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Physical Therapy for Women's Health This unique specialty for physical therapists includes training in the development and changes that occur in a female lifespan. In the life cycle, women undergo changes in their ligaments and tissue structure after reaching puberty, during their childbearing years and again when reaching menopause. A physical therapist specializing in Women's health understands these changes and is comfortable addressing specific pathology which women are susceptible to during their development. A Women's health Physical therapist performs a musculoskeletal evaluation and performs treatment for incontinence, pelvic pain, osteoporosis, sacroiliac/back pain, pre/post partum rehabilitation, interstitial cystitis, constipation/painful intercourse and painful scarring. Incorporating manual therapy techniques with EMG biofeedback to assess and treat pelvic floor muscle dysfunction enables the physical therapist to restore normal function of the muscle. What is EMG/Biofeedback? Incontinence refers to the involuntary loss of feces or urine against your will. Along with leakage there may be other symptoms which include: Urgency: a strong desire to urinate even when the bladder
is not full. This is sometimes followed by pelvic discomfort or pressure. Stress Incontinence refers to sudden involuntary loss of urine when you sneeze, cough, walk, laugh or exercise. Urge incontinence occurs as soon as you get the urge to go to the bathroom. The sensation is over-whelming and your bladder muscle, the detrusor, contracts at the wrong time and you can't control your urine. A careful muscle evaluation can identify the dysfunction and with proper muscle retraining bladder control and pelvic floor muscle strength can improve. What is Interstitial Cystitis? Interstitial cystitis (IC), one of the chronic pelvic pain disorders, is a condition resulting in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms of IC vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include urgency, frequency, or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women's symptoms often get worse during menstruation. In IC, the bladder wall may be irritated and become scarred or stiff. Some people with IC find that their bladders cannot hold much urine, which increases the frequency of urination. Frequency, however, is not always specifically related to bladder size; many people with severe frequency have normal bladder capacity. People with severe cases of IC may urinate as many as 60 times a day. Physical therapy can help to address pelvic floor muscle strengthening to decrease urinary frequency and irritability. Manual therapy applied to abdominal wall and fascia surrounding the bladder can help to reduce muscle spasm along with applied modalities including electrical stimulation and moist heat. Pelvic pain encompasses a wide variety of pain syndromes in the pelvic floor, groin, low back and abdomen. Pain syndromes usually occur from pelvic trauma, which includes childbirth, injury/fall, surgeries and infection. Muscle and joint problems in these areas can contribute to pain and weakness in the pelvic floor. Our PT's can assess pelvic/sacroiliac instability, muscle weakness, trigger points and adhesions and provide the appropriate manual therapy and exercise prescription for symptom improvement and return to function. Osteoporosis is a weakening of
bone caused by hormonal changes as a woman enters menopause. Exercise has been
proven to help Pre/Post Partum Rehabilitation: During pregnancy and nursing, a woman undergoes significant postural stresses, physical and hormonal changes, and ligamentous laxity that can cause or contribute to musculoskeletal problems. Our physical therapists identify areas of increased laxity or weakness and issue a custom exercise program to ensure good spinal and pelvic alignment. We incorporate manual therapy techniques such as massage and muscle energy techniques for sacroiliac stability and can assist with sacroiliac or posture supports if needed. After pregnancy we address abdominal strength and condition and will work with new moms to return to full function and strength. Constipation/Pain with Intercourse can be the result of a hypertonus dysfunction where an increase in pelvic floor muscle tension or active spasm causes musculoskeletal pain. Patients with hypertonus dysfunction present with a pain/pressure/ache, usually poorly localized, in the vagina, rectum, above the pubic bone, or tailbone and sometimes down the back of the thigh. Physical therapy intervention includes normalizing pelvic floor muscle tone with EMG/Biofeedback and use of manual therapy techniques to eliminate pain and restore normal muscle function. Medical Diagnoses treated by Physical Therapists: v Musculoskeletel dysfunctions o Diastasis recti v Genitourinary pain (hypertonus syndromes) o Anismus o Dysmenorrhea o Dyspareunia o Hemorrhoids o Interstitial cystitis o Painful episiotomy o Proctalgia fugax o Vaginismus o Vulvodynia/vestibulitis o Pelvic pain v Genitourinary disorders/weakness o Cystocele o Enterocele o Stress urinary incontinence o Rectocele o Urge incontinence o Urinary frequency o Uterine prolapse v Hypertension of Pregnancy o Chronic or essential o Edema v Post surgical status o Abdominoplasty o Axilary node dissection o Bladder suspension o Hemorrhoidectomy o C-section o Hysterectomy o Lumpectomy o Prostatectomy
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EMG/Biofeedback
is used to create a permanent change in the muscles' ability to respond to and
function in their daily tasks. A patient can see on the computer screen the
muscle activity with video/audio confirmation of a desired response such as
a muscle contraction. Surface electrodes are placed on the pelvic floor and
on the abdominals to assess muscular compensation. This is NOT electrical stimulation.
You will not feel anything but will learn and see with the physical therapist
if your muscles are very weak or in muscle spasm. EMG/Biofeedback is used to
measure muscle activity and record muscle strength progression during rehabilitation.
improve
bone density, and PT's can prescribe gentle, individualized exercise programs
to promote increased strength. The desired outcome encourages a more active
lifestyle while decreasing the potential for falls and possible fractures.