Sheree Palmer is an Orthopaedic Physiotherapist with a special interest in pelvic health and postpartum rehabilitation. Sheree is qualified to do internal pelvic assessments and treatments on dysfunctional pelvic floor muscles (PFM) and scar tissue that may be contributing to urinary incontinence, low back, hip, groin, pelvic or tailbone issues. Sheree is qualified to fit and manage vaginal pessaries to support pelvic organ prolapse and improve urinary incontinence. She uses a biopsychosocial treatment model including education, manual therapy, IMS, realtime ultrasound, pessary fitting, and exercises to address pain and functional deficits.

 

About the Pelvic Floor Muscles (PFM):

 

The PFM have a big role in our deep core system and are involved in bowel and bladder continence and elimination, pelvic organ support, and sexual arousal. PFM can be dysfunctional if they are overactive and tight, or weak and lengthened. Overactive PFM is often caused by our nervous system which in today’s world is often overstimulated or sensitized which can lead to tight muscles.

 

During pregnancy, there are muscular and hormonal changes which may contribute to pelvic girdle, back, and hip pain. Sheree is qualified to use the "Rost Therapy" techniques on clients with pelvic girdle pain, in particular perinatal clients. Tight dysfunctional PFM could make the birthing process more difficult as they need to relax and stretch. Postpartum scarring and dysfunctional PFM can cause tightness and pelvic pain, which inhibits function. Diastasis rectus abdominis (DRA) is a common issue in postpartum women, but can also be seen in anyone with poorly managed intra-abdominal pressure (eg. Valsalva with lifting or sit-up motion). With a dysfunctional core system, it is difficult to create stability across this gap, which leads to more compensation patterns and often pain.

 

Genitourinary syndrome of menopause, due to hormonal changes, causes PFM and tissue atrophy (thinning), which can lead to incontinence, prolapse, vaginal dryness, urinary tract infections, and pain with intercourse. At this stage of life, the pelvic organs may require a vaginal pessary or surgery in addition to PFM training.

 

It is recommended to see a pelvic health physiotherapist if you are experiencing any of these conditions that could be a result of PFM dysfunction: low back, groin, hip, pelvic or tailbone issues since pregnancy or birth, incontinence, pelvic organ prolapse (heaviness in the vagina), or painful intercourse. An internal pelvic health assessment is considered the gold standard for assessing function of the PFM. In the postpartum population it can be performed after 6 weeks postpartum. It is recommended before starting an exercise program.

 

Sheree's mission is to help each client work towards their optimal health potential in order to enhance their love for life through healthy living.