances.
Nerve Mobilization & Desensitization Exercises – These gentle techniques help the nerve glide freely and reduce pain.
Lifestyle Modifications & Ergonomic Adjustments – Small changes like using a cushioned seat, avoiding prolonged sitting, and modifying certain activities can significantly reduce symptoms.

Seeking Help & Finding Relief

If you’re struggling with persistent pelvic pain, you’re not alone. Many people suffer in silence due to a lack of awareness and understanding about conditions like pudendal neuralgia. Fortunately, pelvic health physiotherapy can provide significant relief by addressing the root cause of pain and improving function.

Don’t let pelvic pain control your life. If you suspect you have pudendal neuralgia, consider consulting a pelvic health physiotherapist to explore treatment options tailored to your needs.

What is OAB?

Wed, 23 Apr 2025 03:01:48 GMT

Understanding Bladder Urgency and Overactive Bladder: How to Regain Control

Do you often find yourself rushing to the bathroom or struggling with an uncontrollable urge to urinate? You’re not alone! Bladder urgency and overactive bladder (OAB) affect millions of people, disrupting daily life and causing frustration. The good news? There are ways to manage these symptoms and take back control of your bladder health.

What Is Bladder Urgency and Overactive Bladder?

Bladder urgency is the sudden and intense need to urinate, often making it difficult to delay a trip to the bathroom. Overactive bladder (OAB) takes this a step further, causing frequent urination, urgency, and sometimes even leakage (urge incontinence). These symptoms can occur day and night, impacting sleep, work, and social activities.

What Causes These Symptoms?

Bladder urgency and OAB can stem from various factors, including:

Bladder muscle overactivity – The bladder contracts too often, creating a frequent urge to urinate.
Nerve dysfunction – Conditions like diabetes, stroke, or spinal cord injuries can affect bladder control.
Hormonal changes – Menopause or hormonal imbalances may contribute to OAB symptoms.
Dietary triggers – Caffeine, alcohol, salty foods, and artificial sweeteners can irritate the bladder.
Pelvic floor dysfunction – Weak or tight pelvic floor muscles can contribute to poor bladder control.

How Can You Manage Bladder Urgency and OAB?

The first step to managing OAB is understanding what triggers your symptoms. Lifestyle changes, like adjusting fluid intake, avoiding bladder irritants, and practicing bladder training techniques, can make a significant difference.

How Pelvic Floor Physiotherapy Can Help?

Pelvic floor physiotherapy is a highly effective treatment for bladder urgency and OAB. A pelvic floor physio or osteo can help you:

Strengthen or relax pelvic floor muscles to improve bladder control.
Retrain your bladder with behavioral techniques and deferral strategies .
Reduce tension in the pelvic floor.
Transtibial Nerve Stimulations using TENS (TTNS)

If you’re struggling with bladder urgency or OAB, you don’t have to suffer in silence. With the right strategies and support, including pelvic floor physiotherapy, you can regain confidence and improve your quality of life. Reach out to a pelvic health professional today and take the first step toward better bladder health!

What is Nipple Pain?

Wed, 26 Mar 2025 01:53:52 GMT

Nipple pain is more common than many people realize, yet it’s often dismissed or overlooked. It can be sharp, burning, achy, or sensitive to touch, making everyday activities like breastfeeding, exercise, or even wearing certain fabrics uncomfortable.

While nipple pain is frequently associated with breastfeeding, it can also stem from hormonal changes, postural issues, post-surgical recovery, or nerve-related sensitivity.

The good news? Pelvic health physiotherapy can play a crucial role in identifying and addressing the underlying causes of nipple pain.

What Causes Nipple Pain?

Nipple pain can have a variety of causes, and understanding the root issue is the first step toward effective relief. Here are some of the most common contributors:

Breastfeeding Challenges

Latch issues – A poor latch can lead to excess strain and nipple trauma.
Blocked ducts – When milk isn’t draining properly, it can cause pain and swelling.
Mastitis – A painful inflammation of the breast tissue that can cause redness, warmth, and tenderness.

Postural Strain

Poor posture while feeding, carrying a baby, or working at a desk can lead to muscle imbalances, which can place stress on the chest, shoulders, and back.
Hunched shoulders and forward head posture can cause tightness in the upper body, restricting blood flow and increasing sensitivity.

Hormonal Changes

Menstrual cycles, pregnancy, postpartum recovery, and menopause can all lead to changes in breast tissue and increased sensitivity.
Hormonal fluctuations can lead to increased fluid retention, swelling, and tenderness in the breast and nipple area.

Nerve Sensitivity

Previous breast surgeries (such as augmentations, reductions, or mastectomies) can lead to nerve irritation or damage, resulting in lingering pain or hypersensitivity.
Nerve compression in the neck, upper back, or even the ribs can radiate discomfort to the chest and nipples.

Muscle Tension and Imbalances

Tension in the chest muscles (pectorals), neck, and back can lead to restricted movement and pain.
Even pelvic floor dysfunction can play a role, as core stability and muscle imbalances throughout the body can contribute to discomfort in seemingly unrelated areas.

How Can Pelvic Health Physiotherapy Help?

Pelvic health physiotherapy isn’t just about the pelvic floor—it focuses on how the entire musculoskeletal system, nerves, and fascia work together , recognizing that pain in one area can stem from imbalances elsewhere.

A pelvic health physiotherapist takes a whole-body approach to treating nipple pain, targeting the underlying causes rather than just the symptoms. Here’s how they can help:

Postural Corrections & Muscle Balance – Your therapist can assess your posture and guide you through exercises to reduce strain on the chest, shoulders, and neck, which can alleviate pain over time.
Manual Therapy & Soft Tissue Release – Gentle hands-on techniques can help release tight muscles, improve circulation, and reduce sensitivity in the nipple and breast area.
Nerve Mobilization Techniques – If nerve sensitivity is contributing to your pain, specific mobilization techniques can help desensitize and restore normal nerve function.
Breastfeeding Support & Positioning Advice – For postpartum individuals, physiotherapists trained in lactation support can help optimize breastfeeding positions, reducing strain on the nipples and chest muscles.
Pelvic Floor & Core Strengthening – Because the core, back, and pelvic floor are all connected , strengthening these areas can improve overall posture and muscle balance, reducing tension that may be contributing to pain.

When to See a Pelvic Health Physiotherapist

If you experience ongoing nipple pain that doesn’t seem to improve with basic adjustments, it’s worth consulting a pelvic health physiotherapist. Here are some signs that professional help may be beneficial:

Pain persists despite changing breastfeeding positions or techniques.
You experience burning or shooting pain that radiates from the nipple to the chest or back.
Postural changes don’t seem to relieve discomfort.
You’ve had previous breast surgeries or injuries that may have affected nerve function.
Hormonal shifts lead to significant pain that disrupts daily activities.

Take the First Step Toward Relief

Nipple pain can be distressing, but you don’t have to suffer in silence . Our pelvic health physiotherapists are trained to take a comprehensive, individualized approach to care, helping you find relief through targeted treatments and lifestyle adjustments. If you’re struggling with persistent discomfort, reaching out could be the key to restoring comfort and confidence in your body.

What is Pelvic Girdle Pain?

Mon, 17 Mar 2025 22:29:49 GMT

Pregnancy is a beautiful journey, but it comes with its own set of challenges, including pelvic girdle pain (PGP).

Pelvic girdle pain during pregnancy is a common yet often misunderstood condition that affects many women as their bodies undergo significant changes. While it can be distressing, there are ways to manage the pain and continue enjoying your pregnancy. In this blog, we'll dive into what pregnancy-related pelvic girdle pain is, why it happens, its symptoms, and how you can manage it effectively.

What is Pregnancy-Related Pelvic Girdle Pain?

Pelvic girdle pain refers to discomfort or pain in the pelvic area, particularly around the joints that connect the pelvis to the spine, including the sacroiliac joints (SI joints) and the pubic symphysis. During pregnancy, the body undergoes numerous physical changes to accommodate the growing baby, which can lead to instability or misalignment in the pelvic area. This can result in pain that affects daily activities like walking, sitting, and even sleeping.

PGP during pregnancy is often caused by the loosening of ligaments and joints in the pelvic area due to hormonal changes, particularly the hormone relaxin , which helps prepare the body for childbirth. While this process is natural, it can make the pelvis more vulnerable to strain and discomfort.

Common Symptoms of Pregnancy-Related Pelvic Girdle Pain

Pelvic girdle pain can present in various ways, but some of the most common symptoms include:

Pain in the pelvic region : This pain can be located in the lower back, hips, groin, or pubic area. It may feel sharp, aching, or throbbing.
Pain while sitting or standing : Activities like sitting for long periods, transitioning from sitting to standing, or standing for extended periods can trigger or worsen the pain.
Difficulty walking : Many pregnant women with pelvic girdle pain find walking uncomfortable or notice they have a limp or altered gait due to the pain.
Pain during certain movements : Movements such as climbing stairs, turning in bed, or lifting one leg may intensify pelvic girdle pain.
Reduced mobility : The pain can make it harder to move freely, bend over, or perform other normal activities.
Pain that worsens with physical activity : Walking, lifting, or any activity that puts strain on the pelvis may aggravate the pain.

The intensity of pelvic girdle pain can vary, and it may fluctuate during different stages of pregnancy.

What Causes Pelvic Girdle Pain During Pregnancy?

Pregnancy-related pelvic girdle pain is primarily caused by hormonal changes, weight gain, and postural shifts. Below are some of the key factors that contribute to PGP during pregnancy:

Hormonal Changes
During pregnancy, your body produces the hormone relaxin , which helps relax and loosen the ligaments in the pelvis in preparation for childbirth. While this is essential for allowing the pelvis to expand during delivery, it can also lead to joint instability, making the pelvic area more prone to discomfort and misalignment.
Increased Weight and Pressure
As your baby grows, the weight gain during pregnancy puts additional pressure on the pelvis and spine. The added weight can exacerbate pelvic girdle pain, especially as the pelvis tries to accommodate the growing baby.
Postural Changes
As the pregnancy progresses, your body’s center of gravity shifts. You may find yourself leaning back or altering your posture to compensate for the weight of your growing baby. These postural changes can strain the pelvic joints and muscles, leading to pain and discomfort.
Muscle Imbalances
Pregnancy can cause changes in the pelvic muscles, especially as the body adjusts to the growing belly. Weak or tight muscles in the pelvic floor, lower back, or hips can contribute to pain in the pelvic girdle area.
Previous Injuries or Conditions
If you've had a previous pelvic injury, such as a fall, pelvic surgery, or conditions like sciatica or hip pain, you may be more susceptible to pelvic girdle pain during pregnancy.

How to Manage Pregnancy-Related Pelvic Girdle Pain

Although pelvic girdle pain during pregnancy can be uncomfortable, there are several ways to manage the condition and reduce discomfort. Here are some effective strategies:

Pelvic health physiotherapist
Seeing a pelvic health physiotherapist is one of the most effective ways to manage PGP. A physiotherapist can guide you through exercises to strengthen the muscles that support your pelvis and improve posture. They may also teach you techniques for better body mechanics to prevent strain on the pelvic area.
Pelvic Support Belts
Wearing a pelvic support belt or maternity belt can help relieve pressure on the pelvic joints and provide additional stability. These belts can be especially helpful when walking, standing for long periods, or during physical activities.
Posture and Body Mechanics
Maintaining good posture is key in managing pelvic girdle pain. Try to sit with your back straight and your pelvis aligned. When getting up from a seated position, use your arms to support yourself, and avoid twisting your body. If you need to stand for a long time, try to shift your weight between your legs or use a footstool to rest one leg.
Heat and Cold Therapy
Applying a warm compress or heat pad to the pelvic area can help relax tense muscles and relieve discomfort. On the other hand, if you're experiencing inflammation, ice can help reduce swelling and numb the pain. Always wrap ice or heat in a cloth to protect your skin.
Avoid Prolonged Sitting or Standing
Avoid sitting for long periods or standing in one position for too long, as this can exacerbate pelvic girdle pain. Take breaks to stand, walk around, or stretch if you're sitting for an extended time. When sitting, try using a cushion or pillow for added support.
Gentle Exercise and Stretching
Low-impact exercises, such as swimming, walking, or prenatal yoga, can help maintain mobility and relieve tension in the pelvic region. Stretching the lower back, hips, and legs can also help reduce stiffness and improve circulation. Always check with your healthcare provider before starting any new exercise routine during pregnancy.
Sleeping Position Adjustments
Finding a comfortable sleeping position is crucial. If you're experiencing pelvic girdle pain, try sleeping with a pillow between your knees to reduce strain on the pelvic area. Sleeping on your side with a slight bend in your knees can help alleviate pressure on your pelvis.
Pain Relief
If the pain becomes difficult to manage, talk to your doctor about safe pain relief options during pregnancy. While over-the-counter pain relievers like ibuprofen may not be recommended during pregnancy, your doctor may suggest other options to help reduce pain.

When to Seek Medical Help

If pelvic girdle pain becomes severe or if it significantly interferes with your daily activities, it’s important to consult with your healthcare provider. They may recommend additional treatments or help rule out other conditions that could be contributing to the pain. You should also seek medical help if you experience other symptoms, such as numbness, tingling, or weakness in your legs, as these could indicate a more serious issue.

Pregnancy-related pelvic girdle pain is a common condition that many women experience, but it doesn’t have to control your pregnancy journey. With the right treatment plan, including physiotherapy, posture adjustments, and self-care practices, you can manage the pain and continue to enjoy this special time in your life. Always remember to consult with your healthcare provider for personalized guidance on managing pelvic girdle pain during pregnancy.

Taking care of your body is essential for both you and your baby’s well-being, and with the right approach, you can find relief and continue to feel your best.

If you found this blog helpful, consider sharing it with other pregnant women who may be dealing with pelvic girdle pain. The more we share knowledge, the more we can help each other through the challenges of pregnancy.

What is a pessary?

Sun, 02 Mar 2025 22:57:35 GMT

Vaginal pessaries are a common medical device used to treat a variety of gynecological conditions. Although not often discussed openly, these devices can significantly improve quality of life for many women experiencing pelvic floor issues. In this blog, we’ll explore what vaginal pessaries are, how they work, their benefits, and key considerations for using them.

What Are Vaginal Pessaries?

A vaginal pessary is a small, flexible device that is inserted into the vagina to provide support to the pelvic organs. It comes in various shapes and sizes, depending on the specific condition it is meant to treat. These devices are typically made of medical-grade silicone or rubber, ensuring they are both durable and comfortable for long-term use.

Vaginal pessaries are primarily used to treat pelvic organ prolapse (POP), urinary incontinence, and other conditions related to the pelvic floor.

Pelvic organ prolapse occurs when one or more of the pelvic organs (such as the bladder, uterus, or rectum) slip out of their normal position due to weakened or stretched pelvic floor muscles and tissues.

Common Uses for Vaginal Pessaries

Pelvic Organ Prolapse (POP): Prolapse occurs when pelvic organs, such as the bladder, rectum, or uterus, drop or bulge into the vaginal canal. This can happen due to childbirth, aging, menopause, or other factors that weaken the pelvic floor muscles. Vaginal pessaries help by supporting the organs and keeping them in place, preventing discomfort and improving symptoms like vaginal bulging and urinary leakage.
Urinary Incontinence: Many women experience urinary incontinence, particularly stress incontinence, which involves leaking urine during activities like coughing, sneezing, or laughing. Pessaries can help reduce these symptoms by providing support to the bladder and urethra.
Post-Surgical Support: After certain surgeries, such as a hysterectomy or pelvic floor surgery, a pessary may be used temporarily or long-term to provide support during the healing process.

Benefits of Vaginal Pessaries

Non-Surgical Solution: For women who are not ready or unable to undergo surgery, vaginal pessaries provide a non-invasive, low-risk alternative to manage pelvic organ prolapse and other conditions.
Cost-Effective: Compared to surgical options or long-term treatments, vaginal pessaries are generally affordable, especially when considering the ongoing costs associated with surgeries or more complex medical interventions.
Customizable Treatment: Pessaries come in a range of sizes and shapes, allowing healthcare providers to customize treatment based on the patient's specific needs and anatomical considerations.
Improved Quality of Life: Many women report significant improvement in symptoms, including reduced vaginal bulging, pelvic discomfort, and urinary incontinence, leading to a better overall quality of life.
Minimal Maintenance: Pessaries are relatively easy to maintain with regular cleaning and occasional adjustments by a healthcare provider. They can also be used temporarily or long-term, depending on the severity of the condition.

How to Use a Vaginal Pessary

Using a vaginal pessary is straightforward but requires some instruction from a healthcare provider. Generally, the pessary is inserted into the vagina, where it rests against the pelvic organs to provide support. Many individuals can insert and remove the pessary themselves, while others may need help from us.

Here are the basic steps for using a vaginal pessary:

Consult with a Healthcare Provider: Your physio will assess your condition and recommend the appropriate type of pessary for your needs.
Insertion and Removal: Pessaries are typically inserted when lying down or standing with one leg raised. After insertion, the pessary should be checked periodically to ensure it stays in place. Your physio will also provide instructions for cleaning and maintaining the device.
Regular Checkups: While vaginal pessaries can be worn for long periods, regular follow-up appointments with your healthcare provider are essential to monitor the condition and ensure the pessary remains effective and comfortable.

