Womens health

At Symmetry Physiotherapy we offer a comprehensive service specifically for women’s health. This includes:


Antenatal (Pregnancy)

Our women's health physiotherapists can assist you with

Safe exercises during pregnancy


It is ideal to exercise gently throughout your pregnancy. At Symmetry Physiotherapy we can assist you in developing an exercise program that is safe for you and the unique circumstance behind your pregnancy.

Contact us to book an appointment with our women's health physios.

We also offer water exercise classes & fitball classes for pregnant women. Each class is run by a physiotherapist.

See class details sheet for:
Class timetables


Pelvic floor exercise


It is important to perform your pelvic floor exercises throughout your pregnancy.

Information sheet on pelvic floor exercises for women


Pelvic Instability/Pelvic Girdle Pain


The pregnancy hormones cause a softening of all your ligaments. This softening obviously assists during birth however for some women it also causes the onset of pelvic pain and instability.
If you suffer from pregnancy related pelvic pain or instability it is most commonly felt around the pelvis, sacroiliac joints and or around the pubic bone.
This pain can significantly limit your movement, affect your day to day function and also affect the feelings you have regarding your pregnancy.

Seeking support from your women's health physiotherapist is an important step in ensuring your pregnancy is as comfortable as possible.

Your physiotherapist will liaise with you and your obstetrician regarding how your birth plan may need to be specifically tailored due to your physical limitations. It is important to maintain whatever mobility you have and try to exercise within your limitations. Your physiotherapist will advise you on what you can do. She will also assist you in your pelvic floor exercise program as it is imperative to maintain pelvic floor strength to assist with your recovery after the birth of your baby.

Your physiotherapist will also assist you in the fitting of appropriate braces, sticks or in a worst case scenario, a wheelchair.
The back and pelvic supports below are 2 of the products we recommend:

MiltonBelt
Mitton belt


Information sheet on how to manage pelvic pain or instability


Postnatal



Appropriate Exercises for recovery after the birth of you baby


It is important to retrain your pelvic floor muscles and abdominal muscles after the birth of your baby as you would after any significant muscle trauma or injury. During pregnancy the hammock like muscles of the pelvic floor have been stretched and weakened by carrying your baby. These muscles will not return to normal strength without retraining

It is also important to re strengthen your abdominal muscles which have been stretched, possibly cut (C-Section) and weakened.

Please contact our women's health physiotherapist. She will assess your pelvic floor and abdominal function and design an exercise program specifically for you.

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PDF on how to activate you pelvic floor muscles

At Symmetry Physiotherapy we also offer postnatal pilates exercise classes. These classes are excellent for regaining the shape and tone in your tummy, pelvic floor and buttock muscles.

Pilates information sheet page Timetables


Postnatal Pilates DVD


Symmetry Physiotherapy has helped produce a DVD to assist in your postnatal recovery. This DVD is sold Australia wide and is designed and delivered by a specially qualified physiotherapist. The pelvic floor content has been approved by the Senior Lecturer in Women's Health at The University of Melbourne.

The DVD is designed to be used from 6 weeks after the birth of your baby and has a specific section on how to activate your pelvic floor as well as how to activate your Transversus abdominus muscle - better known as "your core" muscle. The pelvic floor exercises are ideal to help reduce incontinence, prolapse and assist with any future pregnancies you may wish to have.


Feeding Posture



It is common to experience tightness between your shoulder blades and into you neck from feeding your baby regardless of whether you are breast feeding or bottle feeding.

It is ideal to sit in a supportive chair whilst feeding but often this is not practical and rarely done. Most new mums tend to feed on a couch therefore place a pillow on the seat so your bottom doesn't sink lower than your knees. Also a small pillow in the hollow of your back is ideal to lessen the pressure in the upper back and stop you slumping too much. Where possible have a supportive pillow under your arm to carry the weight of your baby so there is no pull on your shoulders. Finally once you have established attachment then try to look up often to minimize the strain on you neck.

An excellent stretch to relieve some of that upper back tightness: Fold a bath towel in half then roll it up. Lay the rolled up towel on the ground then lie on the towel with it running down the centre of your spine from your head to your lower back. Open your arms out palms facing the ceiling and rest in this position whilst stretching your upper back. With all stretches a gentle pulling is fine but you should not experience any pain. Do not over stretch your ligaments are still lax - this ligamentous laxity normally lasts till the return of your first menstruation.


DRAM (Diastusis of the Rectus Abdominus Muscle)



DRAM is most commonly seen in post natal women and can be made worse by significant weight gain and increased abdomen size during pregnancy.

Individual hormonal changes, lower abdominal and pelvic floor muscle weakness and the increased physical demands post-natally, can all exacerbate the abdominal separation.

