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PELVIC HEALTH PHYSIOTHERAPY

The pelvis and pelvic floor muscles and organs play a vital role in the proper functioning of our bodies. They are interconnected with our breathing, gut, bowel & bladder, core stability systems, spinal system, and emotional well-being, among other aspects.

Throughout our lives, we may encounter various pelvic health issues that can impact our overall well-being. These problems can persist and affect us in different ways. However, you don't have to face them alone.

At my practice, I specialise in pelvic health physiotherapy, focusing on understanding the underlying causes of your concerns and offering comprehensive care to address them. I believe in taking a holistic approach, ensuring that you receive personalised attention and tailored treatments that align with your unique needs and goals.

We work together to relieve symptoms and improve your quality of life through a mixture of therapies and techniques.

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I understand that pelvic health issues can be highly personal and sensitive. To alleviate any concerns you may have, I assure you of the following:

  • You have the right to choose a chaperone who can accompany you throughout your treatment

  • I will always treat you with respect and ensure your privacy

  • You will be listened to, and I encourage you to ask any questions you may have

  • You have the right to refuse any form of treatment or intervention at any stage

  • You have the right to stop treatment, even during an examination if you feel uncomfortable

  • All treatments will be performed with your explicit consent, respecting the autonomy of your body

Pelvic icon

Conditions I treat:

Bladder Problems

BLADDER PROBLEMS

The bladder can be affected by various factors. Hormonal changes, gut health, lifestyle choices, and emotional state all play a role. The pelvic floor, supporting the bladder against the pubic bone, can be influenced by musculoskeletal changes in the pelvis, hip joint, and lower back.

Conditions I commonly treat include:

  • Stress Urinary Incontinence (SUI)

  • Overactive bladder (Urge Incontinence, Frequency, Urgency, Nocturia)

  • Difficulties in bladder emptying

  • Urinary retention

  • Chronic/Recurrent Urinary Tract Infections (UTI)

  • Painful Bladder Syndrome (BPS)/interstitial cystitis

Collaboration with your medical team, such as your GP or specialist, allows me to deliver the best treatment options tailored to your needs.

PELVIC ORGAN PROLAPSE

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The organs within the pelvis are naturally designed to move to facilitate functions such as urination, bowel movements, sexual activity, and childbirth. The pelvic floor muscles and connective tissue create a flexible and supportive structure that adapts to breathing and exercise or movement demands. Instead of using the term "prolapse," it may be more appropriate to describe it as difficulties in managing loads or movement of organs to alleviate fear and promote understanding.

It's important to note that not everyone experiences symptoms, and surgery is not always necessary for all cases of prolapse. According to the current NICE guidelines from April 2019, a supervised pelvic floor muscle training program for a minimum of 16 weeks is recommended as the initial approach for women with symptomatic pelvic organ prolapse (POP).
Among other methods, I use ultrasound to help assess and treat the pelvic floor muscles: this helps you see the muscles, understand how to use them and can be very empowering!

 

Conditions that I treat: 

  • Anterior wall prolapse (cystocele)

  • Uterine prolapse 

  • Posterior wall prolapse (rectocele).

  • Pre-hab: Rehab before  surgery to increase the success of the surgery

  • Post-Surgery Advice & rehabilitation return to sport and recreational activities

I have strong links with Gynecology specialists in the area, to support you through all stages of treatment.

Pelvic Organ Prolapse

BOWEL PROBLEMS

The bowel system is a crucial part of our digestive system, and maintaining its proper functioning is essential for a healthy life. A coordinated motion and function between the diaphragm and pelvic floor, as well as maintaining intra-abdominal pressure, contribute to optimal gut health.

I can assist with various bowel-related issues, including:

  • Constipation

  • Rectal Prolapse

  • Hemorrhoids

  • Anal Fissures

  • Fecal Urgency & Incontinence (FI)

  • Anal pain

  • Irritable Bowel Syndrome (IBS)

Whether it's mechanical, musculoskeletal, or emotional factors affecting your gut, I'm here to help you find effective solutions. 

Bowel Problems

MENOPAUSE 'MOT'

Comprehensive Care for Menopause Symptoms

The natural hormonal changes that occur throughout a woman's life can bring about a range of interesting, challenging, and sometimes perplexing emotional, musculoskeletal, gastrointestinal, and pelvic floor changes, among others.

