Women's Health

Incontinence

  • 25% of adults have experienced leaking at some time
  • 35-40% of individuals over 65 have leaking problems
  • >50% of nursing home residents are incontinent

Incontinence should NOT be accepted as normal after childbirth or menopause. Medical treatment models suggest that pelvic floor exercise and habit changes can improve incontinence in 80% of cases (male and female). Pelvic floor strengthening with computerized biofeedback providing visual and auditory feedback, electrical stimulation, bladder re-training and behavioral modifications are conservative and proven treatments for incontinence. Physical therapists need to be specialized in pelvic floor rehabilitation and have experience in this field to provide these services. We work closely with gynecologists, urogynecologists, urologists and family practitioners to find the best solution to reduce and eliminate symptoms.

Overactive Bladder

This is urgency / frequency with more than 9 visits to the toilet in 24 hours with or without leaking. Pelvic floor muscle weakness can be a cause and responds well to computerized biofeedback training, electrical stimulation and bladder retraining. Myofascial spasms of the pelvic, hip or lower back muscles can also contribute to an abnormal urge sensation. We therefore do a detailed musculoskeletal evaluation to determine contributing factors. Treatment may include computerized biofeedback, bladder retraining, electrical stimulation, myofascial release, stretching and specific strengthening exercises.

Pelvic Pain Conditions

Conditions such as vulvodynia, vaginismus, levator ani syndrome, pelvic floor tension myalgia, interstitial cystitis, dyspareunia (painful intercourse), sacro-iliac (SI) joint dysfunction, coccydynia (tailbone pain) for example, often have musculoskeletal components that can be successfully treated by a skilled and specialized physical therapist. Many of these conditions are multi-dimensional and in many cases we will work with a multi-disciplinary team consisting of any or all of the following: family physician, gynecologist, urogynecologist, urologist and psychologist. After a thorough examination, treatment may include Travell trigger point release and stretches, Maitland/ McKenzie / Mulligan specific joint mobilizations, biofeedback, dilators, specific strengthening / stretching exercises and self-treatment techniques.

Musculoskeletal dysfunctions during and after pregnancy

The childbearing year brings dramatic changes to the body. Physical Therapy can assist you in managing these musculoskeletal changes. Conditions we often see during pregnancy are SI joint dysfunctions, sciatica, carpal tunnel syndrome, plantar fasciitis, lower back, neck or thoracic pain and headaches. Postpartum we treat weak pelvic floor muscles with or without incontinence, rehabilitation of lower abdominals or “core” muscles which assist in preventing lower back / pelvic pain, painful episiotomy scars and other common orthopedic dysfunctions. Interestingly, in some countries like France and Sweden, women routinely get 2-4 sessions with a physical therapist 6-8 weeks postpartum for pelvic floor strengthening, lower back stabilization training and postural and kinetic handling training.

Osteoporosis

Women at risk for, or with, osteoporosis need to increase weight-bearing exercise, improve balance and decrease postural strain. At Hands-On Physical Therapy we do a thorough evaluation and develop a customized exercise program to address these issues.