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03 443 7271 | 4 Quinnat street, Albert Town, Wanaka | 15/5 Hawthorne Drive, Frankton Queenstown

Full body restoration

So many beautiful new mums put up with problems  like urinary incontinence, bowel problems, back pain, painful scarring and tummy muscle separation after bub because they think it’s part and parcel of having their new bundle of joy baby. We believe in prevention first at Pelvic Solutions, your women’s health clinic, and know that having a check-in with us can clear up confusion around what’s normal and what’s not. Then we can tackle any issues and set you up for success with a pain-free functional body.

Being pregnant and going through childbirth can really affect the functionality and anatomy of the pelvic floor and the abdominal wall. These changes often cause women to adopt habits in the way they lift, sit and stand, which then has a ripple effect through their bodies. This can  lead to complications down the track from overloaded joints, muscles and organs, problems like diastasis recti (tummy muscle separation, pelvic organ prolapse, and back pain.

We recommend a 60 minute postnatal check, six weeks after delivery – no matter how glorious or labourious the delivery was. This is standard care in some countries like France, but unfortunately not in NZ (yet!). The check will include assessment of the tummy gap, posture, breath, pelvic floor function, screen for sexual dysfunction or problems related to bladder or bowels like incontinence, or constipation and any other problems due to pregnancy or childbirth. Women will then be given advice and an individualised rehabilitation plan to meet fitness goals, and regain stability and function through safe exercise, good breathing, and alignment.

It can be tempting to return to exercise quickly to get fit and toned after having a baby, but if the pelvic floor and abdominals are not ready for this, it could lead to a host of problems like urinary incontinence and pelvic pain. We know how to help you restore your pelvic floor and core strength safely and effectively and can help educate you with tips and habits to maintain life-long pelvic health and avoid pain and weakness. We also offer tailored, specialised postpartum exercise classes designed by a pelvic floor physiotherapist and an exercise scientist. This gives you the confidence to know how to move safely and get into the joy of movement.

No matter your birth story, ,we want you to feel seen and heard. It’s our mission to help you feel great and move well without fear of pain or leaking. We work innovatively and compassionately to restore confidence and control.

So what isn’t normal?

You need to come in and see us if you’re suffering with any of the following challenges after 6-8 weeks postpartum:

  • Urinary incontinence
  • Bowel problems like bowel incontinence or constipation 
  • Bleeding
  • Pain with intercourse
  • Bulging or pressure in the vagina or rectum
  • Pain in the body, be it in the lower back, neck or pelvis
  • Prolonged diastasis recti or tummy muscle separation where the tummy is doming or bulging during exercise or activity
  • Problems with any incisions, either from a C-section, tearing or episiotomy

Conditions we treat

Stress incontinence may occur when you cough, sneeze, laugh, jump or lift and you get urinary incontinence.  Sometimes urinary incontinence happens with impact sport, such as running, or skipping.  With effort or certain activities, the pressure on your bladder from above can cause  leaking of urine. This is can be due to a number of things, including the position of the bladder and weakness to the pelvic floor muscles.  It is never normal to leak when coughing or sneezing, although it is very common.  Do not put up with it!

Urinary urge incontinence occurs when there is a sudden and strong urge to pass urine, and sometimes that causes urinary incontinence. The bladder contracts when you are not on the toilet, which can lead to loss of urine. Some women go to the toilet more frequently during the day and night due to this problem. Urgency may occur with certain triggers such as hearing a key in the door or running water. There are many contributing factors to this problem such as the drinking of bladder irritants such as coffee, tea, or fizzy; bladder habits; bowel problems; and muscle overactivity. This problem can be effectively treated with behavioural and bladder retraining, education and optimising the pelvic floor muscles. Sometimes we need to use more advanced technology to resolve this problem completely.

