Jilly Bond Physiotherapy

Hello!

🔸 We’re inviting ALL women (assigned female at birth) to complete an online survey that can help us to understand sensory and motor changes in pelvic pain, potentially leading to more precise and effective treatments. We need both women who have pelvic pain and women who have no pelvic pain to answer the questions.

➡️ I’d really appreciate if you could have a go yourself, share this with your female colleagues and friends and if you’re a clinician if you could share this with your patients that would be fantastic. (Link via QR code and in bio “pelvic pai survey”)

🌎 We’re trying to get a truly International representative sample of ALL women with pelvic pain, so please share it widely!

Thank you 🙏🏻

Hi Everyone

https://app.onlinesurveys.jisc.ac.uk/s/brunel/sensorimotor-distortion-in-women-with-persistent-pelvic-pain

I'm excited to share that our next study's just gone live - I'd really appreciate it if you could have a go, share with your colleagues and friends, and if you are a clinician please share with any patients with pelvic pain or without. We're inviting ALL women (afab) Internationally to complete the questionnaire - both those with pelvic pain and without. It'll really help us to start understanding sensorimotor changes and building some groundwork for this being a potential target for physio treatment of pelvic pain.
Thank you!

Jumping on the AI bandwagon to wish you all a Very Merry Christmas! 🎄 I hope🎅 was generous and you’ve had time with loved ones.
I’m filling my soul with small people’s excitement, cats, family and cake.

After a particularly busy year it’s great to stop and take a breath. Sending you love and warmth xx

Hey! It’s that time of year again! Use the code CPNWA25 to get 25% off ALL ONLINE COURSES!

🌟 The Happy Bladder Course (for physios treating all pelvic pain)
✅ 9 hours of eternal access to go-at-your-own-pace lectures
✅ Practical solutions to assessment and treatment
✅ Free downloads
✅ Ongoing support & access to Bladder Heroes online group (with FREE webinars, forever)

🌟 The Happy Bladder Program (for people in pain)
✅ 10 weeks of themed information and practical exercises to help you build your own recovery
✅ Top tips and information to support your physiotherapy treatment
✅ 44 page downloadable booklet with worksheets, questionnaires and more info

🌟 Understanding and Challenging chronic UTIs
✅ All the information about UTIs, the problems with testing for them and how they become embedded
✅ Real stories from people with chronic UTIs who’ve recovered
✅ Everything you need to know about new pathways in their treatment to advocate for your care, or your patient’s care 👍💪🏼

Head to www.JILLYBOND.com to find the courses.

The cat’s out the bag! 🐈‍⬛

On November 1st we’re launching the project that and I have been working on for the last year 🥂
✨ Introducing ✨

We started with teaching, upskilling the UK pelvic health physio workforce in treating pelvic pain. I translated my masters research into a pain course, V joined me to teach (but mostly to hang out and talk pelvic pain) and now over 700 physios worldwide have been through either in person or online training💪🏼 Now we want to make pelvic pain treatment what we know the it needs to be - joined up, accessible, equitable.

🔸 The Pelvic Pain Network will allow women to access specialist pelvic health physio treatment for pain from anywhere in the UK, getting rid of the postcode lottery. We’ll build a team around each woman with the support they need to recover. We’ve collaborated with professionals nationwide from the wider MDT - psychologists, dieticians, urologists, gynaecologists, colorectal surgeons, nurse specialists, pain specialists and pain coaches - and it’s growing.

🔸 We’ll host free resources online to support colleagues nationwide and be holding pelvic pain teaching and conference days. And professional mentorship and peer support remains a mainstay of our mission - if we’re all doing well then women get the help they need.

💚 I couldn’t and wouldn’t have done this without Virginia, we’re a great team. I’m so proud of what we’ve achieved so far alongside PhD/research and parenting small children. Cheers to us! 🥂 And I’m excited for you all to meet our growing team, what an incredible group of people we’ve put together 🤩

What a week! I’m still riding the high from , an incredible celebration of women within every context of society that brought the national “Cliterati” to Cardiff 💃🏻
From talks on gender equality and racism in healthcare with & , period poverty campaigns , sexual health and wellbeing with to workshops covering workplace confidence post menopause, menopause nutrition with , every type of exercise for rehabilitation at every stage of a woman’s life with & , open water swimming for mental health with local heroes and powerful political crafts with & . And a fantastic feminist market with & too! Add in 28 degrees of glorious South Wales sunshine, great street food, a gin van and ice cream…

The cherry on the cake was getting to spend some really precious time catching up with and in real life, and cooking up more details of an exciting project that I just can’t wait to tell you about…

My soul is full of pelvic health wellbeing and female fierceness. If you didn’t make it this year make sure you get to the next one!

