Women’s Health Physiotherapy is a specialized branch of physical therapy that focuses on the unique needs of women across different stages of life from pregnancy and postpartum recovery to menopause and aging. This area of Physiotherapy is increasing in accessibility, which is fantastic as women are more empowered to educate themselves about pelvic floor, prenatal, postpartum and menopause related issues and do something about them rather than “just deal” with them. At the heart of this care lies pelvic floor therapy—but the scope of Women’s Health Physiotherapy extends far beyond just the pelvic floor.

Everyone is speaking about the pelvic floor – but what is it? The pelvic floor is a group of muscles, ligaments, and connective tissue that form a supportive sling at the base of the pelvis from the coccyx and sacrum at the back to the pubic symphysis at the front. These structures play a vital role in bladder and bowel control (continence), sexual function, and core stability. When weakened or strained, issues such as incontinence, prolapse, or pelvic pain can arise. When too tight, issues such as painful sexual intercourse can become evident.

Pelvic Floor Therapy begins with the taking of a comprehensive medical history, followed by an assessment of the muscles and tissues of the pelvic floor and surrounding areas. Based on the findings, a specific program is recommended which may include;

● Targeted exercises and/or stretches (example Kegel exercises)
● Biofeedback to improve muscle activation and relaxation
● Manual therapy to release tension and treat painful areas
● Lifestyle guidance on posture, hydration, and activity modifications
As mentioned above, Women’s health physiotherapy encompasses other areas beyond just pelvic floor care:
● Managing back pain, addressing diastasis recti, and providing supporting safe exercise in pregnancy and postpartum
● Helping with changes in muscle tone, bone health, and mobility as women age and enter and go through menopause. This can be a challenging time, but it does not have to be!
● Addressing painful intercourse, scar tissue, or tension that may affect a women’s sexual health
● Supporting women with chronic conditions such as endometriosis, pelvic pain syndromes, or recovery after gynecological surgery such as hysterectomy.

Women’s Health Physiotherapy aims at providing a holistic approach to addressing patient concerns. It is not only about exercises and stretches. One of the main approaches include education and lifestyle management strategies. Many of us are unaware of how certain day to day habits may be affecting certain aspects of pelvic health. For instance, nutrition may need to be addressed to support overall wellness and this may include dietary recommendations. Women may need to incorporate stress reduction techniques to help address excess muscle tension and the ensuing negative sequelae. Medication may also be necessary to address certain conditions. Thus, it may be necessary to collaborate with other professionals such as Nutritionists, Doctors, Midwives, and Psychologists for comprehensive care.

Women’s Health should enable women to feel empowerment and help with breaking the stigma around pelvic health. Women should feel comfortable reaching out to medical health professionals with their concerns surrounding their pelvic health. When should you seek help? If you experience symptoms or signs such as urinary or fecal leakage, pelvic pain, heaviness, or difficulty returning to or starting exercise due to pelvic symptoms. Speak to your Primary Health Care Practitioner about your concerns and if Pelvic / Women’s Health Physiotherapy might be of help along with any other recommendations.

Some simple self-care strategies that some may find helpful include:
● Practice gentle breathing while maintaining good posture. Sometimes poor posture and dysfunctional (e.g. shallow) breathing can affect the functioning of the pelvic floor muscles.
● Avoid “just in case” bathroom trips as this re-inforces pelvic floor muscle dysfunction, only “go” when you need to.
● Women should avoid urinating when standing as the muscles are designed to function optimally when we are squatting or sitting versus standing and frequent urinating when standing or hovering can contribute to pelvic muscle dysfunction. Eg when using public bathrooms, use tissue to cover the seat so that you do not need to stand.

Women’s health physiotherapy aims to empower women during each stage of life and uses a holistic approach to address concerns regarding pregnancy, menopause, sexual health, and chronic pelvic pain conditions.