In this blog series, Lara shares her experience as an oversea-trained physiotherapist working in the UK. From guidance on the HCPC registration process to discussion around UK and international physio news, she hopes to provide help to foreign physios looking to work in the UK - and to connect with those of you who already are!
This is not just a clickbait, fancy heading for St Valentine's Day - it's true, us physios know a lot about sex! And I do not mean about gender, I mean sexual intercourse. There, I said it, like Sheldon Cooper from The Big Bang Theory would say it. (Bonus fact for you: I'm a geek…)
We've all heard how our pelvic floor is important for sexual health. Well, although it's not yet well known to the general public, there are Physios who specialise in this area of our body. They are the heroes of my article today. The all-mighty pelvic-floor Physiotherapists, who help to break the taboo on the topic and bring solutions to those conditions that we didn’t dare mention in the past and still have trouble talking about and treating today.
While writing this article and doing my research on pelvic-floor and Physiotherapy in Women’s Health in general, I found out that these specialities are still relatively new to us - and even more to the general public. Only 20 years have passed since it has been established that more research on the topic was needed and that prescribing sit-ups to help with symptoms was not enough. Writing about this topic has made me realise, even more than ever before, how medicine evolves hand-in-hand with cultural, political and religious beliefs.
For a while, I felt a bit overwhelmed about the topic and left my article unfinished… But it wasn't the end of the story. A few months later, I came across an interview in a Spanish national newspaper about Sexual Health, myths surrounding the topic and how Physiotherapy could improve sexual dysfunctions.
I contacted one of the Physiotherapists interviewed for that article to hear about her story and tell me more about about the role of Physios in pelvic floor, Women's Health, and sex.
"Only 20 years have passed since it has been established that more research on the topic was needed and that prescribing sit-ups to help with symptoms was not enough. "
Laura Pastor is an Spanish Physiotherapist based in Catalonia. She finished her Physiotherapy training in 2001 and started working privately. After working in a few different jobs, she grew an interest in delivering exercise classes for pregnant women and realised how little information there was to help her prepare these.
She started to investigate further about the topic and became a Pilates instructor. She became aware of the work of Marcel Caufriez and the hypopressive exercises (a relatively recent technique used to help in exercising the pelvic floor and toning the abdomen). Laura feels that thanks to this sort of work, advances started to be made on the topic of pelvic health and it slowly stopped being so much of a taboo subject. However, she knew there was more to it than just some exercises, and in her mission to find the missing piece to the Pelvic Floor puzzle, she undertook a Master's in Urogynaecology Rehabilitation.
Thanks to her Master's, Laura learnt not only about the pelvic floor and Women’s Health in general but also about herself as a woman. She described to me how sexual education is extremely limited even in ‘modern’ countries and how little we know about ourselves on the matter. She questioned why we did not talk more about it, not even between friends, or why even doctors failed to give us more guidance on the topic. The evidence is there, why not transmit it?
"However, she knew there was more to it than just some exercises, and in her mission to find the missing piece to the Pelvic Floor puzzle, she undertook a Master's in Urogynaecology Rehabilitation."
Little by little, she focused all her knowledge and skills in treating pelvic-floor issues, both for women and men (although 90% of her patients are female); and she learned about sexual dysfunctions and how much Physios specialised in this area could help.
In the past, sexual dysfunctions were treated mainly by Psychologists, as the issue was thought to be from emotional distress or trauma. Sometimes patients who attended Laura's clinic would tell her that there was something else, that it wasn't all "emotional". That's when she started working with Psychologists, Osteopaths and Gynaecologists to show the benefits of Physiotherapy in the management of those conditions. Today, she has no hesitation in saying that the ideal approach for those conditions should be multidisciplinary.
Laura told me about some the conditions that can be treated with the help of Physiotherapy. Among them vaginismus, dyspareunia and incontinence, which might not be directly related to sexual dysfunction but "if there is incontinence there is most likely collateral sexual dysfunction as well", she affirms.
Although Laura has experienced a big ‘boom’ in patients seeking help for sexual dysfunction and physiotherapists seeking further training, there is still much work to do in term of awareness. Laura feels the role of Physiotherapy in this speciality is still not known, not only to the public but also to medical professionals. She often finds that Gynaecologists are still not fully aware of how Physiotherapy can help and end up referring patients too late.
Another barrier she has encountered is again, regarding information and education available for patients but also the public. As sexual education is quite limited, people often feel overwhelmed when talking about it or when they require specialist diagnostic or treatment such as intra-cavitary examination.
In an effort to come up with a solution to some of those barriers, Laura started her own professional blog, where she explains basic concepts, debunks myths and give out advice about Women’s Health. It started as a guide for her own patients but recently it has grown to be a useful source of information for the general public too. She has a growing audience of over 4k followers on Instagram, all eager to find out more on the topic.
"She then started working with Psychologists, Osteopaths and Gynaecologists and has no hesitation in saying that the ideal approach for those conditions should be multidisciplinary."
Laura's not finished in her mission however: she also offers training to other Physiotherapists, and one of her many other achievements is being a lecturer for Psychologists that are studying their Master's on sexual dysfunctions. Laura teaches the anatomical and physiological aspect as well as stressing the importance of a multidisciplinary approach when treating these conditions (and the role of physio in it, of course).
To wrap up my conversation, I asked Laura what exercise she prescribes the most:
- the mirror exercise! - she said without the trace of doubt.
The mirror exercise consists on dedicating time to getting to know your intimate area. Laura suggests that you create a relaxed environment where you feel comfortable. Perhaps music of your taste, some cushions on the floor or whatever suits you - and of course, a mirror. Use the mirror to differentiate the different parts of your vulva and explore the different textures without fear. Learn the differences between a pelvic floor contracted and relaxed.
Knowing yourself and what ‘normal’ is for you helps to identify problems in the future. It will also help you increase awareness to the pelvic floor, and make sex better, too!
Happy Valentine's Day people!
If you have physiotherapy news that you would like to share, you can contact us on firstname.lastname@example.org.
About the author
Lara is a Spanish physiotherapist who has been working in the UK for the past 3 years. Having worked as a rotational physiotherapist over here, she's had experience in a wide range of specialities and now works as a Band 6 Physiotherapist. However, it hasn't always been easy finding her way and adjusting to the UK system. She's since been sharing her experience and helping other foreign-trained physios to come and settle here; firstly through her own blog, and now as part of the QP team!