Women's Health

Women's Health

Women's Health

is one of my special interests. I assist with various pelvic floor dysfunctions in women only.

Pelvic dysfunctions affect roughly a third of women and Physio forms part of managing these conditions conservatively by:

  • Comprehensively assessing the patient to get all the details about the condition, history, and how it has affected daily life.

  • Assessing your body for function and to establish factors contributing to your dysfunction.

  • Putting a treatment plan in place, taking into consideration your goals.

  • Empowering women and promoting better pelvic function.

Some of the Women’s Health conditions I treat include (but are not limited to)

Pelvic Girdle Pain (PGP) is pain, reduced mobility and discomfort in the pelvic region. Particularly the joints (Sacro-iliac joint, hip joint and pubic symphysis) and ligaments that make up the pelvic girdle. PGP is mostly associated with pregnancy due to the hormonal, postural and muscular changes that occur. However, PGP can also be non-pregnancy related. This is mainly due to a traumatic injury, arthritis, repetitive strain injuries and Lumbo-pelvic problems.

Physiotherapy can help by identifying the reason behind the pain and addressing the contributing factors: 

  • Education to help you understand the nature of the PGP and how to manage it is crucial for long-term relief and prevention. Postural education and advice on how to modify activities is often needed to reduce symptoms.
  • Pain Management: positioning for sleep and rest, hot and cold therapy, support belt (if needed) and relaxation techniques.
  • Manual therapy to improve alignment, release tight soft tissue structures and mobilize joints 
  • Pelvic stability exercises are done to strengthen the muscles that support the pelvis (eg: Abdominals, glutes and pelvic floor). By improving stability of the pelvis, it reduces strain on the joints.

PGP is a common condition, especially during pregnancy, affecting the pelvic region and causing pain during movement. Physiotherapy is an effective treatment for PGP, helping to realign the pelvic joints, strengthen the core and pelvic floor muscles, and improve posture and movement patterns to reduce strain on the pelvic girdle. Through a combination of manual therapy, stabilisation exercises, and personalised treatment plans, physiotherapists can help alleviate pain and improve the stability and function of the pelvis. This allows individuals with PGP to regain mobility, perform daily activities with less discomfort, and manage their symptoms effectively.

Chronic pelvic pain (CPP) is a persistent, often debilitating pain in the lower abdomen or pelvis that lasts for six months or longer. It can have various causes, including gynecological (Endometriosis, Fibroids, Pelvic Inflammatory Disease, cysts), urological (Painful bladder syndrome, UTI’s), gastrointestinal (IBS, Inflammatory bowel disease, Constipation), musculoskeletal (myofascial pain, pelvic floor dysfunction, nerve entrapment) and psychological (stress, anxiety, depression).

Physiotherapy can help with CPP, especially when the pain is related to musculoskeletal or pelvic floor dysfunction, by: 

  • Pelvic Floor Muscle Training:
  • Many cases of CPP are linked to pelvic floor dysfunction, where the muscles of the pelvic floor are either too tight or too weak. A physiotherapist can guide you through exercises to strengthen or relax these muscles, improving muscle coordination and reducing pain.
  • Manual therapy to improve alignment, release tight soft tissue structures and mobilize joints 
    • This can relieve muscle spasms, improve blood flow, and reduce tension in the pelvic area.
  • Postural Education and training can help you improve your posture, which may alleviate some of the pain.
    • Poor posture can contribute to pelvic pain by placing undue stress on the pelvic region. 
  • Stretching and Strengthening Exercises:
    • Exercises targeting the core, hips, and lower back can help improve muscle balance, reduce tension, and enhance overall pelvic stability.
  • Education and Pain Management:
    • Strategies including relaxation techniques, breathing exercises, and lifestyle modifications to better understand your pain and how to manage it can significantly reduce its impact on your life.
  • Electrotherapy:
    • Techniques such as transcutaneous electrical nerve stimulation (TENS) may be used to provide pain relief by interfering with pain signals sent to the brain.

CPP often requires a multidisciplinary approach, including medical treatment, counselling, and sometimes surgical intervention, depending on the underlying cause. Physiotherapy forms part of the management of CPP. Working closely with a healthcare team ensures that all aspects of the condition are addressed.

Diastasis Rectus Abdominus (DRA) is when the rectus abdominus muscle (“six pack muscle”) separates along the midline (called the Linea Alba). This happens naturally during pregnancy and rejoins a few months postnatally. Increased abdominal weight, chronic coughing, constipation and certain exercises performed incorrectly (eg: heavy lifting and intense abdominal exercise) can contribute to DRA in both men and women.  

DRA is a noticeable bulge or ridge running down the midline of the abdomen, especially when the muscles are engaged. It leads to compromised core stability, which can lead to poor posture, lower back pain, and challenges with daily activities that require core strength. In women, DRA can contribute to postpartum problems such as pelvic floor dysfunction, urinary incontinence, and back pain.

How Physiotherapy Can Help with Diastasis Rectus Abdominis:

  1. Core Rehabilitation
    • Physiotherapists use exercises to strengthen the deep core muscles, particularly the transverse abdominis(the deepest abdominal muscle), which helps support the abdomen and bring the rectus muscles closer together.
    • Exercises like modified core strengthening are performed in a way that minimizes intra-abdominal pressure and encourages the activation of deep muscles.
  2. Breathing Techniques
    • Proper breathing techniques, such as diaphragmatic breathing, help reduce abdominal pressure and engage the deep core muscles. This is important to prevent worsening of the separation and to support healing.
  3. Postural Training
    • Physiotherapists can correct postural issues that may contribute to DRA. Improving posture helps reduce pressure on the abdominal muscles and encourages proper core engagement.
    • Postural awareness in activities of daily living, such as standing, sitting, and lifting, also helps prevent further strain on the abdominal muscles.
  4. Pelvic Floor Rehabilitation
    • Since the pelvic floor and abdominal muscles are connected, physiotherapy often includes pelvic floor exercises to help coordinate core muscle function.
    • Strengthening the pelvic floor muscles can provide additional support to the abdomen and improve core stability, reducing the risk of pelvic organ prolapse or incontinence.
  5. Manual Therapy
    • Physiotherapists may use gentle manual therapy techniques to help realign the abdominal muscles and improve the elasticity of the connective tissue. This can also reduce any tension or scar tissue around the linea alba.
  6. Gradual Return to Exercise
    • For individuals with DRA, a physiotherapist can guide a gradual progression back to more intense exercise, ensuring that abdominal muscles are properly engaged and protected to avoid re-injury.

