Women’s Health

The emphasis of health sciences on fitness and wellness has brought to women’s attention a need to pay close attention to their bodies during recreation, work and throughout each phase of life. Gender specific problems require gender specific qualifications for the quickest and most satisfying outcomes. Since Women’s Health or Female Pelvic Health physical therapy is the term used to describe gender specific health problems, it is important to seek care from a physical therapist that is is uniquely and specifically qualified and trained to treat the condition you are seeking help to resolve. It is always most helpful to receive treatment from a “hands-on” manual therapy physical therapist with strong orthopedic and, in some cases, sports injury experience. At Lake Country Physical Therapy and Sportscare, we are dedicated to the improvement of women’s health during all phases of life.

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Female Athlete
Female athletes, whether weekend warriors, seasonal or competitive require special needs at various stages in life. Physical therapists provide instruction in self-care of aches and pains, proper execution of the desired exercise or sport and treatment to eliminate signs and symptoms limiting or preventing performance.

Urinary and Bowel Urgency, Frequency and Leakage (incontinence) Continence Care for Women: Urgency or Urgent urination is a sudden, strong urge to urinate or defecate, it is accompanied by discomfort in your bladder or abdomen. Frequency is urinating more often than every 3-4 hours or defecating more than 3 times per day.

Incontinence can happen to athletes, seniors, middle age, children, after surgery or trauma. Incontinence is the loss of bladder or bowel control resulting in involuntary leakage of urine or stool. Pelvic floor weakness resulting in a reduction of muscular support for the bladder, uterus or rectum may be the cause. The muscles through disuse are unable to tighten and keep the openings closed. Incontinence of urine may be termed stress (leakage with physical activity, coughing, sneezing or laughing), urgency (involuntary bladder emptying whenever the sensation of urge is felt) or frequency. Involuntary leakage of feces and gas can be the result of chronic constipation or trauma. Behavioral assessment of foods, beverage, medications and toilet habits can identify contributing factors. Treatment includes retraining bowel and bladder habits, abdominal and pelvic floor muscle rehabilitation with or without electrical stimulation or biofeedback.

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Surgical Prevention and After Surgery Rehabilitation for:

  • Bladder, Uterus, Rectum or Small Intestine Organ Prolapse
    Progressive instruction and home exercise for the pelvic floor, abdominal, hip and trunk muscle rehabilitation is necessary for recovery after surgery. Instruction on splinting and bracing is also part of the treatment plan. Kinesio Taping is often beneficial. Manual therapies to facilitate good tissue healing and prevent adhesion and scar tissue formation is very important.
  • Hernia
    Hernia of the umbilical cord and groin (inguinal region) require adbominal wall and groin rehabilitation to prevent development of adhesions or scar tissue formation. Exercise to restore tissue mobility and strength after surgery is beneficial.
  • Diastasis Recti
    Diastasis Recti is an abdominal muscle hernia Diastasis recti (also known as abdominal separation) is commonly defined as a gap of roughly 2.7 cm or greater between the two sides of the rectus abdominis muscle. The distance between the right and left rectus abdominis muscles is created by the stretching of the linea alba, a connective collagen sheath created by the aponeurosis insertions of the transverse abdominis, internal oblique, and external oblique. Diastasis of this muscle occurs principally in two populations: newborns and pregnant women. It is also known to occur in men.

Regardless of the type of prolapse or hernia repair, progressive instruction and home exercise for the pelvic floor, abdominal, hip and trunk muscle rehabilitation is necessary to prevent surgery and for recovery after surgery. Instruction on splinting and bracing is also part of the treatment plan. Manual therapies to facilitate good tissue healing and prevent adhesion and scar tissue formation. Kinesio Taping is often beneficial. Instruction in corrective posture and lifting techniques is very important.

Pelvic Floor, Lower Abdominal, Groin Pain / Tension Myalgia / Trigger Points / Trauma
Pelvic floor tension or pain in the sling of muscles which support the bladder, uterus and rectum can be caused by muscle, nerve, joint problems, scar tissue from surgery, childbirth, and endometriosis or after radiation. Pelvic pain can also be caused by hemorrhoids, anal fissures, organ prolapse or constipation. The individual may have painful intercourse, difficulty sitting, and pain in the buttocks, hips, lower abdomen or low back. Imbalances in the muscles surrounding the pelvis can cause or contribute to symptoms of Vulvar Vestibulitis, Vulvodynia, Interstitial Cystitis, or Vaginismus. Rehabilitation includes pelvic floor relaxation training, manual therapies, postural and therapeutic exercise, electrical stimulation and biofeedback.

