Emma James Physio Blog

Chartered Physiotherapy and Clinical Pilates


March 2020


Endometriosis Awareness Month

What is Endometriosis?

Endometriosis is a condition where endometrial tissue (tissue similar to the lining of the womb) starts to grow in other places, such as the ovaries and fallopian tubes. It is one of the most common gynaecological diseases needing treatment (NG73 September 2017). It can affect women at any age however it is mainly a disease of the reproductive years. Whilst the exact cause is not known, it is associated with menstruation and hormonal changes.

What are the symptoms?

enometriosis-diagramThe main symptoms include pelvic pain, painful periods, pain during or after sex, pain with passing urine or bowel movements during your period, feeling sick, constipation, diarrhoea, blood in your urine during your period and infertility.

As a result, endometriosis can have a significant impact on quality of life and in some cases lead to feelings of low mood or depression.

How can it be treated?

Treatments include painkillers, hormone medicines and contraceptives, surgery to cut away patches of endometriosis tissue or in some cases hysterectomy. The current NICE guidelines (NG73 September 2017) note in their recommendations that there should also be access to a multidisciplinary pain management service with expertise in pelvic pain as well as other things.

Physiotherapists can play a role in the management of pelvic pain by helping to strengthen the pelvic floor, which can improve sexual function as well as prevent unwanted leakage or continence issues.

HerPelvipower_magnetic_field_training_EJPhysioe at Emma James Physio we can provide expertise and insight into the management of pelvic pain. Emma herself has a special interest in Women’s Health and has been working hard to develop a service that is accessible for all, in the diagnosis, management and treatment of pelvic pain.

We can provide assessment and treatment using the Pelvipower chair, or perhaps why not try some acupuncture for pain relief. Why not book in for an assessment and find out more about the range of tools we have available to help manage your symptoms?

floatation-therapy-at-ejphysioNot quite ready to tackle it yet?…………… problem, book in for a session in our floatation tank and take some time out for you. Looking after yourself with some ‘me time’ can do the world of good for your state of mind. Our therapists are ready and waiting to help to when you are.


Blog Post by Mary
Senior Physiotherapist MSc, BSc (Hons), MHCPC, MCSP
Emma James Physiotherapy

Why we should Exercise

Adults should do some type of physical activity every day. Any type of activity is good for you. The more you do the better. The following advice is from NHS England.

Adults should:

  • aim to be physically active every day. Any activity is better than none, and more is better still
  • do strengthening activities that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week
  • do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
  • reduce time spent sitting or lying down and break up long periods of not moving with some activity

What counts as moderate aerobic activity?

exercisingModerate activity will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you’re working at a moderate intensity level is if you can still talk, but not sing. Examples of moderate intensity activities include brisk walking, water aerobics, riding a bike, dancing, doubles tennis, pushing a lawn mower, hiking.

What counts as vigorous activity?

Vigorous intensity activity makes you breathe hard and fast. If you’re working at this level, you will not be able to say more than a few words without pausing for breath. In general, 75 minutes of vigorous intensity activity can give similar health benefits to 150 minutes of moderate intensity activity.

riding-a-bikeMost moderate activities can become vigorous if you increase your effort.

Examples of vigorous activities include jogging or running, swimming fast, riding a bike fast or on hills, sports, skipping, aerobics, martial arts.


What activities strengthen muscles?

muscle-trainingTo get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity. It is best to get a chartered physiotherapist or qualified personal trainer to advice you on this.

There are many ways you can strengthen your muscles, whether you’re at home or in a gym and this includes lifting weights, using resistance bands and body weight exercises (such as press ups).

Always gain advice from a qualified professional before starting a new exercise programme or if there is a change in your health status.

How we can help

Stay Healthy

Blog post by Lisa
Senior Physiotherapist

Emma James Physio

For all new mums that love to run!

In this blog, I am going to talk through a recent publication which is rare its in context; providing guidelines for women wanting to return to or begin running after giving birth. It aims to serve as a guide for all new mums that love exercise or want to start after having a new-born.

Let’s dive in!

There is little guidance provided to healthcare professionals on how to transition runners back to activity postpartum; so, it’s easily understandable why new mums themselves may run into trouble (pun intended; apologies). There are three stages within the postpartum phase; lasting up to 6 months, but there are still intrinsic factors such as hormone level changes that are still adjusting even longer than this – so we need to be considerate for a significant period of time when returning to exercise.

Barriers that may affect women when returning to running postpartum may include;

  • new-muminadequate quality and quantity of sleep
  • fatigue
  • learning to care for a new-born
  • a changing schedule
  • physical changes

During pregnancy and postpartum the pelvic floor muscles (PFM) undergo significant change, including stretch from the increased weight gain and postural changes, increased muscular demand because of these changes, possible tearing during childbirth and then ultimately recovery through the pregnancy and postpartum period.

These changes may lead to decreased core stability, pelvic floor weakness, urinary incontinence, stress urinary incontinence (SUI) while running, lower back and hip pain and other musculoskeletal injuries.

See more info on PFM and the affects of pelvic floor weakness in our previous blog here.