Bowel incontinence is one of the most debilitating conditions we commonly see, and shame and stigma prevents many people from seeking the help they need for this problem.  We need to find out why the faecal incontinence cause, which could be from bowel motions that are too loose, or the sensation in the rectum not being quite what is should, difficult childbirth, some medications, infections, some bowel surgery and radiotherapy.  Sometimes loose stool moves down and out around hard stool plugging the rectum, causing bowel leakage.  Loose or watery bowel motions are generally harder to control, and sometimes you can get stool leakage after a bowel movement.  Bowel leakage is more common that you will think, and we unfortunately see it a lot, so reach out for help.

Having the right advice after an in depth assessment can help you smash your fitness goals safely.  Too often we find ladies want to jump back into high intensity training after having a baby, and ignore symptoms of dysfunction like incontinence, or heaviness into the vagina.  With the right information, we can guide you back to your fitness goals safely, ensuring that you are doing the right exercise, with the best strategies for your stage of rehabilitation.  And it is different for everyone!

We certain can progress you when the body and mind is ready back to high performance sport.

Diastasis Recti is when the tummy muscles separate, and the tissues in the midline of the abdominals stretches.  Sometimes this can cause weakness through the core system, pain in the back,  hips and pelvis as well as incontinence.  The goal is to restore the function to the fascia through the middle, and ensure that when you are moving about, or sitting feeding your baby – whatever you have to do for the day, you will be supporting the healing of the diastasis, and loading it appropriately so it will improve.

Having a belly still feeling like you are are still 6 months pregnant, with weakness and instability is no fun at all.  A generic exercise program will not usually do the trick, as there are many contributing factors to a diastasis sustaining, like breathing, alignment and the strength and function of the surrounding team mate muscles. We find your why and get you on track with how to improve.

Trying to be free from chronic hip and back pain can be like searching for the pot of gold at the end of a rainbow.  The often exhausting and emotionally draining journey to be pain free can take its toll on you and those around you.  We take a different full body approach to look for the real reason for persistent pain, and take the time to find all the contributing factors.  We treat holistically; the mind and the body, it is all deeply interconnected.

We find that often the pelvic floor has been missed in the quest for answers and improvement.  We include the pelvis and the pelvic floor in our complete assessment to find out the why, and what to do about it

Prolapse is surprisingly common.  Researchers believe that even as high as 50% of women have some degree of prolapse after childbirth, be it bladder, bowel or uterus. Prolapse symptoms include incontinence, difficulty emptying the bladder or bowel, the feeling of not emptying completely, a vaginal heaviness, aching in the lower back or vaginal or rectal bulge.

There are loads of measures we give on how to help with your symptoms and address the cause of prolapse and we urge you to know that surgery is not always the first port of call.  We teach you how to reduce pressure from above and increase support from below.

Many women have pain around or in the vagina or pelvis with intercourse (dyspareunia) or sexual intimacy. Pain can occur at the entrance to the vagina or on deep penetration, and can be commonly caused by overactivity of the pelvic floor muscles meaning the muscles have trouble relaxing. This can create muscle tension and spasm which can lead to pain.

Other causes of sexual pain can be hormonal changes associated with breastfeeding, how you think and feel, relationship problems, vulval skin conditions, perineal scarring from childbirth or trauma, and some medications, which can reduce sexual desire and cause vaginal dryness.

We can assess why your problem is there, and help you resolve it.

A healthy bowel habit varies considerably between people, bowels are very individual.  Your bowel is healthy if you bowel motions (poo / faeces) are regular, soft and well formed, easy to pass, and leave you feeling that your bowel has been fully emptied.

Bowel incontinence or bowel leakage can be embarrassing and may even stop you from leaving the house.  Leaking flatus (wind / intestinal gas) can also be very annoying, especially if you are in your favourite downward dog position in yoga class.  Rushing to the toilet due to a strong urge to pass a motion can be nerve racking if there is no toilet nearby, especially if there is loose bowel motions.

Straining due to constipation and painful bowel movements can lead to a host of other pelvic problems.  Bowel urgency can be caused by pelvic floor muscle weakness, loose bowel motions and a hypersensitive rectum. Pelvic floor muscles that are too tight can cause difficulty passing a poo, constipation, haemorrhoids and other bowel problems.

