Pelvic Wellness Physiotherapy

Don’t think I’ve ever done one of these posts, but I thought, why not?!

5000+ of you follow my pelvic health page! 😱🥳

From starting this page back in 2020… yep those times 😷, it’s been such an incredible journey of meeting different like minded health professionals, working alongside some of the best in the business, and opening up the doors to Pelvic Wellness almost 3 years ago!

I started this page and then my business to support women through all their life stages and empower them to feel confident in their bodies!

I am SO lucky to have such wonderful patients, and seeing them achieve their goals never gets old.

While I feel like we’ve made so many gains in the pelvic health world with awareness and improvement in care, there’s so much more that can (and hopefully will) be done!

Thank you to everyone who has supported the growth of this page and my business, it’s not an easy feat, and there’s a lot of behind the scenes work which goes into every post.

I’m so excited to share more projects I’m working on later in 2024 so stay tuned 😏.

You guessed it! It’s a YES to pelvic floor exercises during pregnancy even when you don’t have leakage!

Our pelvic floor muscles help us with a range of functions including keeping our 💧 and 💩 in when we aren’t ready to empty, as well as emptying them when we want to effectively.

These muscles also help us with providing support to our pelvic organs, to avoid prolapse, and they have a role on s*xual function.

🤯 They’re basically SUPER muscles! 🦹‍♀️

This research review, which included over 600 women (when looking into the prevention of urinary incontinence during pregnancy), found that pregnant women who performed regular pelvic floor exercises were

🤩 62% less likely to have leakage in late pregnancy
🤩 29% less likely to have leakage at 3-6 months postnatal

So if you’re currently pregnant, or planning a pregnancy, it’s definitely still worthwhile to check in with a physio to ensure your technique and muscle function is 👍
(Even if you DONT have symptoms!)

Send this one to your pregnant friends!

(Woodley et al., 2020)

TIPS YOU MAY NOT HAVE CONSIDERED 🤰

When going through guidelines on returning to running after giving birth, there’s many things to consider outside of pelvic floor strength, lower limb strength and tissue healing.

🏃‍♀️🏃‍♀️🏃‍♀️🏃‍♀️

Scroll through to learn about the extra things you should be thinking about when returning to running postnatally.

Remember that everyone’s journey to recovery is different and if in doubt, reach out to a pelvic health physio for individualised advise 🙋🏻‍♀️

🤍 The information in this post was written by our pelvic health physio, Qianer 🤩

RETURNING TO RUNNING POSTPARTUM 🏃‍♀️💪

⭐️ here are some things you may NOT have considered!

We all talk about the importance of getting our muscles strong (which is SUPER IMPORTANT) but what about

➡️ don’t forget to SAVE this one to refer back to!

💡Breastfeeding
💡 Footwear
💡 Bras/breast support
💡Sleep

All these things are critical in ensuring we return to running in a safe and symptom free way.

Finally, trust your own body, you know it best!

If something doesn’t feel right, reach out to your pelvic health physio to have a personalised assessment.

💪HYPERMOBILITY & PELVIC FLOOR - part 2⭐️

If you missed my first post in the series, check it out!

It’s about a simple test called the Beighton Score which is a way you can assess your own join hyper mobility. It’s also something I use with relevant patients in clinic.

So we know how to assess hyper mobility but how exactly does it relate to pelvic health problems? 🤔

People with hypermobility are 🤸‍♀️more lax and stretchy in their connective tissues, fascia, ligaments which means their joints are more mobile than they should be (aka hypermobile).

So, other soft tissues (like muscles) take on the role to increase joint support. This is often beyond the “workload” these muscles are designed for. This can lead to muscle fatigue and incorrect or suboptimal movement patterns.

The pelvic floor has a number of roles, it acts as a trunk & spine stabiliser, and it houses our pelvic organs. Usually amongst this population, the pelvic floor is hypertonic, and not good at letting go.

There can also be increased tension 😬in surrounding muscles like the abdominals, adductors and glutes.

Coming up: 👀
👉 Next post in the series that will focus on what you CAN DO for your pelvic floor, if you are hypermobile.

Have you been told to do your pelvic floor exercises but keep forgetting to do them, or simply find it “too difficult”.

Well you aren’t alone!

Research shows there’s various barriers and facilitators for why people do and don’t know their pelvic floor exercises.

What are some reasons you don’t get around to doing them as often as you would like to?

I’ve also included 8 WAYS you can improve the likelihood you do them, to make sure they aren’t forgotten.