Considerations and Possible Side Effects

While vaginal pessaries are a helpful treatment option for many individuals, there are some considerations to keep in mind:

Discomfort: Some individuals may initially experience discomfort or irritation when using a pessary, though this often improves as the body adjusts. A well-fitted pessary should not cause pain or excessive pressure.
Vaginal Discharge or Infection: Regular cleaning of the pessary is essential to avoid vaginal infections or discharge. It is also important to use the pessary as directed by a healthcare provider to minimize risk.
Need for Replacement: Over time, pessaries may need to be replaced due to wear and tear or changes in the shape of the vagina.
Not for Everyone: While pessaries are an effective option for many, they are not suitable for everyone. Individuals with severe vaginal atrophy or other complicating factors may require alternative treatments.

Vaginal pessaries are an essential tool in the management of pelvic floor disorders, particularly pelvic organ prolapse and urinary incontinence. They offer a non-invasive, customizable solution for many who seek relief from symptoms without opting for surgery.

While the device may take some getting used to, the benefits—such as improved comfort and quality of life—make it a valuable treatment option for those affected by these conditions.

If you think a vaginal pessary might be right for you, consult with your gynecologist, healthcare provider or pelvic health clinician to determine the best approach for your individual needs. With the right guidance and care, vaginal pessaries can help restore pelvic health and provide lasting relief.

Peyronies

Sat, 01 Mar 2025 07:01:05 GMT

Treatment options for Peyronies Disease

What is Peyronie’s Disease?

Peyronie’s disease is a condition where scar tissue (called plaques) develops inside the penis, leading to curvature, pain, or sometimes even erectile dysfunction. It’s not just about appearance; the curvature can make sexual activity difficult or even painful.

The exact cause isn’t always clear, but it’s often linked to repeated injury to the penis during sex, sports, or accidents. Some men might also have a genetic predisposition to developing this condition.

Your plaque shape and distribution can affect the shape change in the penis

1. Hour glassing = often superficial plaques in one or both sides causing an indent

2. Single small or multiple small plaques in different locations = often does not affect shape but may cause pain or asynchronous filling

3. Long thicker continuous plaque = larger curvature

Conservative (Non-Surgical) Treatments

One pain has settled ultrasound treatment can be intorduced early

Therapeutic Ultrasound : limited evidence but good clinical outcomes seen at our clinic for hour glassing or small plaques
Shock wave therapy : Low-intensity shockwaves may help reduce pain and improve blood flow, regain length and decrease curvature
Penile Pumps with or without penile rings : whilst often not changing the plaque itself these tools can often straighten the penis enough for penetrative intimcay
Oral Medications: PDE5's - viagra, cialis, levitra, stendra and other medication like potassium para-aminobenzoate (Potaba) and vitamin E have been used, but results are mixed
Injection Therapy : Collagenase clostridium histolyticum (Xiaflex) is an FDA- approved injectable treatment that can break down the scar tissue
Traction Devices: Penis traction therapy involves using a device to gently stretch the penis over time, helping reduce curvature over time - used for 30-90 min with restoreX and up to 6-8 hours with more traditional penile traction devises

Surgical Management

When Peyronie’s disease has stabilized (usually after 12 months) and the curvature

significantly affects sexual function, surgery might be recommended. The three main

surgical options are:

Plication Surgery: The shorter side of the penis is stitched to match the length of the curved side
Plaque Incision/Excision with Grafting: The plaque is cut or removed, and a graft is used to cover the area
Penile Prosthesis: For men with severe erectile dysfunction, an implant can help restore both function and straightness

Treatments for Peyronies Disease

Type 1 and 2 (Hour glassing and small plaques);

1. Baseline measurements of the plaques or hour glassing;

Radiological studies
String and tape measures
Serial photography

2. Four weeks of physiotherapy 2 x per week including

Therapeutic ultrasound
Pump therapy where relevant
Penile rings where relevant
Demonstration and explanation of home massage wand stretching with vit E cream
Release of any tension banding along inguinal ligament (lower abdomen) and to into the base of the penis if relevant
Pelvic floor muscle assessment and optimisation if relevant (downtraining for tight muscles and strengthening for weakness)

Type 3: Large plaques

We normally refer on to our urological colleagues for the larger plaques and for shock wave therapy trial as we do not find our conservate therapies are useful for the larger plaques

Final Thoughts

While Peyronie’s disease can feel isolating, it’s important to know that there is a building interest discussion and research into better management pathways for this condition.

At Pelvic Health Melbourne we are passionate about being informed and offering all the evidence and advise around the best treatment options for you. We will talk about ways to be intimate with your disease and discuss options for you. We offer Ultrasound therapy for hourglassing and small plaques and demonstrate how to massage the plaques and refer you onto a local provider for shock wave therapy if you would like to persue this option.

Come in and see one of our experienced clinicians for a consultation and discussion about your how your peyronies disease is affecting you.

Vulvodynia

Tue, 26 Nov 2024 22:00:54 GMT

Vulvodynia is a chronic and often misunderstood condition that affects the vulva, the external part of a woman’s genital area. Despite its impact on many women’s lives, vulvodynia remains underdiagnosed and underdiscussed.

This blog aims to shed light on the condition, provide information on its symptoms, causes, and available treatment options, and offer guidance to those navigating life with vulvodynia.

What is Vulvodynia?

Vulvodynia is characterized by persistent pain or discomfort in the vulvar area, without an obvious cause or visible signs of injury or infection. This pain can vary in intensity and may feel like burning, stinging, itching, or soreness.

For some women, the discomfort can be constant, while others may experience flare-ups triggered by specific activities, such as sitting for long periods, wearing tight clothing, or having sexual intercourse.

While vulvodynia is not a life-threatening condition, it can have a profound effect on a woman’s daily life, affecting her physical health, emotional well-being, and quality of life.

Common Symptoms of Vulvodynia

Vulvodynia symptoms can vary greatly between individuals. Some women experience mild discomfort, while others endure more severe pain. The most common symptoms include:

Burning or stinging sensations: This is the most frequently reported symptom, often described as a hot or sharp pain.
Pain during sexual intercourse (dyspareunia): Many women with vulvodynia report pain during or after sex, making intimacy difficult or impossible.
Soreness or tenderness: The vulva may feel sore or tender to the touch, making everyday activities like sitting uncomfortable.
Itching or rawness: Some women experience a sensation of itching or irritation, similar to an allergic reaction, though it’s not caused by an allergy.
Pain with prolonged sitting or tight clothing: Activities that put pressure on the vulvar area, such as sitting for long periods or wearing tight clothing, can increase discomfort.

The pain can be sporadic or continuous, and there may be periods of relief between flare-ups.

What Causes Vulvodynia?

The exact cause of vulvodynia remains unclear, but several potential factors may contribute to its development.

Understanding these potential causes can help women explore possible treatment options:

Nerve Irritation or Damage: One of the leading theories behind vulvodynia is that it may result from nerve damage or hypersensitivity. The nerves in the vulvar region may become irritated, leading to chronic pain even without any obvious physical injury.
Pelvic Floor Dysfunction: The muscles of the pelvic floor can become tight or weak, leading to pelvic pain and discomfort. Tight pelvic floor muscles can put pressure on the vulvar area, causing pain during daily activities and sexual intercourse.
Hormonal Fluctuations: Changes in hormone levels, particularly during pregnancy, menopause, or after birth control use, may affect the vulva’s sensitivity and lead to vulvodynia in some women.
Previous Infections or Inflammation: A history of yeast infections, urinary tract infections, or other inflammatory conditions in the genital area may be linked to the development of vulvodynia. In some cases, an infection can trigger a lasting pain response in the nerves.
Genetic and Environmental Factors: While not fully understood, genetics and environmental factors such as stress or trauma may increase the likelihood of developing vulvodynia. For example, a history of sexual abuse may make women more prone to experiencing vulvodynia.
Allergies or Irritants: Sensitivity to certain soaps, lotions, or laundry detergents can cause irritation to the vulvar area, and in some cases, this irritation may trigger vulvodynia symptoms.

Diagnosing Vulvodynia

Diagnosing vulvodynia can be challenging because there are no visible physical signs or tests to confirm the condition. Instead, doctors rely on a combination of medical history, a physical examination, and ruling out other potential causes of pain, such as infections or skin conditions.

If you suspect you have vulvodynia, it’s important to consult with a healthcare professional, such as a gynecologist or pelvic floor physiotherapist. Your doctor or physio may perform a pelvic exam, including a tender point examination, to assess areas of discomfort.

Treatment Options for Vulvodynia

While there is no one-size-fits-all treatment for vulvodynia, several options can help manage symptoms and improve quality of life. Treatment often involves a combination of approaches tailored to the individual’s needs.

Medications:

Topical treatments: Over-the-counter or prescription creams, such as lidocaine or estrogen, may be used to reduce pain and inflammation.
Oral medications: Antidepressants, anticonvulsants, or pain relievers may be prescribed to help manage nerve pain and chronic discomfort.
Hormonal treatments: If hormonal changes are contributing to vulvodynia, hormone therapy or local estrogen treatment may help.

Pelvic Floor Physiotherapy:

Pelvic floor physiotherapy focused on relaxing and strengthening the pelvic floor muscles can be incredibly beneficial. A pelvic floor physiotherapist can teach relaxation techniques and help alleviate muscle tension in the vulvar area.

Lifestyle Modifications:

Avoiding irritants: Using gentle, unscented products for hygiene, avoiding tight clothing, and refraining from using harsh soaps or detergents can reduce irritation.
Dietary changes: Some women find that certain foods, like acidic or spicy foods, can exacerbate symptoms. Keeping a food diary and adjusting your diet may help identify triggers.

Psychological Support:

Dealing with chronic pain can be emotionally challenging. Many women benefit from counseling or therapy to help cope with the anxiety, depression, or stress that may accompany vulvodynia. Support groups, either online or in person, can provide a sense of community and reduce feelings of isolation.

Alternative Therapies:

Some women find relief through alternative treatments, such as acupuncture, biofeedback, or mindfulness meditation. These therapies can help with pain management and stress reduction.

Living with Vulvodynia

Living with vulvodynia can be frustrating and emotionally challenging, but it’s important to remember that you are not alone. Many women are affected by this condition, and support is available. Reaching out to healthcare professionals, joining support groups, or simply sharing your experience with loved ones can make a world of difference.

Vulvodynia is a condition that requires patience, persistence, and self-care. By educating yourself, seeking appropriate treatment, and advocating for your health, you can take steps toward managing symptoms and improving your quality of life.

Conclusion

Vulvodynia is a complex and often misunderstood condition, but with the right support and treatment, it is possible to live a fulfilling life. If you suspect you have vulvodynia or are dealing with unexplained pain in the vulvar area, don’t hesitate to reach out to a healthcare professional. Early diagnosis and intervention are key to finding relief and managing symptoms.

Remember: your health is important, and you deserve care, understanding, and compassion on your journey to healing.

If you found this post helpful, consider sharing it to raise awareness about vulvodynia. Together, we can help break the silence around this condition and support those who are affected by it.

SUI - Stress Urinary Incontinence

Tue, 19 Nov 2024 02:18:07 GMT

Understanding Stress Urinary Incontinence: Causes, Symptoms, and Treatment Options

Stress urinary incontinence (SUI) is a common yet often misunderstood condition that affects millions of people worldwide. It can impact anyone, but it’s more prevalent among women, especially those who have had children, are aging, or are experiencing hormonal changes. Despite its name, SUI is not about emotional stress but refers to the physical stress or pressure placed on the bladder that leads to involuntary leakage of urine. In this blog post, we’ll take a closer look at what SUI is, its causes, symptoms, and available treatment options.

What is Stress Urinary Incontinence?

Stress urinary incontinence occurs when the pelvic floor muscles and the tissues surrounding the bladder weaken, leading to leakage of urine during physical activity or moments of increased abdominal pressure. These activities include sneezing, coughing, laughing, exercising, or even lifting heavy objects. The pressure on the bladder can overwhelm the muscles responsible for holding urine in, leading to an unintended release of urine.

While it’s a condition that many find embarrassing to talk about, it is also highly treatable, and understanding it is the first step toward seeking effective solutions.

Causes of Stress Urinary Incontinence

SUI usually results from a weakening or dysfunction of the pelvic floor muscles, which provide support to the bladder, urethra, and other pelvic organs. These muscles can weaken for a variety of reasons, including:

Childbirth : Vaginal delivery, particularly if it’s difficult or involves a large baby, can stretch and weaken the pelvic floor muscles. This is one of the most common causes of SUI in women.
Aging : As women (and men) age, the muscles in the pelvic floor lose some of their strength and elasticity. The decrease in estrogen levels after menopause can also contribute to weakening of the tissues in the pelvic area.
Obesity : Excess weight puts additional pressure on the bladder and pelvic floor muscles, which can contribute to SUI.
Chronic Coughing or Sneezing or constipation : Conditions such as chronic respiratory issues or allergies that cause frequent coughing or sneezing can increase pressure on the bladder and trigger leakage.
Pelvic Surgery or Radiation : Previous surgeries, particularly those involving the reproductive organs, or radiation therapy can damage or weaken the pelvic floor muscles, leading to incontinence.
Genetics and hypermobility : Some people may be genetically predisposed to a weaker pelvic floor or hypermobility, which can lead to SUI.

Symptoms of Stress Urinary Incontinence

The primary symptom of SUI is the involuntary leakage of urine during moments of physical exertion. The severity can vary depending on the individual and the underlying causes. Some common signs and symptoms include:

Leakage during physical activity : Any activity that increases abdominal pressure, like running, jumping, or even lifting a heavy object, may trigger leakage.
Frequent leaks with coughing or sneezing : Many people with SUI experience accidents when they cough, sneeze, or laugh.
Feeling of urgency : Some individuals may feel a sudden and strong need to urinate, especially when combined with physical activity.
It’s important to note that while stress incontinence is the most common type of urinary incontinence, it is different from urge incontinence, which is caused by an overactive bladder.

Management Options for Stress Urinary Incontinence

The good news is that there are many effective treatments for SUI, ranging from conservative measures to surgical interventions. The best treatment depends on the severity of the condition, the underlying cause, and the patient’s overall health.

Pelvic Floor Exercises (Kegel Exercises)
The first line of treatment for SUI is usually pelvic floor exercises, commonly known as Kegel exercises. These exercises involve repeatedly contracting and relaxing the muscles that control urination. Regular practice of Kegels can strengthen the pelvic floor muscles and improve bladder control.
Biofeedback
Pelvic floor physical therapy uses a combination of techniques, including biofeedback, electrical stimulation, and manual therapy, to help strengthen the pelvic muscles. A trained therapist can guide you through these exercises and monitor progress.
Surgical Treatments
For more severe cases of stress urinary incontinence that don’t respond to conservative treatments, surgery may be necessary. Common surgical options include:
Sling Surgery : A sling made of mesh or other materials is used to support the urethra and prevent leakage.
Colposuspension : The bladder neck is lifted and secured to reduce leakage.
Artificial Urinary Sphincter : This implantable device can help control urine flow in cases of severe incontinence.

At Pelvic Health Melbourne, our physiotherapists can help using these management techniques and work closely with surgeons to ensure optimal recovery if surgery is indicated.

Stress urinary incontinence is a manageable condition, and with the right treatment plan, individuals can regain control over their bladder and improve their quality of life. If you’re experiencing symptoms of SUI, don’t hesitate to speak with a healthcare provider. Early intervention can help prevent the condition from worsening and lead to effective relief.

Remember, you are not alone in dealing with this issue, and there are numerous options available to help you feel confident and comfortable again. Take the first step today and seek the support you deserve.

Our Transgender Support Services

Mon, 01 Jan 2024 06:13:10 GMT

At Pelvic Health Melbourne (PHM) we are sensitive to the long and ongoing physical and emotional journey gender affirming surgery can entail.

Your ongoing commitment to hormonal management, adjusting to the physical change, enduring the surgeries and the recovery process as well as the ongoing emotional journey and counselling required to help you along the way.

Some of the components an individual may experience on their gender affirming journey may include:

1. Hormone Replacement Therapy (HRT):

Estrogen (typically the primary female hormone) is used to develop female secondary sexual characteristics like breast development, redistribution of body fat, and skin changes.
Anti-androgens (such as spironolactone or finasteride) block the effects of testosterone, which is important for reducing male-pattern hair growth, deepening of the voice, and other masculine features.
Testosterone (typically the primary male hormone) is encouraged to promote features such as hair growth, muscle growth, voice changes and others.
Ongoing contact with an experienced Endocrinologist - to monitor and adjust hormonal therapy to balance the ongoing changes of affects and side effects of hormonal therapy as we age.

2. Surgical Procedures:

Breast Augmentation: While HRT can cause breast development, some individuals may opt for surgery to achieve a fuller chest.
Orchiectomy (orchiedectomy) and penectomy: Surgical removal of both testes and the penis.
Vaginoplasty: A common surgery for creating a neovagina, allowing for sexual function and appearance that is consistent with female anatomy.
Vulvoplasty: surgery for creating a neovulva (vulva without a vagina) with the external appearance of female anatomy.
Facial Feminization Surgery (FFS): Some transgender women may undergo surgery to soften facial features to achieve a more feminine appearance.
Voice Feminization Surgery: This can alter pitch and resonance, though voice therapy is often used alongside or instead of surgery.

