Pelvic Pain and Sexual Dysfunction – Physiotherapy, Naturopathic Medicine, Social Work, Yoga and more:
Pelvic pain is often multifactorial and can often appear to have a mysterious onset. Many women can pinpoint the moment in their lives where their pelvic pain became a negative focus, while others are just “used” to the pain and can’t remember a moment when it wasn’t there. Pelvic pain can lead to:
- poor sexual experiences
- a difficult pregnancy or post-partum period
- chronic low backpain, hip pain, pubic bone pain and sacroiliac joint pain
- changes in activity levels.
At GWHA or team has many tools to assist you through your journey of recovering your life back. Often people dealing with pelvic pain clients utilize our Physiotherapists, Naturopathic Doctors, Social Workers and our Yoga programing. To learn more click here.
Physiotherapy for Incontinence:
Is it common for you to have episodes of urinary (or fecal) leakage when you cough, sneeze or make a quick movement? Are you avoiding fitness activities because you know your pad won’t be enough protection? We have helped many women get their lives back. To learn more about our approach to the treatment of stress and urge incontinence visit: http://eramosaphysio.com/conditions-we-treat/male-female-incontinence/female-incontinence/
Pregnancy and Beyond – Motherhood Program
You have decided that this is the time to transition into the role of a mother and for a lot of women the reality is you will be wearing many hats and that change is on the horizon.
Some women feel like a new wonderful person in the early stages of pregnancy and other women wonder how they are going to get through the next 9+months. Expecting moms can be dealing with:
- Fertility challenges
- Waves of fatigue/sleep deprivation
- Worry that they are not eating appropriately for the new “two”.
As your body changes you realize that you cannot simply “do” the things you used to.
- Why is getting out of car or chair suddenly giving you sharp back pains?
- Are you dreading the first couple steps of walking?
- Are you are wondering, “am I doing too much?” or “should I really be exercising the same way I used to?”
For a detailed review on our Pregnancy and Beyond Program click here.
The journey of breastfeeding can be incredibly beautiful, but also incredibly challenging. Many breastfeeding dyads struggle with things like latch and positioning, nipple pain/damage, blocked ducts and mastitis. Physiotherapists have not traditionally been a first line support in helping breastfeeding families to resolve challenges, however physiotherapists with the right training in breastfeeding related conditions can play an important role in helping families to reach their breastfeeding goals. There are two main areas in which physiotherapists can help breastfeeding families: the treatment of blocked ducts and mastitis, and the assessment and treatment of conditions of the jaw, mouth and neck.
Mastitis is a very common condition in lactating women that can occur at any time during lactation, but most often occurs during the first six weeks postpartum. Mastitis is often clinically defined as a tender, red, swollen area of breast tissue, associated with flu-like symptoms, and a temperature of greater than 38.5 degrees C. However, the literal definition of mastitis refers to any inflammation of the breast, which may or may not be caused by a bacterial infection. Areas of breast engorgement, or “blocked/plugged ducts” can also present with redness, swelling and pain, though an infection is not necessarily present. Prompt treatment of blocked ducts and mastitis is important, as evidence suggests that there is a progression from breast engorgement or blocked ducts to non-infectious mastitis, to infectious mastitis to breast abscess.
The physiotherapy treatment of blocked ducts and mastitis involves a technique called therapeutic breast massage. The breastfeeding parent is positioned in a comfortable position, and the therapist uses stroking motions starting at the areola and moving towards to arm pit. The pressure applied is initially very light, and becomes more firm as tolerated. This is alternated with hand expression of milk to clear the area of milk stasis. The goal of therapeutic breast massage is to aid in fluid drainage towards the local lymph nodes. Some physiotherapists will also use ultrasound to reduce inflammation and help clear areas of milk stasis. The physiotherapist will also provide education on symptom management at home, including heat/ice, self massage and positioning, as well as guidance on when to return for further treatment, and when to seek care from a physician.
There are several infant factors that can also contribute to breastfeeding difficulties, such as tongue and lip ties and torticollis. In tongue and lip ties, the tissue connecting the tongue and lips to the mouth is shortened, tight or thickened, leading to impaired mobility. This can affect how well an infant is able to latch on to the breast, as well as how efficiently they can transfer milk while breastfeeding. A physiotherapist can use a screening tool to help identify the presence of a tongue or lip tie, and refer a breastfeeding family on to a practitioner that is able to release these tissues (often a family doctor, pediatrician or dentist). A baby who has had a tongue or lip tie may also develop tightness in the muscles of the jaw and neck because of the altered suck mechanics necessary to breastfeed without proper tongue and lip mobility. A physiotherapist can use gentle soft tissue techniques and stretching to normalize the tone in these muscles.
Congenital Muscular Torticollis occurs when an infant is born with restricted neck range of motion because of tightness in the sternocleidomastoid muscle. The infant’s head may rest in a rotated or side-flexed position due to this tightness, which can then lead to difficulty achieving a good latch. A physiotherapist can help to identify when torticollis is present, and treat it with stretching and soft tissue techniques as well as providing the parents with a home stretching and strengthening program, and tips on positioning and tummy time.
