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Samara
NANAYAKKARA
- The Lady Parts Physio -
What can physiotherapy treat?
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Bladder
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Do you leak urine when you cough, sneeze, laugh or exercise?
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Do you rush to make it to the toilet in time?
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Do you feel that you are always going to the toilet?
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The pelvic floor consists of muscles and
connective tissue which sit underneath your
pelvis, and act as a hammock to support the
bladder, uterus (in females)
and rectum. These muscles form a diamond
– shape – spanning from the pubic bone at
the front, to the tailbone at the back, and out
to the sit bones on the sides. These muscles
control urination, defecation and sexual
sensations and function.
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Stress incontinence, urgency, urge
incontinence and frequency are common
bladder issues caused by a loss of pelvic floor control against pressure from above.
This can be due to pregnancy, childbirth, constipation, menopause, ageing, obesity, chronic coughing and sneezing, and high – impact exercise.
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1 out of 3 who have experienced childbirth
will experience bladder leakage. Just like other muscles of the body – the pelvic floor can contract and relax. Sometimes the cause of your bladder issues may be from the pelvic floor being too “tight.” Your bladder issues can be treated with a personalized, evidence – based pelvic health program created by Samara – a specially trained pelvic health physiotherapist.
Do you accidentally pass wind or soil your underwear?
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Do you rush to make it to the toilet in time for a bowel motion?
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Is it difficult to completely empty your bowel?
A change in the sensitivity of your rectum and pelvic floor muscle control can result in the sudden need to open your bowels. This loss of bowel control can be very distressing - resulting in loose bowel motions, passing wind unexpectedly, and soiling your underwear. Some people experience the opposite – being unable to pass a bowel motion for days, feeling that the bowel doesn’t completely empty, and pushing to try to open the bowels.
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The pelvic floor consists of muscles and connective tissue which sit underneath your pelvis, and act as a hammock to support the bladder, uterus (in females) and rectum. These muscles form a diamond – shape – spanning from the pubic bone at the front, to the tailbone at the back, and out to the sit bones on the sides. These muscles control urination, defecation and sexual sensations and function.
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1 out of 10 who have experienced childbirth
will have difficulty controlling wind, bowel motions and/ or feel their rectum sitting lower. Your bowel issues can be treated with a personalized, evidence – based pelvic health program created by Samara – a specially trained pelvic health physiotherapist.
Bowel
Prolapse
Do you have a heavy/ open/ lump or bulge sensation in your vagina or rectum?
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Have you been diagnosed with a bladder, uterine or bowel prolapse?
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Do you need a pessary fitted for a pelvic organ prolapse?
A pelvic organ prolapse occurs when the bladder, uterus and /or bowel drop down and sit lower in the pelvis. This can be uncomfortable, and can affect your daily function, exercise and even sensations during intercourse.
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The pelvic floor consists of muscles and connective tissue which sit underneath your pelvis, and act as a hammock to support the bladder, uterus (in females) and rectum. These muscles form a diamond – shape – spanning from the pubic bone at the front, to the tailbone at the back, and out to the sit bones on the sides. These muscles control urination, defecation and sexual sensations and function. Damage or weakening of the support to the pelvic organs can arise from pregnancy, childbirth, constipation, menopause, ageing, obesity, chronic coughing and sneezing, and high impact exercise.
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As many as 50% of persons who have had a baby
will have a pelvic organ prolapse – some don’t even know they have it! Your prolapse issues can be treated with a personalized, evidence – based pelvic health program created by Samara – a specially trained pelvic health physiotherapist.
Pelvic & Sexual Pain
Do you find intercourse painful or difficult?
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Is it hard to insert a finger or tampon?
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Do you have painful orgasms, or can’t orgasm at all?
Conditions such as genito – pelvic pain disorder (dyspareunia, vaginismus), vulvodynia, painful bladder syndrome, interstitial cystitis and endometriosis, post – surgery, and damage to the pelvic nerves are some of the many reasons why there can be pain or discomfort in and around the pelvic openings.
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Pelvic floor muscle dysfunction can be one of the causes of lower abdominal or pelvic pain. This is usually from over - activity or tension of these muscles.
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This can lead to:
- incomplete or slower emptying of the bladder and bowel
- pain at the entrance to or deeper in the vagina in intercourse
- avoidance of intimacy altogether.
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Other common causes of pelvic or genito-pelvic / penetration pain include:
- hormonal fluctuations from breastfeeding, menstruation and menopause
- childbirth
- skin conditions around the vulva
- emotional state or personal beliefs regarding intimacy and sex
- dietary intake or medications
- relationship issues
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According to the 2018 Women's Health Survey, conducted by the Jean Hailes Foundation:
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More than one in five women (aged 18-50) (22%) have discussed or need to discuss pain around the vaginal area.
Your pelvic and sexual pain issues can be treated with a personalized, evidence – based pelvic health program created by Samara – a specially trained pelvic health physiotherapist.
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Pregnancy Pain
Do you find walking, stairs, sitting and rolling in bed painful or difficult?
