IBS-IRRITABLE BOWEL SYNDROME

Women’s Health is now ONLY available at Northbridge and Liverpool.

IBS -Irritable Bowel Syndrome

“IBS is a group of symptoms that occur together, not a disease. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes.
IBS is diagnosed when a person has had abdominal pain or discomfort at least three times a month for the last 3 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or be relieved by a bowel movement.
IBS is often classified into four subtypes based on a person’s usual stool consistency. These subtypes are important because they affect the types of treatment that are most likely to improve the person’s symptoms. The four subtypes of IBS are:

  • IBS with constipation (IBS-C) ◦hard or lumpy stools at least 25 percent of the time.
    ◦loose or watery stools less than 25 percent of the time
  • IBS with diarrhea (IBS-D) ◦loose or watery stools at least 25 percent of the time
    ◦hard or lumpy stools less than 25 percent of the time
  • Mixed IBS (IBS-M) ◦hard or lumpy stools at least 25 percent of the time
    ◦loose or watery stools at least 25 percent of the time
  • Unsub typed IBS (IBS-U) ◦hard or lumpy stools less than 25 percent of the time
    ◦loose or watery stools less than 25 percent of the time”

Physiotherapists don’t treat a lot of these conditions that I have listed, but the effect of these problems may cause associated muscle tensions within the pelvic floor. Sometimes the condition can be mild and only cause occasional pain, slowly becoming more of a problem as you try and become sexually active. Sports Focus women’s health Physiotherapists trained in the treatment of pelvic pain can help to reduce the muscle tensions, address the pain and work with your doctors to establish the underlying cause. We can offer advice and refer on to appropriate health practitioner.

Pudendal Neuralgia

Pudendal Neuralgia can affect men and women. It is defined as burning, stabbing, and/or throbbing pain in the distribution of the pudendal nerve. The pain typically increases with sitting and exercise and decreases with standing and rest. The pudendal nerve supplies most of the skin, labia and superficial pelvic floor muscles. Pain can be felt around or inside the vagina. Patients with pudendal neuralgia commonly have pelvic floor dysfunction as well as pain. Patients may report urinary dysfunction such as dysuria, (difficulty or pain on urination) urinary hesitancy, urgency, and frequency, and/or bowel problems such as constipation and difficulty evacuating. Some patients may also experience sexual dysfunction such as dyspareunia, (pain on penetration of the vagina) anorgasmia, (inability to reach orgasm) and post-ejaculatory pain. Common causes of pudendal neuralgia include chronic constipation, chronic urological or gynaecological infections, and repetitive sporting activities such as bicycling and strong abdominal and ‘core’ type exercises.

