Physiotherapy in Women’s Health


In this month’s physiotherapy post we look at special conditions affecting women and how physiotherapy can help in both prevention, treatment and recovery.

Physiotherapy in Women’s Health refers to the therapeutic treatment of all dysfunctions affecting the pelvis and pelvic floor.

Pelvic Floor: a complex structure composed of a group of muscles that support the pelvic organs and form the uterine canal and a passage for urine and faeces. These muscles not only need to contract in order to keep a woman continent, but they also need to relax to allow for the passage of urine and bowel movements, natural birth and sexual relations.

Problems with the pelvic floor may arise when its muscles are either very weak (hypotonia) or very tense (hypertonia). A combination of high muscle tension in some areas and excessive relaxation in others may also occur.

Symptoms of Hypotonia in the Pelvic Floor

  • urinary or faecal incontinence
  • urinary or faecal emergency
  • prolapse, or displacement, of the pelvic organs

These symptoms are NOT a natural result of ageing and various reasons exist for why these muscles may weaken.

Studies show that a well-structured exercise plan to strengthen pelvic floor muscles is effective in reversing symptoms in 80% of women.

Symptoms of Hypertonia in the Pelvic Floor

  • frequent urination
  • urinary or faecal emergency
  • incomplete or painful evacuation of the bladder
  • obstipation (severe constipation) or pain during bowel movements
  • pains in the lumbar, pelvic or genital region
  • pain during sexual relations, orgasm or sexual stimulation
  • hypertonia may also contribute towards Interstitial cystitis, Vulvodynia and pain in the pudendal nerve, which runs from the pelvis to the spine

There are various reasons as to why hypertonia may affect pelvic floor muscles. Among them may be trauma sustained by the pelvic floor or organs in the pelvic area (in the case of natural birth), a gynaecological intervention or exam, non-resolved lumbar or hip pain, or complications after an infection.

If these muscles have lost their tone, it may be difficult to initiate or maintain contractions of the pelvic floor. In such a situation, it is important to completely relax these muscles and alleviate any tension before attempting to treat the muscle weakness itself.

Physiotherapy during Pregnancy

Lumbar and pelvic girdle pain, as well as stress urinary incontinence, are all common symptoms in pregnant women. These mostly occur due to hormonal changes and increase in weight of the baby and uterus.

Urinary incontinence during pregnancy should not be ignored. Studies show that if a woman develops stress urinary incontinence during pregnancy, or within 6 weeks after giving birth, she will be more likely to suffer from incontinence 5 years later.

A check-up at a Women’s Health Physiotherapist may prevent this from happening. Making sure that you perform pelvic floor exercises correctly and that you exercise the correct muscles within an adequate amount of time is important for keeping the pelvic floor strong both during and after pregnancy.

Postnatal Physiotherapy

The first few weeks immediately after giving birth are extremely important with regards to the body. Your body undergoes many changes during pregnancy and will continue to do so after giving birth. It is important to treat any symptom that may arise during this time in order to prevent problems later on.

An exam of the pelvic floor is important to establish the cause of these symptoms.  A Women’s Health Physiotherapist can examine you from 6 weeks after normal birth or from 8 weeks in the case of a caesarean section, providing advice on taking up exercising again and on the recovery of separated abdominal muscles (Diastasis recti).

From incontinency to prolapse, to pelvic pain or obstipation, there is growing proof that Women’s Health Physiotherapy can provide relief and, in many cases, cure these symptoms.  The majority of women are unaware of the role of physiotherapy in this field and many feel embarrassed to speak openly about these symptoms.

 Best Doctors encourages you to seek out the specialised help of a Women’s Health Physiotherapist should you show signs of the described symptoms.


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