WOMEN'S HEALTH
Treatment and rehabilitation exercises which manage dysfunction of the pelvic floor, pelvic pain, sexual dysfunction, muscles and other structures.

WOMENS HEALTH OVERVIEW

Women’s health has become a specialised field with a wide spectrum of services.

Our Women’s health therapists evaluate and treat the musculoskeletal disorders that may occur to women throughout their lifespan, with specialised understanding of the physiological differences, to be able to provide treatment and rehabilitation. The health concerns of women are widely varied and can include everyone from young athletes to postmenopausal women.

We aim to return you to optimal function through a combination of physical hands-on treatments, education, and rehabilitation.

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Assessment

We begin our womens health physiotherapy programme with a thorough assessment. This is a key to a successful treatment outcome. There are two sections to the assessment process. A subjective assessment about the womens health history, onset of symptoms, nature, behaviour of symptoms and psycho-social factors. An objective assessment looking at the pelvic floor muscles stabilization, strength and flexibility, joint gliding and integrity, neural integrity, as well as the effect of posture on the pelvic floor and the management of intra-abdominal pressure. After the assessment a diagnosis is made, the different treatment options are explained, and a treatment plan is discussed with the patient.

What are “pelvic flaws”?

“Pelvic flaws” refer to any dysfunction regarding the pelvic floor muscles and structures. The pelvic floor is made up out of layers of muscles and other tissues that form a muscular hammock at the bottom of the pelvis. It forms part of the deepest core stabilizing muscles. 

The pelvic floor muscles play an important role in controlling intra-abdominal pressure, which is vital for core stability, the stability of your lower back and pelvis.

The pelvic floor muscles should have:

To maintain continence when the intra-abdominal pressure increases e.g coughing, sneezing and picking up heavy things, bladder and bowel continence.

Give support to the pelvic organs, enough muscle tone to prevent pelvic organ prolapse.

To allow defecation, normal childbirth and sexual intercourse.

TREATABLE PELVIC FLOOR CONDITIONS:

• Bladder issues
• Bowel issues
• Pelvic organ prolapse
• Pain related problems
• Sexual dysfunction
• Empowerment = Prevention is better than cure

Treatment Plan FOR DIFFERENT CONDITIONS

After your assessment your Physio will thoroughly explain the cause of your discomfort and compile a comprehensive treatment plan which will include rehabilitation exercises which manage dysfunction of the pelvic floor muscles and other.

Bladder Issues

Urinary incontinence symptoms are not always a result of a weak pelvic floor muscle (stress incontinence), but may be due to an overactive bladder (urge incontinence). Treatment for the above mentioned conditions, differ totally from each other, but both can be rehabilitated.

Stress incontinence

This is when one leaks small amounts of urine when there is an increase in intra-abdominal pressure (pressure within the abdomen), such as when coughing, sneezing, laughing, jumping or lifting something heavy. Forces from within overwhelm the pelvic floor and urine escapes through the uthera. A weak pelvic floor and poor timing of pelvic floor contractions are the main causes of this.

Urge incontinence

In the case of an overactive bladder, the bladder is hypersensitive to filling with urine. It results in a premature sensation of fullness, urgency or frequency. Urinating small volumes, very often during the day. It is not related to any specific activity causing an increase in intra-abdominal pressure, such as sneezing or coughing.

Bowel issues

Bowl issues can vary from struggling to get stool out, up to leaking of stool.

Constipation

Constipation is the difficulty to empty the bowels, accompanied by abnormally hard faeces. Constipation can result from a dysfunctional pelvic floor or it can be a result of an irritable bowel, poor eating habits and lack of exercise. Dysfunction of the inner cylinder usually plays a big part here. Diaphragmatic breathing and relaxation of the pelvic floor are usually key to the recovery process.

Pelvic floor dyssynergy

This occurs when the pelvic floor contracts, instead of relaxing as you attempt to pass stool. You may think you are relaxing, but you are tensing the pelvic floor. This action prevents the stool from coming out and may result in latent leaking of stool or chronic constipation. Straining to get your stool out may cause prolapse symptoms in the long run. This is quite a common condition. Treatment includes teaching of the correct defecation technique and combining it with breathing and timing.

Stool (faecal) incontinence

This is predominantly the result of a weak pelvic floor and possible trauma to the muscular hammock during birth etc. Depending on the severity of the problem, pelvic floor rehabilitation can improve the symptoms. 

Pelvic organ prolapse

There are different causes for this condition, but it is when the pelvic organs have moved “downward” from their normal positions, mostly “falling into/through” the vaginal wall. Symptoms of pelvic organ prolapse may include pain in the pelvic region, a heavy, lumpy feeling or bulging of the organ to the outside as you pass stool.

Strengthening the pelvic floor will not fix the anatomical problem involved in prolapse, but it will provide more support to prevent further prolapse. In cases where the prolapse is mild, it may reduce symptoms and decrease the need for surgery.

PAIN RELATED PROBLEMS

Chronic pelvic pain

Tension in the pelvic floor muscles  and abdominal cavity could also present as referred pain in other areas, such as the lower back, abdominal area, inner thighs or coccyx. Many women often experience pain in the pelvic region after pelvic & lower back surgeries or even after an injury to these areas.

This could be due to the fact that a bracing strategy was used to control the pain. Pelvic pain is often described as a “headache” in the pelvis, and can be successfully treated with physiotherapy techniques such as myofascial release, trigger point therapy, breathing exercises and relaxation techniques.

Tight fibrotic tissues
after multiple surgeries

After undergoing surgery, radiotherapy or post injury, fibrotic tissues form as part of the normal healing process. It is necessary to mobilize this tissue to improve the elasticity of the muscle. Women who may have undergone multiple surgeries to their pelvic floor/pelvic organs often struggle with a lot of tight, fibrotic tissue that has to be mobilized by myofacial physiotherapy techniques.

Hypertonic (too tight)
pelvic floor muscle

This is an extremely common condition commonly found in young women, who may or may not be sexually active yet, who are under a lot of stress, and who have pulled in their stomachs for most of their lives. This condition refers to the pelvic floor muscle being too tight, and therefore causing pain with e.g. inserting a tampon or engaging in sexual intercourse. It is treated through myofascial physiotherapy techniques, relaxation techniques and breathing exercises. 

SEXUAL DYSFUNCTIONS

This may range from pain during sexual intercourse
to poor vaginal grip.
Pain during sexual intercourse

A tight pelvic floor can lead to pain and discomfort during intercourse. Many young women are unable to consummate their marriages because of tightness in the pelvic floor area. Physiotherapy can also assist females in decreasing pelvic floor tightness and obtaining a functional pelvic floor.

Muscular tension in this area may also present as referred pain in other areas, such as the lower back, abdominal area, inner thighs or coccyx.

Poor vaginal grip

A strong, but supple pelvic floor can add to sexual pleasure. It can add to vaginal grip and make the perineum more sensitive to stimulation.

EMPOWERMENT PROGRAMME

Lack of knowledge about the pelvic floor structure, and how it function, is not a general topic of discussion among people. There are many misinterpretations about how your pelvic floor muscles work and what their biomechanical functions are. Knowledge is power, so if you are unsure, please contact us for an appointment. 

During your consultation and treatment, our team will provide relevant information and guidance to empower you with the knowledge that you need to improve your quality of life.

...we want to help you, to help yourself...To be independent, to manage your own condition!

Self wellness, care and injury prevention is not a luxury but a necessity. Contact us to book a consultation. We are a dynamic team that cares.

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Phone: 051 444 2391
Mobile: 082 925 3926

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