Pelvic-Pain-Irritable-Bowel-Syndrome-Pelvic-Floor-Physiotherapy
  • Interstitial Cystitis IC: Bladder Pain Syndrome
    What is IC?   The following information is reproduced from the Melbourne bladder clinic website. A great link for a more in depth understanding of this difficult conditionBPS/IC is a chronic, debilitating disease of the bladder that is characterised an unpleasant bladder sensation, of more than 6 weeks’ duration and in the absence of infection or other identifiable causes.How common is it ?
    The incidence of BPS/IC is estimated at 8 to 1600 per 100 000. It affects men and women of all ages, cultures and socioeconomic backgrounds. It is more common in women and the male-to-female ratio is estimated to be about 1:10.What are the causes?
    Despite extensive research, the exact causes of BPS/IC are still unclear.
  • What are the symptoms?Patients complain of frequent urination, sensation of constant urge to void and bladder pain. Chronic pain is an essential component of the syndrome and is described as worsening with bladder filling and is relieved by voiding. This pain is not only localised to the bladder, but can be felt throughout the pelvis (vagina, rectum, urethra, vulva).
  • How is it diagnosed?IC is a diagnosis of exclusion; meaning that other causes of these symptoms such as infection, overactive bladder (OAB), cancer, radiation or other forms of cystitis must be ruled out first.Assessment should include a careful history, physical examination and investigations. In the history, BPS/IC patients void to avoid or relieve pain, whereas OAB patients void to avoid incontinence. The number of voids per day, sensation of urge to void and characteristics (location, severity, character) of the pain should be documented. A bladder diary may be useful here.A urine test is done to exclude a urinary tract infection. It can also be done to look for cancer cells, especially in those with increased risks (over 50 years old, smoking history).Cystoscopy and Urodynamics are considered as an aid to diagnosis and are not necessary in uncomplicated cases.
  • Cystoscopy:
    • A cystoscopy (inspection of the inside of the bladder with a tubelike camera) can be done to look for features of IC, such as bladder ulcers or small bleeding points seen after distension of the bladder with sterile fluid. These findings are helpful but not necessary when making a diagnosis of IC.
    • During the cystoscopy, a bladder biopsy can also be done to look for inflammatory cells in parts of the bladder wall.
    • This can also rule out other bladder pathology like a bladder tumour, stone, or a urethral diverticulum (small out-pouching in the tube that drains the bladder).
  • Urodynamics:
    • Rule out other diagnoses like an overactive bladder (OAB) or a poorly compliant (stiff) bladder.
    • Can look for bladder outlet obstruction from failure to relax the pelvic floor during voiding.
  • Treatments for IC:First of all, it must be clear that at the moment are no curative treatments; the treatments are aimed at alleviating the symptoms such that a patient can continue to have a reasonable quality of life. The patient should be counselled with regards to reasonable expectations for treatment outcomes. Treatment strategies should proceed from conservative ones to more invasive therapies. Some patients may benefit from a combination of treatments. Acceptable symptom control may also require trials of multiple therapeutic options. This
  • Conservative approaches:
    • Diet changes: avoid food that triggers symptoms (e.g. spicy foods, alcohol, caffeine).
    • Altering the concentration or volume of urine, wither by fluid restriction or additional hydration.
    • Application of local heat or cold over the bladder, trigger points and areas of hypersensitivity
    • Strategies to manage flare-ups.
    • Pelvic floor muscle relaxation / avoid pelvic floor strengthening exercises.
    • Bladder retraining with urge suppression.
    • Manual physical therapy (trigger point release by physiotherapist).
  • Multimodal management:
    • May involve medications, stress management or manual therapy.
    • A pain specialist is usually involved.
    • It is difficult to predict which pain medication is most effective; this may require a trial of different medications.
  • Oral medications:
    • Tricyclics antidepressants
    • Some examples are amitriptyline, imipramine.
    • Side effects are fatigue, drowsiness, weight gain, dry mouth (a third of patients cannot tolerate this).
    • Sodium pentosan polysulfate (Elmiron)
    • Acts by repairing defects in the bladder mucosa.
    • A 3 to 6-month course is needed to demonstrate an effect.
    • At a dose of 100mg three times a day, it is well tolerated and has few side effects.
    • Cimetidine
    • Dose of 400mg twice a day.
    • Potential interaction with other medications.
    • Vitamin D

    Antibiotics have no role in the management of BPS/IC in the absence of a proven urinary tract infection.

  • Bladder instillation therapy:
    A catheter is first inserted, and the medication is then infused into the bladder for a period of about 15 – 20 minutes (depending on the drug). Multiple therapies are usually required. This route of administration provides high drug concentrations in the bladder and avoids systemic side effects. Long term remission is achievable in some patients, but most will relapse eventually and need more treatments. Some examples of these medications are dimethyl sulfoxide (DMSO) and Clorpactin.
  • Surgical therapy:
    • Cystoscopy with bladder distension and electrical cautery of bladder ulcers if present.
    • Some patients get relief of symptoms from this procedure, but most of the time, the effects will wear off.
    • Trial of sacral neuromodulation (bladder pacemaker)
    • A temporary stimulator is first inserted during the trial period; a permanent implant is then inserted if the patient demonstrates positive response.
    • Anti – spasm bladder injection – Botox
    • Urinary diversion with or without surgical removal of the bladder
    • The ureters (tubes draining the kidneys to the bladder) are reimplanted into a segment of bowel which is diverted to the abdominal skin surface as a stoma (opening). A bag is then placed over the stoma to catch the urine.
    • This option is often the last resort and can sometimes be very effective.
    • Patients must understand that pain relief is not guaranteed even if the bladder is removed.

    Please, if you have pelvic pain, see your GP and let’s try and get to the cause of your problem. Sports Focus Pelvic Floor Physios can help you deal with overactive pelvic floor muscles, then this may go a long way in reducing and controlling your problem. Remember you don’t need a referral to come and see us. If we think you need other referral/investigations, we will discuss these with you.

