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03 443 7271 | 25a Russell street,
Wanaka
| Remarkable Physios, The Landing, Unit 15
5 Hawthorne Drive
Frankton, Queenstown

Pregnant and in pain? Leaking bladder?

We believe that all pregnant women should be assessed by a Women’s Health Physiotherapist, to prevent common problems that ladies face during pregnancy, help with an easier birth, and ensure the body is physically prepared for birth and post natal recovery.

If you are pregnant and you hurt or have a leaking bladder, then don’t put up with it! In pregnancy, many women suffer unnecessarily with pain in the back, hips, pubic bone and groin (pelvic girdle pain).  Postural changes can occur due to the weight of the baby, and ligaments soften. This can put added strain on your body and lead to discomfort. With the right education and advice on how to strengthen the pelvis and back with safe exercise during pregnancy, most women feel much better after Physiotherapy treatment in a short time. So don’t put up with being in pain during your pregnancy.  If these problems are left untreated they can lead to problems in delivery, as well as post partum and far beyond.

When it comes to childbirth, it’s our focus to prepare your body for this amazing life event. Your body is going to transform throughout pregnancy and there will be new demands on it all the time.

Even if nothing seems wrong, it’s a good idea to check in and get an assessment to prepare the pelvis and pelvic floor for an easier delivery. Learning how to optimise the forces during the birth with perineal massage and learning how to nudge the baby out vaginally with full relaxation and appropriate breathing is important. We also want to check that muscles can relax properly during pregnancy, to make for an easier delivery. If preparing for a C-section, it’s also important to check in so that we can improve any existing scarring. We can advise on the best birthing positions with pregnancy-related pelvic girdle pain and how to speed up your recovery in the first six weeks after birth, until you can have a postnatal review with your therapist.

Conditions we treat

Stress incontinence may occur when you cough, sneeze, laugh,jump or lift.  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.

Urge incontinence occurs when there is a sudden and strong urge to pass urine. 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.

Hip, back and pelvic pain can be very common during pregnancy, but it is very normal and there is loads that can be done to help.  Lower back pain, or hip pain can come from the postural changes during pregnancy, as well as carrying around that extra weight.  With some simple tips and tricks and hands on therapy, you can prevent and resolve these problems.

Your posture changes and your baby grows, and this can put pressure on the back, and ribs.  The pressure from the baby can change the way you are breathing, and this can cause the ribs to hurt and become inflammed too.

Pain felt at the front of the pubic bone, and if left untreated can cause a lot of impairment and difficulty walking during pregnancy, but also cause problems during delivery and in the post partum and beyond period.

We will assess that the muscles can relax well in order to ease delivery, and guide you through the nudge to get baby out and into this world.  Strong pelvic floor muscles leading into the birth will not only help with the delivery, but it is protective against pelvic organ problems and urinary incontinence.

The dreaded pregnancy constipation!  Don’t put up with it! Advice on fluid, fibre and diet is useful, as well as having the most optimal position to take a poop to help it slide on out like a unicorn poop!

Constipation can be addressed before pregnancy, and during.

As baby grows inside, the lungs get a bit squished and the breathing pattern can change.  We help to educate you on optimal breathing, even with baby indoors.

As baby grows your posture changes, which can lead to a host of other problems including back pain, hip pain, trouble breathing, difficulty walking.  You can still maintain a good posture in sitting or standing, even at full term pregnancy.  Let us help you know how.

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 we urge you to know that surgery is not always the first port of call.

Core weakness before pregnancy, or feeling unstable through the core and joints during pregnancy can make everything seem very difficult.  Other pelvic issues like pain with sex can be treated very successfully even when pregnant.

The pregnancy hormones and cravings can wreck havoc on the gut!  Optimising the gut function is one of the best things you can do to support a healthy pregnancy, and maintain a healthy weight.  We want to ensure that your bowels are perfect leading into the birth, free from constipation, straining for motions, with regular motions that are soft and easy to pass.  We will get you practicing to ‘birth your poo’ too!

