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STRESS URINARY INCONTINENCE2021-07-09T13:17:26+10:00


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

Stress Urinary Incontinence

1:3 women who ever have a baby will experience some SUI during their life!!
SUI occurs when your pelvic floor muscles are weakened from an outside influence, like a cough, laugh or sneeze, which causes a small amount of urine to leak from the bladder.
Stress incontinence is often treated with pelvic floor physiotherapy exercises.
Urgency overactive bladder occurs when you have a sudden urge to empty your bladder and leak urine on the way to the toilet. SUI is most prevalent in women during and after they have had children. During pregnancy the position and weight of the growing baby on top of the bladder can cause frequency (needing to go often) and sometimes urgency (sudden and overwhelming desire to go to the toilet).
Some pregnant women may experience small leaks with a full bladder when they cough, sneeze, laugh, run, jump, etc. and this may continue after the birth of their baby. This is not normal and should be addressed with correct pelvic floor muscle awareness and activation during pregnancy. it’s NOT OK to accept this as ‘normal’ after the birth of your baby as it may lead to long term problems.
” Although commonly seen in middle aged and elderly women when a group of female student nurses who had not had children were questioned, 40% admitted some form of incontinence. Many women avoid seeking medical help due to the misconception that the condition is a normal part of ageing or due to embarrassment.”

Types of Stress Urinary Incontinence SUI

Stress Involuntary leakage on effort or exertion, or on sneezing or coughing
Urge Involuntary leakage accompanied by or immediately preceded by urgency
Mixed Involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing
Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet
Overflow Unexpected leakage of small amounts of urine because of an overfilled bladder
Transient Leakage that occurs temporarily because of a condition or situation that will pass (eg, infection, medication)
Deformity Fistula or developmental abnormality

The pelvic floor muscles are on the inside of your pelvis. They sling between the pubic bone at the front and the tailbone at the back. They also run across the back of the pelvis inside between the two bones that you sit on. They are there to keep the bladder, bowel, and uterus up in the pelvis and control the emptying of bladder and bowel. The pelvic floor muscles also play a role in sexual satisfaction and orgasm.

This picture on the right shows a view down into the bowl of the pelvis. You can see the Pubococcygeus, Puborectalis, and Coccygeus muscles. These form the ‘Levator Ani’ muscles. This ‘plate’ of muscles, fascia and ligaments keep the bladder, uterus and bowel up inside the pelvis and controls the emptying of bladder and bowel.
These techniques can assist women find their pelvic floor muscles:

  • When emptying the bladder try to stop or slow the stream. Do this only to help identify the pelvic floorand not as a regular exercise.  Do not perform this technique if you suffer from bladder emptying problems.
  • Imagine you are trying to avoid passing wind in doing so attempt to lift and squeeze the muscles in and around the anus. Your buttocks should stay relaxed and your breathing should remain regular.
  • Use a mirror to view the entrance to your vagina. Try to lift and squeeze in and around the entrance of your vagina. You should see a squeeze and inwards lift of the vaginal entrance.

Symptoms of stress urinary incontinence SUI

  • accidentally leaking urine when you exercise, laugh, cough or sneeze
  • needing to get to the toilet in a hurry or not making it there in time
  • constantly needing to go to the toilet
  • accidentally losing control of your bladder or bowel
  • accidentally passing wind

These symptoms are the result of the muscles around the bladder neck or sphincter not being able to contract enough to withstand the pressures from the pelvic and abdominal cavity above.
Women’s health physiotherapists describe this as the ‘intra- abdominal pressure’ IAP exceeding the ‘intra vaginal pressure’ and therefore causing ‘stress’ leaks.
Some women only experience this with a full bladder and think that it’s OK …it’s still stress urinary incontinence…and we must NOT be soothed by our various incontinence product manufacturers to believe that ‘light bladder leakage’ is the norm.
If you are not confident that you can identify and contract the pelvic floor muscles

  • contact Sports Focus Physio today and have a Pelvic (internal vaginal) assessment
  • see your GP if you are concerned to exclude other pathology
  • reduce your ‘stresses’ on your pelvic floor
  • reduce lifting small and large children
  • address excess weight with a ‘safe’ exercise programme
  • reduce any coughing or sneezing due to viruses, chronic chest problems or allergies by reviewing your medications
  • if you are doing high impact exercises- running, bootcamp / boy exercises and ignoring the problem STOP now you are only making the problem worse
  • if you work with a personal trainer, tell them your problem- you would do so if you had a sore knee or back injury. If they can’t modify your programme …come and see me. I love putting my personal trainer hat on and guiding you into safe exercise options

Sometimes pelvic floor exercises are not enough and don’t fix the problem. We, as women’s health physios need to be able to admit this and refer on to GP – Urogynae – Gynae – Colo rectal specialists for further advice / investigation and possible surgery.