They’re super simple, have a read and let me know if you have any other tips in the comments below.

🚨NEW RESEARCH ALERT🚨

Pelvic floor muscle training isn’t just about leaks and prolapse – it’s also a game-changer for boosting female s*xual function! 💫💕

Yep, you heard that right!

While we’re used to hearing about pelvic floor exercises in the context of bladder leaks, urgency, prolapse, there’s actually WHOLE OTHER part of pelvic health we can help with.

👉👉 Add “s*xual wellness” to the list of incredible things the pelvic floor does!

This research (published just over a month ago) shines a spotlight on how pelvic floor exercises can improve arousal, pain, satisfaction AND MORE!

Unfortunately, s*xual dysfunction is still a taboo not spoken about often enough.

As s*x, intimacy and pleasure are multifaceted, I often refer to s*xology, s*x therapy or psychology, as this achieves best results.

Remember, s*xual dysfunction can happen at different stages in your life, for different reasons. This is why an individualised approach is best.

If this is something you have been experiencing, know you aren’t alone in your journey, and these are some very common problems!

Let’s share this knowledge to stop the stigma 🖐️

Often people associate DRAM with a big no-no to crunches, sit ups and curls.

I’m here to debunk that! More and more research has come out in the past few years to throw those traditional ideas out the window, including new research from 2023 ☝️

Swipe through to learn more 📖💡 and don’t forget to share this with fellow pregnant and postnatal friends

https://doi.org/10.1016/j.jphys.2023.05.017

So you found out you’re pregnant?! 🥳 yay! Congrats!

And overall you’re feeling well (double yay🎉)

❓but you keep hearing about pelvic health, pelvic floor muscles, women’s health physio and birth prep….

Plus you’re still doing your exercise regime as you did before pregnancy, but you aren’t sure when or how to modify things. 😅

You might also recall your friend mentioning bladder leakage in her pregnancy, but that’s normal right?! 🤔🤷‍♀️

🥁🥁🥁

Cue: PELVIC HEALTH PHYSIO

🙋🏻‍♀️ hey, I’m Fiona, a pelvic health physio based in Melbourne Australia

⭐️Optimising your pelvic health (and general well-being) during pregnancy is vital, and there’s so much you can do with a pelvic health physio to optimise your pregnancy, and ultimately your recovery.

Is this something you’ve thought about doing (or did) during your pregnancy?
👇 let me know your thoughts below

🤰💪 We ALL know the benefits of exercise during pregnancy, for both mother and baby, however sometimes it can be hard to remain active.

Our bodies go through incredible physiological changes during pregnancy and some of us can feel exhausted, low energy, unwell and uncomfortable. Also, life is busy!! It’s hard to find time to fit it in!

Fortunately the research shows that we don’t need to do MUCH exercise to have significant benefits on our health.

In fact, a Systematic review (the highest quality of evidence) of over 100 studies, and over 270000 participants, showed that you can reduce the odds by 25% of having several medical conditions by participating in moderate level exercise.

🙌 PRE ECLAMPSIA 🟰 9 MINS PER DAY
🙌 GESTATIONAL HYPERTENSION 🟰13 MINS PER DAY
🙌 GESTATIONAL DIABETES 🟰 19 MINS PER DAY

This is your motivation to get moving!!
🚶‍♀️🧘‍♀️🏋️‍♀️🏊‍♀️🚴

*note: if you are feeling any of the above symptoms, reach out to your medical provider and physiotherapist (for the discomfort) - a lot of these problems are common but not normal!

(Davenport et al. 2018, PMID: 30337463)

SPOOKY THINGS ON HALLOWEEN

(Except I’m one day late 👻🎃)

Here are some spooky things you may hear about Women’s & Pelvic Health 💀

Good thing is - they’re all false!

Have you heard any of these before? What are some others?

I wonder if they’ll be able to give me a little (belated) Halloween scare 😈

👩‍🍼Postpartum dyspareunia 😓occurring in 35% of postpartum women overall.

