Ruth Jones Physiotherapy
"DEDICATED TO HELPING YOU BACK TO OPTIMAL FUNCTION"
Physiotherapy lead by Dr Ruth Jones PhD MCSP
What is specialist pregnancy, post natal & women’s health physiotherapy?
Ruth Jones Physiotherapy is one of the few Southampton or South Coast Physiotherapy clinics to offer a specialist Pregnancy, Post Natal & Women’s Health Physiotherapy service. Ruth Jones is an international leading Physio in this area her PHd was focused on the role of Pelvic muscle ultrasound imaging in patient assessment and management . Ruth Jones Physiotherapy is also one of the only Physiotherapy clinics in the UK to deliver internationally recognised Physiotherapy courses in this specialist area. Ruth Jones is Women’s health Physiotherapy and if you’re not convinced check her out on Google.
What do specialist pregnancy physiotherapists do?
The answer is, they can do a lot!
- They treat pelvic girdle pain ante and post-natally
- Can make a big difference post-natally to your tummy gap (rectus diastasis)
- Can help you return to sport post natally
- Work with female athletes who may have a pelvic problem i.e. triathlete, cross fit, runner
- Assess and treat urinary incontinence (urinary leak) successfully
- Assess and treat a pelvic organ prolapse
- See patients with bowel problems maybe post surgery, post-natally
- See very complex patients who have pelvic pain and have been through a lot of investigations for this
- See very complex patients who have been referred for pain on sexual or sexual related problems
What is Female pelvic pain?
Ruth continues to teach courses in the UK and internationally to other Physiotherapists on Pelvic pain and is recognised as one of the leading figures in this field. She has also published widely on it, including a seminal textbook on pelvic pain. She routinely accepts referrals from other Physiotherapists, Pelvic pain consultants and GPs for a second opinion, and is particularly skilled with complex patients who may have seen numerous other clinicians. Patients will travel long distances to see Ruth.
Pelvic pain can be described as ongoing symptoms in possibly the pelvic area, abdomen, anorectal area (bum), clitoris, vulva or vagina. There may also be pain on sexual activity or passing urine or on bowel movements. It’s likely you will also have undergone considerable examinations such as urological, colorectal with usually negative findings which can be both reassuring and frustrating as the pain and symptoms remain despite the negative tests. The absence of any infectious or bacterial cause also usually results in the somewhat worrying diagnosis of Chronic pelvic pain syndrome. The impact of Pelvic pain and it’s devastating effects are outlined well in our friend and colleague Stephanie’s blog. Help is out there though even though finding it will have challenged you.
Seeing Ruth will have a major impact on your symptoms, condition, relationships and your life.
See Stephanie Prendergast's Blog on Pelvic Pain here
What is Pelvic Girdle Pain
Ruth Jones and her colleagues can make a huge difference to women ante natally who have developed a condition called Pelvic Girdle pain. This can affect up to 1 in 5 women and although more common through the latter stages it can occur at any stage. Pelvic Girdle can lead to quite “nasty” pain in your back, hips, pubic area and lower limbs. It can also affect your mobility or walking and disturb your sleep.
Is it hormonal?
Many women are told it’s due to “lax ligaments” but the current thinking is that it’s more of a problem with some of the joints in your pelvis which may be the pubic symphysis (at the front) Sacro Iliac (back) and or the joints in your low back. This is good news as joint and muscle problems can be treated. Check out the great info on The Pelvic Partnership website at www.pelvicpartnership.org.uk.
Can I have treatment even though I’m Pregnant?
Yes, we see a lot of ladies in the clinic and we get really great results with them. Treatment consists of very gentle joint techniques around your pelvis & Spine, gentle soft tissue techniques to relax some of the muscles in spasm, specialist taping to give you more confidence in moving and reduce some of the apprehension, specialist pregnancy exercises that are safe to do . More importantly we will explain in detail what is going on and what you can do to help at home. Sleep can be a big problem for ladies with pelvic girdle pain and we spend a lot of time sorting this out with you. Everything is a bit better when we get some sleep especially when there is a new baby on the way!
Bowel dysfunction is something one of our colleagues Annette is specialist at. Check out her blog on this here and we can put you in touch with her. She’s brilliant!
We also see ladies post breast cancer and gynaecological cancer. We offer specialist treatment for patients who have undergone surgery, radiotherapy, chemotherapy or endocrine (hormone) therapy for breast cancer.
Treatments are individually tailored to the patient’s needs and aims to:
• Reduce pain and scar sensitivity.
• Improve range of movement of the neck, chest, shoulders and arm.
• Reduce Axillary Web Syndrome – also known as cording.
• Aid with cancer related fatigue.
Specialist breast physiotherapy can help these problems, even if it is months or years after treatment.
We also offer the international Pink Ribbon Program. Which is a series of modified Pilates exercises and has been created to enhance recovery for breast cancer survivors. The program helps to stretch and strengthen shoulder, chest, back and abdominal muscles. Allowing individuals to improve their range of movement and strength to those areas most affected by their breast cancer surgery, treatment and reconstruction.
We believe we have both the expertise and the passion for promoting your well- being after cancer through restoration of movement and getting you back to the things that matter in your life.
This is another very specialised area of Pelvic physiotherapy where there is pain on sexual activity or an inability to be sexually activity due to pain. Some of these conditions may include an over active pelvic floor, vuldodynia, vagissmus, clitoral pain or persistent sexual arousal.
Female Athletic Pelvis
One of our big interests in the clinic is the Sporting pelvis and we see a lot of international and premiership footballers, athletes, crossfitters, dancers and weekend warriors. Ruth also teaches on the athletic pelvis in the UK and internationally.
