Services

What I as a Pelvic Health Physiotherapist treat

At Inside Out Physiotherapy I offer a wide range of pelvic health assessments and treatments.

I treat all people with pelvic health concerns.
I treat people of all ages including young people aged 0-18.
These are listed in groups below rather than related to gender.
It is also common to have symptoms from several groups.

As you will see below pelvic health physio has a role to play in many facets of pelvic health.

Please click below to expand and see all the information.

  • Pelvic floor muscle dysfunction – any change to the pelvic floor that is different from normal.

    Decreased pelvic floor muscle tone – often described as feeling loose, lax, gaping, sagging, open, weak, bulging, full.

    Levator avulsion injury – injury to the pelvic floor at the insertion at the front of the pelvic floor. Usually occurs during first vaginal delivery - requires internal assessment for diagnosis.

    Pelvic floor tension myalgia or Levator ani tension myalgia – pain and increased pelvic floor muscle tone.

    Pain with intercourse (dyspareunia) and/or sexual activity – Pain with any type of sexual activity.

    Pelvic floor myofascial pain syndrome – pelvic floor pain of myofascial origin.

    Vaginismus – often described as vaginal feeling of tightness, constriction or being narrow or pelvic floor spasm causing discomfort, inability to maintain relaxed pelvic floor, burning and or pain with penetration, or complete inability to have intercourse.

    Descending perineum syndrome – where the perineum drops below the ischial bones on strain.

  • Stress urinary incontinence – Urinary incontinence/leakage with activity/exercise and/or cough, sneeze, vomit, laugh, lift, nose blowing. Also common after Radical prostatectomy.

    Urge urinary incontinence- Urinary incontinence/leakage with sudden urge to get to the toilet or on the way urgency develops.

    Mixed urinary incontinence – Combination of stress and urge urinary incontinence.

    Urinary frequency – urinating more than 5-8 times per day.

    Urinary urgency – feeling the need to urinate more often than usual (5-8 x a day) or all the time and/or sudden overwhelming urge.

    Overactive bladder – frequency, urgency, nocturia (urinating more than 0-2 x at night). This can happen with or without bladder leakage.

    Frequent UTIs (urinary tract infection) - three or more UTI’s per year.

    Pain or burning with absence of UTIs (urinary tract infection) – pain or burning associated with & without urination in the pelvic region.

    Nocturia – frequent urination at night.

    Post-Void Drip - dripping after finishing emptying bladder.

    • Interstitial cystitis and bladder related pain – these conditions present with a mixture of symptoms and can be different for each person. Common symptoms can include bladder pain, bladder pressure, general pain in pelvic region, bladder frequency (more than 5-8 x a day), bladder urgency or constant feeling of needing to go, pain with full bladder, pain and/ or burning while urinating, often small amounts when urinating, painful intercourse.

  • Pain with bowel movements – pain with passing bowel movements

    Faecal incontinence – leakage of bowel material.

    Flatal incontinence – unable to stop or hold wind (fart).

    Incomplete bowel empty – difficulty completing a bowel motion or feeling like you’re not finished.

    Constipation – symptoms may be slightly different for each person but may include: firm, lumpy or hard bowel movement, difficulty passing a bowel movement, needing to strain, going less often, pain when going, feeling of a blockage.

    Anismus – anal pain, ache or tenderness. Difficulty and pain when attempting to empty bowel or with anal penetration.

    Hemorrhoids – also called piles.

    Anal fissure – small tear around the anus.

    Obstructed defecation – Inability to initiate or complete a bowel movement though urge is present.

    Rectal prolapse – when the rectal tissue slips in the anorectum.

    Paradoxical puborectalis – muscle spasm instead of relaxation with bowel empty.

    Chronic proctalgia – persistent rectal pain.

    Proctalgia fugax – fleeting rectal pain lasting > 20 minutes at a time.

    Post treatment for colorectal or bowel cancer – symptom dependent.

  • Pelvic organ prolapse – organ slippage in the vagina. May be referred to as anterior wall/cystocele/bladder prolapse, urethrocele/urethral prolapse, posterior wall/rectocele/rectal prolapse, enterocele/small bowel prolapse, uterine prolapse, or vaginal vault prolapse depending on which organ is dropping downward. Can be one or a combination.

    Pelvic floor myalgia- pelvic floor pain and tenderness.

    Vaginal wind – odourless wind escaping from vagina with movement or during or after intercourse.

    Pain with intercourse (dyspareunia) and/or sexual activity – Pain with any type of sexual activity.

    Pain using Tampons – inserting or wearing.

    Vaginismus – often described as vaginal feeling of tightness, constriction or being narrow or pelvic floor spasm causing discomfort, inability to maintain relaxed pelvic floor, burning and/or pain with penetration, or complete inability to have intercourse.

    Vulvodynia – chronic pain and discomfort of the vulva at the entrance to the vagina.

  • Post prostate cancer recovery – pre and post-surgery - bladder control recovery and erectile function recovery – see more specific information here.

