Tag Archives: Kegel Exercises

Runner’s Knee? How Physiotherapy Can Help!

Runner's Knee

Runner’s Knee

Runner’s knee or patellofemoral pain, is a common condition that often affects many individuals, especially of the active and athletic population. The knee pain can be minor to severe and may be felt during only certain activities such as sports, or with day-to-day tasks like climbing up and down stairs. In this blog, we will talk about the causes, symptoms and most importantly, how to treat this pain with physiotherapy.

Cause of Patellofemoral Pain

For most individuals, the pain is caused by a misalignment of the patella (knee cap) within the femur (thigh bone). Usually, the patella glides along the groove during movement of the knee but muscular imbalances around the knee or postural misalignment may contribute to improper tracking of the patella. Some of the most common causes of runner’s knee are:

  1. Improper training/running mechanics such as overpronation or rolling in of the feet can contribute to increased stress at the knee joint
  2. Overuse or overtraining can overload the knee joint if there is not sufficient rest or recovery.
  3. Muscular imbalances, especially of the quadriceps and hip muscles
  4. Sudden increase in activity/unaccustomed activity
  5. Biomechanical issues such as misalignment of the kneecap, leg length discrepancies, foot posture etc.

Recognizing the Symptoms

  1. Dull aching pain around or behind the knee cap
  2. Pain is worse squatting, walking downstairs, or after sitting for long periods of time
  3. Swelling around the kneecap
  4. Popping or clicking of the knee, especially with straightening the knee
  5. Discomfort or pain after high intensity physical activities such as running
  6. Recent increase in intensity or change in training program

Physiotherapy for Runner’s Knee

Physiotherapy for Runner's Knee

Physiotherapy for Runner’s Knee

Once in physiotherapy, your physiotherapist will conduct an assessment to determine the exact cause of your knee pain. Most likely, your assessment and treatment will include:

  • Tailored exercise plan focusing on the hamstrings, quadriceps, and hip muscles to help stabilize and strengthen the knee joint.
  • Stretching exercises for the tight muscles around the knee that may be contributing to increased strain and imbalance at the knee
  • Biomechanical analysis including watching you walk, move, and your posture to identify any abnormalities that may be increasing stress at the knee. Common postures associated with knee pain include pronated flat feet, or knees that fall in when you move.
  • Recommendation or prescription of orthotics and other footwear. These can help correct any postural abnormalities found in the above biomechanical analysis
  • Taping and bracing. This can help provide support to the knee to improve stability and alignment while the knee has time to heal.

How to avoid Runner’s Knee

  1. Gradually increase training load and intensity
  2. Incorporate cross training, and general strength and mobility training into your routine
  3. Take time to do a proper warm up and cool down
  4. Listen to your body, runner’s knee is usually a stress/overuse injury, so don’t push through the pain and take rests when you need it.
  5. Ensure that you have proper footwear for your activity

Runner’s knee can be a tricky problem to resolve, but with the support from a physiotherapist, your pain can go away! By taking care of the problem earlier on, you will experience less interruptions from your regular routine and can get back to doing what you love sooner. If you are experiencing runner’s knee or any sort of knee pain, PhysioNow has many qualified registered physiotherapists that would love to help you out. Book with PhysioNow today for your first assessment and treatment!

Endometriosis and Pelvic Physiotherapy

What is endometriosis?

 

Endometriosis DiseaseEndometriosis is a condition where tissues which is similar to the inner lining of the uterus grows outside the uterus which can affect nearby organs including the bowel and bladder. The tissue thickens
and does shed with the monthly cycle.  At times when tissues get trapped and does not exit the body it can progress to form cyst called endometriomas. At last, it results in irritation to surrounding tissues and organs forming scar tissue and adhesions.

What are the symptoms?

Symptoms includes,
Firstly, Pelvic pain.
Secondly,  Heavy periods.
Infertility.
Abdominal bloating.
Urinary and bowel concerns.
lastly,  Fatigue.
However, endometriosis can be mistaken for other conditions such as Irritable bowel syndrome, Inflammatory pelvic disease. Therefore, early diagnosis will help in managing the symptoms.

