Pelvic Health for both Men & Women

The delights of the pelvic floor

The pelvic floor is a muscle that stretches like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). The muscles of the pelvic floor work with the abdominal and back muscles to stabilise and support the spine.These muscles are normally firm and thick and support our pelvic organs. However, they can become weak and loose or too tight and cause daily challenges for both men and women.

Many cases of incontinence and bladder or bowel weakness can be improved with a specialist continence programme.

How do I know if I have a healthy bladder and strong pelvic floor?
  • empties 4-8 times each day (every 3-4 hours)
  • can hold up to 400-600ml of urine (the sensation of needing to empty occurs at 200-300 ml)
  • may wake you up once at night to pass urine and twice if you are older (i.e. over 65 years of age)
  • tells you when it is full but gives you enough time to find a toilet
  • empties completely each time you pass urine
  • does not leak urine.

If you can’t identify with these statements then you may have a weakness of your pelvic floor muscles.

What are the common problems linked to having a weak pelvic floor?
  • Bladder/ urinary incontinence
  • Bowel/ faecal incontinence
  • Chronic pelvic pain

Please look over the questionnaire and then each of the tabs below to see whether you would benefit from help from our pelvic health expert Diane Wootton.

Pelvic Health Questionnaire

Please look through this questionnaire to see whether you experience any of these common symptoms:
Bladder concerns:
  • Do you sometimes feel you have not completely emptied your bladder?
  • Do you have to rush to use the toilet?
  • Are you frequently nervous because you think you might lose control of your bladder or bowel?
  • Do you wake up twice or more during the night to go to the toilet?
  • Do you sometimes leak before you get to the toilet?
  • Do you sometimes leak when you lift something heavy?
  • Do you sometimes leak when you exercise or play sport?
  • Do you sometimes leak when you change from a seated or lying position to a standing position?
  • Do you go to the toilet more than 8 times a day?
Bowel concerns:
  • Do you experience severe difficulty controlling wind?
  • Do you get a feeling of needing to ‘go’ suddenly?
  • Do you find it difficult to control when you need to ‘go’?
  • Do you strain to empty to bowel?
  • Do you sometimes soil your underwear?
Are your symptoms affecting your quality of life?
  • Do you plan your daily routine around where the nearest toilet is?
  • Is it difficult for you to travel freely or do you feel the need to identify every accessible toilet around the area you want to visit?
  • Is it getting in the way of your work?
  • Is your problem affecting your quality of life?
  • Are social occasions difficult to attend?
Do you have any pain related symptoms?
  • Pain in your pelvic area?
  • Painful sex?
  • A feeling of needing to ‘go’ when not actually needing to? (this could be a prolapse)
  • A feeling of having ‘bulge’ in the vagina? (for a woman this could be a prolapse)
  • A general discomfort in the pelvic area?
  • A ‘pulling’ sensation in the pelvis?

Original questionnaire abridged and edited from ‘Bladder and Bowel Foundation’ website – click here for link

If you said ‘YES’ to some of the questions above then you may have a weak pelvic floor or a dysfunction of your pelvic floor muscle. This wide variety of symptoms can be common to both men and women and some are common to either men or women.

You could benefit from seeking advice from your GP or our specialist pelvic health physiotherapist, Diane Wootton.

Who is at risk?

The risk factors most commonly linked with a weak pelvic floor include:
For women
  • pregnancy (both pre- and post-natal women)
  • younger women who have had children
  • traumatic childbirth
For older women
  • menopause
  • hysterectomy (removal of all or part of the uterus and/or ovaries)
  • Gynaecological surgery
For men
  • Having an enlarged prostate or the recovery period following prostate surgery
  • radiation damage following treatment for prostate cancer – Please see our mens pelvic health page for more details.
For both men and women
  • weightlifting/ kettle bells
  • high impact aerobic exercise
  • distance running
  • athletes
  • chronic urinary tract infections
  • chronic constipation
General Health related risk factors
  • reduced mobility preventing you from getting to or using the toilet
  • neurological and musculoskeletal conditions such as multiple sclerosis and arthritis
Health conditions such as:
  • obesity, diabetes, stroke, heart conditions, respiratory conditions, and prostate problems.
  • some medications.

Bladder Incontinence?

Urinary or Bladder Incontinence

It’s important to realise that, particularly when it comes to bladder weakness, symptoms of accidental leakage or a sudden dash to the toilet should not be considered normal.

These are the more common types of incontinence:

  • Stress Urinary Incontinence

Mainly caused by a weakening of the pelvic floor muscles, causing urine to leak when only slight pressure is applied to the bladder, such as when coughing, sneezing, laughing, shouting, lifting, bending, standing up from sitting, or jumping.

  • Urgency and/ or Urge Incontinence

A sudden compelling urge to pass urine, and maybe leaking on the way to the toilet. This Urge Incontinence occurs when the bladder prematurely sends a signal to the brain that it is full causing the bladder to contract immediately.

