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.

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.
Antenatal Exercise Class
  • Tailor made for promoting fitness during pregnancy
  • Conducted in small groups with in-depth guidance
  • Featuring fit ball exercise and Pilates to enhance core stability
  • Focusing on physical and psychological well-being, posture awareness, prevention of lower back pain and incontinence
  • Aerobic exercise is also an essential element in maintaining pregnancy fitness
Our physiotherapists will provide personal guidance in class to ensure safety and appropriate intensity.
 
Format
  • Number of lessons: 1 session per week, 4 in total
  • Class size: 2 to 4(husbands are welcome)
  • Content: breathing exercise for labour, whole body stretching, core and pelvic floor muscles training, limbs strengthening exercise
  • Time: weekday from 6pm to 7pm
  • Entry requirement: second trimester from week 14 to week 28 (also suitable for those with gestational diabetes)
A doctor’s referral (as proof of no contraindication) for physiotherapy is required for enrollment.
 
Contraindications
A history of premature labour, placenta previa, incompetent cervix, pre-eclampsia, high level pregnancy (e.g. twins or triplets), uncontrolled pregnancy-induced hypertension, uncontrolled gestational diabetes and uncontrolled type 1 diabetes.

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
Postnatal Exercise Class
(A) For Inpatients
Target: Mothers at 1-2 days postpartum with medical clearance
Frequency: 1 session
Contents:
  • Early pelvic floor and rectus diastasis care
  • Postnatal home exercise
  • Postural and back care
Appointment: Please arrange your appointment with the maternity nursing staff.
 
(B) For Outpatients
Target: Mothers beyond 6 weeks postpartum
Frequency: 3 sessions
Contents:
  • Postnatal exercises with Pilates and gymnasium ball elements
  • Circuit training
  • Individual real-time ultrasound imaging of bladder to facilitate pelvic floor muscle training
Appointment: A doctor’s referral for physiotherapy as proof of no contraindication is required.

Antenatal / Postnatal Exercise



Spinal mobilisation



Core stabilisation exercise



Stretching exercise



Strength training

Aerobic training
 

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

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 )