Treatment options available:

There is no cure for endometriosis currently. Although, treatments to manage the symptoms includes,
1. Hormone therapies.
2. Over the counter medication.
3. Pelvic physiotherapy.
4. Surgery.

Pelvic health physiotherapy in Endometriosis

Pelvic health physiotherapy can help to reduce the symptoms, improve the function, improve the flexibility and improve the strength of the pelvic floor muscles. The techniques help to relax the muscles which ultimately help to ease the symptoms. How does pelvic floor physiotherapy help in endometriosis,

  • Relieve endometrial pain: Approaches to down train the pelvic floor muscles and introducing bio-psychosocial approach to help in relaxing the pelvic floor muscles.
  • Reduce painful sex: Helping with stretches and breathing techniques, dilators, and hands on techniques to reduce the tension and resistance in the pelvic floor area.
  • Reduce abdominal bloating or endo belly by helping in assisting venous and lymphatic drainage
    in our body.
  • Painful urination: by educating on proper water intake, and voiding techniques and by
    maintaining a bladder diary to reduce the effects pressure causing pain when bladder fills up.
  • Painful bowel movements: Education and advices on diet and positions on easy bowel movements along exercises to manage the situation.

Also, pelvic floor therapy post endometriosis surgery would help to retrain pelvic floor muscles to relax and to coordinate contractions. This helps to reduce spasms during menstruation.

Lastly, Bio psychosocial component of pelvic floor physiotherapy helps in identifying and addressing the psycho social aspects and its influence on normal function of your body. Relaxation techniques and hands on techniques to calm down the senses that could be the trigger to pain can be managed to a great extent.

Take away message – If you are suffering from endometriosis and are finding difficulty to manage its symptoms, our team of qualified Pelvic PT will help you assess and guide through the whole treatment. Book your appointment today!

PELVIC PAIN AND PELVIC FLOOR DYSFUNCTION

PELVIC PAIN AND PELVIC FLOOR DYSFUNCTION

What is pelvic pain and pelvic floor dysfunction?

There are a number of conditions which cause pain and pelvic floor dysfunction. We have discussed a few of those conditions here today. Fortunately most of the conditions are treated with physiotherapy interventions.

Pelvic area

Pelvic pain and dysfunction

Common conditions related with internal pelvic structures:

Provoked vestibulodynia: In this your pelvic area is very sensitive to touch or pressure. You will feel pain with

  • light touch,
  • pressure,
  • inserting tampons,
  • wearing tight pants or
  • intercourse.
  • urinary urgency

Vaginismus: You feel difficulty and/or pain with vaginal penetration. This will lead to avoidance of sexual activity or internal pelvic examination.

Bladder pain syndrome: You feel pain and pressure with urge to urinate at any time. You will get an increased urge to urinate. Symptoms usually starts with bladder infection.

Dysmenorrhea: You will feel painful cramps with mensuration. It affects about 90% of the women. This could include pelvic adhesions, pelvic inflammatory disease and cervical stenosis.

pelvic pain

Pelvic pain

Conditions related to activities and damage to structures:

Dyspareunia: It is pain with sexual intercourse. Damage to the structures like:

  • episiotomy,
  • tears,
  • reduced mobility of cervix or soft tissues,
  • bladder pain,
  • overactive  muscles and
  • inflammation

Coccyx pain:  It is the pain in tail bone are with sitting, sit to stand, sexual activity, or with bowel movements. Usually caused by any trauma, inflammation or muscle imbalance.

Conditions involving neurological structures:

Pudendal Neuralgia: There is pain and numbness in the area supplied by nerve from anus to penis or clitoris. You will feel pain with sitting, fecal and urinary incontinence.  There are other underlying conditions that can restrict your pelvic mobility. This leads to compression of your pudendal nerve.

