Women’s Health and Pelvic Floor Disorders
Women’s Health Physical Therapy is an area of physical therapy that specializes in the unique needs of women throughout their lives. From the young female athlete, before, during and after pregnancy, to menopausal woman all can benefit from physical therapy intervention.
Pregnancy and Postpartum
During pregnancy and postpartum a woman's body experiences many changes that affect their skeletal system. In particular, the increase in hormone levels may cause joints to become loose to prepare for delivery. Joint laxity along with postural changes and poor body mechanics contribute to the etiology of low back pain, pelvic pain, sacroiliac dysfunction, sciatica, upper back pain, diastasis recti (abdominal muscle separation) carpal tunnel syndrome, urinary incontinence (involuntary leakage of urine), dyspareunia (painful sexual intercourse) and organ prolapse. These are some of the woman’s health conditions a physical therapist can successfully treat.
Urinary incontinence is an involuntary leakage of urine. Sutton Place Physical Therapy successfully treats four types of urinary incontinence .
- Stress Urinary incontinence
Leakage of urine that occurs during coughing, sneezing, laughing, exercise and lifting. Leakage occurs when the intra abdominal pressure exceeds the urethral closure pressure. A combination of weak pelvic floor and abdominal muscles contribute to this disorder. A history of low back pain and pelvic pain can also add to inhibition and weakness of these muscles which can exacerbate this condition.
- Urge Urinary Incontinence
The leakage of urine associated with a strong urge to urinate. Those suffering with this condition will frequently leak urine during the sound of running water, or as they are trying to open the front door with their key.
- Mixed Urinary Incontinence
A combination of both stress and urge urinary incontinence. So those suffering from mixed incontinence leak during coughing, sneezing, laughing and have the strong urge to urinate.
- Functional Incontinence
When you are functionally limited and therefore can not get to the bathroom in time. An example may be someone who has severe arthritis and moves slowly. She may not be able to remove her clothing fast enough or moves very slowly secondary to hip or knee pain and can not get to the toilet in time.
Physical therapy intervention may include a combination of therapeutic exercises to strengthen the pelvic floor and abdominal muscles. Muscles surrounding the hips and spine are also addressed. Other treatment options may be bladder training, education on bladder irritants, EMG biofeedback and electrical stimulation.
Dyspareunia, Interstitial Cystitis (IC), Levator Ani Syndrome, Vulvodynia, Pelvic Floor Dysfunction
In addition to urinary incontinence, a woman’s health physical therapist can treat women suffering from pelvic pain. This can present itself as vaginal pain, pain with intercourse, or pain in the pelvis that radiates to the front or back of the thighs. Some woman experience burning vaginal or anal pain. Men can also experience pelvic pain, also called pelvic floor dysfunction or levator ani syndrome. They experience similar symptoms however frequently described by them as testicular pain, pain at the base or tip of the penis, or in the perineum. They frequently describe their symptoms as “it feels like I am sitting on a golf ball”. This similar pelvic floor condition can cause symptoms of urinary frequency and sexual dysfunction.
What to expect during therapy
Our team of physical therapists provide a thorough subjective and objective evaluation and develop a treatment program specific to your problems and goals.
Treatments may include one or more of the following: manual therapy to reduce muscle guarding and spasms, joint mobilization or muscle energy techniques to correct a rotated pelvis, sacroiliac joint or misaligned cervical, thoracic or lumbar vertebrae.
Specific therapeutic exercises will be prescribed to correct areas of muscle weakness, muscle imbalances or muscle tightness. Neuro-muscular reeducation is provided to instruct patients on proper posture alignment, spine stabilization and facilitation techniques for weak muscles such as those in the pelvic floor. EMG biofeedback is also utilized to re-educate weakness or hypertonus in the pelvic floor muscles.
Depending on your particular dysfunction, specific functional training will be provided geared toward your specific goals. Functional activities may include instructions on proper posture while nursing your infant or body mechanics education to learn how to correctly lift or bath your toddler to eliminate undue stress to your joints.
For a woman suffering from urine leakage, functional training may include education on bladder training or foods that may irritate their bladder and cause urgency and frequency.