Our services related to pregnancy

Postural advice

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. 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 diastasis rectus abdominus.

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, breathing problems.  All of this lengthening and weakening of our abdominal muscles can affect the control of our pelvic floor, the core, spine and pelvis.

Birth preparation

We will assess that the muscles can relax well in order to ease delivery, and guide you through and assess the ‘nudge’ to get baby out and into this world.  Strong pelvic floor muscles leading into the birth will not only help with the delivery, but it is protective against pelvic pain and urinary incontinence after birth.  We will ensure you know how to optimise the strength and function of the pelvic floor to support you through pregnancy and improve your recovery.  We help with tips and trick on birth positions, specifically if you have pain or prolapse already, as well as preparing the perineum with perineal massage.  We want to ensure urinary incontinence and constipation is resolved before birth.

Sex and intimacy during pregnancy

Many ladies tell us the fear having sex during pregnancy.  Some women have pain with sex, which can be on sign that the pelvic floor muscles might be a bit too tight.  We can help teach you how to relax the pelvic floor muscles, for pain free sex, as well as an easier birth.

Some ladies with their raging hormones can also have a huge appetite for gourmet sex  when they are pregnant!  Whatever you are feeling, it is ok, and we can help to reassure you.

Pregnancy Exercise and Education class

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, pelvic girdle pain and other pelvic health problems.

Each week’s class will have a unique focus on important concepts, strategies and knowledge to remain healthy and strong throughout pregnancy.  The weekly outline includes alignment, diastasis (tummy muscle separation), breathing, preparing the pelvic floor, good bladder and bowel habits, fluid and nutrition, relaxation and preparing for birth and labour.  We will share our best tips and tricks that we know help our pregnant clients hugely.  You won’t be saying ‘I wish someone had told me this earlier!’

We also offer 1:1 or 2:1 individualised exercise instruction for pregnant clients.

Strength, conditioning, clinical pilates and functional movement

Ladies, we know that you want to keep moving during pregnancy. We want that for you, too. The most important thing you can do however, for your own health and wellness, is to 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 exercise safely and with support, to ensure no lasting damage and that all pelvic organs stay where they should be. We want you empowered and confident. During pregnancy we can give you the tools and techniques to really understand your body changes and set up for success movement and exercise throughout your pregnancy.  There are many misconceptions about exercise in pregnancy and we can help you get the right information and keep you doing the things you love, with the right strategies.

Hire out a TENS machine

A TENS machine can be used during labour to help combat pain. There is a boost setting which can be used for the extra surge of power needed during a contraction pain. It can help increase your own pain relieving chemicals known as endorphins. It can be used past 37 weeks of pregnancy. We hire TENS machines and teach you how to use them.

Frequently asked questions

There is no evidence that internal vaginal examinations during pregnancy cause miscarriage, however due to the higher risk of miscarriage in the first 12 weeks, Pelvic Floor Physiotherapists may not examine internally during the first 12 weeks of pregnancy if there is a history of unstable pregnancy or miscarriage.

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.

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 are a variety of techniques for perineal massage. Our therapists can teach you the needed techniques as apart of your consultation.

Our therapists have backgrounds in exercise prescription and sports science and will work with you to create a one on one exercise program that is tailored to your needs.

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.

Yes! We can assess for muscle tone which can play a role in perineal trauma and give you so many helpful tips and tricks to support you pre, during and post birth.

A Pelvic health assessment will help us understand your current situation. Based on what we find we will give you the needed tools to strengthen the pelvic floor for post birth, learn to relax it at the needed times, teach mobility exercises to improve mobility for birth, teach breathing techniques and teach techniques to protect the abdominals and the pelvis and spine for the future.

Yes! The classes are a mix of yoga, pilate’s, and general strengthening exercises. Because you would have had your initial assessment with us we will understand the level you are at and can adapt the exercises as needed.

Before attending the pregnancy class we recommend you attend a 1 on 1 consult with one of our therapists to assess the pelvic girdle or back pain. That way we can tailor the class and exercises to your needs.

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.

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