Physiotherapy plays a crucial role in the rehabilitation of DRA by focusing on core strengthening, pelvic floor rehabilitation, postural correction, and breathing techniques. Through a tailored exercise program and manual therapy, physiotherapists can help reduce the gap, improve core function, and alleviate symptoms like back pain and postural issues, promoting long-term recovery.

Dyspareunia refers to persistent or recurrent pain experienced during or after sexual intercourse. It can have both physical and emotional causes, often linked to pelvic floor dysfunction, injury, hormonal changes, or underlying medical conditions. Physiotherapy is an effective, non-invasive treatment option for addressing the physical causes of dyspareunia, especially when the pain is related to muscle tension or dysfunction in the pelvic floor.

Common Causes of Dyspareunia:

  1. Pelvic Floor Muscle Dysfunction: Tight, weak, or overactive pelvic floor muscles can lead to pain during penetration.
  2. Vaginismus: Involuntary spasms of the pelvic floor muscles, which can cause pain and discomfort during intercourse.
  3. Pelvic Floor Muscle Tension: Chronic tension in the pelvic floor muscles, often due to stress, anxiety, or poor posture.
  4. Childbirth Trauma: Scarring, muscle weakness, or injury from childbirth can contribute to pain during intercourse.
  5. Hormonal Changes: Low oestrogen levels, particularly during menopause, can lead to vaginal dryness and thinning, causing pain.
  6. Endometriosis or Pelvic Inflammatory Disease: Conditions causing inflammation or lesions in the pelvic region can also result in painful intercourse.

How Physiotherapy Can Help with Dyspareunia:

  1. Pelvic Floor Muscle Relaxation
    • Many cases of dyspareunia are linked to pelvic floor muscle tension or hypertonicity (overactive pelvic floor muscles). A physiotherapist can teach relaxation techniques to help reduce this tension. These may include diaphragmatic breathing exercises that coordinate with pelvic floor relaxation, promoting muscle release during intercourse.
    • Manual therapy techniques, such as myofascial release or trigger point release, can also help reduce muscle tightness and improve blood flow to the pelvic region.
  2. Pelvic Floor Muscle Strengthening
    • In some cases, pelvic floor weakness may contribute to dyspareunia, especially if the muscles are unable to provide proper support to the pelvic organs. Pelvic floor exercises are designed to improve muscle strength and coordination, helping to alleviate pain by creating a healthier, more balanced pelvic floor.
    • A physiotherapist will guide patients on how to correctly activate and strengthen their pelvic floor muscles without increasing tension, which is critical for improving symptoms of dyspareunia.
  3. Internal Pelvic Floor Therapy
    • For women with pelvic floor dysfunction, a physiotherapist trained in pelvic health may use internal techniques to assess and treat the pelvic floor muscles. This might involve internal massage to release tight areas or address muscle imbalances, as well as trigger point therapy to alleviate specific areas of pain.
    • These techniques are performed gently, and the physiotherapist will provide education on how to perform self-massage or use dilators to stretch and relax the pelvic floor muscles at home.
  4. Scar Tissue Management
    • After childbirth, surgery, or injury, scar tissue may develop in the pelvic region, leading to pain during intercourse. A physiotherapist can use techniques like scar mobilization to break down adhesions and improve tissue mobility, reducing pain caused by the scar.
    • Stretching and manual therapy can improve the elasticity of scar tissue, allowing for better movement and comfort during intercourse.
  5. Posture and Alignment Correction
    • Poor posture or misalignment of the pelvis or lower back can increase strain on the pelvic floor muscles, contributing to dyspareunia. Physiotherapy includes a postural assessment to identify any imbalances or faulty movement patterns that may be aggravating pelvic tension.
    • Postural retraining and exercises to improve core stability and spinal alignment can relieve pressure on the pelvic muscles, reducing pain during intercourse.
  6. Desensitization Techniques
    • For women who experience vaginal sensitivity or anxiety related to intercourse, physiotherapists may recommend desensitization techniques. These involve the use of graded exposure, such as vaginal dilators of increasing sizes, to help the muscles gradually relax and reduce the pain response.
    • The goal is to help the body become accustomed to penetration without triggering pain or spasms.
  7. Breathing and Relaxation Techniques
    • Anxiety and stress can exacerbate dyspareunia by causing involuntary pelvic floor muscle contractions. Breathing exercises and mind-body relaxation techniques taught in physiotherapy help reduce overall body tension and promote relaxation of the pelvic floor muscles.
    • Diaphragmatic breathing, progressive muscle relaxation, and mindfulness are commonly used to help patients manage anxiety, improve muscle control, and create a more relaxed pelvic floor during intercourse.
  8. Education and Self-Care Strategies
    • Physiotherapy includes educating patients about their pelvic floor, the role it plays in intercourse, and how to maintain pelvic health. This might include strategies for lubrication, advice on sexual positions that reduce strain on the pelvis, and general pain management techniques.
    • Patients are taught how to identify their own pelvic floor tension and how to manage or reduce it through stretching, relaxation exercises, and lifestyle changes.
  9. Coordination with Other Treatments
    • For complex cases of dyspareunia involving underlying medical conditions (like endometriosis or pelvic inflammatory disease), physiotherapists may work in collaboration with gynaecologists, specialists, or counsellors to ensure a holistic approach to treatment.
    • This multidisciplinary approach helps address both the physical and emotional aspects of pain, improving long-term outcomes for patients.

Benefits of Physiotherapy for Dyspareunia:

  • Non-invasive: Physiotherapy offers a gentle, non-surgical way to address the muscular and mechanical causes of dyspareunia.
  • Improves pelvic floor function: Targeted exercises and manual techniques help restore balance to the pelvic muscles, reducing pain.
  • Promotes relaxation: Relaxation techniques and breathing exercises help relieve pelvic tension and improve sexual comfort.
  • Holistic approach: Physiotherapy addresses not just the physical symptoms but also lifestyle, posture, and emotional factors contributing to the pain.

Physiotherapy can be highly effective for treating dyspareunia, particularly when it’s related to pelvic floor dysfunction, muscle tension, or poor posture. Through pelvic floor therapy, muscle relaxation techniques, manual therapy, and desensitization exercises, physiotherapists can help reduce pain during intercourse and improve overall pelvic health. By addressing both the physical and emotional aspects of dyspareunia, physiotherapy can significantly improve sexual function and quality of life.

