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女性健康物理治療師有甚麼工作範疇?

由物理治療師岑韻婷撰寫

甚麼是女性健康物理治療?

女性健康物理治療是物理治療中的一個專門範疇,管理女性特有病症。與男性不同,女性在人生不同階段會經歷很多生理變化,尤其是在懷孕、產後和更年期期間。研究表明,三分之一的女性在其一生中會出現女性健康問題。以下網誌重點介紹常見的女性健康問題、各方面的女性健康物理治療,以及女性健康物理治療師在治療,以至實現健康優質生活方面的作用。

甚麼是產前女性健康物理治療?

在懷孕期間,女性體內有許多生理變化,可能導致肌肉和關節痛,以及一些女性健康問題。在此階段,女性健康物理治療師發揮重要作用,照顧女性在婦產科上的需要。

需要產前物理治療的常見狀況和治療:

骨盆帶疼痛(PGP)是懷孕期間發生的常見病症,可能由荷爾蒙變化、姿勢改變以及胎兒生長引起。骨盆帶疼痛包括骶髂關節痛、恥骨痛、腹股溝痛,通常還會引起髖關節痛和腰痛。強烈建議孕婦進行物理治療,因為它是一種保守治療,通常對母親和嬰兒都是安全的。物理治療的方式通常包括手法治療,以幫助骨骼保持更對齊的狀態,以及放鬆繃緊的軟組織。運動鍛煉可提高肌肉的柔韌性,並最大限度地提高肌肉力量和核心穩定性。姿勢和生活方式的改變對於降低懷孕後期出現肌肉骨骼問題的風險也很重要。

尿失禁並不罕見,尤其是在懷孕後期。尿失禁有兩種——壓力性尿失禁和急迫性尿失禁。壓力性尿失禁(SUI)是指在身體活動或用力時尿液從膀胱漏出,例如咳嗽打噴嚏、大笑、提重物、跳躍或運動時。急迫性尿失禁(UUI)是指突然強烈的排尿衝動,伴有或多或少的尿量,並且排尿頻率增加。物理治療方式通常包括盆底肌肉訓練、核心穩定性訓練和懷孕期間生活習慣的調整。

骨盆底器官脫垂是指骨盆中的一個或多個器官(包括子宮、膀胱和直腸)從正常位置滑落,因而發生下墜或突出的現象發生。當支撐器官的肌肉和韌帶減弱或過度拉伸時,就會發生這種情況。雖然骨盆底器官脫垂在分娩後更常見,但也可能發生在分娩前,尤其是曾多次懷孕、難產或使用器械輔助分娩的人。物理治療方式通常包括骨盆底肌肉訓練、核心穩定性訓練和懷孕期間生活習慣的調整。

分娩準備對計劃自然分娩的人來說尤其重要。女性健康物理治療師使用手法治療幫助糾正骨盆排列,可能使分娩更順暢。會陰按摩是一種涉及釋放和拉伸骨盆底肌肉的技術,可由訓練有素的女性健康物理治療師在孕婦懷孕37週後進行,有助降低會陰在分娩期間撕裂的風險和會陰切開術(手術切口)的需要。

甚麼是產後女性健康物理治療?

產後階段是從懷孕到分娩。女性身體會經歷一系列的生理變化和姿勢改變,而分娩後隨時可能發生各種肌肉骨骼和女性健康問題。女性健康物理治療師在這個階段尤其重要,可確保婦女在產後身心全面恢復。

需要產後物理治療的常見狀況和治療:

肌肉骨骼疼痛在分娩後很常見,包括背痛頸痛、骨盆帶疼痛甚至外周關節疼痛。這可能是由於各種原因造成,例如姿勢不良、肌肉無力和核心不穩。手法治療通常由女性健康物理治療師進行,以恢復患者的骨骼排列和肌肉平衡。然後,進行度身定做的鍛煉計劃,通常包括伸展運動、重量訓練和普拉提,以幫助恢復肌肉柔韌性、肌肉力量和核心穩定性。