ALL SERVICES 

NEW – Physio circuit classes “Physio Focus Fit in 45”

At Sports Focus Physiotherapy and Pilates we have a fully equipped Active Physio – Pilates area offering a comprehensive approach to whole body. Rehabilitation. We aim to deliver a personal program of Pilates informed exercise from the broad knowledge base of our Physiotherapists

Sports Focus Physiotherapy is committed to providing solutions for your pain and injury in a personal and caring way. Whether you are young or senior, involved in recreational activities or elite sports, working or retired, we endeavour to make your recovery as complete and as swift as possible.

ACTIVE PHYSIO CLASSES – CIRCUIT is only available at our Northbridge rooms

Work related activity programs are designed specifically for the injured worker depending on their injury and the duties needed to be performed at work.

Our therapists provide education on injury management and prevention and provide the foundations to return to work through a range of exercise techniques.

Hydrotherapy, home exercise programs and gym programs are used to promote self-management and adherence for the injured worker.

Work related activity programs are offered at all our Sydney physiotherapy locations.

The temporomandibular consists of two joints between your cheek bone and jaw bone and it is the most commonly used joint in your body for eating, drinking, talking, and expressing emotions.

The most common symptoms include grinding, jaw clicking, and popping, restriction of the joint or deviation while opening, and inability to clench your jaw completely. Dysfunction of this joint can cause headaches, ear pain, dizziness, upper neck pain, and ear ringing (tinnitus).

Together with help from your Dentist, Physios can assess and treat for pain relief including; massage, dry needling, coordinated mobility exercises, and stretches.

TMJ treatment is offered at all our Sydney physiotherapy locations except Mt Pritchard and Macarthur.

Sports injuries can occur during any sporting activity or gym session. The most common sports injuries include sprains and strains/tears, which can be categorised as being an acute, chronic or an overuse injury.

Physiotherapy management of sports injuries usually involves manual therapy, a tailored exercise rehabilitation program, taping, and sometimes bracing – all with the aim to return to your pre-injury level of function.

Our physiotherapists are skilled in diagnosing and managing all varieties of sports injuries and working with you to help prevent further injury.

Sports physiotherapy is offered at all our Sydney physiotherapy locations.

Spine-related pain is a very common occurrence, and research indicates that most of the population will be afflicted with back pain at some point during their lives.

This can involve the cervical spine (neck); thoracic spine (upper back); the lumbar spine (lower back), or the sacrum /coccyx (pelvis).
For most people, back pain can be managed quickly and easily with physiotherapy treatment.

Whether you have occupational neck pain from spending hours at a desk; or acute pain from a bending or lifting injury; we can help. The physios at Sports Focus are all trained to perform a biomechanical assessment of your spine; and to provide treatment for restoring normal function.

Spinal physiotherapy is offered at all our Sydney physiotherapy locations.

Our Senior services are one-on- one programs designed to improve senior wellbeing and independence.

After an assessment our Physios can recommend either an individual treatment program or one of our ‘classes’ that specialise in Senior’s health. These include;

  • Falls prevention
  • Strength and Mobility – cardiac & respiratory
  • Balance and Bones

Senior physiotherapy is offered at all our Sydney physiotherapy locations. Visit special programs for more info.

Real time Ultrasound uses a diagnostic ultrasound machine to build an image on the screen.

Different layers of muscles can be viewed to see how they contract, relax and work together.

This is very relevant for your “deep abdominal muscles “core” Transverse Abdominus.

It is common for these deeper muscles to not work correctly after any episode of Back or Pelvic pain.

Real time ultrasound is offered at our Northbridge, Willoughby and CBD Wynyard physiotherapy locations.

Real Time Ultrasound

Research has shown that elderly people who participate in a safe exercise program that combines both strength training and balance are less likely to have fall related injuries and will improve overall strength.

At Sports Focus Physiotherapy, our Balance and Bones exercise class is conducted by experienced physiotherapists who will take you through a range of safe exercises each session.

Balance and Bones is offered at our Northbridge physiotherapy location.

Sports Focus Physiotherapy at Castle Hill offers specialised services for golfers, including rehab and advice for golfing injuries and a golf performance program.

Whether you are playing at professional or amateur, senior or junior levels, our expert Sports Focus physiotherapists can help you get the most out of your game.

