Post Partum check-up
• Assessment of Rectus Abdominal Diastasis
• Exercises and education to heal RAD
• Assessment and advice as to when it is SAFE to return to exercise
• Pelvic floor assessment of muscle strength, and education regarding the correct activation technique and strengthening exercises via real-time ultrasound scanning and/or an internal examination
• Postural assessment
• Assessment of Rectus Abdominal Diastasis
• Exercises and education to heal RAD
• Assessment and advice as to when it is SAFE to return to exercise
• Pelvic floor assessment of muscle strength, and education regarding the correct activation technique and strengthening exercises via real-time ultrasound scanning and/or an internal examination
• Postural assessment
Pregnancy and childbirth
have a profound impact on a Women’s body. Many of the women that I see are unaware of just how significant these changes are, and believe that once they have had the ‘all clear’ from their Doctor at 6 weeks, they are safe to immediately resume all the activities and exercises that they were doing prior to falling pregnant.
I strongly believe that this is contributing to the fact that 1 in 3 women are urinary incontinent and 1 in 8 women are faecally incontinent. Incontinence remains a very taboo and awkward subject, and traditionally women have largely suffered in silence with these issues. Thankfully I think that women are now less likely to just ‘accept’ that this is something that they are going to have to live with for the rest of their lives. Many women are empowering themselves by seeking help for their pelvic floors when they have a problem, or even better, they are actually taking steps to reduce the chances of issues developing in the future.
The postpartum checkup can be done anytime after you have stopped bleeding after childbirth. (A few of my clients have come to see me after they have become Grandmothers themselves following their daughters coming to see me; it’s never too late!)
Pregnancy
• Treatment for neck, back and pelvic girdle pain
• Pelvic floor assessment and education
• Education and advice about exercising safely in pregnancy
• Treatment for neck, back and pelvic girdle pain
• Pelvic floor assessment and education
• Education and advice about exercising safely in pregnancy
I believe that all women should visit a Women’s Health Physio at least once while they are pregnant!
It is imperative that you understand the significant musculoskeletal changes that are happening to your body and the impact that pregnancy and child birth (via a natural delivery or caesarean) can have on your body and your pelvic floor. Very few of the women that I treat are aware of how exactly they should be doing their pelvic floor exercises and fail to perform them adequately. It also essential that you understand what exercise is safe to be doing in pregnancy. Research shows that women who regularly do their pelvic floor exercises while pregnant and in the post natal period are less likely to be incontinent in the future, so please ensure that you are doing them!
Neck, back and pelvic pain
While back and pelvic girdle pain are relatively common in pregnancy with a third of women suffering from them, they are not normal. Back and/or pelvic pain can be due to the relaxin hormone which allows your uterus and abdominal muscles to accommodate your growing baby, also loosening the other muscles around your lower back and pelvis. This loosening reduces the stability of these joints and can cause pain. Other reasons for back and pelvic girdle pain include weight gain in pregnancy and the postural changes that occur as your belly grows. Many women also notice that their pelvic floors weaken in pregnancy (and they leak urine with coughing, laughing or sneezing) and this can also contribute to this pain.
Breastfeeding issues
• Laser for cracked nipples
• Ultrasound for blocked milk ducts and mastitis
• Laser for cracked nipples
• Ultrasound for blocked milk ducts and mastitis
Cracked Nipples
Breastfeeding can be extremely painful and uncomfortable for new mothers if the nipples become cracked and damaged while feeding is being established. Women with blonde or red hair are more likely to suffer from cracked nipples and many women struggle to continue to breastfeed as a result of this.
LED phototherapy (laser therapy) has been proven to be an effective tool in accelerating the healing of nipple trauma and is routinely offered by many Physiotherapists in Australia and South Africa.
I offer laser therapy to women with cracked nipples from breastfeeding and I also have a limited number of home-use laser units that can be loaned from my clinic for “top-up” treatments at home. I begin with manual lymphatic drainage massage to the neck and chest to stimulate the lymphatic system to promote healing and then apply the laser to the affected area. The light therapy promotes the production of ATP within the cells which stimulates and promotes the bodies own natural healing response. LED laser is “cold” low-level laser therapy and has no known adverse side effects making it an excellent treatment option for new Mothers.
Blocked Milk Ducts and Mastitis:
Blocked milk ducts and mastitis can also develop while breastfeeding. As well as being lumpy, painful or red in colour, the blocked ducts can also make you feel very unwell.
I use therapeutic ultrasound therapy to treat mastitis and blocked milk ducts. The high-frequency sound waves generated by the head of the ultrasound help to clear the milk ducts and to restore the natural flow of the breast milk. I begin the session with manual lymphatic drainage massage to the neck and chest to promote lymphatic drainage before applying the ultrasound. I may also apply Kinesio tape on the breast over the blocked duct to help with the lymphatic drainage of the area.
Please note that ultrasound to blocked milk ducts can not be done if you have any breast implants, a recent history of breast cancer or if you have a pacemaker.
To optimise the efficacy of the treatment, your baby needs to feed on the affected breast to help to clear the blockage within 10 minutes of the treatment being done, so please try and take this into account when attending the appointment!