Nothing better than a nice, soft, easy to pass bowel motion, that comes regularly! No more heave hoe to get that poo out, and let’s make sure they also don’t slip out when they are not supposed to.  Say ‘NO’ to bowel incontinence and bowel problems.

We teach you how to manage abdominal and pelvic muscles, scars (c-section, episiotomy, 3rd and 4th-degree perineal tears from instrumental delivery), so they do not go on to cause trouble with functional movement, exercise or sex.

Learning how to safely resolve scar adhesions, or stuck bit of scar tissue can help you move easier, strengthen faster, breath better, and allow your body (and your fascia) to respond to the demands that you put on it.  Perineal scarring can cause pain with sex if left un-treated.

Mobility of the spine and muscles can have an affect on mastitis.  We can show you how to do effective breast massage for those hot spots on the breast, and realise the surrounding soft tissues and structures so that you have better circulation and lymphatic flow.  We work closely with a lactation consultant as well.

A lot of women ask us what is the first step towards healing when they’ve had a baby. They’re often surprised to learn, it’s ALL about the breath. Restoring the breathing mechanics after pregnancy is always the first step, as your growing baby has very helpfully redesigned the position of the diaphragm and the rib cage. Without the right sort of breathing, other rehab on diastasis rectus abdominus or the pelvic floor muscles is null and void. Breathe, baby breathe!

The pelvic floor and the diaphragm work in a piston like movement, moving up and down with your breath. On your inhale the rib-cage and stomach expands, the diaphragm lowers and the pelvic floor chillaxes. On your exhale the rib-cage and stomach softens, the diaphragm ascends and the pelvic floor elevates slightly.

Breathing right is the first step towards restoring our posture and our pelvic floor, getting the diaphragm and pelvic floor to work in synergy. Often, gentle hands on massage and myofascial release from our physiotherapists is the first step to get rid of any restrictions so our new mums are ready for breathing well, functional movement and getting their strength back.

Post natal services

Postural Assessment

One of the first things we do in our assessments is look at how your posture is faring. Why? Our bodies and posture go through huge transformation throughout pregnancy and childbirth. All of your muscles and ligaments, which have softened and stretched to accommodate your bub, usually take some months post delivery to recover. Tummy muscles can also separate and the connective tissue through the midline can become stretched, causing something called diastasis rectus abdominus (DRA).

When the pelvis is tilted forward or back (think ‘butt tucking’ or ‘butt sticking out’ J-Lo style!) then the alignment with our spine, pelvis and rib-cage is compromised. This can throw everything out of whack, causing pain and constricting the breath.

All of this lengthening and weakening of our abdominal muscles can affect the control of our pelvic floor, spine and pelvis and depending on the level of trauma during birth, there can be varying degrees of perineal (pelvic floor) pain. This weakening or pain can happen whether you had a vaginal or C-section, and can depend on how long you pushed for or if you had any birthing injuries. Sounds fun!

Post-birth Treatment

Following your amazing, world class feat of having your baby, things may feel pretty funky for six to eight weeks. How funky? Well, you may feel like your bottom is falling out and not know how you should sit or stand – both of which could be painful. Because of your shocked pelvic floor muscles, controlling when you fart, wee or poo might be interesting, and you might find yourself unable to stop going to the loo. If you’ve had a C-section, you might have pain in your tummy or around your scar when you move, laugh or cough, while your hips or lower back may also be suffering. Your bubba isn’t going to carry itself, so all that breastfeeding / bottle feeding and carrying can cause pain in the arms, shoulders and neck.

A lot of these problems can be resolved when you restore your posture to its equilibrium, restore the breath, and some simple tips and tricks to get through the day to day tasks. After we get your posture sorted, we then create a tailored exercise program for you that will slowly progress from static postures to dynamic movement. Please don’t rush off to the gym until you have your foundations sorted – otherwise, issues can raise their ugly snout later on down the track. You want to learn how to get strong and happy in a safe and supported way.

