Understanding Pelvic Health: The Role of Women’s Health Physiotherapy

Women’s health physio is the treatment of pelvic floor dysfunction including urinary incontinence and improved bowel control. The treatment consists of manual therapy, pelvic floor muscle exercise and relaxation techniques.

Strengthening the pelvic floor muscles is hugely important for pregnant and postnatal women to prevent incontinence, prolapse and pain.

Understanding Pelvic Health

Women’s health physiotherapists specialise in the female pelvic area and have an extra level of knowledge, hands-on skills and exercise prescription in this area. General musculoskeletal physiotherapists can assist with injuries to all body areas but often refer their clients who require more specific pelvic care to a women’s health physio. This allows the specialised physiotherapist to optimise treatment results and also prevent any reoccurrence of the injury or symptoms.

Women’s health physiotherapists are trained to assess, treat and manage a variety of conditions caused by pregnancy, childbirth and post-natal issues such as pelvic floor weakness, abdominal separation (diastasis), incontinence and prolapse. They are also skilled in treating pelvic pain caused by endometriosis, vulva disorders like painful sex and gynaecological surgery rehabilitation.

Your physiotherapist will take a detailed history to understand how your pelvic problem started. She will check your stomach muscles, do an internal exam of the vagina and look at your pelvic floor muscles. She will also consider your medical history, birthing details and any other factors that might be relevant.

After completing her assessment, your physiotherapist will provide you with a management plan which may include manual therapy to improve your body alignment and muscle balance, pelvic floor and core stability training and lifestyle modification advice. If your condition is serious, she will discuss further testing and referral to a gynaecologist or pelvic surgeon.

It’s important for any woman to strengthen their pelvic floor muscles before, during and after pregnancy to avoid problems such as urinary incontinence, sex difficulties and prolapse. Your physiotherapist will teach you how to activate and strengthen your deep abdominal muscles and also give you a safe and effective pregnancy exercise program.

Pelvic organ prolapse can occur when the pelvic floor muscles weaken and the tissues that support the organs become overstretched. Your physiotherapist will help you to identify the cause and develop a management plan, which may include manual therapy to release any tight muscle, bladder training, pelvic floor exercises and a tailored lifestyle programme. She will also recommend a vaginal pessary and possibly a bowel support.

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Pelvic Organ Prolapse

Pelvic organ prolapse (POP) happens when the muscles and tissues that support your bladder, uterus and vagina weaken. The organs may droop down into the vagina, where they can push on the pelvic girdle and cause pain. It’s more common in women who have had children, but it can happen to any woman at any time. It’s also more likely to occur if you’re overweight, or after menopause. It can even occur after you’ve had your womb removed (hysterectomy).

POP is not life-threatening, but it can be uncomfortable and embarrassing to talk about. Many women don’t seek help for symptoms like pain or incontinence, or think they have to just live with them. But a woman’s health physiotherapist can help.

Women’s health physiotherapists can help with all kinds of musculoskeletal pain, but they’re especially good at treating the pelvic floor, she says. They use manual therapy to restore balance and muscle strength in the pelvic girdle and core, as well as tailor-made exercise programmes.

If your physiotherapist suspects you have a pelvic organ prolapse, they’ll ask about your symptoms and assess how you move. They may use a special kind of ultrasound, called urodynamic testing, to see how your bladder and urethra work. Then they’ll advise you on treatment. This could include pelvic floor exercises, such as Kegels, which are a series of squeezes and releases of your pelvic floor muscles. Your physiotherapist may also recommend a pessary, a plastic or silicone device that fits into the vagina to help support your organs.

Your therapist will help you learn to do these exercises correctly, so they’re as effective as possible. They might also suggest other treatments, such as a steroid injection to reduce inflammation or pelvic pain medications. Depending on the severity of your prolapse, they might refer you to a gynecologist or colorectal surgeon for further tests.