3. Psychological Support:

Transitioning involves significant psychological changes and challenges, so counselling or therapy with a provider knowledgeable about transgender issues is often recommended. This helps with mental health, body image, and managing potential dysphoria during the transition.

Your transition will be unique and we hope you have the support team helping you to navigate the bumps in the road, and provide resources and treatment you may need.

At PHM we support individuals surgically transitioning with a prehab and rehab routine. Our prehab session involves receiving bladder, bowel, intimacy, and pelvic floor muscle baseline function to address any pelvic health concerns before surgery.

Post-surgery we assist with vaginal dilators to maintain the vaginal space, advice and massage for wound healing, and return to exercise and life. We can also support you with pelvic pain conditions such as; vaginismus, vulvodynia and endometriosis.

For all our community we can help with pelvic and/or intimacy pain. This may involve symptoms in the abdomen, hips, groin, and intimate areas.

J is for . . . The ABC's of Pelvic Health

Tue, 26 Dec 2023 00:28:47 GMT

Jaw, jumping and jellyfish all start with the letter J and are all related to pelvic health. How can we help?

Jaw

For some of us, anxiety can make us clench our jaw and in-turn our pelvic floor muscles. The jaw and pelvic floor have a neuromuscular connection to each other. So, in relaxing our jaw, we relax our pelvic floor. But how do we do that?

Simply being aware is always the best start.
Drop your shoulders.
Next we need to breathe...in through your nose, relax your jaw muscles and focus on the relaxed movement in your pelvic floor muscles. Allow your jaw and pelvic floor to relax or "drop", and while inhaling, focus on the feeling of these muscles lengthening and loosening.
Jaw exercises including your mouth and tongue.
And sing! Belt our your favourite song to loosen your jaw.

While strengthening your pelvic floor muscles is important, it's just as important to relax them.

Jumping

The accidental leakage of wee during physical activity, such as jumping or exertion is called stress incontinence.

Stress incontinence occurs when urine leaks because there is a sudden extra pressure within the tummy (abdomen) and on the bladder. This pressure (or stress) may be caused by things like coughing, laughing, sneezing or exercising (such as running and jumping).

Small amounts of urine may leak but sometimes it can be quite a lot and can cause embarrassment.

We can help!

Jellyfish

Visualising a jellyfish is a great way to assist with pelvic floor exercises.

To engage, gently draw in the jellyfish tentacles and then lift the jellyfish up.

To relax, allow the jellyfish to drop down and the tentacles to relax out.

Pregnancy and Your Pelvic Floor

Mon, 18 Dec 2023 23:28:22 GMT

There are so many wonderful elements experienced during pregnancy and we do our best to be healthy throughout.

We remember to take our prenatal vitamins to ensure our body and bub are getting enough of what's needed.
We stay clear of certain foods to avoid infections.
We keep our body active by exercising but we don't always remember to care for our pelvic floor.

During pregnancy, muscles of your pelvic floor are stretched and weaken. These muscles help to control your bladder. When your pelvic floor muscles are weak, they can't always stop your bladder from leaking. This leaking happens mostly when you cough, laugh, sneeze, lift or exercise.

You may also find holding in a wee difficult, like when putting a key in the front door, suddenly the urge is greater.

By performing pelvic floor exercises, you can strengthen the muscles. Pelvic floor muscle training will assist the body to cope with the growing weight of the baby. Stronger muscles before bub is born will help to reduce or avoid stress incontinence after pregnancy.

It's never too early to start doing pelvic floor exercises, but the earlier and more regularly you practice them throughout pregnancy, the greater the benefits.

If you're unsure if you're performing pelvic floor exercises correctly or would like some guidance, we can help!

I is for . . . The ABC's of Pelvic Health

Mon, 11 Dec 2023 22:53:27 GMT

Incontinence, intimacy pain and initial appointment all start with the letter I and are all related to pelvic health. How can we help?

Incontinence

Incontinence refers to the involuntary loss of wee or poo.

And it doesn't just happen to older people!

It can affect people of all ages, but is more common among older adults and those who have experienced pregnancy, childbirth or menopause.

Incontinence can significantly impact a person's quality of life and may cause social embarrassment, emotional distress and limitations in daily activities.

We can help!

Intimacy pain

Intimacy pain, also known as sexual pain or dyspareunia, refers to the recurring or persistent pain experienced during sexual activity.

It can affect vulva owners and penis owners and can have various causes including physical, psychological or relational factors.

We can help!

Initial appointment

We understand seeing a pelvic health physiotherapist for the first time can make you feel nervous, anxious and overwhelmed.

We are here to support you every step of the way.

Here is a little of what to expect from your initial appointment with us:

An initial appointment is usually a one hour consultation
Your appointment will include history, education, assessment and treatment

Urinary Tract Infection And Sex

Tue, 05 Dec 2023 00:36:52 GMT

How can I prevent getting an UTI after sex?

Urinary tract infections (UTI's) can sometimes occur after sexual activity. However, there are some steps you an take to reduce the risk of developing a UTI.

Here are some preventative measures you can consider:

Wee Before and After Sex: Weeing within 30 minutes of sex can help flush out bacteria and germs that can work their way to the urinary tract during the friction of sex, which can cause UTI's. This is particularly important to those of us with vulvas because our urethras are shorter.
Stay Hydrated: Drinking plenty of water helps maintain good urinary tract health by flushing out bacteria.

Maintain Good Hygiene: Ensure that you and your partner have clean genital areas before engaging in sexual activity. Wash the genital area with water, and avoid using harsh soaps or douches that may disrupt the natural balance of bacteria.

Wipe From Front to Back: After using the toilet, always wipe from front to back to prevent bacteria from the anal region from spreading to the urethra.

Avoid Irritating Products: Certain products, such as spermicides, can irritate the urethra and increase the risk of UTI's. Consider using the alternative forms of contraception if you find that these products contribute to UTI's.

Consider Urinating Before and After Using Sex Toys: If you use sex toys, make sure to clean them thoroughly before and after use. Additionally, urinating before and after using sex toys can help minimize the risk of introducing bacteria into the urinary tract.

Use Lubrication: Adequate lubrication during sexual activity can reduce the friction and irritation, which can help prevent urinary tract infections. Consider using water-based lubricants that are less likely to cause irritation.

Practice Safe Sex: Using condoms can help reduce the risk of UTI's by preventing the transmission of bacteria from your partner.

Remember that these preventative measures can help reduce the risk of UTI's, but they may not guarantee complete prevention. If you develop symptoms of a UTI, such as a burning sensation while urinating, frequent urination, or cloudy wee, it's important to see your GP for proper diagnosis and treatment.

H is for . . . The ABC's of Pelvic Health

Mon, 27 Nov 2023 23:58:17 GMT

Hysterectomy, hormones and hemorrhoids all start with the letter H and are all related to pelvic health. How can we help?

Hysterectomy

A hysterectomy is a surgical procedure that involves the removal of a patient's uterus.

The procedure my also involve the removal of the cervix, ovaries and fallopian tubes depending on the reason for the surgery and the patient's individual circumstances.

Hysterectomy is one of the most common surgical procedures performed, and it can be done using a variety of techniques.

Pelvic health physiotherapy can assist in the recovery and rehabilitation after a hysterectomy.

Hormones

Hormones are chemical messengers produced by glands that are released into the bloodstream and travel to different parts of the body to regulate various physiological functions.

These functions can include growth and development, metabolism, reproduction and responce to stress, among others.

Hemorrhoids

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus.

They can be internal or external and can cause discomfort, pain, itching and bleeding during bowel movements.

Hemorrhoids are a common condition.

If you’re experiencing any of the above, please know you’re not alone.

We’re here to help!

Nuts to Guts

Wed, 12 Apr 2023 04:25:00 GMT

Yes! Penis owners have a pelvic floor too.

EVERY BODY has a pelvic floor! Strong pelvic floor muscles are important for penis owners too.

The pelvic floor sits like a hammock and runs from the public bone to the tailbone and between the two sitting bones.

There a five main functions for the pelvic floor in a penis owner:

stabilising the lower back and hips
supporting the internal organs , specifically the prostate, bladder and rectum
bowel and bladder control
pumping of blood and lymphatic fluid
sexualising functions like arousal, erections and ejaculation.

Pelvic floor dysfunction can affect any of these functions.

The cue "nuts to guts" is a favourite of ours. This pelvic floor cue targets the important lifting action of the pelvic floor.

Give it a try and let us know what you feel.

G is for . . . The ABC's of Pelvic Health

Wed, 05 Apr 2023 02:22:47 GMT

G-spot, groin and gynecologist all start with the letter G and are all related to pelvic health. How can we help?

G-Spot

The G-spot, also known as the Gräfenberg spot, is a small, sensitive area located inside the vagina, typically about 1-2 inches up the front vaginal wall.

The G-spot is thought to be an erogenous zone that, when stimulated, can lead to intense sexual pleasure and even orgasm in some women.

The physiotherapist can educate individuals about the anatomy of the pelvic floor, including the potential location and sensitivity of the G-spot.

Understanding one's own anatomy can contribute to a more positive sexual experience.

Groin Pain

Groin pain refers to discomfort or pain in the area where the abdomen

meets the legs, which is known as the groin.

It can be caused by a variety of factors such as a pulled muscle, a hernia, an injury to the hip or pelvis, or an infection.

The pain can range from mild to severe and may be accompanied by swelling, redness, or tenderness in the affected area.

Gynecologist

A gynecologist specializes in the health of the female reproductive system. They provide care from puberty through menopause and beyond.

Gynecologists and pelvic health physiotherapists can work together to provide comprehensive care for vagina owners experiencing pelvic floor dysfunction.

If you’re experiencing any of the above, please know you’re not alone.

We’re here to help!

Male Bladder Incontinence

Sat, 01 Apr 2023 01:07:20 GMT

1 in 10 Australian penis owners suffer from bladder incontinence.

TYPES OF BLADDER INCONTINENCE

Stress Incontinence

Penis owners can experience stress incontinence with age and following surgery to the prostate. Stress incontinence is urine loss when there is exertion or an increase in pressure in the abdomen e.g. when running, sneezing or coughing.

Urge Incontinence

Urge incontinence is the need to suddenly rush to the toilet as the bladder is filling. This can be the result of bladder spasms, a reduced capacity of the bladder, or with certain triggers. Triggers can include; coffee, fizzy drinks, alcohol, artificial sugars, running water, on route to the toilet or even when putting a key in the door.

Post micturition incontinence

Post micturition incontinence (commonly known as after-dribble) can occur when the muscles that surround the urethra (the tube that carries urine from the bladder to the penis) do not contract properly. This stops the bladder from fully emptying. A common cause of post micturition incontinence is an enlarged prostate or weakened pelvic floor muscles.

It is important that you seek support and help by a health professional if you have any of the following symptoms:

• difficulty starting the flow of urine

• having to strain to wee

• a slow urine stream when weeing

• feeling the need to urgently wee

• burning, discomfort or pain when weeing

• blood-stained urine

• having to get up one or more times during the night to wee

• having to change your lifestyle because of problems with your bladder

Our team are here to help! Book an appointment today!

F is for . . . The ABC's of Pelvic Health

Wed, 29 Mar 2023 22:51:34 GMT

Faecal incontinence, fissures and frequency all start with the letter F and are all related to pelvic health. How can we help?

Faecal Incontinence

A pelvic health physiotherapist can play a crucial role in the management of faecal incontinence. They specialize in treating conditions related to the pelvic floor muscles, which play an important role in controlling bowel movements.

During an initial assessment, we will evaluate the strength and function of your pelvic floor muscles. Based on this assessment, we develop an individualized treatment plan that may include pelvic floor muscle exercises, biofeedback, bowel retraining, dietary & lifestyle changes and manual therapy.

By working with a pelvic health physiotherapist, someone living with faecal incontinence can improve their bowel control, reduce symptoms, and improve their quality of life.

Fissures (Anal)

Our team of pelvic health physiotherapist can provide an individualized treatment plan to help manage and prevent anal fissures, improve bowel function, and reduce pain and discomfort associated with the condition.

We will assess the pelvic floor muscles, provide pelvic floor exercises, educate on proper bowel habits, provide manual therapy and collaborate with other healthcare providers such as gastroenterologists or colorectal surgeons, to ensure comprehensive management of the condition.

Frequency

We can help with frequency of urination or bowel movements in several ways, depending on the underlying cause of the frequency.

Your physiotherapist will conduct a thorough assessment of your pelvic floor muscles, which are the muscles that control the bladder and bowel. They will evaluate the strength, tone, and flexibility of these muscles to determine if there is any dysfunction that could be contributing to your frequency.

They will provide targeted treatment to improve your pelvic health and quality of life.

If you’re experiencing any of the above, please know you’re not alone.

We’re here to help!

Preventing an UTI after sex

Mon, 27 Mar 2023 03:48:54 GMT

How can I prevent getting an Urinary Tract Infection (UTI) after sex?

Urinary tract infections (UTIs) can sometimes occur after sexual activity. However, there are steps you can take to reduce the risk of developing a UTI.

Here are some preventive measures you can consider:

Wee before and after sex: Weeing within 30 minutes of intercourse can help flush out bacteria and germs that can work their way to the urinary tract during the friction of sex, which can cause UTI’s (urinary tract infections). This is particularly important to those of us with vulvas because our urethras are shorter.

Stay hydrated: Drinking plenty of water helps maintain good urinary tract health by flushing out bacteria.

Maintain good hygiene: Ensure that you and your partner have clean genital areas before engaging in sexual activity. Wash the genital area with water, and avoid using harsh soaps or douches that may disrupt the natural balance of bacteria.

Wipe from front to back: After using the toilet, always wipe from front to back to prevent bacteria from the anal region from spreading to the urethra.

Avoid irritating products: Certain products, such as spermicides, can irritate the urethra and increase the risk of UTIs. Consider using alternative forms of contraception if you find that these products contribute to UTIs.

Consider urinating before and after using sex toys: If you use sex toys, make sure to clean them thoroughly before and after use. Additionally, urinating before and after using sex toys can help minimize the risk of introducing bacteria into the urinary tract.

Use lubrication: Adequate lubrication during sexual activity can reduce friction and irritation, which can help prevent urinary tract infections. Consider using water-based lubricants that are less likely to cause irritation.

Practice safe sex: Using condoms can help reduce the risk of UTIs by preventing the transmission of bacteria from your partner.

Remember that these preventive measures can help reduce the risk of UTIs, but they may not guarantee complete prevention. If you develop symptoms of a UTI, such as a burning sensation while urinating, frequent urination, or cloudy urine, it's important to see your GP for proper diagnosis and treatment.

E is for . . . The ABC's of Pelvic Health

Fri, 24 Mar 2023 07:46:24 GMT

Endometriosis, Episiotomy and Erectile Dysfunction all start with the letter E and are all related to pelvic health.

Endometriosis

We play an important role in the management of endometriosis. Here are a few ways we can help:

Endometriosis can cause chronic pelvic pain, which can be debilitating. We use a variety of techniques to help manage pain, such as manual therapy, therapeutic exercise, and electrotherapy.

Those living with endometriosis can develop pelvic floor dysfunction, which can include pelvic muscle spasms, weakness, or tightness. We can assess and treat using techniques like biofeedback, pelvic floor muscle training, and relaxation techniques.

You may require surgery to remove the endometrial tissue. We can provide pre- and post-surgery rehabilitation to help with recovery and regain function.

Episiotomy

Episiotomy rehabilitation includes:

Perform a thorough assessment to determine the extent of the injury and assess the pelvic floor muscles for any weakness, tightness, etc.
Provide pain management techniques to the episiotomy site. May include the use of heat/cold therapy, gentle massage/ manual therapy.
Provide pelvic floor muscle exercises and other techniques to help improve the strength, coordination, and endurance of the pelvic floor muscles.
Provide advice on how to manage the scar tissue to help reduce any pain, stiffness, or sensitivity.
Provide education on safe postures and other activities to avoid re-injury and promote healing.

Erectile Dysfunction

Here are a few ways that we may be able to help:

Assess the muscles in the pelvic floor and surrounding areas, as well as the nerves and blood vessels that are involved in erections.
Educate you on how to improve your pelvic floor muscle function and provide guidance on exercises and techniques that can help improve blood flow to the penis.
Manual therapy techniques such as soft tissue release, trigger point therapy, and joint mobilization can help to release tension and improve blood flow to the pelvic region.

If you’re experiencing any of the above, please know you’re not alone.

We’re here to help!

Penis owners can experience abdominal separation too!

Mon, 20 Mar 2023 01:06:48 GMT

Diastasis recti, also known as abdominal tendon stretching is common in pregnant vagina owners but is possible for penis owners to experience too.

Diastasis recti is a stretching of the connective tissue joining the muscles down the middle of the stomach.

In penis owners it can be caused by increased fat deposits around the organs under the muscle layer or an umbilical (belly button )hernia, forcing the muscles and tendon to stretch.

