Of late, Women’s Health Care Physiotherapy has gained a lot of attention as it offers non-surgical treatment to various ailments involving women. The therapy involves assessment and planned therapeutic treatment specific to various health problems affecting women of all age groups, with complete knowledge of the physiological differences and the impact of hormonal changes on their well being.
Considering the various health concerns of women are as widespread as the role of women themselves in all phases of life and can include everyone from young athletes to postmenopausal women. Most women can attest that they are just built differently than men. From differences in hormones to the unique stresses from pregnancy, female bodies go through a lot in a lifetime.
Women's Health Physiotherapy was founded from the clinical area of Obstetrics and Gynecology and is the care of women in relation to childbirth, both antenatal and postnatal, including the teaching of antenatal classes, in the treatment of incontinence, and in the care of women undergoing gynecological surgery.
The scope of practice has now increased to include all health concerns of women: pelvic/ vaginal pain, prenatal and postpartum musculoskeletal pain, and osteoporosis, rehabilitation following breast surgery, lymphedema, education prevention, wellness and exercise.
All females across the life span, from the young athlete, the childbearing woman, the menopausal and elderly woman receive benefit from physical therapy. So overall, we are seeing a paradigm shift in the sector.
In order to understand several physical and physiological attributes that are unique to women and how physiotherapy plays an important role in women’s health, Rising Kashmir’s Correspondent Mir Baseerat sat down with Dr Saleesa and Dr Zubaira Akhtar, Consultant physiotherapists at Panacea Physiotherapy and Rehabilitation Clinic.
Why is physiotherapy still an elite concept in Kashmir?
A: There could be various reasons for it. However, to state a few, we see the major hurdle is the unawareness of the subject. People tend to have less information about the benefits of physiotherapy. It’s not necessary that you need to have serious injuries before you consult a physiotherapist. You should stay in touch with your physiotherapist to be in a healthy state.
Another thing is ignorance, people who know about physiotherapy but ignore the treatment as they believe it is not something which is mandatory for a patient. Physiotherapy can heal one’s soul even if rendered helpless by modern medications. It seems like a very costly affair, but in reality it is as economical as any other treatment/consultation. So we urge the public not to think physiotherapy as optional but a necessity.
Q: How important is physiotherapy during pregnancy?
A: Pregnancy and labor significantly affects a woman’s pelvic health. Making a trained pelvic health physiotherapist an integral part of any woman’s prenatal and postpartum care team.
Physical activity during pregnancy and the postpartum period confers benefits for the following maternal and fetal health outcomes:
a) Decreased caesarean births and operative vaginal delivery.
b) Better postpartum recovery.
c) Prevention of postpartum depression.
d) Reduced risks of obesity in pregnancy.
e) Prevention of Gestational weight gain (GWG).
In the context of Kashmiri culture, what is the role of physiotherapy for women's health?
In Kashmir, women usually neglect their health because of many factors. Kashmiri women are more prone to calcium and vitamin D deficiency which causes Osteoporosis and Arthritis. That is a major complaint from the patients, and physiotherapy is one of the solutions to tackle it.
Q: What are the common health issues where one needs physiotherapy?
A: Lymphedema, sports injuries, muscle dystrophy, Back and Neck pain, limited range of motion, osteoporosis, Vertigo, Headaches(migraines), Chronic fatigue syndrome, carpal tunnel syndrome. Respiratory issues, Burns in collaboration with medical team, Joint replacement, Sprains and strains, Fractures, Ligament and minuscule injuries. Pelvic floor dysfunction, Parkinson’s are some common health issues where you need to go for physiotherapy.
How many sessions are necessary for a specific health issue?
Every physiotherapy program is different and is customized to the patient’s needs. Women have unique physical and physiological attributes that physiotherapists take into consideration and it completely depends on the ailment. For example, Bell's palsy, some patients recover in 10-15 days, some take longer time, depending on the underlying cause.
What is the importance of physiotherapy for post acute Covid patients ?
During the intake by the physiotherapists, treatment goals are drawn up in consultation with the patient. Following treatment goals can be considered:
· Improving general fitness
· Increase Mobility-Independent transfers, independent walking, and climbing stairs
· Prevent loss of function- contractures, pulmonary complications and deceits
· Respiratory force and adequate coughing techniques
· ADL independence
· Insight/coping due to reduced energy
· Stable mood-treating depression/ anxiety
What has been the role of physiotherapists in Covid times?
Covid has been tough for any field or profession. We have seen so much anxiety and stress among patients. It was certainly the most difficult time.
However, we still need to be careful of new variants and mutations. We should practice safely and follow all Covid SOPs vigilantly. It is not out of place to mention that Physiotherapy has been remarkable in treating Covid patients and providing post recovery support and treatment.
What is your suggestion to Kashmiri women who wish to pursue their career in physiotherapy?
Not too influential as a career option among girls once but now physiotherapy is now gaining momentum. It is largely about skills and not about strength therefore, yes it is an amazing career option, irrespective of gender.
Physiotherapy is neither subsidiary to medicine, nor is it an alternative form of medicine. It is an independent and autonomous profession within the larger healthcare spectrum with a core knowledge that is unique. We need to set the narrative right. Whosoever is associated with healthcare directly or indirectly should be supported and nurtured.
Physiotherapy in women's health
Exercises and techniques to treat issues specific to women include:
· Muscle retraining – This creates body awareness (how you get in and out of your car, how you bend to pick things up, how you sit, overall posture, etc.) and improves movement patterns. Kegel exercises to strengthen weak pelvic floor muscles in addition to Pilates can be very beneficial.
· Exercise Therapy – helps improve mobility, strength, and endurance. This also strengthens bones and joints.
· Modalities – Application of heat and/or ice, electrical stimulation therapy, and massage therapy to reduce pain, stiffness, and swelling.
· Manual therapy – helps improve joint and soft tissue flexibility and mobility by using repetitive and specific hands-on movements and motions.
The following are different life stages where a woman might need a specialized physiotherapist, as well as the common conditions that occur during these stages.
Pelvic / abdominal / low back pain
Discomfort with sexual intercourse / use of tampon
The Child-Bearing Years (Pre/Post Pregnancy)
Abdominal muscle weakness
Pelvic girdle injury / pain
Back ache / stiffness
Bladder / bowel dysfunction
Carpel tunnel syndrome
Decreased fitness levels / inactivity
Pelvic floor muscle damage
Sexual dysfunction or pain
Bowel Dysfunction / Constipation
Pelvic Floor Weakness
Pelvic Organ Prolapse
The Elderly Woman (Geriatrics)
Decreased general mobility / activity