Pregnancy-related Pelvic Girdle Pain (PGP) refers to discomfort, pain, or instability in the pelvic region during pregnancy. This pain often occurs in the joints that connect the pelvis to the spine and thighs, including the sacroiliac joints (at the back of the pelvis) and the pubic symphysis (at the front of the pelvis). PGP can range from mild discomfort to severe pain, affecting mobility and daily activities.

Causes of PGP:

  1. Hormonal Changes: During pregnancy, the body releases hormones like relaxin that loosen the ligaments and joints in the pelvis to prepare for childbirth. This can lead to instability in the pelvic joints.
  2. Biomechanical Changes: The growing uterus shifts the center of gravity, altering posture and increasing stress on the lower back, pelvic joints, ligaments and muscles. The increased weight of the uterus places strain on the pelvic floor muscles. 
  3. Muscle Weakness or Imbalance: Weakness or imbalance in the core and pelvic floor muscles can exacerbate PGP.

Symptoms of PGP:

  • Pain in the lower back, hips, or groin
  • Pain that radiates to the thighs or down the legs
  • Difficulty walking or standing for long periods
  • Pain during activities like turning in bed, climbing stairs, or getting in and out of a car
  • Clicking or grinding sensations in the pelvic area

Physiotherapy for PGP:

Physiotherapy is one of the most effective treatments for managing PGP during pregnancy. A physiotherapist can offer various approaches to help alleviate pain, improve function, and prevent the condition from worsening.

  1. Assessment and Diagnosis:
  • A physiotherapist will assess posture, joint alignment, muscle strength, and movement patterns to identify the specific causes of PGP.
  1. Manual Therapy:
  • Techniques such as joint mobilization and soft tissue massage can help realign the pelvis, reduce muscle tension, and improve mobility.
  1. Exercise Therapy:
  • Tailored exercises to strengthen the core, pelvic floor, and gluteal muscles. These exercises help stabilize the pelvis and improve posture, reducing strain on the joints.
  • Gentle stretches can also alleviate muscle tightness and improve flexibility.
  1. Postural Education:
  • Guidance on proper posture during daily activities to minimize stress on the pelvis.
  • Advice on safe movements and positions for tasks like lifting, sitting, and sleeping.
  1. Supportive Devices:
  • The use of pelvic support belts or braces can provide additional stability to the pelvis, reducing pain and discomfort.
  1. Pain Relief Techniques:
  • Heat and ice can be used to manage pain.
  1. Lifestyle Modifications:
  • Recommendations on activity modifications and pacing to avoid overloading the pelvis.

Physiotherapy can significantly improve the quality of life for pregnant women experiencing PGP by addressing the underlying causes and providing strategies for pain relief and mobility improvement. Regular follow-up with a physiotherapist is important to monitor progress and adjust the treatment plan as needed.

Post-natal Pelvic Girdle Pain (PGP) is pain or discomfort in the pelvic region that persists or arises after childbirth. It can affect the same areas as pregnancy-related PGP, including the sacroiliac joints (back of the pelvis), the symphysis pubis (front of the pelvis), and sometimes the lower back or hips.

Causes of Post-natal PGP:

  1. Hormonal Changes: Even after childbirth, the hormone relaxin can remain in the body for some time, keeping the pelvic ligaments loose and potentially unstable.
  2. Birth Trauma: The physical stress of childbirth, especially in cases of a difficult or instrumental delivery (e.g., forceps or vacuum), can cause strain or injury to the pelvic joints, muscles, or ligaments.
  3. Pelvic Floor Dysfunction: Weakness or damage to the pelvic floor muscles during childbirth can contribute to pelvic instability, leading to PGP.
  4. Muscle Imbalances: The postural changes during pregnancy, combined with muscle weakness or imbalances postpartum, can lead to improper joint alignment and movement patterns.
  5. Overexertion: New mothers may overexert themselves too soon after childbirth, especially with the physical demands of caring for a newborn, which can exacerbate or trigger PGP.

Symptoms of Post-natal PGP:

  • Pain in the pelvis, lower back, hips, or groin
  • Difficulty standing, walking, or climbing stairs
  • Pain during activities like bending, lifting, or getting in and out of bed
  • Clicking or grinding sensations in the pelvic area
  • Difficulty with movements that require pelvic stability, such as balancing on one leg

Physiotherapy for Post-natal PGP:

Physiotherapy is highly effective in managing post-natal PGP by focusing on restoring pelvic stability, improving muscle function, and alleviating pain. Here’s how physiotherapy can help:

  1. Assessment and Diagnosis:
  • A thorough assessment of the pelvis, spine, and surrounding muscles to identify the specific causes of post-natal PGP.
  1. Manual Therapy:
  • Techniques like joint mobilization, myofascial release, and soft tissue massage can help realign the pelvis, reduce muscle tension, and improve joint mobility.
  1. Pelvic Floor Rehabilitation:
  • Strengthening and re-educating the pelvic floor muscles is crucial to restoring pelvic stability and function. A physiotherapist may guide you through exercises such as Kegels or more advanced techniques.
  1. Core Strengthening:
  • Exercises to rebuild strength in the core muscles, particularly the deep abdominal muscles, can support the pelvis and reduce strain on the joints.
  1. Postural Correction:
  • Education on proper posture during daily activities, especially while lifting, carrying, or feeding the baby, to prevent aggravation of PGP.
  1. Exercise Therapy:
  • Tailored exercise programs to address muscle imbalances, improve joint stability, and enhance overall functional movement. These exercises are designed to be safe and effective for postpartum recovery.
  1. Pain Management Techniques:
  • The use of modalities like heat, ice, or TENS (Transcutaneous Electrical Nerve Stimulation) to manage pain and discomfort.
  1. Gradual Return to Activity:
  • Guidance on safely returning to physical activities, including exercise and household tasks, without overloading the pelvis or exacerbating PGP.
  1. Education and Advice:
  • Providing advice on pacing activities, proper lifting techniques, and ergonomic adjustments to daily routines to minimize stress on the pelvis.

Physiotherapy can play a critical role in recovery from post-natal PGP, helping to restore function, reduce pain, and improve overall quality of life. Early intervention is often key to preventing chronic pain and long-term issues, so it’s important to seek help from a physiotherapist if symptoms persist or arise postpartum.

