Women’s health physical therapy is a specialized area that focuses on women’s unique health needs throughout their lifespans. Women’s health physical therapy aims to improve women’s quality of life by treating conditions related to the female reproductive system, pelvic floor, and urinary and bowel functions.
Some common conditions that women’s health physical therapy may address include urinary incontinence, pelvic pain, pelvic floor dysfunction, pregnancy-related musculoskeletal pain, diastasis recti, and lymphedema.
Physical therapists specializing in women’s health use various methods, such as manual therapy, therapeutic exercise, and interventions like biofeedback and education, to help women regain strength, mobility, and function.
Women’s health physical therapy may also involve a holistic approach that addresses the social, psychological, and environmental factors that may impact women’s health. For example, physical therapists may counsel and support women who have experienced trauma or abuse or are struggling with body image issues.
Women’s health physical therapy helps women manage symptoms and reduce pain, improve their strength and flexibility, and prevent future complications.
Is Women’s Health Physical Therapy Important?
Women’s health physical therapy is essential for women’s overall health and well-being. It helps women who experience pain, discomfort, or weakness in the pelvic area and can help them regain their confidence and restore their quality of life. Women’s health physical therapy can also help women prepare for and recover from childbirth, improve their sexual health, and manage conditions related to menopause.
Some conditions treated with women’s health physical therapy include:
Urinary Incontinence
A common condition is Urinary incontinence, which affects women of all ages, and it occurs when the bladder cannot hold urine properly, leading to involuntary leakage. Women’s health physical therapy can help them regain bladder control by strengthening pelvic floor muscles through exercises such as Kegels.
Pelvic Organ Prolapse
When the pelvic muscles and tissues weaken and allow the organs to descend into the vaginal canal, pelvic organ prolapse occurs. Women’s health physical therapy can help strengthen the pelvic floor muscles to prevent pelvic organ prolapse or help manage the condition if it has already occurred.
Pregnancy-Related Conditions
Women’s health physical therapy can help manage and prevent pregnancy-related conditions such as diastasis recti, which is the separation of the abdominal muscles during pregnancy, and pelvic girdle pain, which is pain in the pelvic area during pregnancy.
Painful Intercourse
Various factors, including pelvic floor muscle dysfunction, hormonal changes, and psychological factors, can cause painful intercourse. Women’s health physical therapy can help address the physical causes of painful intercourse and improve sexual health and satisfaction.
Breast Cancer-Related Conditions
Breast cancer and its treatments can cause several physical changes in women, such as shoulder and arm pain, lymphedema, and decreased range of motion. Women’s health physical therapy can help manage these conditions and improve physical function and quality of life.
There are many types of Women’s Health Physical Therapy:
Pelvic Floor Muscle Training
Pelvic floor muscle training is a type of women’s health physical therapy that focuses on strengthening the pelvic floor muscles. It can be done through exercises that involve contracting and relaxing the pelvic floor muscles.
Manual Therapy
Manual therapy is a hands-on approach to women’s health physical therapy that involves the manipulation of soft tissues, joints, and muscles. Manual therapy can help improve the range of motion, reduce pain, and improve overall function.
Biofeedback
Biofeedback is a type of women’s health physical therapy that uses electronic sensors to provide feedback on muscle activity. Biofeedback can help women learn to control their pelvic floor muscles and improve muscle function.
Diastasis recti
Diastasis recti is a condition where the left and right sides of the rectus abdominis muscle (the “six-pack” muscle) separate, creating a gap in the midline of the abdomen. This can happen due to pregnancy, weight gain, or other factors that pressure the abdominal muscles. Women’s health physical therapy can help reduce the separation and improve core strength, reducing the risk of back pain and other related conditions.
Education and Counseling
Their conditions, which can often have a significant impact on their overall well-being.
In terms of education, women’s health physical therapists can provide information about various conditions that affect women, such as pelvic floor dysfunction, urinary incontinence, and pregnancy-related musculoskeletal pain. They can also educate women about exercises and lifestyle modifications that can help improve their symptoms and prevent further complications.
Counseling can help women deal with their conditions’ emotional and psychological aspects, such as anxiety, depression, and self-esteem issues. Women’s health physical therapists can provide a safe and supportive environment for women to discuss their concerns and help them develop coping strategies to improve their overall quality of life.
Overall, education and counseling are essential components of women’s health physical therapy, as they can help women understand their conditions, manage their symptoms, and improve their emotional well-being. In both the physical and emotional aspects of women’s health, physical therapists can provide holistic care that promotes optimal health and well-being for women.