Male pelvic pain issues:

Certain conditions such as dysfunction of pelvic muscles, non-bacterial inflammation of prostate, Pudendal neuralgia, anal fissures, Coccydynia, bladder pain causes pelvic pain in male patients.

If you want more information about the conditions which cause pelvic pain visit this link https://www.onhealth.com/content/1/pelvic_pain_causes

Experiencing any of the above symptoms?

Pelvic floor therapist helps you with thorough assessment and  treatment based on the diagnosis. Educating you about the cause of the pain. Managing with home exercise program.

Pelvic health

Treatment techniques done by pelvic floor physiotherapists:

For vestibulodynia:

Physiotherapy is considered as the first line of treatment for you. Your physio will treat with tissue care, manual techniques for painful points, muscle imbalance,  relaxation techniques. You will learn to avoid wearing tight clothes and diet modification.

For Dyspareunia:

Relaxation techniques along with dilator insertion helps to relieve tension in the vaginal area. Pelvic therapist will  releases scar tissue in the vaginal area which reduces pain. Soft tissue techniques improves the mobility of the cervix and scar tissue.

Bladder pain syndrome:  Releasing the tension in pelvic floor muscles and posture correction helps to reduce your symptoms. Incontinence can be treated with pelvic floor muscle training, positioning and certain stretches of the muscles in the pelvic floor area.

Vaginismus: Treatment involves stretching of pelvic floor tissues with external and internal techniques, scar mobilization, muscle overactivity with dilators and relaxation techniques.

Dysmenorrhea: Techniques involve breaking the adhesions in the pelvic floor area and release the narrowing in the cervix.

Techniques to help to reduce your pain:

  • Relaxation techniques,
  • stretches,
  • soft tissue release

Injury with any activity:

Pudendal neuralgia: Your Physio will treat you with nerve release, stretches, and posture correction. Sensory re-education to reduce the numbness in the pudendal nerve supply.

Coccyx pain: Treatment involves pelvic floor relaxation techniques,  mobilization of coccyx. We will mobilize it internally and externally. Proper positioning with cushion, exercises to improve the mobility  helps to reduce the pain the coccyx.

Male pelvic pain: Treatment includes release of pelvic floor muscles to ease up the pain. We will treat you with stretches, positioning, mobilization, relaxation.

DON’T WAIT TO START PHYSIOTHERAPY  TREATMENT

If you notice any of the above symptoms, it’s important to consult your pelvic floor physiotherapist. You can reduce the risk of complications by taking early treatment.. Book a consultation at PhysioNOW with a Registered Physiotherapist today.

 

Vaginismus

Vaginismus

Vaginismus and Physiotherapy

Vaginismus is a painful feeling of discomfort or inability when inserting a tampon, finger, penis or during a doctor’s internal pelvic exam. It occurs when there are involuntary contractions of the muscles in the outer third of the vagina.

Primary Vaginismus: when a woman has never been able to have pain free intercourse due to pelvic floor muscle spasm.

Secondary Vaginismus: pain that develops sometimes later in life after a traumatic event such as childbirth, surgery, or a medical condition.

With Vaginismus, there is usually significant Connective Tissue Dysfunction that needs to be addressed first before any internal work. It is suggested that you follow up the self-help treatment for connective tissue dysfunction before embarking on the stretching exercises with the dilators.

Pelvic floor exercises and Desensitisation techniques

A physiotherapist may be able to teach you pelvic floor exercises, such as squeezing and releasing your pelvic floor muscles, that can help you gain control over the muscles causing the vagina to close involuntarily. Occasionally, a technique called biofeedback may be useful. A small probe is inserted into your vagina. This monitors how well you are doing the exercises by giving you feedback as you do them.
Biofeedback can help with the following:

• Teach you strategies that may help to relax the muscles that are contracting involuntarily
• Teach you appropriate timing of the contraction and relaxation of the pelvic floor muscles.
• Educate you about your condition and why it might be occurring.
• Teach you various strategies for getting the muscles to relax
• help you to Use manual therapy to release the muscles either externally and/or internally that are causing the contractions.