There’s many reasons as to why this can occur including

🫶 Tissue healing and scarring 👉 helped by understanding the healing process and working with your physio on perineal scar massage

🧬 Hormones 👉 helped by using v***al moisturisers like , lubricants like .aus or seeing your doctor for topical oestrogen

💔 Reduced libido and interest 👉 helped by getting support from your partner and inner circle of friends/family. You can also speak to a s*xologist to help address any psycho-s*xual concerns (I’ve tagged a number of wonderful ones)

😬 Pelvic floor muscle tension 👉 working with a pelvic health physio to assess your muscles and devise an individualised plan

❤️‍🩹C/s scarring 👉 helped by addressing any muscle tension in the abdominal and pelvic region, and working on scar tissue desensitisation with your physiotherapist

There’s many tools and techniques we can use to reduce your pain, so don’t think this is something you need to “deal with” or accept.

Remember to SAVE this for later and SHARE this with a postpartum friend 💕

*x *******se

👩‍🍼POSTPARTUM DYSPAREUNIA ‼️

You may (or may not) have heard of Dyspareunia, which is the clinical term for pain during penetrative in*******se.

Dyspareunia can happen at any life stage, however it is very common after giving birth.

This post is based on a Systematic Review from 2021, which analysed data from over 11,000 women.

It’s important to open up dialogue on this less talked about topic, to break the stigma. Painful in*******se is common, but not normal and there are things you can do to treat it.

Check out my next post (later this week) about WHY this may happen and tips on what you can do.

Till then, send this to a postpartum mum to let her know she isn’t alone! ❤️


*x

🌷Pregnancy Loss 🌷

Pregnancy loss is such a devastating ordeal, and while I do believe we’ve made strides in talking about the emotional distress it causes, we often ignore the physical effects.

It's important to acknowledge and address the physical changes that can result from pregnancy loss.

Many women may experience issues with their pelvic floor health, which can affect their overall well-being and confidence.

I recently received an email from a woman who had a stillbirth 💔

She was wondering whether she should would benefit from seeing a pelvic floor physio (she had already booked in a postnatal check with me in advance).

💕Seeing a pelvic floor physiotherapist can be a vital step in this healing process. We will guide you through tailored exercises and treatments that support your recovery.

💪 Through this journey, we work together to achieve your goals. It's about regaining control and building the confidence to embrace our bodies again.

Remember, you're not alone in this, and there is support to help you heal and thrive. 💖


org.au

⭐️MEET OUR NEW PELVIC HEALTH PHYSIO ⭐️

Qianer is a physiotherapist and a mum of 3 energetic children. Her interest in physiotherapy is in helping women of all stages of life - to be empowered by knowledge and be the best versions of themselves.

She has previously worked in sports and musculoskeletal physio and made the move over to Women's Health physiotherapy 8 years ago.

Over recent years, Qianer has undertraining and studies and continually strives to keep up to date with current research in the areas of incontinence, antenatal/postpartum care, prolapse, s*xual/pelvic pain and defecation dysfunctions.

She knows the importance of women's health physiotherapy and advocacy and believes that all women who seek help should be treated with attention, expertise and care.

Outside of work, Qianer's passion is health and fitness - whether it's cooking to nourish her family or moving her body with strength training and running.

She will be available in the clinic on Tuesdays 1pm - 6pm with potentially more hours in the future.

Book online via the link in the bio.

🧬 We often talk about hormonal changes during pregnancy and postpartum, and how this can affect the pelvic floor and surrounding organs/tissues.

However, there’s another MASSIVE shift in hormones when it comes to
🥁⭐️MENOPAUSE⭐️🥁

Swipe through to read about all the ways Pelvic health can be influenced during menopause ➡️

It’s important to remember that while menopause is inevitable through the female life cycle, there are many things you can do to overcome these symptoms!

📩 Send this to your mum, friend, partner to start the conversation on this stigmatised life stage

But I’ve had a C-section so do I reeallly need to a pelvic floor check?🤨

🤰No matter how you give birth, you’ve still been pregnant for 9 months which means there’s been plenty of changes, stretching and increased pressure on the body, especially the abdomen and the pelvic floor.

💪The abdominal muscles and the pelvic floor also work well together which means connecting with one area can help rehabilitate the other area.

Finally, it’s worthwhile remembering that we don’t need to be pregnant (or have an obstetric history) to have pelvic floor problems.

🫶So many patients I see have never been pregnant and can still experience leakage, urgency, constipation, prolapse or painful penetrative s3x.

⭐️Send this to someone who is currently pregnant or has had a C-section in the past (even if it was a while ago… better late than never!) ⭐️

What are your thoughts?
Did you know about this?

Let me know in the comments 👇

Dyspareunia refers to painful in*******se and is defined as persistent or recurrent ge***al pain occurring before, during or after s3x.

