Overcome Your Condition With Someone You Trust

Female pelvic floor dysfunction. If you are one of the women who have started to talk about your condition and are seeking help – well, I commend you! You may think that this is a relatively unheard of topic (particularly the realm of genito-pelvic pain), but you may have also noticed, that once you tell your friends you have times of incontinence or have been diagnosed with pelvic organ prolapse that you are certainly not alone. In fact, the current research tells us that:

  • 1 in 3 women who ever had a baby will leak urine
  • 1 in 4 will experience symptoms of pelvic organ prolapse
  • 1 in 8 women who have NEVER had a baby will have bladder control problems
  • 21% of US women will have persistent pelvic pain
  • 14% of Australian women will have painful intercourse

Female pelvic floor dysfunction includes:

  • leaking urine with coughing, sneezing, lifting, laughing etc (stress urinary incontinence)
  • Urgency and frequency and sometimes urgency incontinence (overactive bladder)
  • Painful sex (eg vulvodynia or vaginismus)
  • Constipation
  • Faecal incontinence
  • Ano-rectal pain
  • Pubic sympyhasis dysfunction
  • Rectus diastasis
  • Sacro-iliac joint and low back pain

Additionally, you may not have any symptoms of pelvic floor dysfunction, but have just had a baby and would like some advice on return to sport and activity – a post-natal check up. You may like to know if you are at risk of pelvic organ prolapse or if your rectus diastasis is healing well and what you need to do to ensure a healthy and strong pelvic floor and trunk post childbirth.

Zoë Mills can help you with all of the above. She is an experienced musculoskeletal physiotherapist and exercise physiologist with post-graduate qualifications in pelvic floor rehabilitation from Melbourne University. She has extensive experience with treating pelvic floor dysfunction, having treated a diverse range of patients. In this instance, her experience comes from a mixture of private practice and working on a casual basis at The Wollongong Hospital covering on the maternity ward and treating outpatients for pelvic floor dysfunction.  Zoë often works in conjunction with specialists, such as Urologists, Gynaecologists, Colorectal Surgeons, Psychologists, Pain Physicians and General Practitioners.

She is one of few physiotherapists in the Illawarra with a special interest and a whole lot of passion for pelvic floor rehabilitation!

Why Haven’t My Prior Treatments Worked?

There are a number of reasons why, the most common are those listed below:

  1. Instruction from a pamphlet: Many patients who come to us with pelvic floor dysfunction have been given a pamphlet to teach them how to do pelvic floor exercises.  This is like being given a pamphlet on how to play tennis; you can read about how to do it, but when it comes to actually physically doing it, you need one on one instruction and effective feedback to ensure correct muscle contraction. This, in turn, improves your confidence with pelvic floor muscle training - ensuring adherence to the exercise program and good outcomes.
  2. What the internet has to say: The internet…..! Self research on the internet for pelvic floor muscle dysfunction or incontinence most of the time tells you, you have ‘weak’ pelvic floor muscles. However, you are an individual; you are special and different to anyone else. It may be that your pelvic floor muscles are not the main culprit – is it instead your bladder habits? your fluid intake? Or, in the case of sexual dysfunction, there is more to it than just being turned on!! Are you going through menopause? The associated hormone changes can result in vaginal dryness and pain with intercourse. Or, Is it that you have never had intercourse, are trying and just not able? This may, in part, be due to your pelvic floor muscles being to tight!
  3. Previous physiotherapy treatment that is on a time limit and has not been long enough to establish exactly what is going on for you and/or failure to identify barriers and when to refer to specialists.
  4. Poor adherence to your exercise program due to being told you must do an overwhelming amount of these boring exercises and you just can’t fit them in!

What Makes Us Different?

Many people don’t even realize that their condition is not normal. Or, on the other hand, their condition may be quite common, but if not common, there is certainly specific information with regards to your condition. If you have limited genito-pelvic awareness then it’s pretty tough to address the problem and work to solve it. At RehWork, we’ll sit down with you and fill in the gaps in your understanding of your body. Once our patients are fully clued in on why their symptoms are happening, they feel ten times better about their ability to overcome them.

Zoë will initially listen very carefully to your complaint and background history. She will then perform a physical examination, which often involves a musculoskeletal screen, a vaginal examination and in some cases, a digital rectal examination (of course only with your consent and only if indicted) and/or use real time ultrasound to image your pelvic floor muscles. She may also give you a bladder or bowel diary, or even a pain diary to take home and fill out prior to the next consultation, depending upon your specific problem.

Next, we collaborate with you on a pelvic floor recovery program that’s customized to your situation. Where are you now? Are there activities you’re afraid to perform because of your pelvic floor dysfunction? Is this detracting from your work and family life? We’ll build an entire program around improving your situation.

For instance, if you’re suffering from an overactive bladder, we’ll not only teach you about good bladder habits; we’ll show you how to cultivate them. In some cases, overactive bladder may be curable.

In the case of stress urinary incontinence or prolapse, we will provide an individualised and structured pelvic floor muscle training program and educate you on appropriate activity and strategies to help reduce the risk of the prolapse becoming worse.

We use the same techniques to help you manage other symptoms of pelvic floor dysfunction such as chronic pelvic pain. Zoë will work with you and your team (which may involve your GP, gynaecologist and sometimes Psychologist) to help you understand some of the reasons why you have persistent pelvic pain and work towards improving your ability to achieve your own specific goals. You can be reassured that all consultations are absolutely confidential and are conducted in a private purpose built room.

Frankly, pelvic floor dysfunction is no fun; it can impact on your private relationships. It’s frustrating, annoying, embarrassing, and debilitating. But when you come to RehWork, we will formulate a specific plan for you and you can look forward to steady improvement. The ultimate goal is to help you be a happy and healthy you!