These days many women take it upon themselves or are referred to see a Women’s Health Physiotherapist either when they are pregnant or following childbirth to address issues such as pelvic floor weakness, abdominal separation or advice for safe return to sport. However there are another group of women who can benefit from seeing a Women’s Health Physiotherapist. Do any of these things resonate with you?
“I wet myself when I cough, sneeze, lift or run”
This is known as stress urinary incontinence (SUI). It can occur at any stage of life whether having had children or not. It is a sign of a weak pelvic floor. Some reasons that our pelvic floor can weaken include: decreased oestrogen levels post menopause or while breast-feeding, incorrect or heavy lifting, a history of chronic constipation and straining, obesity, or having a condition which results in a lot of coughing such as asthma, pneumonia, COPD and smoking. It is important to be taught how to do pelvic floor exercises correctly and be given a home exercise program with progressions for strengthening.
“ I get a sudden urge and am “busting” to go to the toilet when I pull up in my driveway, put key in door, turn cubicle lock, hear running water” “ Sometimes this sudden urge results in an inability to control urine”
This condition is known as urgency and if there is accompanying loss of control of the bladder, it is known as urge incontinence (UI). This is NOT a normal sensation and it is helpful to learn some urge control strategies. Bladder retraining is also used to teach the bladder to hold larger amounts of urine.
“I have a heavy and dragging sensation in the pelvis, it feels like something is coming down, I’m unable to wear and hold in a tampon, I have a lump at the entrance of the vagina, I have pain during intercourse, I have difficulty completely emptying the bladder or bowel”
These are symptoms of pelvic organ prolapse (POP) which can involve the bladder, uterus, vagina or rectum and can be categorized as mild, moderate and severe. Like stress incontinence they can be due to childbirth, post-menopause, chronic straining, chronic coughing or sneezing, heavy lifting or obesity. If your pelvic floor muscles are weak, there is nothing holding the organs up from underneath and result in prolapse. Prevention for this is better than a cure.
“I keep getting recurrent urinary tract infections and don’t empty my bladder completely”
Physiotherapy can help with advice and education about this, teach you the correct toileting position and teach you good bladder/bowel habits.
“My stomach muscles don’t feel strong and I keep getting low back pain”
Learning how to correctly activate your pelvic floor muscles and deep abdominal muscles gives you a strong “core” which supports you spine. If you learn how to “brace” these muscles when lifting, moving etc. you lessen the risk of hurting your back. Core and Pilates type exercises can be taught by your Physiotherapist.
“I’m about to have gynaecological surgery or have had surgery already such as a hysterectomy”
Some people are lucky enough to see a Phyiotherapist on the ward at the hospital and given advice however there is a lot of learn about moving well post-surgery and strengthening your pelvic floor. After a hysterectomy you have changes in your oestrogen levels and are at greater risk of prolapse thus it is very important to learn how to correctly activate your pelvic floor.
“I go to the toilet over 10 times a day and often through the night” “I always seem to get constipated” “ I strain to open my bladder or bowels”
There is a lot to learn from a Women’s Health Physiotherapist when it comes to good bladder and bowel habits. Filling out a bladder diary and learning the “norms” of toileting and correct positioning can really make a difference to your life.
“Sex is painful” “I find it hard to relax my pelvic floor muscles” “my vagina is dry”
Pelvic pain can be improved by use of a lubricant as when we age oestrogen levels change and the lining of the vagina can become thinner and dryer. You can learn to relax tight pelvic floor muscles and trigger point therapy by your Physiotherapist may be beneficial.
If you are experiencing any of the above, please come and chat to our Women’s Health Physiotherapist Rebekah about it. Rebekah can help assess your individual situation and talk to you about treatment options. Make a booking today to get on top of the problem and get back to enjoying life.