Benefits of Women’s Health Physical Therapy
There are many benefits to women’s health physical therapy, including:
- Improving pelvic floor health: Women’s health physical therapy can help prevent or reduce pelvic floor dysfunction symptoms, such as incontinence or pain.
- Enhancing sexual health: Physical therapy can help women to overcome any discomfort or pain experienced during sexual activity.
- Postpartum rehabilitation: Women’s health physical therapy can help women to recover after childbirth by rebuilding core strength, reducing pain, and promoting healing.
- Reducing pregnancy-related pain: Physical therapy can help women to alleviate common pregnancy-related pains such as back pain, neck pain, and joint pain.
- Managing menopause symptoms: Physical therapy can help women to manage the symptoms of menopause, such as hot flashes, mood swings, and vaginal dryness.
- Improving breast health: Physical therapy can help women to manage breast pain and improve lymphatic drainage.
- Managing osteoporosis: Physical therapy can help women to manage osteoporosis by providing targeted exercises that can help to build bone density.
- Improving overall physical fitness: Physical therapy can help women improve their physical fitness by providing customized exercises.
Women’s health physical therapy is an important area of practice that can help address various issues related to the female body. Whether you are experiencing pelvic pain, urinary incontinence, or pregnancy-related conditions, physical therapy can provide targeted treatment and exercises to help improve your quality of life. If you are experiencing these issues, consider seeking a women’s health physical therapist to help you feel your best.
NourishDoc: Hello, everyone, and happy Friday. Well, we are bringing up a very interesting topic today Physical Therapy for Pelvic Health. Well, we have Doctor Karah. Doctor Karah is joining me live from Oakland, California. She is a physical therapist, yoga instructor, Pilates, and dancer. Thank you so much, and I’m so excited to have you here.
Dr. Karah: Thank you for having me.
What Do We Understand By Pelvic Health?
NourishDoc: Great. Before we go into her physical therapy helps us, let’s understand what pelvic health is.
Dr. Karah: So, pelvic health, specifically in the world of physical therapy, is acknowledging the fact that we have a pelvis, and within that pelvis, there are muscles called your pelvic floor, and I think many people don’t even know about those muscles, and so, as physical therapists, we’re specialists with muscles, with movement, and a pelvic physical therapist is going to be a little bit more specialized with the pelvic floor muscles, and generally, the whole core is a result because those muscles a big role in core stability and so, I think one of the biggest things we try to advocate for and talk about is within Pelvic Health, we like to address the three main things that can go wrong just due to your pelvic floor muscles which are bowel and bladder, sexual function, and then, of course, pelvic pain.
So, those are the main things we can address just through the lens of your pelvic floor muscles. Many times, those issues are addressed more medically with medication. So, it’s exciting to know there’s a more holistic approach to it.
Pelvic Health Toolbox
NourishDoc: That’s fascinating. Most of us go through one or the other during our journey, the women’s health journey. So, let’s talk a little bit about you. You’ve got an amazing toolbox here. So, how do you use it to help with pelvic health?
Dr. Karah: So, generally speaking, as a pelvic floor physical therapist and having all the background I do with movement. It’s a combination of a few things. One of the things that make my specialty unique is that to be a pelvic floor specialist in Physical therapy; you go through extra training to do intravaginal and intrarectal work meaning that we do internal work just like if you went to an OBGYN.
The only difference is that when you see a physical therapist, you focus on those pelvic floor muscles. So, we’re going internally with the consent, of course. We don’t have to do us. We can still assess the muscles externally, maybe not to the same degree, but this allows us to see what’s going on with your pelvic floor, tone, and coordination. Then as a pelvic floor physical therapist, I’m trained in many manual techniques.
So, being able to engage with those muscles provides new neural input. They’re hyper-engaged and protective. We can do techniques to help those muscles release; in addition to that, I am trained in techniques for the visceral, which is very much linked with the pelvic floor. So, if you think about the organs like the bladder, the kidneys, and the liver, these all play a role in the core function, and I don’t manipulate those organs.
I’m not like moving your kidney, but what I am doing in those techniques is, again, like having a conversation with the nervous system, coming into the area where the kidney is, and having a conversation with the somatic framework. So, maybe the fascia around the kidney, for whatever reason, traumatic injury, whatever it might be, has decided to go into protection mode, we can get in there and help that change its game, and so, definitely manual techniques are a big part of what I do.
But in addition to that, I’m a big believer in movement and getting to the root cause of why things have dysfunction in the first place, and so, being a physical therapist, but also being a dancer and a yoga teacher. As a Pilates instructor with my clients, I often use manual techniques to get them out of acute and immediate pain and then use movement for more sustainable results.
