You can use the following sections to find advice and exercises to help you manage pregnancy related aches and pains and concerns
If you have followed the advice and exercises provided but you still require to contact the Physiotherapy Department, you can complete our self-referral form.
Pregnancy related Pelvic Girdle Pain
Pregnancy related Pelvic Girdle Pain is aches and pains experienced during pregnancy or in the early post-natal period around pubic bone, groin, buttocks, hips and/or lower back.
Use the links below for advice on how to manage Pregnancy related Pelvic Girdle Pain (PPGP)
Working from Home – Advice and Exercises: https://www.csp.org.uk/publications/do-you-sit-desk-all-day-leaflets
Reproduced with permission of Pelvic Obstetric and Gynaecological Physiotherapy (pogp.csp.org.uk) and the Chartered Society of Physiotherapy (csp.org.uk).
Pregnancy related Low Back Pain is pain experienced during pregnancy or in the early post-natal period around the bottom of your back. If you have pain in other areas around your back, this information will also be useful.
Use the links below for advice on low back pain during pregnancy or after having a baby:
Diastasis Rectus Abdominus Muscle (DRAM) is the normal widening of your tummy muscles during pregnancy to accommodate your growing baby. After having your baby, this widening can take up to a year to recover.
Factors that may increase the risk of developing DRAM are;
Multiple Pregnancy or larger babies
Stretching in previous pregnancies
Poor abdominal muscle tone
Genetics
A small amount of widening of the abdominal muscles, 2-3 fingers width, is common after most pregnancies and likely to resolve with time. You can check you gap by following the steps below;
Lie flat on your back with your knees bent and your feet flat on the bed
Place 4 fingers on your abdomen just above your belly button
Raise your head and shoulders slightly off the floor
You will feel the two abdominal muscles coming together against your fingers – this is the size of your gap – remember there may not be a gap and that is a sign that your DRAM has resolved.
If you notice the following then you may require a specialist physiotherapist to review;
The gap is more than 3 fingers wide
A visible small bulge protrudes at your midline
Your fingers sink deeply into your abdomen
You can self refer for this up to 6 months after you have had your baby by completing the following form;
Reproduced with permission of Pelvic Obstetric and Gynaecological Physiotherapy (pogp.csp.org.uk) and SqueezyApp.com
Coccydynia
Coccydynia or tailbone pain is pain experienced on the sitting bone, specially when sitting. This can appear during pregnancy or in the early post-natal period due to the changes happening to your body.
Use the links below for advice about coccydynia or tailbone pain:
Reproduced with permission of Pelvic Obstetric and Gynaecological Physiotherapy (pogp.csp.org.uk) and the Chartered Society of Physiotherapy (csp.org.uk).
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is pain, numbness, pins and needles and tingling of the fingers and hand(s). There may be also swelling of the hands and you might feel your hands are clumsy, weak and tire easily. This can appear during pregnancy or in the early post-natal period due to the changes happening to your body.
Use the links below for advice on how to manage carpal tunnel syndrome:
DeQuervains Synovitis is pain on the base of the thumb, swelling and reduced movement. This can appear during pregnancy or in the early post-natal period due to the changes happening to your body.
Use the links below for advice on how to manage DeQuervains Synovitis:
NHS Greater Glasgow & Clyde has 6 Health and Social Care Partnerships (HSCPs) within its area. You can find local contacts on their websites. Your HSCP
The ward team will discuss with you and your family to assess what services you need and the ward will organise these before you go home. These services can still be arranged when you are at home if required.
Palliative and End of Life Care services and resources for patients and carers living in the Greater Glasgow and Clyde area can be accessed through NHS Inform.
NHSGGC – Voices from NHSGGC Palliative Care Accelerated Design Event
This short video shares some of the hopes, aspirations and experiences of participants who attended an accelerated design event in NHSGGC to help develop a new strategy for palliative care across our whole system.
Our X account links palliative and end of life care news, resources & organisations across the Greater Glasgow and Clyde area, Scotland and the UK. www.twitter.com/palliativeggc
Additional Social Media on Palliative Care and Bereavement
CHAS – Twitter Account Children’s Hospice Association – ‘We care for children across Scotland with life-shortening conditions. Even in the pain of grief, we’re determined joy lives on’.
Adult Disability Payment, which replaces Personal Independence Payment (PIP), is launching nationally across Scotland on 29 August 2022.
This means Scotland’s new terminal illness definition, based on clinical judgement, will apply to adults (aged 16 to state pension age) who become terminally ill. This moves away from the current DWP time limited ‘6 month’ definition.
