Your care
Your care
We aim to
- Provide you with a better understanding of your problem
- Provide you with treatment to help resolve your physical problems
- Allow you to better manage your problem day-to-day
- Allow you to feel more confident whilst living with your problem
- Support you to live a less limited life.
During your appointment - the initial conversation
The most underrated part of the assessment- It gives us the foundations to build a thorough assessment on.
We want to know:
- What the problem is
- How the problem is affecting you
- What you have been through
- How you want us to help you
- What you want to achieve with physiotherapy.
This allows us to build a picture of everything that has come before to make the next steps as effective as possible.
During your appointment - the assessment
We use this part of the assessment to confirm our diagnoses from the questions we have previously asked.
On completion of the assessment, we will:
- Fully explain our findings and your problem
- Explain the possible options for treatment
This allows YOU to be involved in each step of this assessment and allows us to provide the most successful and personalised treatment possible, based on the best and most recent clinical evidence and their own clinical experience.
To fully assess and observe how a joint / area of your body is working, there is a potential we will ask you to undress that area of the body. If you don't feel comfortable to do so, please let us know!
Check yourself
Check yourself
Deep vein thrombosis (DVT)
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in the deep veins in your body, usually in your legs.
It is important to prevent a DVT if possible, and to watch for early signs and symptoms.
Symptoms
DVT:
- Pain/tenderness
- Swelling
- Discoloration (bluish, purplish or reddish skin)
- Warmth
- Numbness/tingling
- Can also be present with no symptoms.
Pulmonary Embolism (PE) - A potentially life-threatening complication of deep vein thrombosis (DVT):
- Shortness of breath
- Chest pain (which may be worse with deep breath)
- Unexplained cough (may cough up blood)
- Unexplained rapid heart rate.
Caused when part of the blood clot breaks off and lodges in the lung.
If you experience any of these symptoms, you should seek urgent medical attention at your GP or A&E at your local hospital.
Risk factors
Immobility:
- Hospitalization
- Being paralyzed
- Prolonged sitting.
Surgery and Trauma:
- Major surgery
- Bony Fractures / Casts
- Catheter in a big veins.
Increased oestrogens:
- Birth controls
- Pregnancy and Post Pregnancy
- Hormone therapy.
Medical conditions:
- Cancer and chemotherapy
- Heart failure
- Inflammatory disorders
- Blood clotting disorders.
Other risk factors:
- Previous blood clot
- Family history of clots
- Clotting disorders
- Obesity
- Older age
- Cigarette smoking
- Varicose veins.
Prevention
- Regular activity
- Take regular breaks to stretch your legs and move around
- If your legs tend to swell, raise your legs regularly
- Do not smoke
- Avoid prolonged pressure on the back of the knee.
- Stay hydrated
- Maintain an ideal body weight.
If you are hospitalized or planning for surgery, you may be given a blood-thinning medication (anticoagulant) or special stockings designed to prevent blood clots.
Make sure you discuss your own family history and risk factors for developing a clot with a doctor.
Cauda equina syndrome (CES)
CES is a rare but serious back condition. It can lead to permanent damage or disability. You will need to be seen by an urgently by an Emergency Specialist Spinal Team.
Symptoms
- Loss of feeling/pins and needles between your inner thighs or genitals
- Numbness in or around your back passage or buttocks
- Altered feeling when using toilet paper to wipe yourself
- Increasing difficulity to urinate
- Increasing difficulty when you try to stop your flow or urine
- Loss of senseation when you pass urine
- Leaking urine or recnet need to use pads
- Not knowing when your bladder is either full or empty
- Inability ot stop a bowel movement or leaking
- Loss of sensation when you pass a bowel movement
- Change in ability to achieve erection or ejaculate
- Loss of sensation in genitals during sexual intercourse.
If you experience any of these symptoms, you should seek urgent medical attention at your GP or A&E at your local hospital.
Surgical wounds
Surgical wounds
Most surgical wounds heal up rapidly without and problems. However, a minority of surgical wounds do become infected. This occurs when germs enter the cut that the surgeon makes through your skin in order to carry out the operation.
Many germs live in and on our bodies and also in our environment. Most are harmless or even useful. Our bodies have natural defences against the germs that can cause harm. Our skin normally prevents germs from entering our bodies, but any break in the skin (whether due to injury or surgical incision) can allow them to enter and cause an infection.
