Glute activation

Exercises for Lower Back Pain

A very important part of lower back pain management is exercise prescription. Exercises for lower back pain can be used to improve a variety of potential causes of your back pain. These can include reducing stiffness in the area, improving motor control (activating the correct muscles), improving your strength in the lower back region and associated other areas.

With any back pain, it is ideal to consult your Physiotherapist to have a treatment plan individualised to your injury. If you book in for a session at Barefoot Physiotherapy, your lower back pain treatment plan will typically include; manual therapy, advice and education, stretching or trigger point releases, self-management strategies and exercises to improve your lower back pain. When reducing pain, a part of the treatment plan is helping clients understand how they can prevent their lower back discomfort from reoccurring. It is very important to ensure clients have good work postures, exercise techniques, manual loading, and heavy lifting ergonomics in this instance. When you move well, you are less likely to overload your muscles and injure yourself. 

Lower Back Pain Exercise Examples

There are some typical exercises and stretches examples listed below that clients will often be prescribed for their lower back pain management; however, it is recommended your consult your health professional to decide what works best for your body.

  1. Glute trigger point releases with a lacrosse ball 
  2. Glute stretches 
  3. Hip flexor stretches 
  4. Child’s Pose Stretch 
  5. Deep 360-degree breathing exercises 
  6. Pelvic tilts 
  7. Glute activation squats 
  8. Cat / Cow stretch 
  9. Step ups with glute activation focus
  10. Weight shift with a focus on glute activation

On our website under the Learn More tab we have a variety of lower back exercises for your reference. Click here to learn more.

If you are experiencing any of the lower back pain symptoms mentioned, please don’t hesitate to reach out to the friendly team of Physiotherapists at Barefoot Physiotherapy. They can help relieve your pain and improve your quality of life. You can give us a call on 1300 842 850 or book online


TMJ physio

TMJ Exercises

You may have already seen our jaw releases, which can be very helpful to relieve tension in the jaw and give quite immediate relief. There are additional TMJ exercises for motor control and strength that your physiotherapist may give you. These TMJ exercises can help to reduce likelihood of the jaw muscles tightening back up and to provide ongoing relief from your jaw muscle/joint pain.

TMJ Exercises: Resting jaw position

If we have a tendency to habitually hold tension in our jaw (whether it be the result of postures, habits, or stress), we want to break this cycle! It can take a lot of practice and repetition to form a new habit, so we want to be able to practice this regularly. Here is a TMJ exercises to help relax the jaw.

It can be helpful to become more conscious of the tension we hold in our jaw throughout the day. See if you can notice patterns of when you tighten through your jaw. It might be when at work, driving, or just the end of the day. For best effects, these activities/time of day can be the best place to start practicing your relaxed jaw position.

Specifically, this looks like:

· Tongue resting on the roof of your mouth, behind your top teeth

· Bottom jaw should feel “heavy.” Teeth should not be touching, but lips will be closed (or only resting slightly apart)

It can also feel nice for your hands to rest on the side of the face, hanging down to help the jaw feel heavy and relaxed.

TMJ Exercises: Mindful practice with opening/closing of jaw

Feel TMJ with fingertips (just in front of ears) – if you open/close your mouth you should feel the joint moving under your fingers.

Slowly start to open mouth comfortably (stopping before any clicking occurs). Focus on keeping the joints centred through opening, then closing your mouth

Jaw stability exercises and strength exercises

Jaws don’t just open and close. They also move side-to-side and forward-and-backwards.

We want to be able to activate and strengthen the muscles responsible for these movements. Use your fingers to push against the jaw in different positions, and not push your jaw out of the resting jaw position we just learnt.

You will move hands around:

· Bottom of the chin, trying to force teeth together

· Hooking over chin, trying to open jaw further

· Either side of the jaw, trying to push jaw to the side

· Front of the chin, trying to push jaw back

Each position can be resisted for 5-10 seconds to help promote muscle activity around the jaw joint.

