Written By: Wendy Shum
What is Women’s Health Physiotherapy?
Women's health physiotherapy is a specialized area in physiotherapy that helps deal with various health issues that only happen to women. Different from those of men, women go through a lot of physiological changes at different stages of their lives, especially during the time of pregnancy, post-partum and menopause. Studies have shown that 1 in 3 women will experience some women’s health problem during their lifetime. This blog highlights some common women’s health conditions, various aspects of women's health physiotherapy, and the role of Women’s Health Physiotherapists in managing and treating these issues for a healthy quality life.
What is Pre-natal Women’s Health Physiotherapy?
During pregnancy, women go through a lot of physiological changes within their bodies that could potentially lead to muscle and joint pain as well as some women’s health issues. A Women’s Health Physiotherapist can play an important role to help resolving these problems at this stage.
Common Pre-Natal Physiotherapy Conditions & Treatments:
Pelvic Girdle Pain (PGP)
Pelvic girdle pain (PGP) is common during pregnancy, caused by hormonal and postural changes, and the growing fetus. It includes pain in the sacroiliac joint, pubic area, groin, hips, and lower back. Physiotherapy is recommended as it is safe for both mother and baby. Treatment involves manual therapy to maintain alignment and relieve soft tissue tightness, exercises to improve muscle flexibility, strength, and core stability, as well as postural advice and lifestyle modifications to prevent musculoskeletal problems.
Urinary Incontinence
Urinary incontinence, common in later pregnancy, includes stress urinary incontinence (SUI) and urge urinary incontinence (UUI). SUI occurs with physical activity like coughing, sneezing, or exercising, while UUI involves a sudden urge to urinate with increased frequency. Physiotherapy management includes pelvic floor muscle training, core stability exercises, and lifestyle modifications.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs when pelvic organs slip down and bulge into the vaginal canal due to weakened or overstretched muscles and ligaments. It is more common after childbirth but can happen during multiple pregnancies or difficult deliveries. Physiotherapy involves pelvic floor muscle training, core stability exercises, and lifestyle modifications.
Birth Preparation
Birth preparation is crucial for natural delivery. Women’s Health Physiotherapists use manual therapy to optimise pelvic alignment, potentially easing delivery. Perineal massage, starting after week 37, helps reduce the risk of tearing and the need for episiotomy during childbirth.
What is Post-natal Women’s Health Physiotherapy
The post-partum stage follows pregnancy to delivery. A woman’s body goes through a series of physiological changes as well as postural changes. Various musculoskeletal and women’s health issues could happen any time after childbirth. Women’s Health Physiotherapist is particularly important at this stage to ensure a full postpartum physical and mental recovery.
Common Post-Natal Physiotherapy Conditions & Treatments:
Musculoskeletal Pain
Musculoskeletal pain after childbirth, including back, neck, pelvic girdle, and peripheral joint pain, often results from poor posture, muscle weakness, and core instability. Women’s Health Physiotherapists use manual therapy to restore alignment and muscle balance. A customized exercise programme, including stretches, weight training, and Pilates, follows to regain muscle flexibility, strength, and core stability.
Pelvic Floor Pain
Pelvic floor pain causes significant discomfort and inconvenience. The pelvic floor muscles, which control urination and defecation and support pelvic organs, can be strained or stretched during pregnancy and childbirth, leading to pain. Treatments by Women’s Health Physiotherapists vary based on the pain’s cause, aiming to provide relief through appropriate therapies.
Urinary or Faecal Incontinence
Urinary or faecal incontinence, common after vaginal delivery, results from the overstretched or torn pelvic floor muscles during childbirth. This affects urinary control and impacts quality of life. Women’s Health Physiotherapy focuses on pelvic floor muscle strengthening and may include vaginal electrical stimulation for muscle recovery.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs due to weakened or damaged pelvic floor muscles. Physiotherapy involves manual therapyfor body alignment, pelvic floor muscle training, core stability exercises, and lifestyle modifications. Severe cases may require a vaginal pessary or surgery. Physiotherapists provide advice on symptom management and prevention.