So what are the surgical options for SUI

Surgery is only recommended after the exact cause of urinary incontinence has been found. Strengthening exercises are still the 1st treatment approach generally for SUI
Colposuspension – this procedure involves the bladder neck being lifted back to its proper position. The front wall of the vagina (where the urethra is located) is lifted and stitched to strong ligaments near the pubic bone. The most popular type of colposuspension procedure is Burch colposuspension, which can be performed both abdominally and laparoscopically (key-hole surgery).

Sling procedure – in this procedure, a piece of fascia (strong tissue that covers the body’s muscles) or a synthetic material such as mesh tape, is placed under the urethra like a hammock to support it. Some sling procedures are performed while you are under a general anaesthetic, while others can be done using a regional anaesthetic. The procedure generally requires small incisions in the abdomen and/or vagina.

Surgery should only be considered after you have trialled conservative treatments and undergone a urodynamic assessment to ensure the diagnosis is correct and your condition is favourable to surgical correction. Success rates and risks vary for different procedures and so you should discuss this with your doctor prior to surgery. Surgery may not result in a complete resolution of incontinence symptoms. Surgery is generally not performed unless a woman is not planning any further pregnancies, as pregnancy will impact the ongoing results.

Intrinsic Sphincter Deficiency ISD

ISD another type of SUI where the urethra (tube from your bladder) lacks the normal closing pressure needed to prevent leakage on activities. In ISD, the bladder outlet is open at rest and urine can leak through even with lighter impact activities. It’s like a garden hose that you stand on…but not quite enough to stop the flow.

The neck of the bladder is not staying closed ‘tightly’ The most severe form of ISD-related stress urinary incontinence is that of the fixed ‘lead-pipe’ urethra.
Closure is achieved by a combination of factors including the strength of the connective tissue, (intact pelvic fascia and ligaments)  the blood flow to the urethra, the health  of the  lining of the urethra and the strength of the muscle surrounding the urethra.

Several problems may compromise this closure:

  • Tearing of the nerves to the sphincter during childbirth
  • Peripheral neuropathies as occur with diabetes and other causes.
  • Increased age.
  • The lack of Oestrogen in that area in the post-menopausal phase of a woman’s life.
  • Trauma from surgery [e.g. vaginal repair, urethrotomy].

Intrinsic Sphincter Deficiency [ISD] is diagnosed  by Urodynamic Studies  measuring the Urethral closure pressure UCP. This involves a catheter being inserted into your urethra.  There are several other indicators in the client history and symptoms which will help the Women’s health physiotherapist with this diagnosis.

Prevention – maintenance of good pelvic floor muscles


  1. Local oestrogen in vaginal cream or pessary long term.
  2. Alpha adrenergic agonists—these drugs may stimulate the sphincter.
  3. Injection of peri-urethral bulking agents e.g. Macroplastique.

Success, however, is limited making prevention even more important.
The absolute 1st line of action or “best practise” medicine is to try and strengthen your Pelvic floor muscles. Most GP’s, Gynaecologists and Urogynecologist’s will advise their patients to try 3-6months of Pelvic floor muscle education and re- training before surgical intervention.


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.

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.

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.

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

Learn more about our prenatal Pilates and pregnancy physiotherapy exercise class.

Womens health physiotherapy is available at Northbridge and Liverpool.

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.

Pilates classes tailored by our Sports Focus Physiotherapists. These classes are for all levels – beginner, intermediate or advanced. They are designed by our experienced clinical Pilates Physiotherapists with their background in muscle and joint rehabilitation exercises for all ages.

Follow the link and get started today: Active Physio Classes

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.

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.

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

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; and Postural and Pelvic / lumbar spine assessment

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

Postnatal physiotherapy is available at Northbridge and Liverpool.

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. Book online now.

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 can identify biomechanical patterns or faults within the system.

Whether you’re 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. Book online now.

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 a 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. Book online now.

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.

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.

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, including shoulder physiotherapy, neck physiotherapy and women’s health physiotherapy.

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. Book online now.

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. Book online now.

The temporomandibular consists of two joints between your cheek bone and jawbone and it is the most 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. Book online now.

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.

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 and CBD Wynyard physiotherapy locations. Book online now.

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 and Castle Hill physiotherapy locations.

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.

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. Book online now.

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.

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.

Sport Focus Physiotherapy programs are available to cater to all your Sydney ski fitness needs. Find out more about our Get Fit to Ski programs today.

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