From 29 August 2022, BASRiS forms instead of DS1500 forms should be completed to support applications for disability assistance for the following groups:
Children: for all children living in Scotland age 0 to 16 years: complete a BASRiS form and return it to Social Security Scotland
Adults: age 16 to state pension age: complete a BASRiS form and return it to Social Security Scotland
Adults over state pension age: please continue to use a DS1500 and return to DWP. The date for when you will be able to use a BASRiS form for adults over state pension age is still to be announced.
Your Health Care Professional should be able to access the relevant resources to support applications.
NHSGGC Bereavement Support for Parents, Siblings and Staff
Child Bereavement UK has been commissioned by NHS Greater Glasgow and Clyde with funding from Glasgow Children’s Hospital Charity to provide bereavement support for families bereaved of a baby or child, and training to support NHSGGC staff.
Child Bereavement UK is a national charity which supports families and educates professionals when a baby or child dies or is dying, or when a child is facing bereavement.
Contact NHSGGC Service Telephone. 0141 370 4747 Email. GHsupport@childbereavementuk.org
This leaflet provides information to family and friends when someone is dying. It discusses food and fluids, medicines, breathing, communication and other changes.
The NHSGGC Booklet ‘When Someone Has Died, Information and Support for Relatives & Friends’ has been replaced by the new National Booklet ‘When someone has died – information for you’.
Lifelink offers a range of stress services for adults and young people in communities and schools across Glasgow City.
Living Life
Living Life is a free telephone service available to anyone over the age of 16 who is suffering from low mood, mild to moderate depression and/or anxiety.
NHS Inform
NHS Inform Bereavement area can help you find answers to your questions and guide you through the early days of your bereavement. It can also help you understand more of the experience of loss in the days that lie ahead.’
Good Life, Good Death, Good Grief
Good Life, Good Death, Good Grief is working to make Scotland a place where there is more openness about death, dying and bereavement so that:
People are aware of ways to live with death, dying and bereavement
People feel better equipped to support each other through the difficult times that can come with death, dying and bereavement
EQUIPU
EQUIPU is a service responsible for providing, delivering and installing a range of disability equipment supplied by health and social work services to disabled people living at home.
For further information or to arrange uplift contact:
Arrangements for Death Certification may have changed due to Covid-19. Local Authority websites linked below should have the latest information from your area. The latest National information can also be found on the following websites.
The Macmillan Information and NHS Bereavement Centre is based at Glasgow Royal Infirmary.
The Centre is located on ground floor of the centre block of Glasgow Royal Infirmary. You can drop in between 9.30am and 4.30pm Monday to Friday. For more information call 0141 451 5373 or email macinfoandnhsbereavement@ggc.scot.nhs.uk
The service provides patients, families, carers and staff access to information materials on various types of cancer, long term conditions and their treatment. The team can provide a listening ear and signpost you onto other support services such as benefits advice, a dedicated one-to-one support worker through Macmillan’s Improving the Cancer Journey, or help to get active. Please visit us and see if we can offer you any assistance. We can also visit you on the ward.
We can provide:
time to listen and talk in a comfortable, friendly environment
leaflets and booklets on all aspects of living with and beyond cancer
access to additional cancer support
leaflets and booklets about living with long term conditions
We also offer:
help to arrange counselling and free complimentary therapy appointments if you are affected by cancer
support to access practical help, such as help at home and travel insurance
referral to other available support services.
We will be working in partnership with Palliative and Spiritual Care to offer people the right support at the right time.
The team can also provide emotional and practical advice around end of life care, including information about power of attorney, wills and funeral planning. We also offer support with complex bereavement issues, bereavement counselling and benefits advice to help cover the cost of the funeral.
We can offer information and signposting including:
what you need to do when someone dies
information about carers support for people looking after someone for example a partner, a patient, a relative with cancer or another long term condition
access to other organisations that can help, including local support groups
assisting with repatriation
discussing organ and tissue donation
face to face training for staff
end of life care
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We’re a team of highly skilled physiotherapists who specialise in pelvic floor/health dysfunction. At your appointment, a Specialist Physiotherapist will take a detailed history and, if appropriate, may carry out an examination. Some of the questions may be personal in nature, and your Physiotherapist will explain this at the beginning of your consultation.
In this section, you’ll find an overview of the conditions we treat, some useful resources and advice for managing them, how to access our service and the various locations of our clinics.
What are your Pelvic Floor Muscles?
The pelvic floor muscles are a hammock of muscles that lie beneath your pelvis. Their role is to support the bladder, the bowel, and the uterus. The pelvic floor muscles work to help keep the bladder and bowel openings closed to prevent unwanted leakage (incontinence) and they relax to allow easy bladder and bowel emptying. The pelvic floor muscles also help with sexual intercourse by allowing for increased vaginal sensation for women.