Photos:
1 - all the professionals involved in the day (The Cliterati)
2 - the glorious venue, Insole Court
3 - and I getting ready to speak at the big main stage tent
4 - after giving our Pelvic Pain and Bladders session with &
5 - Highlighting the fantastic books by , &
6 - V***a prints with
7 - Some of the fabulous speakers

Endometriosis Updates from World Congress 2023

Virginia and I had a great time at World Congress. It was inspiring to be surrounded by people from all over the world (600+ from 50+ countries) working hard to find a solution to the pain and suffering of Endometriosis.

There was a huuuuge amount of brilliant science and some big steps forward. We’ve distilled this into a (not so) short video of our best clinical takeaways. Click the link below to catch up on what you need to know about Endometriosis - if you’re a clinician or someone with the condition. I hope this spreads a bit more hope!

Wearable tech for ?

🤔 Bringing research to practice… 3/1

👉🏼Dr Li Ma and associates carried out a feasibility study of a watch-like device that monitored health stats such as heart rate, heart rate variability, respiratory rate, skin conductance and temp (all measures of systemic function and potential predictors of pain state/experience). E.g heart rate may be slightly elevated when in pain.. (paging )

👉🏼They also used a connected app to measure participants pain, cyclical symptoms, sleep, stress and QoL questionnaires

🔸They found a high concordance between the device and NRS scores of Endometriosis-related pain 👏
🔸Wearable tech may provide another way of monitoring someone’s symptoms and providing more detailed information about their response to treatment. It may also be a great way of providing reassurance that we as professionals can “see” their pain.. but that also comes with the potential to exploit/rank symptoms of our patients.

So until then, let’s just believe everyone when they say they’re in pain.

Can we trust this research? How does this help in clinic? - See previous.

🤔 Well.. probably. The larger medical meta-analysis covered a combined population of 27k+ women in trials that were mostly of medications Vs none. Doing something is always going to be better so we’d expect an improved score. They managed to bring the data together to rank the different medications regarding the change they make.

🔸It’s a little depressing as most are making a 15-20% reduction in pain overall (beyond placebo)
🔸 Combining medicines with conservative therapies will likely bring about even more improvement
👉🏼 Be aware of the different medicines available to your patient with
and ensure they’re seen by a gynae endo specialist if their medication isn’t helping.

The Conservative Therapies Meta-Analysis:

🤔 Can we trust it? Yes… ish. Good science but on a very select sample. Only RCTs were chosen (for methodological strength) however there’s rich data in the less rigorous methods.
Physio is SO HARD to test because of the impact of
🔹 the therapeutic relationship
🔹 undocumented social and psych support
🔹 non-specific affects of context, environment, meaning, expectation

They intended to do a meta-analysis on all physio interventions, but there was only enough within acupuncture research to make this possible. So the acupuncture data ISN’T AND ENDORSEMENT, it’s a reflection of what evidence is available.

Should we be offering acupuncture to every person with ? I don’t think so. If you do use it I believe it’s a way into a conversation with their nervous system that offers a *temporary* novel change in input. It’s not a treatment. But short-term, alongside other treatments…? Yes I think that’s ethically substantiated.

But remember:
🔸Nearly all the studies had a high risk of bias (we can’t trust that the results didn’t occur from the way they set it up/recorded results)
👉🏼Use regular outcome monitoring to ensure what you’re doing is helping. If it isn’t, change it up. This doesn’t need to be a formal questionnaire, (though I’m a big fan) it could be monitoring their goal attainment or VAS score with functional activities.

What treatment works for Endometriosis?
Sharing the evidence from World Congress on Endometriosis 1/-

Dr Gibbons + team wanted to ask the big question: “What is the best treatment for endometriosis?” Their systematic review & meta-analysis covered:
🔹53 medical interventions
🔹28 complimentary & alternative medicines*
🔹18 surgical interventions
*mostly Chinese medicine & Acupuncture

👉🏼You can see the modest change in Overall pain (scored out of 10, written in mm E.g -20 means a reduction in 2 points) for several medicines at 6 and 6-18months, giving them a comparative ranking of the treatments.
🔴 I’m surprised by the acupuncture score, and this needs to be taken with a pinch of salt - acupuncture gives a window of opportunity, it isn’t a treatment.
🔴 Physio/dietetic/psych/lifestyle treatments were a glaring omission, but are covered elsewhere.