Rectus Diastasis
Rectus diastasis, a separation of abdominal muscles, occurs during pregnancy to accommodate the growing baby. Post-delivery, it presents as a gap or bulge between abdominal muscles. Treatment includes exercises to strengthen the abdominal muscles and close the gap. Early intervention within 6-12 months post-natally is most effective, but severe cases might need surgery.
Sexual Dysfunction
Sexual dysfunction post-childbirth, including dyspareunia and altered sensitivity, is often due to traumatised pelvic floor muscles or overstretched nerves. Women’s Health Physiotherapists identify the cause and create treatment plans involving manual therapy, muscle relaxation techniques, and lifestyle modifications to alleviate pain and improve function.
Other Women’s Health Conditions treated by Women’s Health Physiotherapist
Women's health physiotherapy is not only for pregnancy related issues. Any women, whether they have experienced pregnancy or not, could also present with women’s health issues any time during their lives. Some conditions such as obesity, menopause, chronic respiratory diseases, lifestyle that required repetitive lifting etc, could also result in some women’s health issues. This section will look at some of these issues and how somebody suffering from these issues can get better with the help of a women's health physiotherapist.
Other Women’s Health Physiotherapy Conditions & Treatments:
Pelvic Floor Dysfunction
Pelvic floor dysfunction includes two main types: weakness and hypertonicity. Weakness results in problems such as incontinence or prolapse, while hypertonicity causes pain and difficulty emptying the bladder or bowel. Treatment for weakness involves pelvic floor muscle exercises to improve strength. For hypertonicity, manual therapy and relaxation techniques are used to release tight muscles.
Pelvic Floor Pain
Pelvic floor pain is common in women and can be caused by factors such as stress, obesity, and ageing. Hypertonicity (tight pelvic floor muscles) is often the culprit. Women’s Health Physiotherapy includes manual therapy to release tight muscles and relaxation techniques to relieve pain.
Urinary and Faecal Incontinence
Incontinence can occur at any time, not just postnatally. It can be caused by pelvic floor weakness, hormonal changes during menopause, core instability, or poor posture. Women’s Health Physiotherapists conduct thorough assessments, including vaginal examinations, to determine the cause and provide targeted treatments.
Pelvic Organ Prolapse
Pelvic organ prolapse can occur at any stage of life, most commonly after childbirth, but also due to aging, menopause, and obesity. Physiotherapy is typically the first line of treatment, with pessary prescription or surgery considered for severe cases.
Overactive Bladder
Overactive bladder causes urinary urgency and frequency. Treatments by Women’s Health Physiotherapists include pelvic floor muscle training, electrical stimulation, and bladder training. These methods help strengthen bladder-supporting muscles, relax overactive bladder muscles, and control urinary urges.
Bowel Issues
Constipation can be due to diet, lifestyle, or pelvic floor hypertonicity. Women’s Health Physiotherapists assess the cause and provide treatments aimed at relaxing tight pelvic floor muscles and modifying diet and lifestyle to improve symptoms.
Sexual Dysfunction
Sexual dysfunction, including vaginismus and vulvodynia, causes pain during intercourse. Vaginismus involves tight vaginal muscles, while vulvodynia causes chronic pain in the vulvar area. Women’s Health Physiotherapy includes manual therapy, relaxation, and breathing techniques for vaginismus and electrical stimulation to desensitize sensitive nerves for vulvodynia.
In conclusion, women’s health issues are common and could happen to any women any time during their lives. Although some women may be embarrassed to seek for help or some even think it is a problem that they need to accept due to childbirth, aging or menopause, most of the women’s health issues can be successfully treated by well-trained Women’s Health Physiotherapists. If you have any concern regarding any of the above conditions mentioned, please do not hesitate to contact our Women’s Health Physiotherapist at OT&P.