骨盆底疼痛是一種使人衰弱的疾病,會導致很多不適和不便。骨盆底肌肉位於骨盆內,像是吊床一樣從恥骨(前面)伸展到尾龍骨(後面),並從一側伸展到另一側。骨盆底肌肉的功能是控制排尿和排便,以及支撐膀胱、子宮和直腸。在懷孕和分娩期間,骨盆底肌肉可能會過度緊張或拉伸,從而導致疼痛。女性健康物理治療師可以根據疼痛的成因進行多種治療。雖然骨盆底疼痛可能是一種難以控制的疾病,但透過正確的治療,可以緩解疼痛。

小便或大便壓力/急迫性失禁在分娩後很常見,尤其是陰道分娩的女性。在自然分娩期間,產婦的骨盆底肌肉承受很大的壓力。有些人可能需要會陰切開術,甚或其他干預措施如產鉗分娩,使分娩更順暢。這些程序都會導致骨盆底肌肉過度拉伸甚至撕裂,從而影響排尿控制。尿失禁對個人的生活質素有巨大影響,包括身體活動減少、社交迴避甚至精神困擾。在此階段,女性健康物理治療很重要,可確保產後盆底肌肉恢復良好。物理治療方式通常包括強化骨盆底肌肉,在某些情況下可能需要電刺激療法來幫助刺激肌肉。

由於骨盆底肌肉減弱或受損,可能會發生骨盆底器官脫垂。物理治療方式通常包括骨盆底肌肉訓練、核心穩定性訓練和懷孕期間生活習慣的調整。女性健康物理治療師也可能會就如何控制症狀,以及如何防止病情惡化提供建議。若情況嚴重,可能需要處方陰道栓劑,甚至手術。

腹直肌分離定義為腹直肌(腹部)肌肉在沿著腹部中線(稱為白線)的纖維結構處分離。腹直肌分離可能發生在懷孕期間,因為腹部肌肉伸展並分開以適應成長中的胎兒。分娩後,它通常表現為兩列腹肌之間的間隙。在某些情況下,它還可能在體力消耗過程中從縫隙中凸出。腹直肌分離的治療通常包括加強腹部肌肉、恢復核心穩定性並幫助縮小肌肉之間的間隙的鍛煉。產後6至12個月治療效果更佳。然而,在嚴重的情況下可能需要手術,尤其是出現腰痛和虛弱等症狀的人。

產後性功能障礙並不罕見,包括性交困難(性交疼痛)、敏感度下降或提高。性交疼痛是最常見的問題,通常是由於分娩過程中骨盆底肌肉受傷,甚至神經過度拉伸所引起。女性健康物理治療師通常會先找出問題的根本原因,並制定治療計劃來解決問題。物理治療方式包括手法治療以放鬆繃緊的肌肉、教導肌肉放鬆技巧和改變生活方式的建議。

其他由女性健康物理治療師治療的女性健康問題

女性健康物理治療不僅針對懷孕相關問題。任何女性,無論是否懷孕,都可能在其一生中的任何時候出現女性健康問題。譬如肥胖更年期、慢性呼吸道疾病、重複舉起重物等,都可能導致女性健康問題。這部分將探討其中一些問題,以及患者如何在女性健康物理治療師的幫助下變得更好。

其他需要女性物理治療的狀況和治療:

骨盆底功能障礙有兩種主要類型:骨盆底肌肉鬆弛和骨盆底張力過高。當骨盆肌肉的力量不足以發揮其功能時,就會出現鬆弛,可能會導致尿失禁或脫垂等問題。當肌肉和組織太緊而無法放鬆時,就會出現骨盆底張力過高,導致各種疼痛,例如性交疼痛,甚至導致尿液無法排空或排便困難。骨盆底功能障礙的治療取決於成因,對於骨盆底肌肉鬆弛的治療可能包括骨盆底肌肉鍛煉和其他提高肌肉力量的療法。對於骨盆底張力過高的治療可能包括:以手法療法來放鬆繃緊的肌肉、骨盆底肌肉放鬆術。

骨盆底疼痛是女性的常見病症。除了懷孕和分娩,骨盆底疼痛還可能由多種因素引起,包括壓力、肥胖和衰老。骨盆底肌肉疼痛通常是由於張力過高(骨盆底肌肉繃緊)引起。女性健康物理治療通常包括放鬆繃緊肌肉的手法治療,以及幫助緩解疼痛的放鬆技巧。