Dr Elise Fraser’s group asked the same question of conservative therapies: “What works for Endometriosis?”

Only 13 studies met the criteria for their review, and covered:
🔹Acupuncture
🔹Electrotherapy
🔹Mind-Body therapies
🔹Exercise
🔹Virtual Reality assisted therapy

🛑They found a high degree of bias throughout.
Due to the higher number of acupuncture studies performed a meta analysis, and found a sig reduction in pain vs controls.

What can we take away from this? Follow the next post!

Just a quick reminder.. this is your LAST WEEKEND to get 25% Off ALL ONLINE COURSES! Celebrate our final bank holiday weekend this month with some learning, grab yourself a bargain.




Link in bio.

Hi 👋

I thought I’d say hello to all the people newly following me. I’m Jilly. I’m a pelvic health physio working in St Nicholas, near Cardiff, who treats everything to do with the pelvic area: bladder and bowel leakage, urgency and issues going to the toilet, vaginal prolapse, pelvic pain and male prostatitis. This includes youngsters to women going through pregnancy and perimenopause, post menopause and onwards.

But my speciality is pain. I love the challenge of sitting with someone with pelvic pain, collaborating to work out how we can change their symptoms and I get a deep sense of satisfaction from seeing people recover and regain their quality of life!

After my masters I started translating research into practice, and have trained over 700 pelvic health physios ( !) worldwide in an evidence-based, biopsychosocial informed way of treatment. I love my BladderHero community, they’re such an awesome bunch of passionate professionals who just want to help people 🙌 🦸‍♀️

After a few years dabbling in research I started my PhD this January with in Australia and Brunel Uni in London. I’m looking at sensory changes that occur when people have had pain for a long time, as I think this is another way in to changing pain and improving lives.

I share research updates for pelvic health physios and education for people with symptoms (check out my channel on YouTube, there’s loads of self help info there). And occasionally you’ll spot me triathlon training (if I ever stop getting bugs from my twins) and sharing fun events that make me happy.

If you’re interested in pelvic pain I’d love to hear from you! Welcome.

In bed with Virginia and Jilly!

I’m still filled with inspiration from World Congress on Endometriosis. It was incredible to meet so many researchers and clinicians from all over the world who are tackling Endometriosis and its symptoms from so many different angles. Diet, genetics, medications, environmental and psychological interventions, plus plenty of physio! And the best bit? Instead of the usual platitudes where the utility of having a multidisciplinary team is discussed, they Actually presented work showing how much of a difference intergrated teams can make.

and I want to share as much of the conference with you as we can. We recorded a debrief with lots of references and resources, from the comfort of a Premier Inn bed round the corner from the conferences Watch out for the link soon!

I’m so happy this project is finally coming to fruition. This booklet will be going out to 250,000 women nationally (subscribers to woman’s own magazine), readers of urology news (to share with their patients!) and will be available to download free for everyone who wants to share Contemporary, evidence-based information about pelvic health.

Coming soon, a new Urology News publication aiming to broaden awareness of continence treatments among women in the community! Articles by POGP Chair Kate Lough, Journal editor Gráinne Donnelly - Absolute.Physio & POGP members Myra Robson - pelvicroar, Emma Brockwell - PhysioMum & Jilly Bond Physiotherapy

I’m so happy this project is finally coming to fruition. This booklet will be going out to 250,000 women nationally (subscribers to woman’s own magazine), readers of urology news (to share with their patients!) and will be available to download free for everyone who wants to share Contemporary, evidence-based information about pelvic health. Well done team 👏 👏 👏

Coming soon, a new Urology News publication aiming to broaden awareness of continence treatments among women in the community! Articles by POGP Chair Kate Lough, Journal editor Gráinne Donnelly - Absolute.Physio & POGP members Myra Robson - pelvicroar, Emma Brockwell - PhysioMum & Jilly Bond Physiotherapy

Please could you share this with your networks and patients? We’re looking for a few more participants with pelvic pain to help us improve our understanding of persistent pelvic pain and how that might affect how your pelvic region feels. Use the QR code to access the study.
Thanks!

It’s official!
Well, it’s officially been 4 weeks but I picked up my badge today so I’m feeling more of a Legitimate Doctoral Researcher 🤓 Hooray!

