What Does A Women’s Health Physio Do In The Clinic?

You’ve gone through pregnancy, had your baby and now you’ve been given the all-clear by your GP at your 6-week check and you want to ‘get back into it. This is a danger zone! The drive and pressure to ‘get fit and ‘get your body back’ postnatally can mean that many women push themselves too hard too quickly, leading to injury and pelvic floor damage.

In October 2019 the APA released a statement calling for Women’s Health Physiotherapists to be included in the care teams for all pregnant women in Australia to reduce the risk of complications and to improve outcomes for women and their babies. During pregnancy, a women’s health physio (WHP) educates and guides pregnant women through general exercise parameters as well as specific exercises for pelvic floor and lumbopelvic stability.

The prevalence of incontinence and prolapse in postnatal women is high, with up to 50% of women having some degree of pelvic organ prolapse (APA). Thus, postnatally, a WHP works to go beyond the GP six-week check-up to guide women on pelvic floor health, abdominal separation and to specifically guide the return to exercise process.

A Women’s Health Physio (WHP) will:

1) Assess abdominal separation. Diastasis Rectus Abdominis (DRAM) occurs during pregnancy when a woman’s Rectus Abdominis (big abdominal muscles) separate slightly to allow room for a growing baby. This separation is a completely normal part of pregnancy and childbirth but ongoing separation and associated weakness postpartum can make it difficult to tension through the rectus abdominis. Your WHP will assess this separation and your functional capacity and then create a tailored exercise program for you.

2) Conduct a thorough pelvic floor exam to check the integrity of pelvic walls and organs, as well as the strength and endurance of pelvic floor muscles. From here they can generate a personalised pelvic floor training program to guide the rehabilitation of the pelvic floor and monitor symptoms of incontinence and prolapse as the mum returns to exercise.

• It’s important to note that pelvic floor training needs to be specific and individualised. Pelvic floor muscle training has been shown across many studies to cure stress urinary incontinence (SUI) in 50% of women and improve symptoms of leaking in 75% of women. These studies had women doing pelvic floor muscle exercises daily for three months. Interestingly, the women who saw the best results were those who did their exercises under supervision.
• This means you need to be accountable to a professional who is checking on you regularly (Cochrane 2018). This also means that, though like most training programs there is a minimum of a 12 week period before you will see the effects…so don’t give up!

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