Diastasis recti develop in penis owners gradually over time and are noted by a protruding bulge in the mid-abdomen. It can be seen when doing a sit-up exercise.

So what are the reasons why diastasis recti can occur in penis owners?

Overloading core exercising
It is important to perform any type of workout routine or strength training exercise with the proper techniques. Diastasis recti can result from poorly managed sit-ups or weightlifting exercises.

Excess weight and obesity
In penis owners, diastasis recti can occur from gaining excess abdominal weight.
Penis owners tend to add extra weight to the abdomen first. When gained quickly, the extra kilos can apply increased pressure to the stomach muscle.

Medical History
Your past medical conditions, as well as family history and traits, can also dictate diastasis recti in penis owners. The risk is higher in those with family members with the condition who often carry weight around the abdomen.

In addition to the noticeable bulge there are other signs and symptoms which can include:

Constipation
Lower back, hip and pelvic pain
Urinary incontinence
Difficulty breathing
Discomfort in body movements
Stomach distension (bulging)
Weakness in the core

If you think you may have an abdominal tendon stretching make an appointment with our supportive team.

D is for . . . The ABC's of Pelvic Health

Thu, 16 Mar 2023 01:11:32 GMT

Dyspareunia, Diastasis Recti (DRAM) & Down-training all start with the letter D and are all related to pelvic health.

Dyspareunia

Dyspareunia is a medical term used to describe pain during sexual intercourse. This pain can be experienced by vulva and penis owners and can occur in different areas, such as the genitals, pelvis, or lower abdomen.

Dyspareunia can have various causes, including vaginal dryness, infections, and injuries, as well as psychological factors such as anxiety, stress, or trauma.

We can help!

Diastasis Recti (DRAM)

DRAM is a condition where the abdominal muscles separate, causing a gap in the midline of the abdomen. This gap can occur during pregnancy or as a result of rapid weight gain, intense abdominal exercises, or other factors that put stress on the abdominal muscles.

Some common symptoms of diastasis recti include a protruding belly or a bulge in the midsection, lower back pain, constipation, and difficulty engaging the core muscles.

We can help!

Down-training

Down-training refers to exercises or techniques that focus on relaxing or releasing tension in the muscles of the pelvic floor.

Down-training exercises may be recommended in cases where the muscles are overly tight or tense, which can cause problems such as urinary incontinence, pelvic pain, and difficulty with bowel movements.

These exercises typically involve breathing techniques and gentle stretches or movements that encourage relaxation in the pelvic floor muscles.

You may be hearing of these conditions for the first time or you may be living with them. If you’re experiencing any of the above, please know you’re not alone.

We’re here to help!

The tampon barrier

Fri, 10 Mar 2023 05:08:04 GMT

Do you experience pain or discomfort when trying to insert a tampon into your vagina?

If you experience pain when inserting a tampon, there could be several reasons:

Lack of relaxation

If your vaginal muscles are tense, it can be difficult to insert a tampon and cause pain. Try to relax your muscles and take deep breaths before attempting to insert the tampon.

Dryness

If your vagina is dry, the tampon may cause discomfort when you try to insert it. You can try using some lube or vegetable oil to help ease the insertion process.

Wrong angle

If the tampon is not inserted at the right angle, it can cause pain. Try aiming towards your lower back instead of straight up. Using an applicator can also assist in achieving the right angle.

Size of the tampon

Using a tampon that is too big can cause pain and discomfort during insertion. Try using a smaller size, the mini is perfect and gradually work your way up if needed.

Medical conditions

Certain medical conditions such as vaginal infections, vaginismus or imperforated hymen can cause pain during tampon insertion. If you do perforate your hymen during tampon insertion, this may cause some one-off pain and bleeding.

Remember, you should never force a tampon in if it is causing pain. If you continue to experience pain or discomfort, consider using an alternative such as pads or period undies.

If you experience persistent pain or discomfort, please make an appointment with one of our fab team.

C is for . . . The ABC's of Pelvic Health

Thu, 09 Mar 2023 04:45:04 GMT

Cystocele, caesarean & clitorodynia all start with the letter C and are all related to pelvic health.

Cystocele

Cystocele, also known as a prolapsed bladder, is a condition that occurs when the wall of the bladder weakens and bulges into the front wall of the vagina.

This can happen due to childbirth, menopause, or other factors that put pressure on the pelvic floor muscles.

As a result, women may experience discomfort or pain in the pelvic region, urinary incontinence, or difficulty emptying the bladder completely.
A pelvic health physio can play an important role in the management of cystocele. The physio will assess the strength and function of the pelvic floor muscles and develop a treatment plan based on the individual's specific needs. Treatment options may include pelvic floor muscle exercises, biofeedback, electrical stimulation, lifestyle changes and/or a pessary.

Caesarian or C-Section

A pelvic health physiotherapist can treat a C-section scar using a variety of techniques. Some of the most common methods include scar massage, stretching exercises, myofascial release, trigger point release, education and advice.

A pelvic health physio plays an important role in the recovery process after a c-section, helping alleviate pain and discomfort, improve mobility, and promote healing of the scar tissue.

Clitorodynia

Clitorodynia is a condition characterized by chronic pain in the vulvar region, specifically the vestibule, which is the area surrounding the entrance to the vagina.

The pain associated with clitorodynia can be described as burning, stinging, itching, or rawness, and can occur during sexual activity or any kind of pressure applied to the vulvar region, such as sitting or wearing tight clothing.

Treatment strategies may include pelvic floor muscle relaxation exercises, pelvic floor muscle strengthening exercises, manual therapy, biofeedback, education and advice.

1 in 4 women will experience constipation during pregnancy

Tue, 07 Mar 2023 09:11:51 GMT

Is this familiar?

�� Constipation is when your "poos" are infrequent and/or incomplete and you have trouble passing them because they are often dry and hard. Other signs you may be consti pated are pain, cramps or swelling in the abdominal area or you leave the toilet feeling your bowel is not completely empty.

So what can cause constipation during pregnancy?
��Lower levels of dietary fibre in your diet.

♀️ An increase in the pregnancy hormone progesterone. This can cause your gut to work less efficiently and your food to move more slowly through your intestines.

�� Medicines and supplements that some women take during pregnancy. Medicines prescribed for nausea and vomiting, antacids for heartburn, and some strong pain medicines can induce constipation in some women. Supplements like iron and calcium, as well as some multivitamins can also trigger constipation.

⚠️ Unfortunately women who have had constipation before pregnancy are very likely to experience worsening of symptoms during pregnancy.

So, how can you get things moving again?
��Drink plenty of fluids. Water, water, water! If you struggle to drink water, try adding fruit to it. Prune juice also can also help with getting things moving.

��Include more fibre in your diet. Choose high-fibre foods, such as fruits, vegetables, beans and whole grains.

��‍♀️Include physical activity in your daily routine. Being active can help prevent pregnancy constipation.

�� Positioning! Sit with your knees higher than your hips, using a foot stool, lean forward and put your elbows on your knees. This position straightens out where the colon and rectum join and allows poo to pass more easily.

Constipation may continue after birth. Women who have had a caesarean often experience constipation for a few days until their regular bowel movements return. This is due to the anaesthetic and strong medications.
Women who have stiches after a vaginal birth may hesitate on the toilet due to fear and pain, which can also cause a build-up in their bowels.

We can help! ��

B is for . . . The ABC's of Pelvic Health

Thu, 02 Mar 2023 06:47:07 GMT

Bedwetting, bladder and bowel all start with the letter B and are all related to pelvic health.

Bedwetting

Also known as nocturnal enuresis, is a common condition in which a person unintentionally wees in their sleep. It is most common in children under the age of 5, but can occur in people of all ages.

The exact cause of bedwetting is often related to developmental or medical factors and can also be caused by psychological factors such as stress or anxiety.

If you or someone you know is experiencing bedwetting, let them know we're here to help!

Bladder

I s a muscular organ located in the lower abdomen that stores wee until it is ready to be eliminated from the body.

The bladder can expand and contract as it fills and empties, and it is connected to the urethra, which is the tube that carries wee out of the body.

The bladder is controlled by the autonomic nervous system, which means that it can function without conscious effort. However, people can learn to control their bladder function through various techniques, such as bladder training or pelvic floor exercises.

Bowel

Also known as the intestine, is a long, muscular tube-like organ that is part of the digestive system. It is divided into two main parts: the small intestine and the large intestine.

The small intestine is where most of the digestion and absorption of nutrients takes place. The large intestine is responsible for the absorption of water and electrolytes, as well as the formation and elimination of poo.

Overactive pelvic floor? Weak pelvic floor?

Mon, 27 Feb 2023 06:10:27 GMT

An overactive pelvic floor can present like a weak pelvic floor.

Urinary incontinence?

Constipation?

Painful sex?

Pelvic pain?

Hip pain?

Coccyx pain?

Incomplete emptying of bladder or bowel?

Lower back pain?

Urinary frequency?

All these symptoms sound like a weak pelvic floor but what if I told you they can present in an overactive pelvic floor too...��

Symptoms are varied and it is only possible to diagnose an overactive pelvic floor through an assessment by your pelvic health physio. That's where we can help! ��

Once you've been assessed, our physio will write you a treatment plan and guide you in training your pelvic floor muscles to fully relax after a contraction.

They'll also talk to you about positive toilet habits, bowel and bladder health, sexual positions, posture and breathing.

So those pelvic floor exercises you've been doing, might not be what your pelvic floor needs!

If you think you may have an overactive pelvic floor, book with us today for an assessment.

A is for . . . The ABC's of Pelvic Health

Thu, 23 Feb 2023 04:55:23 GMT

Adenomyosis, anal pain, and anxiety all start with the letter A and are all related to pelvic health.

Anxiety

Can play a huge part for anyone experiencing overactive bladder symptoms (urgency or leakage), faecal incontinence (gas or bowel movement), vaginal prolapse, pelvic pain conditions including dyspareunia, vulvodynia, endometriosis and anal pain.

The stress hormones released with anxiety may make all these conditions worse.

Anxiety can play a huge part in your pelvic health. Firstly, for some of you, even making the appointment to discuss your pelvic issues can bring anxiety. For some, leaving the home while dealing with incontinence can bring anxiety. And for others, having sex knowing it’ll feel painful, can bring anxiety. We’re here to help.

Adenomyosis

Is the sister of endometriosis. Adenomyosis is a medical condition in which the tissue that normally lines the inside of the uterus grows into the muscular wall of the uterus.

This can cause the uterus to become enlarged, tender, and painful, and can also result in heavy or prolonged menstrual bleeding.

Adenomyosis is most commonly diagnosed in women who are in their 40s and 50s and have had children, but it can occur in women of any age who have not gone through menopause.

The cause of adenomyosis is not entirely clear, but it is thought to be related to hormonal imbalances or changes in the immune system.

Anal pain

Can be the result of many different causes including haemorrhoids, anal fissures, fistulas and muscle spasms.

You may be hearing of these conditions for the first time or you may be living with them. If you’re experiencing any of the above, please know you’re not alone. We’re here to help!

Does your child hide to do a poo?

Mon, 20 Feb 2023 23:29:27 GMT

Does your little one hide, reappearing with the smell of poo in their nappy or pants?

Does this image look familiar?

Does your little one hide behind the couch reappearing with the smell of poo in their nappy or pants?

This is a great sign that they're aware they need to poo. This body awareness is only one of the milestones toddlers need to meet before they are ready to toilet train, but it's an important one.

So why does your little one hide?

For some, it may be an embarrassment but for most, it's wanting privacy. This is a fantastic time to introduce them to the toilet as a private space.

How can you set up your toilet for your little one?

A toddler-sized seat that sits on top of your toilet

A footstool

A little bin with a liner

A bottle of Cheeky Squirt bum gel. Sometimes little bums prefer the feeling of a wipe rather than paper as it's what they're familiar with. With one squirt, your toilet paper will feel like a wipe and is flushable!

A fun, bright poster for the back of the toilet door or wall. This is a great way to help your little one relax by looking at things. It could be numbers, the alphabet, Bluey or Cocomelon.

Special soap to wash their hands with and their own hand towel.

Give lots of positive praise and feedback every time they sit on the toilet whether or not they have done a poo or wee.

Dress them in clothing that they can easily get off, avoiding zips and buttons.

If you have any concerns or need some support, please make an appointment with us or book online.

Sticky poo & the never ending wipe

Fri, 17 Feb 2023 04:25:15 GMT

Do you have to wipe multiple times to get your bum clean?

Do you notice skid marks in your underwear even after you've wiped clean?

You may have what we call “sticky poo”.

Sticky poo is a common digestive issue that can be uncomfortable and embarrassing. This type of poo is characterized by its dense and difficult-to-wipe consistency.

So what causes sticky poo?
�� Diet: Eating a diet high in fat and low in fibre can cause sticky poo. Fat slows down digestion and can cause poo to stick together, making them difficult to pass.

��Dehydration: Dehydration can cause the body to pull water from the stool, making it more dense and sticky.

�� Inflammatory bowel disease (IBD): IBD, such as Crohn's disease or ulcerative colitis, can cause inflammation in the digestive tract, leading to sticky poo.

�� Medications: Certain medications, such as opioids and iron supplements, can cause constipation and make your poo more dense and sticky.

So what can you do?
�� Increase your fibre intake. Eat more fibre-rich foods, such as fruits, vegetables, and whole grains. These can help to soften poo and make them easier to pass.
�� Stay hydrated: Drinking plenty of water can help to keep poo hydrated and reduce their stickiness.
��‍♀️Exercise regularly: Physical activity can help to stimulate the digestive system and promote regular bowel movements.
�� Avoid fatty foods: Limiting your intake of high-fat foods can help to reduce the stickiness of poo.
�� Have a bottle of Cheeky Squirt Bum Gel to keep you feeling clean.

If your sticky poo is caused by a medical condition, such as IBD, it's important to seek treatment from your GP or specialist. Treatment may involve medications, dietary changes, and lifestyle modifications.

Sticky poo is a common problem that can be managed with some simple changes to your diet and lifestyle.

If you're experiencing persistent symptoms, it's important to seek medical advice to determine the underlying cause.
Our team of pelvic health physiotherapists are here to help! ��

Lymphatic Massage

Sat, 15 Oct 2022 03:34:05 GMT

A Lymphatic Massage is a treatment used to assist the body in processing excess fluid. The tissues of the arms and legs (and sometimes the torso) can accumulate fluid and when this happens it is called lymphoedema.

Lymphoedema can occur with injury, after surgery, after radiotherapy or with some medical conditions such as heart disease. Anyone with swelling which is bothersome and poorly controlled should be assessed for lymphoedema. As should anyone who has had surgery or radiotherapy to the armpit or groin region, as lymphoedema can sometimes come on months or even years after their procedure.

Clearing this excess fluid away is important as it contains inflammatory waste products and if left, can create scar tissue and fatty tissue collections, which can in turn make the swelling worse.

Excess fluid can cause pain, heaviness, and loss of function. Together with compression and appropriate exercise, lymphatic massage can help treat this.

Treatments can take up to an hour depending on the size of the area involved.

Our senior physiotherapist Melissa offers lymphatic massage appointments in our Taylors Lakes clinic.

Ever wondered about your Pelvic Floor?

Tue, 04 Oct 2022 05:33:42 GMT

It’s a funny thing when we discover that we have been wrongly conditioned to believe something about ourselves. And for me, that belief was actually about my Pelvic Floor!

Having a weak pelvic floor was something that had become so ingrained in me that in many ways it impacted how I trained, how frequently I was doing my pelvic floor exercises (too often!), as well as the frequency I was going to the bathroom pre-workout or long drive!

As an Exercise Physiologist and Running Coach, Pelvic floor (PF) and core stability is a topic I discuss with clients, literally on a daily basis and almost exclusively the topic of ‘strengthening’ and training the pelvic floor (PF) complex. Despite being in the Health and Fitness Industry for over 20 years it has only been in recent months the concept of an ‘overactive pelvic floor’ has hit my radar and how it can affect your pelvic stability. You see, the majority of fitness professionals are trained and conditioned to believe the PF complex will be weak in almost everyone you see and all the cueing and information we are taught at uni and beyond is on how to work it in one direction - up! Lift, hold, count, repeat. We are always encouraging clients to hold in that wind, stop the flow of urine, to master the gold standard 10-second endurance hold. There was no consideration that these muscles could be overworked or could get stuck in a state of almost constant contraction! Naturally, if a muscle is already contracted there will be very little movement on assessment and thus presumed to be weak or underactive.

On reflection, there has been one occasion when I discovered the importance of being able to relax that pelvic floor and that was when I had a Physio assessment during my pregnancy back in 2018. During that appointment, I remember the Physio mentioning that “it would be a good idea to practice relaxing my PF as the chance of a tear during birth and long-term issues postpartum will be high. To be honest I don’t remember much in the way of technique instruction and really just tried to ignore the underlying fear I now had while I practiced a technique with no idea if I was doing it effectively. This fear became so ingrained in me that when I woke from the General Anaesthetic post-C-Section birth (it's a long story!!) my first memory is of doing my PF lifts. True story. I had gotten myself in quite a state about it and had secretly panicked about the birth for the remaining months of pregnancy. All the while I silently pleaded with these PF muscles to relax while no doubt clenching the crap out of them in my stress state!