If you’ve ever experienced painful in*******se, speaking to your doctor or pelvic health physio can help!

Here are some of the ways we can assist:

1️⃣ Identify the underlying cause

We would start with taking a history, likely doing an examination, and ordering the right tests.
Some reasons for painful s*x including conditions like vaginismus, endometriosis, cysts, infections and hormonal imbalances.

2️⃣ To start the right treatment and arrange appropriate referrals - depending on the cause of the pain, treatment options may include medications, if postmenopausal or postpartum, maybe topical hormonal cream. Referrals may include pelvic floor physiotherapy, or to other specialists depending on underlying cause - such as an Endo specialist for more investigation into Endometriosis, or a gynaecologist for Vulvodynia

3️⃣ To limit its impacts on your life

If we leave painful s3x untreated, we can start to really fear intimacy, which can hugely impact your relationships, and enjoyment in life. There are also mental health effects of dyspareunia. A 2021 study suggested that dyspareunia could lead to depression, anxiety, negative body image and poor self esteem (Tayyeb M, Gupta V. Dyspareunia. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearlsPublishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/)

4️⃣Assess your pelvic floor muscle function

Painful in*******se can be from a number of reasons and usually there is associated pelvic floor dysfunction that goes hand in hand with this presentation. 57% of women who have an overactive pelvic floor experience Dyspareunia so teaching you how to connect with and relax these muscles is important. (PMID: 29318334)

Caption continued in the comments 👇


To learn more check out and .pelvichealth.doc

Send this to a friend who needs to hear this!

*x *******se

For Day 3 of the theme is “Happy Hormones” so I wanted to place some attention on

🥁🥁🥁

📣 Oestrogen 👏

Its one of the various hormones in our body that plays a big role through several life stages.

⏭️ Swipe through to read more and send this to someone who would benefit from this info 🫶

✨ VULVAL SELF CHECKS ✨

It’s not really a commonly discussed topic, especially when we compare it to breast self examinations.

The v***a refers to the external female ge***als.

It’s important to understand what your normal is so you can be promptly detect any changes.

We’re currently in and day 1 is all about Women’s Health Checks. Highlighting the importance of v***al self checks can encourage open conversation and break stigma about this topic.

Swipe through to learn more 👉



***alove ***apower ***as

🤰 MATERNITY GARMENTS✨

There’s so many options out there, from belts to bands, wraps, shorts and compression tubes.

I hope this guide helps you understand the different options and find what’s right for you.

As always an individualised approach is best so speak to your Women’s Health Physio.

Have you been recommended a support garment? Did it help? Let me know!

Mastitis is an inflammatory lactation condition that affects ⅓ of breastfeeding/lactating mothers.

In 2022, the Academy of Breastfeeding Medicine (ABM) released their new Mastitis Spectrum Protocol. These are care guidelines for breastfeeding parents and children, and are based on rigorous, peer-reviewed clinical research.

These new findings propose that our previous understanding of mastitis may be been partially incorrect.

Unfortunately a lot of outdated information is still circulating, both in the medical world and from generational advice.
Share this post so we can spread the current, evidence based advice and help mums with mastitis.

…. but belated 😅

🏥 Have you been putting off seeing your doctor for a cervical screening test (aka Pap test)?

Now if it’s because you’re time poor… I get

it, life is busy! 😥
Remember there’s also DIY tests available now to make it more accessible.

➡️ BUT if you’ve been putting it off because of fear of pain or you have a history of painful gynaecological examinations, then you might have vaginismus! ‼️🚨

⚠️Vaginismus is the involuntary spasm of the pelvic floor muscles and can cause pain during penetrative in*******se, using a tampon/menstrual cup or gynae exams.

It’s actually a really common presentation, with statistics suggesting approx 14% of females experiencing this problem.

💪Seeing a pelvic floor physiotherapist can help with addressing this muscular spasm, teaching you to relax and be more aware of your muscle tension, and give you practical tools to implement so you don’t have to experience this discomfort.

*x

🌟 C-Section recovery tips 🌟

🔔 but first… DONT FORGET TO SAVE THIS ONE FOR LATER!!

1️⃣ use pain relief to ease your discomfort and help in your healing journey. Your healthcare provider will determine the best options for you. Remember you just had MASSIVE surgery, take the pain relief!!

2️⃣ Start pelvic floor exercises to strengthen your muscles and regain control. You can do approx 24-48h after the catheter has been removed. These exercises, will help improve bladder control and speed up your recovery process. (P.s. did you know you CAN have pelvic floor issues after a c/s 🤯🤯… I know crazy!)

