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What Is Women’s Health Physical Therapy?

Women’s health physical therapy is a specialty within physical therapy. It aims to treat problems that occur primarily in women. The problems can be from any point in the woman’s lifespan.

When considering a definition for women’s health physical therapy, womenshealthapta.org sums it up rather well:

“The emphasis of the health sciences on fitness and wellness has brought to women’s attention a need to pay closer attention to their bodies during recreation, work, and throughout life. Many physical therapists have specialized training which will benefit women with a variety of medical conditions. These therapists use every facet of their physical therapy training to evaluate and treat female clients, promoting and enhancing health through the life span. All treatments are individually designed after thorough evaluation”.

Some of the issues that a women’s health physical therapist may diagnose include:

• Pain during and after pregnancy
• Postpartum rehabilitation
• Perimenopausal or menopausal symptoms
• Urinary and fecal
• Pelvic Floor Dysfunction
• SI Joint Dysfunction
• Lumbosacral Strain
• Fibromyalgia
• Chronic Pain & Headaches
• Osteoporosis
• Musculoskeletal Dysfunction

Many of these are specific to women, such as pain related to pregnancy, while other diagnoses involve conditions that are not limited to women, but that occur more frequently in women than in men, such as osteoporosis.

Pain Or Dysfunction Associated With Pregnancy Or Postpartum

Pain is not a normal part of motherhood, but there are a number of changes that can occur in a woman’s body when she has a baby. In addition her body is placed under new and perhaps unfamiliar strain once the baby is born as she may be required, for example, to bend down more frequently and carry a heavy baby. There are a number of issues that can arise as a result of this, and, as a physical therapist with specialization in women’s health, you will be required to diagnose the true causes of the aping in the patient and systematically create a treatment program that will relieve the symptoms. The symptoms that may occur in this regard are:

• Lower back pain
• Tail bone pain
• Pubic bone pain
• Pressure or heaviness
• Hand or wrist numbness or swelling
• Sacroiliac pain (The sacroiliac joint is in the low back where the spine meets the pelvis. Sacroiliac joint pain is discomfort in this area. This pain is a symptom that may come from a number of conditions or diseases)
• Calf cramps
• Headaches
• Incontinence

A women’s health physical therapist will learn the best physical therapeutic methods for dealing with these symptoms and ensuring that the patient is able to return to fairly normal functioning as soon as possible.

Urinary Incontinence

Although urinary incontinence can occur for a number of reasons, pelvic floor muscle weakness is the reason that you will be most interested in as a physical therapist with a specialization in women’s health physical therapy. There are a couple of statistics related to urinary incontinence in women which are pertinent to being a physical therapist in this line of work:

• Incontinence affects  15% of adult Americans
• 26% of women between 30 and 59 years have problems of this nature
• Many women restrict fluids to avoid losing control of their bladder
• More than 50% of nursing home residents have incontinence have problems. The majority of nursing home residents are female.

According to http://desert-springs-physical-therapy.com women’s health physical therapy “assists patients to restore pelvic floor muscle strength through exercise and biofeedback training to teach the correct way to perform Kegel exercises.  Treatment also provides education regarding normal function, stress management, and good toileting habits“.

A large part of your job as a physical therapist with a specialization in women’s health will revolve around educating patients in matters of this kind and helping them become aware that urinary incontinence is not inevitable and that, through the correct exercises and measures, it can be controlled and even, in some cases completely cured. This applies to elderly members of the population as well as new mothers suffering from incontinence problems.

Pelvic Pain Or Dysfunction

There are a number of diagnoses that can be used to explain pelvic pain. These diagnoses include:

• Chronic yeast infection
• Chronic urinary tract infection
• Irritable bowel syndrome
• Vestibulitis
• Vulvodynia
• Dyspareunia

There are many symptoms, in addition, that are used to give a diagnosis of pelvic pain. These include:

• Burning
• Itching
• Rawness
• Aching
• Pelvic pressure
• Back pain
• Abdominal pain
• Tailbone pain
• Urinary urgency and frequency
• Pain with sexual intercourse
• Discomfort with tampon use

As a women’s health physical therapist you are interested in pelvic pain that is caused by the following:

• Musculoskeletal dysfunction such as muscle spasm
• Joint dysfunction
• Abnormal postures
• Weakness
• Decreased flexibility
• Any combination of the above

There are about 80 muscles that are connected to the pelvis. If there is an imbalance for whatever reason in any of these muscles, pelvic pain may arise as a result. This is in line with one of the main ideas that you will have already learned in the field of physical therapy by this point, namely that everything in the body is connected and dysfunction in one area of the body can cause pain in another.