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Painful Intercourse
Dyspareunia is the term used for painful intercourse. A very helpful reference to learn more about dyspareunia is http://www.acog.org/Patients/FAQs/When-Sex-Is-Painful. Asymmetry in the spine, pelvis, hips accompanied by tight, imbalanced muscles in the trunk, hips and pelvic floor may be the source of painful intercourse. Pelvic floor tension or pain in the sling of muscles which support the bladder, uterus and rectum can be caused by muscle, nerve, joint problems, scar tissue from surgery, childbirth, endometriosis or after radiation. The individual may have painful intercourse, difficulty sitting, and pain in the buttocks, hips, lower abdomen or low back. Imbalances in the muscles surrounding the pelvis can cause or contribute to symptoms of Vulvar Vestibulitis, Vulvodynia, Interstitial Cystitis, or Vaginismus. Rehabilitation involves the spine, pelvis and the pelvic floor. Treatment includes manual therapies, postural and therapeutic exercise, relaxation training, electrical stimulation, biofeedback and education in self care.

Organ Prolapse
When the muscles and ligaments supporting a woman’s pelvic organs weaken, the pelvic organs can slip out of place (prolapse). Symptoms include:

  • Pressure in the vagina or pelvis.
  • Painful intercourse (dyspareunia).
  • A lump at the opening of the vagina.
  • A decrease in pain or pressure when the woman lies down.
  • Recurrent urinary tract infections.

Pelvic organ prolapse can worsen over time, and you may need surgery to fix it if 3 months of pelvic floor and abdominal rehabilitation and pessary use have failed. Urinary and or bowel urgency, frequency and or incontinence may occur after the placement of trans – vaginal mesh to correct organ prolapse.There are different types of pelvic organ prolapse. Some women develop pelvic organ prolapse after childbirth, a hysterectomy or menopause. Anterior or bladder prolapse is called a cystocele. Posterior or rectum prolapse is called a rectocele. Uterine prolapse, and a small bowel prolapse is called an enterocele). Small bowel prolapse occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge.

Scar Tissue, Adhesions, Swelling After Surgery, Radiation, C-section, Labor and Delivery
After any type of surgery or radiation treatments the body must rest and recuperate. During this time the muscles atrophy with rest. In addition scar tissue and adhesion may develop during the healing process. In some people too much develops and restricts mobility of the muscles and joints causing pain. Movement is compromised and painful. After a radical neck procedure, cesarean section, abdominal surgery, breast surgery, hysterectomy or hernia repair there are questions about when movement and what type of movement is recommended. Physical therapy treatment provides guidance in the return to activity and eliminates question of safety or re-injury. Manual therapies, postural education and therapeutic exercise are instructed to facilitate adequate healing. Graston technique and Kinesio Taping are often very beneficial.

Pregnant Woman

Prenatal Prevention of Incontinence and Hernia
Pain management and safe exercise prescriptions for women during this phase of their life. It is important for your health and the health of your baby to choose a women’s health specialist. A consultation and treatment with a Women’s Health Physical Therapist will provide you with information regarding conditions that would benefit from physical therapy. Click here to read more

Dysmenorrhea
Painful menstruation, often associated with bloating or pain during intercourse, may be relieved with certain postural and therapeutic exercises and positioning. Transcutaneous electrical nerve stimulation (TENS), Interferential electrical stimulation or biofeedback treatment may be used to reduce pain.

Pregnancy / Labor and Delivery / Postpartum Related Pain (Orthopedic and High Risk)
Pregnant women may suffer from pain or aching in the back or shoulder blades, rib cage, groin area or wrists due to changes in posture, weight, or hormonal factors. Not only are these women more susceptible to pain and injury during pregnancy, but related orthopedic problems may persist or begin after delivery (postpartum). Maternity supports, pain management manual therapy, strengthening or activities of daily living retraining techniques are typical treatments. Post-delivery (postpartum) rehabilitation including strengthening and endurance training of the abdominal wall and pelvic floor is crucial whether a vaginal delivery or Cesarean section. Some women may experience painful intercourse after labor and delivery due to trauma to the pelvic floor muscles and development of scar tissue or adhesion. Manual therapies, relaxation and breathing exercises, dilator use, yoga and self care instruction may all be part of the treatment plan.

For women in a high risk pregnancy, bed rest is often necessary. The physical therapist will design an individual program of exercises and positioning as well as incorporating relaxation training into the overall program.

