Category Archives: Pilates


Perineal Massage & Pelvic Floor Preparation

Antenatal digital perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain. Women should be made aware of the likely benefit of perineal massage and provided with information on how to massage (Beckmann & Stock 2013).

This is based on a review including four studies (2497 women) comparing digital perineal massage with control. Antenatal digital perineal massage was associated with an overall reduction in the incidence of trauma requiring suturing and women practicing perineal massage were less likely to have an episiotomy. These findings were significant for women without previous vaginal birth only.

No differences were seen in the incidence of first- or second-degree perineal tears or third- or fourth-degree perineal trauma. There was a reduction in the incidence of pain at three months postpartum in women who had previously given birth vaginally. No significant differences were observed in the incidence of instrumental deliveries, sexual satisfaction, or any type of incontinence for women who practiced perineal massage compared with those who did not massage.

The basic perineal massage technique is the woman or partner performs daily 5-10 minute perineal massage from 34 weeks. One to two fingers are introduced 3-4 cm in vagina, applying alternating downward and sideward pressure using sweet almond oil (Labreque 1994). Other descriptions are to perform massage for 4 minutes 3-4 times per week from 34 weeks, 5cms into the vagina and sweeping downward from 3 o clock to 9 o clock (Shipman 1997).

The Epi-No® has been designed to assist women with antenatal perineal release and it is recommended to use it from 37 weeks. It is recommended to insert the balloon 2/3rds into the vagina and to contract and relax the muscles against the balloon, which provides resistance. It should then slowly be inflated to the point of stretching and comfort each day and the muscles are stretched more. After the stretching phase the pelvic floor muscles are relaxed to allow the inflated balloon to be gently expelled from the vagina. A randomized controlled trial on this product showed that antenatal use of the Epi-No® device is unlikely to be clinically beneficial in the prevention of intrapartum levator ani damage or anal sphincter and perineal trauma as diagnosed with ultrasound imaging (Atan et al. 2016).

It has been shown that almost 60% of women who have never given birth report some pelvic floor symptoms (Durnea et al 2014) and clinically it can be observed that many women present with high tone and sometimes painful pelvic floor at this stage. At we teach breathing release for the pelvic floor from 34 weeks gestation and gradually increase to include perineal massage, connective tissue manipulation of the external perineum and extend to manual therapy of the deep pelvic floor muscles. We recommend 3-4 sessions as needed with a chartered physiotherapist with a special interest in women’s health depending on the resting position and tension of the pelvic floor. We teach a home exercise program for daily practice.


Milltown Physio at International Pilates Conference

Our chartered physiotherapist and leader of our ante/post natal Pilates classes, Stephanie Crossland attended the prestigious APPI Pilates Conference in the UK last weekend.

At the conference Stephanie completed a workshop and met with Alan Herdman who is recognised as bringing Pilates to the UK in 1970, after he served an apprenticeship with 2 instructors who had trained with Joseph Pilates himself!
Some of the highlights included an antenatal based exercise class with Cherry Baker, gaining more knowledge and insight into using Pilates exercises safely with pregnant women. She loves to share the new information and research within the clinic.

Interestingly she also attended a post natal session with emphasis on return to sport with Biljana Kennaway (APPI Master). While there she got some great information on cutting edge research for use with her mother and baby Pilates class.

Stephanie has a huge knowledge base in Pilates and has conducted research on the use of Pilates-based exercise in ante and post-natal women with pelvic girdle pain gaining an Masters in the process! Stephanie has a special interest in the treatment of Pelvic Girdle Pain in Pregnancy. Additionally, she is an instructor in Pilates for this client population.


Call us now for Ante & Postnatal Pilates Classes

Pictured here is our physiotherapist Elaine with a few of the younger members of her popular Postnatal pilates class! Elaine has a special interest in women’s health and a wealth of experience in women’s health conditions.