If you want to learn more about TMJ Exercises please book in to see one of our Barefoot physiotherapists via the link.

Other blogs to read on our page: How to Release Jaw Tension and Physiotherapy for TMJ

tmj physio with barefoot

Physiotherapy for Headaches

Physiotherapy for headaches often involves a combination of manual therapy techniques to reduce nerve irritation present in the upper-cervical region, and improve neck and upper body range of movement. In addition exercises can be helpful in improving the strength of the neck and surrounding muscles. This can help to reduce the build up of tightness in the area. Our brains are really good at ignoring musculoskeletal pain, especially when it has happened slowly over time or remains the same every day. This is one of the reasons why pain/injuries can occur seemingly out of nowhere.

Headaches are a symptom of different causes and affect many Australians often on a weekly or even daily basis. There are several types of headache; migraine, tension-type, cervicogenic or combined. Whilst it is best to be assessed by a Barefoot Physiotherapist who can provide you with a tailored treatment plan primary headaches such as those migraine and tension type headaches can try the exercises in the following link for some symptom relief. Tension type headaches are commonly combined with mechanical impairments, however other factors may also be at play. Finally, a cervicogenic headache occurs secondary to a neck dysfunction and can greatly benefit from the aforementioned tips/ physio treatment.

Neck Pain and Headache

If the nervous system receives excessive signals from the neck it can become sensitised. Therefore, this can cause referred headaches can occur prior to any feeling of neck pain. Other individuals may notice reduced neck range or pain/ stiffness in the neck. In addition, Cervicogenic headaches can be aggravated with neck movements, postures or worsen by the end of day. Textbook cervicogenic headaches are intermittent and usually side dominant. However, if neck dysfunction is bilateral or it is a mixed migraine or tension-type headache with cervicogenic contribution, this may not be the case. Therefore, to find out the likely cause of your headache and best treatment, it is recommend to see a Barefoot Physiotherapist.

Physiotherapy exercises for headaches

Using specific hands on assessment techniques, Barefoot physiotherapists can assess muscle and joint dysfunction in the neck. They will have a special focus on the upper neck which is most closely related to neck-caused headaches. Where the neck is a significant cause of headaches, treatment of these joints and muscles can help de-load the area and dampen down the sensitised nervous system which provides relief of headache symptoms. Your Barefoot Physio will assess your various postures to ensure you are set up in the best way to reduce the build up of tightness in this area of the body. In addition, your physiotherapist will prescribe you with some exercises.

If you would like to chat to someone about your neck pain and headaches please get in touch with us at barefoot. Give us a call (the number is on our website) or book in for an initial consultation at the link here.


Should I try Dry Needling?

 Here at Barefoot Physio we use a variety of techniques to get the best results for our clients. We often incorporate dry needling as part of our treatment plan because it has a wide variety of benefits. This is always done in consultation with our clients. In this blog, we’ve covered some of the most common questions we get about needling to help you work out if dry needling is right for you.  

What is dry needling? 

Dry needling involves inserting very thin, single use needles into a specific location in the body to elicit a response. It is named “dry” needling as the needle does not contain any fluid. This is unlike a medical injection (eg a cortisone injection) which would be considered “wet needling”. Dry needling should only be performed by a qualified health professional who has done further training.  

Is it the same as acupuncture? 

Acupuncture is an entire treatment methodology that comes from Traditional Chinese Medicine. To be an acupuncturist typically requires a 4 year training program. Dry needling (also referred to as Western dry needling) is just one technique from within acupuncture that other allied health professionals (eg physiotherapists, podiatrists or massage therapists) can perform safely after further training. Traditional acupuncture uses meridian lines and the focus of treatment is on the flow of energy (qi) throughout the body.