Diatasis Recti Prevention, Treatment and After Repair Care
Diastasis recti (also known as abdominal separation) is commonly defined as a gap of roughly 2.7 cm or greater between the two sides of the rectus abdominis muscle. The distance between the right and left rectus abdominis muscles is created by the stretching of the linea alba, a connective collagen sheath created by the aponeurosis insertions of the transverse abdominis, internal oblique, and external oblique. Diastasis of this muscle occurs principally in two populations: newborns and pregnant women. It is also known to occur in men. Progressive instruction and home exercise for the pelvic floor, abdominal, hip and trunk muscle rehabilitation is necessary to prevent surgery and for recovery after surgery. Instruction on splinting and bracing is also part of the treatment plan. Kinesio Taping is often beneficial. Manual therapies to facilitate good tissue healing and prevent adhesion and scar tissue formation is very important. Instruction in corrective posture and lifting techniques is very important.

Cancer Related Fatigue And How PT Can Help

Surgical procedures, radiation and chemotherapy all cause significant fatigue. Physical therapists are educated on proper progression to resume physical activity. They also provide instructions on energy management.

Fatigue, also described as being weak, tired, or stressed can be exhausting on your body and it is unfortunately a symptom of cancer. A lot of cancers release a protein called cytokines, which cause fatigue to your body. Fatigue also occurs when your body tries repairing your cells and tissues. This happens from treatments such as chemotherapy, or radiation because they destroy your healthy cells. However there are ways around feeling like this and physical therapy is the key.

Physical therapists have an approach to this where they help improve strength and endurance, while improving balance and coordination. Your physical therapist will help you come up with exercise programs and strengthening regimens, in order for you to get back on track, and feeling like a new person. Physical therapists also have massage therapies, which can help reduce stress and depression. With exercise comes everything including flexibility, motivation, and strength. If you want to improve your wellbeing, you have to be willing to exercise and stretch. You will learn how to conserve energy and pace yourself for your everyday physical activities. Believe it or not rest is not the answer to fatigue, you have to find ways to get your energy levels up through exercising.

Physical Therapists will come up with certain programs that best fit that person’s fatigue. By letting them teach you the proper way to increase stamina and performance you will start feeling a lot better about your body. Stretching is extremely important because it helps improve mobility, posture, and muscle balance. Don’t sit around and let fatigue take a toll on your life, there are ways around it, call a physical therapist today.

Constipation
Constipation refers to bowel movements that are infrequent (less than daily) or hard to pass. Constipation is a common cause of painful defecation / bowel movements. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction, which can progress to bowel obstruction and become life-threatening. Physical therapy treatment includes pelvic floor muscle relaxation and breathing techniques to calm the nervous system, manual therapies to promote soft tissue relaxation and symmetry and instruction in behavioral and lifestyle modifications.

Anal Fissures and Hemorrhoids
Treatment is focused on the use of ultrasound and electrical stimulation to reduce anal spasms, pain and inflammation. Treatment also includes pelvic floor muscle relaxation and breathing techniques to calm the nervous system, manual therapies to promote soft tissue relaxation and symmetry and instruction in behavioral and lifestyle modifications.

Older woman exercising

Limitations in Function and Fatigue Related to Menopause
Menopause is the term used when menstruation has ceased for one year. Peri-menopause is the term used when menstruation is less frequent, has an abnormal cycle and may occur any time within a 20 year span. Hormonal, cardiovascular, pulmonary, gastrointestinal, renal and musculoskeletal system changes occur during this range of time. These changes can affect energy levels which require adjustments in one’s own personal exercise intensity. Physical therapy provides instruction in self-care of aches and pains, proper execution of the desired exercise or sport and treatment to eliminate signs and symptoms limiting or preventing performance.

Osteopenia/Osteoporosis
Osteopenia is the precursor to osteoporosis. Osteoporosis is a condition in which bones become thin and brittle, and break more easily. Screening is available to identify peak bone mass. Prevention education and treatment programs include fall prevention, balance activity, instruction in proper body mechanics and exercise, fitting of braces or orthotics and pain management.

Woman on Ball

Orthopedics
Arthritis, aches, pains, stiffness, challenges getting out of bed, climbing stairs and more…

Physical therapy is strongly recommended for any muscle, bone, joint, ligament, fascial, or cartilage injury or after surgery.

From head to toe, hands-on body work, known as manual therapies, such as Primal Reflex Release Techniques (PRRT), Associated Awareness Techniques (AAT), joint mobilization, manipulation and more is used to quickly break the pain cycle allowing motion and tolerance to exercise for restoring flexibility, strength, agility, balance and endurance for activities of daily living (ADL) and job performance. Graston Technique® or Kinesio Taping® may be helpful. Modalities may be used to reduce pain, spasm, and inflammation, swelling and joint irritability. Modalities such as ultrasound, electrical stimulation, iontophoresis, spinal decompression/traction or biofeedback are commonly used. Instruction is provided in home self-care, postural correction and exercise. Ergonomic training is also incorporated in the plan of care. This is learning how to work safely to avoid pain and repetitive trauma.


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