  • After-Dribble (aka ‘post-micturition’ dribble)

Leaking a small amount of urine after leaving the toilet

  • Frequency

Going to the toilet to pass urine more than 6-8 times a day, during the day and/or at night.

These problems are often linked to weak pelvic floor muscles or damage to the nerves that supply the bladder following prostate surgery or child birth.

It is best to be assessed by our clinical specialist physiotherapist, Diane Wootten to see if pelvic floor muscle training is appropriate.

Bowel Incontinence?

What is Bowel Incontinence?

Bowel incontinence can be caused by damage to the muscles or nerves around the anus or a weakness of the pelvic floor muscles due to those risk factors outlined.

The experience of bowel incontinence can vary from person to person and talking through your particular difficulties may put your mind at rest and help you manage or improve your quality of life.

What are the symptoms of bowel incontinence?

These are some of the terms used by professionals to describe some of the symptoms of bowel incontinence :-

  • Urge bowel incontinence

Feeling a sudden, urgent need to go to the toilet, and incontinence occurs because they are unable to reach a toilet in time.

  • Passive incontinence

Experiencing no sensation before passing a stool, known as passive incontinence or passive soiling, passing a small piece of stool while passing wind.

  • Constipation

Finding it difficult to have a bowel movement or have a bowel movement less than 3 times a week and having to strain excessively or not feeling completely empty.

  • Diarrhoea

Passing watery or very loose stools more than 3 times in a day.

For more information visit http://www.nhs.uk/conditions/Incontinence-bowel/Pages/Introduction.aspx

How will I know if i should seek further help or advice?

If you answer YES to any of these statements or questions in the questionnaire then please seek the advice of our Specialist Physiotherapist Diane Wootton to see whether some simple steps can help.

How can physiotherapy help me?

It is never too late to get help with your bowel problems. Physiotherapy can be extremely useful in this condition, again by helping improve muscle function.

Our clinical specialist physiotherapist, Diane Wootton will first assess the root cause of your difficulties. Trying the least intrusive treatments first, such as dietary changes may be the first option to look at. Diane may recommend that simple dietary changes may offer a significant improvement.

Nutrition

At the Physio Studio, we have a qualified Nutrition expert who can give you advice and guidance on changes that can help. Our Nutritionist ‘Auriol Moores’ of ‘Vitology’ works with us on site at the Physio Studio and can be booked directly through our reception team if that is what is recommended for you.

Exercises

Alongside this, our Physiotherapist can guide you through a specifically tailored exercise programme over a period of weeks or months.
These exercises will help you strengthen the muscles that support your bowel and pelvic floor and provide vital reassurance that you can go on to manage your condition yourself in future.

Bowel incontinence is not something to be ashamed of – it is simply a medical problem that is no different from diabetes or asthma.

  • It can be treated – there is a wide range of successful treatments.
  • Bowel incontinence is not a normal part of ageing.
  • It will usually not go away on its own – most people will need treatment for the condition.

For more information please visit http://www.nhs.uk/conditions/Incontinence-bowel/Pages/Introduction.aspx

Please call the reception team or email: diane.wootton@physiostudio.com to discuss your particular needs.

Chronic Pelvic Pain?

Chronic pelvic pain/ Pelvic pain syndrome in men and women
What is it?

Pelvic floor dysfunction in both men and women can be myofascial (i.e. within muscles and tissues) and clients may have some exquisitely tender areas within the muscles known as trigger points.

Where would I feel the pain?
  • Some people have localised pain in the pelvic/ pubic area.
  • Some people have pain radiating out to the pelvic/ abdominal area.
  • A burning sensation on passing urine
  • Increased muscle tension around the pelvic area

Chronic pelvic pain may be caused by a number of reasons both bladder and bowel related, but sometimes the pain may have other origins.

One of the origins of this type of pain can be a tightness of the pelvic floor muscles causing them to be held in constant spasm, just like having a permanently clenched fist. This constant tightness then causes a dysfunction of not just the pelvic floor muscles but also other related structures around the pelvic girdle.

How can Physiotherapy help me?

Physiotherapy aims to reduce muscle tension in the pelvic area and calm the tender areas that are ‘too ready’ to send pain signals. These symptoms can respond well if carried out and demonstrated by a specialist pelvic health physiotherapist. This can include (based on Cochrane review recommendations);

  • Massage and stretches
  • Trigger point and muscle tension release techniques
  • Acupuncture
  • Stretches
  • Exercises
  • Manual therapy
  • Coccyx mobilisation
  • Biofeedback
  • Stabilising and strengthening exercises
  • Lifestyle changes
  • Relaxation

Chronic pelvic pain treatment is available by Diane Wootton, our clinical specialist physiotherapist and is usually covered by any Health Insurance policy you may have.

Please call the reception team or email:diane.wootton@physiostudio.com to discuss your particular needs.