What type of things do Women’s Health Physiotherapists Treat ?

Performance Plus Women’s Health Practice is conveniently situated in Mount Waverley. Physiotherapist Samara Nanayakkara discusses what Women’s Health Physiotherapists treat. She specialises in Bladder and Bowel Conditions, Prolapse, Sex Dysfunction and Pain, Pregnancy, Exercise and Menopause related issues.

Bladder Conditions

Do you leak urine when you cough, sneeze, laugh or exercise?

Have you had to rush to make it to the toilet in time?

Do you feel that you are always going to the toilet?

​Stress incontinence, urgency, urge incontinence and frequency are common bladder issues caused by a loss of pelvic floor control against pressure from the structures above.

This can be due to pregnancy, childbirth, constipation, menopause, ageing, obesity, chronic coughing and sneezing, and high impact exercise.

​1 out of 3 women who have experienced childbirth, will experience bladder leakage.  Just like the other muscles of the body, the pelvic floor can contract and relax.  Sometimes the cause of your bladder issues may be from the pelvic floor being too “tight.” 

Your bladder issues can be treated with a personalised, pelvic health program based upon the latest evidence created a specially trained Women’s Health Physiotherapist.

Bowel

Do you accidentally pass wind or soil underwear?

Do you rush to make it to the toilet in time for a bowel motion?

Is it difficult to completely empty your bowel?

A change in the sensitivity of your rectum and pelvic floor muscle control can result in the sudden need to open your bowels.  This loss of bowel control can be very distressing. It can result in loose bowel motions, passing wind unexpectedly, or soiling your underwear. 

Some women may experience the opposite. So this may present as being unable to pass a bowel motion for days, feeling that the bowel doesn’t completely empty, or excessive pushing to try to open the bowels.

​1 out of 10 women who have experienced childbirth will have difficulty controlling wind, bowel motions and/ or feel their rectum sitting lower.  Your bowel issues can be treated with a personalised, evidence based pelvic health program created by our Women’s Health Physiotherapist who are specially trained in managing these issues.

Prolapse

Do you have a heavy/ open/ lump or bulge sensation in the vagina or rectum?

​Have you been diagnosed with a bladder, uterine or bowel prolapse?

Do you need a pessary fitted for a pelvic organ prolapse?

A pelvic organ prolapse occurs when the bladder, uterus and/or bowel drop down and sit lower in the pelvis.  This can be uncomfortable for a woman, and can affect her daily function, exercise and even sensations during intercourse.

​Damage or weakening of the support to the pelvic organs can arise from pregnancy, childbirth, constipation, menopause, ageing, obesity, chronic coughing and sneezing, and high impact exercise.

As many as 50% of women who have had a baby will have a pelvic organ prolapse. Some don’t even know they have it!  Your prolapse issues can be treated with a personalised, evidence based pelvic health program created by Samara who is a specially trained pelvic health physiotherapist.

Pain with Sex

Do you find intercourse painful or difficult?

Is it hard to insert a finger or tampon?

Do you have painful orgasms, or can’t orgasm at all?

Conditions such as genito–pelvic pain disorder (dyspareunia, vaginismus), vulvodynia, painful bladder syndrome, interstitial cystitis and endometriosis, post–surgery, and damage to the pelvic nerves are some of the many reasons why there can be pain or discomfort in and around the vagina.

Pelvic floor muscle dysfunction can be one of the causes of lower abdominal or pelvic pain.  This is usually from over – activity or tension of these muscles. 

This can lead to:

– incomplete or slower emptying of the bladder and bowel.

– pain at the entrance to or deeper in the vagina in intercourse.

– avoidance of intimacy altogether.

Other common causes of pelvic or genito-pelvic / penetration pain include:

– hormonal fluctuations from breastfeeding, menstruation and menopause.

– childbirth.

– skin conditions around the vulva.

– emotional state or personal beliefs regarding intimacy and sex.

– dietary intake or medications.

– relationship issues.

More than one in five women (aged 18-50) (22%) have discussed or need to discuss pain around the vaginal area. 

Your pelvic and sexual pain issues can be treated with a personalized, evidence based pelvic health program created by Samara – a specially trained pelvic health physiotherapist. 

Pain in Pregnancy

Do you find walking, stairs, sitting and rolling in bed painful or difficult?

Does your back and hips ache?

Is there pain in your pubic region?

Unsure of what exercises to do in pregnancy?

Pelvic girdle pain, pubic symphysis dysfunction, pregnancy related back pain and pain in your coccyx can be painful and debilitating.  

2 out of 3 women will experience pelvic girdle pain through their pregnancy.

It can prevent you from sleeping, exercising, walking up and down stairs and even sitting in comfort.  You shouldn’t put up with pain!  Unfortunately some women can continue to have pain in and around their hips and pelvis for years after having their baby.  

Through hands – on treatment, exercise, postural correction and lifestyle advice, you can enjoy your pregnancy and exercise without pain!

Mastitis of the Breast

Do you have a blocked duct?

Is there redness, a lump, a fever & difficulty draining the breast while feeding?

Mastitis is an inflammation of the breast that can lead to infection, and is commonly experienced while breastfeeding and expressing breastmilk.  Mastitis can feel like you have the flu; you may feel hot and have body aches and pains.  It may also be difficult and even painful to express milk as there may be a blockage in the flow of breastmilk. 

1 in 10 women who are breastfeeding, bottle – feeding their own milk, and even weaning can experience mastitis.

Your doctor may recommend a course of antibiotics and treatment with a physiotherapist. 

Treatment with a physiotherapist will include therapeutic ultrasound on the affected area, and advice on feeding and massage techniques. A number of daily treatments of ultrasound is recommended.  Samara will advise you regarding how many sessions will be needed for you.

Menopause and Vaginal Atrophy

Does your vagina feel dry?

Does wind escape your vagina when you do yoga, cough, sneeze or laugh?

A woman enters an age when her period is no longer needed, and menopause is considered to be when a woman has not experienced a period for greater than 12 months. The support structures around the bladder, uterus and bowel rely on these hormones – namely oestrogen and progesterone – for elasticity, blood flow, and natural lubrication in the vagina. 

Women in menopause commonly report hot flushes, night sweats, stress incontinence, urgency, a bulge sensation in the vagina, and even a loss of control of wind. 

This can be embarrassing for women, who may choose to reduce or even stop their regular exercise altogether. 

This can have significant impacts on cardiovascular and bone health.  These conditions are manageable with the correct treatment and appropriate exercise program for your body.  

Exercise After Baby

Do you want to return to exercise after having your bub?

When can you start running & jumping?

What core exercises are safe to do?

Remember – the six week check up with your doctor does not mean you are ready to jump back into the same exercise you were doing before you fell pregnant!    Pushing yourself too hard too soon post-baby, increases the risk of urinary incontinence (which affects 30% of new mums), generalised pain, hernias, separated abdominal muscles, pelvic organ prolapse and musculoskeletal injuries.  Provided there is no pain, you can start pelvic floor exercises as soon as you are comfortable.  Basic core exercises can be prescribed – Samara will decide which are correct for you.

After your 6 week postnatal checkup with your Women’s Health Physiotherapist, ongoing check ups every few weeks are recommended to ensure that your pelvic floor is recovering.  This is to progress your exercises safely, and prevent long term damage that can occur by progressing your exercises too early.

All exercise needs to start small and gradually increase as if you are completely new to exercise.  Samara will create an exercise program based on your goals and recovery.