Physical therapists can solve or improve the above mentioned problems through the following methods:

• Manual techniques
• Therapeutic exercise
• Relaxation training with biofeedback
• Postural education
• Movement strategies

Post Surgical Pain Or Loss Of Function

Surgical procedures that result in pain that you will be interested in as a women’s health physical therapist include, obviously, those procedures solely or most frequently performed on women. These procedures include the following:

• C-section
• Episiotomy
• Hysterectomy
• Breast surgery
• Abdominal surgery

It is not abnormal for pain to result due to such procedures as tissue could be damaged in the process. A physical therapist trained in women’s health is an expert in relieving these pains and creating a situation where the woman in question is able to return to her normal level of functioning. Women’s health physical therapists primarily see female patients. Usually they will only work with female patients. This means that there are a number of surgical procedures, such as transplant surgery and appendectomies, that can be performed on any gender that you may also need to treat should those procedures result in marked pain and discomfort for your patient. However you will be primarily trained in areas of the health care profession related specifically to issues faced only by women and will therefore focus on sexual and reproductive functions. If faced with a patient who has come to you for another reason a referral may be necessary if you feel under qualified to cope.

Perimenopausal & Menopausal

A condition that only women suffer from is menopause, and there are a number of physical bodily changes that are associated with this phase of the life cycle. In many cases these bodily changes can lead to discomfort as well as to pain and it is therefore the job of the women’s health physical therapist to find a way to relieve these symptoms and assist your patient in returning to normal functioning as soon as possible. The most common ailments that a woman at this stage of her life cycle may face include:

Post-Hysterectomy Adhesions and Deconditioning

• Osteoporosis
• Incontinence
• Joint Pain
• Fibromyalgia

There are a number of treatment options that can be considered for any of the above complaints, but it must be remembered that “each woman and her experience during menopause is unique” (atipt.com). This means that each woman will react differently. Consequently your job as the physical therapist who is working with menopausal patients is to ensure that you tailor your treatment methods and strategies in such a way that they suit the particular patient or patients under you care. An ability to adapt your treatment methods to suit particular patients is one that is required by physical therapists in all walks of life and who work in each of the subdivisions of the physical therapy industry.

Osteoporosis

According to thefreedictionary.com “The word osteoporosis literally means “porous bones.” It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis”. This is a condition that is primarily faced by women, although it is possible for a man to develop osteoporosis over time as well. Usually it affects women after menopause and onwards.

Common ailments and complaints that a woman suffering from osteoporosis may approach a physical therapist about include the following:

• Vertebral Fractures
• Kyphotic Posture
• Loss of Height
• Back Pain
• Respiratory Compromise

There are a number of standard treatment procedures used in women’s health physical therapy that can be used to address these issues. These include:

• Balance and Proprioception Training
• Postural Corrective Exercise
• Breathing Pattern Education
• Soft Tissue Mobilization
• Weight-Bearing Resistive Exercise
• Dynamic Flexibility Exercise
• Fall Prevention
• Modalities
• Prescription of External Supports

However the actual treatment methods undertaken and prescribed will depend on the patient herself as many factors, such as age and physical fitness, can affect the safety of the methods used.

Chronic Pain & Headaches

When it comes to chronic pain and headaches a number of diagnosis may be made:

• Myofascial Pain Syndrome
• Fibromyalgia
• Headaches

The more common treatment options include:

• Correction of Postural Imbalances
• Aerobic
• Strength & Flexibility Training
• Progressive Aerobic Exercise
• Soft Tissue Mobilization
• Nutritional Guidance
• Relaxation Techniques

Headaches and chronic pain can be due to a number of different conditions and ailments, not all of which are treatable through physical therapy. It is therefore essential that you are absolutely certain that you are properly informed regarding the causes of the pain that your patient is experiencing. If you treat a patient with physical therapy who would, in fact, benefit better from surgery or another form of traditional medical treatment, you are not keeping the best interests of that patient in mind. If necessary, refer your patient to a health care professional who will be better equipped to help them. In addition you can never assume that your patient is an expert in their own physical condition. A patient’s ‘self-diagnosis cannot be relied on in order to begin physical therapy. During your physical therapy training you will be given guidance on how to assess a patient and determine what the likeliest route cause of the pain they are experiencing is as well as the best methods for treating that particular type of pain.

Many of the conditions and problems mentioned above are solely problems that can be faced by women. Even those that men could experience too, such as chronic pain and headaches, tend to be more frequently experienced by the female demographic of the population. As a physical therapists with a specialization in women’s health physical therapy you will, effectively, have a patient base that consists of half of the population, which means that your employment opportunities will never dry up and you will always be in demand as long as there are women in the world suffering from the above mentioned conditions.