While Eastern acupuncture can be used as part of a treatment plan for musculoskeletal problems, it is more commonly used for overall wellbeing. Including stress management and can even be helpful in the treatment of morning sickness. On the other hand, dry needling typically focuses on trigger points within muscles and is used for reducing muscle tension.  As a result, dry needling also often uses longer needles. At Barefoot Physiotherapy we mostly use Western techniques though occasionally Eastern techniques are used to support treatment as well. 

How does dry needling work? 

Dry needling works using a number of mechanisms: 

  • Local (where the needle goes in): needling initiates a small local inflammatory response. There is also release of local endorphins (feel-good chemicals). Increased local blood flow also helps bring nutrient rich blood and clear waste products. Sometimes a muscle twitch occurs resulting in changes to calcium channels in the muscle fibres and subsequent relaxation of the muscle 
  • Segmental (at the spinal cord) effects: Enkephalin (an endorphin) is released which acts as a pain relief. Pain gating also occurs, which is when information from the needle insertion overrides other information from the area. (think of how you rub your shin if you hit it on a coffee table) 
  • Extra-segmental (at the brain) effects: A number of chemicals are released including serotonin, adrenaline and endogenous opioids which help to reduce pain felt in the whole body (not just the area where the dry needling occurs). 
  • Sympathetic effects: Needling can stimulate the autonomic system and reduce the sympathetic nervous system (“fight or flight”) activity and increase the parasympathetic nervous system (“rest and digest”) activity 
  • Immune effects: Enodgenous opiods that are released can support regulation of the immunoinflammatory. 

What conditions is dry needling helpful for? 

Knowing that it can help reduce muscle tension as well as provide a host of overall benefits, dry needling can be useful for a variety of conditions, including:  

  • Back pain 
  • Neck pain  
  • Rotator cuff injuries 
  • Nerve pain and problems 
  • Shoulder bursitis and other shoulder pain 
  • Hip pain 

It is beneficial for both new and persistent (long term/chronic) problems.

Dry Needling

What should I expect with dry needling? 

Before getting dry needling, your therapist should ask some general questions about your health to ensure it is safe for you to receive dry needling. They will then explain what is going to happen and gain your consent. Then, the area that is being treated needs to be exposed so that the needles can be inserted directly into the skin (going through clothing is an infection risk). For many body parts, such as your calf, it may already be safely accessible. However, for an area such as your glute or hip, your therapist may need to move your shorts to gain access. Once the area is prepared then treatment can begin.

Types of Dry Needling Techniques

There are a number of dry needling techniques that may be used. Most commonly, needles will be placed into the muscle and left in for approximately 5-10 minutes.Iideally waiting for the muscle to relax before removing them. It is common to feel a dull ache or tugging sensation and your muscle may even twitch. Another option, especially for muscles around the lungs where extra safety precautions are necessary, needles may be inserted and moved around searching for the “twitch” response in the muscle and then removed once that has been achieved. Both of these techniques are effective but one may be more suitable depending on your condition or the body part being treated. For both of these, potential treatment side effects are an achy feeling in the muscle and potentially a small bruise in the area.  

Press Stud Needling

Another treatment option we are using more often at Barefoot Physio is press studs. These are small needles that are attached to a small plaster and are left in for up to 3 days. The needles can be used in the area of symptoms or where treatment is being focused. They work on the neurophysiology model of providing stimulus to an area of tissue to help change the information going to the brain. This in turn, helps to reduce the ‘threat level’ assessment in the brain and consequently reduce overall pain and symptoms. Press studs can be effective for a variety of conditions, including chronic or persistent pain as well as acute injuries.  
If you want to know more about dry needling discuss it with one of our physios today. Book in online here.  

Hypermobile exercise

What is Hypermobility

Hypermobility is present in up to 15% of the population in one form or another.  For the general public, hypermobility most commonly refers to general joint hypermobility (or an increased range of joint movement). Being extra flexible is an advantage in activities such as swimming, dancing or gymnastics.  Most flexible people don’t experience pain or symptoms due to their flexibility.  However, being “flexible” or “double-jointed” is only one part of the large spectrum of hypermobility conditions. These conditions range from extra joint range to hypermobility spectrum disorder (HSD) or Ehlers Danlos Syndrome (EDS).  The most common type of EDS is hypermobile EDS (or hEDS).  