Groin pain in women refers to discomfort or pain experienced in the area where the lower abdomen meets the upper thigh, often encompassing the inner thigh, the area around the hip joint, or the pubic region. Groin pain can vary from mild to severe and can be sharp, dull, aching, or burning. It can result from various causes, ranging from musculoskeletal issues to conditions affecting the reproductive or urinary systems.

Physiotherapy for Groin Pain in Women:

Physiotherapy can be highly effective in managing groin pain, particularly when the cause is musculoskeletal or related to the pelvic floor. A physiotherapist will tailor the treatment based on the specific cause and symptoms of the pain.

  1. Assessment and Diagnosis:
  • A comprehensive assessment to identify the specific source of the groin pain, including evaluating posture, muscle strength, flexibility, joint mobility, and movement patterns.
  1. Manual Therapy:
  • Techniques like soft tissue mobilization, myofascial release, and joint mobilization to relieve muscle tension, improve circulation, and enhance joint mobility.
  • Trigger point therapy to address specific areas of muscle tightness or spasm.
  1. Exercise Therapy:
  • Strengthening exercises targeting the core, hip, and groin muscles to improve stability and support.
  • Stretching exercises to increase flexibility in the adductor muscles, hip flexors, and surrounding musculature.
  • Gradual, progressive exercises tailored to the individual’s activity level and specific injury or condition.
  1. Pelvic Floor Rehabilitation:
  • Exercises to strengthen or relax the pelvic floor muscles, depending on whether there is a weakness or hypertonicity (tightness).
  • Biofeedback techniques to enhance muscle control and function.
  1. Pain Management Techniques:
  • Modalities like heat, ice, ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) to reduce pain and inflammation.
  • Taping or bracing techniques to support the groin and hip area and reduce strain during activities.
  1. Postural and Movement Retraining:
  • Education and training on proper body mechanics and posture to reduce strain on the groin area during daily activities, work, and sports.
  • Gait analysis and retraining, if necessary, to address any abnormalities contributing to groin pain.
  1. Core Stability Training:
  • Exercises to strengthen the core muscles, which provide a foundation for pelvic stability and help distribute load evenly through the pelvis and groin.
  1. Education and Self-Management:
  • Guidance on activity modification, pacing, and safe ways to perform daily tasks to avoid exacerbating pain.
  • Home exercise programs to continue progress outside of physiotherapy sessions.
  1. Ergonomic and Lifestyle Modifications:
  • Advice on ergonomic adjustments for workstations or daily routines to minimize strain on the groin and pelvic region.
  • Recommendations for gradual return to activities or sports to prevent re-injury.

Physiotherapy can play a critical role in managing groin pain in women by addressing the underlying causes, providing pain relief, improving mobility, and preventing recurrence. Early intervention and a tailored treatment approach are essential for effective management and recovery. If groin pain persists or is severe, it is important to seek professional medical advice to rule out any serious underlying conditions.

Groin pain in women refers to discomfort or pain experienced in the area where the lower abdomen meets the upper thigh, often encompassing the inner thigh, the area around the hip joint, or the pubic region. Groin pain can vary from mild to severe and can be sharp, dull, aching, or burning. It can result from various causes, ranging from musculoskeletal issues to conditions affecting the reproductive or urinary systems.

Physiotherapy for Groin Pain in Women:

Physiotherapy can be highly effective in managing groin pain, particularly when the cause is musculoskeletal or related to the pelvic floor. A physiotherapist will tailor the treatment based on the specific cause and symptoms of the pain.

  1. Assessment and Diagnosis:
  • A comprehensive assessment to identify the specific source of the groin pain, including evaluating posture, muscle strength, flexibility, joint mobility, and movement patterns.
  1. Manual Therapy:
  • Techniques like soft tissue mobilization, myofascial release, and joint mobilization to relieve muscle tension, improve circulation, and enhance joint mobility.
  • Trigger point therapy to address specific areas of muscle tightness or spasm.
  1. Exercise Therapy:
  • Strengthening exercises targeting the core, hip, and groin muscles to improve stability and support.
  • Stretching exercises to increase flexibility in the adductor muscles, hip flexors, and surrounding musculature.
  • Gradual, progressive exercises tailored to the individual’s activity level and specific injury or condition.
  1. Pelvic Floor Rehabilitation:
  • Exercises to strengthen or relax the pelvic floor muscles, depending on whether there is a weakness or hypertonicity (tightness).
  • Biofeedback techniques to enhance muscle control and function.
  1. Pain Management Techniques:
  • Modalities like heat, ice, ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) to reduce pain and inflammation.
  • Taping or bracing techniques to support the groin and hip area and reduce strain during activities.
  1. Postural and Movement Retraining:
  • Education and training on proper body mechanics and posture to reduce strain on the groin area during daily activities, work, and sports.
  • Gait analysis and retraining, if necessary, to address any abnormalities contributing to groin pain.
  1. Core Stability Training:
  • Exercises to strengthen the core muscles, which provide a foundation for pelvic stability and help distribute load evenly through the pelvis and groin.
  1. Education and Self-Management:
  • Guidance on activity modification, pacing, and safe ways to perform daily tasks to avoid exacerbating pain.
  • Home exercise programs to continue progress outside of physiotherapy sessions.
  1. Ergonomic and Lifestyle Modifications:
  • Advice on ergonomic adjustments for workstations or daily routines to minimize strain on the groin and pelvic region.
  • Recommendations for gradual return to activities or sports to prevent re-injury.

Physiotherapy can play a critical role in managing groin pain in women by addressing the underlying causes, providing pain relief, improving mobility, and preventing recurrence. Early intervention and a tailored treatment approach are essential for effective management and recovery. If groin pain persists or is severe, it is important to seek professional medical advice to rule out any serious underlying conditions.

Lumbar, Thoracic and rib cage pain related to pelvic floor dysfunction is pain or discomfort experienced in the lower back (lumbar spine), mid-back (thoracic spine) and rib cage area that is linked to problems with the pelvic floor muscles. Although the thoracic spine and rib cage are anatomically distant from the pelvic floor, dysfunction in this area can impact posture, breathing, and muscular function throughout the body, leading to pain in seemingly unrelated regions.

