Women’s Health Physiotherapy is the therapeutic treatment for all disorders affecting the pelvis and pelvic floor.
I’m glad to share information on how physiotherapy is related to women’s health, which can be an embarrassing topic to discuss at times. Physiotherapists aided by available facilities, can help you fight incontinence, a prolapsed uterus, pelvic pain and antenatal and postnatal problems. I hope this article is helpful in answering some of the questions you may have about your body and Women’s Health Physiotherapy.
The pelvic floor
The pelvic floor is a complex structure made up of a group of muscles that support the pelvic organs and form the birth canal and passages for urine and stool.
Pelvic floor muscles are often described as a hammock lifting and supporting the pelvic organs above. These muscles need to be able to contract to keep us continent, but they also must relax to allow for urination, bowel movements, childbirth and sexual intercourse.
Problems with the pelvic floor can occur when these muscles are too weak (hypotonic) or too tight (hypertonic). Hypotonic muscles can lead to symptoms such as urinary or bowel incontinence and urgency as well as cause pelvic organ prolapse.
A structured exercise programme can help strengthen pelvic floor muscles. This is effective in reversing the symptoms in 80% of women.
Hypotonic pelvic floor treatment
Following an assessment, treatment for the symptoms of hypotonic pelvic floor muscles can be tailored to fit an individual. These include:
- Pelvic floor re-training and exercises
- Provision of pelvic floor educators/muscle stimulators to improve activation and pelvic floor contraction power
- Assessment and treatment of any low back/pelvic pain issues, which can lead to weakness of the pelvic floor muscles
When pelvic floor muscles are hypertonic they can cause urinary frequency, urgency, hesitancy or incomplete emptying, and painful urination. This is because the muscles are unable to relax fully to allow the passage of urine down the urethra.
There are many reasons for hypertonicity, including trauma to the pelvic floor/pelvic organs (for example, in childbirth), gynaecological intervention or investigation, unresolved low back or hip pain or after an infection.
Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and strengthening exercises are prescribed.
Hypertonic pelvic floor treatment
Following an assessment, treatment for the symptoms of hypertonic pelvic floor may include:
- Internal manual therapy techniques to relax the pelvic floor muscles, including trigger point release, myofascial stretches and scar massage
- Neural mobilisations
- Relaxation and breathing techniques
- Pelvic floor exercises and general exercise to assist in the release and re-training of pelvic muscles
- Assessment and treatment of any unresolved low back, hip or pelvic pain
- As and when suitable pelvic floor muscle strengthening sessions
Can Women’s Health Physiotherapy help during pregnancy?
Pelvic girdle pain and stress urinary incontinence are common among pregnant women. These symptoms occur due to hormonal changes and the ever-increasing weight of your baby and uterus. Women’s Health Physiotherapy can help during pregnancy and the postnatal period via numerous treatments, including:
- Guidelines on safe exercise during pregnancy
- Provision of antenatal classes
- Treatment and management of pelvic girdle pain including symphysis pubis dysfunction
- Low back pain
- Rib pain/thoracic pain
- Carpal tunnel syndrome
- Postnatal rehabilitation of pelvic floor and abdominals (including Diastasis Rectus Abdominis)
Please feel free to contact us at the Rehabilitation Department to find out more.
