The term Women’s health refers to various conditions that pertain specifically to women. This umbrella term encompasses conditions such as incontinence or bladder (or bowel) leakage, chronic pelvic pain caused by conditions like endometriosis (a condition where the tissues lining the uterus grow outside it), breast cancer, and muscle spasm. Women’s health also includes issues relating to female sexual health, pregnancy, and parenthood such as back or sacroiliac joint pain in pregnant women, mastitis (an inflammation of breast tissue caused by infection), carpal tunnel syndrome, and so on.
What is a women’s health physiotherapist?
A Women’s health physiotherapist is a trained physiotherapist that specializes in the assessment and treatment of conditions relating to women in their prenatal and postnatal periods. Some of the specialized assessments that women’s health physiotherapists are trained to carry out include:
- Internal pelvic floor examination
- Bladder & bowel diaries
- Vaginal dilators
- Vaginal electrical stimulation (pelvic pain, muscles weakness, urgency)
- Biofeedback for exact pelvic floor measurements and assessment
- Clinical equipment programs – safe tailored and individualized programs for women experiencing pelvic pain, bladder or bowel dysfunction
- Prescription and loan of TENS machines for use in labor.
What is prolapse?
Prolapse refers to the falling out or bulging of certain body parts such as the vagina or rectum as a result of weakened supportive tissues. The statistics for this condition are quite similar to that of incontinence (a condition that causes loss of voluntary control over urination or defecation). In the western world, up to 20% of women are likely to need surgery for prolapse and incontinence. Prolapse and incontinence affect 1 in 3 women and 10% of women are going to get surgery for these conditions in their lifetime.
Many of the patients that suffer from these conditions are unaware of the role that physiotherapy and the right rehabilitation exercises can play in helping them improve the symptoms of prolapse and incontinence. A physiotherapy program for this condition usually consists of the following:
- biofeedback: This involves using your mind to become more aware of your body’s internal dynamics and gaining more control over your health.
- pelvic floor exercises are routines aimed at improving coordination, endurance, and strength of pelvic muscles
- postural and breathing exercises
- Fitting of a silicone pessary to provide added support. Although women’s physiotherapists are qualified to fit and manage support pessaries, they usually liaise with GPs and gynecologists on it.
What is incontinence?
Urinary incontinence refers to the accidental leaking of urine from the bladder. Fecal Incontinence on the other hand refers to the accidental passing wind or feces from the bowel. Statistics show that up to 21% of all Australians above the age of 15 years suffer from either urinary incontinence, fecal incontinence, or both conditions.
Physical stress such as coughing or exercise is among the most common causes of triggers of incontinence. A large number of young women involved in high-level sports have UI or FI. Urinary incontinence in women is also quite common after childbirth. In men, Urinary incontinence may occur after undergoing prostate surgery or radiation therapy. Although Incontinence is quite common, you do not have to live with it-you can seek medical help.
What is sexual pain?
A large number of women experience pain in the pelvic region during vaginal penetration. This is known as sexual pain. 10 to 20% of women between 20 to 50 years of age experience some form of sexual pain.
A good number of these women have always suffered from this condition and they’ve never had an enjoyable sexual experience. Some women on the other hand experience a sudden onset of sexual pain later in their life after years of normal sexual function. Some factors that can cause this include childbirth, the onset of menopause, or an injury to the pelvic region.
Most women suffering from sexual pain do not seek professional help. They often end up suffering in silence for a condition that is quite treatable with medical intervention
How do I know if my condition requires physiotherapy or other medical attention?
Women’s health physiotherapists are experts at designing specific exercise programs to help improve a variety of health conditions. Some of the conditions a physiotherapist can help with include:
- Bone health for women during or after menopause
- Exercises to optimize wellbeing during and after pregnancy
- pelvic floor down training
- Stretching and relaxation exercises for pain and muscle overactivity
- Exercise regimen for women undergoing cancer treatment.
In recent times, there has been growing awareness of pelvic floor muscle overactivity and the chronic pain associated with it. Many doctors and fitness coaches are starting to realize the role of women’s health physiotherapists in the treatment of these conditions.
Women who have had a history of endometriosis or painful period or who experience pain while inserting a tampon or during intercourse may be suffering from muscle overactivity. In the past, weak core muscles have been blamed for the back pain a lot of women experience and stability training is often recommended for them. However, in many cases, the problem isn’t weak core muscles but muscle overactivity. Other signs of overactivity include difficulty emptying your bladder or bowel, painful intercourse, and even incontinence.
When you consult a women’s health physiotherapist, you’ll undergo a comprehensive assessment to understand the complete history of your condition. Usually, a vaginal examination will be carried out with your consent. This typically involves palpating the muscles of your pelvic floor to determine the cause of the pain. All of these make it possible to come up with an accurate diagnosis of your condition and recommend the best treatment approach.
Your physiotherapist may also work closely with your GP or gynecologist to get a comprehensive picture of your case and figure out how best to help you.
How can physiotherapy help women’s health conditions?
Pelvic floor muscle down training, mindfulness and relaxation exercises, stretching, and general exercise advice are some of the things involved in a typical physiotherapy treatment. These exercise routines are designed to help restore normal coordination and boost the strength of the muscles.
Physiotherapists can also help women deal with the rigors of pregnancy and the early year of motherhood. That’s in addition to helping in the assessment, diagnosis, and treatment of a wide range of conditions that are associated with pregnancy including musculoskeletal issues like pelvic girdle, low back or rib pain, and carpal tunnel syndrome. They can also assist breastfeeding women with finding the optimal and most comfortable position for holding the baby during breastfeeding.
Working alongside doctors, women’s health physiotherapists can help manage mastitis, incontinence, and prolapse which are issues that are common in women after childbirth. They can recommend safe and effective exercises that help return the muscles of the pelvic floor to optimal function after childbirth.