尿失禁和大便失禁不僅發生在產後,如果女性骨盆底鬆弛,失禁可能會在女性一生中的任何時候發生,這意味著即使從未分娩的女性也可能患有尿失禁。此外,更年期荷爾蒙的變化也會導致尿失禁。女性健康物理治療師通常會進行徹底的評估,包括陰道檢查,以找出問題的根本原因,例如與骨盆底功能障礙、核心不穩甚至姿勢不良等有關,然後根據評估結果進行針對性治療。

與尿失禁一樣,骨盆腔器官脫垂也可能發生在任何女性一生中的任何時候。骨盆腔器官脫垂最常見於分娩後,但也可能由衰老、更年期、肥胖等因素引起。在大多數情況下,通常會先做物理治療。若情況嚴重,可能需要處方陰道栓劑,甚至手術。

膀胱過度活躍症是膀胱肌肉過度活躍和收縮過於頻繁,導致尿急和尿頻的情況。女性健康物理治療師使用多種治療方法來幫助患者,包括骨盆底肌肉訓練、電刺激療法和膀胱訓練。骨盆底肌肉鍛煉有助加強支撐膀胱的肌肉,並有助控制漏尿。電刺激療法有助放鬆過度活躍的膀胱肌肉並減少尿頻。膀胱訓練可幫助患者控制小便的衝動並減少去洗手間的次數。

便秘等腸道問題可諮詢女性健康物理治療師。雖然飲食和生活方式是導致便秘的主要原因,但也可能是骨盆底肌張力過高所致。女性健康物理治療師會進行詳細評估,找出腸道問題的原因,以便建議適當的治療方案,通常旨在放鬆繃緊的骨盆底肌肉,調整飲食和生活方式,以幫助改善症狀。

性功能障礙如陰道痙攣和外陰疼痛是在性交過程中引起疼痛的常見病症。陰道痙攣是指陰道周圍的肌肉變得非常繃緊,導致插入困難或無法插入。外陰疼痛是外陰區域(陰道口周圍的區域)的慢性疼痛或不適,可能在性行為期間甚至不進行性活動時發生。對於陰道痙攣,女性健康物理治療通常包括手法治療以放鬆繃緊的肌肉,以及教導放鬆和呼吸技巧,以幫助患者放鬆繃緊的骨盆底。對於可能由過度活躍的神經引起的外陰疼痛,電刺激療法可用於幫助敏感神經脫敏,有助緩解疼痛。

BodyWorX CTA

OT&P領康醫療建議

總括而言,女性健康問題很普遍,任何女性在其一生中的任何時候都可能面對婦女疾病。雖然有些女性可能不好意思尋求幫助,甚至認為這是分娩、衰老或更年期而需要接受的問題,但大多數女性健康問題都可以通過訓練有素的女性健康物理治療師成功治療。如果你對上述任何情況有任何疑慮,請隨時聯繫我們 OT&P 的女性健康物理治療師。

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Physiotherapy
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  • RPT(H.K.)
  • RPT(U.K.)
  • BSc Hon in Physiotherapy, University of Birmingham
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English, Cantonese, Fluent Mandarin

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Victor Chan is a hands-on physiotherapist who helps patients to reach their ultimate health goals. His profession goes beyond reducing their pain, improving the quality of patients' life.

His core objectives are to identify the mechanisms of injuries, understand patients' needs, educate patients through clinical reasoning, and provide tailor-made injury prevention plans. In addition, he has established a holistic patient-centered care approach to build a trusting relationship with patients.

Victor offers a wide range of treatments under various medical conditions. His western treatment includes joint mobilisation, soft tissue release, rehabilitation exercise prescription, and electrotherapy. In the meantime, he also provides Chinese medicine, including Chinese cupping and muscle scraping.

Victor completed his physiotherapy degree at the University of Birmingham in 2017. After graduation, he returned to Hong Kong and joined Tai Po Football Club as a sports physiotherapist. He then entered private practice and worked as a managing physiotherapist for Cathay Pacific and Bank of China.