There is an association with the intrinsic changes above and altered running gait post-partum. Therefore, it may be important to modify frequency and intensity of running with the guidance of a healthcare professional.

So, when is it safe to return to running?


There is currently no guidance available for women who want to return to running or begin to run postpartum.

There are some recommendations for exercise in general. Return to exercise gradually when it is medically safe, when physical stress is tolerable.

The recommendations outlined in the aforementioned study are as follows;

  1. Clearance to exercise by physician
  2. Evaluation by healthcare professional specialising in pelvic health
  3. Comprehensive assessment of physical function and biomechanics
  4. Initiation of running and strength programme

Walking is a great way to begin safely exercising immediately postpartum. It provides many of the psychological benefits of exercise while preparing the body for running. Despite the overwhelming changes that occur postpartum, many women progress or start with running much sooner than their bodies are ready to.

If you do suffer from incontinence, diastasis recti abdominis (DRA) or any other associated post-partum issues; it doesn’t mean you cannot return to running, it may just mean modifying activity and completing specific exercises to address any issues. Many women are under the misconception that leakage while running is normal and it is not.

To summarise

Many women return to running between 6-8 weeks post-partum, without guidelines or instruction from a healthcare professional, with biomechanical and physiological changes that occur during pregnancy and remain postpartum potentially increasing risk of injury.

Currently, there is no gold standard for the management and care of women returning to running postpartum. The reviewed article highlights changes that occur during pregnancy that may alter the way women walk, run, lift and move postpartum.

Following the 4 stages of returning to running above should reduce the risk of complications and increased injury risk, whilst being under the guidance and care of a healthcare professional.

mummy-mot-certified-logoAt Emma James Physio we pride ourselves in offering specialist women’s health, biomechanical and strength and conditioning services. So, come and see us and we will get you back to where you want to be, or for you new mums; help you take those first steps after your new-born!

Adam 😊adam


Blog post by Adam
Senior Physiotherapist at Emma James Physio

Reference: Edwards, Kate. (2019). Considerations for the Postpartum Runner. Strength and Conditioning Journal. Publish Ahead of Print. 1. 10.1519/SSC.0000000000000453.

The importance of pelvic floor health in a sporting population

What is your Pelvic Floor?

Your pelvic floor is the group of muscles and ligaments in your pelvic region. The pelvic floor acts like a sling to support the organs in your pelvis – including the bladder, rectum and uterus or prostate.

Contracting and relaxing these muscles allows you to control your bowel movements, urination and for women particularly, sexual intercourse.

The importance of Pelvic floor health

What issues can you face with a dysfunctional pelvic floor?

Pelvic floor dysfunction is the inability to control the muscles of your pelvic floor. This term refers to a range of issues such as:

  • urinary issues, such as the urge to urinate or painful urination
  • constipation or bowel strains
  • lower back pain
  • hip pain
  • pain in the pelvic region, genitals, or rectum
  • discomfort during sexual intercourse for women
  • adductor pain

The importance of pelvic floor health in a sporting population

weight-lifting-womanAthletes are at greater risk of stress urinary incontinence due to their continued exposure to increases in intra-abdominal pressure throughout training.

What does this mean? Well, most sports involve one of two exercise forms; jumping and landing (eg. running, athletics) or the Valsalva maneuver (eg. weight lifting).

These two activities exert different deformations upon the pelvic floor due to their distinct direction and type of pressure loads.

Hip & Adductor injuries in a sporting population

Did you know that your pelvic floor muscles are directly attached you your hip muscles?

That’s right, the hip bone is connected to the pelvic bone and the pelvic floor muscles are connected to the one of your hip muscles: the obturator internus (OI)! It is reported that 64-72% of patients with hip dysfunction also experience pelvic floor dysfunction. This is largely due to weak lateral rotators and tight adductors.


How can we help you?

Personal Training
A personal trainer can help you to strengthen your lateral rotator muscles to help prevent hip dysfunction.

Sports Massage
A deep tissue massage of the adductor muscles can help to relieve muscle pain and tension, as well as overloading the pelvic floor.Pelvipower_magnetic_field_training_EJPhysio

The PelviPower Chair
This non-invasive method involves sitting on a chair as the pelvic floor muscles contract up to 25,000 times by the magnetic waves in the seat. One to two training sessions per week are adequate to effectively strengthen the pelvic floor.

Pelvic Floor Trainers & Toners

My Pelviva

Pelvic Floor muscle trainer with reactive pulse technology

Pelviva is an award winning, life changing, Pelvic Floor muscle re-trainer that uses a specially developed stimulation programme to treat the symptoms of bladder leakage in women.

Receive 10% off purchase price when you use the code EmmaJames at checkout when you purchase online.

Visit the Pelviva Website for more details and how to buy.

Secret Whispers


Secret Whispers ™ is a pelvic floor toner for women. Its 6 Step Pelvic Floor Exercise Strengthen & Tighten Your Pelvic Floor Fast. It helps with – pregnancy, childbirth, incontinence and bladder control.

Secret Whispers ™ pelvic floor packs are available to purchase from our main Emma James Physio clinic or online:

Click here to Purchase Secret Whispers Products

Bye for now 😉

Blog Post by India
Sports Therapist at Emma James Physio

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