I’m so excited at the prospect of spending the next 5 years focussed on the research that I want to do and answering clinical questions that I want answered. I’m exploring sensorimotor distortions in pelvic pain - when the pelvic region feels different, foreign, altered, or you’re not able to engage with it as you’d expect to. I hope that understanding this more will lead us to better treatments for pelvic pain.

I’ll still be seeing patients and speaking here and there, but this is my focus for now. Welcome along for the ride!

Back in clinic today, my happy place.
It feels like coming home after a long break.
Spending time helping people regain their confidence and returning to themselves after pelvic issues or pain gives me a deep sense of satisfaction. And is SUCH a gorgeous place to be supported through your recovery.
Loving my job today. And working with 🥰

I’M SO EXCITED!!

After years of collaborating and supporting one another, I’ll finally be joining and her team at ! Hill and I have wanted to work together for a decade or more, this is a dream come true. I couldn’t think of a better place to return to my clinical work. Gill’s built a nourishing space to support women and their pelvic health throughout their lifespan. Station House is a gorgeous Victorian police station that’s been rejuvenated into a holistic wellness space complete with a full gym, ballroom pilates hall, meditative counselling rooms and relaxing clinical spaces. It’s a one stop shop for women’s health needs - nutrition, fitness, recovery, physio, psychology and medicine. I’m really excited to join the team, can you tell?

Appointments will be available on my website soon, watch this space.

Last few spaces!
If you’re in a North American timezone catch this one-off Live Online Happy Bladder (Reframed) with in November - it’s your last chance to sign up!

Spend a few hours with me every Sunday and embrace the evidence for the best treatment of visceral pelvic pain. It’s not just about the bladder…
We’ll cover everything from the who, what and why of visceral pain and IC/BPS specifically, trauma informed assessments, how to use your body language to quickly establish a safe therapeutic alliance, expand your assessment techniques with the emerging research of interoception, and then build you a strong toolbox of manual treatments and graded sensorimotor learning techniques that build cognitive flexibility and self efficacy in your patients.
This is a one-stop shop of how to approach pelvic pain.
Plus you’ll become a and get exclusive and eternal access to our online group where I regularly share free evidence updates to practice and group clinical reasoning sessions.
Head to to book your space before it’s gone!

Good morning! I’m back from a much needed long weekend of forest bathing with my family. We found where the fairies live and met a mountain troll. There was also soft play and bouncy castles to keep my 62yr old mother happy - if I have half her energy in my 60s I’ll be doing well.
I’m bringing this calm energy into my week.
And I wanted to let you all know that the Happy Bladder course in Hartlepool in December will be my last for a while. I’m not currently planning any for 2023… I’ve got more exciting news coming! So if you’re keen to join the tribe grab your spot while you can.

Had a few days r&r in the big smoke.

Got to swim in my favourite reservoir. I mean, look at it. Sparkling. Warm, sapphire blue with a sprinkling of ducks. Bliss.

And I’m back sleeping in my childhood room. How many people can claim this as their view of central London? Gorgeous.

Just what my nervous system ordered. Exercise, rest, regular arguments with toddlers.

I try to follow my own advice when I can. OWS is my happy place 🏊🏼‍♀️ 🦆

Increased muscle tone doesn’t equal pain.
Or rather… increased PF tone isn’t necessarily the /cause/ of pelvic pain.
Doesn’t mean you don’t treat it, but how we think and talk about it with our patients is important

The Dias et al (2020) gives us a snapshot of muscular activity in women with and without IC/BPS & pelvic pain (yes..small motivated sample and some methodological issues, but just have a look at the images).

🌈 Red and yellow mean higher muscular tone (on EMG) and blue is relaxed. Women with IC/BPS & pelvic pain have generally increased PFM tone, and anteriorly as you’d suspect.

➡️ However, some in the pain free control group have increased tone and some in the pelvic pain group have no increased tone. But they are experiencing pain.

➡️ The tonal changes are also individualised. There’s no true anterior pattern.

➡️ There may be increased tone in the PFM of someone experiencing persistent pelvic pain, and their might not.

🌟 Pain and tone increase are both symptoms of persistent pelvic pain conditions, one doesn’t cause the other

🤔 So why does “treating” the PFM tone reduce pain? 👉🏼 you’re having a conversation with their local neuroimmune system. Calming things. Getting the muscle to work in ways it hasn’t in a while, in a surprisingly comfortable way. And you’re kind to them, you listen, you don’t hurt them. This all helps to change local predictions about tissue viability and improve function. PH PT is an intimate and intense treatment that breaks a lot of taboos, this helps.

