WHAT IS PHYSIOTHERAPY?
For people affected by injury, illness or by developmental or other disabilities, physiotherapy uses evidence based physical approaches to promote, maintain and restore physical, psychological and social well-being.
WHAT SHOULD I EXPECT?
The first appointment will take 45 minutes. It will include a full assessment, with a few questions for you to answer to obtain all of the relevant information regarding the problem and to ascertain your goals for treatment. It will also include a comprehensive physical examination that assesses not only the problem area but also other areas that may be contributing to the problem. The diagnosis and prognosis are then discussed with the patient and together a goal orientated treatment plan is established. Subsequent appointments will likely range between 30 to 45 minutes.
Accurately diagnosing the nature and severity of a problem, but also identifying its underlying cause is essential to physiotherapy. By treating the source of a problem rather than just its symptoms, treatment is likely to be more effective in curing the problem as well as preventing any re-occurrence. Treatment is multi-faceted and will include manual ‘hands-on’ techniques to reduce pain and increase movement in the short-term and specific exercises to correct posture, improve muscle function and movement control for a long term solution.
COMMON MUSCULOSKELETAL CONDITIONS
•Sciatica & trapped nerves
•Muscle tension and imbalances
•Work related and postural disorders
COMMON MUSCULOSKELETAL INJURIES
•Knee Injuries – ACL injury, medial ligament tears, meniscus tears, patella Pain, Jumper’s Knee, Osgood Schlatter’s disease
•Lower Leg and Ankle Injuries – shin splints, ankle sprain, calf strain, muscle tears, anterior compartment
•Elbow Injuries – tennis elbow, golfer’s elbow, bursitis
•Foot Injuries – Plantar Fascitis, Heel pain, Foot Pain
•Arm/hand pain/ RSI
•Neck pain – whiplash, disc prolapse, postural
•Shoulder dysfunctions – rotator cuff injury, dislocated shoulder, AC joint sprain
•Back pain – acute low back pain, chronic low back pain, sciatica, prolapsed disc
TREATMENT TECHNIQUES USED
•Joint and spinal mobilisation and manipulation
•Soft tissue massage
•Myofascial release techniques
•Individualised exercise therapy and rehabilitation
•Advice and education – because self management is so important!
WHAT IS WOMEN’S HEALTH PHYSIOTHERAPY?
Women’s health is a specialist area of physiotherapy that focuses on problems related to the pelvic floor and the pelvis. These problems may be either gynaecological or obstetric (pregnancy) and include conditions such as incontinence, pelvic organ prolapse, diastatis rectus and pelvic pain.
High impact exercise, high-intensity interval training (HIIT), pregnancy and menopause are all common causes of women’s health problems. Many women adapt their lifestyles and struggle on with a condition that is often easily treatable, not seeking treatment as they feel the only treatment on offer is surgery. The vast majority of these issues can be treated effectively with physiotherapy. The National Institute of Clinical Excellence (NICE) guidelines recommend physiotherapy as the first treatment option for most people experiencing incontinence or bladder problems.
WHAT SHOULD I EXPECT?
At the initial appointment you will need to answer a few questions about your general health, medical history and more detailed questions about how your bladder problems affect your quality of life. You may also be asked to fill out a bladder chart – how often you drink, how often you pass urine and how much fluid you are able to hold.
Examination – research indicates that the only effective way to assess the pelvic floor is working correctly is to perform a vaginal examination. This examination is done for several reasons:
•To ensure nothing else is causing your bladder problems (such as a prolapse).
•To ensure you are contracting the pelvic floor muscle correctly. It is possible to make symptoms of incontinence worse if the pelvic floor is not contracting correctly.
•To assess the quality of the muscle so that an exercise programme can be designed specifically for your needs.
An internal examination is not routinely carried out until your second appointment, and then only if you agree. This is the best way to work out what your problems are and to decide on your treatment options. Understandably some clients are anxious about having an internal examination. As a woman who’s gone through this herself, the therapist knows how they feel! You are welcome to bring a chaperone with you, if that would make it a less daunting prospect. (we would also add that we do not use a speculum when carrying out an examination.) Hopefully we will have gained your trust and confidence by the time an examination is necessary. But, if you simply do not want to be examined, we am happy to treat you without one.
Once your assessment has been completed, we will design your personal treatment programme.
•Pelvic pain – including symphysis pubis dysfunction
•Low back pain
•Rectus abdominus divarication (a separation of the abdominal muscles)
•Stress urinary incontinence
•Urinary urgency and urge incontinence
•Pelvic organ prolapse
•Weak pelvic floor muscles
TREATMENT TECHNIQUES USED
– Most women only need an intensive programme of pelvic floor muscle training to see a noticeable improvement with their symptoms.
– Manual therapy (trigger point release, myofascial release and connective tissue manipulation), can be used to address pain related to PFM tension. Manual therapy techniques involve forceful passive movement of the fascial elements through restrictive directions, allowing for muscular relaxation or decreasing painful scar tissue attachment, increasing general circulation, freeing tissue material, and releasing nerve entrapment by surrounding structures.
– Specific techniques can be taught to train the bladder to hold more urine and therefore need emptying less often.
– This equipment is used to teach correct and effective activation of pelvic floor muscles. It can also be used to assess if there is any improvement in the strength and endurance of the muscle.
– When pelvic floor muscle are very weak and unable to contract independently muscle stimulation can be used to remind the muscle how to work. When the muscle control has improved exercises are then added into the treatment programme.
– Anxiety and tension make bladder problems worse. Specific relaxation techniques can help to gain control over your bladder.
General advice – About fluid intake, bowel control, exercise levels, lifting techniques and transfers, support belts and aids and setting achievable goals.