The evidence is now conclusive - educating patients about the science of pain is an essential component of treating persistent pain. Exploring how pain experiences are constructed in response to dangers and threats in our bodies and influenced by our thoughts, beliefs and context and the insight and knowledge gained throughout this process can be one of the keys to recovery.

Anorectal or bowel dysfunction is common, yet is under-reported, under-diagnosed and under-treated. Nearly 2% of Australian adults experience faecal incontinence and 4% experience both urinary and faecal incontinence. A staggering 40% of the world’s population are impacted by Disorders of Gut-Brain Interaction (DGBI) eg Irritable Bowel Syndrome (IBS).

Every day, we speak with people who seek our support regarding painful sex. Often their stories include fear, confusion and a poor understanding of the vulva, clitoris and vagina. Many people hold unhelpful beliefs and perceptions of what is and isn’t normal. As Pelvic Health Physiotherapists, part of our role is to educate, enlighten and empower individuals to develop a healthier perspective about their genitals and guide them toward safe, comfortable and pleasurable experiences with their body. Here we explore relatively recent discoveries regarding the clitoris and the relevance to those we see with pelvic health concerns.

Trauma, neglect and attachment disorders are common and create behavioural, physiological and cognitive adaptations that impact daily function and health via the effects on the neurological, endocrine and immune systems. The experience of trauma can result in loss of trust, feelings of guilt and shame, a decreased sense of safety and loss of hope for the future. These changes can affect the way people approach potentially helpful relationships and make it harder for them to engage with health care practitioners.

Pessaries are being increasingly utilised as a component of the biopsychosocial non-surgical management of Pelvic Organ Prolapse (POP), in addition to pelvic floor muscle training, lifestyle changes and topical oestrogen. It is vital that these treatments are provided effectively and safely following evidence based and competency assessed standards.

The concept of sensorimotor retraining gained national and international attention in 2022 when a group of Australian researchers found promising benefits of graded sensorimotor retraining on pain intensity in patients with chronic low back pain. Known as the RESOLVE¹ study, they used a framework that included graded, novel precise exercises which showed statistically significant improvements in pain. As movement therapists it is important that Physiotherapists understand how changes in sensorimotor representation within a sensitised nervous system requires us to move beyond typical therapeutic stretching and strengthening exercises. We take a deep dive into the neuroscience behind this and explain how remapping exercises can target the sensorimotor dysregulation contributors to persistent pelvic and sexual pain.