Women’s Health – It May Not Be So Normal After All
By Sara Davenport
It’s no secret that pregnancy and childbirth does a doozy on a woman’s body – a growing belly, weight gain, widening of the hips, and the frequent need to urinate are just a few of the changes women experience.
I was one of the last of my friends to have my first child, so I remember calling each of them up to whine about my aching back, my swelling feet and to ask the ever popular question, “Is this normal?”
I think almost every pregnant woman on the planet is told, or assumes, that back pain, frequent urination, and bladder leakage are a rite of passage to holding our precious little bundle of joy at the end of a long nine month journey. Our mothers tell us, our friends tell us, our sisters, our colleagues – heck even our health care providers tell us that this is just par for the course!
So, in most cases, all this talk causes women to do what women do best – put on a smile, move on and start dealing with our “new normal.” Well, what if what you thought was normal, really was not so normal after all? Uh-oh!
I think most of us are aware that October is Breast Cancer Awareness Month, but it’s also National Physical Therapy Month. I had the opportunity to sit down with Joanne O’Connor, PT, OCS with Columbus Regional’s Human Performance Rehabilitation Center (HPRC) to talk about their Women’s Health Program. Joanne is one of three physical therapists that specialize in women’s health; she is joined by Babette Smith, PT and Laura Sherwood, PT, DPT.
Each of these ladies focus on a different area of physical therapy that can greatly improve a woman’s quality of life through non-surgical means during pregnancy and postpartum, as well as after surgeries such as mastectomies and hysterectomies.
Physical Therapy During Pregnancy & Postpartum:
A study performed in 2012 found that 50% of women complain of moderate to severe back pain during pregnancy, and 40% of those women continue to struggle with back pain post-pregnancy. A woman’s body goes through tremendous “mechanical” changes during pregnancy – her abdominal muscles stretch and become elongated; she can experience an exaggerated curve to the spine; her pelvic floor muscles stretch; and she has increased laxity throughout the pelvis.
Those of us who have read, What to Expect, When You’re Expecting are probably somewhat familiar with a hormone called relaxin. In general, relaxin is the pregnancy hormone that helps “relax” our body’s muscles, joints and ligaments during pregnancy. It’s the responsible party that helps our pelvis stretch and widen to accommodate the vaginal delivery of a baby.
Joanne states, “The hormone is not the problem. The muscle is the problem.” Physical therapists, Joanne and Babette have both received further education and training to acquire a Certificate of Achievement in Pregnancy and Postpartum, for understanding the physiological changes and special needs of women during this time. With this training, they are able to alleviate pain and stiffness in the pelvis and spine through physical therapy techniques that are safe during pregnancy.
Joanne also pointed out that they help increase a pregnant woman’s core strength by demonstrating safe and effective abdominal exercises. “If you don’t have good abdominals, you don’t have a good back.”, says Joanne.
With a physician’s permission, Joanne and Babette can also recommend positions for labor and delivery for women suffering with back pain. These positions may offer them more comfort than the traditional “lie on your back and push” position.
Physical Therapy for Incontinence & Pelvic Pain:
Who knew there was physical therapy for incontinence and pelvic pain? Well, there is and it has been proven to be a successful, non-surgical alternative for women of all ages. Most young women that struggle with incontinence and pelvic pain do so as a result of trauma to the pelvic floor muscles during pregnancy and childbirth. We all think this is our “new normal” when in reality it’s not so normal after all.
Joanne states, “It is normal for women to have issues with bladder leakage during the last four weeks of pregnancy and for about four to six weeks after delivery. It’s not normal after that [time] and physical therapy can help in most cases.”
In addition to her Certificate of Achievement in Pregnancy and Postpartum, Joanne has a Certificate of Achievement in Pelvic Physical Therapy. Most of us have had a midwife or OBGYN tell us how important it is to do kegel exercises, during and after pregnancy, to strengthen our pelvic floor muscles. The problem is, statistics point out that 51% of women can not correctly perform a kegel exercise by verbal instruction alone. That’s where Joanne’s specialization in Pelvic Physical Therapy comes in handy. Through a vaginal exam, she is able to determine the strength of a woman’s pelvic floor muscles and is able to create a therapy plan that is patient-specific.
Physical therapy for the pelvic floor muscles can include:
- Manual Therapy – A hands-on technique used to restore function to the joint.
- Functional Restoration Therapy – Identifying what the patient is unable to do because of pain or incontinence – such as picking up a laundry basket or sexual intercourse – and formulating a plan to fix the problem.
- Bio Feedback Therapy – Uses a vaginal or rectal electrode that is connected to a small electronic device. As the patient contracts the pelvic floor muscles, the intensity of that contraction is measured and displays on a screen. This allows the patient and therapist to measure the patient’s progress as they gain strength.
- Stim Unit Therapy – Uses a vaginal or rectal electrode that causes the muscle to contract with electric stimulation. This therapy is used for patients who are unable to voluntarily contract their pelvic floor muscles due to trauma or a lack of use.
Physical Therapy for Lymphedema:
According to the American Cancer Society, one in eight women will develop invasive breast cancer in her lifetime and the average chance of a woman being diagnosed with endometrial (uterine) cancer during her lifetime is about one in 38.
Cancer treatment plans often include surgical procedures such as lumpectomies, removal of the lymph nodes, mastectomies, and partial or full hysterectomies. These procedures can greatly impact the lymphatic system and can cause Lymphedema. Lymphedema causes excess fluid to collect in the arms, legs or other parts of the body, which results in debilitating swelling. Lymphedema can also be genetic.
Laura Sherwood, PT, DPT of Columbus Regional’s Human Performance Rehabilitation Center (HPRC) specializes in treating patients with Lymphedema. Laura uses manual techniques to move excess fluid to the patient’s functioning lymph nodes so that it can be properly drained by the body. She instructs patients how to care for themselves so they can independently manage their swelling and skin care routines. Currently, there is no cure for Lymphedema so physical therapy is a necessary and on-going process.
Is physical therapy for you?
If you had an “ah ha!” moment while reading this, make an appointment with your doctor to see if physical therapy may be an option for you. Most insurance plans require a patient to be referred to a physical therapist by their health care provider. DO NOT be embarrassed – most of us who have given birth have already lost all modesty anyway! It is your responsibility to take control of your health AND your quality of life. Click here to access a great resource that describes what to expect on your first visit with a Women’s Health Physical Therapist.
The Women’s Health Program of Columbus Regional’s Human Performance Rehabilitation Center (HPRC) has recently relocated to 2200 Hamilton Road, Suite C, Columbus, GA 31904. You can contact them at 706-571-1090 for more information or make an appointment. Click here to learn more about HPRC’s services and visit the American Physical Therapy Association’s (APTA) website to read more on women’s health.