3️⃣ Wear compression garments for added support and to minimize swelling. Ensure it is correctly fitted and is appropriate for postpartum recovery. This will help abdominal separation recovery, increase support in your back and reduce initial discomfort in the abdomen.

4️⃣ Avoid heavy lifting initially, allowing your body the time it needs to recover. Where possible, try to only lift the weight of your baby for up to 6 weeks.

5️⃣ Enjoy horizontal rest and give your body the restorative break it deserves ! 🥰 This will help reduce pressure in your legs but also your incision.

6️⃣ Remember to roll out of bed slowly and with care, protecting your incision area. Pretty much what you did during your pregnancy!

7️⃣ Gradually start a gentle walking program to regain your strength and mobility. As soon as you feel ready, trying going for short walks, and building up as able over the coming weeks.

CONTINUED IN THE COMMENTS ⬇️

A review by researchers at the published in the included over 1000 trials (and over 100,000 participants) showed physical activity is extremely beneficial for improving symptoms of depression, anxiety, and distress. 🥳🥳

👉 Now this is nothing new… we know that movement and exercise has profound effects on our mental health.

BUT… here are some things I found fascinating 🤗
☀️ 12 weeks or shorter were the most effective timeframes for reducing mental health symptoms, highlighting the speed at which physical activity can make a change

☀️The largest benefits were seen in certain populations of people including people with depression, pregnant and postpartum women & people with chronic disease

☀️Moderate & high intensity exercise had greater improvements for depression and anxiety than lower intensities

☀️Longer exercise durations weren’t necessarily better, showing smaller effects than short and mid-duration bursts
☀️ All types of physical activity were shown to beneficial (including aerobic, resistance, mixed-mode exercise and yoga)

☀️ Lifting weights was more helpful for depression

☀️ Exercise like Pilates and yoga was more helpful for anxiety

SO how does this relate to pelvic health?

‼️Well, there are several studies highlighting the prevalence of anxiety and depression amongst people who experience pelvic pain 🚨urinary incontinence 💦 and in the pregnancy and postpartum population 🤰.

What should we be doing?

I think we should be supporting the value of exercise (in its various forms, since all types encouraged positive outcomes) ESPECIALLY when it comes to pelvic health symptoms.

What is your go to exercise? Comment below!

Don’t forget to share this with a friend 🤗

😬The Jaw and Pelvic Floor connection: PART TWO ✨

If you missed my earlier post, PART ONE, check it out to learn the MANY different ways these two parts of the body are deeply interconnected.

🤔Did you know that they also look SO alike?

Swipe through to see some beautiful anatomical images of these two structures. You can see that no matter the view (top, side or bottom) they are so similar.

Who would’ve thought? 🤯🤯🤯

My next post in this series will focus on all things you can implement to improve the jaw and pelvic floor connection.

So if you’ve got
💥 have jaw pain
💥are a teeth grinder
💥 have painful in*******se
💥 have chronic constipation
💥 have endometriosis (or pelvic pain)
💥 have been told your pelvic floor isn’t good at relaxing

… keep your eyes out for the next one 👀

📸:

*x

Some friday humour to celebrate the end of the week 😜

BUT it’s kinda true!
(I’m waiting for my fellow health care practitioners to tell me I’m not alone!)

When I have a patient that comes in for preventative treatment, it is SO exciting!

So when would someone come in for an assessment if they don’t have symptoms? Examples include:
🌀 During pregnancy
🌀Post natal check
🌀Pre or post endometriosis excision surgery
🌀 Family history of pelvic health problems like prolapse, pelvic pain or leakage
And more!!!

Remember that it’s always simpler to work on things preventatively rather than waiting till there’s a problem. 💡

😬😬😬

Are you a jaw clencher? How about a teeth grinder?

Well, if so… you are most like a pelvic floor clencher too!

The jaw and the pelvic floor are connected in a variety of ways including
💥 FASCIA (connective tissues)
💥 EMBRYOLOGY
💥 STRESS RESPONSE
… and more

This is why understanding how your entire body works is part of addressing any pelvic health problem, including leakage and pelvic pain!

Who would’ve thought that something on the other end of the body could relate to your pelvic floor muscles?! 🤯

Swipe through to learn more 👉

BUT WAIT… there’s another way they’re connected, check out Part 2 in this series (spoiler: it’s a pretty cool way 😎)