Menopause is not a disease but rather a stage of life, and being well-informed equips women to navigate this phase in a positive, comfortable, and assertive manner.

As a physiotherapist, manual therapist, Pilates Instructor, and mindfulness practitioner, my aim is to empower women, helping them understand what is happening in their bodies and providing them with a comprehensive menopause symptoms care program.

I want women to feel supported, informed, and capable of caring for themselves, while also knowing when to seek assistance and from whom. 

Women may experience a variety of symptoms during menopause, and I am equipped to assess and treat them all. These include:

  • Pelvic Organ Prolapse

  • Osteoporosis 

  • Vaginal Atrophy, Vaginal Dryness, Genitourinary Syndrome of Menopause (GSM)

  • Sexual Dysfunction

  • Pelvic Pain 

  • Pudendal Neuralgia

  • Sleep Management and Quality

  • Musculoskeletal aches & pains

The ‘menopause MOT’ includes:

  • Self-Care Strategies: Offering advice on mindfulness techniques and other self-care strategies to improve mood, sleep, well-being, and stress management.

  • Comprehensive Musculoskeletal Screen and Treatment: Assessing and treating joint and muscle concerns, as well as addressing general aches and pains.

  • Exercise Plans: Tailoring exercise plans to accommodate your changing needs and abilities.

  • Hands-on, manual therapy, acupuncture and soft tissue techniques as required.

My goal is to create a supportive environment where you can openly discuss your symptoms, concerns, and goals. By understanding your unique situation, I can develop a personalized treatment plan that addresses your specific needs and helps you navigate this stage of life with confidence and resilience.

Remember, menopause is a transformative phase, and with the right knowledge, support, and care, you can embrace it as a time of growth and empowerment.

Menopause MOT

PELVIC PAIN CONDITIONS

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Pelvic pain can be experienced anywhere around the pelvis, in the front-lower tummy area, and the lower back. It can be experienced in the perineum (the area between your legs, where the sphincters are), or deep inside. There are many factors involved in the causes of pelvic pain, both physical and emotional.

 

Conditions that I treat include:

  • Vulvodynia

  • Vaginismus

  • Pudendal neuralgia

  • Endometriosis pain

  • Period pain

  • Tailbone pain (Coccydynia) 

  • Bladder pain syndrome (interstitial cystitis)

  • Dyspareunia (painful intercourse)

It is important to have a thorough assessment to help establish the factors involved, the causes, find triggers, and understand how your body copes with the pain. I use Ultrasound as a part of the assessment and treatment – to help you understand how the pelvic floor muscles are working and how to use them correctly.
This will help formulate a bespoke treatment plan that is practical and accessible for you so you can start your journey toward relief and improved well-being. 

Pelvic Pain Conditions

PREGNANCY RELATED CONDITIONS

Pregnancy is an incredibly special and emotional time in a woman's life. My goal is to help you stay healthy, physically active, and pain-free throughout your pregnancy journey, help prepare for labour, and rehabilitation in the postnatal period. I combine my extensive experience in Pilates and musculoskeletal therapy to offer a wide range of treatments, for the following conditions:

  • Pregnancy-related pelvic pain (PGP)

  • Sacroiliac joint dysfunction

  • Diastasis recti (abdominal muscle separation)

  • Carpal tunnel syndrome

  • Back and hip pain

  • Ribcage and thorax pain 

  • Pelvic floor advice and perineal massage

  • Preparing you for active labor

  • Providing exercise programmes during pregnancy

  • Acupuncture for nausea and musculoskeletal discomfort & scar recovery

  • Tailbone pain (Coccydynia) 

  • Recovery from perineal tears and episiotomy

  • Pelvic floor difficulties following labour: pain, incontinence, prolapse

Pregnancy
Post Natal Treatment

POSTNATAL TREATMENT

 Specialised Care for the Fourth Trimester and beyond

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Welcoming a baby into the world is a beautiful experience, but it can also pose physical and mental challenges. Whether you've had a vaginal delivery or a cesarean section, and whether you are breastfeeding or bottle-feeding, your body undergoes a transformative journey. At my Pelvic Health Clinic, I offer comprehensive and specialised assessment, treatment, and rehabilitation after childbirth.

