Women's Health
Women's Health Physiotherapy
Sycamore Health offers services for women’s health conditions. Problems such as poor urinary or bowel incontinence, dyspurenia, prolapse, peri-natal and pelvic pain can have a huge impact on the life of women limiting engagement in social activities, relationships, maintaining health, mental health and work. These conditions are highly treatable and with the appropriate strategies, you can make positive changes, manage and improve your condition. We know women can be silent sufferers with these problems and we needn’t be - as women, we aim to provide a safe space to discuss these issues and more to make a meaningful difference in your life with quality treatment.
Who might need women’s health physiotherapy?
If you experience symptoms such as the following, you may benefit from engaging in women’s health physiotherapy treatment:
- Leaking urine with coughing, sneezing or lifting
- Suffering from frequent, strong urges to pee
- Increased frequency of urination, sometimes needing to go and little urine being voided
- Difficulty controlling your bowels
- Pre and Post-natal pain or dysfunction
- Prolapse and vaginal heaviness
- Sudden or severe changes to your menstration
- Peri and Post-menopause changes
- Acute and chronic pelvic pain
What does a women’s health physiotherapy appointment look like?
A women’s health consultation will start with a good chat to gather information about your condition (the exact problem you are experiencing, deep diving into your symptoms, how long it’s been going on, etc.). We then conduct a thorough medical history, discussing things which might be contributing to your condition and areas we might be able to address (such as a diet, fluid intake, pregnancy, exercise) and gain an understanding of your life (what you like to do, your work, relationships, hobbies, etc.) and how your condition is making an impact in your life so treatment can best be tailored to suit you.
From there we will go on to an objective assessment to gain further insight into understanding your problem. This often includes assessment of your pelvic floor muscle function. We have access to real time ultrasound which allows us to get a real time image of how your pelvic floor muscles are functioning, your ability to actively control their contractions, their endurance and strength. If indicated, a neurological screen and a movement exam will be conducted. We also use questionnaires and diaries to assess urinary and bowel habits which may be playing a part in the problem condition.
With our assessment findings, we will work with you to devise a treatment plan. This will likely entail an exercise program to train your pelvic floor muscles. We will discuss strategies to manage your condition to lessen its impact on your life in the meantime whilst we work towards resolution. We will work together to create a holistic plan to improve your general well-being - healthy lifestyle changes, general exercise, diet, assistance with engaging in support groups and liasising with your medical team where needed. Creating a safe space to discuss any issues which may be arising due to the impact of your condition.
Women’s Health at Sycamore Health
Tackling these health problems can be challenging, they’re difficult to talk about and can cause large disruptions to how you want to live your life. At Sycamore Health, we’re committed to providing the highest quality holistic treatment. We’re here to walk with you through your health journey, offering support, professional advice and treatment to help you get on top of your condition and return to life.
Why choose Sycamore Health?
Two Convenient Locations in Morayfield and Sippy Downs: our clinics are ideally located in the heart of Morayfield and Sippy Downs.
Easy online bookings: we offer a straight-forward online booking system so that you can book your appointment in seconds, no matter the time of day.
Same-day appointments: we understand that sometimes you need to be seen by our team as soon as possible, so we keep a number of appointments each day for those who need help urgently.
Private treatment rooms: our treatment is provided one-on-one in private rooms to make sure you are comfortable.
A range of physiotherapy services: we offer a range of physiotherapy services, including hands-on treatment, custom home exercise programs, gym-based rehabilitation and tailored advice.
Qualified, highly-trained physiotherapists: our team of physiotherapists are all highly-skilled and fully qualified.
Customised therapies: we know that your situation is unique and will tailor your program and exercises to suit you.
Overactive Bladder
Our pelvic floor physiotherapists are trained to manage the signs and symptoms of OAB.
Overactive bladder (OAB) is a condition characterised by involuntary contractions of the bladder muscles (detrusor muscle). The bladder is controlled by a complex network of nerves and muscles that work together to store and release urine. When the bladder is full, receptors which detect stretch of the bladder wall send nerve signals to the brain, which interprets the signals as the need to urinate. In individuals with OAB, this detection/signaling process can become disrupted, leading to a sensation of urgency even when the bladder isn’t full and an increased frequency of urination.
