Women's health at every life stage

Women face many unique changes throughout their lives. This Women’s Health Week, we talk about women’s health from a physical and physiotherapy standpoint according to life stage.

Girls

As mothers and fathers, we want to be role models to our girls (and boys). Childhood is the time to start modelling good behaviours in the areas of body image, eating and exercise.  

Peak Bone Density

We all hear about the effects of menopause on decreasing bone density. What we don’t hear about (and I wish we did!) is that when we achieve a higher peak bone density we have better starting base, therefore a bit more bone density in the bank to spare. By 17 years of age, 90 per cent of bone growth is complete.

So what do we do you may ask to get this higher peak bone density. Easy! Get the kids out jumping, running, doing impact activities, swinging from monkey-bars. Bone is laid down in response to stress, so put a bit of stress through the bones. And of course a healthy diet. It is better to start early, but better late than never, so get going.

Correct toileting and constipation

This is an area that is definitely not widely talked about or even known about in the general population. Constipation and straining to defecate can put all sorts of strain on your pelvic floor. A significant number of women who have incontinence and/or prolapse issues have had a long history of constipation.

Start the conversation with you daughters (and even sons), and if there is a problem get it addressed. This sounds ominous but really most of the time with children it is nothing major. It usually is about knowing what normal or correct behaviour is, and setting a few strategies to achieve it. In fact, getting help and direction with this can make parenting easier, as it can take away one of the big battle grounds.

Puberty and Adolescence

This is a big time of change hormonally and physically. Breasts develop, growth spurts happen and the hips widen. These all lead to specific biomechanical issues with girls. It is important to maintain strength through these changes, and actively strengthen certain areas. General exercise through this period is critical to keep muscles strong. This will help to increase the bone density. Unfortunately, at this crucial time girls often drop off their physical activity.

In my opinion growth spurts, breasts and posture are all linked. Girls develop earlier than the boys. This can create confidence issues leading to a slouched posture. Combine this with increased study time, it is unsurprising so many of them end up slumping and complaining of sore upper backs. Encouraging specific stretching and strengthening can help alleviate the pain and set up good posture habits for the future.

Knee, ankle and hip pain is another area that is common in this age group. The hips widen changing the alignment of the lower limb often leading to weakness and pain. Again targeted strengthening and stretching can usually mean sport and general activity can be continued with relatively little issue. You probably have heard the term run like a girl. While I hate this term I can see where it comes from. The majority of the time it is due to weak glutes so I am on a mission for the whole world to strengthen their butts. Doing clams and single leg squats is a start to address this. Remember good form is key here.

Having said this if you or your child is complaining of hip, knee or ankle pain please get it assessed by a physio.

Further reading: Strength training for women – your secret weapon

Child bearing years

Pre and post natal – prehab and rehab        

The majority of the pregnancy issues are due to the effect of hormones. Not only do we see a significant change in body shape, our hormones act to relax our joints. What is not widely known is that these hormonal changes remain until after breast feeding is finished and ovulation returns to normal. So briefly I am going to say: stay fit, active and healthy before and during your pregnancy. Address problems early - and before you return to activity after having your baby.

The aches, pains, and issues of pregnancy are often worse with subsequent pregnancies. This is partly due to increase demands on the body with caring for toddlers, but also that many women go into subsequent pregnancies in a poorer physical state than their first pregnancy. Be proactive and think of the time in between children as a preseason, and aim to get your body back to the same if not better than before the arrival of child number one.

Further reading: Ab separation in pregnancy
Further reading: How to manage back pain during pregnancy
Further reading: How to stay fit and healthy while pregnant
Further reading: Benefits of exercising while pregnant

Pelvic girdle pain

Pelvic girdle pain can occur pre and post-natally, with subsequent children or even with no children. It is a complicated area with many contributing factors. Apart from the normal biomechanics of the pelvis, back and lower limbs, there is also the role of the pelvic floor. It is way too complicated to discuss briefly here except I will say that the pelvic floor can be overactive or underactive. Underactivity, can often be described as weakness and may lead to a lack of stability and overactivity. Alternatively, muscle guarding or over tensing is often described as a headache in the pelvis. A correct diagnosis is vital.

Pelvic floor

Issues such as incontinence, both stress and urge incontinence, as well as pelvic organ prolapse are an area where physiotherapy is considered the first line of treatment. Specific exercises and behaviour modification can make a huge difference in this area. So if you have bladder leakage, go to the toilet frequently, find it hard to empty your bladder or bowel, have a sensation of heaviness, bulging or discomfort in the pelvic area, have pain in the pelvic area or have painful sex, you may have a pelvic floor problem.

Get it checked out! Doing something about it is not as bad as you think and it won’t go away if you ignore it - in fact it will most probably get worse.

Further reading: Incontinence – how physio can help
Further reading: Pelvic floor and continence

Menopause and the later years

Menopause is associated with loss of oestrogen. Due to this pelvic floor issues are often worsened or become apparent at this time. Signs of osteoarthritis and osteoporosis may become evident. Exercise is important in helping prevent and manage both osteoarthritis and osteoporosis. The exercise needs to be specific to target muscle and bone strength. Weight bearing and resistance training exercises are the best. Generally, exercise and activity can also help with the side effects of menopausal changes.

Further reading: Osteoarthritis and exercise
Further reading: What is osteoarthritis?

Falls prevention

Falls prevention is important to consider. Here at Back In Motion Bayswater we have developed a falls prevention program, assessing any areas of weakness and developing targeting exercises to address these. The use of whole body vibration is very beneficial in this area.

To book your Free Initial Assessment contact your local Back In Motion practice.

Author

Emma Hindhaugh, physiotherapist – Back In Motion Bayswater

Emma is a physio with a special interest in Women’s Health at Back In Motion Bayswater. Emma has completed post graduate certificates in Pelvic Floor and Continence, and Musculoskeletal Disorders and Exercise for Women, and is the mother of three boys.

External links
Continence Foundation of Australia             
Jean Hailes for Women's Health