Pelvic Wellness

After World Continence Week we got thinking about light bladder leaks. We wanted to know more!
Why do they happen and what can you do about?
So, we sat down with Pelvic Wellness Physiotherapist Fiona!

Luna: Thank you for meeting with us today, Fiona! We are so excited to be able to have the chance to sit down with you.

Fiona: Thanks, for having me! I’m so glad we could finally sit down and find the time!

Luna: Likewise! Fiona, tell us about yourself and what made you get into the field of women’s health?

Fiona: I am a women’s pelvic health physiotherapist, originally a physiotherapist and then I think either by default as a female you end up seeing a lot of pregnant women and ended up in the women’s health space. I had to make a decision whether I liked working in that space, and realised I loved it, so I went on to grow more and progress in the women’s health space. I felt that a big part of that for women was the pelvic floor, and as a general physio you don’t learn a whole lot about that region. So, I decided to go back to university and completed my post-grad in pelvic floor physiotherapy and that enabled me to add a big tool to my kit, which was internal examinations. Which is really the gold standard for assessing the pelvic floor. From there I was then able to work across a variety of areas such as maternity wards and privately in my own clinic.  I support women post-partum, and clients with a mix of incontinence, bowel problems, pelvic pain, endometriosis, PCOS and adenomyosis.

Luna: What exactly is pelvic floor physiotherapy?

Fiona: A lot of people don’t know what it is, haven’t heard of it or think you’re a regular physio which is not the case. I look at it as physio’s are experts in muscles, and the pelvic floor is a region with plenty of muscles. Essentially, Pelvic Floor physiotherapy works with the muscles in this specific region, as it wraps around three major organs, the bladder, the uterus and the bowel. As a pelvic floor physio therapist, I choose to incorporate my generalised physio learnings to my practice. Looking at things like back pain, pelvis pain, hip assessment to make it more of a holistic approach. A lot of research shows that its really important to not limit ourselves to looking inside the pelvis, but looking beyond that. We help people with bowel and bladder problems, painful sex and pelvic pain conditions. Ideally, getting them back to what they want to do.

Luna: How can a pelvic physio help with bladder dysfunction, i.e., light bladder leaks?

Fiona: Through internal examination, we look at your strength of internal contraction, we check the tissue and internal sensation.  It’s similar to any other muscular assessment essentially. We might look at your hips or back, and then your bladder and bowel health. For bowel and bladder health, this is done externally, mainly through conversation and education. Often clients will be required to complete a bowel or bladder diary which tells us so much about what’s really going on. It’s an amazing tool, and it’s cool to see how much you can help improve someone’s condition by simply educating them on correct bowel and/or bladder function.

Luna: Women often joke about peeing when they cough or sneeze, is this something that you would consider to be normal?

Fiona: No, it’s not normal. I have a friend who often jokes about this! Any involuntary loss of urine is not normal. 

Luna: What are the signs that perhaps something isn’t normal, and that it’s time to see a pelvic physio?

Fiona: If you leak when you cough, sneeze or laugh. If you are unable to hold your urge in, or feel like you need to rush to the toilet, although common is not normal. Chronic constipation, straining, haemorrhoids, things like that. Obviously, these aren’t just physio related, but often if a patient has seen a dietician, ruled out anything medical, then it’s usually time to look at the mechanics of that, which is where I come in. I also recommend, ideally, before someone falls pregnant or post-partum having your pelvic floor checked as this tends to put a lot of strain on your pelvic floor.

Luna: Do you think awareness for pelvic health and light bladder leaks is improving?

Fiona: I think so! I think generally pelvic health is becoming more talked about and less taboo.  I think social media has helped with that, as a professional in the field people now have access to information and discussions about these typically taboo topics, and the information is becoming more spoken about mainstream which is great to see.

Luna: Do you have any tips or tricks for people who may feel embarrassed to discuss pelvic health?

Fiona: I would say see a pelvic floor physio. I think it’s important for people to know that its not just them. Incontinence is really common and its not just an ‘old persons problem’ and its not just a thing that happens post-partum. I think it’s important to note too that being pregnant is not a reason to leak, and it’s not as simple as what our grandmothers or mums used to say like ‘I’ve had two kids what do you expect.’ Your body isn’t just a write off after that, not even just with regards to the pelvic floor, but holistically we need to appreciate what our body has done and is capable of. Knowing that you can do things and there is help. Pelvic physiotherapy is proven to really help with issues such as incontinence. It’s just up to that person to make the decision to strengthen it and commit to improving their pelvic floor, like they would any other muscle.

Luna: Thank you so much for taking the time to speak with us today, Fiona, it’s been a pleasure!

Fiona: No problem! Spread the word about Pelvic health!

If you’d like further information on Fiona and her practice you can find her on Instagram @pelvicwellnessphysio or online at https://www.pelvicwellness.com.au/