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Physiotherapy integral to postnatal recovery

Photo: Australian Physiotherapy Association
Having a baby is one of the most exciting times in a woman's life.

It's also one of most physically strenuous, with numerous potential short and long term consequences for both body and mind.

In the information age, most women are well-versed on the importance of looking after their physical and mental health, and many have a broad network of medical professionals to keep them on track both pre and post birth.

GPs, obstetricians, councillors, nurses and midwives all form part of the broader health network of expectant and new mums.

While physiotherapists routinely visit maternity wards to complete a general examination, increasingly, they are joining the list of required therapists for individual women post-birth, thanks to growing awareness of the impact of pregnancy and birth on the pelvic floor.
As a result of the weight placed on the pelvic floor during pregnancy, the muscles and tissues can become overstretched and weak, which can have consequences for bladder and bowel control, or even result in pro-lapse.

"Physiotherapists can assist women to regain their function and return safely to pre-pregnancy exercise," says physiotherapist and member of the Australia Physiotherapy Association, Julienne Moore.

"When it comes to pelvic floor dysfunction, after thorough assessment individual exercise programs are prescribed."

But while more women understand the importance of pelvic floor care through physiotherapy, many remain unaware of the myriad other pregnancy and post-birth related conditions that can benefit from physiotherapy.

Along with pelvic floor dysfunction and abdominal weakness and separation, physiotherapy can also assist with low back and pelvic girdle pain, as well as upper back and postural pain, all common following pregnancy and birth.

Even mastitis, though not commonly associated with physiotherapy, can benefit from the treatment, through therapeutic ultrasound, lymphatic massage and education regarding bra fitting, application of ice and heat packs and feeding positions.

Physiotherapy can also assist with hand and wrist pain due to tendinopathy and Dysparaunia..

Women's health physiotherapist and new mum Elizabeth Burke knows first hand how physiotherapy can assist in the treatment of common postnatal conditions, having managed and reduced the severity of her own ailments both during pregnancy and beyond.

"During the pregnancy I suffered from fluid retention and leg cramps at night. I noticed both were made worse if I didn't do leg exercises and stretching several times a day," says Ms Burke, whose prior knowledge enabled her to effectively combat the ailments through appropriate exercises.

"I also noticed my pelvic floor muscles had weakened in my last trimester, because if I had a large sneeze I would leak a little (mild stress incontinence)."

For the past six months, since the birth of her daughter, Ms Burke has continued with physiotherapist recommended pelvic floor exercises, and as a result, no longer suffers from incontinence issues.

"By doing my pelvic floor exercises I have been able to sneeze repetitively without leaking. I also jumped on the trampoline with my nieces last week without any issues!"

According to Ms Burke, an increase in medical referrals, along with growing media interest, has contributed to the acceptance of physiotherapy as an integral part of the recovery process, following pregnancy.

"The body had gone through some dramatic changes over a short period of time and is changing again following birth," she says.

"I think the more women understand what impact those physical changes have on the body, the better they can manage them.

"Physios are experts in those changes and exercise. They focus not only on managing women's health issues but also prevention."

But the benefits of physiotherapy to women's health doesn't end with pregnancy and birth.

There are multiple women's health problems that can be treated using physiotherapy that many people are not aware of, though this too is beginning to change.

"Physios can be treat internal pelvic pain such a vaginimus and dyspareunia," says Ms Burke.

"The most common bladder condition treated by physiotherapy is stress urinary incontinence, but women's health physios can also assist in other bladder conditions such a urge urinary incontinence, overactive bladder, other voiding dysfunctions and pelvic organ prolapse."

Physiotherapists can also assist in the treatment of bowel related symptoms such as constipation and faecal incontinence or urgency.

"We have a lot of great research supporting physiotherapy which has improved the referral rate from other medical practitioners," says Ms Burke.

"It is now the recommended first line of treatment for incontinence and pelvic organ prolapse prior to surgical intervention."

Physiotherapy is also increasingly recommended for managing osteoporosis and for rehabilitation during and post cancer treatment.

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.