Breathing assessment

A lot of women ask us what is the first step towards healing when they’ve had a baby. They’re often surprised to learn, it’s ALL about the breath. Restoring the breathing mechanics after pregnancy is always the first step, as your growing baby has very helpfully redesigned the position of the diaphragm and the rib cage. Without the right sort of breathing, other rehab on diastasis rectus abdominus or the pelvic floor muscles is null and void. Breathe, baby breathe!

The pelvic floor and the diaphragm work in a piston like movement, moving up and down with your breath. On your inhale the rib-cage and stomach expands, the diaphragm lowers and the pelvic floor chillaxes. On your exhale the rib-cage and stomach softens, the diaphragm ascends and the pelvic floor elevates slightly.

Breathing right is the first step towards restoring our posture and our pelvic floor, getting the diaphragm and pelvic floor to work in synergy. Often, gentle hands on massage and myofascial release from our physiotherapists is the first step to get rid of any restrictions so our new mums are ready for breathing well, functional movement and getting their strength back.

Breathing chills us out, gives us energy and is our life force. When we breathe shallowly from stress, because of being squished from growing a baby, or breathe only in our bellies, we aren’t using the healing properties of breath to its full potential. If you’re popping up or flaring through the ribs, or if you’ve got a hypertonic (overly tight) rib cage, then everything else is affected. The body is a wonderful set of dominos, and the ripple effect is a biggie!

Running assessment pelvic solutions
Post natal Return to Running assessments

Oh it feels good to run again post birth however over the 9 months that it takes to grow a baby you will have changes in your rib position, pelvis position, foot arch structure, pelvic floor and abdominal muscles just to name a few which can change your running technique and place increased stress on some structures.

During running the ground reaction forces travel through the body placing increased load on the pelvic floor and its associated structures causing stretching of the structure over time. This is increased if these structures are already in a weakened state…but never fear…there are many changes or supports we can offer such as pessaries to help support the pelvic organs and improve continence control

Our running analysis is performed by an exercise scientist and pelvic health physio; Ingrid Vollweiler. These assessments provide a comprehensive evaluation of your structural changes post birth, pelvic floor status, breathing and running technique via real time feedback using smartphone and tablet apps.

Ingrid will identify possible reasons for leakage, heaviness, pelvic pain, other structural pain, risk of injury and areas for potential improvement in speed and efficiency. You will be given a specific exercise program and plan for your individual needs.

Strength, conditioning and guided back to exercise and movement

Ladies, we know that you want to return to exercise and movement ASAP following the delivery of your baby. We want that for you, too. The most important thing you can do however, for your own health and wellness, is to give yourself some time to heal and come in for a proper assessment to understand your pelvic health, before hitting the gym or pounding the pavement. With Pelvic Solutions on your side, you can take the right strategies moving forward to get you back to exercise safely and with support, to ensure no lasting damage and that all pelvic organs are where they should be. We want you empowered and confident – and that sometimes takes a little time. Whether you had your baby eight weeks or eight years ago, we can give you the tools and techniques to really understand your body and set up for success.

Many women put up with leaking during running or high impact sports and think it’s normal.  Although it is common, it’s never normal. There is plenty that we can do to ensure a safe return to exercise.

Prolapse management
Prolapse management

A prolapse diagnosis can be a hugely emotional moment for women. This is an area that still carries a lot of stigma and shame, and we’re so passionate about breaking down the walls around this topic and empowering women to make choices that give them their lives back. A prolapse is not a death sentence to a normal life – there are so many treatment options available to you and we can help you make informed choices towards feeling like you have your life – and body – back under control.

A prolapse often feels like a vaginal bulge or presents as pelvic/ perineal pressure or as lower back ache. There are loads of measures we give on how to help with your symptoms and we urge you to know that surgery does not have to be the first port of call.

Basically, we need to increase support from below the pelvic organs and reduce downward pressure from above the pelvic organs.  We have to make sure the bowels are working well and the bladder and bowel is emptying properly.