Postnatal treatment includes:

  • Assessment of posture, pelvic floor muscles, and abdominal muscles to determine their recovery post-childbirth.

  • Use of ultrasound to help see and understand how the pelvic floor and abdominal muscles are working and enhance rehabilitation.

  • Tailored exercise and treatment program to aid in your recovery and help you achieve your activity and fitness goals.

  • Hands-on manual therapy to address soft tissue, joint, and muscle recovery.

I can help with the following concerns:

  • Postural screening

  • Managing intra-abdominal pressure (prolapse, reflux, incontinence, pain)

  • Diastasis recti assessment and treatment (abdominal muscle separation)

  • Pelvic girdle pain rehabilitation

  • Back pain, shoulder pain, thoracic & ribcage pain

  • Cesarean scar recovery and management :  massage / acupuncture 
    (Learn more about acupuncture for scar tissue healing)

  • Post natal exercises

  • Screening and education for bladder, bowel, and sexual dysfunction

  • Management of constipation

  • Perineal tear and episiotomy recovery rehabilitation

  • Tailbone pain = Coccydynia

  • Use of ultrasound to help understand and rehabilitate the abdominal and pelvic floor muscles

Female Sexual Dysfunction

FEMALE SEXUAL DYSFUNCTION

The pelvis and pelvic floor muscles play a vital role in sexual health and function. At my clinic, I provide comprehensive support for various conditions related to female sexual well-being.

Here are some of the conditions I specialise in treating:

  • Dyspareunia (painful intercourse)

  • Difficulties with orgasm, anorgasmia

  • Coital incontinence (loss of urine with intercourse or orgasm)

  • Permanent arousal disorder

  • Vaginismus

  • Vaginal flatus

To ensure a holistic approach, I collaborate closely with colleagues in psycho-sexual counseling services. Together, we work as a team to help you achieve your desired goals and provide a wholesome therapeutic experience.

Men's Health

MEN'S HEALTH

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Men's pelvic health is an important aspect of overall well-being. It's estimated that 1 in 10 men may experience continence or pelvic floor issues at some point in their lives. In such cases, physiotherapy can offer valuable assistance and support.


I provide treatment and advice for various conditions, such as:

Prostate Related Problems:

  • Benign Prostatic Hyperplasia (BPH) – enlargement of the prostate gland causing bladder dysfunction

  • Urinary incontinence after radical prostatectomy – surgical removal of the prostate gland for prostate cancer

Pain: 

  • Pelvic pain

  • Chronic nonbacterial prostatitis 

  • Chronic pelvic pain syndrome (CPPS)

  • Genital pain

  • Pain during or after sex (post-ejaculatory pain)

Bladder Dysfunction

  • Dysuria – pain or discomfort while urinating

  • Urinary Leakage / Incontinence — Involuntary loss of urine

  • Urgency and Frequency — An strong sensation to urinate

  • Incomplete Urination / Post Urination Dribble — Involuntary loss of urine immediately after urination

  • Nocturia — A frequent need to urinate at night time which disturbs your sleep

Bowel Dysfunction

  • Constipation

  • Urgency – a sudden and compelling need to use the toilet

  • Bowel accidents (Fecal incontinence) – involuntary 

  • leakage of stool

As a Men's Health Physiotherapist I encompass a thorough assessment of your condition, personalized treatment plans, and helping you improve your pelvic health and overall well-being. Several assessment and treatment techniques are used: Ultrasound is often used to help you understand how the pelvic floor muscles are working and learn how to relax and contract them appropriately. Manual therapy, acupuncture and exercises are often very helpful to help men manage and improve their symptoms, and enhance rehabilitation.

Testimonials
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WHAT MY CLIENTS SAY

"I've been one of Deb's Pilates students for years, after being recommended to her by my osteopath. She is endlessly cheerful and seems to know what her student's bodies are capable of better than they do themselves, which enables her to tailor exercises to allow for any specific problem you may have.

Her physiotherapy skills are exceptional - my rotator cuff problem was improving well under her ministrations."

MO - AGED 72

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