How Pelvic Floor Dysfunction Can Cause Lumbar, Thoracic and Rib Cage Pain:

  1. Altered Posture:
    • Pelvic floor dysfunction often affects posture. Weakness, tightness, or imbalance in the pelvic floor muscles can cause compensatory changes in posture to maintain balance and stability. For instance, if the pelvic floor muscles are weak or imbalanced, it may lead to an anterior pelvic tilt (pelvis tilting forward), which can increase the curvature of the lower spine (lumbar lordosis) and affect the alignment of the thoracic spine. This can cause strain on the muscles and joints of the spine, leading to back pain.
  2. Breathing Pattern Changes:
    • The pelvic floor muscles work in coordination with the diaphragm, abdominal muscles, and deep spinal muscles (the “core”) to support breathing. Dysfunction in the pelvic floor can alter the normal breathing pattern, causing over-reliance on the accessory muscles of the neck, chest, rib cage and lower back. This can lead to tightness in the rib cage and spine with reduced movement and pain.
  3. Muscle Imbalances:
    • When the pelvic floor muscles are not functioning properly, other muscle groups may compensate for this weakness, leading to overuse, fatigue, or strain in the muscles of the thoracic region, back, and rib cage.
  4. Referred Pain:
    • Pain from pelvic floor dysfunction can be referred to the lumbar, thoracic and rib cage areas due to the complex network of nerves and fascia (connective tissue) connecting these regions. This referred pain can manifest as aching, tightness, or discomfort in the back or rib cage.
  5. Fascial Connections:
    • The pelvic floor is connected to the rest of the body through a network of fascial planes. Restrictions or dysfunction in the pelvic fascia can transmit tension to other parts of the body, including the thoracic spine and rib cage.

Symptoms of Lumbar, Thoracic and Rib Cage Pain Related to Pelvic Floor Dysfunction:

  • Pain or discomfort in the back (lumbar spine and thoracic spine) or around the rib cage. Pain can sometimes worsen with specific activities (deep breathing, twisting, or lifting).
  • Muscle tightness or spasms in the lower back (lumbar region), mid back (thoracic region) or rib cage region
  • Altered breathing patterns, such as shallow breathing or overuse of accessory breathing muscles
  • Associated symptoms of pelvic floor dysfunction, such as pelvic pain, urinary incontinence, or bowel dysfunction

Physiotherapy for Lumbar, Thoracic and Rib Cage Pain Related to Pelvic Floor Dysfunction:

Physiotherapy can be highly effective in managing spinal (Lumbar and Thoracic) and rib cage pain related to pelvic floor dysfunction. Treatment focuses on addressing the underlying pelvic floor issues, improving posture, optimizing breathing patterns, and relieving pain.

  1. Assessment and Diagnosis:
  • A thorough assessment of posture, breathing patterns, pelvic floor function, thoracic and lumbar spine mobility, and muscle imbalances to identify the contributing factors to the pain.
  1. Pelvic Floor Rehabilitation:
  • Pelvic Floor Muscle Training: Exercises to strengthen or relax the pelvic floor muscles, depending on whether the dysfunction is due to weakness or hypertonicity (tightness). This can help restore proper pelvic alignment and reduce compensatory strain on the lumbar and thoracic region.
  • Biofeedback and Internal Techniques: Specialized techniques (performed by trained pelvic health physiotherapists) to address specific dysfunctions in the pelvic floor muscles.
  1. Breathing Exercises:
  • Diaphragmatic Breathing: Teaching proper diaphragmatic breathing techniques to coordinate the movement of the diaphragm with the pelvic floor muscles, reducing overuse of accessory breathing muscles and tension in the rib cage.
  • Breathing Pattern Retraining: Exercises to promote optimal breathing patterns and reduce tension in the thoracic and rib cage muscles.
  1. Manual Therapy:
  • Soft Tissue Techniques: Myofascial release, trigger point therapy, and massage to release tension and improve mobility in the lumbar and thoracic spine, rib cage, and surrounding musculature.
  • Joint Mobilizations: Techniques to improve the mobility of the hips, pelvic joints, lumbar and thoracic spine and rib joints, alleviating pain and stiffness.
  1. Postural Education and Correction:
  • Postural Training: Education on proper posture and body mechanics during daily activities to reduce strain on the spine and rib cage.
  • Core Stability Training: Exercises to strengthen the core muscles, including the deep abdominal muscles and the muscles of the lower back and pelvis, to support proper posture and alignment.
  1. Exercise Therapy:
  • Strengthening Exercises: Exercises to strengthen the muscles of the back, shoulders, and core to provide support and stability to the lumbar and thoracic spine.
  • Stretching Exercises: Stretches to improve flexibility in the lumbar and thoracic spine, rib cage, and surrounding muscles, helping to alleviate tension and pain.
  1. Pain Management Techniques:
  • Use of modalities such as heat, ice, ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) to manage pain and reduce inflammation.
  1. Ergonomic and Lifestyle Advice:
  • Recommendations for ergonomic adjustments at work or home to maintain good posture and reduce strain on the thoracic region.
  • Advice on activity modification, pacing, and techniques for managing symptoms during daily activities.

Physiotherapy can play a crucial role in managing lumbar, thoracic and rib cage pain related to pelvic floor dysfunction by addressing the underlying causes, improving posture and breathing patterns, and providing strategies for pain relief. Early intervention and a personalized treatment approach are essential for effective management and recovery, helping to improve function and quality of life.

 Incontinence is the involuntary loss of control of urination or bowel movements, leading to unintentional leakage. It can affect people of all ages but is more common in women, particularly after childbirth, during menopause, or as they age. Incontinence can significantly impact quality of life, but the good news is that physiotherapy can play a crucial role in managing and even reversing these conditions.

Urinary Incontinence

Urinary incontinence is the unintentional leakage of urine. There are several types:

  • Stress Incontinence: Occurs when physical activity or exertion, such as coughing, sneezing, or exercising, puts pressure on the bladder, causing leakage.
  • Urge Incontinence: Characterized by a sudden, intense urge to urinate, followed by involuntary leakage. This is often associated with overactive bladder syndrome.
  • Mixed Incontinence: A combination of both stress and urge incontinence.
  • Overflow Incontinence: When the bladder doesn’t empty completely, leading to frequent dribbling of urine.

Fecal Incontinence

Fecal incontinence is the inability to control bowel movements, leading to the accidental passage of stool. This condition can range from occasional leakage of stool while passing gas to a complete loss of bowel control. It often results from weakened or damaged pelvic floor muscles, nerve damage, or conditions affecting the digestive tract.

