The Role of Physical Therapy in Women's Health
The human body is an amazing machine! It is bone, connected by ligament and muscle with a complex highway of nerves that coordinate movement. Physical therapists have special training in treating problems with bone, ligament, muscles and nerves.
A specialty section of the American Physical Therapy Association was developed over 20 years ago to address treatment issues surrounding pregnancy. It has since expanded to include other women's health issues such as pelvic pain, incontinence, and osteoporosis. Any of these broad diagnosis categories can be helped with physical therapy treatment.
Pregnancy
Anyone who has been pregnant can tell you about aches and pains during pregnancy. These pains can sometimes alter our lifestyle and are not normal. Low back, pubic, and pelvic pain due to changes in posture and muscle function can be alleviated with special braces designed for pregnancy. Stretches and joint mobilizations done by the therapist can calm muscles and nerves, and realign bony changes causing pain. Mobilizations and stretches to episiotomy scars and old c-section scars are very effective. Exercises and proper use of heat and ice may also help keep the pain away.
Pelvic Pain
Sometimes pelvic pain can be a lasting result of pregnancy. However, pelvic pain can occur for many reasons, such as multiple abdominal and pelvic surgeries, trauma to the pelvis or perineum, and vascular or nerve changes following chronic bladder infections and vulvar irritations. There are many national and international associations dedicated to the diagnosis and treatment of pelvic pain because the pain can be life-altering. Specific scar and soft tissue manipulations in the legs, pelvis, and abdominal regions can help relax an overactive nervous system and calm muscle spasms. Biofeedback is utilized to teach proper use of the muscles in the pelvis and to help relax overactive muscles. Modalities such as deep heat, ice and electrical stimulation can be beneficial also.
Incontinence
Incontinence affects millions of women, but treatments involving surgery are not widely known. National guidelines regarding urinary incontinence treatment from the Agency for Health Care Policy and Research state that non-surgical treatment options should be tried before surgery and are effective in 70-80% of all women with incontinence. Some of these options include muscle strengthening, particularly of the pelvic floor and
abdominals, electrical stimulation, changes in diet, and scheduled voiding. Both stress and urge incontinence can be complicated by weak pelvic floor and abdominal muscles. Pelvic floor muscles can be difficult to exercise correctly because when they are very weak or have sustained nerve damage, they are hard to locate. Because the abdominal muscles are one of the main supports of the pelvic organs, weakness from continued separation after pregnancy, abdominal surgery, or abdominal weight gain needs to be corrected. Electrical stimulation can assist the muscle in contracting and can be applied at a different frequency to relax an overactive bladder. Soft tissue and scar mobilizations are also performed so to not restrict the pelvic organs or muscles and therefore will relax an overactive bladder.
Osteoporosis
Osteoporosis also affects millions of women. Physical therapy treatment for patients with osteoporosis can range from education on prevention, specific exercises to minimize the possibility of fracture, balance exercises, and specific treatments to address that pain and immobility resulting from an acute fracture. Another important part of treatment includes self-management techniques, including pain management, so the patient can function on their own.
Contributed by The Nebraska Medical Center's Physical Therapy Department, (402) 559-4465.
Date last updated: January 27, 2003
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