Underactive Pelvic Floor
What is an Underactive Pelvic Floor?
The pelvic floor muscles are a group of muscles that span from the pubic bone at the front of the pelvis to the tail bone at the back of the pelvis. This group of muscles assists with stabilising the pelvis during movement supports the pelvic organs (rectum, bladder and uterus) as well as opening and closing the anus, vagina and urethra to assist with emptying the bowel and bladder as well as sexual function.
If the pelvic floor is underactive, this usually means that there is difficulty in activating the pelvic floor musculature or weakness of the pelvic floor musculature.
What Causes an Underactive Pelvic Floor?
There are a number of factors that can lead to underactive pelvic floor including:
- Childbirth esp. Involving prolonged labour or the use of forceps
- History of chronic respiratory conditions
- History of chronic constipation or straining when making a bowel movement
- Regular heavy lifting
- Elite / high-level athletes involving high impact and high load sports. E.g. running, gymnastics and weight lifting.
- Hormonal changes. E.g. menopause
- Pelvic Surgery
What are the Symptoms of an Underactive Pelvic Floor?
The symptoms of the underactive pelvic floor may include:
- Leakage of urine during coughing, sneezing, lifting, running or other forms of physical activity
- Losing control of the bowel or bladder before making it to a toilet
- Inability to control ‘wind’
- Low back pain
- Dislodging of tampons
- Pelvic and vaginal discomfort
- Prolapse – slipping of the pelvic organs
- Neural damage
How is an Underactive Pelvic Floor Diagnosed?
Usually, a clinical diagnosis can be made using the information you have given, as well as a physical examination. During this examination, your physiotherapist may need to perform an internal exam to assess the ability of the pelvic floor muscles to activate, as well as testing the coordination and strength of the pelvic floor musculature. If further information is required, other tests and investigations can be performed including the use of ultrasound, EMG biofeedback or manometry devices, bladder testing and/or urine testing. However, these tests will only be performed if required based on your individual presentation.
What Treatments are available for an Underactive Pelvic Floor?
Often, physiotherapy is considered the first line of treatment for the underactive pelvic floor, and can include:
- Lifestyle Recommendations
- A pelvic floor exercise program
- Ultrasound to assist with pelvic floor activation
- Electrical Stimulation to assist with pelvic floor activation
- Adjustment of usual toileting habits
- Advice to modify or manage lifting and exercise habits
- Controlled coughing
What Results Can You Expect?
A large proportion of people with an underactive pelvic floor will have their symptoms improved or resolved with physiotherapy treatment. However, if left untreated, often the problem continues to gradually worsen.
Will You Need Surgery?
There is a percentage of people who may not experience enough improvement with physiotherapy alone and may need to go on to have surgery to resolve their symptoms.
For more information please consult your physiotherapist with a special interest in pelvic floor conditions.
- Faecal Incontinence
- Mastitis/Blocked or Plugged Ducts
- Pelvic Floor Exercises
- Pregnancy Back Pain
- Pregnancy Massage
- Rectus Diastasis / Abdominal Separation
- Stress Incontinence
- Underactive Pelvic Floor
- Urge Faecal Incontinence
- Urgency/Overactive Bladder (OAB)/Urge Incontinence
- Pre and Post-Pregnancy Exercise Prescription and Rehabilitation
Q: What Do You Need To Bring To Your Women's Health Appointment?
A: Please bring any information regarding your condition from your GP, medical specialists or other health care providers with you to your appointment. You will also need to arrive 10 minutes before your appointment to fill out some paperwork. Alternatively, we can email information to you before your appointment.
Q: What Do You Wear To Your Appointment?
A: Please wear clothing that you can move around freely in.
Q: Will the Information That You Provide During Your Appointment Remain Confidential?
A: Yes. All the information that you provide in your appointment will remain confidential, and your physiotherapist will only communicate with other healthcare providers involved in your care with your consent. We also conduct your appointment in individual rooms to ensure that what you say remains confidential. The one exception to this is cases of rectus diastasis, which we may treat in the general physiotherapy curtained consulting area unless otherwise requested.
Q: How Long Will Your Appointment Be?
A: The length of the appointment can vary depending on the condition that we treat. Please see the table below for further information. Your initial women's health appointment will normally take 1-hour. Mastitis and rectus diastasis appointments will normally take 30 to 40-minutes. For information specific to your needs, please call our receptionist.
Q: What Will Your Women's Health Physiotherapy Appointment Cost?
A: The cost of the session can vary depending on the condition that will be treating. Please call our reception staff at Sandgate (Ph: 3269 1122) or Ashgrove (Ph: 3366 4221) for further information.
Q: Is Your Women's Health Physiotherapy Appointment Claimable Under Private Health Insurance?
A: Yes. Please bring the private health insurance card with you to your appointment so we can process your claim on the spot.
Q: Is Your Appointment Covered Under An EPC/Medicare Referral?
