Pelvic Health Physiotherapy
What is Pelvic Health Physiotherapy?
Pelvic floor physiotherapy involves specialized assessment and treatment for pain and dysfunction of the pelvic floor. It includes a comprehensive assessment of the function and quality of your pelvic floor to diagnose, treat, and help optimise muscle, nerve, and joint function to help improve quality of life. The goal of treatment is to improve whole body function including soft tissue, muscle, joint, and nerve function using strengthening exercises, education, therapeutic modalities like TENS or heat, stretching, manual or hands-on treatment, and lifestyle changes.
What is Your Pelvic Floor?
It is a group of muscles and connective tissues within the bottom of your pelvis between your tailbone and pubic bone.
The muscles run front to back and side to side, attaching to the front of your pelvis, the sides of your pelvis, and your tailbone. They have several functions including supporting your organs, working to maintain bladder and bowel continence, helping with lymphatic flow, and aiding in sexual functioning. Since the pelvic floor has a large muscular component, it is important to ensure the muscles are coordinated, flexible, and strong enough to do all their jobs properly. The pelvic floor muscles should be able to contract when necessary but also be able to relax to function properly.
What is Pelvic Floor Dysfunction?
The muscles in the pelvic floor can become too tense or become weak. Symptoms can include pelvic, back, or hip pain, bladder or bowel incontinence, increased urge to pee, constipation, and feeling of pressure or bulging at the bottom of your pelvis. This often can occur prenatally, after childbirth, or after surgery. Dysfunction can also develop over time in people with low back, hip, or pelvis pain. Pelvic floor dysfunction can have a large effect on quality of life, but it is a very treatable condition. Any person can experience pelvic floor dysfunction and we are a gender inclusive clinic. If you are experiencing any of these symptoms it would be beneficial to book in with our pelvic health physiotherapist for an evaluation.
What to Expect on Your First Visit?
First, we will provide you with intake forms to fill out before your session. It is important to fill these out in full so we can have a good understanding of your health history. Your initial assessment will then begin with the physiotherapist taking a full health history and will include the physiotherapist asking questions to learn your health concerns and goals for treatment. Next, the physiotherapist will explain the options for a physical exam. This examination may involve assessing movement, strength, and mobility of the muscles surrounding the lower back and hips. If indicated and if you are comfortable with having an internal exam, the physical exam may involve an internal assessment where the pelvic floor physiotherapist assesses for any tenderness, weakness, or dysfunction in the pelvic floor and areas around it. An internal examination does not need to be done on the first appointment. You and your physiotherapist may choose to wait to do this examination later or not at all. The reason why an internal examination is performed is because an internal exam is considered the gold standard assessment to evaluate the function and quality of the pelvic floor. It is possible to only do an external assessment of the pelvic floor or to forgo internal or external exams altogether, but there are limitations in not performing an internal examination. Without an internal examination, it is hard to gauge the ability of the pelvic floor to appropriately contract or relax and we cannot get a comprehensive measure of strength. If you are uncomfortable with the idea of an internal examination, please let your physiotherapist know as there are alternative options to an internal exam and an internal exam is not mandatory.
After the physical assessment is done, we will work with you to determine the best treatment options and begin treatment. All treatments are highly individualised and tailored to your specific needs, goals, and concerns. It is important that you continue to engage in your exercise program as prescribed to receive the best outcome.
Frequently Asked Questions
Yes, we can still perform internal exams or treatments when you are menstruating. We can
also focus more on non-internal work, exercise, and other treatments as needed.
Yes, an IUD is not a barrier to receiving pelvic floor physiotherapy sessions.
It is common to be nervous and we will do our best to minimize any fears or concerns you may have at the start of the appointment. We will decide together what part of the assessment you are comfortable with after we take a full history and come to understand your concerns. Your physiotherapist will explain the benefits and risks before you decide whether you want to proceed with an internal examination if indicated. An internal or external examination is only done if you feel comfortable with these types of examinations and provide consent for your pelvic floor to be assessed. The physiotherapist will leave the room so you can undress from the waist down and lie on the treatment table. You will be provided with a drape sheet. You can bring one support person to the appointment if desired. It is your decision whether to proceed with an internal examination after all assessment options are explored and all your questions are answered. If you and your physiotherapist decide to continue with an internal exam, the examination is performed manually with one or two gloved fingers inserted into the vagina and/or anus with the use of gel lubricant. This exam is done to assess the strength, tone, mobility, and coordination of the pelvic floor muscles to determine if there is any possible dysfunction. The physiotherapist explains each step of the process and gets consent at each step. The examination is done one-on-one in a private room. The pelvic floor physiotherapist is trained to the experience as gentle as possible. You can revoke your consent at any step of the process for any reason.
No, you do not need a referral to book an appointment. However, your insurance plan may require a doctor’s referral. You may want to check your insurance details before booking in to ensure coverage.
- Low back or hip pain
- Urinary or bladder incontinence (leakage)
- Urinary or bladder urgency (needing to pee too frequently)
- Bowel or fecal incontinence
- Constipation
- Pelvic organ prolapse
- Pelvic pain
- Postpartum recovery
- Diastasis recti
We can treat anyone from young to older adult and of all levels of physical abilities. Our pelvic floor physiotherapist is experienced in working with athletes, too!