Female Health

Post-Surgery

BREAST SURGERY
Exercise helps to decrease any side effect after surgery and help you to return to normal daily activities and preventing shoulder stiffness after surgery.
HYSTERECTOMY
A woman can experience discomfort with intercourse due to the tightness in the connective tissue at the scar area and due to vaginal dryness. She can also have trouble to activate and relax the pelvic floor leading to incontinence or vaginal prolapse.
VULVECTOMY (REMOVING CANCER OF THE VULVA)
A woman can experience discomfort with intercourse due to the tightness in the connective tissue at the scar area and due to vaginal dryness. She can also have trouble to activate and relax the pelvic floor leading to incontinence or vaginal prolapse.

After a vulvectomy women may feel the following due to the scarring at vulva

  • Discomfort if they wear tight slacks or jeans because the “padding” around the urethral opening and vaginal entrance is gone.
  • Less sensation around the vagina due to the scarring. If scarring narrows the entrance to the vagina a light caress and the use of a lubricant can help to prevent painful irritation. Vaginal dilators and physiotherapy can help to stretch the tissue. Vaginal moisturizers are also important for the tissue.
  • Swelling of the genital areas or the legs due to the removal of the lymph nodes in the groin.
  • Difficulty to reach orgasm all depending on how much of the vulva has been removed. If surgery has removed the clitoris and lower vagina, then orgasms may not be possible.
  • Numbness in their genital area but the feeling may return slowly over the next few months.
RADIATION AND CHEMOTHERAPY
Women getting chemo often have symptoms of early menopause. These symptoms can include vaginal dryness and tightness leading to pain full intercourse and leaking of urine
Physiotherapy options
  • Multidisciplinary approach – referral to other professionals for advice and help to improve the outcome of a successful rehabilitation e.g. medical doctor for medication.
  • Pain physiology education
  • Peripheral and central nervous system desensitization strategies
  • Behavioural and lifestyle modifications.
  • Pelvic Floor and Pelvic Girdle Neuromuscular Re-education
  • Manual Therapy Techniques

- Pelvic Girdle alignment

- Connective Tissue Manipulation

- Myofascial release and myofascial trigger point release

- Neural mobilizations

- Joint mobilizations


  • TENS: Trans Cutaneous Electrical Stimulation is a neuromodulation therapy where a low voltage electrical current is used to stimulating the nerves in the pelvic floor or lower back via a vaginal or an anal electrode to strengthen the pelvic floor muscle or to inhibit the detrusor overactivity.

  • Biofeedback:
- Biofeedback tells you when your bladder and urethral muscles contract, to help you gain awareness and control of your urinary tract muscles.
- This means that weak muscles can be better activated on demand, muscles that are too tense can be relaxed, and overall muscle activity can be coordinated.
- Biofeedback can take different forms.
- The physiotherapist's hand: can you squeeze your muscles round a finger
- A tampon: can you resist its removal?
- Manometry: small balloons are put in your vagina or anus and filled with air or water. You contract your pelvic floor muscles and the pressure on the balloons measures the strength of the muscles in your pelvic floor.

Electromyography (EMG): electrical sensors are placed on the skin inside the vagina or the anus to measure the electrical activity of your muscles at rest and when they contact. The reading is shown either on a graph or screen.


  • Home exercise program development to supplement in-office treatments.
- Foam rolling
- Pelvic floor muscle relaxation exercises
- Diaphragmatic breathing
- Scar mobilising
- Stretching when appropriate
- Strengthening if weak
- Dilator exercises

  • Vaginal weights:
Vaginal weights are plastic cone (variable sizes and weight) inserted into the vagina for progressive length of time during daily activities to strengthen the pelvic floor muscle.