Women’s health physiotherapy. What is it?
There are so many different stages of a woman’s life and each provides it’s own unique physical challenges. A physiotherapist who is expert in these stages can make the world of difference.
Women’s health physiotherapy encompasses a huge variety of conditions that may effect women throughout their life, including;
- Incontinence or leakage of the bladder or bowel.
- Pelvic pain that could include endometriosis or muscle spasm;
- Sexual intimacy issues
- Pregnancy and post natal conditions such as back or sacroiliac/pelvic joint pain, carpal tunnel syndrome and breast engorgement and mastitis.
- Prolapse (descent of the pelvic organs) diagnosis and management.
- Bone health management.
- Cancer patient well being.
- Teenage girl strength development
- Female athlete guidance
- General active lifestyle advocacy.
The Pelvic Floor
There are a number of conditions unique to women’s pelvic floor for which physiotherapy can be life changing.
Prolapse is a condition that will affect 1 in 3 women in her lifetime, with a similar statistic for incontinence. Prolapse is when an organ (usually bladder uterus or bowel) descends down into the pelvis. Symptoms include a feeling of heaviness or dragging or bladder and bowel issues.
Incontinence is when urine or faecal matter leaks out when it’s not suppose to. There is no such thing as LBL!
Women in the western world now have a lifetime risk of surgery for incontinence or prolapse of up to 20% – 1 in 5 women will have surgery for these problems!
Physiotherapy for management of incontinence and prolapse is now the first line recommendation by the international organisation, the International Consultation on Incontinence. This means that you should access physiotherapy before medication or surgery.
Physiotherapy will usually include pelvic floor exercises to improve coordination, strength, and endurance, postural and breathing exercises, as well as general exercise advice. It may also include the fitting of a silicone pessary to provide support.
Pelvic floor muscle over activity and chronic pelvic pain
Women may have a history of endometriosis/adenomyosis or painful periods, may have always had difficulty in inserting a tampon, or may experience pain with intercourse. Sometimes, she will have suffered a back injury, and been told she had weak core muscles and was encouraged to do a lot of “core muscle” training. In some cases, she never really had weak muscles, and she has developed a pattern of over activity as a method of protection against perceived harm to her back. Some women have a long term history of anxiety or have had an extremely stress time in their life which has caused ‘wind up’ a situation where a large number of their muscles are permanently turned ‘on’ including their pelvic floor muscles.
The signs of overactivity have then occurred – difficulty fully emptying her bladder or bowel or pain with intercourse. Some women develop sensitivities to tight clothes around their tummy or certain types of underwear.
Vital Core Women’s health physiotherapists are highly skilled at taking a very complete history and thorough assessment and when appropriate an examination of the over active pelvic floor muscles. This then leads to an accurate diagnosis and then a plan to help get the woman back to enjoying life.
Pregnancy and the early years of motherhood
These are a time of enormous physical and emotional change. Vital Core women’s health physiotherapists assess, diagnose and treat many conditions that are commonly associated with pregnancy including musculoskeletal conditions such as pelvic girdle, low back or rib pain, carpal tunnel syndrome, de Quervain’s syndrome (thumb joint pain).
We also hire out TENS for labour and our physio’s are skilled in teaching women and partners how to use the device.
They can assist with optimal positioning for breast feeding and baby holding, and can manage mastitis where 95% of the time it isn’t an infective process, but an inflammatory condition.
With the significant changes in posture and weight, the pelvic floor can become strained during pregnancy. Our pelvic floor physio’s can give you advice on this.
Vaginal deliveries unfortunately can cause significant trauma to the pelvic floor. Post natal incontinence and sensations od prolapse are very common. In many cases they will ease with time. However an expert pelvic floor post natal assessment and management plan will put you a step ahead in your recovery and give you peace of mind.
Exercise in the child bearing year can be very challenging. Vital Core Physio offers both pregnancy (mummycise) and post natal exercise (mums and bubs). Classes are held a few times each week please see our class timetable.
Menopause is another critical time of life for women with hormonal change often uncovering problems with pelvic health that were only just being managed when hormones were still adequate. This is a common time for incontinence of bladder or bowel to be a problem for the first time, and is often related to the relative damage done when these women were having their babies. It is often also a busy time for women with work, elderly parents and teenaged children all competing for her time and assistance. Exercise is important here for general well being, to avoid weight gain and to improve bone density, as we lose 25% of our bone mass in the 2 years either side of menopause.
