Women’s health physiotherapy - more than just pelvic floor

A Women’s Health Physiotherapist specializes in the assessment, treatment and education of women throughout the stages of life. Women’s Health physiotherapists are specialists in supporting women through the Childbearing Year, through managing various gynecological, urological and gastrointestinal conditions as well as helping women with issues related to bone health, post breast surgery and menopause.

The scope of the Women’s Health physiotherapist is often not fully understood by the general public, and as women will usually seek advice from their GP for a variety of women’s health issues it is pertinent that GP’s are aware of conditions that are appropriate to refer to a Women’s Health Physiotherapist.

The Childbearing Year

Women’s health physiotherapists assess, diagnose and treat conditions that are commonly associated with pregnancy including

• Pregnancy-related Lumbopelvic Pain
• Neuralgias such as carpal tunnel syndrome
• Diastasis rectus abdominus
• Pelvic floor conditions including urinary incontinence and constipation
• Rehabilitation post-caesarean

Women’s health physiotherapists play a significant role in providing appropriate advice and education to women during the Childbearing Year using a biopsychosocial approach. They utilize a variety of treatment techniques including manual therapy, prescription of splints and braces and most importantly exercise based therapies (including hydrotherapy) that are tailored to pregnancy with consideration to precautions and contraindications to exercise.

Urinary and bowel dysfunction

The 6th International Continence Society guidelines recommend that supervised pelvic floor muscle training should be offered as a first-line conservative therapy for women of all ages with urinary incontinence. Women’s health physiotherapists are experts in assessing and training pelvic floor muscles for a range of conditions including urinary incontinence, faecal incontinence, pelvic floor prolapse and during the pre and postpartum period.

Menopause

Some women modify or stop exercising because of incontinence or pelvic health issues that occur during menopause. Women between 40-60 years who undertake regular physical activity or who increase their physical activity after menopause have a lower tendency to gain weight than less active women. Women’s health physiotherapists can assist women by prescribing appropriate exercise programs to gain fitness and improve pelvic health.

Pelvic pain

Pelvic pain affects 1 in 5 women and can be caused by a range of conditions including endometriosis and irritable bowel syndrome (IBS), and in some cases can lead to Chronic Pelvic Pain. Women’s health physiotherapists can assist women by assessing pelvic floor muscle activation and providing down-training for overactive muscles, teaching relaxation and stretching exercises and providing education on central sensitisation and the neurophysiology of pain.

Women’s health physiotherapists can provide effective solutions and management strategies for women of all ages and are well placed to help women continue to participate in all the activities they enjoy.

Maya Khanna
Physiotherapist
Mt Wilga Private Hospital

References:

1. Australian Physiotherapy Association choose.physio
2. World Health Organisation 2019, Women’s health, Geneva, Switzerland: World Health Organization, Downloaded 5th August 2019 from www.who.int/topics/womens_health/en/
3. International Organization of Physical Therapists in Pelvic and Women’s Health (IOPTPWH). About IOPTPWH. World Confederation for Physical Therapy. www.wcpt.org/ioptwh/about. Published 29th May 2019. Accessed 14th Sept 2019
4. Sternfeld B, Wang H, Quesenberry CP Jr, Abrams B, Everson-Rose SA, Greendale GA, Matthews KA, Torrens JI, Sowers M. Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women's Health Across the Nation. Am J Epidemiol. 2004 Nov 1;160(9):912-22. doi: 10.1093/aje/kwh299.
5. Williamson DF, Madans J, Anda RF, Kleinman JC, Kahn HS, Byers T. Recreational physical activity and ten-year weight change in a US national cohort. Int J Obes Relat Metab Disord. 1993 May;17(5):279-86.
6. Pelvic Pain Foundation of Australia: pelvicpain.org.au

Women’s Health Physiotherapy services are available through Ramsay Health Plus operating at Mt Wilga Private Hospital. For more information or to discuss treatment options please contact us at 9847 5015 or TherapyBookings.MWP@ramsayhealth.com.au.