We can also provide support devices such as pessaries if indicated, which help support the bladder, uterus and bowel if they’ve dropped a bit. We can give you advice on appropriate exercise, when to rest with feet elevated in the middle of the day, management of constipation and respiratory conditions, weight loss and advice on avoiding / safe lifting.

Post natal exercise and education classes

Our post natal exercise and education classes are a unique blend of carefully selected exercises to safely build strength, stability and flexibility and the information you need to know about post natal life such as incontinence, nutritio nand hydration to heal, bowel care, diastasis recovery, restorative breathing, how to get a power house pelvic floor, and guide back to intimacy as well as higher intensity sport. Our physio-led classes are tailored to the individual.

These holistic classes have been designed by expert pelvic health physiotherapists and an exercise scientist to assist and empower women to gain confidence in their bodies and return to full strength and fitness safely. We understand the impact pregnancy and birth have on the body and how to best support you in healing.
The intention of these classes are to provide you with the knowledge and techniques you need to care for your body during pregnancy and after birth. We know the important tips, tricks, and techniques to stay healthy, strong and safe during pregnancy, and recover faster after birth without leaks, pain or pressure into the pelvis.

Each class will be individually thought out with medically proven exercises focusing on alignment, core strength, mobility and relaxation. Classes will benefit clients with abdominal muscle separation, prolapse, pain and other pelvic health problems.

Hire out a stims machine

This machine is indicated for some ladies to help progress improve the function of the pelvic floor muscles. Under guidance, this technology can help those who are challenged to extend how much they can hold the pelvic floor muscle activation for, good for pelvic pain issues through the pelvis, and to improve vaginal sensation. Fabulous innovation that when used correctly can certainly do the trick!

Frequently asked questions

No.  You can make your appointment without a referral.  ACC and private appointments are available. If you do have a referral from your doctor or health care provider, then they will send it to Pelvic Solutions directly. To book now click here.

Most people feel fine after an internal vaginal examination, no different than after a pap smear test usually. If treatment involves extended internal body work, releasing the pelvic floor muscles and trigger points, then some people can experience some aching after treatment (like after a massage!), but this generally resolves within a few hours. Some people can feel thirsty, have headaches, and feel tired after internal body work, especially if the muscles are chronically tight. Listen to your body and rest as you need to. It is important to hydrate with plenty of water. It is recommended that after an internal examination you drink a large glass of water, and empty your bladder as standard care. You will be provided with detailed aftercare instructions after your treatment.

If you have any concerns about how you are feeling after internal body work then please get in touch with us by email here.

Some results can be felt immediately after the first session, however for permanent changes to be made it usually takes longer. Usually 3 treatments are indicated initially one week apart, then usually a follow-up anywhere between 2-4 weeks later, and then further treatments less often as required. This is due to the complex nature of most cases our therapist treats, and usually the problems are chronic, meaning it takes time to change behaviour, and strengthen muscles and co-ordinate body systems to improve function. We will strive to resolve your problem in the minimum number of treatments; the greatest success occurs when you are an active participant in your treatment program, and follow the advice given. Our therapists communicate directly with patients outside of appointments and are always available by email or phone to discuss any problems or concerns you may have with your program.

 

For our out of town clients, it may be difficult to get to the follow up appointments.  We will discuss with you the suitability or an online follow up, if you are unable to make it in person.

**Due to high demand we encourage all new patients to book their initial and two follow up appointments two weeks apart to ensure you get the most out of your treatment.

Expect improved control, higher self-esteem, better sex, improved continence, increased confidence, better natural lubrication, improved sensation in the vagina and much more!

While we strive to be family-friendly it can be beneficial for Mums if children are not present, so they can focus completely on the treatment. There is often a lot of new information to absorb and if internal treatment is required we want you to be as relaxed as possible. However, we will do our best to accommodate the needs of your family.

