Tag Archives: Kegel Exercises

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.

Pelvic Health Physiotherapy

Pelvic Health Physiotherapy
Pelvic Health Physiotherapy

What is pelvic health physiotherapy?

Pelvic floor muscles form the ‘bowl’ or ‘hammock’ that supports our lower back and pelvic organs (bladder, uterus/prostate and rectum).
Pelvic health physiotherapists have taken courses allowing them to perform an internal evaluation in order to assess the tension and strength of these muscles. Often there is too much tone of the pelvic floor leading to weakness.

What are common symptoms of pelvic health dysfunction?

• Leakage of urine with coughing, sneezing, laughing and exercise
• Urgent need to urinate or leaking before you get to the washroom
• Constipation/straining with bowel movements
• Heavy feeling or bulge in the vagina
• Pain in the pelvic or low back or genital area
• Pain with intercourse
Check out this link for more information.

Some benefits of Pelvic Floor Physiotherapy

• Leave your house without worrying about your bladder
• Exercise without worrying
• Sleep through the night
• Learn to control urgency

What can I expect on my first Visit for Pelvic Health physiotherapy?

A medical history will be taken with a discussion of your concerns. Questions will be asked to further understand your symptoms. Your posture, muscles of your hip, low back and abdominal will be assessed for contributing factors such as weakness or tightness. In addition to the external exam, an internal exam of your pelvic floor (vaginally and rectally) may be included to assess imbalances and dysfunction of the muscles and soft tissues.
Based on the assessment findings and your goals, the physiotherapist will put together a treatment plan.

What can I expect for treatment with Pelvic health physiotherapy?

Pelvic Health Physiotherapy Treatments Typically include,

• Correcting postural dysfunction
• Manual therapy
• Connective tissue release
• Pelvic floor muscle facilitation with breathing techniques
• Exercises for other core muscles
• Training for healthy bladder and bowel habits
• Education such as behavioural therapy/stress management

We have fully trained Pelvic Health Physiotherapists at each of our clinics ready to help you. If you have any questions, or would like to book an appointment, please contact the clinic .

Endometriosis Physiotherapy

Endometriosis Physiotherapy

Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis Physiotherapy: fortunately there is something that you can do about this!
Endometriosis Physiotherapy

Cause of Endometriosis

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the retrograde flow of menstrual debris through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity (i.e. the peritoneum).
It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy or Cesarean section scars).
Finally, there is evidence that some women with endometriosis have an altered immune response. They are less commonly found to involve the vagina, cervix, and bladder.

Signs and symptoms of Endometriosis Physiotherapy

Some women experience mild symptoms, but others can have moderate to severe symptoms. Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:
• painful periods
• pain in the lower abdomen before and during menstruation
• cramps one or two weeks around menstruation
• heavy menstrual bleeding or bleeding between periods
• infertility
• pain following sexual intercourse
• discomfort with bowel movements
• lower back pain that may occur at any time during your menstrual cycle
• bloating and distention

Endometriosis Physiotherapy Treatments

A Pelvic health Physiotherapist will evaluate the alignment, musculature, fascial systems, and movement patterns in the pelvis and body for issues that activate your pain and decrease your quality of life.
They develop a treatment programme according to your specific needs. Registered Physiotherapists can help to manage the symptoms of endometriosis such as painful menstrual cramping, abdominal discomfort, pelvic floor pain, and painful intercourse by:
• treating connective tissue dysfunction
• treating myofascial trigger points
• “Visceral manipulation therapy” mobilizing viscera (gentle manual therapy techniques aimed at releasing adhesions and restoring the proper mobility of the internal organs, such as the uterus, bladder, colon and small intestine)
• correcting postural and movement dysfunction (often when we are in pain not only does it change our muscle tone but it causes us to move and posture ourselves differently than we typically would.
• providing patients, the correct postural techniques.
Registered Massage Therapy may also be beneficial in the treatment of Endometriosis, especially if you are suffering from Low Back Pain. If you are interested in booking a massage, give us a call today!
Check out this link to the Mayo Clinic for a bit more information .

At PhysioNow, we have specially trained Pelvic Health Physiotherapists standing by to help Now! Call today to get started on your recovery from Endometriosis!

Post Prostatectomy Incontinence

post-prostatectomy-incontinence
Post-prostatectomy-incontinence is a common problem after radical prostatectomy. Patients report that this is the symptom which most disrupts their quality of life. Up to 75 percent of men experience a short period of mild incontinence. This is particularly after removal of the catheter that was placed during surgery. Most patients regain total urinary control after radical prostatectomy. However, this can take up to a year to achieve. Apparently, a small percentage (2% to 4%) experience permanent incontinence. Following radical prostatectomy, men who experience post-prostatectomy-incontinence may express concerns about visible wetness, urine odor, and the type of clothing that can be comfortably worn.
post-prostatectomy-incontinence
Types of Urinary Incontinence

The two types of post-protatectomy incontinence following prostate surgery are:
• Stress incontinence – Stress incontinence is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze. These . activities put increased “stress” or pressure on the bladder.
• Urge incontinence – Urge incontinence is the sudden need to urinate due to bladder spasms or contractions.

What Can Be Done to Treat post-prostatectomy-incontinence after Prostate Cancer Treatment
• Pelvic floor exercises: Kegel exercises strengthen the muscles when you squeeze them
• Stop urinating mid-stream. These exercises can be combined with biofeedback programs that help you train these muscles even better.
• Supportive care. This treatment includes behavioral modification. This includes drinking fewer fluids, avoiding caffeine, alcohol, or spicy foods, and not drinking before bedtime.

People are encouraged to urinate regularly and not wait until the last moment possible before doing so. In some people, losing weight may result in improved urinary control. Supportive care also involves changing any medications that interfere with incontinence.

Neuromuscular electrical stimulation.
This treatment is used to retrain and strengthen weak urinary muscles and improve bladder control. With this treatment, a probe is inserted into the anus and a gentle current is passed through the probe at a level below the pain threshold.This causes a contraction. The patient squeezes the muscles when the current is on. After the contraction, the current is switched off.

As you can see, there are many things that can be done to treat post-prostatectomy-incontinence. PhysioNow has trained pelvic Health Physiotherapists ready to help you get started on regaining your life. It is hard to talk about these symptoms, and harder yet to find somebody who can help. Our therapists are sensitive and discreet. You will be treated in a quiet private room and your privacy will be fully respected. Get started today! Call today and ask for a pelvic health physiotherapy consultation at PhysioNow.