 

How Physiotherapy Can Help with Incontinence

Physiotherapy offers a non-invasive and effective approach to managing both urinary and fecal incontinence by focusing on strengthening and retraining the pelvic floor muscles, which play a crucial role in maintaining continence.

Pelvic Floor Muscle Training

  • Pelvic Floor muscle exercises involve contracting and relaxing the pelvic floor muscles, which support the bladder, bowel, and uterus. Regularly performing these exercises can strengthen these muscles, improving control over urination and bowel movements.

Bladder and Bowel Retraining

  • Bladder Training: involves helping you to understand your bladder’s specific problem and encouraging you to train your bladder so it behaves better (eg: following a scheduled voiding plan, strategies to manage leaking or learning to control the urge to urinate).
  • Bowel Training: Similar to bladder training, bowel training helps establish regular bowel movements by creating a routine and using strategies to avoid leakage.

Lifestyle Modifications

  • Dietary Advice: Certain foods and drinks can irritate the bladder or bowel, making incontinence worse. Physiotherapists can provide guidance on what to avoid and suggest alternatives that support continence.
  • Postural and Breathing Techniques: Correct posture and breathing during activities can reduce pressure on the pelvic floor and improve muscle function.

Manual Therapy

  • Physiotherapists may use hands-on techniques to release tension in the pelvic floor muscles, improve blood flow, and enhance muscle function.

Education and Support

  • Education: Understanding the anatomy and function of the pelvic floor helps patients manage their symptoms more effectively.
  • Support: Physiotherapists provide ongoing support and guidance throughout the treatment process, helping patients regain confidence and improve their quality of life.

 

Physiotherapy helps you to Regain Control 

Incontinence, whether urinary or fecal, can be distressing, but it’s important to know that help is available. Physiotherapy offers a personalized, non-surgical approach to treating incontinence by strengthening the pelvic floor and retraining the bladder and bowel. With the right treatment plan, you can regain control and improve your quality of life.

Painful Bladder Syndrome (PBS), also known as Interstitial Cystitis (IC), is a chronic condition characterized by bladder pain, pressure, and discomfort, often accompanied by urinary frequency and urgency. Unlike typical urinary tract infections, IC/PBS doesn’t have an infectious cause, and it can be difficult to diagnose due to its overlapping symptoms with other conditions.

Symptoms of Painful Bladder Syndrome (Interstitial Cystitis)

  • Chronic Pelvic Pain: Persistent pain in the bladder or lower abdomen, which may worsen as the bladder fills and improve after urination.
  • Urinary Frequency: The need to urinate frequently, often in small amounts, which can disrupt daily activities and sleep.
  • Urinary Urgency: A strong, sudden urge to urinate, even if the bladder isn’t full.
  • Pain During Intercourse: Women with IC/PBS may experience discomfort or pain during sexual activity.

The severity of symptoms can vary, with some people experiencing mild discomfort while others endure severe, debilitating pain that affects their quality of life.

 

How Physiotherapy Can Help with Painful Bladder Syndrome

Physiotherapy plays a significant role in managing Painful Bladder Syndrome by addressing the pelvic floor muscles, which often become tense and overactive in response to chronic bladder pain. 

Pelvic Floor Muscle Relaxation

  • Manual Therapy: Physiotherapists use hands-on techniques to gently stretch and relax the pelvic floor muscles. This can help reduce muscle tension, alleviate pain, and improve bladder function.
  • Myofascial Release: This technique involves applying gentle pressure to trigger points in the pelvic floor muscles to release tight areas and relieve pain.

Bladder Retraining

  • Scheduled Voiding: Physiotherapists can help you establish a bladder retraining program, which involves gradually increasing the time between bathroom visits. This helps reduce urinary frequency and urgency.
  • Fluid Management: Guidance on fluid intake, including how much and when to drink, can help manage symptoms without worsening bladder pain.

Pain Management Techniques

  • Transcutaneous Electrical Nerve Stimulation (TENS): TENS therapy involves using a low-voltage electrical current to relieve pain. Electrodes are placed on the lower back or abdomen, which may help reduce bladder pain.
  • Relaxation Techniques: Physiotherapists may teach relaxation exercises, such as deep breathing or progressive muscle relaxation, to help manage chronic pain and reduce overall tension in the body.

Postural Education

  • Correct Posture: Poor posture can exacerbate pelvic floor dysfunction and bladder symptoms. Physiotherapists provide guidance on maintaining proper posture to reduce pressure on the bladder and pelvic area.

Lifestyle and Dietary Advice

  • Avoiding Irritants: Certain foods and drinks, like caffeine, alcohol, spicy foods, and acidic fruits, can irritate the bladder. Physiotherapists can provide dietary advice to help minimize bladder discomfort.
  • Physical Activity: Regular, low-impact exercises such as walking or swimming can improve overall health and reduce symptoms, but it’s important to avoid activities that put pressure on the bladder or pelvic floor.

 

Painful Bladder Syndrome (Interstitial Cystitis) is a challenging condition, but with the right physiotherapy approach, you can manage symptoms and improve your quality of life. Through pelvic floor relaxation, bladder retraining, pain management, and lifestyle modifications, physiotherapy offers a holistic treatment option that addresses both the physical and emotional aspects of IC/PBS.

If you’re struggling with chronic bladder pain or related symptoms, consider consulting with a specialized pelvic floor physiotherapist to develop a personalized treatment plan.

Constipation is a common digestive issue characterized by infrequent or difficult bowel movements. It can cause discomfort, bloating, and a feeling of incomplete evacuation of the stool. While everyone’s bowel habits are different, constipation is typically defined as having fewer than three bowel movements per week, with stools that are hard, dry, and difficult to pass.

Symptoms of Constipation

  • Infrequent Bowel Movements: Having fewer than three bowel movements per week.
  • Straining: Excessive effort needed to pass stool.
  • Hard or Lumpy Stools: Stools that are dry, hard, or lumpy, making them difficult to pass.
  • Feeling of Incomplete Evacuation: A sensation that the bowel hasn’t been fully emptied after a movement.
  • Bloating and Discomfort: Abdominal bloating, cramping, or discomfort.

Constipation can be caused by a variety of factors, including dietary habits, lifestyle, medications, and underlying health conditions. Chronic constipation can lead to more serious issues, such as haemorrhoid’s, anal fissures, or even pelvic floor dysfunction.