While this physio had in fact suggested the concept of relaxing these incredible muscles it was only provided in the context of being important during birth. Similarly, when I had my assessment post-birth by a different physio I was told my PF “wasn’t great, but it likely never had been” so continue with the daily PF endurance holds, bounces and glute squeezes. Sound familiar to anyone?

Now I am at no point suggesting these Physio’s did the wrong thing because I’m also a trained professional and I never questioned it either. I just continued believing that I was like many women - weak through the PF, that my years of running, endurance training and overzealous toileting habits had likely made it worse. I also didn't start to connect the dots that the niggling pelvic, tailbone, hip and glute injuries that started to occur within 6 months of birth may have been due to anything other than my own pelvic structure and hormones changing.

What I am suggesting is that knowledge is power and that it is important to consider all that is going on rather than make a presumption that weakness of the PF is the only option.

So here I am some hours after my appointment at Pelvic Health Melbourne feeling a combination of relief, direction, focus, awe, and just a little bit of frustration and embarrassment that I didn’t know all this sooner. So why did I book in for a Pelvic Health Assessment four years postpartum with no apparent PF issues or symptoms? Initially, the idea was solely to go for my own learning and development and to find out exactly what I would be referring my clients for!

With a lot of PD occurring in the background of my life with a particular focus on Women’s Health it was only natural that I would start to link my learning to clients I was seeing and as fate would have it just recently I had been referred a patient who had torn a PF muscle during exercise due to it being hypertonic (muscle tightness/ increased tone). The more I read and researched in recent weeks the more I started pondering my own long-term hamstring and hip issues, particularly since having my daughter. By the time I arrived at my appointment I was almost excited to get confirmation that it was my pelvic floor causing a lot of my injury issues that despite long-term rehab would not go away.

Again I will re-state - Knowledge is Power and in my appointment today I saw via Real Time Ultrasound and as well as a complex examination that my previous conditioning and belief were all wrong. My left side pelvic floor musculature is basically locked on and when attempting the lifts and holds it barely moves from its already elevated state. Because of this over-active muscle, the rest of my pelvis is being pulled in odd directions and it gives reason and explanation to almost every niggly injury and irritation that has presented over the past four years. It also explains why on many occasions I’ve struggled to pinpoint exactly where the pain was originating from… turns out I was trying to find it on the outside of my pelvis when all the while it was on the inside.

So now I have a different type of rehab ahead of me, getting the muscles to release and relax using a combination of pressure release work and belly breathing techniques to encourage the pelvic diaphragm to work effectively.

So to wrap up and provide you with some practical takeaways…

If you haven’t had a complex and in-depth Pelvic Health Assessment then book in now! Honestly, it is worth it. Pelvic pain, incontinence, instability, unexplained injuries, and prolapse are all treatable and they are surprisingly common, it's just that we don't talk openly about our issues!
I 100% recommend Pelvic Health Melbourne and if there isn’t one near you they can advise on who to see in other areas. Email: info@pelvichealth.melbourne
If something doesn’t feel right for you or you have a chronic or ongoing niggly injury that won't rehabilitate, ask questions, think outside the box and follow your intuition. Don’t settle or ignore it and hope it will go away!
If you had a C-Section you still need to be assessed! And if you are male you too may need to be assessed. Everyone can experience Pelvic Health issues.
PF training should involve mastering both relaxations as well as contractions. It is not just about contracting and holding.
Finally and somewhat shockingly Bluey, or more specifically Bandit was wrong about this. A tactical wee is actually not a good idea in the long term and can cause a number of issues. Crazy I know!

If anything in this blog resonates with you please reach out and ask any questions you have.

I am in no way affiliated with Pelvic Health Melbourne, nor do I receive any compensation or reward for recommending them. This is my honest opinion of the treatment I have received and I couldn’t be more impressed.

Blog re-posted with permission from Kylie Royal Meehan from Fit Well You. https://www.fitwellyou.com.au

Thank you Kylie

Kylie Royal Meehan - Fit Well You

A little about Kylie

Kylie is an advocate of wellness in every sense of the word!

Her passion for anything health, fitness and wellness is like a beacon but she also has a strong belief in balance and making the most of life’s opportunities!

Kylie has been in the industry since the late 90’s working as an Exercise Physiologist and Personal trainer as well as in high-level injury rehabilitation, with elite athletes at the AIS and NTIS and with the general population.

Kylie's aim is that her positive attitude and high level of motivation will rub off on her clients and they will live their best lives.

Qualifications : Accredited Exercise Physiologist, Level 2 Recreational Running Coach, Personal Trainer.

Mental Health First Aid trained and Peer Support leader (Emergency services sector).

Nipple Trauma

Thu, 29 Sep 2022 03:26:44 GMT

Nipple trauma - a dry, sore, irritated, grazed or cracked nipple

80% of breastfeeding women will have some form of nipple pain which can be so severe that they stop breastfeeding.

Cracks, grazes and blisters can be difficult to heal because of regular feeds.

What can cause nipple trauma?

⁃ friction from sucking action and poor latch

⁃ strong infant sucking

⁃ anatomical differences in baby’s palate or tongue

⁃ dermatitis

⁃ psoriasis

⁃ Raynaud’s disease

⁃ flat or inverted nipples

⁃ infection eg thrush on the nipple

⁃ suboptimal positioning and attachment

Laser therapy can help. ��

So, what is laser therapy?

⁃ low-grade laser applied on the nipple

⁃ does not cause any damage to tissue internally or externally

⁃ non-invasive light

⁃ photochemical effect where the light is absorbed by the tissues and promotes healing

⁃ no heat, sound or vibration

What does laser therapy help with?

⁃ promotes wound healing

⁃ immediate pain relief

⁃ increase blood flow to the area

⁃ reduces inflammation

⁃ more comfortable breastfeeding

The laser is designed for pain relief and wound healing to hopefully enable women to continue feeding however we also look to find the source of the problem.

Endometriosis awareness

Mon, 07 Mar 2022 07:42:52 GMT

Endometriosis, or endo, is when tiss ues similar to the lining of the womb grow outside it in other parts of the body like the bladder and bowel.

More than 830,000 Australians have endometriosis and there is a 6.5 year delay in diagnosis for many of them.

Symptoms are variable but can include pelvic pain, issues with menstrual cycle and infertility.

Pain can vary from mild to extreme or severely debilitating and occur anywhere in the lower abdomen, bladder, lower back, pelvis, rectum and vagina.

Pain associated with periods, but not always.
Women often experience pain during or after sex or doing a poo.
Heavier or irregular periods or spotting inbetween.
Nausea, constipation and/or vomiting with severe episodes of pain.
Pain with ovulation.
Fatigue and sometimes depression.
Fertility problems may also develop.

Pelvic health physiotherapy can help with endometriosis by managing your pain, especially with your menstrual cycle, intercourse, urination and bowel movements.

Support can also be found at Endometriosis Australia

Pelvic Floor Physiotherapy for Prostatectomy rehabilitation

Wed, 02 Mar 2022 06:27:38 GMT

Pelvic floor physical therapy plays a huge role in your prehab and post prostatectomy rehabilitatio n.

Pelvic floor physical therapy plays a huge role in your prehab and post prostatectomy rehabilitation.

We highly recommend two appointments pre-surgery. During these app ointments we work with you on the activation of your pelvic floor muscles, discuss post-surgery processes including the use of a catheter bag, abdominal wounds, urinary containment (pads and continence pants) and erectile function.

Once you've undergone surgery, we will review you 1-2 weeks after catheter removal, then at seven weeks, three and six months.

Our aims for your post-surgery physiotherapy include:

Improving your muscle strength and control
Reducing your pelvic pain
Supporting the recovery of your erectile function
Restoring your continence
Rehabilitating your abdominal muscles

If you are undergoing a prostatectomy soon, book an appointment to see one of our physiotherapists to start your rehabilitation.

Is your little one about to start kinder or school?

Tue, 25 Jan 2022 06:55:23 GMT

Starting kinder or school can be stressful for children and parents alike – want to know some awesome tips to help them feel ready for their new toileting environment?

Starting kinder or school can be stressful for children, and their parents/care givers.

Stress, anxiety, and fear can affect your child’s bladder and bowel (wee & poo).

Getting to the toilet in their new environment may become difficult because:

Your child is not used to public toilets
The toilets may be a little smelly or different from home
Your child may be afraid to ask to go to the toilet when they need to
Your child may not want to miss out on the action, so holds on all day
And finally, your child’s eating and drinking habits often change – eating and drinking less or more, eating, and different food at different speeds.
Any of these changes can cause constipation, an overflow of poo, daytime wetting, or a return to bed wetting.

How can you help your child adjust?

Visiting public toilets is a great way to introduce independent toileting to your child.
Get them to choose a toilet
Have them close the door and practice locking/unlocking it
Practice zipping/unzipping, buttoning/unbuttoning, lifting skirts/dresses, pulling up/down pants
Show them how to use the toilet/urinal
Show them how to wipe themselves
Flushing
Washing hands including turning on taps

Talk about different smells, possible floaties in toilets and toilet paper in weird spots in a fun way to make all the possible scenarios they may come across acceptable to your child

Also, discuss with your child that it is importance to go to the toilet when they need to so asking within class is not only OK but important. Holding on all day – can lead to problems!

Explaining that going to the toilet before school starts, recess, lunchtime and after means they may not have to go during class time. Ensure they are ok to go to the school / kinder toilet and if not, take the time to go daily with them before and after school to help them through any worries they may have.

This might all sound basic but to a little one who has always had you or another adult with them, independent toileting can be scary

Some other toileting tips:

5-10 minutes is enough time on the toilet for anyone!
Add markers with stickers or a black sharpie on their water bottle to encourage drinking at school.
Chat with your child’s teacher if there are any toileting issues
Ensure that their poo and wee technique is effective; sitting with chest forward, elbows on knees, and pushing the tummy out helps the poo to exit more easily.

If your child is experiencing bedwetting, daytime wetting or soiling we can help. The answers are often remarkably simple and toilet success will follow

The best hammock ever created!

Thu, 02 Dec 2021 07:07:28 GMT

Your pelvic floor is a 'sling' of mu scles, a bit like a small muscle hammock that runs between the pubic bone in the front, and the tailbone at the back.

A woman’s pelvic floor muscles support her womb (uterus), bladder, and bowel (colon). The urine tube (urethra), the vagina, and the anus all pass through the pelvic floo r muscles.

A man’s pelvic floor muscles support his bladder and bowel. The urethra and the anus all pass through the pelvic floor muscles.

Your pelvic floor muscles help you to control your bladder and bowel and are involved with sexual function.

Because of these very important functions, it's vital to keep your pelvic floor muscles strong.

Doing regular pelvic floor muscle exercises can help:

Improve bladder and bowel control
Reduce the risk of prolapse
Improve recovery from childbirth and gynaecological surgery (in women)
Improve recovery after prostate surgery (in men)
Increase sexual sensation and orgasmic potential
Increases social confidence and quality of life.

And that's why it's the best hammock ever created !

What should my poo look like?

Thu, 18 Nov 2021 08:53:53 GMT

Although everyone has their own uniq ue size, shape and smell, there are a few things that can indicate a healthy (or unhealthy) poo.

Poo is mostly just undigested food, proteins, bacteria, salts, and other substances that are produced and released by our intestines.

A question many find too embarrassing to ask, so we'll answer it as best we can here.

Firstly, what exactly is poo?

Poo is mostly just undigested food, proteins, bacteria, salts, and other substances that are produced and released by our intestines. Although everyone has their own unique size, shape and smell, there are a few things that can indicate a healthy (or unhealthy) poo.

What should healthy poo look like?

During your bowel assessment, your physio will ask you about the colour, shape, size, consistency, frequency (how often) and duration (how long) of your poo.

You will be shown a copy of the Bristol stool (poo) chart. This chart was developed in 1997 as a clinical assessment tool and makes poo knowledge basic and easy to understand. There are seven types of stools according to the chart.

Type 1:

Appearance: Hard and separate little lumps that look like nuts and are hard to pass.

I ndicates: These little pellets typically mean you’re constipated. It shouldn’t happen frequently.

Type 2:

Appearance: Log-shaped but lumpy.

Indicates: Another sign of constipation that shouldn’t happen frequently.

Type 3:

Appearance: Log-shaped with some cracks on the surface.

Indicates: This is the gold star of poo, especially if it’s somewhat soft and easy to pass.

Type 4:

Appearance : Smooth and snake-like.

Indicates: Also considered a normal poo that should happen every 1 to 3 days.

Type 5:

Appearance: Small, like the first ones, but soft and easy to pass; the blobs also have clear cut edges.

Indicates: This type of poo means you’re lacking fibre and should find ways to add some to your diet through cereal or vegetables.

Type 6:

Appearance: Fluffy and mushy with ragged edges.

Indicates: This too-soft consistency could be a sign of mild diarrhea. Try drinking more water and electrolyte-infused beverages to help improve this.

Type 7:

Appearance: Completely watery with no solid pieces.

Indicates: In other words, you’ve got the runs, or diarrhea. This means your stool moved through your bowels very quickly and didn’t form into a healthy poo.

So, how often should you poo?

It’s common to poo once a day, although it’s still normal to be more or less often. Being regular really means that soft yet well-formed bowel motions are easily passed and that this happens anywhere from 1–3 times a day to 3 times a week.

If you unexpectedly poo at the wrong time or in the wrong place, you may be experiencing poor bowel control, or faecal incontinence. You may also pass wind (fart) when you don't want to.

Poor bowel control is more common than you think. About 1 in 20 people experience poor bowel control and it affects both men and women. It's more common as you get older, but young people can also have poor bowel control. In some cases, people with poor bowel control also have poor bladder control and may leak urine (urinary incontinence).

Medication, vitamin supplements, pregnancy, dehydration, stress and diet can all play a big role in your poo changing from what you know is "normal".

We're here to help!

If you have any concerns about the appearance of your poo, frequency or experiencing pain when using your bowels, please book an appointment with one of our award-winning physiotherapists.

Toilet Training – When is my child ready?

Tue, 09 Nov 2021 19:59:44 GMT

Going to the toilet independently is a major milestone in a toddler’s life.

As well as taking pressure off the family, no more nappies, the sense of independence and personal control gained can be liberating. Children normally show signs of readiness between 18 months and two years and it is helpful to recognise the signs that a child may exhibit when they are ready to start using the toilet. It is important to remember every child develops the ability at their own rate, some pick it up quickly while others can seem to take forever.

Signs of readiness:

Signs of interest, this might be following people to the toilet, talking about using the toilet.

Your Child can communicate when they have done a wee or poo.

Your child may try to take their nappy off after they have done a wee or poo, or they may try and hide when they are doing either.

They may be able to go for longer periods before needing to wee.

They may be dry or no longer dirty nappies at night.

As well as signs that your child may be ready there are some skills that can make the whole training process easier:

Your child can easily get to and from the toilet, they know where it is in your home.

They are able to remove clothing with ease, so they can take their pants off in readiness to use the toilet

Your child should be able to communicate with you with either using language or signs/pictures.

Being able to sit still for a couple of minutes is a good sign that they are ready to try using the toilet.

Tips for Success:

Making sure your child is comfortable on the toilet, you may need a stool to put their feet on, or an insert so they don’t feel like they are going to fall through. Should your child be fearful a potty may be a good start until they are comfortable.

Ensure your child sits comfortably on the toilet with feet on the floor or stool, the whole bottom is on the seat and they are leaning forward.

Some boys may prefer to sit when they start to wee and poo on a toilet, once they have established the ability to use a toilet, transitioning to standing up for wee is the next step.

Giving your child time at home is important, accidents can and generally do happen and being home will allow your child to feel ok when they happen.

Plenty of praise is vital to learning a new skill and can help to motivate your child. Sometime even a reward might give a child confidence to try something new. As your child gains confidence and independence these can be phased out.

When to seek further help?

It is common for some children to be able to wee independently but have difficulty learning to sit and poo. Children may be anxious or fearful, which can lead to constipation or refusing to take a nappy off. Children’s toilet training can at times go backwards after a period of success. If your child is not progressing it may be a sign to ask for help.

A Pelvic Health Physiotherapist can work with you and your child to help establish good toileting routines and teaching your child good wee and poo habits for the rest of their life. They may be able to help identify reasons for backwards steps and can provide advice on how to steer your child back on the path of toileting success.

Erectile Dysfunction

Fri, 18 Jun 2021 15:32:02 GMT

Erectile dysfunction is the inability to maintain or achieve an erection that allows sexual activity and penetration.

As a society we've become so much better at talking about women’s health. However for men, discussing anything related to their sexual anatomy can be awkward and embarrassing, resulting in delaying or avoiding support and treatment. Especially the topic of erectile dysfuction/impotence.

Erectile dysfunction is the inability to maintain or achieve an erection that allows sexual activity and penetration. In Australia, it affects around 40% of men over 40, 50% of men over 50, and 60% of men over 60.

Erectile dysfunction can be a sign of a physical or psychological condition causing stress, relationship strain and low self-confidence.

