What does a women’s health physiotherapist do? This is by far the question I get asked the most and usually at the dinner table when I’m having a good time with friends. When I start to explain the long list of things we do, with a very open manner, some people find it embarrassing (usually men) and others find it very interesting (always women!) I must admit that prior to becoming a women’s health physiotherapist I used to feel very uncomfortable talking about things such as childbirth, bowel movements, periods and sex… but those days are long gone and I’m glad of it!
A women’s health physiotherapist is a specialist in the physiotherapeutic care of women with problems affecting the pelvis and pelvic floor, in relation to:
- Sports or direct trauma
- Childbirth, both before and after
- Pelvic girdle pain both before, during and after pregnancy
- Bladder and bowel dysfunction (incontinence, urgency, frequency and pain)
- Gynaecological or pelvic surgery
- Sexual dysfunction
- Menopause
Women’s health physiotherapists are therefore qualified to help women who are struggling with problems such as:
- Pelvic pain
- Pudendal nerve disorders
- Pelvic floor dysfunction
- Painful sex / Vaginismus
- Vulvodynia
- Urinary and Faecal Incontinence
- Interstitial cystitis/ Painful bladder syndrome
- Irritable bowel syndrome
- Constipation
- Pelvic organ prolapse
- Pregnancy related pelvic girdle pain and back pain
- Abdominal separation/rectus abdominis diastasis (commonly known as “tummy gap after pregnancy”)
- Gynaecological and breast cancers/surgery
- Endometriosis
- Coccyx / tailbone pain
- Low back pain
Going back to the dinner table conversations; the question that then follows is: “Pelvic floor? What is the pelvic floor?!” And the reaction to my answer is even funnier. When I start by saying that the pelvic floor is a group of muscles that join the tailbone and the pubic bone together and with this description, I use my hands to demonstrate and point where they are, that’s when the people who are embarrassed get even more embarrassed and want to leave!
On a more serious note, the pelvic floor muscles, like any other muscles in the body can become tight, weak, shortened and painful. This can happen in any stage of a woman’s life and because of different reasons. Painful periods, frequent constipation or diarrhoea, pelvic pain, pregnancy or childbirth, pelvic surgery, menopause or trauma to the pelvis after a fall are just some examples of events that can affect the way these muscles work and lead to a dysfunction in the pelvic area. Not only are these muscles important for sexual health and to control the bladder and bowels, but they also give support to the pelvic organs, and to the pelvis to create stability while we move and breathe, so you can see how a lot of problems may arise if they aren’t healthy.
If you are a women having symptoms of any kind, you might think that you are the only one struggling with this. I guess that’s because it’s not easy to explain to others that you cannot sit down for long because of the pain you feel in your lady bits, tailbone or tummy, as opposed to simply saying you have low back pain. And that’s perfectly okay, you don’t need to share personal information with anyone that’s not close to you. But the fact that no-one is talking openly about it makes the problem seem more uncommon, leading women to think that this type of pain must be very bad and rare, as no-one else seems to be struggling with the same issues.
However, the statistics say otherwise.
We know that in the UK alone:
– 38 in 1000 women suffer from chronic pelvic pain.
– 1 in 10 women struggle with endometriosis.
– 3 to 6 million people (women and men) struggle with urinary incontinence.
– 1 in 10 women finds sex painful.
And worldwide:
– Between 50 to 70% of pregnant women worldwide struggle with lower back pain.
– Between 14 to 22% of all pregnant women have serious pelvic girdle pain with 5 to 8% of these having severe pain leading to disability.
– Approximately 7% of women continue to have pelvic girdle pain post-delivery.
– Approximately 54 % of pregnant women struggle with stress urinary incontinence during pregnancy.
As you can see, the numbers are huge. So why is it so hard to find treatment for it? This shouldn’t be the case and there is no need to suffer in silence.
There is growing evidence to show that physiotherapy, as part of a multidisciplinary approach, can alleviate and in many cases cure these symptoms. So what can women’s health physiotherapists do to help? To put it simply, women’s health physiotherapists work to improve the pelvic health of women, men and children focusing on helping them to:
– Achieve optimal relaxation, function and strength of the pelvic floor muscles.
– Improve the work of the abdominal muscles, diaphragm and muscles in the thighs and groin.
– Improve connective tissue (fascia, muscles, ligaments, nerves etc.) mobility and function.
– Improve mobility of the pelvis, lumbar spine and hips joints.
– Achieve good bowel, bladder and sexual health.
– Restore correct breathing patterns.
– Learn about how the brain processes pain and how simple lifestyle changes may have a significant impact on quality of life.
The treatment is always carefully planned according to all the findings of an initial assessment so treatments are tailored for each person depending on the cause of the problem.
If you are struggling with pelvic health problems and you need help you can self-refer yourself to see a specialist women’s health physiotherapist.
If you wish to start your recovery today you can book now for an initial consultation. You can find me in three different locations across London or alternatively, if you just need advice, you live abroad, or you are not sure if this treatment is a good option for you, you can always book a skype consultation for an initial screening.
Useful links:
– http://pogp.csp.org.uk/publications/role-womens-health-physiotherapist