How to Exercise your Pelvic Floor Muscles
To exercise the pelvic floor muscles, lie sit or stand with your knees slightly apart. Tighten up your back passage as though you are trying to stop yourself passing wind. At the same time tighten the muscles that you would use to stop yourself from passing urine. The feeling is one of ‘squeeze and lift’, closing and drawing up the back and front passage (imagine you are trying to stop urine and wind from passing at the same time).
There are two ways to exercise your pelvic floor muscles:
Slow Squeezes
Tighten your pelvic floor muscles for up to 10 seconds
Relax fully for 4 seconds
Now tighten again for the same time
Relax fully for 4 seconds
Repeat this until your muscles get tired
Fast Squeezes
Quickly tighten up your pelvic floor muscles
Hold for 1 second and relax
Repeat this until the muscles get tired
Bladder Issues
Bladder dysfunction/issues refers to problems with storing or emptying urine. It can affect both men and women and may have a significant impact on daily life. Physiotherapy can help manage many types of bladder problems using non-surgical methods. Common types of bladder issues include:
Stress Urinary Incontinence
Stress urinary incontinence (SUI) occurs when urine leaks out during activities that put pressure on the bladder. It can happen when you cough, sneeze, laugh, lift, exercise, rise from a chair, walk upstairs or downstairs, or during sexual intercourse. Physical strain increases the pressure on the abdomen, which in turn puts pressure on the bladder. If the pelvic floor muscles or the muscles controlling the bladder are weak, urine can leak out. While SUI is more common in women, some men can experience it as well.
Urinary Urgency
Urinary urgency is a sudden, strong need to urinate that’s difficult to delay. It can happen even if your bladder isn’t full and may make you feel anxious about finding a bathroom in time.
Urinary Urge Incontinence
Urinary urge incontinence (UUI) happens when you leak urine because of a strong urge to empty your bladder. You may not make it to the toilet in time. It is often caused by bladder muscles that squeeze too often or without warning.
Overactive Bladder
Overactive bladder (OAB) is a condition that includes:
A strong, sudden need to urinate (urinary urgency)
Going to the bathroom more than 6 to 8 times during the day (frequency)
Waking up more than once at night to urinate (nocturia)
Sometimes leaking urine before reaching the toilet (urinary urge incontinence)
Common Causes of Bladder Issues
Life stages: Pregnancy, childbirth, ageing, menopause.
Weight and lifestyle: Obesity, high-impact activities (e.g., trampolining).
Pelvic Floor Exercises: Strengthen the muscles that support the bladder and improve control.
Bladder Training: Helps increase the time between toilet visits to reduce urgency and frequency.
Lifestyle Advice: Guidance on fluid intake, diet, and healthy toileting habits to support bladder health.
Electrical Stimulation: A gentle current may be used to activate and strengthen weak pelvic floor muscles when they are difficult to contract.
Biofeedback: Uses sensors to show how the pelvic floor muscles are working, helping you learn how to contract them correctly.
Bowel Issues
Good bowel health is very important to feel healthy and when things aren’t working properly it can quickly affect quality of life. It is estimated that bowel problems affect 10% of the general population. Physiotherapy can help you manage these issues and whilst it can be difficult to talk about, our Physiotherapists will make you feel at ease whilst trying to help you with your issues. Common types of bowel issues include:
Constipation
Constipation is where there are changes to how you move your bowels, including not opening your bowels as often as normal and finding it hard to get your stool (poo) out. Often the stool is hard and lumpy and difficult to pass. Most people will suffer from an episode of constipation at some point in their lives, but usually this is temporary and not serious. Unfortunately, for some people constipation can become a long term issue.
What Can Help:
Stay Hydrated: Aim to drink 1.5–2 litres of water-based fluids each day.
Diet: Eating more fibre can help keep stools soft and easier to pass.
Toilet Positioning: Using the right posture on the toilet can make bowel movements easier. Watch this video for tips.
Faecal incontinence is when there is an unwanted leakage of stool or wind from the back passage. It can be an extremely distressing condition that can be made worse by diarrhoea. It can happen without warning or can be associated with an urge to move your bowel but an inability to make it to the toilet on time.
What Can Help:
Anal Sphincter Exercises: Strengthening the muscles around the back passage can improve control.
Healthy Diet: Make sure you’re eating enough fibre to keep stools well-formed.
Toilet Positioning: Using the correct position can help with better bowel emptying. Watch this video for tips.
Medication: Some people may benefit from medication—speak to your healthcare professional.
‘Just Can’t Wait’ Card: This card gives you quicker access to public toilets. You can apply for one online here.
Obstructive Defecation
Obstructive defecation is a term used to describe having difficulty opening your bowels. It is often associated with frequent visits to the toilet and a feeling of being unable to fully empty the bowel. This can result in excessive straining, which can increase the risk of vaginal or rectal prolapse.