Golf performance is offered at our Castle Hill physiotherapy location.

Do you work in the fitness industry? Interested in learning kinesiology taping techniques to help prevent client injury?

Andrew Hughes, senior partner at Sport Focus Physiotherapy and Sports & Olympic Physiotherapist regularly conducts certified taping courses for the sporting community including coaches, athletes and parents at our practices across Sydney.

Sports taping is offered at all our physiotherapy locations.

Make an appointment for 2 weeks after delivery with our experienced Women’s Health Physiotherapists.
At Sports Focus Physio we can examine and assess

• Breast problems from feeding – Mastitis
• Abdominal /scar examination – Diastasis Rectus Abdominis (DRA) assessment
• Pelvic Floor Muscle (PFM) assessment
• Prolapse assessment
• Postural and Pelvic / lumbar spine assessment

Early assessment and advice is really valuable for a good safe recovery and return to exercise.

Postnatal physiotherapy is offered at all our Sydney physiotherapy locations except Castle Hill and Macarthur.

Orthotics are shoe inserts that support the foot. They are designed to assist in changing gait abnormalities that are causing pain or discomfort.

Orthotic prescription can be done after a biomechanical assessment by your Physiotherapist to determine your individual needs. First steps will often involve taping and sometimes shoe prescription to help change problematic movement issues.

Orthotic prescriptions are offered at all our Sydney physiotherapy locations.

At Sports Focus we have experienced Massage Therapists who work to restore optimal function, wellness and health through various types of massage therapies. Relaxing and restorative or remedial and injury specific our therapists can help.

Massage therapy is offered at our Castle Hill, CBD 428 George, Liverpool, Mt Pritchard and CBD Wynyard physiotherapy locations.

Manual therapy is a “hands on” approach to the body’s joints and soft tissue structures in order to restore normal function.
Our highly qualified clinicians are experienced in delivering various methods of manual therapy tailored to everyone.

With the use of palpation, our therapists are skilled in identifying whether these structures are abnormally tight, in spasm or in some cases hypermobile (too much movement).

Manual therapy can be practiced on all regions of the body.

Manual physiotherapy is offered at all our Sydney physiotherapy locations.

The purpose of a musculoskeletal athlete screen is to develop a clinical picture of an athlete’s capability regarding their sport.
Athletes require strength, range of motion and co-ordination, not only to maximise their performance, but reduce the risk of injury.

During the screening process the athlete is asked to perform a battery of tests and the results of these tests are compared to normative values to identify areas which may place the athlete at risk of injury.

Injury prevention should be the top priority for all athletes to maximise their performance, and longevity of their sporting careers.

Musculoskeletal athlete screening is offered at all our Sydney physiotherapy locations.

Kinesiology tape (K-tape, kinesio tape, rocktape, dynamic tape) is a form of stretchy sports tape that’s used to dynamically assist muscle function without restricting any range of movement. Our physio’s can use kinesio tape with most athletic injuries and a variety of physical disorders in all phases of rehab.

For example, K tape can be used in early post-operative rehab, muscle injuries or in late stage rehab assisting return to sport exercises.

Kinesio taping is offered at all our Sydney physiotherapy locations.

At Sports Focus Physiotherapy we offer a wide range of Women’s Health treatments from our experienced Physiotherapists who have an interest in Women’s Health.

Learn more about our women’s health physiotherapy pregnancy exercise class.

Women’s health Physio is now ONLY available at Northbridge and Liverpool. 

Skiing and snowboarding both demand a lot from the muscles in the quads and lower back, and from the knees. A good conditioning program should start long before the snow season starts, and involve strength, power, flexibility, endurance and agility drills.

Evening classes run in two seasons – pre-Australian season and pre-Northern hemisphere season, 8-10 weeks, one hour.

Get Fit to Ski is offered at our Northbridge physiotherapy location.

Shockwave is a safe, non-invasive physiotherapy modality that effectively treats a variety of musculoskeletal conditions. It can be a great alternative to surgical intervention, and can often treat stubborn, recalcitrant conditions.

Shockwave therapy is done in conjunction with a suitable physiotherapy program, such as an exercise or loading program, and any manual therapy.

Shockwave therapy is offered at our Liverpool, Mt Pritchard, Northbridge and CBD Wynyard physiotherapy locations.

