Conditions which Women’s Health Physical Therapy Improves

March 6, 2010 by  
Filed under Physical Therapy

Jane O’Brien, PT, MSPT


This is due to faulty connective and muscle tissue support allowing the vagina, uterus, bladder, urethra, rectum, and small intestines to fall below their normal positions. It could be caused in childbirth, or due to persistent coughing, repetitive lifting, congenitally weak, weakened, elongated or atrophied tissue. Complaints are of symptoms of heaviness, the feeling of falling out, pressure in the pelvis, and back pain. There may be associated bowel or bladder dysfunctions (constipation, incontinence, frequency, urgency).
How can physical therapy help?
By increasing strength, endurance and support of the pelvic floor through pelvic floor muscle ( PFM) strength training, biofeedback, electrical stimulation, as well as behavior modification, training in proper lifting, bracing and body mechanics, and reduction of exacerbating activities.


A collections of symptoms including pain, pressure or discomfort in the rectum. The condition is aggravated by sitting and may radiate to the vagina, coccyx and thighs.
How can physical therapy help?
Treatment may consists of Manual Therapies aimed at releasing the tension in the levator muscles, Patient education to encourage proper toileting techniques, electrical stimulation to fatigue the muscle spasm and joint mobilization to restore the length-tension ratio of the soft tissues.


URINARY URGE INCONTINENCE- The involuntary leakage of urine associated with a strong desire to void. The bladder muscle contracts abnormally during filling and causes a leakage
STRESS INCONTINENCE-  The involuntary leakage of urine during increased abdominal pressure such coughing, lifting or sneezing.  It may be a failure of the system to store urine properly.
How can physical therapy help?
A women’s health physical Therapist can help a client to regain control of the bladder so leakage, urgency and frequency are lessened or eliminated. This is done through bladder training, voiding records and schedules, behavior modification, pelvic floor muscle strengthening, biofeedback, postural corrections, abdominal strengthening, fluid and dietary adjustments, and patient education on bladder irritants, urination physiology, and proper voiding techniques.


Chronic pain at the vulva characterized by burning, irritation, stinging and rawness. It is suspected that diets high in oxylates can irritate the skin when excreted in urine.
Pain at the vulvar vestibule on touch or with vaginal entry, diffuse erythema in vestibule. May start after acute inflammatory episode ie yeast infection. Limits intercourse and speculum exam or tampon use.
How can physical therapy help?
Use of biofeedback, strength and stretching of  PFM (to restore soft tissue mobility and elasticity of the pelvic floor, scars of the perineum and vaginal tissues), thermal agents ( ultrasound, electrical stimulation, heat and ice), manual therapies ( Myofascial release, muscle energy techniques, joint mobilizations, soft tissue mobilizations) vaginal dilators, electrotherapies ( TENS, NMES, HiVolt stim) and patient education.


Painful penetration due to muscle spasms  or organ pain

How can physical therapy help?

Use of manual therapies designed to reduce muscle tension, vaginal dilators, electrotherapies, stretching and muscle balancing around the pelvis and trunk.


Complaint of suprapubic pain related to bladder filling accompanied by daytime and nighttime frequency in the absence of urinary infection or other pathology. Symptoms may include urgency, frequency, nocturia, difficulty starting the flow of urine, difficult emptying bladder, pain, spasm, painful intercourse, and gastrointestinal, pelvic or chronic somatic pain.
How can physical therapy help?
Use of biofeedback, electrotherapies, aerobic exercise, manual therapies, PFM exercises, trigger point releases, bladder retraining, postural and body mechanics training and musculoskeletal corrections.


This is not a disease, but a symptom consisting of at least 2 of the following in any 12 weeks over 12 months: straining more than 25% of the time, fewer than 3 bowel movements a week, sensation of incomplete evacuation in more than 25% of BM, lumpy or hard stool in more than 25% of BM, the necessity to digitally manipulate to facilitate evacuation for more than 25% of BM
How can physical therapy help?
Scar mobilizations, massage, visceral manipulation, general body conditioning, PFM rehab, strengthening, biofeedback, joint mobilizations, posture instruction, correction of muscle imbalances, bowel training and diet instruction.


Often, scar tissue can become restricted after breast surgery causing pain and restriction of motion of the extremities. Implants can become contracted leading to pain, restricted motion and uneven appearance of breasts.
How can physical therapy help?
Manual techniques such as Myofascial release, scar tissue releases, joint mobilizations, stretches and strengthening.


Incontinence of urine after prostate surgery in men.
How can physical therapy help?
Bladder training, diet modification, PFM exercises, biofeedback, electrical stimulation, use of PFM with ADL’s, ADL modification , assistance with use of collection devices and weaning from such devices.