Women’s Health Physiotherapy:
Women who suffer with urinary leakage can cause acute embarrassment, panic and a fear of future episodes. Leakage may occur during activities such as sneezing, coughing, running, laughing and dancing or just following a desperate urge to empty the bladder. (Dr. Grace Dorey Phd MCSP 2003). Incontinence affects at least 1 in 4 women. Urinary leakage is generally caused by events, which may damage your pelvic floor muscles. These muscles form a muscular hammock or a sling at the bottom of the pelvis and they support the bowel, womb and bladder within the abdomen. They allow the release of urine and faeces from the body and they are active during sexual activity. Events such as physical sport, sexual activity, pregnancy, childbirth, hysterectomy, abdominal surgery, menopause, obesity, constipation, persistent coughing, lifting, pushing, prolonged standing and ageing may place extra strain on the pelvic floor muscles resulting urinary leakage. (Dr. Grace Dorey 03)
There are two types of urinary incontinence:
- Stress Incontinence can occur during activities, which increases the pressure inside the abdomen such as coughing/sneezing, running and jumping. This puts strain on the bladder and causes the bladder to leak if the pelvic floor muscles are weak.
- Urge Incontinence occurs when there is a strong need to urinate. Women who experience this feel they must rush to the toilet very frequently however normal frequency of urination is normally 4-6 units per 24 hours.
Women can be referred for treatment by their G.P., Gynaecologist or they can self refer for treatment. Hilary, a specialist continence physiotherapist will provide a detailed assessment, which involves a gentle vaginal examination to assess the strength, endurance and integrity of the pelvic floor muscles and also assess for a possible prolapse (pelvic organ descent). Hilary will then provide the appropriate treatment such as pelvic floor strengthening exercises, postural advice and soft tissue mobilisations.
In some cases where physiotherapy is not indicated, Hilary will refer these women to the most appropriate professional for further investigations. Hilary’s aim is always to get to the root of the problem and ensure that each case is appropriately managed. (Ref: ‘Clench it or Drench it’ by Dr. Grace Dorey Consultant Physiotherapist 2003)
Pregnancy - Antenatal:
Pregnancy can often cause your muscles and joints to be painful. This is due to the release of a hormone called relaxin, which allows your ligaments to relax so that the baby can grow and most importantly allow the delivery of the baby through the pelvic floor. Many women complain of back, pelvic and neck pain during their pregnancy and physiotherapy can help with treating these aches and pains by providing advice on correct posture and exercise. We can also use hands on techniques, which are proven to be safe and effective.
Post Natal Care:
Following pregnancy and birth, your pelvic floor muscles and abdominal muscles are stretched and weak and you need to be advised on the correct exercises to improve your general strength, condition, and to ensure you recover properly. The physiotherapist can advise on postural advice, abdominal and pelvic floor exercises and when to return to sport and other exercise.