Symptoms of Hypermobility

Many of the people on this spectrum experience negative effects, some of the most common symptoms include:  

  • frequent subluxations or dislocations 
  • chronic pain 
  • neural tissue pain (eg. pins and needles) 
  • gut issues (eg. IBS)  
  • autonomic dysfunction (eg. POTS)  
  • anxiety  
  • fatigue  
  • general deconditioning  
  • excessive bruising  
  • disrupted sleep  
  • headaches / dizziness  
  • pelvic floor concerns or prolapse 

Types of Treatment

If you, or someone you know, is living with hypermobility an important part of managing it is to have a team of informed health practitioners to support and guide you. The evidence for how to manage hypermobility tells us that general movement is key.  Some of the types of movement that may be used include: 

  • strength training – improve muscle capacity for load 
  • proprioceptive training – improve awareness of body position in space  
  • aerobic training – improve general conditioning for activities  

There is no specific “do this exercise to fix hypermobility”. It is important to take a holistic approach and consider each individual. Physiotherapy and exercise for hypermobility have been found to:  

  • increase general fitness levels and ability to complete daily activities,  
  • decrease pain and subluxations, 
  • improve confidence and self-esteem,  
  • decrease symptoms of autonomic dysfunctions (eg POTS).  

How Physiotherapy Can Help:

Some of the ways a Barefoot Physiotherapist will work with you to manage your symptoms include:  

  • determine baseline of activity without symptom flare ups 
  • improve accessible range of movement without protective responses  
  • motor control and proprioceptive exercises to improve your mind-body map  
  • utilise an activity journal to establish better pacing strategies 
  • include mindfulness and relaxation exercises to support your parasympathetic nervous system (PNS)  
  • “low and slow” strength exercises to develop strength in muscles without symptom flare ups 
  • Guidance on external supports such a taping, compression garments or splints  
  • Strategies for pain managements including muscles releases, TENS, gentle movements  

Hypermobility and its spectrum of conditions stems from dysfunctional collagen within the body.  Because of this, hypermobility, HSD, hEDS and EDS are very much a systemic condition as collagen in found in nearly all (if not all) tissues within the body. Connective tissues provides strength and support, binds and separates tissues, and resists deformation while still having the ability to change and stretch. People with hypermobility disorders vary greatly in their symptoms and what has the largest impact to daily life and function. It is important to simultaneously manage your gut health, cardiovascular health, musculoskeletal health and mental health. A multidisciplinary team is important in the management of hypermobility.  

If you are seeking support to self-manage hypermobility symptoms, contact the Barefoot Physiotherapy team on 1300 842 850 or book online for your first consult.  

TMJ Physio

Physiotherapy for TMJ

What Is TMJ? 

Have you ever wondered if something is wrong with your jaw, or asked yourself “why is my jaw clicking?” Perhaps you have been told by your doctor or dentist that you have something called “TMJ dysfunction.” What does this actually mean? And how can Physiotherapy help your TMJ ?

What is TMJ dysfunction? 

First, to answer this question, we need to answer a different question: “what is the TMJ?” TMJ stands for temporomandibular joint (no wonder we abbreviate it, hey?!). This is the joint connecting our temple bone to our mandible, or jaw bone, and we have two of them – one for either side of our face, and they are located just in front of our ear canals. Like any joint, there are multiple structures that make up the joint, including: ligaments, cartilage disc, and of course the bones. 

Our TMJ is the most used joint in the body! It not only opens and closes, but can also move but side-to-side, and in forward-and-backward directions, meaning it can create many complex movements. This joint is involved in any activity we use our mouth for, including chewing, talking, singing, yawning, and facial expressions. 

When there is a problem with the TMJ, it is referred to as TMJ dysfunction or a temporomandibular disorder (TMD). 