Common causes of erectile dysfunction include:

Prostate surgery
Pelvic floor muscle weakness
Vascular disease and hypertension
Cigarette smoking
Psychological factors

Treatments/Solutions:

A supervised pelvic floor muscle training program
Vacuum assisted devices
Erectile rehab program specific for your individual requirements

Our supportive pelvic health physio team can provide a thorough assessment and provide you with an individually tailored treatment plan.

If you have any concerns about your pelvic health, make an appointment today.

Peyronies Disease

Wed, 16 Jun 2021 07:16:43 GMT

Penises come in all different shapes and sizes and having a curved erection isn't necessarily a cause for concern. But, if this is something you've noticed, you may like to read on. ..

A condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections.

Peyronies Disease occurs when scar from a trauma has not been reabsorbed into the circulatory system but sits in the erectile tissue and hardens over time. The thickened connective tissue (called plaque) can develop as a result of trauma during intimacy, during life or develop over time without incident.

If the thickened tissue progresses, it can result in curvature of the penis which may contribute to painful intimacy or difficulty maintaining an erection.

For many men, Peyronies Disease also causes stress and anxiety, greatly effecting your mental health and wellbeing.

Peyronies Disease rarely goes away on its own. In most men with Peyronies disease, the condition will remain as is or worsen. Early treatment soon after developing the condition may keep it from getting worse or even improve symptoms. Even if you've had the condition for some time, treatment may help improve bothersome symptoms, such as pain, curvature, and penile shortening.

Symptoms

Peyronies Disease signs and symptoms might appear suddenly or develop gradually. The most common signs and symptoms include:

Scar tissue - The scar tissue associated with Peyronies D isease — called plaque but different from plaque that can build up in blood vessels — can be felt under the skin of the penis as flat lumps or a band of hard tissue.

A significant bend to the penis - Your penis might curve upward or downward or bend to one side.

Erection problems - Peyronies D isease might cause problems getting or maintaining an erection (erectile dysfunction). But, often men report erectile dysfunction before the beginning of Peyronies D isease symptoms.

Shortening of the penis - Your penis might become shorter as a result of Peyronies D isease.

Pain. You might have penile pain, with or without an erection.

Other penile deformity - In some men with Peyronie s D isease, the erect penis might have narrowing, indentations or even an hourglass-like appearance, with a tight, narrow band around the shaft.

Early treatment gives you the best chance to improve the condition — or prevent it from getting worse

Treatment

Therapeutic Ultrasound is showing promising evidence as an effective conservative treatment to reduce the size and progression of these plaques.

At Pelvic Health Melbourne we use therapeuic Ultrasound which directs the sound waves through the area of thickened tissue to commence reducing the plaque size and thickeness. We Ultrasound the area for 10 minutes 2-3 times a week over 4 weeks and track changes to the plaque area.

The patient will then use Vitamin E oil to massage into the plaque area on the day of treatment and the day after to help maintain the softened tissue and help remove the tissue that has broken down.

If you have any concerns, please make an appointment with our supportive physio team.

Mens urinary dysfunction?

Tue, 15 Jun 2021 07:40:34 GMT

Urinary dysfuction (bladder incontinence) is a common condition affecting 1 in 10 men in Australia.

Types of Urinary Dysfunction

Stress Incontinence

Men can experience stress/exertion incontinence with age and following surgery to the prostate. Stress incontinence is urine loss when there is exertion or an increase in pressure in the abdomen e.g. when running, sneezing or coughing.

Urine Urgenc y

Urine urgency is the need to suddenly rush to the toilet as the bladder is filling. This can be the result of bladder spasms, a reduced capacity of the bladder, or with certain triggers. Triggers can include; coffee, fizzy drinks, alcohol, artificial sugars, running water, on route to the toilet or even when putting a key in the door.

Post micturition incontinence

It is important that you seek support and help by a health professional if you have any of the following symptoms:

Difficulty starting the flow of urine
Having to strain to empty your bladder
A slow urine stream when emptying your bladder
Feeling the need to urgently empty your bladder
Burning, discomfort or pain when emptying your bladder
Blood-stained urine
Having to get up one or more times during main sleep time to empty your bladder (nocturia)
Having to change your lifestyle because of problems with your bladder.

Dyspareunia (Dis-puh-roo-nee-uh)

Fri, 11 Jun 2021 08:56:37 GMT

Dyspareunia is the term used to desc ribe pain with sexual intercourse.

Dyspareunia has many causes and it can be identified as superficial (on the outside of the vagina and vulva region) and deep (inside the vagina).

Sex should never be pa inful. It should be desired by both partners and be an enjoyable experience for both. Pain reduces sexual desire, arousal, and pleasure. This can lead to longer term issues for you and your relationship.

Dyspareunia is not always related to an underlying condition

It may be caused by:

Lack of lubrication
Hormonal changes; breastfeeding and menopause result in the body producing less oestrogen
Oral medications e.g. anti-depressants, sedatives, contraceptive
Lack of foreplay and sexual arousal prior to intercourse
Inflammation or infection to the vaginal tissue or vulva, this may be current or recurrent, and includes infections - thrush, urinary tract infections, vaginitis, eczema, psoriasis, lichen planus, lichen sclerosus
Chronic syndromes: endometriosis, adenomyosis, painful bladder syndrome etc.,
Scarring due to surgery, vaginal childbirth or other trauma
Overactive / hypertonic pelvic floor muscles – vaginismus

Emotional factors can include:

Psychological issues
Stress
History of sexual abuse

Some steps that may be helpful to treat dyspareunia at home include:

Emptying your bladder fully prior to intercourse
Taking a warm bath
Using a water- based lubricant
Applying an ice pack to the vulva
Communicating your pain to your partner
Engaging in longer foreplay to encourage secretion of the body's natural lubricants
Choosing comfortable sexual positions to minimize deep pain

If you're experiencing recurrent pain during sex or have worries or concerns, please make an appointment with one of our supportive pelvic physios.

Urinary leakage in pregnancy

Fri, 12 Mar 2021 22:56:39 GMT

Pregnancy is full of firsts. One surprise may be urine leakage – urine incontinence.

The pelvic floor muscles are a group of muscles at the base of the pelvis. They contract to hold fluids and solids in and relax to allow them to pass out. Incontinence is when urine, wind or bowel motion escape without your conscious control.

This happens for a variety of reasons:

The ever-increasing size of foetus, uterus and abdominal fluids
The hormones of pregnancy – particularly oestrogen – soften the “soft” tissues of the pelvis – this includes muscles and ligaments.
Sudden increase in abdominal and pelvic forces associated with vomiting
General whole-body weight increase
Developing a urinary tract infection
Constipation and straining with bowel movements
Pre-existing urinary conditions such as urinary urgency, overactive bladder, urinary incontinence
Pre-existing respiratory conditions that include coughing

The above first five reasons for urine loss relate to the downward forces overwhelming the available strength and speed of the pelvic floor muscles in contracting.

Urinary tract infections (UTIs) irritate the bladder wall and make it more irritable. Generally, there is increased urinary frequency, urgency, incontinence and pain with UTIs. It is important to have all UTIs treated by a medical doctor – especially in pregnancy. Symptoms tend to take a while to settle – often up to 6 weeks following a UTI.

Constipation and straining have several effects. The pelvis is a small space. A full rectum takes up space – a filling bladder will come into contact with the full rectum sooner, signalling the spine and brain that it is full – sooner. Another issue is with straining – a difficult and forceful bowel motion can cause urine leakage during the motion and in the longer term cause the pelvic muscles to lose efficiency and weaken.

What are the statistics?

A study this year by Moossdorff-Steinhauser and others surveyed 407 women during pregnancy and found a high rate of urine incontinence. The incontinence increased over the pregnancy from 55-70%. That is very, very common! The incidence of urine loss worsened with subsequent pregnancies and with pre-existing problems.

Surprisingly only 13% of those surveyed asked for professional help. Of course, as a generalisation, those who sought help improved.

How can you help yourself?

Please see your medical doctor if you suspect a UTI. Please do not put with a UTI during pregnancy. Have a urine test to determine the most appropriate antibiotic for you. A UTI will change bladder function for a long period of time for the worse if left untreated. Do not self-treat with over-the-counter alkalisers.

Avoid caffeine and carbonated drinks if you have a pre-existing overactive bladder issue – urgency and frequency.

Maintain a good fluid and fibre intake to pro mote healthy bowel actions and a normal weight range.

Accept that there will be some change due to hormones which may improve once the pregnancy has finished…….BUT seek help in the meantime.

How can an expert pelvic physiotherapist help pregnant women with this urinary incontinence?

See an expert pelvic health physiotherapist who can assess your urine problem, current and past history and perform an examination to determine what you should do. This will include learning how to perform pelvic floor muscle exercises well and developing a regime – when to do the exercises.

It is preferable to see a physio while you have the problem. But most definitely, recommended to see a physiotherapist in the early postnatal period -4-8 weeks postnatally. The physiotherapist can assess all ante-natal and post-natal physical concerns to formulate an individual plan for you.

Pelvic Health Melbourne has a number of expert pelvic physiotherapists who can help you address your urinary incontinence. We look forward to helping you.

Source:

https://link.springer.com/article/10.1007/s00192-020-04566-0 Moossdorff-Steinhauser, H.F.A., Berghmans, B.C.M., Spaanderman, M.E.A. et al. Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior. Int Urogynecol J (2020).

One little surprise in pregnancy you didn’t ask for: urinary leakage.

Tue, 17 Nov 2020 00:21:00 GMT

Pregnancy is full of firsts.

One surprise may be urine leakage – urine incontinence.

This happens for a variety of reasons:

The ever-increasing size of foetus, uterus and abdominal fluids
The hormones of pregnancy - particularly oestrogen - soften the "soft" tissue of the pelvis - this includes muscles and ligaments
Sudden increase in abdominal and pelvic forces associated with vomiting
General whole-body weight increase
Developing a urinary tract infection
Constipation and straining with bowel movements
Pre-existing urinary conditions such as urinary urgency, overactive bladder, urinary incontinence
Pre-existing respiratory conditions that include coughing

The above first five reasons for urine loss relate to the downward forces overwhelming the available strength and speed of the pelvic floor muscles in contracting.

What are the statistics?

A study this year by Moossdorff-Steinhauser and others surveyed 407 women during pregnancy and found a high rate of urine incontinence. The incontinenc e increased over the pregnancy from 55-70%. That is very, very common! The incidence of urine loss worsened with subsequent pregnancies and with pre-existing problems.

Surprisingly only 13% of those surveyed asked for professional help. Of course, as a generalisation, those who sought help improved.

How can you help yourself?

Avoid caffeine and carbonated drinks if you have a pre-existing overactive bladder issue – urgency and frequency.

Maintain a good fluid and fibre intake to pro mote healthy bowel actions and a normal weight range.

Accept that there will be some change due to hormones which may improve once the pregnancy has finished…….BUT seek help in the meantime.

How can an expert pelvic physiotherapist help pregnant women with this urinary incontinence?

Pelvic Health Melbourne has a number of expert pelvic physiotherapists who can help you address your urinary incontinence. We look forward to helping you.

Source:

The post One little surprise in pregnancy you didn’t ask for: urinary leakage. appeared first on Pelvic Health Melbourne .

Written by our wonderful Pelvic Health Physiotherapy Expert - Annette Beauchamp

Breastfeeding composition

Fri, 07 Aug 2020 03:26:00 GMT

Your breastfeeding composition across your baby’s da y

Did you know your breast milk changes as the day progresses? Your body is so amazing.

The morning sees a greater volume and more liquid in breast milk. The evening sees less volume and a greater density of fats. This helps your baby feel sleepy. Think of the last big rich meal that you had and how it made you feel sleepy too.

Milk composition changes across one feed as well – it begins with more fluid and ends with less fluid – i.e. more fats.

This has implications if you are expressing milk. Collect milk into containers across a few days – but importantly from the same period of time. That means collect the expressed milk from the morning for several days in a row and store that separately to the milk you collect later in the day. It helps to label the day and time that you have collected.

On some days, you may plan to express for a short while before you start feeding baby. On other days you may plan to express after you have finished the feed. – the baby gets “foremilk” and “aftmilk” this way.

In turn, this means you would offer the expressed milk – at a similar time of day – so that the baby gets the appropriate breast formula at the correct time.

The phenomenon of “chrononutrition” has been discussed by researchers. The natural breast formula helps baby develop a circadian rhythm – when to be alert, and when to be sleepy. You are teaching them the difference between day and night.

Hormones in milk are a good thing and change across the day as well. In the morning, the baby receives more cortisol – the “wake up” chemical. In the evening, the baby receives more melatonin – the “go to sleep” chemical. This hormone starts to increase around sunset and peak close to midnight. There are lots of other changes including proteins, iron, nutrients, antibodies across the day – which isn’t a reflection of what mum is eating at the tune, but more so it is her body and breast’s ability to create the perfect formula for her baby.

The expert physiotherapists at Pelvic Health Melbourne will assess your breast. We will provide ultrasound +/- laser if it is appropriate. Mum’s notice a difference by the end of the first treatment, and usually continue to improve quickly over the next few feeds. We will show you how to correctly and gently massage the breast to assist resolution of the problem and give you other advice to help at home. You will learn how to avoid future relapses.

Enjoy your baby. Enjoy breastfeeding.

References:

Jennifer Hahn-Holbrook , Darby Saxbe , Christine Bixby , Caroline Steele , Laura Glynn Human milk as “chrononutrition”: implications for child health and development. Pediatr Res 2019 Jun;85(7):936-942. doi: 0.1038/s41390-019-0368-x

Cubero J, Valero V, Sánchez J, Rivero M, Parvez H, Rodríguez AB, Barriga C. Neuro Endocrinol Lett. 2005 Dec; 26(6):657-61. The circadian rhythm of tryptophan in breast milk affects the rhythms of 6-sulfatoxymelatonin and sleep in newborn. PMID: 16380706

Physiotherapy for the Breast

Fri, 07 Aug 2020 02:53:00 GMT

Physiotherapists use ultrasound and laser in therapy for mastitis.

What is happening during mastitis?

Fluid collects in the breast during mastitis. It sits in the spaces between the ducts and compresses the ducts – which is why mamas think their ducts are blocked. It is the pressure from the fluid that causes the symptoms in mastitis: discomfort, pinkness, warmth and density – and reduction in milk volumes.

Mastitis is a state of inflammation. There is reduced blood flow in the area and inflammatory particles in the affected tissue. This happens with damaged nipples as well.

How does ultrasound improve the mastitis?

The ultrasound machine emits sound waves – these penetrate the tissues of the breast. This causes vibration in the cells, across the cell membranes and in the spaces between the cells where the fluid of mastitis collects. The vibration increases movement within the fluid that collects in mastitis and makes it more mobile. You can feel the difference in the texture of the breast during ultrasound therapy.

How does laser improve the mastitis?

The theory is that concentrated red light emitted from the laser probe is preferentially absorbed by cells, the cell nucleus and small internal o rganelles called mitochondria. This absorption process speeds up the inner workings of the cell and produces energy in and around the cell. This promotes chemical processes for healing. Its fancy name is photobiomodulation (PBM). Photosynthesis is another example of PBM – you know how plants use sunlight to grow….

Laser results in reduced pain signalsquickly , reduced inflammation and improved local blood supply. Laser improves healing of nipple cracksquickly .

We use cold laser. Cold laser is not painful and is safe for breasts and breastmilk.

The expert physiotherapists at Pelvic Health Melbourne will assess your breast. We will provide ultrasound +/- laser if it is appropriate. Mums notice a difference by the end of the first treatment, and usually continue to improve quickly over the next few feeds. We will show you how to correctly and gently massage the breast to assist resolution of the problem and give you other advice to help at home. You will learn how to avoid future relapses.

Enjoy your baby. Enjoy breastfeeding!

References:

Buck M.L., Eckereder G., Amir L.H., (2016), Low level laser therapy for breastfeeding problems, Breastfeeding Review , Vol. 24, No. 2; 27-31

Mastitis during breastfeeding

Fri, 07 Aug 2020 02:17:00 GMT

Mastitis can be distressing. Anyone who has experienced it will tell you without a doubt that they feel very unwell. Mastitis can be called a blocked duct as well.

Mastitis is related to breastfeeding.

Usually mums notice that baby is fussing at the breast.

Signs and symptoms vary

You may feel and notice any of the following:

Density – a thicker area in the breast – it may be diffuse or concentrated in one spot.

Colour – the colour may be normal, pinker or reddened. Occasionally it can become very pale.

Heat – the breast is often warmer in the affected area

Tenderness / Pain – this can be in the dense area, the whole breast, the nipple, the underarm or more generalised into neck, shoulder and back aches. In fact, if you think you have the flu while you are breastfeeding – suspect mastitis first!

Ideally the breast is soft and comfortable after each feed. If symptoms persist for a few feeds, then you can suspect mastitis and should seek help.

Enjoy your baby. Enjoy breastfeeding.

Pelvic Girdle Pain

Sun, 12 Jul 2020 23:58:39 GMT

Are you experiencing pain or discomfort in your pelvis, particularly when getting in and out of the car, pushing a shopping trolley or even vacuuming?

You may have Pelvic Girdle Pain.