A: Yes, we do accept GP referrals under EPC guidelines. However, but due to the extended time allocated by your women's health physiotherapist, there will be a gap payment to cover the total cost of your consultation after the Medicare rebate is applied. Please call our reception staff at Sandgate (Ph: 3269 1122) or Ashgrove (Ph: 3366 4221) for specific information.
Electric Muscle Stimulation (EMS)
EMS MachinesElectronic muscle stimulation (EMS) may help you to strengthen weak muscles.
How Does Electric Muscle Stimulation Assist Strengthening?There are several theories on how an EMS Machine may assist in muscle strengthening. One potential reason is that when you maximally contract a muscle, at best, only 30% of all your muscle fibres are in a state of contraction. The remaining 70% are dormant and awaiting recruitment when the contracting fibres fatigue. With EMS, you can potentially electrically stimulate these resting muscle fibres to improve their strength. Clinically, EMS appears to be more effective when the muscles are frail, and you have difficulty performing regular anti-gravity exercises.Another reason that EMS potentially works is via an improvement in the recruitment of nerve conduction rates. Explained simply, it takes approximately 10000 repetitions for your brain to learn how to quickly send a message to your muscles via the quickest nerve pathways. This contraction pattern becomes your "memory engram". The more frequent your muscle recruits, the better your body becomes at finding the fastest way to recruit that muscle. EMS can potentially provide you with repeated contractions to accelerate this learning process.To achieve your best outcome, we recommend that you seek professional advice on how to best utilise your EMS machine from your local physiotherapist who has a particular interest in EMS muscle retraining.
Important EMS Machine InformationUse your machine only as directed. A TENS machine and EMS machine are electronic medical devices. Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional before use and if symptoms persist.
Sandgate Physio WorksThe most extensive product range is held atSandgate Physio Works.
18 Bowser Pde
SANDGATE QLD 4017
Why Do Physiotherapists Prescribe You Exercises?The prescription of exercise appropriate to you and your injury or fitness level is one of the many professional skills of a physiotherapist. Whether you have suffered an acute injury, chronic deconditioning or are recovering from surgery, the correct exercise prescription is essential. That's why your physiotherapist's knowledge and skills will personalise your exercise dose.Your physiotherapist not only is educated in injury diagnosis but also exercise physiology or the science of exercise. This training enables your physiotherapist to assess and diagnose your injury, plus also to prescribe injury, fitness or age-appropriate activities targeted to you now.
What Exercises Should You Do?Your exercises shouldn't be painful. Please take caution with some overzealous exercise prescribers who believe that the more painful the activity, the better. Thus simply isn't true—notably, the frail, immunosuppressed, deconditioned or post-operative person.You'll find that your physiotherapist will thoroughly examine you and prescribe a series of exercises suitable for you in quantities that will not injure you further. Please seek an exercise expert, such as your physiotherapist, when you are planning your rehabilitation.
What Happens When You Stop Exercises?Without some simple exercises, we know that specific muscles can become weak. When these supporting muscles are weak, your injured structures are inadequately supported and predispose you to linger symptoms or further injury. You can also over-activate adjacent muscles that may lead to further damage.It is also essential to understand that even if you are "in good shape", you may have crucial but weak localised or stability muscles. When you have an injury, you should perform specific exercises that specifically strengthen the muscles around your injury and the adjacent joints. Your physiotherapist will assess your muscle function and prescribe the right exercises specific for your needs.The exercises prescribed will usually be relatively simple, and do not require any special weights equipment, and can be performed safely at home.
Would You Stop Your Daily Prescription Drugs?Your physiotherapist will prescribe your individualised dose or exercises. They are using their professional expertise to optimise your exercise dose. Would you just stop taking your regular blood pressure medication because you were too busy or didn't think it was working? We would hope not!Exercise, when prescribed by an expert such as your physiotherapist, should be treated as your recommended dose. Just like when you don't take your blood pressure medication, you can't expect the drugs to work of you don't take it as prescribed by your health professional.So, next time you skip your "exercise dose" just remember that you are not putting your health first. If you have any questions, please contact your Physio Works physiotherapist for your best care.
Private Health Insurance Rebates
PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for the majority of your treatment fees, leaving you with only a small gap payment.
However, Private Health Funds do vary their rebates payable depending upon the level of cover that you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly others haven't, with rebates similar to what they were a decade ago.
HICAPS - Instant Health Fund Claims
Most health funds are members of the HICAPS instant claims system. Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. For more information, please visit Hicaps for the latest funds which can use their instant claiming system.
Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.
- All Private Health Insurance Funds including BUPA, Medibank Private, HCF
- For a full list of Hicaps instant claim funds see here: Hicaps Funds
- HCF More for Muscles Program
PhysioWorks practitioners are registered providers for government, Workcover and insurance companies including:
- Australia Post; Coles Myer; Woolworths
- Department of Veterans' Affairs
- CTP & Sports Insurers