What causes TMJ symptoms? 

TMJ dysfunction is an umbrella term encompassing many different causes of TMJ symptoms. These may be due to: 

Trauma to the joint  

Myofascial causes – changes to the musculature surrounding the joint/s. For example, this may arise due to: 

  • Habits such as bruxism (grinding teeth) or clenching the jaw. This can commonly arise with chronic stress and anxiety 
  • Poor posture of the head, neck and/or jaw 
  • Strain from eating habits – e.g. too large bites, from hard or chewy foods, eating on only one side of the mouth 

Intra-articular causes – changes within the joint as a result of inflammation or mechanical changes to the joint itself 

  • Autoimmune and inflammatory conditions affecting the jaw (e.g. osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, lupus) 
  • Hypermobility disorders affecting the jaw joint 
  • Internal derangement (abnormal relationship of the TMJ disc to any of the other components of the joint) 

What are the symptoms of TMJ dysfunction? 

There can be several different symptoms associated with TMJ dysfunction, and may include any combination of: 

  • Jaw pain and/or tightness 
  • Jaw clicking, popping or grinding of the jaw during use 
  • Limited mouth movements, including reduced ability to open the mouth wide or close the mouth 
  • Neck pain and/or stiffness 
  • Headaches 
  • Ear pain 
  • Tinnitus (ringing in ears) 
  • Aural fullness (a feeling of blocked ears) 
  • Dizziness or vertigo 

So many important structures are housed in the head, the jaw joints being just one of them. We also have eyes, ears, balance organ (vestibular system) and a number of muscles. With so many sensitive and important structures housed so closely together and sharing common nerve supply pathways, problems arising in one of these structures (like the jaw) can also cause symptoms from these other structures. 

How can a physio help with TMJ dysfunction? 

Physiotherapy for TMJ includes a variety of treatment options, you can firstly expect your physiotherapist to assess the range of movement of your jaw and neck. They will also conduct a thorough assessment of the muscles and joints of these areas to help form a personalised treatment plan for you. Treatment may entail: 

  • Releasing jaw muscles and teaching you how to do this yourself  with external or internal jaw releases 
  • Hands-on treatment around the neck, jaw and head to relax involved muscles and joints 
  • Teach you a comfortable resting jaw position and/or neck position 
  • Exercises to retrain and strengthen your jaw muscles as appropriate 
  • Advice around chewing and eating, such as avoid chewing gum, or switch to softer food choices and smaller bites 
  • Breathing exercises to help de-load overactive neck muscles that may be contributing to excessive jaw tension 
  • Stress-management strategies 
  • May recommend sourcing and trialling a mouthguard or splint to help reduce stress through the TMJ with grinding or clenching 

If you have been experiencing pain in your jaw and are searching for ways to manage and improve your quality of life, book in with a Barefoot physiotherapist. Our Physiotherapy treatment for TMJ aims to understand the different factors contributing to your jaw symptoms to personalise treatment for you. 


What Is Proprioception?

The six sense!

What is proprioception? Proprioception is the way that we know where our body is in space or in relation to other body parts and whether a body part is still or moving. This information comes from sensory receptors in the skin, joints and muscles that feed information continuously to the brain. Different tissues have different receptors, for example Golgi Tendon Organs are found in all tendons and give information about tendon stretch or muscle contractions, while Pacinian corpuscles detect pressure changes and vibration and are primarily located in the skin of the hands and feet. There are many types of receptors, all gathering and feeding information to our nervous system.  

There are many reasons that proprioception is disrupted or decreased.  Acute injuries such as ligament sprains or muscle strain lose some ability to gather information. This can lead to recurrent injuries if not rehabilitated well.  Chronic conditions such as neurological injuries, diabetes and hypermobility can also result in a decreased proprioceptive ability for a variety of reasons.  

Now we know what Proprioception is how can Physiotherapy help?