Are you pregnant or have just given birth? To be eligible to join the ante natal class you must be at least 16 weeks pregnant and 6-8 weeks following delivery for the postnatal class.

All ante and postnatal Pilates classes are led by Chartered Physiotherapists who are experienced in the rehabilitation of women’s health conditions such as pelvic girdle pain and pelvic floor dysfunction.

Tara Murtagh

Welcome to the clinic – Tara

We are delighted to welcome Tara Murtagh to the clinic due to increasing demand. Tara has a wealth of experience, and also expert post graduate training in Pelvic Floor rehab and continence.

Tara is passionate about treating prenatal and post natal musculoskeletal conditions, pelvic floor and continence rehab, clinical Pilates, dry needling as well as exercise prescription and rehabilitation.
Welcome on board Tara!

Welcome to the clinic – Helen and Louise

Milltown is delighted to announce due to increased patient demand two new physiotherapists for the clinic. Dr. Helen French joins us part time as she combines her role as a Senior Lecturer in the Royal College of Surgeons with some clinical work. We are delighted to be able to tap into some incredible experience and knowledge of cutting edge research.

We are also very happy that Louise Blackburn has agreed to join our team here in Milltown Physiotherapy. Louise (pictured) has extensive experience working in private practice in New Zealand. She has a masters in acupuncture, and specialises in orthopaedics, sport and spinal injuries.

We also say goodbye to  Niamh Dillon, who now takes up a teaching post in St. Vincent’s. While her clinical work ends, she has agreed to stay to continue to teach her very popular pilates evening classes. Good luck with the new job Niamh!

Back To Work Workshop – Helping New Mums Figure Stuff Out

Mum with baby on knee


Are you going back to work soon or have recently gone back to work after your maternity leave?

Some people find themselves dreading it. Some look forward to getting their brain back in action, getting dressed up and being able to take a coffee or lunch in peace. Many are a combination of both with a bit of self-doubt thrown in…

Can I still do my job? (Yes, you can) Will I be able to manage? (Yes, you will).

Adding in a spoonful of working mum guilt, a cup full of added responsibilities and a pot full of the juggling ahead makes it a challenging time. But by actively managing that transition back to work and being clear about your priorities – at work and at home – you can set yourself up to succeed in this new phase.

If you think that you could benefit from taking some time out to work through some of these thoughts and emotions, join us for our next workshop run by Dearbhalla Baviera, Executive Coach with a focus on Women in Business, on Saturday June 13th in Milltown Physiotherapy where we will help you:-

  • Get in the right and positive mindset to ramp up effectively when you get back to work
  • Clarify your objectives for the next 12-18 months at work and at home/in your life
  • Own your personal brand which is an important part of managing this transition
  • Prepare for any difficult conversations that you might need to have to help you set yourself up to succeed
  • Own this transition back to work as a working mum. It’s your career and your choices

Other themes that come up throughout the workshop include confidence, working mum guilt, assertiveness, and resilience – all key parts of navigating our career as successful women.

This workshop is an opportunity to learn, reflect, share experiences with like-minded women in similar situations. It always helps to know that you are not the only one in your situation.

The half day programme is run as a coaching style workshop – through listening, discussion and personal exercises which give you space to think on a personal level, you will walk away feeling energised, inspired and motivated to put in place the things that you can do to set yourself up to succeed.

Dearbhalla Baviera has been there. She went back to work as a Management Consultant after her first baby. She had time out at home after baby two during an international move and now after babies three and four (together!) she has set up her own business, Clearbird, as an Executive Coach and Consultant where her main focus is helping women in business to figure stuff out. This means navigating and succeeding from the mid career phase and beyond.


For more information and to book or check out


Next workshop will be held on

Date and time: June 13th 2015 from 12:00-17:00 in Milltown Physiotherapy Pilates Studio

Cost: €175 euro per person.

Workshop plus 1:1 coaching package available on request.

