Category: Physiotherapy Blogs

Physiotherapy For Pelvic Floor & Common Exercises To Alleviate Pain

Physio for the pelvic floor can help when the pelvic floor muscles you have relied upon throughout your life weaken or present other symptoms that indicate a pelvic floor dysfunction. 

The pelvic floor muscles are located between the hip bones and the sacrum. The uterus, prostate, bladder, and colon are positioned in the pelvic floor area, supporting these organs. When the muscles in this area are either too weak or too tight, you can suffer from urinary incontinence, constipation, bowel movement strain, pelvic organ prolapse, and sexual dysfunction. 

A dysfunctional pelvic floor is common during pregnancy. Therefore, most patients who seek physiotherapy help are women. However, pelvic floor physiotherapy (PFPT) can help both men and women build strong and supportive pelvic floor muscles.    

Do I Need Physio for Pelvic Floor?

When you show up at your physiotherapist’s office, you will learn about the muscles, nerves, joints, and connective tissue in the pelvic floor area and how they affect the concrete pelvic floor dysfunction you suffer from. 

Usually, people seek physio help when the problem progresses, becomes unbearable or too embarrassing (for example, you cannot wait to get to the toilet or suffer from accidental leaks during sports, coughing, or sneezing). 

Many women accept pelvic floor dysfunction as a common childbirth consequence and don’t do anything about it. 

Sportspeople who work hard, especially on the muscles in the abdominal area, can tighten the pelvic floor muscles too much. 

Although weaker pelvic muscles are normal as you age, a simple set of physio exercises for the pelvic floor and appropriate treatment can solve the problem in several months.     

Physiotherapy for Pelvic Floor Dysfunction

The longer you wait with physio after noticing the first signs of a weak or tight pelvic floor, the more effort you will need to invest in getting better. 

When you experience constipation or faecal incontinence that won’t go away, pain during intercourse or urination, muscle spasms in the pelvis, pain or pressure in the rectum, you should schedule a visit to a physiotherapy clinic to get an exam. The physio for pelvic dysfunction can include:

• Education about how pelvic muscles work
• Pelvic floor exercises (Kegel exercises)
• Manual relaxation, which provides for hands-on massage to help with circulation, stretching, and mobility.
• Biofeedback, based on a computer analysis of a probe test. 
• Electrical stimulation, including a low voltage current to train the patients how to contract pelvic floor muscles. 
• Uroflowmetry test
• Medications, depending on what organs bear the difficulties of the pelvic floor dysfunction
• Relaxation techniques, such as yoga, meditation, warm baths, or acupuncture.
• Trigger point injection (TPI) to relax knots that form in the muscle after inactivity. 

Surgery, a last resort for many physio pains, is not an option for the pelvic floor because you need to work on the muscles. It is important to keep in mind that physio for pelvic floor issues won’t solve all problems with your pelvic floor organs. For example, if you have an underlying bowel disease or inflammation issues in the area, you may need alternative treatment.

Pelvic Floor Exercises

Kegel Exercises

Kegel exercises, also known as pelvic floor strengthening exercises, are by far the most popular pelvic floor workout. 

It will take some time to get used to contracting precisely the muscles in the pelvic area because they are difficult to isolate if you don’t exercise them regularly. 

How to Do Kegel Exercises

Kegel exercises are performed on an empty bladder, in a lying, sitting or even standing position. 

Hold the muscles tight for 3 to 5 seconds, then release. Breathe deeply and try not to squeeze other muscle areas. In time, you’ll get better with this practice. 

Try not to over-exercise, as you may need to go the other way around and seek physical therapy for tight pelvic floor muscles. 

Common Misconceptions about Pelvic Floor Physiotherapy (PFPT)

Common myths about pelvic floor physio people have are: “I’m too old”, “I’m a man”, and “I’ve just had a baby, so the damage is done.” The physio for the pelvic floor is for men and women. Men do not have a uterus, but they do have pelvic muscles. Age is not an obstacle – physio shows results at any age. And if you start physiotherapy soon after childbirth, you will get back in shape in no time. 

As you may reasonably assume, success requires persistence on your part. In the case of pelvic floor physiotherapy, this could take about 4 to 6 weeks. 

