Women's Health Physiotherapy

Aims: We offer specialised physiotherapy treatments to cater the needs of women at different stages in the areas of obstetric and gynaecology care.

Antenatal / Postnatal Exercise


Spinal mobilisation



Core stabilisation exercise



Stretching exercise



Strength training

Aerobic training
 


Common conditions that we treat during pregnancy and after birth:
  • Pregnancy related pelvic girdle pain
  • Pregnancy related carpal tunnel syndrome
  • Other musculoskeletal pain includes shoulder girdle, wrist , back and neck pain
  • Urinary incontinence or bowel problem
  • Pelvic organ prolapse

Gynaecology Care
Women suffer from pelvic floor problems are common in their lifetime. We provide physiotherapy treatment in various conditions such as urinary incontinence, pelvic organ prolapse, bowel problem and pelvic pain.

Urinary incontinence is a common symptom that can affect women of all ages. Predisposing factors in women include childbearing, obesity, and constipation, it is commonly associated with pelvic organ prolapse in stress incontinence. Nice guideline recommended a supervised pelvic floor muscle training as a first line treatment for urinary incontinence.

Pelvic Floor Rehabilitation
Pelvic Floor Exercise - Kegel Exercise
  • Effective pelvic floor muscle contraction prior to and during effort clamps the urethra and increases the urethral pressure to decrease urinary incontinence
  • The bladder neck receives support from a strong pelvic floor muscle , thereby limiting its downward movement during effort
The exercise programme include:
  • Awareness of the function and anatomy of pelvic floor muscle
  • Strength training
  • Endurance training
  • Knack coordination training
  • Pelvic floor exercise with indicator

Electrical Stimulation
Weak pelvic floor muscle is reinforced with electrical stimulation and visual feedback from EMG tracing.


Bladder Training
Bladder training aims to increase the interval between voids and get better control of bladder. It is recommended as a treatment for mixed incontinence or overactive bladder.

A bladder diary is used to record times and amounts of urine passed, leakage episodes, pad usage and other information such as fluid intake, degree of urgency and degree of incontinence.

Lifestyle Modification
Nice guideline on recommendation of lifestyle modification:
  • Caffeine:
    Recommend a trial of caffeine reduction to women with overactive bladder
  • Fluid intake
    Modification of high or low fluid intake in women with urinary incontinence or overactive bladder
  • Weight
    Advise women with urinary incontinence or overactive bladder who have a BMI greater than 30 to lose weight

Obstetric Care
Antenatal Care
Aims of antenatal care:
  • To prevent and help alleviate both the physical and emotional stress of the pregnancy and labour.
  • Improve fitness and understand of what changes occur during pregnancy
  • To reduce and prevent pregnancy related pain and urinary incontinence
Antenatal care includes antenatal exercise , breathing and relaxation control and postural advice.

Postnatal Care

Aims of postnatal care:
  • Postural correction and awareness during breast feeding or bottle feeding
  • Back care skills and awareness for household and childcare activities
  • Core muscle activation in daily activities
  • Progressive postnatal strengthening and stretching exercises
  • Pelvic floor muscle awareness and exercise


References

  • Dumoculin C and Hay-smith J. (2010). Pelvic floor muscle training versus no treatment , or inactive control treatments, for urinary incontinence in women ( Cochrane review ). Cochrane database of systematic reviews, issue 1
  • Smith et.al. (2013). Urinary incontinence in women: the management of urinary incontinence in women. ( National collaborating centre for women's and children's health, National Institute for Health and Care Excellence )