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  • BSc Physiotherapy (The Netherlands)
  • Diploma in Acupuncture (China)
  • Certified Neuro-Rehabilitation Specialist (HK)
  • Certificate in Sport Rehabilitation (The Netherlands)
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English, Cantonese, Mandarin, Dutch

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Selina Cheung has more than 17 years of experience as a physiotherapist in the Netherlands and Hong Kong. Graduated from the Hogeschool van Amsterdam, University of Applied Sciences in 1994, Selina specializes in musculoskeletal problems, sports injuries, back and neck problems as well as women's health.

Before she moved to Hong Kong, Selina worked in both private practice and hospital settings in the Netherlands.

In Hong Kong, Selina spent over a decade in a rehabilitation centre, where she worked with sport and spinal cord injuries. She also designed return-to-work programmes for chronic back pain patients. A well-trained acupuncture practitioner, she is fascinated by the synergy effect of combining the traditional treatment and other physiotherapy modalities in treating patients.

Selina is also very interested in women's health. In particular, she has gained postgraduate qualifications in pelvic floor rehabilitation, antenatal and postnatal care as well as menstrual problems. Neuro-rehabilitation is another area that Selina is passionate about. She has extensive postgraduate training in neurology and regularly gives lectures to students and physiotherapist graduates.

When not working, she spends a great deal of time on community work. In 2008, she went to Sichuan to help the earthquake victims by giving them physiotherapy treatments.

Regularly, she gives talks to different charities organizations. A sports enthusiast who enjoys skiing, volleyball and jazz ballet, she is also a volunteer physiotherapist in a few international figure skating and ice hockey institutes.

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  • Masters in Clinical Physiotherapy - Pelvic Health and Continence (AUS)
  • Bachelor of Science - Physiotherapy (AUS)
  • HKPA Registered Physiotherapist
  • AHPRA Registered Physiotherapist
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English, French

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Camille completed her studies in Australia where she also worked in both private clinic and hospital settings. 
Camille has a particular interest in pelvic health for athletes and post-partum return to high-impact sport. She has an integrative and transparent approach and an experienced understanding of how to help achieve your individual goals with physiotherapy.

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  • Female, male and children pelvic health and continence
  • Urinary & bowel incontinence and dysfunction
  • Overactive bladder
  • Pelvic Organ Prolapse
  • Pre- and post-natal care
  • Post-natal return to high impact sport
  • Rectus diastasis
  • Pelvic floor dysfunction and pain
  • Pelvic pain (endometriosis, Genito Pelvic Pain Penetration Disorder including dyspareunia, vulvodynia/vestibulodynia)
  • Sexual pain and dysfunction
  • Pre- and post-op care gynaecological or urological surgery (hysterectomy and prostatectomies), and pelvic radiation treatment
  • Lactating breast: cracked nipples, blocked ducts and mastitis 
  • Breast cancer related cording, joint stiffness, reduced strength and endurance.
  • Musculoskeletal pain including neck, back and pelvic pain
  • Sporting injuries
  • Headaches
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  • Registered Physiotherapist
  • IBCLC Lactation Consultant 
  • Master in Manual Therapy (Australia) 
  • BSc (Hons) Physiotherapy (UK)
  • Dip. Clinical Acupuncture (HKU)
}', 3='{type=string, value=Cantonese, English, Mandarin}', 4='{type=string, value=Wendy is a British trained Physiotherapist who qualified in 2005 and completed the Master in Manual Therapy at The University of Western Australia in 2011. She is also a qualified acupuncturist (Dip in Clinical Acupuncture, HKU). With her interest in sports rehabilitation, she attained a Certificate in Advance Sports Rehabilitation with Manual Concepts (Australia) and became a qualified Clinical Pilates Instructor. Her knowledge, skills and experience give her the expertise to treat the full spectrum of spinal and sports injuries from acute injuries, chronic repetitive overuse problems to post-operative rehabilitation and biomechanical analysis for performance enhancement.

After graduated at King’s College London, Wendy returned to Hong Kong in 2005 and began her career in private practice, but also spent four years gaining invaluable experience working in Hong Kong’s public hospitals. Wendy was the Team Physiotherapist for rugby at the Hong Kong Football Club; the Hong Kong Orienteering Team at the Asian Orienteering Championships in 2014; and part of the physiotherapy team at the ITU Triathlon Asian Cup in 2013.

