Women have different healthcare needs than men. This is most apparent in their musculoskeletal health. Beginning in adolescents, hormones are released in preparation for menstruation. This release results in changing the integrity of ligaments. The shape of the female pelvis changes and weakness in the hips and core become more obvious. Young females tend to have more ACL tears, knee and hip pain as a result.

During the childbearing years, muscle and spine pain during pregnancy is common and unfortunately accepted as part of being pregnant. Healthcare providers and well meaning friends or family often tell the mother- to- be to “just deal with it, it will be over soon.” The truth is this is the time when women undergo enormous musculoskeletal changes. These changes are cumulative in nature. Many physical therapy evaluations begin with “I did not have a problem until I was pregnant”, or “the second pregnancy did me in.” Delivery can involve an episiotomy, forceps or a prolonged pushing stage. This can result in pelvic floor pain, complaints of incontinence, and difficulty returning to previous activity level. Women need to deal with these issues instead of hoping they will go away.

 Menopause results in more hormonal changes which contribute to issues with overactive bladder, urinary frequency/urgency and various kinds of incontinence.  Despite what the drug companies want you to believe, this is not normal.  Unfortunately, women have been told for years by their mothers, grandmothers, TV ads and doctors that all of these complaints are part of being a woman. These issues should not be an accepted result of being a woman!

Breast Cancer, reconstructions, and abdominal surgeries, have post surgical issues that must be carefully managed. Osteoporosis, spinal compression fractures, hip fractures and other impairments including frozen shoulder and hip bursitis are also more common in the female population.

Kegals are a term that is very familiar to women.  The unfortunate thing is when manually assessed 60% of women do the exercise incorrectly.  These muscles need to be trained very specifically to be effective.   Women often express to us their frustration that no one showed them how to do them correctly from the start.

A Physical Therapist will evaluate your needs and teach you the specific exercises that YOU will benefit from so your valuable time is better spent and your complaints are addressed effectively.     It is time to take a more proactive approach to these issues and we can help.

ACL, hip pain, knee pain

Most ACL trauma in females is non-contact.  The injuries occur from not planting their foot correctly during cuts or jumping and landing “awkwardly” Research has shown that females do not cut or land the same as males.  This is a result of weakness through the hip stabilizers.  As the pelvis changes shape, the angle of muscle pulls changes.  Muscle strength needs to stay ahead of the growth curve, or the body becomes susceptible to injuries.  A thorough evaluation of the biomechanics during activity and the strength of important stabilizers in a functional situation are imperative to the abolition of symptoms.

Childbirth Years/Pregnancy

Pregnancy results in enormous musculoskeletal changes.  The hormone relaxin peaks in the fourth month of pregnancy.  This hormone increases the flexibility of the ligaments.  Ligaments provide the stability to your joints that muscles do not.  As a result women, complain of back or SI joint pain.  Sciatica and buttock pain are also common.  Often the cause is a combination of the pregnancy and a provoking factor: a poor postural habit, a particular activity or a weakness they had prior to pregnancy.  The weight of the baby and the relaxin make it very difficult for your body to compensate as it likely had before pregnancy.  In addition, research has now shown us that the ligaments never go back to 100% of their pre pregnancy strength.  The number seems to be more like 85%.  A subsequent pregnancy then starts at that 85% and you lose stability from there.  This is what makes each pregnancy cumulative.  Often musculoskeletal complaints do not linger until after the second pregnancy.   It is important to get a program going as soon as possible to correct undue physical stress on the body as well as increase muscle strength to help the ligaments.  Research is now available that reinforces the importance of restoring pelvic floor and abdominal strength after pregnancy to avoid any future or reoccurring back and or hip pain.

Pelvic Floor Pain

Many women have pain with intercourse, bowel movements or just an aching pain in their pelvis or lower abdomen.  They have been examined by MD’s, given ultrasounds, CT scans, and medication.  Nothing seems to help.  Physical therapy has proven to be very effective in these situations. The pelvic floor is made up of muscles that can go into spasm, have trigger points or are shortened secondary to episiotomy scars, surgery, sexual trauma or for no reason at all.  Postural factors and biomechanical issues with the SI joint can also contribute to the cycle of pain.  Education, soft tissue work and corrective measures  can give women their quality of life back.

Incontinence

Childbirth is traumatic to the pelvic floor.  The soft tissue is pushed to its limit, and tears and/or episiotomies often result.   Recently, it has been proven that the Pudendal nerve, which is the main source of innervation for the pelvic floor and the urethral and rectal sphincters, is injured in 60% of vaginal deliveries secondary to a prolonged pushing stage.   As a result of all of the above, complaints of leaking urine and/or feces is very common for months after delivery.    However, common is not the same thing as normal.  With any soft tissue injury there is a correct way to rehabilitate it.  While it is true most symptoms get better after two months, it is also true that the symptoms can be worse with the second pregnancy and return again years later.  When symptoms appear for the first time, this is the time to fix it and not wait!  A strengthening program specific to your injury will improve healing time, decrease symptoms faster and prevent reoccurrence.  Physical therapy is recommended by the International Continence Society and the International Pelvic Pain Society as a valuable and effective treatment for this problem and should be prescribed before more invasive treatments.

Urinary Urgency/Frequency

Urgency is the intense need to urinate. Typically you find yourself running to the bathroom as you are unable to control it.  Sometimes episodes of incontinence can occur on the way to the toilet.  Frequency is the need to urinate more than 5-7 x /day.  Sometimes you feel you are not emptying your bladder all the way, other times you think you must just have a “small bladder”.  Getting up more than once per night is also a symptom of frequency.   The reasons why these two things happen are complicated.   These symptoms can occur anytime during the life of women.  A bladder retraining program, implemented with a pelvic floor strengthening program is very successful at controlling these symptoms.

Breast Cancer

Surgeries for breast cancer involve removing tissue from areas that are very sensitive to invasive procedures.  Edema, loss of motion in shoulder and postural changes commonly develop.  A gentle range of motion program respecting the healing process with postural strength and education are necessary for full return to function.  Reconstructions involving trunk muscles cause loss of flexibility and a “tight” feeling in your abdominal wall.  It is not normal to continue experiencing any loss of motion or vague feelings of “tightness” across your lower abdominal wall or pelvic floor. A physical therapy evaluation will determine if there is a musculoskeletal cause.  Typically a specific stretching program relieves most of these symptoms.

Osteoporosis

Osteoporosis is the leading cause of spinal compression fractures and hip fractures.  It has been proven that weight bearing exercises stop the decline in bone density at ANY age.  But what if you have issues that prevent walking for exercise, or lifting weights? A physical therapist can provide you with exercises that will give you the load through your bones you need without aggravating other issues you may have.