What is Pelvic Girdle Pain?

This is pain in the joints of the pelvis during pregnancy and the postnatal period. It is related to the higher level of circulating hormones – particularly estrogen and relaxin. These rise during pregnancy, having 2 peaks – around 14 weeks and again at about 36 weeks. Both hormones drop dramatically by about the end of the 2nd day following birth.

How does it happen?

The circulating hormones increase the flexibility of all the soft tissue close to the birth outlet – vagina and perineum. This means the muscles, connective tissues and the ligaments of the pelvis, low back and hips. There is much less flexibility when we are not pregnant. After pregnancy, the hormones lower quickly, but the mechanical effect remains for a while longer.

What do I feel if I have Pelvic Girdle Pain?

Women expect some discomfort during pregnancy and put up with this until they can’t! They may limp or find they can’t put weight equally on both legs. Usually, the pain increases with climbing and descending stairs and getting into and out of cars, and particularly when rolling in bed and getting out of bed.

There is often a spot of sharp pain surrounded by an area of aching. It can be related to the habits of how you stand – which means it might affect one joint more than others. The sharp pain is associated with the laxity. The ache is often associated with the overworked and fatigued muscles that surround the joint.

What can I do at home?

Avoid the heavy housework – this means vacuuming and mopping and lifting loads of laundry. These activities tend to take some time – it is difficult to maintain muscle support required for the duration. So, spot clean the floors and reduce the weight of the laundry loads.

Get into and out of the car and the bed “like a lady”. Keep your legs together. Put your bottom into the car seat first and then lift your legs in. Roll onto your side in bed and then use your hands to push yourself up into sitting.

Going up and down the stairs – Squeeze your lower buttocks with each foot fall on the steps – We call this credit card butt!

Ask for help – arrange online shopping – to avoid carrying heavy loads. Ask family members to carry loads in from the car. Ask them to make the bed for you.

Some women find ice or heat over the aching area of comfort.

Change it up – don’t do one thing for too long – don’t sit or stand in the one position for longer than 20-30 minutes at a time. The same applies with exercise, listen to your body. Rest every 20-30minutes if you are going for a long walk.

What can my Pelvic Health Physiotherapist do for me?

The physiotherapist will assess your pelvis and spine to determine which joints, ligaments and muscles are affected.

We can advise you further on other self-help strategies.

You will learn exercises to strengthen the supporting muscles and stretches when needed.

We provide supportive pelvic girdle belts and taping to reduce movement and pain across the affected joints.

Pelvic Health Melbourne are experts in pregnancy related pelvic girdle pain – pain over the sacrum, sides of the pelvis, tailbone and pubic bone. We are the leading educators in Australia of this issue during and following pregnancy.

We promise to see you through your pregnancy and beyond and will help you to enjoy this time.

Thank you to our fabulous expert physio Annette Beauchamp for this detailed piece.

World Incontinence Week 2020

Wed, 17 Jun 2020 06:39:00 GMT

Can you laugh without leaking?? This simple, seemingly silly question is the tagline for the 2020 World Continence week. And it’s no laughing matter.

This year, World Continence Week runs from the 18th to the 24 th of June with events across the country. Incontinence is where you have an involuntary loss of urine, wind or stools. Some people may experience bladder or bowel incontinence because of an urge to empty, and they are unable to make it to the toilet in time.

Incontinence affects 1 in 3 women, 1 in 5 men and 1 in 4 kids/adolescents. These statistics highlight how prevalent incontinence is amongst our community and it can be treated and managed, and in many cases cured.

How can a Pelvic Health Physiotherapist help you?

Pelvic floor muscles are key to maintaining continence of both your bladder and bowel. As muscle and exercise experts, specially trained Physiotherapists can assess, diagnose and treat your incontinence.

At Pelvic Health Melbourne, our Physiotherapists have all accessed additional post-graduate education and training enabling them to assess and manage dysfunction in these muscles in both Men, Women, children and the LGBITQ community. We can play an active role in the prevention, treatment and management of incontinence, before and after diagnosis.

Who Can We Help With Pelvic Floor Dysfunction?

Pre and post pregnancy is often the first time many women think about their pelvic floor. This is a time when a healthy pelvic floor is so important, and our physiotherapists play a huge role in the education and exercise to prevent complications and aid in recovery post birth.
People with a history of constipation or chronic respiratory problems can be more at risk of incontinence. GPs often refer patients to Physiotherapists for early assessment.
We see many children who are experiencing incontinence including soiling, bed wetting and day time incontinence which may be the result of developmental delays, sensory processing disorders, poor toilet habits or fear of toileting.
Pre and post gynaecological surgery or men pre and post-prostate surgery and
Anyone who is just not sure if they are looking after their pelvic floor correctly.

After a comprehensive assessment, your Pelvic Health Melbourne Physiotherapist may include:

Pelvic floor muscle training
Bladder retraining
Relaxation
Timed visits to the toilet Toilet positioning to improve symptoms of incontinence
Many more individualised treatment options for your specific issue

In an ideal world, we would all be made aware of the importance of our pelvic floor and good toileting habits when we are still school aged. The word is getting out, and more people are talking about how they have prevented or overcome incontinence with the right care – through working with Physiotherapists, GPs, Gynaecologist, Urologist and Dietitians.

Incontinence is not something that people need to put up with. It is not something that we should keep quiet about, and it is not something that only happens to your grandmother. Don’t be afraid of having a laugh, sneezing in public or jumping in a puddle with your kids.

At Pelvic Health Melbourne we play an active role in the management and prevention of incontinence.

Book your appointment with our friendly team now!

Telehealth at Pelvic Health Melbourne

Fri, 20 Mar 2020 01:53:06 GMT

Book now to continue to optimising your Pelvic Health with Telehealth.

In the current climate we are adapting the ways we treat in order to continue to meet the needs of all of our patients, so they can continue to optimise their Pelvic health. Telehealth is a face to face online service which can be accessed via your phone, laptop or pc. We provide this service to our clients who are unable to attend the clinic in person, so they can still access care, no matter where they are located.

Incontinence and Pregnancy

Tue, 23 Jul 2019 02:45:00 GMT

What causes incontinence in pregnancy?

During pregnancy the hormones circulating in your body causes the ligaments, connective tissue and muscles to weaken and this can lead to increase stress on your bladder and bowel. An increase in body weight is also a significant risk factor for incontinence in pregnancy, as the baby grows inside your uterus this places extra stress on your bladder and bowel. As your pregnancy progresses your bladder is not able to store as much urine and this can lead to more frequent toilet stops and for some people urgency to empty their bladder.

Signs and Symptoms of bladder and bowel issues in pregnancy?

Leakage of urine with cough/sneeze/laugh or exercise
Incomplete bladder or bowel emptying
A sense of urgency to empty your bladder or bowel
Leakage of urine or faeces associated with the urge
Straining to pass urine or a bowel motion

Prevention is the key! If you have any of these symptoms during pregnancy, your Pelvic Health Melbourne physiotherapist can assess your bladder and bowel function and develop a suitable pelvic floor training program to help prevent your incontinence from worsening and also help to reduce the incidences of post partum pelvic floor dysfunction.

If you have incontinence during pregnancy, our team at pelvic Health Melbourne is here to help you.

Pubic Bone Pain in Pregnancy

Wed, 17 Jul 2019 09:19:00 GMT

Pubic Bone Pain in Pregnancy?

Have you felt a sudden sharp pain in your pubic bone when you walk, roll over in bed or get out of the car?

Do you wake up with a deep ache in your pubic bone area or feel like it is bruised?

If you have answered yes, then you may be suffering from pubic symphysis pain in pregnancy. This is a common and painful condition during pregnancy due to the ligaments and muscles relaxing, causing more stress on the pubic bone. Pubic bone pain in pregnancy can be managed and often cured if you seek the right help from our team of Pelvic Health Physiotherapists.

Tips to self-manage your pubic bone pain during pregnancy

Apply ice to the pubic bone for 10-15 minutes, 3-4 times per day
Avoid standing on one leg and going up/down flights of stairs
Try sleeping with a pillow in between your legs
Sit your bottom down in the car first and keep your legs together as you swivel in
Sit down to get dressed and to put your shoes and socks on

How can we help you at Pelvic Health Melbourne?

Individualised assessment to establish your main concerns, goals and to help you maintain and improve your function
Provide you with a suitable exercise program to help keep you fit, healthy and pain under control during your pregnancy
Soft tissue therapies to painful muscle spasms
Advice on braces, Tubigrip or other supportive garments if appropriate

Give our team a call if your are experiencing Pubic Symphysis pain during your pregnancy.

Your coccyx in pregnancy

Thu, 11 Jul 2019 07:00:00 GMT

What is coccyx pain in pregnancy?

Coccyx (tailbone) pain can occur at any time during your pregnancy due to the increase in body weight, softening of the ligaments and muscles around your pelvis. Most women who experience coccyx pain will complain of an ache through their tailbone area. The pain maybe worse when sitting or when rising from sitting on a chair or couch.

Common causes of coccyx pain during pregnancy:

Muscles - Your pelvic floor muscles attach onto the coccyx bone, therefore any abnormal tension in these muscles can aggravate your pain. Additionally, if your lower buttock muscles are tight it can also aggravate your pain.

Sitting Posture - you may have adjusted your sitting posture during pregnancy and are sitting more on your sacrum rather than your SIT bones. This is a common occurrence after pregnancy as the pregnancy backward tilt is maintained after birth, causing the woman to sit on her sacrum which in turn aggravates the tailbone pain.

Hormones - During pregnancy your hormones change and are designed to relax and soften all your muscles and ligaments of your body. This can sometimes result in altering the position of your coccyx.

How can you manage your coccyx pain?

Ice / heat pack on your tailbone region
Avoid slumping postures
Self massage to your gluts and back muscles

Come and see one of our physios if your are experiencing coccyx pain during your pregnancy.

Wrist Pain and Hand Pain in Pregnancy

Thu, 04 Jul 2019 01:32:00 GMT

What causes wrist and hand pain?

During pregnancy your muscles and ligaments can become stretchy and weak. This places extra stress on the joints, causing inflammation and pain in your wrist and hand. In pregnancy you have an increase in fluid retention and this can create more pressure in the joints and places extra stress on the already stretched muscles.

Symptoms of wrist and hand pain in pregnancy

Pain with gripping, turning a key or making a fist
Tingling in hands and fingers
Pain that may radiate from the thumb, wrist or up the forearm
Difficulty picking up objects

Tips on managing your wrist pain at home:

Ice on wrist and hand
Adjusting your desk position to make sure you do not have to over-reach or stretch
Avoid carrying heavy items in your hands, try using a shoulder bag
Tapes or braces to help offload the muscles in your wrist and hand

If you have wrist or hand pain while your are pregnant, give our team a call to get some help.

Upper back and rib pain in pregnancy

Tue, 02 Jul 2019 00:52:00 GMT

Upper back and rib pain in pregnancy

Upper back and rib pain is very common in pregnancy and it is commonly caused by hormones which make your soft tissue, ligaments and muscles more stretchy to allow the baby to grow inside the uterus. By your third trimester the uterus has expanded so much that it sits under your diaphragm and your ribs begin to stretch more forward to allow the baby to continue to grow.

What does rib pain in pregnancy feel like?

Pain under the sternum or around the ribs
Tenderness to touch along the ribs
Pain with coughing, sneezing or taking a deep breath
Pain in sitting, bending or slouching

How can our Physio’s help?

Our treatment usually involves soft tissue therapy to the muscles around your ribs and upper back

Postural advice and taping

Tubigrip can be helpful to support the ribs and back

Postural strengthening exercises and stretches to help loosen up tight muscles and joints

Do Men Have Pelvic Floor Muscles?

Thu, 20 Jun 2019 10:01:00 GMT

Surprisingly for some men, the answer is YES men do have pelvic floor muscles.

Where are Male Pelvic Floor Muscles?

Your pelvic floor muscles lie inside the pelvic bones.

The deeper layer of muscle sits directly underneath the prostate and help maintain your urinary continence.

The more superficial layer can be felt at the base if your testes and it helps to maintain an erection and pushes out the last few drops of urine in the tube.

What does my pelvic floor muscles do?

Stop you from leaking urine or stool - Helps with urine leakage by closing the urine tube (urethra), 20cm long. Stops stool leaking by helping the anal canal to maintain good closure pressures.

Maintain normal sexual function - Your pelvic floor muscles help to hold the blood in the inflatable sinuses on either side of the penis this helps maintain an erection. Additionally, if the pelvic floor muscles are too tight intimacy can cause pain sometimes within the testes or on the head of the penis and sometimes pain can be felt in the lower abdomen.

How do I activate my pelvic floor muscles?

Below are a few cues to help you activate your pelvic floor muscles:

Back Passage

Function: Control stools, wind
Action : Imagine you are holding wind in or squeeze around your back passage or anal sphincter and lift up and in

Middle section

Function : Helps remove last few drops of urine and helps maintain blood in the erect penis
Action: Lift your testes towards your stomach. Imagine you are walking into a cold ocean

Front Section

Function : Control of urine
Action: Imagine you are holding on to a full bladder, or

Imagine you are retracting the base of your penis, or

Imagine your penis is like a telescope that can fold back inside itself, or

Imagine your penis is like the head of a turtle pulling back inside the shell

How many should I be able to do?

3 sets of 10 repetitions of 10 seconds holds in standing.

How often?

Daily or bring them in when you lift.

In this way, you are doing them functionally throughout every day.

If you feel your pelvic floor muscles may not be performing as they should, seek some help from our physiotherapists to regain that control.

Breastfeeding – Positions and Support

Tue, 21 May 2019 02:45:00 GMT

Antenatal classes ? – check. Reading lots of pregnancy, birth and parenting books? – check. Breastfeeding classes? Hmmm!

For such a natural and precious part of being a mother, breastfeeding isn’t something you can really ‘learn’ or know how to do until your beautiful babe arrives and is safely in your arms. Here’s the incredible thing; babies are born with a survival instinct that means they know how to breastfeed; and they’re often much better at it than we are (at least initially). Try to remember that when learning any new skill, practice makes perfect; but there are a few tips and positions I’m about to share with you to assist you with mastering the art of breastfeeding.

Environment and Set- up

Ideally lying down. A relaxed, familiar feeding setup is going to promote a more enjoyable experience for you and baby. Bed, couch or floor, pillows are great; whether you use a boomerang pillow, cushions or a special nursing pillow, supporting your baby helps optimise their positioning on the breast and reduces unnecessary strain on your neck, shoulders and back. Be prepared with snacks and water on hand, as well as a tv remote or your phone close by. If you can get organised go to the toilet before you lie/sit down to feed! You don’t want that awful feeling of being desperate to go when the baby takes ages to feed or has fallen asleep and you don’t want to move for fear of waking them. This is a great time to do your pelvic floor exercises though! Ha you thought you got out of it didn’t you!!!

Latch

If you can take ‘baby to breast’ and not ‘breast to baby’. When you bring baby to the breast their head will be tilted back slightly with the chin elevated and nose close to the breast. Ideally you can see and hear rhythmic swallowing once the milk starts flowing after the let-down. If the latch is painful, take baby off the breast and attempt to re-latch. I know painful, but worthwhile in the long run !!??!!

Hydrate

Drink plenty of water! Breast milk is approximately 90% water and breastfeeding will make you thirsty. Hydration = good for milk supply, not to mention your overall well-being. It is especially important to drink enough to replace lost fluids through sweat or exercise. Research suggests a small amount of caffeine is considered safe while breastfeeding. I know huh……. argghhh. But on this one I think it is a trial and see. If you think your bub is more unsettled if you have a coffee … or two maybe reducing in the short term may enable more sleep for YOU and bub at night.

Eat well (and enough) – Breastfeeding takes it out of you, literally. It is recommended that breastfeeding women add an extra 400-500 calories into their daily caloric intake, Guys that’s an extra chocolate bar!!! “Ohhh, really I should not eat that kit kat” – mmmm –“ maybe if I kept some healthy snacks on hand, I’d feel better for it in the end and hey it may help milk quality and supply as well”!!!

OK it’s a no brainer but OOOOhhh not so easy when I am deliriously tired and craving something!!!!

GIRL, get organised with healthy snacks on hand and stop the excuses!!!! Cos you will feel better.

Supply

If you are concerned about low milk supply, speak with your GP for medical advice. Some women find lactation biscuits/balls effective, and there is a belief that brewer’s yeast, flaxseed and healthy fats are supply-promoting foods. This is however, not evidence-based theory; so it is worth speaking to a lactation consultant or dietitian prior to implementing any significant dietary changes.

Position

You will be guided by midwives and nurses, but we often find women are not taught to feed lying down. Breast size and baby size may impact position choice. Some breastfeeding positions to try include:

Side lying – Lying in bed or on a comfy couch with baby snuggled next to you not only promotes the bonding and skin-to-skin contact that boosts those breastfeeding hormones, but it gives you a chance to lie down and rest! For smaller breasted women, try feeding from the bottom breast, while larger breasted women may like to utilise gravity and feed from the top breast if baby’s head control and latch allows for this. This position is very relaxing and can be much more comfortable than sitting for some women, particularly those who have had a Caesarean delivery.