If you have an active fever or flu-like symptoms, it is best that you visit your GP and commence antibiotics ASAP. Once you have been on the antibiotics for 12 -24 hours we can start the ultrasound treatment.
Best results are usually achieved with the laser or ultrasound treatments being done 2 days in a row.
Incontinence
• Urge urinary incontinence (overactive bladder)
• Stress urinary incontinence
• Pelvic floor muscle assessment and strengthening
• Pelvic organ prolapse
• Posture and lifestyle advice
• EMG biofeedback
• Real-time ultrasound scanning to visualise your pelvic floor
• Safe exercise advice
• Urge urinary incontinence (overactive bladder)
• Stress urinary incontinence
• Pelvic floor muscle assessment and strengthening
• Pelvic organ prolapse
• Posture and lifestyle advice
• EMG biofeedback
• Real-time ultrasound scanning to visualise your pelvic floor
• Safe exercise advice
Urinary incontinence (accidentally wetting yourself) is thought to affect 1 in 3 women in the UK. Physiotherapy can be very beneficial in managing and reducing symptoms of incontinence by having an assessment of your pelvic floor activation technique and muscle strength and being prescribed appropriate exercises.
If you are struggling with any involuntary loss of urine when coughing, laughing, sneezing, lifting, jumping or with any other exertion, or you are struggling with uncontrollable urges to pass urine before getting to a toilet, you are likely to benefit from seeing a Women’s Health Physiotherapist.
Breast Cancer
• Manual lymphatic drainage massage
• Treatment for ‘cording’
• Rehabilitation of the shoulder
• Advice on managing lymphoedema
• Measuring for a compression sleeve and request to GP to provide it
• Advice on safe and appropriate exercise during cancer treatment
• Manual lymphatic drainage massage
• Treatment for ‘cording’
• Rehabilitation of the shoulder
• Advice on managing lymphoedema
• Measuring for a compression sleeve and request to GP to provide it
• Advice on safe and appropriate exercise during cancer treatment
The different types of treatment for breast cancer depend on the exact type of cancer that has been diagnosed. Many women have one or all of their lymph nodes removed as a result of their cancer treatment and will also have a lumpectomy or full mastectomy. This surgical intervention can sometimes cause significant pain and discomfort on top of the strong chemo or radiotherapy treatment required.
The lymphatic system is a complex one, and the symptoms arising from the removal of axillary lymph nodes can be negligible for one woman, and significant for another. Pain, swelling and ‘cording’ where a string is felt along the arm and into the axilla can cause great discomfort. Many women also struggle with regaining pain-free active movement in their shoulder on the affected side after breast cancer.
I recommend that any lady who has had any surgery for breast cancer has lymphatic drainage massage as soon as possible to help to maintain the lymphatic flow in the arm and over the chest wall and to promote the regeneration of the fine lymphatic pathways. I will also advise you on the need for a compression sleeve and ask your GP to prescribe an appropriate one. Using very gentle manual techniques and stretching and strengthening exercises I will help you to regain the function in your shoulder. I will also help you to work out the safest and most appropriate forms of exercise to be doing while you are pregnant.
If you are currently still undergoing cancer treatment, please check with your Oncologist that they are happy for you to be having manual lymphatic drainage massage and Physiotherapy.
Fertility Acupuncture
Acupuncture has been used by couples hoping to conceive a baby for many years, often in conjunction with medical fertility treatment.
Research studies have shown that acupuncture can be effective in assisting women to conceive, (and like with many interventions, other studies that have found it doesn’t always help).
Acupuncture is thought to be helpful in:
• Helping support ovulation dysfunction
• Improving blood flow to the pelvic organs including the uterus and ovaries
• Regulating the menstrual cycle
• Reducing overall stress
• Improving sperm health
Acupuncture has been used by couples hoping to conceive a baby for many years, often in conjunction with medical fertility treatment.
Research studies have shown that acupuncture can be effective in assisting women to conceive, (and like with many interventions, other studies that have found it doesn’t always help).
Acupuncture is thought to be helpful in:
• Helping support ovulation dysfunction
• Improving blood flow to the pelvic organs including the uterus and ovaries
• Regulating the menstrual cycle
• Reducing overall stress
• Improving sperm health
Lulu is passionate about helping women who are hoping to conceive, and provides a holistic approach for women on their fertility journey drawing on her training in yoga, mindfulness, psycho neuro immunology, functional nutrition for chronic pelvic pain and extensive training in pelvic and women’s health Physiotherapy.
For ladies who are struggling with pelvic pain (with a tampon or intercourse), pelvic floor Physiotherapy can be beneficial in reducing the tension in the muscles in the pelvic floor and helping improve the mind body connection to the reproductive organs and pelvic bowl.
The feeling of having a needle inserted varies between people, but is not usually painful. You may feel tingling or dullness around the site, but most people find the sensation of the needles and the experience very relaxing.
Electro acupuncture involves placing little crocodile clips on to the acupuncture needles which are connected to a TENS machine. A mild current then runs through needles and is thought to amplify the needles effects upon the body. The sensation is usually perceived as a light tingling. Some studies have found that electro acupucture can be helpful in treating PCOS, enhancing oocyte maturation and improving fertility rates with IVF. Lulu uses electro acupuncture frequently in her practice.
