Women’s Health Physiotherapy

Specialist physiotherapists provide specific care for all aspects of a women’s health specific female anatomy and physiology.

From incontinence to prolapse, pelvic pain or constipation, there is evidence that physiotherapy can alleviate, and in many cases is the primary management tool for these conditions.

Most women don’t know that help is available, and it has been an embarrassing topic for many years but now these topics are more openly discussed and should not be left untreated.

Often these conditions are related to pelvic floor muscle function. The 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 also they must relax to allow for urination, bowel movements, child birth and sexual intercourse. The pelvic floor muscle can change in tone to create a wide range of symptoms sometimes they have low tone and need exercises to help strengthen the muscles but in some cases the muscles are poorly functioning because of high resting tone. Patients can have similar symptoms with completely different pelvic floor tone.

These symptoms are NOT a normal part of aging, and the muscles can become weak or overactive for many reasons.

That’s where a women’s health physiotherapist can help. The good news is that a structured physiotherapy program for the pelvic floor muscles is effective in reversing the symptoms in 80% of women.

Women’s health physiotherapy for pelvic floor related conditions

From incontinence to prolapse, pelvic pain or constipation, there is evidence that physiotherapy can alleviate, and in many cases is the primary management tool for these conditions.

Most women don’t know that help is available, and it has been an embarrassing topic for many years but now these topics are more openly discussed and should not be left untreated.

These symptoms are NOT a normal part of aging, and the muscles can become weak or overactive for many reasons.

Following an assessment treatments for pelvic floor function may include:

Pelvic floor re-training and exercise rehabilitation
Provision of pelvic floor educators/muscle stimulators to improve your activation and power of your pelvic floor contraction
Pilates based pelvic stability exercises to strengthen the abdominal muscles which play a supporting role for the pelvic floor
Internal manual therapy techniques to relax the pelvic floor muscles, including trigger point release, myofascial stretches, scar massage,
Myofascial release of the connective tissue of the abdomen, hips and pelvis which support the pelvic floor
Relaxation and breathing techniques
Fluid management advice
Where appropriate information regarding appropriate medication management for bladder conditions and vaginal dryness
Advice on toileting and positional modifications
Advice on the use of vaginal trainers, pelvic floor educators or muscle stimulators to assist in the release and relaxation of pelvic muscles

Women’s health physiotherapy during pregnancy- antenatal physiotherapy

Pelvic girdle pain, back pain, and stress urinary incontinence are common symptoms suffered by pregnant women. Symptoms often occur due to hormonal changes and the ever increasing weight of your baby and uterus.

Urinary incontinence in pregnancy should not be ignored as research suggests that if you develop stress urinary incontinence during your pregnancy, or within 6 weeks following the birth of your baby, you are more likely to suffer from incontinence 5 years later.

An assessment with a Women’s Health Physiotherapist is often all you need to prevent this. Making sure that you are doing the right pelvic floor exercises; activating the correct muscles for a suitable length of time is important in maintaining a strong pelvic floor through your pregnancy and beyond.

Back pain is common experience for pregnant women (1 in 3 women suffer low back pain during their pregnancy) and whilst pelvic girdle pain is less common, around whilst 1 in 5 suffer. This is often a result of the hormones Relaxin and Oestrogen relaxing the ligaments which support your pelvis. In such conditions the muscles supporting these ligaments become extra important in providing stability and control.

There is much evidence to support physiotherapy for pelvic pain in pregnancy and the treatments you may be offered include:

Manual therapy techniques
Connective tissue release of the abdomen, back, hips and pelvis
Provision of Pilates based pelvic stability exercises
Acupuncture
Provision and fitting of pelvic stability belts
Advice on sleeping positions, exercise, and movement modification

Women’s health physiotherapy after the birth of your child- postnatal physiotherapy

The immediate weeks after the birth of a baby is an important time for your body. Your body undergoes many changes during pregnancy and continues to change post-natal. It is important to address any issues that occur at this time so as to prevent problems later in life. In some cases childbirth can lead to pelvic floor trauma, perineal tears and pudendal nerve injury (the nerve which supplies your bladder and pelvic floor). Consequently, the pelvic floor can weaken and you may experience urinary or bowel urgency and/or incontinence, urinary frequency, incomplete emptying, pain on urination/defaecation, vaginal prolapse and pain or discomfort with sexual intercourse. In addition Diastasis Recti can occur in the third trimester of pregnancy when the abdominal muscles are at their greatest stretch.

A pelvic floor assessment is important to establish the cause of these symptoms and a women’s health physiotherapist should assess you from 6 weeks post-natal or after your 6-week check. We are able to assess patients with pelvic pain or DRAM sooner than this but at this stage without vaginal examination

It is also important to have an assessment to determine if your muscles are stretched; “Divarification Recti” or separated “Diastasis Recti” as this will determine which exercises are suitable for you. An assessment can be carried out from 6 weeks if you had a vaginal delivery or 8 weeks if you had a C-section.

Following an assessment treatment for pelvic floor function may include:

Provision of a personally tailored progressive post-natal pelvic floor programme of exercise rehabilitation
Provision of pelvic floor educators/muscle stimulators to improve your activation and power of your pelvic floor contraction
Pilates based pelvic stability exercises to strengthen the abdominal muscles which play a supporting role for the pelvic floor
Internal manual therapy techniques to relax the pelvic floor muscles, including trigger point release, myofascial stretches, scar massage
Myo-fascial release of the connective tissue of the abdomen, hips and pelvis which support the pelvic floor
Diastasis recovery program
C section recovery program
Advice on the return to postnatal exercise

Mummy MOT

At Physis Physiotherapy our Women’s health physiotherapists provide a specialist Mummy MOT to help assess all aspects of your recovery from childbirth and analyse all aspects of your post-natal recovery. We were one of the first physiotherapy clinics to offer this type of assessment.

The Mummy MOT is a specialist in-depth postnatal physiotherapy assessment recommended for all women following childbirth (vaginally or by C-section), whether 6 weeks after delivery or many years later.

It specifically assesses the strength and function of your abdominal and pelvic area. It will check your posture, breathing, tummy and pelvic floor strength.

You will receive a summary report of the findings. You will be provided with appropriate individualised advice and safe exercise programme to help you recover will be discussed.

The aim is to help you recover and prevent long-term childbirth related complaints.

A Mummy MOT includes:

1-hour post-natal assessment with a Specialist Women’s Health Physiotherapist
In -depth check of your pelvic floor strength and tummy
Assessment of any physical problems arising from pregnancy and birth
A written report of findings

Follow up physiotherapy/rehabilitation sessions are charged separately and will involve formulation of a bespoke post-natal recovery programme devised especially for you, your lifestyle and fitness goals. This may include specific and safe post-natal exercises to improve your stability, posture, core and pelvic floor strength.

What will happen at your first Women’s Health Physiotherapy appointment?

The female physiotherapist will assess you in a private room and ask you questions about your symptoms. Where appropriate, you will be offered a physical examination which may include an internal examination vaginal or rectal. All examinations will be fully explained and only carried out with your consent. You are always free to say no or ask for more information before you make up your mind. If you wish you may also arrange to bring a suitable chaperone.

To find out more about our women’s health treatments or to make an appointment at any of our Edinburgh physiotherapy clinics, please call us on 0131 478 4646 or email [email protected].

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