my story

Journey

to becoming a women's health physiotherapist

As a child, I wanted to become a doctor, but by chance, I ended up studying physiotherapy instead – and today I am very happy that I found this particular specialty. 2013. Back then, no one in Estonia talked about diastasis. Elsewhere in the world, women’s health physiotherapy was still developing. Again, by chance, I started researching this topic and felt how several puzzle pieces began to fall into place. Today I can say that I am one of the pioneers of women’s physiotherapy in Estonia – and probably the person who has seen the most diastases. Over the years, I have learned to assess abdominal muscle function with various methods, and the therapy goals have also changed significantly. While in 2013 the primary focus was on reducing the gap between the muscles, today my focus is on effectively training the core, regardless of diastasis. My experience shows that this is precisely the most challenging aspect of diastasis: achieving changes in the abdominal area through regular training. There’s no need to fear exercise – my goal is to teach you to train smartly and with maximum effectiveness.

my mission

Live confidently – at every stage of life!

A natural continuation of my journey was discovering pelvic floor physiotherapy in 2016. In this field, too, I am one of the first practitioners in Estonia. The ability to assess pelvic floor muscle function vaginally has provided me with invaluable feedback over the years. Today, I cannot imagine not recommending this assessment method to women after childbirth. The information it provides about the pelvic floor’s condition is extremely important for offering recommendations on how to consciously train one’s body.

A person is a whole, and in my work, I adhere to the biopsychosocial model. This means I don’t just consider the physical aspect of the body, but also your emotional well-being, lifestyle, stressors, and daily habits. Pain and symptoms are often the result of multiple interacting factors, which is why a holistic approach to recovery is crucial. I value evidence-based practice, but I believe clinical experience and critical thinking are equally important. Relying solely on scientific literature may not provide a complete picture, whereas experience and analysis help to understand which solutions work best for each individual.

It is a privilege to meet and empower women during one of life’s most delicate, yet also most remarkable periods. I am deeply passionate about my field and work with dedication, as it brings me joy to support women on their journey back to their bodies and self-confidence. What captivates me about physiotherapy is the opportunity for continuous development – I read, learn, listen, and consistently enhance my skills, participating in professional training every year. I also collaborate with gynecologists, urologists, family doctors, plastic surgeons, as well as chiropractors and personal trainers.

In addition to my work, I am also a mother of three. I have been able to apply all my knowledge and skills to my own pregnancies and postpartum recovery. I know from personal experience and sincerely believe that many problems can be prevented.

Your time is valuable. I inspire you to act consciously and take responsibility for your health and well-being, so that you can live a physically active and confident life into old age.

・Physiotherapist・Coach・Educator・

Organized Trainings

✓ 2025 – Training Day for the Midwives’ Association: Physical activity during pregnancy, prevention of diastasis and pelvic floor disorders. Pelvic floor muscles and childbirth, fourth trimester, initial assessment, starting exercise after childbirth, warning signs and referral to physiotherapy.
✓ 2024 – Lecture at CARA on “4th Trimester”
✓ 2024 – Baby Club at GOSpa
✓ 2022 – Academy of Public Health: “Postpartum and Lactation Period Physical Activity”
✓ 2016 – Lectures for the Midwives’ Association: “Physical Activity During Pregnancy”, “Promoting Perineal and Pelvic Floor Muscle Recovery Through the Eyes of a Physiotherapist”
✓ 2015 – Training for members of the Tallinn Family Doctors’ Society: “Physiotherapy for Postpartum Problems. Rectus Abdominis Diastasis”
✓ 2015 – Baby Club at GOSpa
✓ 2014 – Training for members of the Estonian Midwives’ Association in Tallinn and Tartu: “Physiotherapy for Postpartum Problems. Rectus Abdominis Diastasis”
✓ 2015–2017 – Helle Nurmsalu participated in an applied research project at Tartu Health Care College and conducted assessments of abdominal and pelvic floor muscles in women who had given birth; a total of over 200 women were assessed.

Helle Nurmsalu - Naistefysio

MY VALUES

FRIENDLY

PERSON-CENTERED

EVIDENCE-BASED

SEX-POSITIVE

Learning from the best in the world

Professional Trainings

2021-2025

  • Levator ani avulsion injuries (AUS)
  • The pelvic floor from physiology to pathology with focus on the role of ultrasound (ISUOG)
  • Tummy Tuck Core Rehab for Professionals (CA)
  • Certified LPF-CT (Low Pressure Fitness Level 1, Level 2, Level 3) (USA)
  • The Coccyx Course (UK)
  • Treating and Training the Female Runner (or Any Female Athlete) (CA)
  • Diastasis Rectus Abdominis & The Postpartum Core (CA)

2016-2020

  • Diastasis Revolution: evidence-based evaluation and management (UK)
  • C-Section, Hysterectomy and Abdominal Scar Immersion (UK)
  • Advanced Post Natal Wellness Practitioner Level 2 (UK)
  • Modern Pregnancy Assessment, Core Restore & Functional Exercise Programming (UK)
  • A Closer Look at Pelvic Pain (UK)
  • 2016 Rehabilitative Ultrasound Imaging in Women’s Health Physiotherapy (UK)

2015

  • Systematic Comprehensive Checklist for Evaluation & Treatment of Pelvic Pain Patients (UK).
  • New Perspectives from The Integrated Systems Model for Treating Women with Pelvic Girdle Pain, POP, SUI and/or DRA (UK).
  • Rectus Diastasis Rehabilitation Integrating Post Natal Physiotherapy and Functional Fitness Training Or… Don’t Mind the Gap! (UK)

2014

  • Physiotherapy Assessment and Management of Female Urinary Dysfunction (UK)

2013

  • First Diastasis Training in New York (Tupler Technique™)
  • Treatment of Diastasis Recti (UK). Ante & Post Natal Physiotherapy (UK)

2003-2009

  • University of Tartu, Master of Health Sciences MSc (Physiotherapy) 2009
  • Tartu Health Care College, Physiotherapy (cum laude) 2006

Contact Us

Collaboration proposals and questions: helle@kohukliinik.ee