How Physical Therapy Can Treat Women’s Health Conditions

A woman’s body undergoes tremendous changes throughout the course of her lifetime, particularly during childbearing and childbirth.These changes can lead to episodes of pain and muscle dysfunction of the pelvic floor. Too often, women are dismissed when they raise concerns over incontinence, chronic pelvic pain, or painful intercourse and continue to suffer these symptoms untreated for months or even years.

Women no longer have to suffer in silence. Physical therapy is an effective treatment to address underlying musculoskeletal disorders that contribute to pelvic pain and incontinence. 

What is the Pelvic Floor?

The pelvic floor is a bowl-shaped muscle group that supports the colon, bladder, and uterus. It is made up of a layer of muscles and other tissues that stretch from the pubic bone to the tailbone. This muscle group helps an individual control their bladder and bowel and helps with sexual function. The pelvic joints are the pubic symphysis, sacroiliac joints, and hip joints. 

What is Pelvic Floor Dysfunction?

Pelvic pain can occur when the pelvic floor muscles are too tight. Pelvic floor dysfunction results when the pelvic joints do not work in harmony causing nearby muscles and nerves to tighten and weaken. If the sacroiliac joint, the coccyx, the low back, and/or the hip joint are impaired, an individual could experience pelvic pain and loss of function. 

How is the Pelvic Floor impacted during Pregnancy and Childbirth?

Pregnancy and childbirth cause physiological changes to the structure and the function of the muscles, nerves, and connective tissue that make up the pelvic floor. The weight of the baby and the growing uterus produce anatomical changes to the bladder, the pelvic joints, and pelvic muscles. During childbirth, particularly a vaginal birth, the child’s head stretches the pelvic floor muscles, tissues, and nerves of the mother; this can potentially tear the pelvic muscles. The stretching and possible tearing of the muscles and trauma to the nerves can result in pelvic floor dysfunction after birth.

What does Pelvic Floor Rehabilitation involve?

Pelvic floor rehabilitation with a trained female physical therapist is done in conjunction with an interdisciplinary team, including the patient’s OBGYN. The physical therapist will conduct an orthopedic exam to evaluate the spine, hips, posture, and gait of the patient and perform a flexibility and strength assessment. An internal exam of the pelvic floor, completed following the patient’s verbal and written consent, will assess muscle tone at rest and with strain to test the ability of the pelvic floor muscles to contract.

Pelvic floor rehabilitation with the physical therapist can include:

  • Manual therapy

  • Stretching and strengthening exercises

  • Postural exercises

  • Myo-fascial release

  • Relaxation techniques

  • Internal and external mobilization of the joints and soft tissue

  • Bladder training and patient education on lifestyle changes

  • Sensory, motor, sympathetic, and parasympathetic nerve re-training

  • Neuromuscular electrical stimulation

  • Home exercise plan

What other pregnancy-related women’s health issues can physical therapy treat?

During and after pregnancy and childbirth, a woman may experience low back pain and a separation of the abdominal muscles, known as Diastasis Recti. 

Low back pain is a common issue due to the weight-bearing strain of pregnancy on the back and abdominal muscles, vaginal or c-section delivery, and lifting and holding of the baby. Physical therapy can address low back pain through strategic strengthening exercises, education of correct body mechanics, management of muscle spasms, stretching, and an exercise program to strengthen muscles around the spine and pelvic floor to support the lower back.

Diastasis recti, the separation of abdominal muscles that can happen during pregnancy, occurs as a result of both the uterus pushing against the abdominal wall and pregnancy hormones that soften the connective tissue of the abdomen. Diastasis recti can contribute to low back pain and pelvic instability due to the weakness of the abdominal wall. To treat diastasis recti, a physical therapist will train the patient in safe core stabilization exercises, posture training, and proper mobility and lifting techniques. A physical therapist can also treat through hands-on therapy involving soft tissue mobilization.

Are you a woman suffering from chronic pelvic pain or incontinence issues after childbirth? Are you expecting and experiencing low back pain? You don’t have to suffer in silence any longer. Call to schedule a physical therapy evaluation today to start the journey to healing and relief!

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