Pelvic health physiotherapy

Our pelvic health physiotherapy service offers specialist assessment and treatment for musculoskeletal pain associated with pregnancy. This includes:

• back pain
• pelvic pain
• pelvic floor dysfunction such as bladder, bowel, vaginal and sexual problems for all adults and genders.

Our service also provides support and advice for staff and patients on the Trust’s postnatal and gynaecology wards, for the women who have a higher risk of pelvic floor dysfunction after birth or gynaecological surgery.

Our aim is to understand a patient’s condition and set out an agreed management plan, to achieve the best possible outcome.

We have one of the largest teams of pelvic health physiotherapists in the UK across St. Mary’s, Charing Cross and Queen Charlottes and Chelsea Hospital’s.

We try to provide physiotherapy at the most convenient location for patients at community clinics or the nearest Imperial College Healthcare NHS Trust hospital site.

Conditions we treat

Pelvic floor conditions we treat include:

• Stress urinary incontinence (a leaking of urine which happens with an increase in abdominal pressure such as coughing, sneezing laughing or physical activity or exercise)
• Urgency urinary incontinence (when you feel a sudden , very intense need to wee, and leak urine a few seconds after that feeling)
• Mixed (stress and urgency) urinary incontinence
• Overactive bladder (this causes someone to wee more often and to feel a sudden and intense need to wee)
• Voiding dysfunction (difficulty weeing or fully emptying your bladder)
• Pelvic organ prolapse (when one or more of the organs in the pelvis move downwards from their normal position and bulge into the vagina)
• A 3rd or 4th degree perineal tear after birth
• Pain during sex
• Vaginal and/or vulval pain
• Constipation
• Faecal incontinence (a leaking of poo or faecal matter)
• Anal pain

Conditions we treat in pregnancy include:

• Lower back pain, with or without leg pain
• Pelvic pain (in the front or back of your pelvis)
• Hip or buttock pain
• Rib pain/Middle back pain
• Wrist pain and associated pins and needles and/or numbness - carpal tunnel syndrome
• Pelvic floor problems during pregnancy e.g. leaking urine, leaking from the back passage, constipation, heaviness or bulge from the vagina (vaginal prolapse) or pain with sex

 

Treatments we offer

We offer the following treatments:

• Manual therapy and soft tissue techniques. (This is where a therapist will use their hands to examine and treat your muscles, joints and tissues. It often includes kneading and manipulation of muscles, joint mobilisation and joint manipulation.)
• A programme of exercises that is personalised to meet your needs. This can improve movement, increase flexibility and strengthen muscles
• Supplying you with equipment that could help, such as pelvic belts, elbow crutches and wrist splints
• Advice on lifestyle changes
• Biofeedback for the pelvic floor muscles (this is where we electronically monitor the pelvic floor muscles, to help show you how to control and strengthen them) Neuromuscular electrical stimulation (the pelvic floor muscles are exercised and strengthened by placing an electrical probe within the vagina)

Classes

• Healthy pregnancy class – one class for women who are between 12-20 weeks pregnant, with expert advice on having a healthy pregnancy
• Elective caesarean section Class – one class for women who are booked in to have an elective caesarean section (c-section)
• Core stability classes – four group exercise classes to strengthen the muscles in your back, pelvis and hips

Further online resources

• Pelvic Obstetric and Gynaecological Physiotherapy (POGP)
• Continence Foundation
• Bladder and Bowel community
• Chartered Society of Physiotherapists
• Pelvic Pain Support Network
• Mothers with anal sphincter injuries in childbirth
• Squeeze app: pelvic floor muscle training apps