Are you a sports woman in Ballet, Performing arts, gymnastics, athletics, Olympic or power lifting? Are you a Tri-Athlete or runner or maybe you enjoy Crossfit , boot camp or Military fitness? Maybe you have recently returned to sport after having a baby.
Whether you have had children or not you have a pelvic floor which works with your rib cage, breathing mechanism and abdominals to support your lumbar spine and pelvis. If you do sports especially at a high level your Pelvic floor is very very important.
We know the incidence of stress incontinence in the general public is 1/3 and has been found to be much higher in some elite sports. People performing at elite level sport tend not to have had children so this relates to you also even if you haven’t had kids. Ok there are exceptions like Paula Radcliffe and Jessica Ennis but they are the exception.
Kids or no Kids: Your Pelvic floor is important for sports.
If you have any of the following it may mean you have a pelvic floor problem
- Leakage of urine while training or performing (this is not normal). This may progress to leakage on more normal everyday activities.
- Rectal symptoms (oops!) usually release of gas ie farting on activities. This is also not normal.
- Doming of the abdomen on training or lifting post natally and a definite gap in the abdominals. This is a Rectus Diastasis or Tummy Gap that needs addressing.
- Feeling of heaviness or pressure in the vagina. This can often mean you may be developing or have a prolapse. Again, the is not normal.
- Pain in the pelvis, groin, lumbar spine, hips on training.
- Symptoms usually pain that are not improving with traditional physiotherapy or treatment.
- Performance being affected or reaching a plateau with training or competing due to a spinal or hip/pelvis problem that hasn’t responded to treatment.
- Hip and groin pain or back pain that other treatment such as surgery or injections haven’t helped.
- Pain on sexual activity that is getting worse with increased training.
How will Specialist Pelvic Floor Physiotherapy Differ that other treatment I’ve had?
A lot is the basic answer.
You will have a discussion about your symptoms and how they relate to your urinary control and whether you have any pelvic, groin, vaginal symptoms. You will also discuss whether your symptoms are affecting your sexual activity or activities like using a tampon.
What will the Assessment involve!
Yes, Your pelvic floor will be examined but this initially doesn’t involve an internal examination. Initially your pelvic floor can be reliably assessed using ultrasound imaging by your physio. This is a little bit like the scanning that is done during pregnancy although without the baby bit !
We will see how well you can contract the fast twitch part of your pelvic floor ( Usain Bolt bit) and the endurance part ( Mo Farah bit) . Like your calf muscles both fibres are important especially if you are a sports person.
We will also look at how well you can work your Mo and Usain fibres while doing weigh bearing activities such as squatting, lunging, jumping, landing etc. This is dynamic pelvic floor assessment and relates to your sport.
Lots of time is also spent seeing how your pelvic floor works with your abdominals , hip and breathing muscles. This is where the problem tends to be i.e they don’t work well together.
We also look at your hip, lumbar spine (low back ) and pelvic joints and your rib cage to make sure it’s all moving and working well.
Will I need to stop training?
This is unlikely as training is a key part of your rehab process but possibly with some modifications.
What will Treatment consist of?
- Yes, there will be pelvic floor exercises but very specialised ones for the Mo and Usain bits but in very functional dynamic ways.
- Specialised abdominal/breathing strategies.
- Manual (hands on) treatment to your lumbar spine, pelvis and hips where needed.
- Yoga type mobility exercises to get your optimum moving back.
- A lot of fun as if you enjoy your rehab it’s likely you’ll do it.
Post Natal Return to Sport & Exercise
Whether it’s Triathlon, Mud run, couch to 5, pilates , yoga, buggy fit or Zumba returning to exercise can be challenging especially if there is an increased tummy gap, weak pelvic floor or post natal symptoms such as pelvic pain, low back pain or urinary leakage. Seeing a post natal physio specialist will allow you to return to exercise at an appropriate level and will give you the confidence that to do so. Exercise is good and important but with the right amount and type post natally.
Post Natal Complications
Those who come may be having problems such as Low back or pelvic pain, Rectus Diastasis ( Tummy gap) Pelvic floor issues, urinary leakage , constipation, abdominal ( tummy ) weakness , difficulty returning to sport & exercise. We also see ladies who have symptoms of pelvic organ prolapse or pain and symptoms post perineal trauma.
The Active and sporty Pregnant Female
We also see ladies who are pregnant who develop neck and low back pain, shoulder, knee problems and we are very comfortable treating these.
In Ruth Jones Physiotherapy we have a lot of expertise treating a range of female sports people from Elite Athletes, Yogis , Tri-athletes, Runners, Hockey and netball players, dancers, weekend warriors and recreational athletes. Pregnancy doesn’t mean having to stop exercising but modifying it. The sporty and active pregnant female is always re-assured coming to us as we have a unique combination of sports and pregnancy expertise.
Prolapse & Urinary Incontinence
Some of the main conditions we see are:
There are many types of urinary incontinence ( involuntary urinary leakage) and it affects approx. 1/3 of women. This responds very well to expert and specialised pelvic rehab. Check out the video from our friends down under!
What does a Specialist Pelvic Physio do?
A pelvic physiotherapist will assess your pelvic floor to understand why there is a prolapse or urinary or faecal incontinence. Using the most up to date treatment techniques, they will determine whether physiotherapy can "cure" you of your problem and then through a method of manual therapy, self treatment and an exercise regime, work towards that goal.
Pelvic Organ Prolapse
This is where your pelvic organs ( bladder, uterus ) may bulge or press down into the vagina. You can also get a rectal prolapse. Ladies who have a pelvic organ prolapse often describe heaviness or pressure in the vagina, lump in the vagina, problems passing urine, difficulty with bowel movements, pain on sexual activity and a lump bulging out of your vagina.
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