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Musculoskeletal disorders associated with “women’s health” issues are extremely common and, unfortunately, often not dealt with effectively.
At HFS Clinics, we are lucky to have a leading women’s health physiotherapist, Yolanda Royan, helping many women to overcome uncomfortable and undignified or embarrassing conditions such as stress incontinence, pelvic floor prolapse, pelvic pain, bad period pain and sexual dysfunction as well as pain associated with abdominal problems like irritable bowel syndrome (IBS).
Many of these problems are associated with weakness in the muscles around the base of the pelvis, the pelvic floor, as well as the interaction of these muscles and their nerves and connective tissues with the other pelvic and trunk muscles. These include the diaphragm, torso and abdominal muscles above as well as the hip and thigh muscles below.
The muscles of the pelvic floor are like a sling or hammock between the tailbone, the sitting bones and the base of the pubic bone, that support and, importantly, lift the internal organs above it. Constant low level tone in them is required to keep us continent, something that is often affected after pregnancy and sometimes with regular back or pelvic pains. However, they also have to relax to allow us to pass water, have normal bowel movements and during penetrative sexual intercourse. During childbirth, they need to fully relax but are also inevitably traumatised as they are taken beyond their normal limits to allow for a vaginal delivery. Whilst they are spared to some degree with c-section delivery, the pressure bearing down on them during pregnancy, especially during the later stages, still creates abnormal distorsion and often leaves them unable to work to their full potential post delivery.
Full, effective function of the pelvic floor often fails to return spontaneously after episodes of back pain, after childbirth or as a result of chronic abdominal pain and this is where specialist physiotherapy can be life transforming for many of our patients.
Specialist physiotherapy including the use of hypopressive exercise techniques, and clinical Pilates, forms the main rehabilitation strategy for these patients along with varying amounts of soft tissue manipulation. Exercising muscles that are deep inside your pelvis is not always easy and so internal electrical stimulation as well as biofeedback is also extremely useful in the short term for many of our patients.
Some patients also require investigation with medical specialists and, due to the psychological and social impact of lots of these conditions, a great many of our patients also find real benefit from clinical psychology input. We are able to coordinate all this within our close network of trusted colleagues in these areas so that the underlying issues of all aspects of women’s health problems are dealt with effectively.