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Women’s Health

What Does A Women’s Health Physical Therapist Do?

The emphasis of the health sciences on fitness and wellness has brought to women’s attention a need to pay closer attention to their bodies during recreation, work, and throughout life. Many physical therapists have specialized training which will benefit women with a variety of medical conditions. These therapists use every facet of their physical therapy training to evaluate and treat female clients, promoting and enhancing health through the life span. All treatments are individually designed after thorough evaluation.

 

What is Pelvic Pain?

Pelvic pain is described as pain in the lower abdomen, pelvis, or perineum and is considered to be chronic when symptoms have been present for more than six months. The pain may be described as aching or burning in the area of the perineum or abdomen.

 

What causes pelvic pain?

Pelvic pain can be caused by problems such as pelvic joint dysfunction, muscle imbalance within the muscles of the pelvic floor, trunk, and/or pelvis, incoordination in the muscles related to bowel and bladder function, tender points in the muscles of the pelvic floor, pressure on one or more nerves in the pelvis, and weakness in the muscles of the pelvis and pelvic floor. Pelvic pain can also be related to the presence of scar tissue after abdominal or pelvic surgery. There can be organic disease processes related to pelvic pain as well therefore a consult with your doctor is appropriate as well.

 

How can physical therapy help?

Physical therapists are trained to evaluate and treat joint dysfunction, muscle tightness, weakness or imbalance in muscle groups, and nerve entrapment- all potential signs of pelvic pain. Physical therapists trained specifically in the area of pelvic health can identify the possible generators of pelvic pain and develop a treatment plan specific to the patient suffering from pelvic pain. A physical therapist trained in this area may utilize hands on techniques to address muscle tightness or targeted exercises to improve muscle strength and reduce faulty patterns of muscle recruitment. Other treatment strategies may include biofeedback, retraining of incoordinated muscles, postural training, and strengthening of the abdominal core muscles

 

What is Urinary Incontinence?

There are several types of urinary incontinence, but in general incontinence refers to the leakage of urine at inappropriate times. Stress incontinence is leakage of small amounts of urine when there is increased pressure on the bladder. This can happen with exercise or with sneezing, coughing, lifting or other activities. Urge incontinence is the leakage of medium to large amounts of urine when a person feels a sudden strong urge to urinate. Mixed Incontinence includes symptoms of both stress and urge incontinence. Functional Incontinence is urine leakage that occurs when a person can not get to the toilet in time.

 

What causes Urinary Incontinence?

Stress incontinence usually results from weakness and lack of support in the muscles of the pelvic floor. These are the muscles that attach to the bottom of the pelvic bones and run front to back, forming a bowl-like structure that lifts to support the internal organs and controls the sphincter muscles. The pelvic floor muscles also work to strengthen the low back, stabilize the pelvic bones, and help with sexual function.

Women with stress incontinence often have “under active” pelvic floor muscles.

Causes of under active pelvic floor muscles include:

  • Pregnancy and Childbirth
  • Injury or trauma
  • Surgery in the vagina or rectum
  • Episiotomy (during childbirth)
  • Lack of exercise and lack of use

 

Women with urge incontinence often have weak or “over active” pelvic floor muscles. Possible causes of mixed incontinence can include any combination of the causes of stress and urge incontinence.

Functional incontinence can be caused by:

  • Joint pain or muscle weakness
  • Problems with mobility
  • Confusion, dementia or delirium
  • Environmental barriers (i.e., the bathroom is too far away, use of a walker or cane, too many obstacles to navigate around)
  • Psychological problems such as depression or anger

 

How can physical therapy help?

Because many symptoms of urinary incontinence are caused by pelvic floor muscle weakness and dysfunction, a specially trained Women’s Health Physical Therapist is the ideal provider to help you gain control over your symptoms. (Many treat men with urinary incontinence as well). Physical Therapists use their specialized medical training to completely evaluate and design a treatment program that is individualized for each patient.

