Women's Health Concerns

Women's health spans an age range from teenagers and young athletes through their childbearing, menopause, and into their elderly years. Women's health issues include pre-natal/post-partum care, pelvic pain, incontinence, osteoporosis, endometriosis, fibromyalgia, irritable bowel syndrome, musculoskeletal injuries...

Pre-natal/post-partum care:

Bladder Disorders:

Interstitial cystitis
Pelvic floor organ prolapse
Urinary incontinence including urgency, frequency, retention

Bowel Disorders:

Constipation
Diarrhea
Fecal incontinence
Hemorrhoids
IBS
Inflammatory bowel disorders
Pelvic floor organ prolapse

Sexual Dysfunctions:

Dyspareunia
Endometriosis
Lichens Planus
Lichens Sclerosus
Pelvic Congestion
Pelvic Inflammatory Disease (PID)
Pelvic Pain
Vaginismus
Vulvar Vestibulitis
Vulvodynia

Musculoskeletal:

Fibromyalgia
Osteoporosis

General:

Infertility: The inability to conceive after one year of well timed and unprotected sexual intercourse. Physical therapy can help to free soft tissue restrictions and adhesions in order to increase mobility of the reproductive organs. Treatment can also help decrease spasms around the reproductive organs, ease localized pain and related anxiety.
Post Mastectomy: Lack of movement can cause stiffness in the shoulder and pain or swelling in the upper extremity. Physical therapy will assist with increasing range of motion, strength, improving posture and decrease swelling. It can also help to decrease pain in the neck, shoulder, chest and abdomen. Manual techniques will help decrease scar tissue and increase circulation.
Hysterectomy: It is the surgical removal of the uterus. It is performed for conditions such as uterine prolapse, fibroids, carcinoma, or abnormal vaginal bleeding. A hysterectomy can be carried out vaginally, abdominally, or laparoscopically.
- Total abdominal hysterectomy is the most common type of hysterectomy. It involves removal of the uterus and cervix (with or without the removal of the ovaries or fallopian tubes) through a large abdominal incision.
- Vaginal hysterectomy is the removal of the uterus and cervix through the vagina. Recovery from a vaginal hysterectomy is of shorter duration than an abdominal hysterectomy. Laparoscopically-assisted vaginal hysterectomy is a vaginal hysterectomy with the insertion of a laparoscope through a small incision in the navel.
- Laparoscopic supracervical hysterectomy is the removal of the uterus (sparing the cervix) through incisions in the navel and abdomen. This procedure has the shortest recovery time. Sparing of the cervix may have some benefits which reduces the risk of pelvic floor prolapse and urinary incontinence.
A complication of hysterectomies is pelvic adhesion or scar tissue that forms within the pelvis and causes organs to stick or bind to one another. Pelvic adhesions are also seen with other gynecologic surgeries such as cesarean section and in the treatment of endometriosis, and with pelvic inflammatory disease. Pelvic adhesions can cause pelvic pain, pain during intercourse, infertility, and bladder or small bowel obstruction.
Physical therapy can help to break down pelvic and abdominal adhesions and aid in increased mobility of the connective tissue and of the muscles. This in turn may decrease pelvic pain, pain during intercourse, infertility and any bowel or bladder obstructions.

Endometriosis

Endometriosis is a medical condition wherein tissue similar to uterine tissue is found outside the uterus (ovaries, fallopian tubes). Menstrual endometrium regurgitates from the uterus, through the fallopian tubes, and into the pelvis and peritoneal cavity. The tissue can also be found in scars (c-sec, laparoscopy) and on the bladder, bowel, intestines, colon, appendix, and rectum. Rarely, it is found inside the vagina, bladder, or on the skin. Lymphedema: Pelvic congestion:

Lymph is a clear watery fluid containing white blood cells that circulates throughout the lymphatic system, removing bacteria and certain proteins from the body's tissues, transporting fat from the small intestine, and supplying mature lymphocytes to the blood for the immune system as it travels back to the venous system through the thoracic duct.
Lymphedema is chronic swelling in the arm or leg following damage to the lymph nodes or lymph vessels.
Lymphatic massage/manual lymphatic drainage is a technique that uses very light pressure with soft pumping movements in the direction of lymph nodes to help increase lymph flow, removing harmful substances from tissues and improving metabolism, which will increase immune function.

Pelvic Floor Organ Prolapse:

Cystocele
A cystocele is the fall of the bladder into the vagina due to pelvic floor muscle weakness and may result in incomplete emptying of the bladder and consequently urinary leakage. It is graded from mild (grade 1; possbily no symptoms) to severe (grade 3, wherein the bladder protrudes out of the vagina). It may occur due to repeated muscle straining (during childbirth) and/or estrogen deficiency (seen with menopause and/or oral contraceptive pill usage). Hysterectomies also weaken the pelvic floor muscles and may lead to a cystocele.
A cystocele can be managed with pelvic floor physical therapy which includes strengthening of the pelvic floor muscles. A pessary (ex. Colpexin) may also be prescribed by the referring physician. Surgery is prescribed when physical therapy and/or a pessary are not effective.
A cystocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation (increases pressure on the bladder during straining), weight control, and kegels (performed under supervision of the physical therapist initially to prevent pelvic floor muscle tightness).
Enterocele
Herniation of the small intestine between rectum and vagina.
Rectocele
A rectocele is the herniation of rectal tissue in the vaginal wall and may sometimes lead to drooping of vaginal tissue out of the vaginal canal. It may occur with childbirth, chronic constipation, chronic coughing, heavy lifting, estrogen deficiency and/or obesity. Symptoms may include constipation and/or pelvic pain. A rectocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation, weight control, and kegels. A rectocele can be managed with pelvic floor physical therapy, pessary, or surgery.
Uterine Prolapse
Herniation of the uterus into the vagina.