    Urinary incontinence – stress incontinence, urge incontinence or mixed.

    Erectile dysfunction - post prostatectomy or after investigated medically.

    Post void drip – leaking after urinating.

    Peyronies disease – curvature in the penile shaft.

    Penile fractures – damage to the tunica albuginea, sometimes also suspensory ligament damage.

    Penile/perineal pain – all pain in this region including due to compression eg from bike seat. Once investigated medically.

    Post vasectomy pain – pain beyond 6 weeks after procedure.

    Benign nonbacterial prostatitis – internal pain not related to an infection of the prostate.

    Testicular pain – once investigated medically.

  • See also Mama Care section for specially designed B.A.B.E assessments and education classes.

    Pain during pregnancy - low back pain, pelvic girdle and sacroiliac pain, thoracic or upper back pain, round ligament pain, lightening crotch.

    Pelvic floor muscle – weakness, low tone, high tone, checking you are able to activate and do pelvic floor exercises correctly. Also see PELVIC FLOOR RELATED section.

    Bladder – all bladder conditions listed in BLADDER RELATED section.

    Bowel - all bowel conditions listed in BOWEL RELATED section.

  • Perineal tears – all tears and the consequences.

    Perineal and abdominal scars.

    Pain with intercourse (dyspareunia) and/or sexual activity – Pain with any type of sexual activity.

    Pregnancy Recovery – posture, strength, return to exercise and activity. for more information see - B.A.B.E assessments.

    Caesarean section (C-section) recovery

    Abdominal and diastasis recovery

    Levator avulsion injury – injury to the pelvic floor at the insertion at the front of the pelvic floor. Usually occurs during first vaginal delivery - requires internal assessment for diagnosis.

    Pelvic organ prolapse – organ slippage in the vagina. May be referred to as anterior wall/cystocele/bladder prolapse, urethrocele/urethral prolapse, posterior wall/rectocele/rectal prolapse, enterocele/small bowel prolapse, uterine prolapse, or vaginal vault prolapse depending on which organ is dropping downward. Can be one or a combination.

    Coccyx pain and fracture – Pain at the end of the tail bone.

    Pelvic floor muscle – weakness, low tone, high tone, checking you are able to activate and do pelvic floor exercises correctly. Also see PELVIC FLOOR RELATED section.

    Bladder – all bladder conditions listed in BLADDER RELATED section.

    Bowel - all bowel conditions listed in BOWEL RELATED section.

  • Pelvic floor tension myalgia or Levator ani tension myalgia – pain and increased pelvic floor muscle tone.

    Pain with intercourse (dyspareunia) and/or sexual activity – Pain with any type of sexual activity.

    Pelvic floor myofascial pain syndrome – pelvic floor pain of myofascial origin.

    Pain using Tampons – inserting or wearing.

    Vaginismus – vaginal tightness or pelvic floor spasm causing discomfort, burning, pain, penetration problems, or complete inability to have intercourse.

    Vulvodynia – chronic pain and discomfort of the vulva.

    Pudendal nerve pain or neuralgia – pain in one or more areas which are supplied by the pudendal nerve.

    Endometriosis – treatment is of the associated symptoms. This may include bladder and bowel symptoms, vaginal and sexual function symptoms and pain related symptoms.

    Pelvic pain – Pain located in the pelvic region including that which has not responded to other therapies or treatments in the past.

    Coccyx pain – Pain at the end of the tail bone.

    Vaginal or penile/testicular pain – pelvic floor muscles and be related to pain in these areas.

    Pain in the abdomen, back, hips or muscles of the pelvis –pain in these areas may originate from the pelvic floor muscles or can be related to referral from the bowel, bladder, uterus or prostate.

  • Babies – constipation

    Toddlers – up to age 5 – constipation and toilet training.

    Children -age 5-10

    o Bed wetting (nocturnal enuresis)– over the age of 5

    o Daytime wetting (enuresis)

    o Constipation and soiling/ fecal incontinence

    Adolescent treatment – aged 10-18 years

    o Bladder – all bladder conditions listed in BLADDER RELATED section.

    o Bowel - all bowel conditions listed in BOWEL RELATED section.

    o Pain - Pain or difficulty using Tampons and all conditions listed in PAIN RELATED section

    o General pelvic health education

     Increasing awareness and pelvic health literacy and autonomy.

     Filling the gaps that are not always discussed in our education curriculum.

  • Pre- and Post- Surgical Programs – facilitating best outcomes with pelvic surgeries ensuring pelvic floor function is optimised before and after surgeries. Also incorporating all systems and strategies to ensure enhanced recovery and return to all activities - breathing, posture, alignment and coordination, bladder and bowel function, general strengthening and graduated activity specific rehabilitation.

    Pre/Post-Prostatectomy - bladder/continence control and penile rehab for erectile function recovery optimisation - pelvic floor exercises started 4-6 weeks prior to surgery if possible, to develop pelvic floor strength and facilitate better coordination before it is required after surgery.