Pelvic Health: Ruth Schubert's Top Tips for Women
Name: Ruth Schubert
Job: Pelvic health physiotherapist
Location: Byron Bay NSW
The first 10 years of my career was spent in sports medicine, working with football teams. Once I had my first daughter, I couldn’t believe the difference in the care birthing women received compared to the athletic population! My own pelvic health journey inspired my drive to create change and improve the outcomes of those with pelvic health concerns.
This narrative is changing, with more awareness and incredible advocacy through social media platforms. However, there is a deeply personal and emotional impact of pelvic dysfunction that makes it hard to discuss. That’s why it is critical we continue to train trauma informed professionals who are caring and passionate about improving outcomes for those with pelvic problems.
Pelvic floor problems can start at any time, and for many people, this is way before pregnancy and birth. For example, did you know nearly 30% of girls can have bladder leakage with exercise? Pelvic physios also treat bowel dysfunction and constipation which can start at any age.
One of the main focuses of my clinical and research work is in menstrual pain and endometriosis which can result in a pelvic region that is overly sensitive and tight.
Another myth is that you must have a vaginal exam when seeing a pelvic physio. We have so many options at our disposal (including abdominal and pelvic ultrasound) which can give us great insight without having to do an internal exam if this is a concern for you.
The hormonal changes we see throughout the cycle impacts the ligaments and muscles of the pelvic floor. A common symptom is that women may feel more symptomatic (e.g pelvic dragging or urinary leakage) as they lead into their period. Additionally significant menstrual pain and inflammation can increase the tension and sensitivity in the pelvic region leading to a cascade of other symptoms (e.g. bowel pain or pain with intercourse).
Pain in the pelvis can increase the sensitivity of the nervous system and muscles leading to other pelvic problems (eg IBS, sexual pain etc). Endometriosis is linked with IBS, bladder pain, pain with intercourse and a whole host of other pelvic floor symptoms which are very treatable.
[When it comes to menstruation,] the muscles and the nervous system in the pelvis respond to the hormonal and inflammatory changes during our period and can increase menstrual pain, but also create other symptoms outlined above.