 

Physical Therapy can:

  • Give you control over your life and your bladder
  • Save money and embarrassment by allowing less use of pads and undergarments
  • Reduce use of medications for incontinence
  • Possibly prevent the need for surgery

Physical Therapy Treatment may include

  • Education on diet and nutrition to avoid food and drinks that may irritate the bladder
  • Advice on how to change behaviors that make symptoms worse
  • Techniques to help you find the right muscles and learn to use them correctly
  • Pelvic floor exercises to strengthen the pelvic muscles
  • Exercises to stretch and strengthen other important muscles
  • Ways to decrease urinary urge and frequency
  • Biofeedback that shows you how your muscles are working
  • Electrical stimulation to improve awareness and strength of the muscles

 

Who Should be Referred to a Women’s Health Physical Therapist?

Those with:

  • Trouble leaking urine during normal daily activities
  • Urine leakage with sneezing, coughing, or laughing
  • Trouble starting the urine stream
  • Trouble holding urine when feeling a strong urge to go
  • Trouble with frequent urination (more than every 3-4 hours during the day, up more than once to urinate at night)
  • Trouble getting to the bathroom because of other problems such as knee or hip pain or balance problems

 

What musculoskeletal issues are associated with the prenatal and postpartum periods?

The prenatal period is a time of great change for a woman, physically, emotionally, and hormonally. As the fetus grows, the overall musculoskeletal system is challenged by altered posture, shortened muscles, potential muscle imbalances, and changes in spinal mobility. These changes may cause pain and dysfunction. In the postpartum phase, fluctuating hormone levels combined with additional physical changes as a result of delivery may also result in musculoskeletal problems such as excessive joint mobility, weakness of the core stabilizers, and altered spinal mobility and function.

 

What causes dysfunction in the prenatal and postpartum periods?

Fluctuating hormone levels in both the prenatal and postpartum phases may cause excessive joint mobility which can cause pain and dysfunction. Because of the postural changes associated with pregnancy, some muscles become tight to support the changing posture, while others are stretched and become weak. This results in muscle imbalance and a potential for decreased stabilization. Mobility of the spine can be affected in both the prenatal and the postpartum periods as the spine adjusts to the changing posture as the fetus grows.

 

What are symptoms of musculoskeletal dysfunction during the prenatal and postpartum periods?

Symptoms of dysfunction may include pain in the joints of the pelvis or spine, muscular pain in the hips and L/E’s, or numbness into the extremities. Weakness may be present in the abdominals, resulting in pain with transitional movements or lifting. Weakness may also be manifested as urinary incontinence in the postpartum period. Muscle imbalance may also cause pain or contribute to urinary issues in the postpartum phase.

 

How can physical therapy help?

Physical therapists are skilled in evaluating and providing patient centered treatment of musculoskeletal problems. Physical therapists trained in the area of women’s health have further knowledge about issues directly related to women as they move through different stages of life, from childbearing years to the post menopausal period. Physical therapists can provide hands on treatment to address spinal and pelvic joint dysfunction, instruct in exercises to address muscle weakness and imbalance, and provide guidance and instruction related to modifications of activities of daily living that may be difficult during the prenatal and postpartum phases.

 

Who Should be Referred to a Women’s Health Physical Therapist?

Those with:

  • Back, sacral, hip, pelvic, rib pain
  • Pain in the neck or upper back
  • Headaches
  • Sciatica, carpal tunnel, thoracic outlet or other nerve symptoms
  • Decreased ability to do normal daily activities
  • Weak or tight muscles
  • Pelvic pain with sexual intercourse, use of tampons or gynecologic exam
  • Desire to start or continue an exercise program
  • Urinary incontinence

Book an Appointment:

Address: 104 - 145 Asher Road, Kelowna, BC V1X 3H5
Phone: 250-765-2665
Fax: 250-765-7841
Email: info(at)RutlandPhysio.ca
Hours: 7:30 am - 6:00 pm - Monday to Friday
Free Parking: Behind our building - Access from Roxby Road (Look for the blue awning)

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