Common Women’s Health Issues
Women are strong. Very strong. We put our bodies to the test in many ways and sometimes the weakest part will ‘give way’. This could be a knee injury or neck pain, but commonly for females it’s our pelvic floor. Some females experience bladder urgency from being a small child; pregnancy can result in pelvic & back pain; and childbirth can cause pelvic floor weakness. These are all common issues, but common does not mean ‘normal’, and females certainly shouldn’t just ‘live with it’.
Seeking help from a physiotherapist with a special interest in Women’s Health is an important and essential part of your recovery of getting back to being yourself again.
+ Pregnancy Related Pain
You may have heard words like ‘pubic symphysis’, ‘sacroiliac joint’, ‘relaxin’, ‘instability’ and be feeling overwhelmed by the changes going on in your body, let alone the added issue of back and pelvic pain. Here’s a few facts about pregnancy related pain:
Back pain prior to pregnancy tends to improve or remain constant during pregnancy
Women may develop a ‘new’ pelvic pain or lower back pain which may progress as the pregnancy progresses
Pelvic pain with onset during pregnancy tends to not spontaneously resolve during pregnancy, and gradually increases in intensity as pregnancy progresses if it is not treated
Physiotherapy treatment of pelvic pain and lower back pain at early stages of onset can stop the pain getting worse throughout pregnancy
+ Abdominal Separation
Abdominal Separation, officially known as Diastasis Recti occurs when the connective tissue that your abdominals attach to gets stretched during pregnancy, leaving you with a gap between your abdominals, and is a natural occurrence affecting the majority of women.
Abdominal separation is often perceived as a cosmetic problem as the abdominals can no longer hold the abdominal contents as effectively and so the tummy is not as flat as it was pre-pregnancy, however the abdominals play a huge role in the body and if abdominal separation is not addressed then the weakness can lead to a whole host of issues including back pain, pelvic floor dysfunction, bladder leakage and even pelvic organ prolapse.
What can I do?
Seek advice from a Women’s Health Physio as soon as you feel able to after birth to get an accurate assessment, up to date advice and specific exercises that you can be doing to help improve your abdominal separation. Today’s widespread information on social media from ‘experts’ recommending abdominal exercise programs to prevent and treat abdominal separation is in strong contrast to the lack of evidence of any positive effect……don’t just believe what you read online as being the most appropriate treatment. We are all individual and all need individually tailored exercise programs.
Research suggests that the correct abdominal exercises can commence from day 2 after birth and will improve the closure of your separation……we strongly suggest that these are prescribed by a Physiotherapist with a special interest in Women’s Health.
+ Pelvic Organ Prolapse
Pelvic Organ Prolapse is a slipping of the pelvic organs (bladder, uterus or rectum) out of their ‘original position’.
How often does Prolapse occur in the female population?
Pelvic Organ Prolapse is now accepted as one of the most common health problems in Australia
Approximately 75% of women develop at least some degree of prolapse during their lifetime, some will not experience symptoms and never know they have a prolapse
1 in 3 will have a prolapse to the level of the vaginal entrance or beyond
We are all unique and individual, and so not all women with the same grade of prolapse will experience the same symptoms
How would I know if I have a prolapse?
You may experience some of the following symptoms:
Seeing or feeling a bulge in your vagina, which may cause discomfort
Pressure in your pelvis or lower abdomen
Lower back ache
Painful sexual intercourse
Hesitancy or straining to wee
Incomplete bladder emptying and needing to go again
Urgency and high frequency of ‘going to the loo’
Sensation of your bowel movement being stuck and needing to use your finger to assist
Who could Pelvic Organ Prolapse affect?
Any women having given birth (especially with forceps delivery)
History of chronic constipation
Elite/high level athlete
History of chronic respiratory condition ie asthma
History of heavy lifting
What should I do if I have concerns about POP?