Generally, physiotherapy management of a condition or injury will involve some sort of proprioception exercise.  This is aimed at challenging the body and improving the amount and accuracy of information gathered. We can utilise our other senses such as vision or our vestibular system to create varying levels of challenge.  

A simple proprioceptive exercise to try at home is based on joint position sense.  Sit at a table with your hands flat on the table. Now, with your eyes open and looking at the hand, start to point the thumb towards the ceiling and turn the palm. Here you are using vision and proprioception (through pressure and joint position sense). Now return the hand to the table and close your eyes.  Can you return the hand to the exact same position? Can you do the exact same movement with your eyes closed but with your hand off the table? Check your accuracy!   

How to train Proprioception?   

If you find yourself being quite clumsy or frequently rolling your ankle or running into walls – it might be your proprioception needs work! Contact Barefoot Physiotherapy at 1300 842 850 or book online to discuss a plan.  

Yoga for Hypermobility

Yoga with Hypermobility

Hypermobility can be a complex condition to manage and there are multiple ways that symptoms can be managed. A large part of management for hypermobility is movement. People who are more flexible are often drawn to activities that their flexibility gives them an advantage. One that we see all the time is yoga. It’s not uncommon to hear the phrase “but I can’t do yoga, I’m not flexible enough”. The assumption is only flexible people can do yoga, and they don’t have to try hard. This is untrue. If anything, people with hypermobility doing yoga need to work even harder than others.

What is Hypermobility and how does this affect Yoga:

Hypermobility is due to a dysfunctional collagen tissue. What this means practically, for movement, is that your muscles and ligaments don’t provide enough support and that you are less aware of where your body is in space. In yoga this can lead to hanging on your joints and excessive loading of joint structures. This is not to say that you shouldn’t do yoga, you just need to have the correct strategies.

Tips for practicing Yoga with Hypermoblility:

Co-contraction around joints: Even if you can fully extend your arms and legs, it doesn’t mean you should be hanging in your joints. Especially when putting weight through your limbs it’s important to maintain a micro bend through elbows and knees. This micro bend provides muscular support from all sides of a joint, hugging and supporting. Try leaning on a straight arm (eg in downface dog or plank) and shift between fully straight and relatively passive, and a micro bend of the elbow to “unlock” the joint. You will likely find the micro bend is both more comfortable and more work!

Imagery: As proprioception is often decreased in hypermobile bodies, imagery can be a great addition or alternative to internal awareness. You can include cues such as arms pushing into honey (eg in warrior I and II), hug into the midline (eg in trikonasana or tuladandasana), or a weight falling off your tailbone.

Finish your movements: It’s easy to get caught up in what’s coming next and flop from one pose to another. Really focus on the end of the movement and fully completing the pose (for whatever that looks like for you). For example, in transitioning from downface dog to upface dog it can be easier to flop onto your belly and then push up hanging in the shoulders. Try to break down the poses into smaller chunks, or easier options and experience each movement fully.

Adjustments: Hands on adjustments are fairly common in yoga classes. For a hypermobile body it’s recommended that you talk to your teacher and avoid being pushed further into range. Hands on adjustments that encourage activation and awareness are still useful. If you are not comfortable with hands on corrections in a class, just let your teacher know! Use props: using props such as yoga blocks or straps are a great way to increase the support and awareness of your body. For example, using a strap around the lifted leg in extended hand to toe pose means you can focus on the mini bend of the knees to provide more stability.

Barefoot Physiotherapy Can Help:

If you are hypermobile and practicing (or would like to practice yoga) get in touch with the Barefoot Physiotherapy team for individualised recommendations. Our team will help you be able to practice yoga with hypermobility in a way that helps your body. Contact us at 1300 842 850 or book online via clicking here.