Some lovely ladies who have attended this workshop previously have said…

“I wish I had done this type of workshop before I went back to work after my first baby”

“Really interesting topics that made me stop and think about my priorities and where to focus my energies”

“I feel really motivated to take my career up a gear”

“Very inspiring. Had me thinking about where I want to be in a year and in 20!”



Pilates at Milltown Physiotherapy

A nice informative account on pilates by our chartered physiotherapist and pilates instructor Gráinne Wall.

“Physical fitness is the first requisite of happiness. In order to achieve happiness it is important to gain mastery of your body” Joseph Pilates.

The Pilates method of exercise originally designed in the early 1900’s by Joseph Pilates still remains at the forefront of the exercise and rehabilitation industry today. Pilates is a whole body workout that is based on the principles of breathing, centering, control, precision and concentration. Joseph Pilates often called the abdominals, lower back muscles and buttocks the “powerhouse” of your body, where strength and stamina are built to prevent injury.

Pilates has been popular for decades in the dance industry and has grown in popularity due to the unique approach to mind-body awareness and extensive research promoting its benefits in treating back pain, a safe method of exercising during pregnancy, and also assist in postnatal recovery.

What can you expect to achieve from doing Pilates?


The spine supports the majority of your body weight and is under daily stress and strain spending hours sitting at a desk during the day or on the couch at night. During your Pilates class, the correct breathing technique will be taught to enhance your abdominal workout, improve circulation and enhance your flexibility.

Pilates will improve your balance, co-ordination of movement, body positioning and spatial awareness whilst also increasing strength which corrects postural faults and improves stamina.

Studies have shown the effectiveness of a few weekly Pilates sessions as helping to significantly reduce lower back pain (Patti et al 2015). Pilates exercises train the “core muscles” which decrease compression around the spinal joints and alter the tilt of the pelvis to a more neutral position. Much attention is paid to the legs, thighs, buttocks and spine and focus on developing good postural habits and relieves low back pain, a condition up to 80% of the population will be affected by at some point in their life.

Pilates during pregnancy


Exercises are also geared toward strengthening the pelvic floor muscles. When you are pregnant, muscles begin to stretch as the pelvis widens to support the added weight of the baby. In Pilates, we work on strengthening this area throughout pregnancy. Building a strong base of support will relieve your body from everyday aches and pains. The arms, legs and back are also worked extensively to prepare for labour and carrying a baby!
The benefits of Pilates are however not only physical. It assists with stress relief, has been proven to have a positive effect in treating depression, and helps clear the mind for optimal well being! It can be beneficial to everyone, regardless of age or ability!



Patti, Antonino, et al. “Effects of Pilates Exercise Programs in People With Chronic Low Back Pain: A Systematic Review.” Medicine 94.4 (2015): e383.

Rydeard, Rochenda, Andrew Leger, and Drew Smith. “Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial.” Journal of orthopaedic & sports physical therapy 36.7 (2006): 472-484.

Mokhtari, Mahyar, Maryam Nezakatalhossaini, and Fahimeh Esfarjani. “The effect of 12-week pilates exercises on depression and balance associated with falling in the elderly.” Procedia-Social and Behavioral Sciences 70 (2013): 1714-1723.

Van Middelkoop, Marienke, et al. “A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.” European Spine Journal 20.1 (2011): 19-39.

The Importance of Flexibility in Golf


Did you know that a PGA golf professional has 50-100% more upper body flexibility than the average person?

With the last box of Roses now having been devoured and one last Turkey sandwich finished off we are all feeling a bit sluggish. But our lack of flexibility can really impact our swing, reduce force and can increase the risk of injury.

During the off season, working on our mobility and core strength through pilates and flexibility exercises can help improve our swing and add yards to our drive.

Check out a large video library of golf exercises from the Titleist Performance Institute that we can do at home or read Roger Frederick’s great piece here – Flexibility and Your Golf Swing