• Firstly we will take a thorough history asking personal questions about your sex life and toilet habits to get the full picture (don’t worry, we’ve heard it all before and just want to help!) before moving onto a physical examination.
• Education about bladder/bowel function in relation to the pelvic floor.
• Optimise breathing, “core” function and muscle condition around the pelvic region.
• Evaluate posture, lower back mobility and pelvic girdle alignment
• External and internal rectal examination with your informed consent checking for sensitivity and pelvic floor activation
We would typically also spend some time discussing:
• The complex interplay between pain, sleep, stress, exercise and diet. (Do not underestimate the simple stuff!!!)
• Normal bladder/bowel function and how to optimise this.
• How the pelvic floor relates to continence and how poorly functioning pelvic floor muscles may be contributing to bladder/bowel issues and driving some of your pain.
• Work out an individualized strengthening and / or stretching program and also an appropriate exercise type/dosage.
• Electrical stimulation/biofeedback training (essentially using different equipment to help you find and use your pelvic floor muscles more effectively).
• Using rectal dilators or magical wand to treat deeper pelvic floor muscles.
Your pain is NOT “all in your head”, and it’s certainly not as simple as “just relax”! Persistent pain is very real and very complex. Living with pain can cause ripple effects to all areas of your body, your mind and your life and relationships; managing it often requires a holistic approach with an understanding multidisciplinary team and support network which hopefully involves a good Pelvic Health Physio.