Bladder Incontinence

Bladder incontinence can be frustrating and embarrassing. Thankfully, women’s health physiotherapists can help you manage your bladder symptoms to get back to your normal life. You can avoid urinary accidents by learning how to recognize your urges and plan ahead. Keeping a bladder diary can be helpful to track your symptoms and help you find out what triggers them. For example, you may learn that consuming caffeine or alcohol can trigger your urges to empty the bladder. Avoiding irritants like perfumed soaps, powder, toilet wipes with alcohol and smoking can also improve bladder control. You can also limit fluid intake and take regular urination breaks to avoid overfilling your bladder.

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Women’s health physiotherapists also treat bladder problems using Kegel exercises, biofeedback and muscle-strengthening exercises. They can also teach you about lifestyle modifications to reduce bladder issues like avoiding irritants, planning ahead for trips away from home by scoping out bathroom locations and taking frequent urination breaks. In some cases, medications or electrical stimulation can help you find relief.

A woman’s pelvic floor muscles can be weakened by pregnancy, childbirth and menopause. Women’s health physiotherapists can teach you how to strengthen these muscles to prevent incontinence and pelvic pain after pregnancy, childbirth or surgery. They can also address postural changes and musculoskeletal pain that occur during and after a caesarean section.

The goal of a women’s health physiotherapist is to help you live your best life, free from discomfort and pain. Contact a women’s health physical therapist today to see how they can help you!

Women’s Health Physio is an emerging clinical area within the American Physical Therapy Association (APTA) and is focused on the unique needs of women throughout the life cycle, including pelvic pain, incontinence, pre/post-partum care, gynecologic issues, and cancer recovery. These specialists are trained in the latest evidence-based practice and have experience treating all ages of females, including adolescents, post-menopausal and pregnant patients. They are experts in the treatment of pelvic/vaginal dysfunction, prolapse, urogynecologic disorders and the rehabilitation of post-operative conditions of the breast, chest and abdominal wall. They are also knowledgeable in the management of chronic diseases that affect the women’s body, such as osteoporosis, lymphedema and menstrual pain.

Pregnancy

Women experience unique physio needs throughout their lives due to their hormones, structural makeup and pregnancy. This is why specialised women’s health physiotherapy exists, to ensure a healthy quality of life.

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A physiotherapist who specialises in Women’s Health will have the extra knowledge, hands on skills and exercise prescription to help treat women’s specific conditions. As a result of this, GPs will often refer patients to see a specialist women’s physiotherapist for pelvic pain and/or gynaecological related issues as they have the expertise in this area of the body.

Pregnancy is a big part of women’s health physiotherapy. The pelvic floor muscles will undergo huge stress during the pregnancy and childbirth process, so it’s important to strengthen these muscles before and throughout the pregnancy. This will reduce the risk of pelvic girdle pain, leaking, prolapse and bladder/bowel dysfunction postpartum. A specialised women’s physiotherapist can teach clients how to perform effective pelvic floor exercises (including diaphragmatic breathing) to strengthen and prepare the muscles for labour and birth.

Women’s health physiotherapists can also teach clients techniques to help minimise abdominal separation & tearing during a vaginal birth or how to manage a Caesarean section birth. They can also give advice on how to manage perineal/sacropelvic pain & how to best care for yourself after your baby is born.

If you are thinking about becoming a women’s health physiotherapist, it is a worthwhile investment to consider an MSc in Rehabilitation Studies: Women’s Health Physiotherapy or another postgraduate degree that is specifically focused on this area of the body. This will give you the best chance of being successful in this specialized field of physiotherapy. Having this additional education and training will make you stand out in the industry and improve your chances of gaining employment. It will also set you up for career longevity as the skills gained in this specialised field are relevant across all areas of physiotherapy. This means you can work in a variety of settings, including private practice, the NHS, local authority and with sports teams. This gives you the opportunity to enjoy a varied and fulfilling career.

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