So actually getting to the root cause of your movement, what are your mechanics, and then getting you to integrate into a movement that feels sustainable, ideally getting back into like a group class because we know there are many benefits to moving with groups of people, a little harder during the pandemic right now. But that’s like the toolbox I’m using is man techniques and then getting back to movement.
Age Group & Conditions
NourishDoc: Okay, that sounds great. So, in what age group do you see women having this problem? Do you see some pattern, or is it all across the board from puberty to menopause?
Dr. Karah: It’s a good question. I would say that I’m seeing people of all ages because different issues will present. I would say that with Pelvic Health, two age groups, in particular, are especially for female-identifying people, which would be when women start birth control. I have found that birth control has links to creating pelvic pain, and that could be a whole other seminar.
But different birth controls and that kind of period certainly can create some pelvic pain. Then we also see a lot happening in menopause and both of these reasons. Pelvic pain is happening due to hormonal causes, and so again, even though I’m a physical therapist and not prescribing anything. I have to be aware of how hormones affect muscle function.
So I would say those two age ranges are big ones. However, everything in between, particularly another age group or area we focus on, is postpartum care and even during pregnancy. So, that would probably be what I see the most of.
NourishDoc: Sure, and what kind of issues can happen? The transgender community, which we don’t talk about.
Dr. Karah: So, with transgender care, I think I’ve worked with a few clients, particularly post-surgery, if they did a gender-affirming surgery and sometimes issue. I mean, you think about any surgery in our body, and that’s a relative trauma to the body we think about if someone had a knee replacement, of course, they would get physical therapy.
However, for whatever reason, when we think about abdominal surgeries, pelvic surgeries, delivering a baby, or any of those things, it hasn’t become the norm also to think that’s surgery. We need rehabilitation, and so, I would say in the transgender community, a big area where Pelvic PT can help is certainly post-surgery.
However, we also can talk about prehab getting in before the surgery because we want those muscles and fascia to be in the best position possible. So, post-surgery, there’s not as much effect with the scar tissue and those muscles entering that guarding place. So, that would probably be the biggest thing we can help with.
Home Exercises & Movements
NourishDoc: All right. Here are a few tips you could share. This is a quick 10-minute session that we do daily to bring quick wellness tips, anything you could share like what we could do at home, some yoga poses, some dance movements, Pilates; I know you can’t demonstrate it here, but maybe you could help us.
Dr. Karah: Sure. I think probably one of the quickest tips I could give is having people understand; if you’ve heard anything about pelvic health, I feel like what most people have heard is to do Kegels, and what I’m trying to get people to understand is that Kegels, although not wrong. We could go into a whole other seminar on that; they’re overused and overtalked about, and what people are often talked is, oh, you have to tighten and engage your pelvic floor.
When the reality of what I’ve seen clinically is that most people’s pelvic floor dysfunction is due to the muscles being over-engaged, and so if I were to teach anyone anything, I would teach them that what we need to focus on is a little bit more of that relaxation piece of the pelvic floor. One of the best ways to do that is diaphragmatic breathing.
I could spend 5 to 10 minutes explaining what diaphragmatic breathing is. However, a quick way to explain it is to understand how to breathe into the rib cage and belly rather than just the chest. When you breathe into your rib cage and belly and allow for that expansion, there’s a connection to the pelvic floor, and those muscles start to expand as well; this is one of the best ways to start understanding how to get your pelvic floor to relax.
NourishDoc: Well, any asanas, any particular yoga movement?
Dr. Karah: Yes, good question. My top three yoga asanas that relatively stretch the pelvic floor would be the happy baby child’s pose, where your knees are a little wider, and then the yogi squat Malasana. So, when you’re in that deeper squat, those are all relative stretches, and I say relatively because it depends on how you’re doing it.
So, suppose you’re in those positions, but you’re still gripping. In that case, there are ways that we can get you to relax or breathe differently to get those muscles to relax. However, generally, those are some good ones.
NourishDoc: Great. Thank you so much, Dr. Karah, for being with us. To everyone else and all the women out there, we know that we must take care of our pelvic home. We don’t discuss it, so we wanted to bring up this very interesting today. Have a great weekend, everyone. Anything else you like to add before I wrap up? Thank you so much.
Dr. Karah: Thank you so much for having me. I appreciate this.
NourishDoc: Absolutely. Thank you, everyone, for your support. We’re launching workshops, so stay tuned. Thank you, and have a great weekend.