Normally, when you open your bowels, the muscles around the back passage relax to allow stool to pass. In obstructive defecation, these muscles may not relax fully, or they may even tighten, making it harder to have a bowel movement.
What Can Help:
Fluids: Drink 1.5–2 litres of water-based fluids daily.
HealthyDiet: Make sure you’re eating enough fibre to keep stools well-formed.
Stay Active: Aim for 30 minutes of physical activity a day to support bowel movement.
Belly Breathing: This relaxation technique helps release the pelvic floor. Your physiotherapist can teach you how to do it correctly.
Faecal Urgency
Faecal urgency is a sudden and strong urge to empty your bowels. You may reach the toilet in time, but it can also lead to accidental leakage/faecal incontinence.
What Can Help:
Healthy Diet: Keep your diet balanced and rich in fibre to regulate bowel movements.
Holding On Programme: This programme helps train your bowel to delay the urge to go. A healthcare professional can guide you through it.
Anal Sphincter Exercises: These exercises strengthen the muscles around the back passage to improve control and confidence in your ability to get to the toilet on time.
Pelvic Organ Prolapse
Pelvic Organ Prolapse (POP) occurs when one or more of the vaginal walls, or the top of the vagina, move downwards, leading to a bulge or a sensation of heaviness at the vaginal entrance. This may cause pressure or discomfort in the vagina, and in some cases, you may feel a bulge inside or outside the vaginal opening. Prolapse can also affect your bladder, bowel, or sexual function.
What Can Help:
Pelvic Floor Exercises: Regular pelvic floor exercises can help support the pelvic organs and reduce symptoms over time.
Pelvic pain can have many different causes. It’s important to get the underlying cause checked by your GP, Advanced Nurse Practitioner, Sexual Health Clinic, or Consultant. Depending on the diagnosis, Pelvic Health Physiotherapy may help you manage and reduce your symptoms.
Bladder Pain Syndrome
Bladder pain syndrome is a condition that causes pelvic pain and difficulty urinating. It can be difficult to diagnose because there isn’t a single test that can confirm it.
Vaginismus
Repeated difficulty allowing vaginal entry of a penis, finger, or other object. It may lead to involuntary tightening of the pelvic floor muscles, along with fear or pain.
Dyspareunia
Dyspareunia is painful sex. This can be pain or discomfort at the opening to the vagina or felt deeper into the pelvis.
Tight or Overactive Pelvic Floor Muscles
Pelvic floor muscles may be tense or overactive. This can be linked to conditions such as Endometriosis, Adenomyosis, Irritable Bowel Syndrome (IBS), or Vulvodynia, or may occur alongside other causes mentioned above.
What Can Help:
Relaxation techniques: Learning to relax your pelvic floor and abdominal muscles can help reduce pelvic pain.
Brook – Painful Sex: Information on causes, symptoms, and ways to manage painful sex.
Pelvic Pain: Comprehensive guide to understanding pelvic pain and management strategies.
Before and After Gynaecology Surgery
You will be seen by a specialist physiotherapist on the gynaecology ward following your surgery. They will provide guidance on:
Staying comfortable during your hospital stay
Getting up and moving safely after surgery
Advice on improving your recovery and beyond, allowing you to return to your normal activity levels
You may be invited to attend a GERAS Class (Gynaecological Enhanced Recovery After Surgery) at one of the NHS GGC hospitals. This is a one-off session that provides advice on preparing for surgery and supporting your recovery.
If you need physiotherapy after your surgery, speak with your consultant or GP, who can refer you to the GGC Pelvic Health Team.
After your prostate cancer diagnosis and the decision to have Robotic Assisted Removal of Prostate (RARP) surgery, your Urology consultant or clinical nurse specialist will inform the GGC Pelvic Health Team.
You will be invited to attend a pre-surgery appointment at one of the NHS GGC hospitals. This may be offered individually or as part of a group session. The appointment aims to provide:
Advice about your surgery
Information on staying comfortable and moving safely after surgery
Education on pelvic floor muscle exercises to help manage likely urinary incontinence after surgery
Guidance to support your recovery and help you return to normal activity levels
Post-Surgery Follow-Up
A follow-up appointment will be arranged from six weeks after surgery to monitor your progress. Any additional appointments will depend on your recovery and symptoms.
Useful Resources
Prostate UK – Information and support for men with prostate conditions.
Prostate Scotland – Support and guidance for people affected by prostate issues in Scotland.
NHS Greater Glasgow and Clyde’s Did Not Attend and Cancellation Policy
If you fail to answer a telephone or video appointment or fail to attend any face-to-face appointment and don’t contact us within 24 hours, we will discharge you.
If you cancel an appointment on more than 2 occasions, we will discharge you.
To cancel or change your appointment please contact your Obstetrics, Gynaecology and Pelvic Floor Physiotherapy Department with as much notice as possible.
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