Over the years of her practice, Wendy has developed a special interest in pelvic health, which motivated her to complete her specialty training in Australia and became a qualified Women’s Health and Men’s Health Physiotherapist. In addition to her orthopedic background, Wendy is able to skillfully treat a full spectrum of pelvic issues in both men and women using both specialist knowledge and skills in pelvic health and a holistic biomechanical approach, which involves assessing the whole body and optimising body alignment to identify the root cause of the problem in order to enable full neuromuscular function. Wendy also uses ‘core’ training (Pilates) principals to formulate the most effective rehabilitation and strengthening program for conditions ranging from post-partum women returning to exercise, to the elite level athlete. As a mother, Wendy understands the demands placed on a woman's body from pregnancy and childbirth. She also understands the changes that a woman's body undergoes from early adulthood to more senior years. She is dedicated to help women both physically and mentally in all stages of life.

Wendy is also committed to support breastfeeding mothers by becoming an International Board Certified Lactation Consultant (IBCLC). Having gone through her own breastfeeding journey, Wendy understands the physical and mental demands that could be placed on a breastfeeding mother. This specialty enables her to assist both the breastfeeding mother and her baby to overcome various issues throughout their breastfeeding journey. Conditions include latch/sucking problem, nipple pain/damage, tongue tie, breast refusal, low/ oversupply, blocked ducts and mastitis etc could lead to early weaning from breastfeeding. Early detection and management of these conditions can successfully optimize the duration of breastfeeding which results in better health outcome to mother and baby both physically and mentally.

Wendy is available to treat any musculoskeletal conditions, sports injuries, women’s & men’s health conditions and pregnancy & breastfeeding issues.}', 6='{type=image, value=Image{width=491,height=615,url='https://www.otandp.com/hubfs/wendy-shum.jpg',altText='',fileId=null}}', 7='{type=list, value=[{id=61148854915, name='null'}]}', 9='{type=list, value=[{id=59518997850, name='null'}]}', 10='{type=number, value=87}', 11='{type=option, value={id=2, name='Health Practitioner', order=1, label='Health Practitioner'}}', 12='{type=string, value=Wendy Shum is a physiotherapist with qualification from Hong Kong and UK. Learn more here. }', 13='{type=string, value=
  • Women’s Health including Urinary or Faecal Incontinence, Pelvic Organ Prolapse, Pelvic Floor Muscle Retraining, Bladder Dysfunction, Dyspareunia (pain during intercourse), Vaginismus and Coccyx Pain
  • Prenatal and Postnatal Issues including Pregnancy Lumbopelvic Pain and Rectus Abdominis Diastasis
  • Breastfeeding Issues - Blocked Ducts or Mastitis
  • Men’s Health
  • Pelvic Girdle Pain
  • Neck and Back Pain
  • Musculoskeletal Conditions
  • Sports Injuries
}', 14='{type=number, value=0}', 22='{type=string, value=WSHUM}', 27='{type=number, value=0}', 28='{type=number, value=1}', 29='{type=string, value=https://www.otandp.com/online-appointment?preferred_doctor=Wendy+Shum&service_category=physiotherapy}', 30='{type=number, value=0}'}, {id=91546677337, createdAt=1667188379991, updatedAt=1705556267160, path='mark-cameron', name='Mark Cameron - Physiotherapist | OT&P Healthcare', 32='{type=number, value=0}', 1='{type=string, value=Mark Cameron}', 2='{type=string, value=
  • Registered Physiotherapist
  • B.Phty of Otago University (New Zealand)
}', 3='{type=string, value=English}', 4='{type=string, value=Mark Cameron graduated from Otago University in New Zealand and moved to Hong Kong in 1995. Growing up in sports mad New Zealand lead him to providing Physiotherapy to a number of International Sports teams and events over the years. Including:
  • Hong Kong Men’s National Rugby Fifteen and Sevens teams. (10 plus years, over 50 matches and 7’s tournaments).
  • Asian and European Golf Tours. (15 plus events). Including Seve Ballesteros Royal Trophy - Europe vs Asia.
  • HK Team Physiotherapist Busan Asian Games. (Covering Hockey and Games Village Clinic)
  • HK Gaelic Football International Tours.
  • International Tennis exhibition tournaments. (Including Pete Sampras vs Andre Agassi)
Mark has made Hong Kong his home the past 27 years and has focused on treating a combination of Sports Physiotherapy, lumbar/cervical pain and post-op rehabilitation. He has a particular interest in providing a treatment that is focused on the individual needs of each patient. Taking them through a complete journey from injury to a pain free active life. Expert treatment, combined with strong patient/physio communication is the key to a great outcome. }', 6='{type=image, value=Image{width=491,height=615,url='https://www.otandp.com/hubfs/mark-cameron.jpg',altText='',fileId=null}}', 7='{type=list, value=[{id=61148854915, name='null'}, {id=153457093927, name='null'}]}', 9='{type=list, value=[{id=59518997850, name='null'}]}', 10='{type=number, value=88}', 11='{type=option, value={id=2, name='Health Practitioner', order=1, label='Health Practitioner'}}', 12='{type=string, value=Mark Cameron is a physiotherapist with qualification from New Zealand. Learn more here. }', 13='{type=string, value=
  • Sports Physiotherapy
  • Back and Neck Pain
  • Post Operative Rehabilitation
  • Dry Needling
  • Personalised Exercise Prescription - all ages!
  • Running Assessments
}', 14='{type=number, value=0}', 22='{type=string, value=MCAMERON}', 27='{type=number, value=0}', 28='{type=number, value=1}', 29='{type=string, value=https://www.otandp.com/online-appointment?preferred_doctor=Mark+Cameron&service_category=physiotherapy}', 30='{type=number, value=0}'}, {id=124115236221, createdAt=1689060224479, updatedAt=1702004194196, path='celia-leung', name='Celia Leung - Specialist in physiotherapy | OT&P Healthcare', 32='{type=number, value=0}', 1='{type=string, value=Celia Leung}', 2='{type=string, value=
  • BSc Physiotherapy (UK)
  • Registered physiotherapist (UK)
  • Registered physiotherapist (HK)
  • Diploma in Modern acupuncture
  • Qualified clinical Pilates instructor
}', 3='{type=string, value=Cantonese, English, Mandarin}', 4='{type=string, value=Celia Leung is a highly skilled and dedicated physiotherapist interested in exercise therapy and sports injury management. Her practice provides high-quality, evidence-based treatments tailored to patients' unique needs and goals.
 
