What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a division of physiotherapy that addresses pelvic floor dysfunction. Pelvic floor muscles may become stretched during childbirth, weak during aging, hypertonic with increased stress, or damaged with surgical intervention or trauma, eventually leading to pelvic floor dysfunction. A pelvic health physiotherapist will develop an individualized treatment plan to improve pelvic floor muscle strength, endurance, power, and relaxation. Depending on the goals of the patient, treatments will be focused on restoring of all of the 5 functions of the pelvic floor – support, sphincteric, sexual, stability, and sump-pump.

Did you know?

• 1 in 4 women and 1 in 9 men have urinary incontinence.

• Although it is common, it is a misconception to think that urinary leakage is normal after childbirth or as you age.

• It is normal to urinate 5-8x/day and once at night over the age of 55. 

• 96% of people with lower back pain also have pelvic floor dysfunction – and in these cases the pelvic floor is often too tight.

• Your tailbone should be able to move by ~30 degrees

• The pelvic floor has 5 functions; support, sphincteric, sexual, stability, and sump-pump

• The pelvic floor and bladder muscles work together – when one contracts the other relaxes. 

What kind of issues can pelvic floor physiotherapy help with?

Research has shown that pelvic floor physiotherapy can improve or cure symptoms of urinary or fecal incontinence, pelvic organ prolapse, peripartum and postpartum pelvic floor dysfunction, bladder pain syndrome, endometriosis, pelvic floor myofascial pain, dyspareunia, vaginismus, vulvodynia, and persistent genital arousal disorder.

What are the risks?

The risks associated with pelvic floor physiotherapy are rare, but include minor bleeding or mild reaction to the water-based lubricant. An internal examination will not be performed if you are uncomfortable with this form of assessment/treatment, you are pregnant and your doctor has restricted sexual intercourse, you have an active infection, or are less than 6-weeks post-operative. 

What does a typical pelvic health assessment include?

Your appointment will begin with your story. Your physiotherapist will ask open ended questions to gather information on your symptoms, things that make your symptoms better or worse, past medical history, and goals for treatment.

After gathering subjective information, your physiotherapist will evaluate your posture, lower back, pelvis, and lower extremity. Your physiotherapist may evaluate the way you breathe, muscle recruitment patterns and tone of the muscles of the abdomen, hips, glutes, and thighs.

The internal assessment may involve vaginal and/or rectal palpation to evaluate prolapse, sphincteric function, muscle tension/strength/endurance, tailbone mobility, episiotomy/scarring, and more! 

What does a typical pelvic health treatment include?

All treatments are individualized; however, it is safe to say that each pelvic health treatment will include education, manual therapy, and exercise, with occasional use of modalities. 

The education piece may include information on bladder or bowel function, irritants, constipation, lifestyle factors, toileting positions, and recommendations for at home.

Exercises will include strengthening, endurance, coordination, and/or muscle relaxation, depending on the dysfunction. The physiotherapist will use cuing and biofeedback to facilitate proper muscle recruitment and ensure that the patient has confidence to continue their exercise program at home. Written exercise instructions with/or without a recording will be given at the end of the appointment.

Physiotherapy and osteopathic manual techniques will be used to facilitate proper structure and function of the pelvic floor and associated structures, such as the lower back. 

The treatment may also include modalities such as acupuncture, functional dry needling, taping, and/or ultrasound therapy.

If you would like to book a pelvic health assessment, call (902) 406-7200 or book online.

We look forward to helping you reach your goals!