More information about Vaginismus can be found here.

Some general tips about pelvic floor muscle exercises:

• Choose a convenient time and place where you can exercise regularly.
• Put a reminder about pelvic muscle exercises somewhere obvious to you (or set an alarm on your watch or mobile phone).
• Avoid quick pelvic floor muscle exercises where you don’t hold the contraction. This tends to cause an increase in pelvic floor muscle resting tone.
• Be aware that it will take 6 to 8 weeks of regular exercise before you can expect to see improvement. It will take approximately 3 months for the pelvic muscles to strengthen.
• You could try inserting one finger into the vagina to check the strength of your squeeze as you pull in the pelvic muscles. Alternatively, you may be able to feel a pelvic floor contraction if you place the tip of your index finger on the perineal body (on the outside, between the vagina and back passage).

Other tips to reduce Vaginismus:

• If you are overweight, try reducing your weight.
• Try not to become constipated, as a full bowel will put pressure on the bladder. Straining to empty your bowel will weaken the pelvic muscles.
• If your job involves lifting, think of your pelvic muscles as well as your back. Pull up your pelvic muscles when lifting a heavy weight.
• If you smoke, consider quitting. Frequent coughing puts a strain on the pelvic muscles.

If you or someone you know suffers from Vaginismus, please call PhysioNow today! Our specially trained Physiotherapist can start your treatment Now!

Dyspareunia

Dyspareunia and Physiotherapy
Dyspareunia
Dyspareunia is genital pain experienced by women just before, during or after sexual intercourse. Some women have always experienced pain with intercourse from their very first attempt. Other women begin to feel pain with intercourse or cyclically with menstruation. They can also have pain after an injury or infection . Sometimes the pain increases over time. When pain occurs, the woman may be distracted from feeling pleasure and excitement.

Causes

• vaginal dryness from menopause, childbirth, breastfeeding, medications
• skin disorders that cause ulcers, cracks, itching, or burning
• infections, such as yeast or urinary tract infections
• spontaneous tightening of the muscles of the vaginal wall
• endometriosis
• pelvic inflammatory disease
• uterine fibroids
• irritable bowel syndrome
• radiation and chemotherapy

Other factors that affect a woman’s ability to become aroused can also cause dyspareunia.
These factors include:
• stress, which can result in tightened muscles of the pelvic floor
• fear, guilt, or shame related to sex
• self-image or body issues
• medications such as birth control pills
• relationship problems
• cancer, arthritis, diabetes, and thyroid disease
• history of sexual abuse

Symptoms of Dyspareunia

• Pain while inserting a tampon or during penis penetration
• Pain with certain sexual partners
• Deep pain during thrusting
• Burning pain or aching pain
• Throbbing pain, lasting hours after intercourse

Check out this link for more information.

Physiotherapy Treatment for Dyspareunia

Education:

To help describe how the pelvic floor muscles can cause pain. Education can also provide techniques that can be used at home.

Manual Physiotherapy: to mobilise muscle and soft tissue, normalize overactive muscles, improve circulation and desensitize painful areas.

Desensitization therapy: learning vaginal relaxation techniques, such as Kegel exercises, that can decrease pain.

Sex therapy: learning how to re-establish intimacy and improve communication with your partner.

Water-based lubricants rather than petroleum jelly or other oil-based lubricants are preferable. Oil-based lubricants tend to dry the vagina.

Psychologic therapies: Cognitive-behavioral therapy and mindfulness-based cognitive therapy can be helpful.

Pelvic muscle relaxation exercises: used with biofeedback, this can help women with tight pelvic muscles learn to consciously relax tight muscles.

If you or someone you know suffers from dyspareunia, please call today to get started on Physiotherapy treatment! We can help at PhysioNow. Often only a few visits with our specially trained Phyiotherapist can help to get you on the road to recovery.