How Physiotherapy Can Help with Constipation

Physiotherapy offers effective, non-invasive treatment options for managing constipation, particularly when it’s related to pelvic floor dysfunction. The pelvic floor muscles play a key role in bowel movements, and physiotherapy can help restore proper function and ease the symptoms of constipation.

Pelvic Floor Muscle Training

  • Relaxation Techniques: Some individuals with constipation have overly tight or uncoordinated pelvic floor muscles, which can make it difficult to have a bowel movement. Physiotherapists can teach you how to relax these muscles, making it easier to pass stool.
  • Biofeedback: This technique uses sensors to monitor muscle activity in the pelvic floor, providing feedback to help you learn how to properly coordinate these muscles during bowel movements.

Bowel Retraining

  • Scheduled Toileting: Physiotherapists can help you establish a regular toileting schedule, which can train your body to have more regular bowel movements.
  • Postural Adjustments: Proper positioning on the toilet can make a big difference in facilitating easier bowel movements. Physiotherapists can teach you how to position your body to reduce strain and improve the effectiveness of your bowel movements.

Abdominal Massage

  • Manual Therapy: Physiotherapists may use gentle abdominal massage techniques to stimulate the bowels and promote movement of stool through the intestines. This can be particularly helpful for individuals with slow-transit constipation.

Exercise and Physical Activity

  • Regular Exercise: Engaging in regular physical activity can help stimulate intestinal function and reduce the risk of constipation. Physiotherapists can provide guidance on safe and effective exercises to support bowel health.
  • Core Strengthening: Strengthening the core muscles can improve overall abdominal and pelvic floor function, which can help alleviate constipation.

Education and Lifestyle Modifications

  • Dietary Advice: A diet low in fibre and fluids is a common cause of constipation. Physiotherapists can provide dietary recommendations to increase fibre intake and improve hydration, which are key factors in preventing constipation.
  • Stress Management: Stress can affect the digestive system, leading to or worsening constipation. Physiotherapists may incorporate relaxation techniques and stress management strategies into your treatment plan.

Constipation is a frustrating and uncomfortable condition, but with the right physiotherapy approach, you can find relief. By focusing on pelvic floor relaxation, bowel retraining, and lifestyle modifications, physiotherapy offers a comprehensive, non-invasive solution for managing constipation and improving your digestive health.

If you’re struggling with chronic constipation, consider consulting with a specialized physiotherapist to develop a personalized treatment plan that addresses your specific needs.

Pelvic Organ Prolapse (POP) occurs when one or more of the pelvic organs (such as the bladder, uterus, rectum, or small intestine) descend from their normal position and push against the vaginal walls. This happens due to the weakening or stretching of the pelvic floor muscles and connective tissues that normally support these organs. POP is more common in women, particularly those who have given birth, are going through menopause, or have had pelvic surgery.

 

Types of Pelvic Organ Prolapse

  • Cystocele (Bladder Prolapse): When the bladder drops into the front wall of the vagina.
  • Rectocele (Rectal Prolapse): When the rectum bulges into the back wall of the vagina.
  • Uterine Prolapse: When the uterus descends into or outside the vaginal canal.
  • Enterocele: When the small intestine bulges into the vagina, usually after a hysterectomy.
  • Vaginal Vault Prolapse: Occurs after a hysterectomy when the top of the vagina loses its support and drops.

 

Symptoms of Pelvic Organ Prolapse

  • Pelvic Pressure or Heaviness: A feeling of pressure, fullness, or heaviness in the pelvic area.
  • Visible Bulge: A bulge in the vagina that you can see or feel, often described as something “falling out” or “sitting on a golf ball”.
  • Urinary Symptoms: Difficulty emptying the bladder, frequent urination, or urinary incontinence.
  • Bowel Symptoms: Constipation, straining during bowel movements, or incomplete evacuation.
  • Discomfort During Intercourse: Pain or discomfort during sexual activity.
  • Lower Back Pain: Aching or discomfort in the lower back or pelvis.

 

How Physiotherapy Can Help with Pelvic Organ Prolapse

Physiotherapy is a highly effective, non-surgical approach to managing and treating Pelvic Organ Prolapse. By focusing on strengthening the pelvic floor muscles and improving pelvic organ support, physiotherapy can help alleviate symptoms, prevent further prolapse, and improve overall quality of life.

  • Pelvic Floor Muscle training exercises are designed to strengthen the pelvic floor muscles, which support the pelvic organs. A physiotherapist can guide you in performing these correctly to ensure maximum benefit.
  • Weight Management: Maintaining a healthy weight can reduce pressure on the pelvic floor and help prevent worsening of the prolapse.
  • Avoiding Heavy Lifting: Lifting heavy objects can strain the pelvic floor, so learning proper lifting techniques or avoiding heavy lifting is crucial.
  • Bowel Management: Preventing constipation through diet and fluid intake is important, as straining during bowel movements can worsen prolapse.
  • Soft Tissue Release: Physiotherapists may use manual therapy techniques to release tension in the pelvic floor muscles and surrounding tissues, improving muscle function and reducing discomfort.
  • Joint Mobilization: Mobilizing the joints of the pelvis and lower back can improve alignment and reduce pressure on the pelvic floor.
  • Bladder Training: A physiotherapist can help you establish a bladder retraining program to manage urinary symptoms associated with POP, such as incontinence or frequent urination.
  • Bowel Training: Techniques and exercises to promote regular bowel movements without straining can be part of the treatment plan.
  • Correct Posture: Proper posture reduces the strain on the pelvic floor. Physiotherapists can teach you how to maintain optimal posture throughout daily activities.
  • Pessary Fitting: While this is typically done by a doctor, physiotherapists can support you in the use and management of a pessary (a device inserted into the vagina to support the pelvic organs).

 

Pelvic Organ Prolapse can be a distressing condition, but physiotherapy offers a safe and effective way to manage symptoms and improve pelvic floor strength. Through personalized exercises, lifestyle modifications, and manual therapy, physiotherapy can help you regain control and enhance your quality of life.

If you’re experiencing symptoms of Pelvic Organ Prolapse, consider consulting with a specialized pelvic floor physiotherapist to develop a treatment plan tailored to your needs.

Pudendal neuralgia is a chronic pain condition caused by irritation or damage to the pudendal nerve, which runs through the pelvic region. The pudendal nerve is responsible for sensation in the genitals, anus, and perineum, and also controls some of the pelvic floor muscles. When this nerve is irritated or compressed, it can lead to significant discomfort and pain in these areas, often making everyday activities like sitting or going to the bathroom painful.

