Your reproductive system continues to influence your life long after you've given away the last of your children's outgrown clothes and toys. As they're putting on their graduation caps and gowns or beginning families of their own, your maturing body is taking you through more changes.
Menopause
Menopause is a biologic phase which marks the end of hormonal changes and ovary function and menstrual periods. Some women notice "side effects" of menopause, including hot flashes, tingling, muscles aches and pains, plus changes in temperament and sleep patterns. Physical therapists understand the importance of exercise and fitness for the mature woman. They encourage continued exercise, with modifications if necessary, with special emphasis on preventing osteoporosis.
Osteoporosis
Osteoporosis is the loss of bone density that begins by your early 40s. How much density you lose depends on your diet and exercise choices. Once the bones lose a significant amount of calcium, they become brittle and can break easily. For women who already have osteoporosis, physical therapists will recommend postural strengthening exercises and activities such as walking, possibly using an exercise bicycle, and perhaps some light swimming. Good nutrition, plenty of calcium, estrogen supplements after menopause, and weight-bearing exercise like walking with good posture can help prevent this debilitating condition from happening to you.
Hysterectomy
Hysterectomies, the surgical remove of the uterus, are prescribed by physicians for a variety of reasons. While new developments in diagnostic procedures and surgical techniques have provided options, you may someday need to undergo this operation. A physical therapist can put you on a good postoperative treatment plan to ensure a healthy recovery after the hysterectomy. Physical therapy techniques for hysterectomy recovery include pelvic floor exercises, stretching, deep breathing and weight-bearing exercise.
Mastectomy
Women who go through a moderate or radical mastectomy are often worried about their body image and are afraid to move because of the tightness they feel in their chest and shoulders. A physical therapist will help you become accustomed to your new shape. You will learn how to gently massage your scar tissue to prevent adhesion, and your physical therapist will teach you deep breathing plus tailor an exercise program that will help you regain the full range of motion in your shoulder and upper body.
Incontinence
Incontinence means difficulty with bladder control. The bladder's function is to store and empty urine. Normally, it fills to capacity and the detrusor, the muscle that lines the bladder, contracts and causes the urge to relieve. Incontinence occurs with the lining of the bladder becomes irritated, causing the bladder to contract prematurely and/or frequently.
Incontinence strikes all ages. Over 12 million Americans experience some form of incontinence, twice as many women as men. Factors that can contribute to incontinence are weight, number of babies you've delivered, chronic illness, smoking, caffeine, and certain medicines that cause bladder irritability. But understanding incontinence doesn't make it any less embarrassing if you have a bladder control problem.
Two major types of incontinence physical therapists work with are stress and urge. Stress incontinence is the sudden, involuntary loss of urine because of physical stress, such as coughing, laughing, jumping or sneezing. Urge incontinence occurs when the urge to urinate is so strong it can't be overcome - the bladder does not relax so it can fill normally and you get the sensation to go - and you have no control over it.
Incontinence is a symptom of an underlying problem, not a disease itself. Incontinence can be a sign of a bladder infection or more serious disease. But once these conditions have been ruled out by a physician, the source of the problem might be weak pelvic floor muscles.
Knowing that you can do something about it is a step in the right direction. Physical therapists are trained to rehabilitate muscles and have a variety of methods to teach clients how to correct pelvic floor weakness. More importantly, they can teach you how to exercise you pelvic floor muscles to prevent the onset of incontinence or help to reverse the process. You can also check the strength of your pelvic floor the next time you urinate. Partially empty your bladder, then try stopping or slowing down the flow of urine. If you're successful with either, then you're contracting (tightening) the right muscles. Try doing these contractual exercises (called Kegel exercises after the physician who developed them) throughout the day, driving, sitting in a meeting or talking on the phone. You can also vary these exercises: contract your pelvic muscles and hold for 10 seconds, then relax the muscles for 10 seconds. Or contract and release quickly. Or contract, and while holding, cough. The purpose is to vary these exercises and do them several times throughout the day. Remember that Kegel exercises are discreet. Nobody will notice.
*Sourced from: American Physical Therapy Association (www.APTA.org). "For Women of All Ages. A Physical Therapist's Perspective on Women's Health." 50M/3-07/PR-38