FAQs
Questions are everything. A large part of Physiotherapy is helping people to make informed choices about their own care and treatment. Discussions, reviewing information, explaining options and taking the time to answer all your questions is essential.
Here are some of the frequently asked questions I encounter regularly in my practise that may be of interest to you, or help you in your own decision making.
FAQs
Questions are everything. A large part of Physiotherapy is helping people to make informed choices about their own care and treatment. Discussions, reviewing information, explaining options and taking the time to answer all your questions is essential.
Here are some of the frequently asked questions I encounter regularly in my practise that may be of interest to you, or help you in your own decision making.
Bladder
Urinary leakage or incontinence can happen for different reasons; giving birth vaginally is only one factor that may cause incontinence for some people. A thorough assessment with a Pelvic Health Physiotherapist will help determine why you may be experiencing incontinence.
Bladder leakage or urinary incontinence can happen for different reasons. Sometimes pelvic floor muscle exercises (PFME) can be useful, but not always. A thorough assessment with a Pelvic Health Physiotherapist will help determine if PFMEs are beneficial for you or not.
Constipation
Everyone is different, what is typical for one person will be different for another. Usually anything from three times a day to once every three days is considered normal.
Exercise
Incontinence and other pelvic floor dysfunctions can affect young people as well as adults. Getting the right advice and intervention is important and Pelvic Health Physiotherapists can help here too.
Everyone is different. Every pregnancy and every childbirth experience is different. Some people are able to return to some level of exercise within a few weeks, some people may be a few months, others can be longer. Some people have a considerable amount of support and help available to them postnatally and others don’t. There are many different factors and elements that will determine anyone’s readiness to return to exercise postnatally. Advice should be individualised, realistic and achievable.
No. Inactivity, being overweight, overtraining, smoking, poor nutrition or poor sleep can all be more problematic for our knees (and whole health). Poor training regimes or overloading our bodies when we may not be ready for it, can mean we might experience pain with running, but doesn’t mean that ‘running is bad for knees’.
Some people will choose to stop all exercise because of leaking, others won’t. Urinary incontinence is something that can be improved or cured with the right treatment and so even if people choose to stop exercising in the short term, it doesn’t need to be avoided forever.
We need exercise to keep us healthy, fit and strong and to help maintain our overall well-being. When we have issues, injuries or pain, we may need to modify our exercise levels or what we’re doing, but ideally we find ways to keep some level of activity going. Your physiotherapist should work with you to help you navigate this.
Periods
This is a brilliant question because there is a massive variation is what people experience.
We still don’t have a lot of good quality research on all this, but increasingly there is more acceptance of what is considered ’typical’ parameters for periods, these include
- Periods lasting between 3 – 5 days
- Able to use one period product at a time (needing to use 2 or more period products at a time indicates extreme heavy flow)
Period products ideally lasting at least 4 hours (products lasting 2 hours or less indicates extreme heavy flow)
- Able to continue with usual activities of daily living, uninterrupted, with / without mild medication use, e.g. paracetamol.
Yes, you can and this happens all the time. The more important question to ask is, do you want to? Some people don’t care and are happy to proceed with their appointment regardless, and I fully support this. Others however would rather not and I support this choice too.
Physiotherapy appointments
Nothing, I trust there are good reasons why any home exercises haven’t been done. Life got in the way or something came up, it happens. Physiotherapists have the responsibility of meeting their clients where they are at, so it’s important that anything set to do at home, or in your own time, is completely achievable and realistic.
(Loose, comfortable clothing)Clothes!…Bear in mind, we can access a fully equipped gym if needed, so comfortable sports clothing may be useful, but it’s not at all essential.
When you book your initial assessment with Jo, you will be asked to complete a series of screening forms in advance. These are useful to help make the most of our time together in the actual physio session, although it is up to you how much information you supply. In the session, your presenting symptoms are assessed and your specific goals are discussed. Any physical assessment recommended will be fully explained and at each stage, your full and informed consent will be sought prior to any intervention.
Pregnancy
There are no set rules here. Not everyone needs to have a postnatal check up, but where people may have concerns, issues or questions then a session can be useful. For some issues such as perineal tears, episiotomies, incontinence, diastasis recti or pain, a session in the first few weeks may be more beneficial. Some people prefer to wait until at least six to eight weeks, others opt for a few months postnatal.
Postnatal physiotherapy
Yes it can! Pregnancy related back and pelvic girdle pain (PRBPGP) can be very common, but before any treatment is recommended a thorough and detailed assessment is needed. There can be many factors causing PRBPGP, some can be treated very quickly delivering almost instant results. Some factors require modifications and more intervention. Some causes need to be managed and monitored throughout the rest of the pregnancy. A detailed assessment is the essential first step to effective management
Lifting weights and strength training is a really beneficial form of exercise for almost everyone. It is something that can be endlessly modified and adapted for different age groups and abilities to make sure it is safe; modifying for pregnancy is no exception. I always recommend working with an experienced coach and trainer, because with the right knowledge, experience and qualification, any good coach will be able to guide a woman through her pregnancy. I often work with many coaches and their clients to help modify and adapt a training program if there are any particular issues or concerns. If you would like me to help you, please do get in touch.
In short, yes. In fact in nearly all cases, it is recommended. Of course there are exceptions and there will be times where someone will be advised to avoid or minimise their exercise levels during pregnancy. Your medical and OBGYN team will make this clear to you if this is the case and if in doubt you can always ask.
However, for the majority, exercising during pregnancy offers many positive benefits for both the mother and baby and there are many international guidelines, with clear advice and recommendations for people to follow.
See my library for some of these guidelines.
Prolapse
Pelvic organ prolapse (POP) refers to the downwards movement of one, or more, of the pelvic organs (bladder, uterus or bowel). In females, the drop occurs into the walls of the vagina, typically causing a bulge in the vaginal wall. The vagina is designed to move a lot, this is normal and very natural. Any movement down or bulging of the vaginal wall that can reach the level of the hymen, is considered more prolapse.
Typical symptoms of prolapse include…
- Feeling or seeing a bulge in the vagina
- A feeling of ‘something coming down’
- An uncomfortable feeling or pain in the vagina, which is worse when standing
- Heaviness or a dragging feeling in the lower abdomen or back
- Needing to strain to empty the bladder
- Feeling the bladder or bowel have not emptied completely
With prolapse the pelvic organs are not actually damaged, but rather the supporting structures (ligaments, connective tissue and fascia) holding the organs in place are the issue. Not all vaginal wall issues needs to be treated! Up to 50% of women in their 20s who’ve never even been pregnant, will have some amount of movement in their vaginal walls. This is normal. Remember, the vagina is designed to move.
Where there is significant bulging AND symptoms, then treatment is indicated. Treatment focuses on improving the support networks for the pelvic organs and learning strategies to help manage pressure, but treatment plans will differ for each individual.
Sex
There are many different reasons why people may experience pain with penetration. Tight pelvic floor muscles, hormonal changes, breastfeeding, gynaecological conditions or other health issues can sometimes cause pain with penetration. Importantly there are many things that can be done to help this, it doesn’t just need to be tolerated and a full assessment with a Pelvic Health Physiotherapist can be an important first step.
There are no set rules but there are things to consider…has postnatal bleeding stopped? Are there any stitches? Was there an episiotomy? How comfortable and ready are you feeling?
Pelvic health means the best possible functioning of our bladder, bowel, reproductive organs & the whole of the pelvic area, not just the absence of issues, symptoms or pain.
Why not explore Jo’s library, an archive of videos, podcasts, guides and more about physiotherapy & female pelvic health?
“The one who asks questions never loses their way”
Akan proverb
