PELVIC FLOOR PHYSIOTHERAPY

 

Pelvic Floor Physiotherapy is a specialized type of physiotherapy treatment dedicated to the assessment and treatment of conditions associated with pelvic floor dysfunction.

What is your Pelvic Floor?

The pelvic floor is a group of muscles located between the tailbone (coccyx) and the pubic bone providing support to our internal organs including: the bladder, bowel, and the reproductive organs in women (i.e. uterus, vagina). Pelvic floor dysfunction is one of the largest unaddressed issues in women’s health; however, men can also be affected.

Pelvic floor dysfunction may include the following conditions: urinary incontinence, fecal incontinence, pelvic organ prolapse, lower urinary tract symptoms, defecatory dysfunction, sexual dysfunction, and chronic pain syndromes, and peri-natal related pelvic pain/weakness.

 

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a specialized branch of physical therapy that focuses on the assessment and treatment of the pelvic floor muscles, ligaments, and connective tissues. The pelvic floor plays a crucial role in supporting various organs such as the bladder, uterus, and rectum, and is integral to functions like bowel and bladder control, sexual function, and core stability. Our pelvic floor physiotherapists employ a combination of manual techniques, exercises, and education to address issues such as pelvic pain, incontinence, pelvic organ prolapse, and sexual dysfunction. Through personalized treatment plans, patients receive guidance on exercises to strengthen or relax the pelvic floor muscles, as well as lifestyle modifications to improve overall pelvic health.

What can pelvic floor physiotherapy help with?

 Both men and women can experience significant improvements through targeted treatments. Pelvic floor physiotherapy can help individuals:

  • Preparing for labor and delivery
  • Recovering from pregnancy and childbirth
  • Managing prolapse and/or experiencing a feeling of downward pressure in the pelvis
  • Addressing bowel and bladder issues, including incontinence and constipation
  • Alleviating pelvic pain
  • Treating pain during intercourse and sexual dysfunction
Do I need a referral from my doctor?

No! You do not need a referral to see a physiotherapist. Some insurance companies, however, need a referral in order to reimburse you.

How many appointments will I need?

Number of sessions ranges anywhere from 1-10+, but averaging about 5 or 6 for most clients. The frequency and duration of required visits depend on the severity of symptoms and whether the issue is recent or chronic. If you are symptom-free and seeking a proactive assessment of your pelvic floor, such as during pregnancy or postpartum, a single visit may be sufficient. 

Can I submit to insurance?

Yes. Our physiotherapists are registered, and we are often able to bill your insurance company directly, on your behalf. We can also provide a standard physiotherapy receipt containing the physiotherapist’s license number for every appointment.

Do I have to have an internal exam?

No! Our pelvic floor physiotherapists are qualified to do internal exams, but they can also get a lot of information from external exams and your history. Sometimes our work is actually helping clients build up to internals (such as a Pap Test), so helping those who are not having internal exams is as much a part of our work as doing an internal.  You are in control of your treatment at all times, and helping you within our scope and your boundaries is our priority.

Why do an internal exam?

Conducting internal pelvic floor exams prove valuable, as they enable us to evaluate both the strength and flexibility of your pelvic floor. These examinations allow for the assessment of potential prolapse or post-birthing issues, providing valuable insights, and allowing us to better tailor your individual treatment plan. They provide an opportunity to offer constructive feedback on proper muscle exercise techniques and, if necessary, administer manual releases for enhanced therapeutic benefits.

Can I come when I am menstruating?

Yes! It is absolutely fine to assess and/or treat you internally while you are menstruating. This is normal for us, however, if the bleeding is heavy and/or you are not comfortable, remember not all sessions need to include an internal anyway, and lots can still be done for you.

When during pregnancy should I come?

A pelvic floor assessment is best during the second trimester, but anytime up until the birth is helpful!

Do I need pelvic floor physiotherapy, even if I had a c-section?

There are multiple reasons why a pelvic floor assessment is beneficial after a c-section. The pelvic floor experiences a lot of stress and change during pregnancy, and if the c-section was not planned, the pelvic floor may have experienced an increase in pressure while you were in labour. Scar tissue from a c-section is connected to your bladder and pelvic floor, and may be linked to increased bladder frequency and discomfort during intercourse later on, if it is not addressed. A diastasis assessment on your abdomen will help determine if some ab rehab is necessary post pregnancy and surgery.

Do you treat men with pelvic floor issues?

Yes. Our services are for individuals of all gender identities, including men with penises and men with vulvas. Our approach covers the entire gender spectrum. Internal assessments for those with penises is through an internal rectal exam. However, it’s worth emphasizing that, just like with all our clients, we have a range of assessment strategies and interventions beyond internal exams.

Pregnancy and Pelvic Floor Physiotherapy

Pelvic floor dysfunction is common during the pre- and post-partum periods. Childbearing can stretch and subsequently weaken the pelvic floor muscles, however PFP can help strengthen the muscle group through a variety of techniques. It is recommended that women see a PFP prior to delivery for pelvic floor assessment, education, rehabilitative exercise, and manual therapy. Post-delivery, women should work with their PFP over a course of 6-8 weeks to increase strength and improve function.

Men and Pelvic Floor Physiotherapy

Urinary incontinence is a major issue in the male population and is most commonly associated prostate surgery. Current research and clinical practice guidelines demonstrate the evidence for PFP in treating male incontinence, especially for pre- and post- prostate surgery.

Children and Pelvic Floor Physiotherapy

Urinary incontinence in children is most often associated with underlying overactivity (over active bladder – OAB). Children with urinary incontinence require a multidisciplinary (team of practitioners) approach which includes PFP. The PFP will help educate both parent and child on normal bladder behaviours, pelvic floor muscle awareness, and bladder voiding mechanics/posture.

Older Adults and Pelvic Floor Physiotherapy

The presence of urinary incontinence increasing with age affecting overall quality of life and independence. In older adults, urinary incontinence may be associated with reversible factors which your PFP may be able to identify and refer you to proper resources (e.g. medical doctor).