What to expect from a Womens' Health Physiotherapist?

Womens’ Health Physio, Pelvic Health Physio, pelvic floor rehabilitation, Diastasis Recti rehabilitation, scar tissue massage, post-partum recovery, Pregnancy Physio, safe return to exercise after having a baby, pelvic floor or pelvic health issues in peri-menopause / menopause, prolapse, urinary or bowel incontinence, leaking, painful sex, low back pain, hip pain, abdominal pain.... These are all ways of describing ‘Womens’ Health Physiotherapy’ and conditions you could expect them to address. 

Although it may not be the first intervention you think of when such symptoms or events occur, the impact of pelvic health physiotherapy can be significant. For example, it has been identified that 80% of urinary incontinence can be resolved or improved by physiotherapy input.  

An initial consultation with a Womens’ Health Physio will usually comprise of lots of open conversation and discussion about your symptoms, your medical history and your lifestyle. This will enable you and your physiotherapist to identify key areas to examine and assess, as well as understanding possible contributing factors to your symptoms. These questions will be discussed with sensitivity and empathy, and of course, completely confidentiality. We understand the impact these conditions can cause and know that they can so often coincide with times of big change, stress and anxiety in a woman’s life. Our aim is to put you at ease, reassure you and to come up with sensible and realistic solutions or management strategies to improve your symptoms and quality of life.  

The assessment will comprise of your physiotherapist looking at your posture, movements, standing position. They may ask you to perform certain tasks or functional movements, particularly if you have identified things that aggravate your symptoms. They will usually look at you lying down on your back, checking things like your rib position, breathing technique, abdomen, and any scars. They will often gently feel your hips / pelvis and abdomen to help understand if there are any areas of dysfunction. They may test the strength of your abdominal muscles, hips, legs etc too.  

If an internal examination is required, your physiotherapist will always discuss it with you before undertaking any assessment, and explain the reasons why the assessment is recommended. If you do agree to go ahead, you will be asked to undress discreetly and lie on the bed and cover yourself with couch roll. Once you are ready you can tell your physio they can come back into the room or from behind the curtain. Your physiotherapist will take great care to put you at ease and will don sterile gloves for this part of the assessment. You can expect your physiotherapist to look at the external area first and will talk you through each step of the assessment. Once you are happy for them to do so they will insert one gloved finger into your vagina or rectum to feel the internal muscles and anatomy. They may then ask you to perform contractions, cough /laugh, move your hip to help them check whether the muscles are performing well. They may also gently ‘sweep’ the area to check for areas of pain or myofascial tension. Once they have completed the assessment, they will remove their finger, ensure you are covered over and instruct you to redress. You will not be obligated to participate in an internal examination if you don’t want one! Be reassured that there are lots of other techniques and treatment options that can still be of great benefit. 

When you are ready, your physiotherapist will explain their findings and discuss potential treatment plans with you, taking your thoughts and opinions and personal goals into account. In some cases, you may only need one session and can go away with advice and exercises for self-management. In other cases you may require a few sessions to help you on the route to recovery, but you will always be well-informed of the plan and what the aims of treatment are. 

Your physiotherapist may also give you some advice about diet and lifestyle changes you could make which can help to improve or manage your condition. Sometimes, this may mean recommending you to another professional such as a dietician, exercise specialist or masseuse who could aid you with your ongoing recovery.  

I hope this gives you a brief insight into what you may expect from your Womens’ Health Physiotherapy appointment, however the most important advice is if in doubt, request to chat to your physiotherapist first to find out if you are comfortable with them and give them an opportunity to advise how they may be able to help. There’s no need to suffer in silence! 

Emma Bradley