With experience working in both the NHS (UK) and various private clinics in Hong Kong, Celia has had the opportunity to treat patients from all walks of life. She provides various treatment modalities, including acupuncture, exercise therapy, clinical pilates, taping, and manual techniques. Celia also aims to get her patients to engage actively in their recovery through education and setting clear goals.
 
Celia completed her degree in Physiotherapy from Coventry University in 2019. She adheres to the highest professional standards as a member of the Chartered Society of Physiotherapy (CSP) and registered with the Health and Care Professions Council (HCPC). She is dedicated to providing exceptional patient care. Celia enjoys staying active and supporting local sports teams in her spare time.}', 6='{type=image, value=Image{width=982,height=1230,url='https://www.otandp.com/hubfs/Celia%20Leung_Headshot.png',altText='',fileId=null}}', 7='{type=list, value=[{id=61148854915, name='null'}]}', 9='{type=list, value=[{id=59518997850, name='null'}]}', 10='{type=number, value=105}', 11='{type=option, value={id=2, name='Health Practitioner', order=1, label='Health Practitioner'}}', 12='{type=string, value=Celia Leung is a physiotherapist with qualification from Hong Kong and UK. Learn more here. }', 13='{type=string, value=
  • Neck and back pain
  • Acupuncture
  • Musculoskeletal condition
  • Sports injuries
  • Chronic pain management
  • Manual therapy
}', 14='{type=number, value=0}', 22='{type=string, value=CLEUNG}', 27='{type=number, value=0}', 28='{type=number, value=1}', 29='{type=string, value=https://www.otandp.com/online-appointment?preferred_doctor=Celia+Leung&service_category=physiotherapy}', 30='{type=number, value=0}'}]

Topics: 骨科及物理治療

岑韻婷

岑韻婷

註冊物理治療師,擁有香港及英國的專業資格

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