We provide general physiotherapy treatments to patients of all ages. Doctor referral is generally not necessary for private self-pay clients and our HICAPs system can provide you on-the-spot private health fund claiming.

Our physiotherapists also collaborate with your GP, other allied health professionals or insurance company when providing physiotherapy services via Department of Veterans’ Affairs (DVA), Medicare Chronic Disease Management (CDM) program, workers compensation or third-party insurance claims.

General physiotherapy is offered at all our Sydney physiotherapy locations.

Dry needling is a useful and effective technique using fine filament needles which are inserted into the fascia or muscle to correct imbalances within the tissue. Often, we target the active trigger points which elicit a twitch response and allow the muscle to release and relax. It can also be used to stimulate a weak or inactive muscle.

It can be used in the treatment of muscular pain, myofascial dysfunction, tendonitis, tension headaches and back pain.

Dry needling is offered at all our Sydney physiotherapy locations.

Sports focus physiotherapy can help you manage fractures and injuries that require casting, bracing or splinting.

This service is available for people of all ages and includes the application and removal of casts, moulding thermoplastic splints and fitting braces across a wide range of joints in the body.

We use a fiberglass casting material with the option for a waterproof Delta-Dry liner, which allows the water to pass through the cast, has great ventilation properties and dries very quickly.

Casting and splinting is offered at all our Sydney physiotherapy locations except Mt Pritchard.

The human body is complex and has many moving parts. At Sports Focus, our physiotherapists have a great understanding of the body’s anatomy and are able to identify biomechanical patterns or faults within the system.

Whether your recovering from an injury or aiming to reduce your risk, a biomechanical assessment can determine areas of weakness or tightness so that a tailor-made exercise program can be created to your specific requirements.

The biomechanics of the human body can be viewed in many different functional tasks such as walking, running, squat and overhead lifting. Whether you are struggling with repetitive injuries, poor posture or trying to ensure your body is working optimally for your sport; a biomechanical assessment can help you to achieve your goals safely.

Biomechanical analysis is offered at all our Sydney physiotherapy locations.

Aquatic Physiotherapy is a tailored programme of exercises and mobilising techniques prescribed and monitored by an Exercise Physiologist or Physiotherapist. Programmes are conducted on a 1-on-1 basis at our Willoughby and Mount Pritchard clinics.

Aquatic physiotherapy uses the buoyancy and resistance of water to decrease pain and swelling, increase function, strength and range of movement. It is helpful for orthopaedic, spinal and arthritic conditions as well as sports injuries, work related injuries and neurological conditions.

Aquatic physiotherapy is offered at our Mounties and Willoughby physiotherapy locations.

It is never too early or too late to visit a physiotherapist!

Acute care

It’s important to seek help after any injury. Here at Sports Focus Physio, our Physio’s can assess your problem and decide on suitable immediate treatment or referral on for further investigations.

We can provide you with early support for soft tissue injury or mobilisation for stiff and painful joints. An exercise program tailored specifically to your injury will assist with quick recovery.

Chronic Injury/problems

Physiotherapy treatment is very effective in the later stages of an soft tissue injury or chronic joint problem.

At Sports Focus Physio we are experienced in rehabilitation of long-term sporting injuries (such as ACL reconstructions), post-operative joint replacements, as well as ongoing management of degenerative injuries such as osteoarthritis.

A mix of hands-on treatment as well as an independent exercise program will be tailored to meet your needs until you have returned to your pre-injury ability and promote ongoing self-management.

Acute care and chronic physiotherapy and rehabilitation is offered at all our Sydney physiotherapy locations.

Our NordBord is a special piece of equipment that focuses on strengthening athletes’ hamstring muscles through different exercise techniques.

At Sports Focus Physiotherapy we specialise in providing programs that focus on strengthening muscles for athletes in premium teams, to help prevent injuries before they occur.

NordBord is offered at our CBD 428 George, Liverpool, Northbridge and CBD Wynyard physiotherapy locations.

For those of you who are ‘physically isolating’ at the moment we can still help, even if you can’t come into see your Physio.
TeleHealth allows you to gain remote access to our experienced practitioners from your phone or device.
Get the physiotherapy treatment you need from the safety of your own home.

Book your Telehealth video consult

Sport Focus Physiotherapy programs are available to cater to all your womens pelvic health needs. Find out more about our pregnancy exercise class and programs.

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