Semi-reclined - This is generally the first position used if baby is placed on your chest after delivery, so baby can ‘breast-crawl’ and enjoy that special first feed. This reclined position or even lying flat on your back may be useful if you have large breasts and a small baby, or a forceful let down.

Cradle - hold or cross body cradle hold. This ‘tummy to mummy’ position is very popular; but can be hard with a small newborn. Make sure you’ve got lots of pillows to support your back and under baby; and try not to spend the entire time looking down or with your shoulders rounded and back hunched over. As beautiful as it is to watch them feed and to have baby look up at you, your neck and back muscles will very quickly get tired of this constant looking down, and with your hormones (Relaxing, in particular) affecting ligament laxity, this can result in ongoing neck/back pain or cause headaches.

Rugby ball hold – The rugby ball hold (or football hold if you’re a keen AFL supporter) may be a nice position choice to use with a newborn, twins, following a C-section or if you’re a larger-breasted mum. Baby is tucked under your arm with feet towards the back of the chair or your body. Baby will feel safe nestled in to your body and you have the added benefit of being able to see baby’s face.

Upright or koala bear hold – When your baby is much heavier and wrigglier you may have to get creative with feeding positions! If your little livewire is too heavy to hold or gets reflux symptoms, this position may be beneficial. It can also be a discreet way of breastfeeding while out in public.

Dangle feeding – Some women report utilising gravity and dangle feeding in a kneeling position helpful for unblocking ducts and potentially preventing mastitis (although there is no published evidence for this). Baby lies on their back underneath Mum who ‘dangles’ over top and feeds in this fashion. This position may be a nice alternative but can place strain on the shoulders and arms if used for prolonged periods.

Hopefully the above tips and positions are of some assistance in terms of promoting an enjoyable breastfeeding experience for both you and your baby. Mums’ know best though, so if you have any concerns or questions, seek assistance from a trained medical professional or lactation consultant.

Breastfeeding and Mastitis

Tue, 23 Apr 2019 03:38:00 GMT

Breastfeeding 101: Let’s start at the beginning.

It is day 3/4/5 or whenever your milk develops (we used to say “comes in” but this is technically incorrect, as the pregnant body produces colostrum before delivery). Your perhaps previously small breasts have suddenly jumped up a few cup sizes and now resemble large blue bowling balls; this is called engorgement. You’ve been giving this feeding thing a good go for the past few days, and baby is (hopefully) latching well. It can take time to perfect the latch, so persevere and it’ll get quicker and easier for both you and bub.

Get Comfortable

Make yourself comfortable, take a big breath and try to relax
Be patient with yourself and with your baby. As the baby will pick up on your emotions and any stress around feeding or their attachment; particularly in the early days when their other senses are heightened until their vision develops
Contrary to what you're told about breastfeeding not causing pain, there may be an initial moment of discomfort as baby latches. Once correctly attached, there should be minimal pain and only an odd prickling sensation for some women when the let-down occurs.

If you do experience discomfort it may be due to cracked or damaged nipples. Try to modify the position for feeding so the baby takes the areola in their mouth and not just the nipple. Alternatively you may wish to try a nipple shield. Speaking with a lactation consultant can be useful as there may be able to advise on modifying your baby’s latching technique. Some women find Lanolin cream applied before and after a feed helpful. Gently hand expressing a small amount of breastmilk which can be rubbed over the nipple after a feed (this is just one of the many amazing ways breast milk promotes healing!).

Engorgement… Ouch!!

Engorgement occurs when the breasts produce more milk than they can hold (common when your milk matures) or if a feed is missed. This causes the brea sts to feel hard and uncomfortably full. If this occurs and is left untreated, blocked ducts or mastitis may develop. Blockages and mastitis can also develop as a result of a tight bra or clothing, pressure from nursing pads or trauma to the breast/nipple. As tired as you probably are, if a thoughtful relative or friend offers to watch baby while you nap. Try to set an alarm and make sure they’re back in time for the next feed. If you nap on the couch, make sure your nursing bra/singlet isn’t too tight, this can cause compression of breast tissue. Going bra-less or “free-boobing” is often good for the girls!

Mastitis; what is it?

Red, angry, sore patches on the breast, sometimes accompanied by streaks and shiny skin, and often a feeling of general malaise; as if you’re getting the f lu. It is caused by milk being pushed into the surrounding tissue. Possible due to bra / hand compression or increased force through duct due engorgement. Your body is well trained to recognise anything out of the norm (like this backflow). So inflammatory markers are released to ‘protect’ you from these foreign cells. Clever body! The only down side is that while you’re fighting this inflammation, your body isn’t functioning at full capacity. It is your body’s way of saying you’ve overdone it and need to rest.

If detected early, it is relatively easy to reduce and recover from symptoms of Mastitis. Firstly, REST! Leave the housework – call upon your partner or family members to help. Your priority is looking after yourself so that you can better look after baby.

Drink plenty of fluids, and make sure you're eating well and enough

A hot shower or warm washcloth applied to the breast before a feed can help soften areas of tension and may assist with clearing any blockages

An ice pack applied after feeding can assist with reducing heat and inflammation. Some women also apply cold cabbage leaves to the breast or soak the breast in warm water and Epsom salts

Have a break from feeding off this breast for a feed to allow some recovery provided engorgement is not an issue.

If you feel the need to express, do so gently as we do not want to promote an oversupply or cause further inflammation

Can a Physiotherapist help?

A Pelvic Health physiotherapist may use therapeutic ultrasound on the affected area to reduce pain and swelling. Massaging towards the armpit to promote lymphatic drainage is helpful. But, please do not use a comb to aggressively massage lumps out of your breast. There is a school of thought that this is beneficial, but it may in fact worsen symptoms. Massage gently with the pads of your fingers, but not to the point of pain.

Your Physio will cover massage techniques. They will also be able to make recommendations of feeding positions, appropriate clothing for adequate support. They will provide advice on reducing the risk of subsequent episodes of Mastitis. Seek treatment from a GP for advice and pharmacological intervention if your symptoms do not improve.

Exercise after having a baby

Mon, 08 Apr 2019 03:43:00 GMT

When can I return to my "normal" exercise?

As the haze of those early days with a newborn start to disperse and “baby brain” moments happen less often, you may think fondly of your pre-baby body, and naturally; wonder when it is safe to start exercising again. For some mums with time and energy constraints, a walk most days is a huge achievement and is great for your psychological well-being; however, for other mums, the burning question of “when can I return to my “normal” exercise?” is a big focus and needs to be answered.

After about six weeks, when your GP or obstetrician has given you the “all clear” to exercise and prior to starting back at the gym or going for a run, it is sensible to seek advice from a trained pelvic health physiotherapist to design an individualised strengthening program and provide advice on exercises to avoid or to focus on. In terms of returning to pre-baby exercise, there is no “one-size-fits-all” rule for when this is safe, so it is important to listen to your health practitioner and to your body.

Important points to consider

Abdominal wall stretching affects 100% of pregnant and postpartum women and whilst abdominal curls/crunches are not recommended for everyone, this exercise may be necessary for assisting abdominal recovery so be guided by a professional before performing abdominal exercises.
It is advised to focus on abdominal and back muscle strengthening and endurance after mastering adequate pelvic floor contraction.
Your muscles may respond very differently after having a baby and it will take time to build back your pre-baby strength. While it may be tempting to push yourself, muscle soreness may affect your ability to function as a mum so be gentle on your body to start with and if you tolerate the initial intensity, increase the challenge next time.
Hydration and adequate nutrition are exceptionally important, especially if you are breastfeeding. Some babies don't like the taste of breast milk after the mother has exercised
Wear supportive clothing and a well-fitted bra to minimise damage to breast tissue and the chance of developing mastitis from over-compression of the breasts. Also research shows that exercise gear can be motivating so some colourful, flattering exercise clothing may be a great way to feel empowered in your postpartum body.
Be guided by your body, enjoy the endorphins and have fun!

Exercise Post-birth

We have included 6 great exercises that you can start from 6 weeks to get ready for running or more loaded exercise at 12 weeks:

Six safe exercises

Exercise During Pregnancy

Fri, 22 Mar 2019 02:01:00 GMT

From the second you find out you’re expecting, you become a mother. A mama bear, with an innate, in-built protection mechanism to ensure the safety of the tiny human growing inside you.

Like anything new, there are certain challenges that come with pregnancy – hormones that make your ligaments stretchy and joints clicky (not to mention the emotional hormonal rollercoaster) sleep deprivation, nausea, lack of energy, significant body changes and societal pressure; not to mention other general life stresses. These factors undoubtedly affect our attitudes and behaviours toward exercise and health during pregnancy. Which is why I was so surprised at the controversy surrounding exercise during pregnancy and the number of questions nobody really has an answer to.

What exercise is ‘safe’ for me and baby?

Are there specific exercises I should avoid?

Is it important to do my pelvic floor exercises?

My personal experience

After some investigation and my own experience, I’d like to share a few thoughts which I hope you find helpful!

I went into pregnancy the attitude that – you know your body best and with the right knowledge, you are completely capable of pushing yourself within your own limits.

Mums-to-be are wrapped in cotton wool – scared to lift the groceries out of the car or a full washing basket off the floor.

I think we should be nurturing strong, capable mamas who are well-prepared for labour and for the demands of being a mum once baby arrives.

Some caution is necessary…

Now is probably not the time to take up ice hockey or marathon running, but you can apply some logical reasoning in terms of what your body is conditioned to do prior to falling pregnant and modify the exercise as needed.

For both my mental and physical health, my pre- and during pregnancy exercise was strength training. I’m lucky – I had an easy pregnancy; with only mild morning sickness from weeks 6-12, an annoying need to pee more during the day, and intermittent lower back pain from my compact (but heavy!) growing belly. Training 4-5 days a week until the day before I went into labour was great for me.

I believe the ease of my recovery post-delivery came down to maintaining consistency with training while pregnant. Now, this exercise regime was right for me but will not necessarily be right for you. My heart goes out to women who are limited with exercise during pregnancy if they want to be more active; to be limited in the exercise I do would be hard for me physically and physiologically.

What I have learned

I’ve learned that things you never had to think twice about before falling pregnant, like sneezing without wetting yourself or getting out of bed without grunting and a five-point turn now require a lot more consideration. Pre-activating your pelvic floor before a cough or sneeze works wonders (there’s even a name for this – “the knack”) and if you roll on to your side, lock your legs together and then sit up to get out of bed, this is much better for reducing any abdominal separation. Despite having what I considered a strong core, I developed a large abdominal separation or DRAM. I stopped doing any abdominal curls or lying abdominal work very early and had to modify any exercise where I felt my abdominals pulling apart.

The separation was measured regularly, and I wore a Tubigrip for support most days. At my widest point, above my belly button, I was measuring about 5cm on curl up and a scary 13cm at rest. I wore a three-strap abdominal binder following the birth, which absolutely healed accelerate my recovery as well as supporting my achy lower back.

Getting back on track

Although I am a long way off a flat tummy and a six-pack, I am now doing specific core strengthening exercises under the guidance of my physio and continue to see slow but definite improvements in abdominal tone and strength.

Despite there being no clear answer as to what ‘safe’ exercise during pregnancy looks like, there are a few guidelines we can follow. The British Journal of Sports Medicine advises that all exercise recommendations must be individualised based on the mother’s pre-pregnancy activity levels, and that there must be frequent close monitoring of both mum and baby’s well-being throughout. My ‘safe exercise’ consisted of pelvic floor exercises (most days), squats, upper back strengthening, pulldowns and lunges BUT other than pelvic floor strengthening, this is not what I would recommend for everyone. Recommendations on exercise during pregnancy are: to exercise for 150 minutes per week at an exertion level of moderate which is slightly out of breath but can still talk.

Tips for Exercising while pregnant

Seek clearance from your GP or health professional to start/continue exercising
Stay hydrated and nourished both during and afterward
Identify what exercise works for you (under the guidance of a Physio or trainer)
Strengthen specific muscles to support your growing belly and breasts ie. Upper and lower back
Listen to your body – if it doesn’t feel great, don’t do it
Avoid any exercises on your back from week 1
Ensure you don’t get too hot or out of breath
Take your time when changing positions to avoid dizziness and blood pressure changes
Try to do your pelvic floor exercises daily
Enjoy yourself and have fun!

Stop if you feel any of the symptoms below:

Bleeding
Shortness of breath prior to exercise
Dizziness
Headache
Chest pain
Calf pain / swelling
Amniotic fluid leakage

It is important to stop immediately if you experience any urinary incontinence or pain/discomfort during exercise. Remember that every pregnant woman is so different and therefore safe exercise is also very different for everyone. Provided you have been cleared by your pelvic health physio or your GP, the best advice I can give in terms of pregnancy-safe exercise is listen to your body and do what feels right for you.

What is a DRAM?

Thu, 05 Oct 2017 23:58:00 GMT

A DRAM (Diastasis Recti) is known as a separation or stretching of the central tendon between your rectus abdominus muscle.

A DRAM is commonly seen in pregnant & postnatal women and can correlate with a large abdominal circumference during pregnancy, a large weight gain, large baby/fluid and weakened abdominal muscles.

During the postnatal period, hormonal changes, increased physical demands and lower abdominal and pelvic floor weakness can all exacerbate the abdominal separation.

Why is important to have my DRAM assessed?

An assessment of your DRAM in the early post natal period will help identify if you have a significant DRAM which places you at increased risk of low back pain, pelvic floor dysfunction, abdominal hernias and other injuries.

A DRAM which is greater than normal width anywhere along your central tendon is clinically significant and requires personalised advice as to safe exercises and or support garments.

How to manage your DRAM

Your Physiotherapist may recommend the following to help in your recovery.

Compression garments: these will help to provide stability to trunk and lumbar spine, whilst helping to keep your abdominal muscles as close together as possible. Your Physiotherapist will recommend the right garment for you respecting your pelvic floor and stomach stage of recovery.
Behavioural modification: Learn how to protect your DRAM avoiding activities that increase the strain on the central tendon. Your physiotherapists will ensure you know what to look for that will tell you when you are overloading.
Safe and effective exercises for you at your stage of recovery respecting pelvic floor.

The Day My Life Changed meeting my Pelvic Floor Physiotherapist.

Mon, 19 Jun 2017 04:07:11 GMT

Discover how one woman's life changed for the better after meeting her pelvic floor physiotherapist.

I am a fit woman aged in my late 70's who whilst living in a rural area gave birth to 4 children. The first child being born 52 years ago. Apart from my first child the births were extremely quick and not supervised by a Doctor. In hindsight, it appeared that muscles and nerves had been damaged in the process.

As the years passed I began to have problems with the muscles and nerves surrounding my rectum. My Faeces were gradually becoming looser and looser and often at inconvenient times. This gradually worsened until I was afraid to go out in the morning unless I had been up for at least two hours during which time, after constant movement I would hopefully have been to the toilet.

This condition worsened until I felt I would need to wear a nappy! I began to place paper, occasionally pads in my briefs as often it would be fluid and I experienced no sensation of needing to go to the toilet. Daily I would give serious thought as to whether I would leave the house as my fear was so great that I would experience an 'accident'. From a trail and error basis, I knew I was intolerant to wheat, preservatives and citrus fruit.

In my early 60's I had a most successful operation to sew the muscles together. Unfortunately, nothing could be done for the damaged nerves. This procedure is still holding the muscles together.

My Options

Eighteen months ago I consulted my GP who referred me to a Specialist who suggested I had some options open to me:

A Sacrol Nerve Stimulation operation.
Consult a Physiotherapist qualified in the Pelvic Floor.
Consult a Dietician and test foods to see to which foods I was intolerant then follow a suitable diet.

The Path I took

I choose to follow a Physiotherapy/Diet option. The Specialist recommended a strong passionate, dedicated Pelvic Floor Physiotherapist, based in Melbourne. Under her supervision, instruction and guidance I followed plus months, of specific daily exercises. I visited her on

Under her supervision, instruction and guidance, I followed plus months of specific daily exercises. I visited her on a regular fortnightly visit which gradually extended to 6 weekly visits to 3 monthly visits. After nine months I have improved in strength enough to be referred to a Clinical Pilates Class doing specialised exercises to strengthen my core muscles. I did Pilates 3 times per week for two months before dropping back to twice a week. During this time my Pelvic Floor Physio consulted with my Pilates Physio on a regular basis as to my progress and which exercises I was doing. In conjunction with the Pelvic Floor exercises, I was supervised by a Dietician in discovering which foods I was intolerant too.

This combination, of adhering strictly to a modified Fodmap Diet suitable to me, regular exercises and Pilates, my Pelvic Floor Physiotherapist's supervision and advice, has resulted in my muscles strengthening sufficiently that I rarely have 'accidents'. Occasionally paste but no fluid. Occasionally a day will pass without a 'motion' being passed. Every now and again I will loose smaller faeces during the day after one or two normal motions passed earlier in the day, but it is nothing I cannot live with. This combination of factors has prevented the need at these stage of an operation. This journey is allowing me the freedom to live as close to a normal life as possible, I am not in a constant state of anxiety.

Thank you to my Physiotherapist whom I will forever be grateful to you - it was a wonderful day when I met you.