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Does your back and hips ache?
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Do you have pain in your pubic region?
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Unsure of what exercises to do in pregnancy?
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Pelvic girdle pain, pubic symphysis dysfunction, pregnancy - related back pain and pain in your coccyx can be painful and debilitating.
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2 out of 3 will experience pelvic girdle pain through their pregnancy.
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It can prevent you from sleeping, exercising, walking up and down stairs and even sitting in comfort. You shouldn't put up with pain! Unfortunately some persons can continue to have pain in and around their hips and pelvis for years after having their baby.
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Through hands - on treatment, exercise, postural correction and lifestyle advice, you can enjoy your pregnancy and exercise without pain!
Breast & Mastitis
Do you have a blocked duct?
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Do you have redness, a lump, a fever & difficulty draining the breast while feeding?
Mastitis is an inflammation of the breast that can lead to infection, and is commonly experienced while breastfeeding and expressing breastmilk. Mastitis can feel like you have the flu; you may feel hot and have body aches and pains. It may also be difficult and even painful to express milk as there may be a blockage in the flow of breastmilk.
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1 in 10 women who are breastfeeding, bottle - feeding their own milk, and even weaning can experience mastitis.
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Your doctor may recommend a course of antibiotics and treatment with a physiotherapist.
Treatment with a physiotherapist will include therapeutic ultrasound on the affected area, and advice on feeding and massage techniques. A number of daily treatments of ultrasound is recommended. Samara will advise you regarding how many sessions will be needed for you.
Menopause & Vaginal Atrophy
Does your vagina feel dry?
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Does wind escape the vagina when you do yoga, cough, sneeze or laugh?
Women entering or going through menopause will experience a drop in their sex hormones. A woman enters an age when her period is no longer needed, and menopause is considered to be when a woman has not experienced a period for greater than 12 months. The support structures around the bladder, uterus and bowel rely on these hormones – namely oestrogen and progesterone – for elasticity, blood flow, and natural lubrication in the vagina.
Women in menopause commonly report hot flushes, night sweats, stress incontinence, urgency, a bulge sensation in the vagina, and even a loss of control of wind.
This can be embarrassing for women, who may choose to reduce or even stop their regular exercise altogether.
This can have significant impacts on cardiovascular and bone health. These conditions are manageable with the correct treatment and appropriate exercise program for your body.
Exercise After Baby
Do you want to return to exercise after having your bub?
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Are you unsure of when you can start running & jumping?
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What core exercises are safe to do?
What to expect from
Pelvic Floor Physiotherapy
How do you know what is going on down there?
To maximise our 1:1 consultation time, I will send you a questionnaire to complete beforehand. This discreet online form will prompt you regarding your bladder and bowel habits, obstetric history (if relevant), sexual function (if relevant) and medical history. Further questionnaires to establish your baseline symptoms and function may also be sent.
Our 60 minute, 1:1 consultation will further refine your goals. A real - time ultrasound is a non - invasive scan to assess the function of your pelvic floor and bladder. An internal examination (vaginal and/ or rectal) can be performed, at your discretion, to assess the pelvic floor for strength, tone, tearing and prolapses.
A tailored treatment plan with links to any required equipment will be sent to you online.
How will I know if I am performing my treatment correctly?
Our follow - up consultations will be booked in regularly to assess your function and progress your treatment. In addition to your treatment program being on my online portal, you will also receive email support, and ongoing correspondence from myself with your doctor as required.
Do I need a referral from my doctor for Pelvic Floor Physiotherapy?
A referral is not required. Discreet correspondence and communication between myself and your doctor will only be done with your consent. If you have been referred, please bring your medical reports, scans and correspondence from your medical provider.
Some pelvic floor conditions will be outside of the scope of assessment and treatment via pelvic floor physiotherapy. These conditions may require referral onto a specialist, such as a urologist or gynaecologist. A correspondence and referral letter will be sent to them on your behalf.
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Private health rebates are available. The Extended Practitioner Care (EPC) Plan provides a maximum of five, Medicare – funded physiotherapy sessions, which include Telehealth physiotherapy in Australia.
Exercise is known to improve mood, reduce depression and anxiety, maintain cardiovascular fitness and promote weight loss. However, pushing yourself too hard too soon post-baby, increases the risk of urinary incontinence (which affects 30% of new mums), generalised pain, hernias, separated abdominal muscles, pelvic organ prolapse and musculoskeletal injuries. Provided there is no pain, you can start pelvic floor exercises as soon as you are comfortable. Basic core exercises can be prescribed – Samara will decide which are correct for you.
After your 6 week postnatal check - up with your Women's Health Physiotherapist, ongoing check ups every few weeks are recommended to ensure that your pelvic floor is recovering. This is to progress your exercises safely, and prevent long - term damage that can occur by progressing your exercises too early.
Remember - the six week check up with your doctor does not mean you are ready to jump back into the same exercise you were doing before you fell pregnant!
All exercise needs to start small and gradually increase as if you are completely new to exercise. Samara will create an exercise program based on your goals and recovery.