URGENT: Any suspected infection should be taken seriously. If it is left untreated it can progress into a much more serious problem.
Signs and symptoms
- The skin round your wound gets red or sore or it feels hot and swollen
- Your wound has a fluid discharge, often green or yellow coloured pus
- Your wound opens up
- You feel generally unwell or feverish, or you have a temperature.
If you experience any of the above symptoms, you should seek urgent medical attention at your GP or A&E at your local hospital.
MRI information
MRI reports
Don't worry about what you read in MRI reports
When you have a scan the report will always show "stuff“ (disc bulges / degeneration / dehydration and facet joint degeneration) however research has shown this is rarely linked with pain.
People who have never had low back pain also have “stuff” on an MRI, the “Stuff” can create a lot of worry that can distract from helpful activities like exercise. These things are normal parts of the aging process – like grey hairs or wrinkles.
A scan is only essential if serious disease is suspected.
Common terminology
Common terminology
Don't be put off by common terminology
You may have heard the terms;
- "out of place"
- "slipped
Research has clearly shown that this does not happen to discs, bone or joints in your back. Anatomically your back is a strong stable structure capable of lots of movement. If a person experiences a severe episode of back pain when lifting, nothing has fallen out of place - though it might feel like it!
Pelvic health physiotherapy
Pelvic health physiotherapy
Please note: this information is for people who have been referred to the pelvic health physiotherapy service by their GP or consultant. The service is only available to those referred by a healthcare professional.
What is pelvic health physiotherapy?
Pelvic health physiotherapy is a part of physiotherapy that helps with the health and function of organs in the pelvis, like the bladder, bowel, and uterus, as well as the muscles around them.
Our experienced physiotherapists can assist with issues such as leaking urine or stool, pelvic organ prolapse, and painful conditions in the pelvis, including vulvodynia, vaginismus, and pelvic pain.
These problems are often related to how well your pelvic floor muscles are working.
What can I expect at my physiotherapy appointment?
Your assessment will happen in a private room, and everything discussed will stay confidential. It's normal to feel a bit nervous before your appointment, but our team is here to help you feel comfortable and supported.
When you arrive, someone at Reception will welcome you and take you to the room for your assessment. To better understand your condition, your physiotherapist will ask you some questions about your symptoms, such as:
- When did your symptoms start, and what are they?
- Are there any activities or movements that make your symptoms feel better or worse?
- How many times do you go to the toilet during the day and night?
- How much and what types of drinks do you usually have?
- Have you had any tests or procedures for this issue?
- What medications are you currently taking?
- What do you hope to achieve through physiotherapy?
After going through these questions, your physiotherapist will talk with you about the physical examination, which may include an internal check-up.
What is an internal examination?
An internal examination is a way to check the health and condition of the muscles in your pelvic area. It can be done through the vagina or the anus. Your physiotherapist will first show you a model of the pelvis to explain what will happen during the exam.
The process is gentle, and we don't use any tools like speculums. We will only continue if you agree, and you can stop the exam whenever you want. You are welcome to bring a friend or family member with you, or you can ask for someone to be there with you for support if that makes you more comfortable.
What happens next?
Your physiotherapist will talk to you about what they found during your assessment, using pictures and models to make things clearer. Together, you'll create a treatment plan, which will probably include exercises tailored for your pelvic floor muscles and other related muscles. Feel free to ask questions anytime during your assessment. Your physiotherapist will usually schedule another appointment for you about 4 to 6 weeks later to check on how you're doing.
Further information
You may find the following leaflets and online resources useful.
- Patient information from the Pelvic Obstetric and Gynaecological Physiotherapy website
- Booklets and resources from the Pelvic Obstetric and Gynaecological Physiotherapy website
- Squeezy - a smartphone app reminding you to do your pelvic floor exercises and providing pelvic health advice and information (£2.99 download cost)
- Leaflets from the International Urogynaecology Association (IUGA) (variety of Languages available)
- Your Pelvic Floor website
- Bladder Health UK website
- Bladder and Bowel Community website
- Pelvic floor exercises information leaflet [pdf] 567KB
- Pelvic floor trauma information leaflet [pdf] 334KB
- Overactive bladder information leaflet [pdf] 336KB