Pelvic floor muscle over activity and chronic pelvic pain are now gaining increasing awareness amongst doctors and fitness coaches, and the role of a the Vital Core women’s health physio in the team has never been more important!
It’s not always about making your pelvic floor muscles strong. Sometimes it’s more important to teach them to release. A tight over worked pelvic floor can cause pain (just think of how sore your quads feel after doing too many squats). Only a pelvic floor physio can accurately assess this and teach a woman what she needs to do to release her pelvic floor muscles.
Women may have a history of endometriosis or painful periods, may have always had difficulty in inserting a tampon, or may experience pain with intercourse. Sometimes, she will have suffered a back injury, and been told she had weak core muscles and was encouraged to do a lot of “stability” training. In some cases, she never really had weak muscles, and she has developed a pattern of over activity as a method of protection against perceived harm to her back. The signs of overactivity have then occurred – difficulty fully emptying her bladder or bowel, pain with intercourse, and sometime incontinence.
Vital Core Women’s health physiotherapists are highly skilled at taking a very complete history and thorough assessment which will involve a pelvic floor examination to manually palpate the pelvic floor muscles. Accurate diagnosis can then be made.
Physiotherapy treatment will include muscle down training, relaxation and mindfulness training, muscle lengthening exercises, and general appropriate exercise advice.
Adolescent girl health and activity/ TeenFit
Keeping our teenage girls in sport and loving it is essential for their lifetime health and well-being. It is up to us all as a community to support them wherever possible. Did you know that most girls drop out from formal sport between the age of 13 and 15?
We know the benefits of sport to the young female body. At the stage where most are dropping out, young teenage bodies are developing strong bones. This is the time they must be doing hard running, jumping, climbing and movement. This bone density is what they will take through their lives. Read more about why we want to keep teenage girls in sport.
Teenfit classes run 8 weeks of each school term. We currently run two streams.
The first is for girls aged approximately 12-14. This age for girls has huge changes developmentally and the girls often lack core control and strength in the lower limbs. This can make them more susceptible to knee injuries in particular. There is often a lot of self consciousness at this age also, so any ‘group’ exercise they do must be carefully tailored to them in a very supportive environment with girls of a similar age and ability.
The second group is the slightly older girls generally around 15-17 who generally have better physical control of their body. These girls still need a lot of control work, however they now also need more sport/ activity specific strength exercises. Depending on their preferred sport, they need to be able to jump, run, pull, balance. This is also the age (both girls and boys) when kids will often have their largest quantity of formal sport of their lives. There is often school, club, social and for some kids state or national representation. Their bodies need optimum control, strength, mobility and flexibility. They need to be able to withstand the huge loads that are put on them. Even those kids that aren’t doing a huge amount of formal sport, it is a time of significant physical development and being able to hold and move their body with confidence goes a long way to building self confidence.
As physio’s it is our role to help as many kids as possible to move better. We recognise that there are a number of different developmental stages for girls that which require specific management approaches. We believe all kids are athlete’s regardless of their public achievements. More importantly we believe that all kids deserve the opportunity to improve their physical abilities which leads to improved confidence.
Vital Core Physiotherapy can help
What can you expect?
We will work out from questioning and thoroughly examining you, what exactly is causing your problem and why and most importantly, what are your goals! What can’t you do that you’d love to be able to do? Once we’re clear on this, then together we can formulate an accurate and complete treatment plan to get you back to your best as soon as possible.
We aren’t about the quick fix. We are about the long term resolution of dysfunction and the promotion of healthy, active living.
Vital Core physio’s can do all the fancy treatment techniques from dry needling to kinesiotape as well a number of old fashioned tried and tested techniques of mobilisation and massage. Most importantly though Vital Core physio’s will spend the time to develop a treatment plan with you that will include a progressive exercise plan. That is the ONLY way to ensure long term success.
What about exercise classes?
Why, I’m glad you asked!
Our exercise classes are all run by physiotherapists who are experts in safe movement. There are many options to choose from and your Vital Core physio can help guide your choice. In the coming weeks I’ll be writing about the classes we have on offer that may be helpful. In the meantime I invite you to have a look at our class time table and give us a call or you can book an assessment online. We’d love to help you get active.