Continence and Women’s Health Physiotherapy Services by Claire De Vos (Physiotherapist)

Total Physiocare is now offering Continence and Women’s Health Physiotherapy Services!

Women’s health physiotherapists are highly trained and skilled in assessing, diagnosing and managing a variety of health concerns that may affect women throughout their lives. Such conditions may include; incontinence and bladder dysfunction, pelvic organ prolapse, sexual pain or dysfunction, chronic pelvic pain, lactation issues, as well as musculoskeletal aches and pains associated with pregnancy and menopause.

Our Women’s Health Physiotherapist Claire explains a little more about common conditions she treats below:

Bladder Dysfunction:

Bladder dysfunction refers to difficulty with the storage or emptying of the bladder. Common forms of bladder dysfunction include:

  • Stress urinary incontinence: leaking on exertion e.g. cough, sneeze, laugh, jump, run
  • Urge urinary incontinence: leaking on the way to the toilet
  • Mixed Urinary Incontinence: both stress and urge urinary incontinence
  • Urinary Urgency: experience of a sudden, non-deferrable urge to empty your bladder. May be accompanied by urge incontinence and/or urinary frequency (see below).
  • Urinary Frequency: Emptying your bladder frequently (more than 6x per day, or more than 2x overnight)
  • Difficulty or pain emptying your bladder/feeling of incomplete emptying.

Physiotherapy is considered by the International Continence Society to be a first-line treatment of these conditions. Treatment may include: pelvic floor muscle training, bladder training and bladder calming techniques.


Pelvic Organ Prolapse:

Pelvic organ prolapse is extremely common, occurring in 1 in 3 women (a very similar rate to incontinence). It often occurs as a result of pregnancy/childbirth and may worsen during menopause. Pelvic organ prolapse occurs where there is increased laxity in the vaginal wall, resulting in descent of one or more pelvic organs (bladder, bowel, uterus or cervix) into the vagina.

Symptoms may include:

  • Heaviness or dragging within the vagina, particularly after long periods on your feet, lifting or at the end of the day
  • Some women may feel low back pain

Physiotherapy management often includes pelvic floor muscle training as well as education about strategies to reduce the symptoms of prolapse. Your physiotherapist will work closely with your GP/specialist to help you manage your prolapse and achieve your goals.


Chronic Pelvic Pain:

Chronic pelvic pain can have a significant impact on a woman’s quality of life. It may be associated with other conditions including endometriosis, painful periods and IBS.

Women with chronic pelvic pain may experience associated heavy periods, experience pain/difficulty with insertion or removal of tampons and often experience discomfort during intercourse.

Physiotherapy treatment will often involve pelvic floor muscle down-training, mindfulness, relaxation strategies and stretches. Your physiotherapist will work with you and your healthcare team (which may include GP, specialist and psychologist) to help to decrease your discomfort and get back to activities.


Pelvic Girdle Pain:

Pelvic Girdle Pain (PGP) occurs frequently during pregnancy, with approximately 50% of women experiencing some degree of PGP during their pregnancy.

PGP refers to pain felt either over the joint between the sacrum (lower spine) and pelvis on either one or both sides of the body. It may also radiate into the sides of the hips or be felt over the pubic symphysis (the bone at the front of your pelvis).

PGP usually resolves once you have delivered your baby but in the meantime physiotherapy can help you manage you symptoms and keep active for the remainder of your pregnancy.



Mastitis, which often occurs as a result of blocked milk ducts results in inflammation of the breast tissue. This can result in redness, engorgement and pain for the breastfeeding mother. Fortunately, therapeutic ultrasound administered by a physiotherapist is effective at relieving the inflammation of mastitis and enhancing your recovery.


Abdominal Separation:

During pregnancy your tummy muscles stretch to accommodate your growing baby. After delivery you may have been told you have an abdominal separation or “DRAM” which is where these stretched muscles are taking a little more time to come back together.

There are certain exercises you should avoid if you have an abdominal muscle separation, particularly crunches.

Your physiotherapist can assess your tummy muscles (usually around 6 weeks post-natal) and advise you on the best exercises to manage your separation.


Post-Natal Check:

Congratulations on the arrival of your new baby! Growing and delivering a baby, as well as taking care of a new born can be both physically and emotionally draining.

One of the best ways to help manage this is by getting regular exercise. However, we recommend a post-natal check (usually around 6 week’s post-partum) so that your physiotherapist can guide you on an appropriate return to exercise plan.

It is common to experience pelvic floor dysfunction and abdominal separation (see above) following the delivery of your baby and it is important to have these issues assessed and addressed before returning to high level exercise.


Book an appointment today for your assessment!

Blog by Claire De Vos (Physiotherapist)

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