Symptoms of OAB in women may include sudden, intense urges to urinate that cannot be delayed, high frequency of urination (eight or more times per day), waking up at night to urinate (nocturia), and urge urinary incontinence (having such a strong urge to pee that some urine is leaked).
OAB can have significant impacts on the lives of those experiencing the symptoms from it. It can be extremely limiting in social situations, making people avoid engaging in interactions due to fear of leaking or embarrassment. It can be restrictive for people to be able to engage in healthy habits such as exercise. Often people suffering from OAB will have their daily lives, routines and movements dictated by their symptoms such as planning out where they go based on availability of toilets, limiting variety of areas they go where they go due to familiarity of where bathrooms are located, peeing (or trying to) before every activity or going out.
- While there is no specific cause of OAB in most cases, symptoms can occur secondary to poor urination behaviour, which can put pressure on the bladder, reducing its capacity and irritating the bladder wall.
- Neurological conditions, such as damage or dysfunction to the nerves that control the bladder, can cause OAB. This may be due to conditions such as multiple sclerosis, Parkinson's disease, or a spinal cord injury.
- Other conditions may cause symptoms like that of OAB, however are specific and treated accordingly such as urinary tract infections (UTI), bladder stones, bladder cancer, polyuria (increased urine production by the kidneys)
- Psychological factors: Anxiety, stress, and depression can exacerbate OAB symptoms.
Overactive bladder is a clinical diagnosis, meaning it is diagnosed based on the symptoms of the condition outlined above. Other tests may be performed to rule out other potential causes of the same symptoms such as urinalysis to rule out urinary tract infection. Once these are ruled out, a diagnosis of OAB can be made.
Other tests which may be performed are urodynamic tests (obtaining measures of flow & pressures), Post-void residual volume (PVR) to measure urine left in the bladder after urinating and bladder dairy (measuring frequency and volume of voids across a (usually) 3 day period).
Physiotherapy can help with the management of overactive bladder using a few different methods, used in conjunction with each other. These involve pelvic floor muscle training, bladder retraining & optimising lifestyle factors which negatively impact OAB.
A women’s health physiotherapist will help walk with you along your rehabilitation journey with your OAB symptoms to help with progression as you conquer these symptoms, to aid when you have setbacks (which are likely) and provide guidance on managing day to day with OAB symptoms.
Bladder training is a process by which we retrain the communication between the bladder and the brain to restore normal signalling that the bladder is full. This involves gradually increasing time between visits to the bathroom either by sticking to a set schedule & slowly extending the duration between bathroom visits or by deferring bathroom visits when you get urges. This helps ‘stretch’, or rather, improve the bladder's tolerability to stretch and how soon it signals to the brain that it is full.
Distraction and relaxation techniques can be used to help reduce the intensity of urges during the training process.
It will likely take several months to overcome the effects of overactive bladder. It can take some time to improve strength & control of pelvic floor muscles and improve the communication of nerve signalling between the bladder and the brain.
Pelvic Floor
Women's health physiotherapy work specifically to help strengthen and train your pelvic floor. Often, the pelvic floor is ignored, yet it contributes to a significant number of urinary, faecal and sexual functions in the body.
The pelvic floor is a group of muscles that stretch from the tailbone to the pubic bone (from the back to the front of the base of the pelvis) and support the pelvic organs, including the bladder, rectum, and prostate gland in men. These muscles are made up of three layers: the superficial layer, the middle layer and the deep layer. The superficial layer is composed of the bulbospongiosus, ischiocavernosus, and transverse perineal muscles which are involved in urinary and faecal continence. The middle layer consists of the deep transverse perineal muscles and the perineal membrane. The deep layer includes the puborectalis, pubococcygeus, and iliococcygeus muscles and is involved in the maintenance of continence and supporting the internal organs.