If you would like to read about the use of Props in Yoga CLICK HERE

Incontinence physio

Physiotherapy for Incontinence

Urinary continence is the ability to fully control your bladder movements; i.e. there is no leaking. Therefore, urinary incontinence is defined as an involuntary loss of urine. Whilst urinary incontinence can be common it isn’t normal and should be addressed to help people regain a sense of control over their bodies.  Physiotherapy for incontinence can be a great help in improving symptoms. To understand how physio can help your incontinence it is important to understand the type of incontinence.

The most common types of incontinence are stress urinary incontinence and urge incontinence. Urge incontinence can also be called (OAB) overactive bladder syndrome. Or there is mixed incontinence which is a combination of both.

Stress Urinary Incontinence (SUI)

SUI is defined as a leakage of urine during movements that place stress on the pelvic floor. This can include moments of physical activity that increase your intra-abdominal pressure for example: coughing, sneezing, laughing, jumping, running or other forms of exercise.

SUI occurs due to weakness of the muscles and tissues around the pelvic floor. This weakness causing poor control of the opening and closing of the urethra.

How Physiotherapy can help your Stress Urinary Incontinence

Physiotherapy for SUI focuses on improving the strength around your pelvic floor muscles. This can include the following:

  1. Kegels (pelvic floor activation and relaxation): learning how to properly activate your pelvic floor and therefore fully relax which is vital to healthy bladder habits
  2. Glute strength: to ensure the pelvic floor can activate correctly it is important to make sure the glutes are strong and have the ability to lengthen.
  3. Making sure you have a safe return to exercise post pregnancy i.e. not returning to high load exercises before your pelvic floor has healed.

Urge urinary incontinence or OAB

OAB is used to describe a sudden overwhelming urge to pass urine even when the bladder isn’t full. These urges are caused by involuntary bladder spasms as the bladder is filling with urine. People often feel these urges when they hear running water or place their key in the door as they arrive home. 

People with urge incontinence will need to use the toilet more often than others, have difficulty deferring the urge to pass urine and leaking associated with the urge.

Urge incontinence can occur due to many reasons. These include weak/ poor control of the pelvic floor muscles, poor bladder habits, infections including UTI, diabetes and pelvic prolapse. It can also occur due to conditions that affect the nervous system.

How Physiotherapy can help your urge incontinence

At Barefoot Physiotherapy our physios will help you address your OAB or Urge incontinence through the following treatment methods:

  1. Discussion around a bladder diary: it is important to track your habits so you can identify if there are patters or foods/drinks that are irritating your bladder
  2. Exercises to increase pelvic floor strength: Good bladder control requires a strong pelvic floor that is able to contract and relax as needed
  3. Double voiding: your physiotherapist will discuss trying a double voiding technique which means you empty your bladder twice. This may be helpful for people who have trouble fully emptying their bladder. After you go to the bathroom, you wait a few seconds and then try again.

If you are struggling with incontinence issues book in to see one of our friendly physiotherapists at Barefoot Physiotherapy. They will work with you to identify the cause of your incontinence and tailor a management program to suit you.

Pelvic floor model

Pelvic Floor Physio is Important for Everyone

Pelvic Floor Physio for all populations

Everybody has a pelvic floor. There is often a lot of discussion around pelvic floor for women, given its importance in pregnancy and childbirth. However, pregnancy is just one of many times the pelvic floor needs extra attention as pelvic floor dysfunction may be implicated in many other populations – including men and women who have never been pregnant. Pelvic Floor Physio can help everyone; as it can focus on activating and strengthening this muscle group.

The “pelvic floor” refers to a group of muscles located at the base of our pelvis and has several important roles.