Symptoms of Pudendal Neuralgia

  • Pelvic Pain: A burning, sharp, or stabbing pain in the pelvic region, including the genitals, perineum, or anus.
  • Pain with Sitting: Increased pain when sitting, often relieved by standing or lying down.
  • Urinary Symptoms: Difficulty urinating, urinary urgency, or a frequent need to urinate.
  • Bowel Symptoms: Painful bowel movements, constipation, or difficulty controlling bowel movements.
  • Sexual Dysfunction: Pain during intercourse (dyspareunia) or other sexual activities, and in some cases, reduced sexual sensation.
  • Numbness or Tingling: Sensations of numbness or tingling in the areas supplied by the pudendal nerve.

Pudendal neuralgia is often misdiagnosed due to its complex and varied symptoms, and it can significantly impact a person’s quality of life. The condition may be caused by prolonged sitting, childbirth, pelvic surgery, cycling, or trauma to the pelvic area.

How Physiotherapy Can Help with Pudendal Neuralgia

Physiotherapy is a key component in the management of pudendal neuralgia, focusing on relieving nerve irritation, improving pelvic floor function, and addressing the underlying causes of pain. Here’s how physiotherapy can help:

Pelvic Floor Muscle Rehabilitation

  • Muscle Relaxation: Physiotherapists can teach techniques to relax the pelvic floor muscles, which are often tight and overactive in people with pudendal neuralgia. Relaxation can help reduce pressure on the pudendal nerve.

Manual Therapy

  • Soft Tissue Mobilization: Physiotherapists may use hands-on techniques to release tension in the muscles and connective tissues around the pudendal nerve. This can help reduce nerve compression and alleviate pain.
  • Myofascial Release: Targeted pressure is applied to areas of tightness or trigger points in the pelvic floor, helping to release these areas and improve nerve function.

Nerve Gliding Exercises

  • Pudendal Nerve Mobilization: Physiotherapists can guide you through gentle exercises designed to mobilize the pudendal nerve, helping to reduce irritation and improve its movement within the pelvic region.

Postural Education

  • Correct Posture: Poor posture can contribute to pelvic floor dysfunction and nerve compression. Physiotherapists provide guidance on maintaining proper posture to reduce pressure on the pudendal nerve during activities like sitting.

Activity Modifications

  • Ergonomic Advice: Physiotherapists can offer advice on modifying daily activities to reduce nerve irritation. This may include adjusting your seating position, using cushions designed to relieve pressure, and avoiding activities that exacerbate symptoms.
  • Exercise Recommendations: Gentle, low-impact exercises such as swimming or walking can be recommended to maintain overall fitness without aggravating symptoms.

Pain Management Techniques

  • TENS (Transcutaneous Electrical Nerve Stimulation): TENS therapy involves using a low-voltage electrical current to relieve pain by disrupting pain signals sent by the pudendal nerve.
  • Relaxation Techniques: Physiotherapists may teach relaxation exercises, such as deep breathing or progressive muscle relaxation, to help manage chronic pain and reduce overall tension in the body.

Pudendal neuralgia can be a challenging condition, but physiotherapy offers effective strategies for managing symptoms and improving quality of life. By focusing on pelvic floor muscle rehabilitation, manual therapy, nerve gliding exercises, and lifestyle modifications, physiotherapy can help reduce pain, improve function, and support your recovery.

If you are experiencing symptoms of pudendal neuralgia, consider consulting with a specialized pelvic floor physiotherapist to develop a personalized treatment plan tailored to your needs.

Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically occurring between the ages of 45 and 55. It is diagnosed after 12 consecutive months without a menstrual period. Menopause involves a significant reduction in the production of hormones like oestrogen and progesterone, which can lead to a variety of physical and emotional symptoms.

Symptoms of Menopause

  • Hot flashes and night sweats
  • Vaginal dryness, itchiness and discomfort
  • Mood swings and irritability
  • Sleep disturbances
  • Weight gain, especially around the abdomen
  • Joint and muscle pain
  • Fatigue and reduced energy levels
  • Reduced bone density, increasing the risk of osteoporosis
  • Decreased bladder control (urinary incontinence)

How Physiotherapy Can Help in Menopause

Physiotherapy plays a crucial role in addressing many of the symptoms and physical changes associated with menopause. Here’s how:

  1. Pelvic Floor Dysfunction
    Menopause can weaken the pelvic floor muscles, leading to urinary incontinence, pelvic organ prolapse, and sexual discomfort. Physiotherapists, especially those trained in pelvic health, can:
    • Teach pelvic floor exercises to strengthen the muscles.
    • Offer advice on bladder retraining and techniques to prevent incontinence.
  2. Musculoskeletal Health
    The decline in oestrogen during menopause can lead to joint stiffness, muscle pain, and a decrease in bone density (osteoporosis). Physiotherapy can help by:
    • Designing personalized exercise programs to improve strength, flexibility, and posture.
    • Introducing weight-bearing exercises to maintain bone density and reduce the risk of fractures.
    • Recommending stretches and manual therapy techniques to alleviate joint and muscle pain.
  3. Posture and Core Stability
    As women age, they may experience changes in posture and reduced core stability due to hormonal changes and weakened muscles. Physiotherapy focuses on:
    • Strengthening the core muscles to support posture and reduce back pain.
    • Implementing exercises like Pilates to enhance overall stability and balance.
  4. Cardiovascular Health
    Menopause is associated with an increased risk of cardiovascular issues due to the loss of oestrogen’s protective effects. Physiotherapists can:
    • Encourage aerobic exercises, such as walking, swimming, and cycling, to improve heart health and maintain a healthy weight.
    • Educate on how to safely engage in physical activity, considering any limitations or health conditions.
  5. Mental and Emotional Well-being
    Exercise has been shown to improve mood and reduce anxiety, depression, and stress, which can be heightened during menopause. Physiotherapists can:
    • Incorporate relaxation techniques, breathing exercises, and gentle movement to manage stress.
    • Introduce mind-body approaches such as yoga or Pilates to support emotional balance and reduce tension.
  6. Improving Sleep and Reducing Fatigue
    By addressing issues such as musculoskeletal pain and hot flashes through exercise, physiotherapy can help women sleep better, reducing overall fatigue and improving energy levels during the day.

Pelvic health physiotherapy can offer holistic support during menopause by helping with pelvic floor health and musculoskeletal issues.

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