What is going on and what can be done to improve things?

Women’s health-related issues are manifold and can be complex in nature. As such, it is often difficult to get a clear diagnosis and explanation as to what is going on and what can be done to improve things. This can lead to a serious level of compromise in our quality of life, affecting us in our personal relationships as well as socially and professionally. Nevertheless, physiotherapy centred around the very specific anatomy of a women’s pelvis and abdomen can help to address these problems, helping to restore confidence in your body and achieve your life goals.

Written by Wendy Casterton, Physiotherapist


What problems in the pelvic region can women suffer from?

  • Bladder problems such as incontinence, overactivity or urge frequency
  • Vaginal issues including vaginismus or bladder, bowel or uterine prolapse
  • Bowel problems like constipation or incomplete emptying
  • Low back pain
  • Pain around the pubis
  • Abdominal pain or diastasis recti


Why do we suffer with these women’s health problems?

There can be many reasons, but they often occur post-pregnancy or in some post-natal women, do not manifest themselves until the menopause. They can also be due to postural imbalances or are sometimes stress and anxiety related. The muscles around the pelvis and abdomen – the abdominals, diaphragm, pelvic floor muscle and hip musculature – can become altered and not work as well as they should. Normal function of these muscles is to work in harmony to protect the internal pelvic and abdominal organs, providing us with that ‘core’ strength we need in everyday life for standing, walking and lifting for example.


How can physiotherapy help to address these types of problems?

Firstly, a thorough assessment is required to find out what is at fault and contributing to ongoing symptoms. After some questioning and talking through your problem, a physical examination could, for example, lead to diagnosis of diastasis recti (gapping between the left and right sides of the rectus abdominus muscle) or pelvic floor muscle dysfunction. Internal assessment of the integrity of the pelvic floor muscle can also be carried out where necessary and if a patient is comfortable to do so.

Secondly, manual therapy – where indicated – can help to release structures in the body that are tight and not moving well. This can include deep tissue massage, trigger pointing or mobilisations. Again, where necessary, it can involve treatment of the pelvic floor muscle internally.

Following release, it is necessary to restore any subsequent instability with activation and strengthening of muscles that are not working optimally. You may be led through some pilates-based exercises to activate and train the core muscles to regain balance and harmony.

Finally, it is important that you are equipped with advice, techniques and exercises to continue at home the work done in clinic. Often we live with these types of problems for months or even years and as a consequence, it can take some time to arrive at their resolution.


Written by Wendy Casterton, Physiotherapist, In Touch Physiotherapy, Singapore


Find out more:
How do physiotherapist get back to fitness after pregnancy
Q&A with Women’s Health Physio: Back pain early in pregnancy

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