When I am tell people I am a Women’s Health Physio, 99% of the time they look at me blankly! Their next question is “So how does that differ from a general Physio?” It’s a fair question! But this lack of awareness about Women’s Health Physio means women don’t know we exist, so don’t know the importance of seeing us.
So today I am going to explain why Women’s Health Physio’s are very different to General Sports & Musculoskeletal Physio and why Women’s Health Physio’s are VITAL practitioners during pregnancy, postpartum & beyond!
If you find this informative, I would love you to share this blog with a woman in your life as she will benefit from knowing too 🙂
What is Women’s Health Physio?
Women’s Health Physio’s work with conditions pertinent to women during any life stage. To specialise in this area, we need to have done post-graduate studies (on that note- make sure your Women’s Health Physio has done postgraduate study!). We help:
- Pregnancy-related musculoskeletal pain e.g pelvic girdle & low back pain
- Pregnancy education including safe exercise, pelvic health and preparing you for birth
- Pelvic floor recovery after childbirth (including perineal tear/episiotomy)
- Abdominal muscle rehabilitation after pregnancy
- Safe return to exercise post-baby
- Postnatal-related musculoskeletal pain e.g. back pain from breastfeeding
- Mastitis
- Pelvic floor dysfunction- weak or overactive pelvic floor muscles
- Prolapse
- Bladder leakage – stress incontinence or urge incontinence
- Bladder frequency, urgency & nocturia
- Voiding dysfunction e.g. incomplete bladder emptying
- Painful intercourse
- Bowel issues e.g. poor control or constipation
- Pre/post-gynaecological surgery e.g. Hysterectomy
- Menopause symptoms
Women’s Health Physio’s can also help:
- Osteoporosis
- Child bedwetting
- Men’s health: pre/post-prostatectomy
What is General Physio?
General Physio’s treat both men AND women who suffer musculoskeletal pain in any area of their body and sport-related injuries. So if you sprain your ankle or have shoulder pain then you should see a General Physio. Some of these Physio’s specialise in certain areas- such as the foot, spine or sporting injuries.
Why should you see a Women’s Health Physio during pregnancy?
- Help you to understand and navigate the changes in your body.
- Learn correct pelvic floor exercises (many women do them incorrectly)*
- Learn how to activate & strengthen your deep abdominal muscles.
- Learn core exercises specific to you.
- Learn optimal posture.
- Learn how to exercise safely during pregnancy (pelvic floor safe that is- which a lot of pregnancy exercise in the fitness world is not!).
- Learn how to move in ways to help minimise abdominal separation.
- Learn how to help prevent pelvic or back pain.
- Learn how to prepare your pelvic floor for childbirth.
- Learn how to prevent prolapse.
- Treat any pelvic girdle pain, hip pain or back pain.
- Learn a specific home exercise program.
- Treatment of any bladder symptoms e.g. incontinence.
- Treatment of any bowel symptoms e.g. constipation.
- Fit you with a support & recovery garments such as SRC shorts.
- Learn how to optimise your wellbeing & self-care.
- Learn how to optimise recovery early postpartum.
*Every pregnant woman should see a Women’s Health Physio to learn how to do her pelvic floor exercises.
Why does every pregnant woman need to learn pelvic floor exercises?
1. To prevent prolapse and bladder leakage.
A pretty good reason I think! The evidence shows that doing regular, supervised pelvic floor exercises during pregnancy can prevent prolapse & incontinence.
2. Optimise post-birth recovery.
Having strong & healthy pelvic floor muscles during pregnancy will help the speed of recovery postpartum. When you have been regularly exercising your pelvic floor muscles you develop what’s called neuromuscular motor patterns. This means that after the muscles are stretched in childbirth, they have the ability to recover better.
3. Birth preparation.
During a vaginal birth, your pelvic floor muscles need to relax and stretch to accommodate for your baby’s head. Ensure you are relaxing your pelvic floor muscles completely when you do pelvic floor exercises. Also make sure you are not holding tension in them subconsciously during the day. Diaphragmatic breathing is a great connect with your pelvic floor prior to labour, and work on releasing/softening these muscles. Your Women’s Health Physio will teach you this.
You may be thinking that having a c-section will mean you avoid pelvic floor issues down the track, but this is not always the case. You can still develop pelvic floor dysfunction following a c-section. Firstly, the weight of the baby during pregnancy can be enough to cause pelvic floor weakness, and secondly, due to fascial, core & neural connections, the c-section can interfere with your ability to activate your pelvic floor muscles. I have seen causes where this has led to pelvic floor overactivity following a c-section.
When should you see a Women’s Health Physio during pregnancy?
Ideally in your 2nd trimester, but it is NEVER too early or late!
Why should you see a Women’s Health Physio postpartum?
- Help you to understand and navigate the changes in your body.
- Learn how to optimise your abdominal and pelvic floor recovery.
- Learn correct core muscle activation.
- Treatment of any pelvic floor injury or dysfunction from childbirth.
- Learn how to prevent prolapse.
- Treatment of any bladder or bowel symptoms you may experience.
- Assessment & treatment of abdominal separation (diastasis).
- Learn how to safely return to exercise specific to your body and birth.
- Learn optimal posture for breastfeeding.
- Treatment of any pelvic, back, neck or shoulder pain.
- Specific lifestyle advice for you.
- Learn how to optimise your wellbeing & self-care.
When should you see a Women’s Health Physio postpartum?
Typically at 6 weeks postpartum, as this is when it is safe to do an internal assessment (see below). However, you can have an assessment earlier than this to learn core muscle activation via the real-time ultrasound.
How does a Women’s Health Physio assess your core muscles?
- Real-time ultrasound machine
The real-time ultrasound machine is used to visualise your muscles via your lower abdomen to show you how to activate them correctly. This is a great, non-invasive way to assess your pelvic floor muscles and deep abdominal muscles. The visual biofeedback you receive from seeing your muscles work on the screen make it easier for you to learn the correct contraction, get feedback from the practitioner and feel confident about doing your exercises correctly.
- Internal assessment
Otherwise known as a vaginal examination, this is a more comprehensive way to assess the pelvic floor. The Women’s Health Physio can actually feel the muscles and give you reliable feedback. The assessment will determine:
- If you have any overactivity (tension/tightness) or underactivity (looseness) in your muscles
- Technique- if you are contracting your pelvic floor muscles correctly
- If you are completely relaxing your muscles
- Strength of the individual muscles
- Overall strength
- Endurance
- How many repetitions you can do
- If you can contract your muscles quickly
- If your muscles co-contract with your deep abdominal muscles
- Whether you have a prolapse & what degree it is
- If you have any pain or tension
I know “internal examinations” can sound scary, but they really aren’t. It is not painful like a papsmear with a speculum. It is gentle and we ensure you feel comfortable the entire time.
*Note: You can’t assess core muscles by looking or touching externally. This is because the muscles are deep and it is very hard to see or feel if the person is doing the contraction correctly externally. There are certain movements to look out for which indicate they are doing it incorrectly, but apart from this, women really do need a Women’s Health Physio Assessment. So if you have seen a General Physio or personal trainer who has ‘taught” you pelvic floor and core muscle activation via touch, do yourself a favour and book in with a Women’s Health Physio!
I hope this has cleared up any unknowns about what Women’s Health Physio is all about! If you have any questions, don’t hesitate to post them below.
In health & happiness,
Anna x