The pelvic floor muscles contribute to continence by acting as a sling or hammock, supporting the pelvic organs and maintaining their proper position. The muscles are responsible for controlling the urethral and anal sphincters, which allow for voluntary control of urination and defecation. When the pelvic floor muscles are weak or dysfunctional, it can lead to incontinence (an inability to control voluntary function of bladder or bowel movements leading to leakage of urine or stool). The pelvic floor muscles also physically support the bladder and bowels, helping maintain the correct pressure within the bladder. Additionally, the pelvic floor muscles are involved in sexual function, including maintaining an erection in men and orgasm in both men and women.
The pelvic floor muscles contribute to maintaining our continence as they surround the urethra (the tube that carries urine from our bladder out of our body) and the rectum (the passageway from our intestines out of our body). By surrounding these structures, when these muscles contract, they squeeze around these tubes, constricting them and disallowing the passing urine or faeces. We can control this, and conversely (hopefully when we’re at the appropriate place to urinate or defecate) when these muscles relax, they allow urine or stool to be released. The strength & coordination of these muscles are key factors in being able to maintain our control of this function, thus our continence.
The pelvic floor can become dysfunctional and the pelvic floor muscles can become weak, tight, or have poor coordination, leading to a range of symptoms, most typically incontinence by not being able to control the constriction of the urethra and rectum as outlined above. Other symptoms can include erectile dysfunction, painful urination or bowel movements, and pain or discomfort in the pelvic area.
There are a few factors that can contribute to dysfunction of the pelvic floor muscles. Pregnancy, and changes to the reproductive organs (hypertrophy, fascial stretching, etc.) can lead to dysfunction of the pelvic floor. Menopause and hormonal changes are also important factors in maintaining the patency and function of the tissue.
- Increases in age
- Chronic coughing - every time you cough, the pressure within your abdominal cavity increases putting pressure on the bladder, the pelvic floor muscles contract to constrict the urethra to prevent urine flow. Coughing lots for a long time can lead to strain and tension within these muscles.
- Chronic constipation can lead to strain and tension within the pelvic floor muscles
- Obesity can increase the demand on the pelvic floor muscles, leading to fatigue and weakness
Pelvic floor muscle training (PFMT) is a great tool to help overcome challenges you may have with dysfunction and improve your continence. Just like any other muscle, your pelvic floor can be trained! It can be tricky though as you can’t see your pelvic floor, thus it’s hard to get feedback on whether you’re performing the exercise correctly. This pelvic floor muscle training can help improve the strength and endurance of these muscles but most importantly your control of these muscles (the ability for your brain to signal to these muscles to contract).
It is important to learn to isolate and contract the pelvic floor for pelvic floor training. Using cues is most helpful to achieve this. Cues such as ‘holding a grape’ or ‘stopping the flow of urine’ or ‘perform a kegel’ are helpful for most women trying to contract these muscles. It is important to ensure the contraction is localised to just the pelvic floor (the rest of your body should be relaxed - don’t hold your breath or contract your abdominals!). A physiotherapist can help guide you through this and ensure you are performing the exercises correctly.
Often it is recommended to use various types of contractions to train your pelvic floor in different ways. Your muscles have two different types of fibres called slow twitch and fast twitch fibres. Slow twitch fibres are better for endurance (think contracting all day to support your organs and provide light pressure to the urethra to prevent leaking) and fast twitch fibres are better for contracting quickly and forcefully (think preventing leaking when you cough, run or jump). Therefore it’s best to practice holding a light contraction for a few seconds before releasing and fully relaxing (this is important) the pelvic floor and slowly increasing the time you can hold it. To train the fast twitch fibres you can do what is called ‘the knack’ ('ma ma ma myyy Sharona! ... no, not that Knack ... but if that helps you remember it, great!). This is a fast, strong, well timed contraction held briefly, then fully relaxed.
At Sycamore Health, we have expert physiotherapists who have undergone additional training in the area of Women’s Health. We can provide a thorough assessment of your pelvic floor function and work with you to regain control of your continence and your life. We will work with you to ensure you are able to perform the exercises properly and have the correct prescription. We have access to real time ultrasound which can be a very effective tool to get live feedback of your pelvic floor function and your ability to control it.
Make an enquiry with our lovely reception staff on (07) 3046 1700, or email info@sycamorehealth.com.au. Otherwise, if you're ready to book, book online here.
