Women’s & Men’s Health Physiotherapist, Peony Fernandes from The Alignment Studio gives us the low down on exactly what she does and who can benefit from it.
If you’re suffering from pelvic discomfort, bladder or bowel incontinence, overactive bladder symptoms, painful intercourse or pelvic organ prolapse symptoms, you’re not alone. Thankfully, these common conditions are among those that can be managed, and often resolved, with the help of women’s health physiotherapy.
A specialist physiotherapist with extensive training in the management of bladder, bowel and pelvic floor dysfunction, the women’s health physiotherapist is equipped to identify and treat a variety of pelvic health concerns.
While many symptoms first arise during pregnancy, women’s health physiotherapy has the ability to improve the lives of all women – from early adulthood to childbirth, menopause and beyond.
WHEN SHOULD YOU SEE A WOMEN’S HEALTH PHYSIOTHERAPIST?
Treating conditions associated with the pelvic floor, such as bladder and bowel dysfunction, women’s health physiotherapy can be particularly beneficial for pre and postnatal women and peri and postmenopausal women.
A trained women’s health physio can assist with conditions including:
Stress incontinence – involuntary urine leakage during everyday activities
Overactive Bladder symptoms
Pelvic organ prolapse
Vaginismus (spasm of the vaginal muscles) and dyspareunia (painful intercourse)
Overactive pelvic floor (seen in conditions such as endometriosis and pelvic pain)
Pelvic girdle pain during or following pregnancy
Separation of abdominal muscles during pregnancy/childbirth (diastasis recti)
Carpal tunnel syndrome – often associated with pregnancy.
Appropriate early intervention can help in the management and/or resolution of many of these symptoms.
WHAT TECHNIQUES DOES A WOMEN’S HEALTH PHYSIOTHERAPIST USE?
A women’s health physiotherapist may use various techniques, such as:
Pelvic floor muscle awareness and training
Down-training for an overactive pelvic floor
Advice for prolapse management
Biofeedback for bowel evacuation retraining
Pelvic floor-safe exercise advice
Post-surgical rehabilitation and exercise advice (following gynaecological surgery)
Prescription of abdominal support garments, pelvic girdle belts and other supports
Core muscle training
Real Time Ultrasound for visual biofeedback
Occasionally, specialised equipment and small hand-held machines may be used.
WHAT HAPPENS IN A CONSULTATION WITH A WOMEN’S HEALTH PHYSIO?
The women’s health physiotherapist will take a comprehensive history including your general health, occupation and regular physical activities, your obstetric and gynaecological history, and ask for details about your bladder, bowel and pelvic floor function and your sexual health at your first visit. This will highlight key areas of interest.
The physiotherapist will often do a pelvic floor examination, with your consent, at the first or second visit. This usually involves a vaginal and/or rectal examination, and its purpose is to gain more information about your pelvic floor strength and function.
Following this, goals are set and a treatment plan is discussed, including some of the physiotherapy techniques that may be used and a realistic timeframe for achieving them. The physiotherapist will often prescribe a pelvic floor home program for you and ask you to fill diaries to bring back on subsequent visits. Maintaining healthy bladder and bowel habits is an integral part of this plan, as is weight management and an appropriate general exercise program.
DO YOU NEED A REFERRAL TO SEE A WOMEN’S HEALTH PHYSIOTHERAPIST?
A referral from a GP or Specialist is not essential, but can be very useful, particularly for clients over the age of 50, or with pre-existing health conditions. You will most likely be required to bring relevant scans and reports, details of prior surgeries and a list of current medications.
If it is a complex or chronic condition that you have had for six months or more, and a specialist and/or other allied health professionals are involved, you may qualify for a Medicare Team Care arrangement. The Care Plan is devised by your GP and is subsidised by Medicare for up to five visits in a calendar year; however, there will be a gap payment. Your GP can tell you whether you are eligible. The plan must be lodged with Medicare before your appointment.
Peony Fernandes is a women's and men's health physiotherapist with over 25 years experience and currently practices at The Alignment Studio in Melbournes CBD.