Physiotherapy for Sciatica

People often ask for physio for sciatica relief once the pain becomes unbearable. If you experience moderate to severe pain, stiffness, weakness, and tingling (pins and needles) in your lower back, hip, leg or foot, you are a likely patient for sciatica physiotherapy. Before you can hardly move your hip and lower back, you may feel low to moderate pain. A deep, dull ache can also be a sign of sciatica. Sciatica pain can also occur suddenly or worsen in a matter of hours. 

Self-help is possible, and many patients get better over time. However, if the condition produces electric-shock-like pain or has rendered you immobile, you may need immediate physiotherapy treatment for sciatica.

Physiotherapy for Sciatica Relief

Sciatica, also called lumbar radiculopathy, is a condition of a pinched or damaged nerve in the lumbar area of the spine. A herniated, bulged, or slipped lumbar disc is a common reason for sciatica. Other known reasons include spinal stenosis, spinal misalignment or osteoarthritis of the spinal vertebrae. But sciatica can also have more innocuous causes, such as an improper sitting posture (and long hours on the chair), wearing uncomfortable (high) heels, or poor lifting and bending techniques during work or sports.

While the pain running down the buttock and the back of the legs can be debilitating, it rarely produces chronic nerve damage. The pain is caused by inflammation, which can be successfully treated by a physiotherapist. 

Sciatica Diagnostics

Your physiotherapist will first run a series of tests to reveal the sciatica cause, including:

• Exploring your medical history    
• Spinal, orthopaedic, and neurological exam
• X-ray, CT or MRI scan

The physiotherapist will work on reducing pain and inflammation, strengthening weakened muscles and restoring movement. Best results are achieved with passive and active physio treatment for sciatica.      

Physio for Sciatica Pain (Passive Physiotherapy)

If you are in pain or motionless, you are most likely to avoid any movement. Instead of actively participating in the treatment, you may prefer passive help. The physiotherapy for sciatica, in this case, can include over-the-counter medications, light stretching, deep tissue massage, ultrasound, TENS (transcutaneous electrical nerve stimulation), and cold or hot packs.

Over-the-Counter Medications for Sciatica

Ibuprofen, Aspirin, Ketoprofen, and Naproxen Sodium can provide immediate sciatica relief by reducing pain and inflammation.   

Deep Tissue Massage

Deep tissue massage is a type of physiotherapy that uses soft strokes and firm, gliding pressure to reach deep layers of muscles and fascia. It eases pain and tension in sore muscles and tissues and can improve limited mobility. This type of sciatica therapy is always best performed by a licensed physiotherapist who will use hands, elbows, fingers, knuckles, and palms to “untie” knots or rigid tissues in the painful area.  

Ultrasound Therapy

By gently heating the muscles and improving circulation, ultrasound waves can help decrease pain faster and reduce inflexibility, tension, cramping, and swelling. 

Cold and Hot Packs

Start with ice bags wrapped in a soft towel to heal acute pain in the affected area. Move to hot packs – heating pads or a heat lamp – after a couple of days, and alternate hot and cold packs if the pain remains. 

Physio Exercises for Sciatica (Active Physiotherapy)

The type of physio exercises for sciatica will depend on the cause of your condition. Exercises that stretch the piriformis muscle, the hamstrings, and the hop extension will alleviate lower back and leg pain.

Light Anti-sciatica Stretching 

 Examples of helpful sciatica exercises are:  

• Pigeon pose (reclining, sitting and forward) 
• Seated spinal stretch
• Knee-to-opposite-shoulder
• Knee hugs
• Standing hamstring stretch
• Cat/cow pose

You may want to remain inactive if severe pain persists. But bed rest is not recommended, as long as you can move within the pain constraints. Keep in mind there are movements to be avoided when suffering from sciatica.

Hydrotherapy

Light muscle toning exercises performed underwater will help you strengthen the body in the sore areas, thus supporting the spine and the weakened muscles. Water aerobics and swimming usually don’t cause pain for patients with sciatica.

Adhering to ergonomics principles, active life and weight reduction is typically on the list of long-term help your physio clinic will recommend once the acute condition subdues. You will need to familiarise yourself with how your habits affect your body posture and develop new ones to prevent future issues.