Physiotherapists are experts at working with the musculoskeletal and neuromuscular systems of the body. With their additional specific training, Pelvic Floor Physiotherapists are well-placed to assess and treat muscle groups, including the pelvic floor. The muscles of the pelvic floor are found at the opening of the vagina (in women), urethra, and rectum. Thoroughly assessing the function of the pelvic floor is possible with an examination performed with one finger (gloved) inserted into the vaginal or rectal canal. There is a strong anatomical basis for this seemingly unconventional exam. Pelvic Floor Physiotherapists train in both internal and external evaluation and treatment techniques and current medical research backs this approach.

An internal assessment is the “gold standard” for a comprehensive assessment of the pelvic floor. Some patients may be hesitant at first but then choose to go ahead with internal assessment. However, for patients who are not comfortable with internal examinations, there is no obligation to have one. Pelvic Floor Physiotherapists can assess the function of the pelvic floor by using external observation and cueing. A surface EMG (electromyography) biofeedback test can be used to assist this examination.

No. To be able to practice in this highly-regulated profession, our therapists have completed extensive post-graduate training in this field to gain the knowledge and clinical skills necessary to treat this complex clinical area. Our therapists study through The Women’s Health Training Associates and Melbourne University, as they offer a comprehensive training for Physiotherapists in this field. To be competent to work in this area, our therapist’s professional development has included hundreds of hours of theory and practical study, and multiple workshops, courses and monthly peer review meetings with other trusted colleagues in this field. Although our therapists can treat musculoskeletal injuries like ankle or shoulder sprains, they focuses on treating those with pelvic floor dysfunction, rather than standard injuries, but take a whole body and mind approach to treatment.

This is a very common misconception. Urinary incontinence is a failed system, not just a failed muscle. Having a strong muscle does not necessarily mean it is coordinated. To remain continent, people need a fully-functioning system including muscle groups which are strong but flexible, and which can coordinate how to tighten when they need to and relax when they need to. Assessment with a Pelvic Floor Physiotherapist involves looking at these muscle groups, including the pelvic floor muscles, abdominals, hip muscles, lumbar spine and diaphragm, as well as breathing mechanics, and how they function as an integrated system. Sometimes pelvic floor muscles can be shortened and irritated, and this can also lead to incontinence just as much as having a weak pelvic floor. Your Pelvic Floor Physiotherapist will advise you of the individualised exercises that are required to help your specific problem.

There is strong evidence that treating prolapse (Grade 3 or less) conservatively with Pelvic Floor Physiotherapy (for up to 6 months) can significantly improve or even reverse prolapse and symptoms. Grade 4 prolapse (outside of the vagina completely) usually needs surgical intervention to resolve.

Pelvic floor/perineal injuries covered by ACC are usually only after instrumental deliveries (forceps and ventouse), or trauma caused in an accident e.g. broken pelvis. Generally, ACC will only cover treatment within 12 months of the date of injury. If an ACC claim has expired there is a possibility it could be reactivated. Your practitioner can discuss this with you.

If you have sustained a musculoskeletal injury due to an accident and it has affected your pelvic floor function, in most cases you will be able to lodge an ACC claim at the time of your appointment. If you have lodged a claim with your GP, or have had ACC-covered treatment from another therapist (e.g. Osteopath, Physiotherapist, Chiropractor or Acupuncturist), please bring the relevant information, such as claim number and date of claim, to your appointment.

ACC will only cover part of the cost of treatment, so there will be a balance to pay. Please click here for treatment rates. You will be required to pay the full private fee until you have provided the relevant claim information and it has been confirmed by ACC to be valid. If you need assistance understanding whether you are eligible for ACC, please get in touch with us.

Book an appointment

Take the first step and book your appointment 60 minute appointment, which is always 1:1, and involves a treatment tailored to you exact needs.

Would you prefer to chat over the phone?

Wondering if we can help you after having a baby? Give our women's health physiotherapist a call!
We can answer your detailed questions, and if we're not a great fit for you, we can provide resources and recommendations for treatment options.

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