Rectus Diastasis (RD) occurs when the front abdominal muscles pull apart during pregnancy. This actually happens in 60-100% of women during pregnancy. The problem arises post-partum if the abdominal wall does return to its normal state.
Many women will notice a “bulge” in their stomach muscle or suffer during the embarrassing moment when 3 months post partum their friend asks if they are pregnant again.
If RD is present a specific exercise program should be used. Many typical stomach muscle exercises actually can cause more harm than good. Like many complaints during and after pregnancy, RD may be common but it is not normal and treatment is readily available. A pelvic physiotherapist can not only assess the integrity of the core from the outside, they can also enhance strengthening with the pelvic floor.
Prolapse (Cystocele, Rectocele)
Women who suffer from prolapse can notice a variety of symptoms ranging from minimal to more noted severity. Often women will feel a sense of vaginal heaviness as the day progresses or after they have been standing on their feet for too long. Other women will be suddenly alarmed when they actually feel or see a bulge extending from their vaginal opening.
Prolapse can be a result of the the bladder pushing downwards or “falling” against the vaginal wall, the rectum pushing against the vaginal wall or the uterus descending downwards on the vaginal canal.
There are several options available for women with prolapse including conservative physiotherapy care and surgery. Recent studies demonstrate the physiotherapy can improve the “grade” of prolapse and prevent unnecessary surgeries. In addition, studies are showing that women who participate in pelvic floor strengthening prior to surgery have less post surgical recurrences of prolapse.
Low Back Pain
Low back pain can impact women along their lifespan. Young women will often experience low back pain secondary to increased mobility and often lack of core strength. Conversely women across all ages have experienced low back pain secondary to common postures like prolonged sitting or standing. Unique low back can surface during times of pregnancy and menopause. Our approach to low back explores the body as a whole and evaluates your posture, joints, discs, muscle and how they coordinate with each other. Read more about our detailed approach to low back pain: http://eramosaphysio.com/conditions-we-treat/back/
Shoulder pain can be as minimal as a quick intermittent pain that is often described as a sharp catch, but can progress to a more constant dull ache down the arm. Common medical diagnoses for shoulder pain include: rotator cuff tendonitis, rotator cuff tear,impingement syndrome, frozen shoulder, shoulder dislocations and shoulder separations. Read more about our approach to Shoulder Pain http://eramosaphysio.com/conditions-we-treat/shoulder/
Women are just as likely to suffer from shoulder pain as men, but some conditions appear to be more common in women like frozen shoulder or adhesive capsulitis. The research is unclear as to what is the mechanism that appears to make women more prone to adhesive capsulitis, but it is often seen in pre and postmenopausal women.
Breast Cancer Rehabilitation:
Physiotherapy plays an integral role in the management of breast cancer in women who have undergone either a lumpectomy or full mastectomy as part of their breast cancer treatment. Physiotherapy treatment targets edema, loss of shoulder range of motion, burning sensation from neural sensitivity, fatigue levels and general return to activity and/or work considerations. For a detailed review of the role of physiotherapy and breast cancer visit: Breast Cancer – Post Lumpectomy or Mastectomy Rehabilitation
Pelvic Girdle/Sacroiliac Joint Pain/Tailbone Pain
A unique area of low back pain is often referred to as Pelvic Girdle or Sacroiliac Joint (SIJ) pain. The SIJ is the junction where your tailbone(sacrum) meets your hip bones (innominate). SIJ pain is a common subgroup of low back pain, and women who have had episodic SIJ pain prior to pregnancy are more likely to have increased SIJ or Pelvic Girdle pain during pregnancy.
Osteoporosis is often referred to as the “Silent Disease”. While Osteoporosis is more common in women than men secondary to hormonal changes, it is also seen as a side effect to medications that contain steroids.
Our osteoporosis program utilizes exercises taken from research studies and incorporate specific weight training exercises at the correct intensity, weight bearing exercises, balance and postural exercises. Utilizing such a program has been shown in research to increase or maintain bone mineral density when compared to control groups who did not exercise.
Osteoporosis is multifactorial, and we strongly urge our clients to access as many resources as possible. While we know that exercise alone can offer great value, combining with nutritional, hormonal or medication regimes may also add benefit.
Child and Youth Pelvic Physiotherapy
Childhood pelvic health complaints are very common, yet not often talked about. “Bathroom Accidents” such as leaking urine or stool during the day or at night, can be stressful for everyone. Late night sheet and pajama changes, extra laundry, and planning extra outfits for school and playdates can be exhausting, inconvenient and frustrating. But, more importantly, parents worry about how their child’s bowel and bladder struggles are impacting their confidence, self esteem, and ability to participate with their peers. They wonder: “Will my 5 year old smell like urine because he still wears a pull-up? Will his friends notice?” or “ Is my child avoiding activities because they might have an accident? Are they being teased by their classmates?” Parents may even worry that they have somehow caused their child’s bowel and bladder difficulties. Read more about our approach to Shoulder Pain https://guelphwomenshealthassociates.com/conditions-we-treat/child-and-youth-pelvic-physiotherapy/