Female and Male Reproductive System Conditions

Question 1

Pelvic Floor Incompetence and Weakness

Answer 1

PT intervention: may include the use of ES and biofeedback to the pelvic floor to assist with reeducation of the muscles to reduce incontinence. Also, use of weighted inserts for strengthening.

Question 2

Breast carcinoma

Answer 2

PT intervention may be required for women who have a total radical mastectomy when the lymph nodes are removed.

• Exercises for UL to ensure FROM.
• Instruction in elevating UL to ↓ risk of edema.
• Strengthening ex’s for return of fx.
• Management of lymphedema.

Question 3

Pregnancy: PT Contraindications

Answer 3

• US, especially around the spine and abdomen.
• Heat near abdomen or Lx spine.
• Most PTs avoid ES, although TENS can be used to manage pain.
• Mobilizations of joints due to ligamentous laxity changes.
• Craniosacral techniques.
• Shortwave diathermy in the abdomen region (best not at all).

Indications could be gentle massage and moderate exercise.

Question 4

Low Back Pain in Pregnancy: Causes

Answer 4

• Ligamentous laxity leading to SIJ dysfunction or symphysis pubis pain.
• Coccyx dislocation.
• Muscular pain due to altered centre of gravity, which leads to ↑ lordosis and results in muscular imbalances.
• Stretching of abdominal muscles and weakness in the abdominal muscles contributes to lack of support of the Lx spine.
• Additional overweight during pregnancy may overstress the muscles, especially when the abs are weak.
• Additional theories point to pressure on the aorta and vena cava from the uterus causing ischemia of the muscles which leads to pain.

Question 5

Low Back Pain in Pregnancy: PT intervention

Answer 5

Focus should be on:

• Use of pregnancy back supports such as SI belts or abdominal binders.
• Postural reeducation.
• Postural ex’s.
• Abdominal and pelvic floor strengthening ex’s.
• Aerobic programs.
• Aquatherapy.
• Resting in prone lying.