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Women Health &Pelvic Floor Physiotherapist is a trained physiotherapist who helps women in managing some specific health problems and dysfunctions, in their different periods of lives. The following are some examples of these issues :
1: PREPARATION FOR PREGNANCY
Due to hormonal and physiological changes during pregnancy, many women may suffer “low back pain”, “pelvic pain ” and “diastasis recti” which can be easily managed by a specialised physiotherapist.Pregnancy and labour significantly affects a woman’s pelvic floor, making a trained pelvic health physiotherapist an integral part of any woman’s prenatal and postpartum care team. Furthermore, physiotherapy can be helpful to prepare for delivery of the baby.
A Pelvic health physiotherapist will assess the cause of pain internally and can help with scar release to improve tissue mobility, reduce pain, and restore pelvic floor muscle strength.
2: PELVIC FLOOR DYSFUNCTIONS
If you think of the pelvis as being the home to organs like the bladder, uterus (or prostate in men) and rectum, the pelvic floor muscles are the home’s foundation. Pelvic floor dysfunction is the inability to correctly activate and coordinate your pelvic floor muscles. In Canada, pelvic floor dysfunction affects about 1 in 3 women and 1 in 5 men.
These issues can materialize in many different forms including
- Pelvic Organ Prolapse
- Sexual Pain or Dysfunction
- Chronic Pelvic Pain
- Coxalgia or Tailbone pain
Pelvic floor physiotherapy is a therapy that focuses on targeting your pelvic floor muscles, soft tissues and nerves in order to manage pelvic floor dysfunction and get you back to feeling your best.
Incontinence is defined as any amount of accidental or involuntary leakage of urine from the bladder (Urinary Incontinence) or bowel motion, faeces or gas from the bowel (Bowel Incontinence).This can happen at any age, and many people experience this at some point in their lives. Various types of Urinary Incontinence such as “stress urinary incontinence”, urge urinary incontinence” overflow urinary incontinence” and mixed types may happen due to numerous causes including giving birth, pelvic surgeries, menopause or merely as a result of aging. According to the International Continence Society,Physiotherapy is the first line of treatment for almost all types of Urinary Incontinence which established effective methods includingPelvic Floor Muscle Training.
2-2: Pelvic Organ Prolapse
Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—drops from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery. It may cause low back pain as well as incontinence or constipation. With individualised exercise plans to strengthen the pelvic floor muscles ,and using some modalities many of these symptoms can easily be controlled.
2-3:Chronic Pelvic Pain
Chronic pelvic pain is different for every person and may be felt anywhere between the stomach and pelvic area. The pain comes and goes and may be aggravated by bladder or bowel motions, periods, intercourse or other activities. Chronic pelvic pain must be persistent for at least 6 months.
Often chronic pelvic pain is diagnosed in the absence of other pathology. This means you have had some tests done that have ruled out other disease or illness that may be causing the pain. Physiotherapy is one of the first line treatment options available for this condition which uses different modalities such as manual therapy, relaxation techniques and specific exercises.
Menopause is when your period stops permanently. Menopause does not happen all at once. As your body transitions to menopause over several years, you may have menopause symptoms and irregular periods. Most commonly experienced symptoms during menopause include hot flashes, vaginal dryness and infections, pain during intercouse, urinary problems and memory difficulties. The most feared long term effects of menopause are Bone mass loss and osteoporosis.
One of the most effective nonmedical treatment options to control and alleviate symptoms of menopause is physiotherapy .
Osteoporosis is a common condition affecting many Canadians in which bones become fragile and brittle leading to a higher risk of fractures, than in normal bone. As bones become thinner and less dense, even a minor bump or fall can cause serious fractures. The most common sites are the hip, spine, wrist, upper arm, ribs or forearm. Fractures in the spine due to osteoporosis can result in losing height or changes in posture. Fractures can also lead to chronic pain, Change in the posture and Decreased quality of life.
While some medications are being used to improve osteoporosis, research has shown physiotherapy to be an invaluable part of treatment plan for preventing and managing osteoporosis. An specialised exercise plan including both weight bearing and balance exercises will help strengthen the muscles, improve the balance and prevent any possible future falls and fractures.
5: PREMENSTRUAL SYNDROME (PMS)
Many women experience symptoms such as bloating, headache, and fatigue 5-10 days before menstruation, usually after ovulation in the middle of the menstrual cycle.For some women, these symptoms may be severe and prevent them from attending normal daily life.
Physiotherapy is one of the recommended first line treatments for controlling PMS symptoms. The treatment program may include relaxation techniques, mindfulness and an individualised exercise program devised by our specialist physiotherapist.
Prevention and Management of Musculoskeletal and Pelvic Floor Muscle Dysfunctions including:
✔ Chronic pelvic pain
✔ Pregnancy related mechanical dysfunctions and poor posture
✔ Pregnancy related low back & pelvic girdle pain
✔ Stress urinary incontinence
✔ Overactive bladder
✔ Pelvic organ prolapses
✔ Functional constipation
✔ Painful intercourse and vaginismus
✔ Erectile dysfunctions
✔ Post prostatectomy urinary incontinence
✔ Pelvic pain in males
✔ Post pelvic surgeries
What do we do?
After taking a detailed history and a comprehensive examination, based on the assessment findings, an individualized treatment plan will be implemented.
Treatments may include one or more of the following options:
✔ Lifestyle modifications
✔ Pelvic floor muscle training
✔ Postural retraining
✔ Some modalities such as: TENS
✔ Biofeedback training
✔ Manual therapy
Why Choose Our Pelvic Floor Dysfunction rehabilitation?
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Farideh D. Manshadi
Farideh has been a physiotherapist for 25 years. She earned her Bachelor and Master’s Degrees in Physiotherapy from Iran University of Medical Sciences in 1989 and 1993 respectively. She then worked as a faculty member, where she was responsible for facilitating and supervising the practical education of physiotherapy students in a university hospital.
Having worked with a wide variety of patients, she found that many of them were struggling with issues like a lack of urinary control or other pelvic floor disorders, but they were not able to talk about their problems due to feelings of shame or embarrassment. She felt strongly about fighting the stigma surrounding these health issues and helping people to live more comfortably. Thus, from 2005 to 2010, as a Ph.D. Candidate, she focused on women’s health and pelvic floor dysfunctions and worked with the Gynecology department of Tehran University of Medical Sciences. Participation in a specialized pelvic floor rehabilitation course, conducted by Dr. Alain Bourcier, enhanced her knowledge and practice in the field of pelvic floor rehabilitation.
From 2010 to 2018, Farideh worked as an Associate Professor and as the head of the Women’s Health Branch of the Iranian Physiotherapy Association. She is currently a member of the International Continence Society.
As an experienced clinician, Farideh believes wholeheartedly in the ability of skilled hands and therapeutic exercises to relieve patients’ pain, to help them to overcome their movement challenges, and to improve their quality of life.