So, Brooke and I had a bit of an online chat for you. And it's probably a good thing that it was an online chat, as most of our face to face chats involve a glass of bubbles!
Brooke is the director of Back In Motion: Melbourne on Collins, a fantastic physiotherapist who just happens to specialise in Continence and Pelvic Floor Physiotherapy and a wonderful friend with a very enviable shoe collection!
So, Brooke, what exactly is Women's Health Physiotherapy?
Women’s health physiotherapy, is a sub-branch of musculoskeletal physiotherapy that has arisen from a need for specialists to treat and manage all things pelvic floor based. There’s been a real push in the last 5 yrs or so to call ourselves “Continence and Pelvic Floor Physiotherapists” because we treat so much more than women. We are involved in:
- all things Continence based (both urinary and faecal),
- all things bladder and bowel related (pain, constipation, long term diarrhoea),
- all things pelvic organ prolapse related,
- and any pelvic pain (vaginismus, vulvodynia, painful intercourse, erectile dysfunction).
And in fact, there is a large area of my work that covers Men and the management of their conditions which can include many of the above areas too. Most of the male treatment has arisen very recently with the advent of better Prostate Cancer diagnoses, treatment options and thus better referral on to us to assist in helping these men recover from their surgery, which nearly always results in a stint of significant incontinence and long term erectile dysfunction.
Given the pelvic floor is a muscle, it makes sense that Physios, who are experts in all things muscle and rehabilitation, would be perfectly placed to manage these types of problems. We should be the first line of treatment for anyone who experiences any kind of pelvic floor dysfunction – incontinence, prolapse, chronic pelvic pain, because we are so well trained in fixing it and luckily for us, the research and many studies back this up :-)
Many in this field will also treat children and their pelvic floor issues, but for me, after learning it at university, I haven’t had any clinical experience so I wouldn’t say I can treat kids as confidently as I can a woman or man who presents to my clinic.
We also manage pre and post-natal musculoskeletal pain; pelvic girdle pain/instability, spinal pain related to pregnancy, mastitis, blocked breast ducts, teach and run exercise classes for pre and post-natal ladies and generally manage the women who are in that peri-natal period.
All “women’s health Physiotherapists” or continence and pelvic floor physiotherapists will have gone back to university and studied either a masters or a post grad certificate on top of their bachelor degree to become one. We have the skill set to perform vaginal and rectal examinations and are thus able to identify the type of incontinence, or the extent of a prolapse and manage the very painful and debilitating chronic pelvic pain syndromes. This makes us or sets us apart from a regular physio who may have a real time ultrasound that can image your pelvic floor through a full bladder. These physios and this treatment can be quite useful in many circumstances, but as a general rule, if you are suffering from any of the above, we’d always recommend you see someone a little more qualified to get a more rounded examination and assessment of the condition.
How do I know if I need to see a Continence and Pelvic Floor Physiotherapist?
If you experience leaking, either of urine, wind or faeces, then you should definitely see a Women’s health physio :-) The important thing to realise is that it shouldn’t be seen as something embarrassing; in fact 1 in 3 women who have ever had a baby will wet themselves. And 50% of the population will experience a prolapse. So as I like to say, it is quite common, but please don’t consider it normal. I think women particularly, are hopeless at looking after themselves and tend to organise everyone around them before taking the time to attend to their own health needs. I see this a lot in my clinic, mums coming in years after the delivery of their first child and they’ve been leaking or suffering the whole time. If you can’t get through an hour of high impact exercise eg. A body attack class/ aerobics or running without stopping half way through to toilet, then you would most definitely benefit from an assessment.
Similarly, if you experience pain with/after intercourse, pain when passing a stool, if you couldn’t consider riding a bike because it would be too painful, then you would be helped immeasurably by seeing a women’s’ health physio.
What made you want to specialise in this field of physiotherapy?
Like a lot of career pathways, I pretty much fell into it. I was working in the UK at the time and accepted a locum/contract position on an obstetrics ward and fell in love with it. I had done a placement at uni in my undergraduate course at the Mercy Hospital and got a taste for it then so when I landed the role in the UK I realised that it was for me. One returning home from the UK, I completed the Post Graduate and have been doing it ever since! I’m now the clinical lead across the Back In Motion network, of which I’m a Practice Director. I now mentor the junior physios, run professional development sessions and am the go-to for all the network’s clinical questions.
My real love for this type of physio is more to do with make a real change to my patient’s lives and their day to day activities. Something that is so simple as being continent can be life changing for many. It’s the small wins and the average Joe who is helped by my skills as a clinician so this makes be very happy. It’s also pretty fun seeing all the babies too!!
If you had one message for the ladies reading this, what would that be?
If any of the above resonates with you, take action! You can do something about it, you can fix it and it’s not nearly as hard as you think!!!