Pelvic Health
Physiotherapy
Pelvic floor physiotherapy is the assessment and treatment of the group of muscles involved with your urinary, bowel and sexual function.
What is Pelvic Health Physiotherapy?
It is more than just doing your kegels! Pelvic floor physiotherapy is the assessment and treatment of the group of muscles involved with your urinary, bowel and sexual functions, as well as core stability. The pelvic floor muscles attach from your pubic bone to the tail bone (front to back) and sit bones (side to side). They act as a trampoline and are required to support your bladder/uterus/rectum, stabilize your low back/pelvis, and close the openings where urine and stool come out. The goal of pelvic floor physio is to help resolve and prevent the common pelvic dysfunctions that many of us have been told are a normal part of aging or pregnancy.
What to Expect
During the initial assessment, there will be a detailed history taking, an external exam, and if indicated, an internal examination. The external will consist of assessment of postural alignment, strength, and how much movement you have in your low back, hips, and pelvis. Breathing patterns are also analyzed. How you breathe and breath awareness is important because the diaphragm, core, and pelvic floor work together. Many people breathe incorrectly or hold their breath, which profoundly affects the function of the pelvic floor.
An internal examination is completed vaginally and/or rectally. The internal exam provides information on the strength of your pelvic floor muscles, can identify trigger points, and determines how the pelvic floor is functioning. The goal of the session is to evaluate symptoms based on personal boundaries and to NOT create a painful response.
Based on assessment findings, each client will be given a personalized treatment plan. This may include education with visual aids, exercises, manual therapy, activity modification, and relaxation practices.
Follow up sessions will focus on treating the root cause of the symptoms through hands on manual therapy, exercises, breathing techniques, and more!
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FAQs
Who would benefit from Pelvic Floor Physiotherapy?
ANYONE! Or just about anyone. Did you know that 78% of women with low back pain report a pelvic floor dysfunction? Individuals who may benefit from pelvic floor physio include people with unresolved low back pain, unexplained hip pain, tailbone pain, pelvic organ prolapse (POP), incontinence (leakage), constipation, internal pelvic pain (pain with intercourse, vaginismus, interstitial cystitis), pre and post natal women, post-menopausal women, men who are experiencing chronic pelvic pain, post-prostatectomy, and anyone who has undergone pelvic or abdominal surgery.
What are some conditions that would indicate a Pelvic Health Physiotherapy assessment?
Pelvic Health physiotherapists often treat and help prevent: unresolved low back/SIJ/pubis symphysis pain, coccydynia (tailbone pain), diastasis recti (abdominal separation), painful sex (Dyspareunia), pre and post natal women, pelvic organ prolapse (POP), incontinence (urinary or fecal leakage), constipation, pelvic pain (vaginismus, interstitial cystitis, endometriosis), men who are experiencing chronic pelvic pain (post-prostatectomy), unexplained hip pain, and anyone who has undergone pelvic or abdominal surgery.
What is an internal exam? What does it entail?
An internal examination is the assessment of your pelvic floor strength, tone, laxity, coordination, and connective tissue. To complete the internal exam, the physiotherapist will leave the room for you to undressed from the waist down and have you lie on the treatment table. A cover sheet will be provided. Using non-latex gloves and a sterile surface for lubricant, the physiotherapist will insert one or two gloved fingers into the vaginal canal and/or rectum. The physiotherapist will explain and ask for consent prior to each step of the assessment. **This exam is completed IF you are not experiencing acute pelvic pain, feel comfortable, and consent to the examination.**
Do all sessions require an internal examination? Do I have to have one?
No. An internal pelvic exam is not mandatory, but is the gold standard to assess how your pelvic floor muscles and connective tissue are working. An internal exam may be recommended to further investigate and evaluate symptoms, but this is based on comfort. The physiotherapist will discuss pros and cons to the internal component and give feedback throughout the assessment to allow a better understanding of the assessment findings. Often, external treatment options are taken after the assessment is completed, so an internal examination is not indicated for every follow up session. **You will always be asked to provide consent before any assessment or treatment is provided and you are welcome to remove your consent at any time.**
Do I need a doctor’s referral to see a Pelvic Health Physio?
In British Columbia, you are not required to have a referral in order to see a Pelvic Health Physiotherapist. If you plan to use extended health insurance for the session, it is recommended you contact your insurance company to find out if you need a referral from your physician in order to receive reimbursement for physiotherapy. Pelvic Floor Physiotherapy is included within the physiotherapy portion of your health benefits.
How many sessions of Pelvic Health Physiotherapy will I need?
The number of sessions needed will vary depending on your condition, the nature of the problem/complexity, and personal goals. In general, you can expect anywhere from 6-12 treatments, but the physiotherapist will discuss the optimal number of sessions needed to achieve your goals as effectively and efficiently as possible.
What should I wear to my first appointment?
You do not need to wear anything specific, but comfortable clothing is encouraged. It is best to wear loose fitting or flexible clothing to allow the physiotherapist to get a sense of your body’s mobility.
Should I make an appointment before, during, or after pregnancy?
It is recommended to book an assessment after your first trimester (around 13 week’s gestation). The strengthening of the pelvic floor and core muscles is encouraged after your first trimester. Around 34 week’s gestation, the emphasis is on preparation for labour and delivery. After the baby arrives, we recommend waiting 6 weeks to ensure your body has had some time to heal and you have seen your family doctor for a postpartum follow up.
Contact Us
179 West 2nd Avenue
Vancouver, BC V5Y 1B8
Tel: 778.819.6565
Email: info@focusphysio.ca
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