Book yourself an Initial Assessment with a Physiotherapist who has specialist training in this area
You will be provided with appropriate pelvic floor exercises specific to your body which can help to manage the symptoms of POP and advice on other potential treatment options
Incontinence refers to accidental bladder or bowel leakage and ranges from just a small leak to complete loss of control. Current statistics suggest that it effects over 4.8 million Australians, so if you’re experiencing problems, you’re not alone. The good news is that it can be treated and managed. In many cases it can be cured.
If you experience problems but are not sure whether you should seek professional advice, ask yourself the following questions
Do you have to rush to the toilet?
Do you sometimes leak before you get to the toilet?
Are you frequently nervous because you think that you might lose control?
Do you sometimes leak when you exercise or play sport?
Do you plan your daily routine around where the nearest toilet is?
Do you sometimes leak when you lift something heavy, sneeze, cough or laugh?
Do you sometimes feel that you have not completely emptied your bladder?
Do you sometimes leak when you change from sitting/lying to standing?
Do you wake up twice or more during the night to go to the toilet?
If you answered ‘yes’ to any of the above questions you may have a bladder control problem and could benefit from an Initial Assessment with a Women’s Health Physiotherapist. You do not need a referral from your GP.
There are different types of incontinence which can be treated, better managed and in many cases cured. Make a positive change to your quality of life by booking an appointment today with a Women’s Health Physiotherapist.
Did you know, urinary incontinence affects more than 1 in 3 women?
+ Stress Urinary Incontinence
Involuntary loss of urine on effort or physical exertion. This could be when sneezing or coughing, running or jumping, or even being hit in the stomach with a ball when playing soccer!
Stress incontinence in women is often caused by pregnancy, childbirth and menopause, but can occur at any time. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing leakage during activities that push down on the bladder.
+ Urge Urinary Incontinence/Overactive Bladder
Urge incontinence is a sudden and strong need to urinate. You may also hear it referred to as an unstable or overactive bladder, or detrusor instability.
In a properly functioning bladder, the bladder muscle (detrusor) remains relaxed as the bladder gradually fills up. As the bladder gradually stretches, we get a feeling of wanting to pass urine when the bladder is about half full. Most people can hold on after this initial feeling until a convenient time to go to the toilet arises. However, if you are experiencing an overactive bladder and urge incontinence, the bladder may feel fuller than it actually is which means that the bladder contracts too early when it is not very full, and not when you want it to, making you suddenly (desperately) need the toilet and perhaps leak some urine before you get there. There may be certain times in the day when your strong urge is triggered. These are many strategies to assist with these symptoms and a physiotherapist with a special interest in Women’s Health can guide you through treatment options to achieve your goals.
Nocturia is the need to frequently pass urine and wake several times a night to do so. It can lead to sleep deprivation, depression and reduced quality of life.
A Women’s Health Physiotherapist can help you by taking time to understand your problem and how it affects you, assessing your pelvic floor and providing you with guided exercises that are specific to your body and your lifestyle.
Signs of a healthy bladder
A normal bladder:
Empties 4-8 times each day (every 3-4 hours)
Can hold up to 400-600ml of urine (the sensation of needing to empty occurs at 200-300 ml)
May wake you up once at night to pass urine and twice if you are older (i.e. over 65 years of age)
Tells you when it is full but gives you enough time to find a toilet
Empties completely each time you pass urine, and
Does not leak urine
+ Returning to exercise after giving birth
When is it safe to return to exercise after giving birth?...and which activities can I do? Both are common questions for new mums and the answer will vary from person to person. Important factors are:
how fit and active you were through your pregnancy
what type of exercise you have done previously
what type of birth you experienced
how your pelvic floor or abdominals were affected during pregnancy and birth
what type of exercise you are planning on returning to
Your Activate physiotherapist will gain a thorough understanding of your pregnancy and birth history, and then guide you through an internal assessment to determine whether you are able to return to exercise and which types of exercises to commence or avoid. Together you will set goals and exercises can be prescribed help you achieve these. Depending on the outcome of your assessment and your exercise goals, follow up appointments may be required.