The (Many) Roles of the Pelvic Floor

The pelvic floor muscles work together with other muscles of the body to contribute to several important roles, including:

  1. Pelvic organ support – pelvic floor muscles form the base of the pelvic cavity, and as such, they provide key support for your bladder, bowel, and uterus (in women).
  • Bladder/bowel function and continence – both the urethra (passage for urine) and anus (passage for stool) pass through the pelvic floor muscles in both men and women. The pelvic floor muscles include sphincters to control when you empty your bladder/bowel until it is convenient. Pelvic floor activity is dynamic and changes level of activation depending upon our activities. For example, during periods of increased intra-abdominal pressure (i.e. when coughing, sneezing, laughing, lifting something heavy, exercising, etc) the pelvic floor will increase tone to prevent leakage of urine or stool.
  • Pregnancy / Childbirth (for females) – because the pelvic floor supports the uterus (aka the home for the growing fetus/es during pregnancy) it comes under high levels of stretching and strain during pregnancy and birth
  • Sexual function – the pelvic floor has a close relationship with sex organs in both males and females. In women it contributes to sexual arousal, whereas for men it is important for erectile function and ejaculation
  • Stability and regulation of intra-abdominal pressure – the pelvic floor forms the bottom or “floor” of the abdominal cylinder, which also includes the diaphragm (the top), abdominal muscles and deep spinal muscles (walls). These muscles function synergistically to regulate pressure within the abdominal cavity to provide trunk stability. This is important to provide a stable base for our limbs to work off to enable us to move easily and go about our everyday activities.
  • Breathing
    • The close relationship of the pelvic floor with these other “abdominal cylinder” muscles means that the pelvic floor has an active role with breathing. During inhalation, as our diaphragm draws downward to expand our lungs, our abdominal muscles and pelvic floor expand to maintain our abdominal pressure. On the exhale, the diaphragm lifts up, abdominal muscles contract and pelvic floor returns to its resting position.

How Can the Pelvic Floor be Dysfunctional?

Pelvic floor dysfunction simply refers to inability to correctly activate, relax, and/or coordinate your pelvic floor muscles. This can be caused by:

  • Weakness
  • Tightness/overactivity
  • Or, a combination of the two!

What can cause this?

  • Pregnancy/childbirth
  • Age
  • Stress/ Anxiety
  • Prolonged physical activity, especially high impact
  • Obesity
  • Respiratory diseases or poor breathing patterns
  • Chronic coughing
  • Eating disorders
  • Connective tissue disorders
  • Gynaecological disorders
  • Post-prostatectomy
  • Restrictions in back or hip mobility causing compensations by the pelvic floor muscles
  • Traumatic injuries to the pelvic (e.g. fracture)

What Symptoms Can be Caused by Pelvic Floor Dysfunction?

The close relationship the pelvic floor has with other muscles of the abdomen, back and hips means that abnormalities in any of these areas can both arise from, or cause, pelvic floor dysfunction.

Therefore, pelvic floor dysfunction might look or feel like:

  • Hip pain
  • Pelvic or groin pain
  • Back pain
  • Shallow breathing patterns
  • Incontinence (bladder/bowel)
    • Accidentally leaking urine or passing wind when laughing, coughing, exercising
    • Feeling of urgency to use the bathroom and not make it in time
  • Difficulty emptying bladder or bowel
  • Painful intercourse
  • Gonadal pain – vulva, penis, or testicles
  • Erectile dysfunction
  • Pelvic organ prolapse – may feel like a bulge or heaviness in the rectum or vagina (e.g. feeling the need to void bowels without actually needing to go)

Pelvic Floor Physio

Physiotherapy is the first-line treatment for pelvic floor dysfunction. Your physiotherapist can provide specific advice and exercise therapy to help reduce unwanted symptoms. Your treatment may include:

  1. Advice and education surrounding bladder/bowel management and training    
  2. Muscle releases of the pelvic floor or hip
  3. Pelvic floor re-training, including
    • Teaching you how to and relax your pelvic floor correctly, click here for tips on how to activate your pelvic floor
    • Improving strength and endurance of the pelvic floor
    • Optimising correct patterns of muscle activation

If you would like to address any issues that may be related to the pelvic floor, we invite you to book now and see a Barefoot Physiotherapist. They will be able to conduct a personalised assessment and create a treatment plan suited to you.

You may be interested in reading Pelvic Girdle Pain or Pregnancy Physio