➡️ Yes, of course there are local tissue dysfunctions that can add to a pain state. But they aren’t necessarily the driver. We’ll talk about this soon.

Isn’t physio complex and brilliant!

🦸‍♀️ Instead of telling them their “tight PFM is causing their pain” talk about there being tension/increased tone AND pain. And you’re going to work out ways to make the area feel more comfortable, together 🙌

📷 from Dias et al (2020) High density surface electromyography ax of pelvic floor dysfunction in women with IC/BPS. Jurology 204:1275-1283

Cats out the bag! I’m joining this Autumn for a refreshed, live-online version of my Happy Bladder course. Can’t wait to have more American and Canadian heroes in our tribe!
Don’t stress over complex pelvic pain cases… learn evidenced, state of the art techniques to take your treatment to the next level.

https://reframerehab.com/collections/foundation-courses/products/happy-bladder-north-america-uk-october-17

4 Sundays of 3-hour sessions and a follow up 6 weeks later. Not just a course but a community - once you’re in you join our online tribe for support, ongoing free CPD FOREVER.

This Live Online course gives you:
🔸 An overview of the most up-to-date concepts in visceral pelvic pain
🔸 Environmental and body language tips and tricks to make your assessment more meaningful
🔸 Evidence-based treatment strategies that work for all pelvic pain
🔸 The pathophysiology of bladder pain syndrome and visceral pelvic pain
🔸 How to supportively and subjectively assess a human in pain
🔸 How to approach your objective assessment
🔸 Clinical reasoning techniques to easily break down complex cases
🔸 Evidenced manual treatments that work for pelvic pain
🔸 How and when to use a pelvic wand
🔸 How, when and why we should use a graded exposure approach to sensory integration training with pelvic pain

🔷 And finally, (drumroll please) all participants gain access to the Online Tribe Facebook Group for ongoing sharing, learning and collaborating. Regular evidence updates and webinars are shared exclusively for free to tribe members to ensure you stay up to date, forever.

No death by PowerPoint, we have lots of fun. Come and join us! It’s time to be a

Hello! I’m Jilly.
It’s been a while so I thought I’d reintroduce myself.

I’m a twin mum and a pelvic health physio. I’ve temporarily paused clinical work while I grow some children and complete a PhD. When I get spare time I love open water swimming and do triathlons with my team “Tri Hards”..

I’ve always been fascinated by the science behind what we do, and how we can be better at helping people suffering with pelvic pain. I dipped my toe into research with my MSc, looking at pelvic floor muscle self-treatment for people with Bladder Pain Syndrome (prev called IC) and showed what an incredible difference Physiotherapy can make to lives. I’ve been involved with lots of trials over the last 5 years, made the best friends and mentors in the international research community and helped make a few outcome measures along the way. Now it’s time for me to follow my passion down the rabbit hole of sensory motor distortions in pelvic pain - does it feel different or weird or detached down there now? Can we change that? If we change how it feels does that change your pain? I’m going to hopefully answer a few of these questions.

In the mean time I teach professional development courses to physios who want to learn how to treat pelvic pain - you can find dates for live courses and the go-at-your-own-pace online course on my website: www.jillybond.com

I also put out evidenced information about pelvic pain on my YouTube Channel, and have a course for people with pelvic pain to get going with their recovery - the “Happy Bladder Program” which you can also find on my website.

If you’re interested in pelvic pain and physio I’d love to hear from you ☺️

3 spaces have just become available for the live course at St George’s hospital in London on June 25th-26th.
If you’ve been holding out to take the course this is your sign… grab a space before it’s gone!
Link in bio.

Spaces also available for Cardiff October 1st/2nd.

EPIC. That’s truly the only word suitable for the zoom chat I just had with and 🤯

We talked about the massive shifts we’d made with our appreciation of pain thanks to and Mick Thacker’s recent course, and what it really means clinically. And then we tackled GMI for pelvic pain - hint: it really isn’t GMI.
It was so good to have someone really break down where we are with more neuroimmunocentric (and biopsychosocial!) approaches to physiotherapy and give us a framework for how to progress.

Epic.

The video will be up in the group tomorrow for the tribe and available on YouTube for everyone soon - if you’re treating pelvic pain you’ll want to see it.

If you’re keen to upskill in pain I have courses open for London and Cardiff. Head to jillybond.com to register 👍