What is women’s health physiotherapy?

Pelvic health physiotherapists will treat a range of conditions around the pelvic area for both women and men. It is often just described as women’s health as women are at much higher risk of the kind of conditions treated and not all women’s health Physios treat men as well. But men can still suffer from complaints in this area relating to their pelvic floor.
This is a speciality that is less well known within Physiotherapy and often deals with complaints that are not openly discussed or there may be embarrassment around. This is despite there being a large number of people who suffer from problems in this area.
As a Physiotherapy Pilates company, we see a lot of patients who are referred by women’s health Physios or who we refer on to a women’s health Physio.
We want to explain what a Women’s Health Physiotherapist does and how they might be able to help you.

We chatted to Complete Physio’s pelvic health specialist Clare Pacey about her role in women’s and men’s health and what kind of complaints she sees in her clinics.

We asked these questions;

  • What is pelvic health Physiotherapy?
  • What’s the most common thing you see in your treatment room?
  • What can you expect from a women’s health assessment?
  • What sort of treatments do you offer as a Pelvic Health Physiotherapist?
  • Does the pelvis area contribute to pain elsewhere?
  • What one top tip would you give to a pelvic health patient?
  • What if I want to be a Pelvic Health Physiotherapist?

Have a listen to the interview in the video above. We have summarised the discussion below.

The kind of complaints that a women’s health Physio may deal with can include;

  • Bladder complaints
    • stress incontinenc
    • urge incontinence
  • Bowel conditions
    • severe constipation
    • incontinence
  • Pelvic organ prolapse (when pelvic organs such as bladder, bowel or uterus drop due to weakness in the pelvic floor)
  • Post-natal rehab (of the whole body as well as the pelvic floor muscles)
  • Rectus diastasis (a gap between the abdominal muscles often seen during and after pregnancy)
  • Pelvic girdle pain (of any sort including during and after pregnancy)
  • back pain in pregnancy
  • pain with sex (for men or women)
  • coccyx pain (for men or women)

What’s the most common thing you see in your treatment room?

  • Ladies during pregnancy, this can be for a number of reasons, but it is advisable for all pregnant ladies to have a check-up with a women’s health physiotherapist.
  • Ladies post-partum, it’s important to be assessed properly for your pelvic floor and abdominal rehabilitation as well as your whole-body recovery after pregnancy and giving birth. In this way, the rehabilitation can be specific and precise to you and your body and the problems you may be having getting back into normal activity and exercise.
  • People with pelvic pain, this can be anyone, and they may also be seeing a musculoskeletal Physiotherapist as well.
  • People with coccyx pain again can be anyone and may have already had other treatment before coming to see a pelvic health Physio.
  • Usually, referrals from musculoskeletal physios as that is the first port of call often from orthopaedic surgeons
  • Male patients with coccyx pain, this is a common reason for men to come to the pelvic health Physio and in some cases, there can be a fairly quick fix for these in a few sessions if the pelvic floor is hypertonic and needs some down training.

What can you expect from a women’s health assessment?

This can be a little daunting for patients as it is often an area of our health that we don’t like to talk about. However, a women’s health physiotherapist is used to dealing with these problems and will carefully guide you through the assessment. It will start with questions about what your complaint is and what your goals are so that they know why you are there. There will then be specific questions about your bladder health, bowel health, sexual health, what kind of exercise you do, and what kind of treatment you may have already had.

The Physiotherapist would then want to look at your posture and alignment and your movement patterns. This can often indicate what is happening with the muscles around the pelvis. The abdominal muscles are also often checked along with the core system as a whole.

It will often involve an internal assessment of the pelvic floor; this means inside your vagina as a woman as this is the only way we can feel the pelvic floor muscles and observe what’s happening with a prolapse. This can also be done in standing to see what happens with gravity. This is not compulsory, and we can still treat without it, but it gives a full and thorough assessment and gives a lot of information about what is happening with the pelvic floor.

What sort of treatments do you offer as a Pelvic Health Physiotherapist?

The kind of treatment offered varies greatly depending on the patient. Each patient is individually assessed and considered for their own treatment plan specific to their needs. Often patients will go to the GP saying they have done pelvic floor training, but the pelvic health physio offers a lot more than just the simple Kegel exercise squeezes.

Training the pelvic floor – train the muscles to travel through their full range of movement and be very precise with the training.
This means going further than just the basic pelvic floor squeezes. It includes the need to train the pelvic floor for the demands you put on it, e.g. for runners the training needs to be more than static contractions in sitting. The pelvic floor also needs to be coordinated, coordinating with the whole musculoskeletal system so that the body works in a balanced way.
It can also include internal release and ‘down training’ which can then be self-administered. Breathwork can also help with this to relax the pelvic floor or using your breath to get effective contraction of the pelvic floor.
The aim is to get you back to the things you currently find challenging; this might be lifting, impact exercise, walking or running. Whatever the problem, the treatment has to be specific to that.

Does the pelvis area contribute to pain elsewhere?

Yes, patients will often be rehabbed together with a musculoskeletal physio and pelvic health physio. This is because there is often a pelvic floor component to back pain, pelvic pain and hip pain.
There can be a complete disconnect to the pelvic floor as we are not always aware of how those muscles contribute to the function of the pelvis, hips and back.
Patients tend to get a better result when we work together as a team with other clinicians.

What one tip would you give a client presenting to a pelvic health clinic?

Like in so many areas of healthcare prevention is key. We need to take this area of medicine seriously, particularly as a woman as we are higher risk of problems with our pelvic floor. Ideally, you should have a consultation with a women’s health physio before any issues arise. Learn good habits and get in optimal movement patterns that will prevent future problems. You need a balanced core system to prevent future problems with your pelvis.

What if I want to be a Pelvic Health Physiotherapist?

Excellent as there is a need for more pelvic health physios! Working in a department in the NHS is a great place to learn with support from a big team and a large volume of patients. Seek out the specific Physio courses if working privately but also find a team that you can link with.
Get involved with special interest networks in your area and use opportunities for regular training.
It is a very good idea to have someone who can be a mentor to bounce ideas off.

If you have any further questions regarding Pelvic health as a woman or a man, please do get in touch with us here at complete Pilates. We have a team of specialist Physio and non-Physio instructors who work closely with Clare pacey to deliver a team approach to Physiotherapy and pilates whatever your pelvic health problem. Get in touch now on info@complete-pilates.co.uk

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