It is important to get your DRAM assessed. After 4 months there is rarely any further reduction of your DRAM unless you do specific exercises in an attempt to reduce the DRAM. Anything greater than 2 fingers width is considered problematic as it may predispose you to back pain, injury or possible abdominal prolapse.

Your physiotherapist will assess your DRAM and in the early stages may fit you with a supportive bandage which will help hold you together whilst you are recovering and regaining your strength.


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Information sheet on how to look after your DRAM


Braces and supports


Braces and supports can be a great help after the birth of your baby. If you have a DRAM greater than 2 fingers width it is ideal to wear a supportive garment to maintain support for your back while you are recovering. Your hospital will often fit you with tubigrip but if this has been missed please contact our clinic to be fitted with some tubigrip or an appropriate garment.

If you are experiencing pelvic or back pain postnatally there are wonderful supportive underwear available to purchase.

The bellow products we have trialled and highly recommend.


Need other back brace from belly bound?


Incontinence


The International Continence Society (ICS) contends that pelvic floor muscle training should be first line treatment for women with stress, urge and mixed incontinence.

Incontinence affects 80%of women - an absolutely staggering figure. You may experience occasional leakage with a sneeze or cough (Stress Incontinence) or you may have an urgency problem (Urge Incontinence). Physiotherapy can help.

Stress incontinence
Stress incontinence is the involuntary leakage of urine or faeces on effort, exertion, or a sneeze or cough and can happen when the pelvic floor muscles are weak.

Stress incontinence is the most common of the incontinence disorders. The good news is that there is high level research that supports pelvic floor muscle training for treating this condition.

At Symmetry Physiotherapy we offer a range of treatments for helping stress incontinence:
  • Pelvic floor muscle training
  • Tampons, reusable foam pessaries or prosthesis to splint the bladder neck
  • Electrical stimulation
  • Fluid intake advice
  • Dietary advice
We have excellent success rates in curing patients who suffer from stress incontinence

Urge incontinence
Urge urinary incontinence is when you experience leakage due to an involuntary contraction of the bladder muscle. Urge incontinence may be a symptom of a condition called overactive bladder.

Treatment for urge incontinence is slightly different than for stress incontinence as the bladder also needs to be retrained.

Sometimes bladder retraining and pelvic floor muscle retraining does not fix or reduce the urgency problem and in these cases medication can assist. Your physiotherapist will liaise with your GP or specialist and discuss the merits of including medication in your management plan.

You can also experience faecal urge incontinence and this is also managed with pelvic floor muscle training and we assist you with dietary and fluid planning to minimize accidents.

Good bladder habits Diet for a healthy bowel Bladder retraining

For more information visit the Continence Foundation of Australia.

Prolapse


One in every 3 women will experience a prolapse.

A prolapse occurs when support for your abdominal organs (Bladder, uterus and rectum) has been lost and it results in the descent of these structures. This occurs due to pelvic floor muscle weakness and/or stretching of the supportive ligaments holding the organs in place. Depending on the extent of the prolapse, you may experience:
  • A heaviness or dragging sensation through your vagina
  • A lump in the vagina
  • Decreased sensation or pain during sexual intercourse
  • Difficulty in emptying your bowel or bladder
  • Recurrent urinary tract infections
  • Increased symptoms in upright or standing positions

Some causes of prolapse are:
  • Childbirth/pregnancy - stretching/damage to the ligaments and pelvic floor muscles
  • Chronic cough - prolonged increased abdominal pressure
  • Repetitive heavy lifting over time
  • Chronic constipation and straining

Doing pelvic floor exercises can significantly assist your prolapse. It is necessary to have a women's health physiotherapist assess the degree of the prolapse and design an exercise program that will help you. The physiotherapist will also advise on ideal lifestyle changes to help manage your prolapse symptoms.


Prolapse information sheet Book now


Menopause



Menopause is known as the end of the reproductive period for a woman and consists of many physiological changes. This is due to the depletion of oestrogen production by the ovaries. Menopause generally occurs in women in their early to mid 50’s. Some of the symptoms experienced include:
  • Cessation of periods
  • Hot flushes and sweating
  • Atrophy of soft tissues- This can result in muscular weakness and dryness of mucosal surfaces (such as the vaginal walls)
  • Musculoskeletal aches and pains
  • Osteoporosis
  • Skin changes
  • Insomnia
  • Mood swings, anxiety and depression
  • Weight gain


Exercise during and after menopause has been shown to have positive effects on symptom management. Improving physical fitness assists in weight management, decreasing cardiovascular disease risk, preserving muscle mass, maintaining bone mass and density, decreasing the risk of mental health conditions.

Our physiotherapists and dietician can assist in both exercise prescription and dietary management of these symptoms.


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If you are experiencing any of the above symptoms or have any concerns, please feel free to speak with our Women's Health physiotherapists.

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