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What Exactly is 'Pelvic Health' Physiotherapy?

Updated: Feb 22

Written by: Devonna Truong

Date Written: April 26, 2021

Have you been referred for pelvic health physiotherapy?

Have you known others who have done and benefited from pelvic health physiotherapy?

Are you interested in learning more about it?

We are here to share!

What is it?

Pelvic health physiotherapy is similar to 'typical' physiotherapy, but with a focus on the pelvis and the pelvic floor muscles. This is a growing area in the profession and more people have become aware of the role of the pelvic floor and the importance of it in our health!

The pelvic floor plays a role in your bladder health, bowel health, sexual health, pre-natal/post-partum health and the function of many parts of your body (most directly the thorax, low back, pelvis, hips and knees) as it is a component of your core. Pelvic health physiotherapy is a conservative way to manage issues that the pelvic floor plays a role in.

A physiotherapist who has a focus in pelvic health has sought out professional continuing education opportunities to learn more about how to help patients who are struggling with the many different health concerns that are associated with the pelvic floor. This can include issues with your bladder, bowels, intimacy, pregnancy, labour and delivery, and persistent low back/pelvic/hip/knee pain (see "What can it help with?" below).

We think it's important to emphasize that although there is a focus on the pelvic floor in these appointments, the pelvic floor is a part of the body that functions as an integrated whole with the rest of your body to impact your health outcomes. Many elements of pelvic health physiotherapy overlap with what you would typically expect from physiotherapy, with an additional lens to capture a more inclusive picture of your health.

The song we learned at a young age is true - all the bones (and rest of the body) really ARE connected!

Did you know?

  • Pelvic floor physiotherapy is for children, women and men of ALL ages.

  • Although the list below of "What can it help with?" are common, they are not normal and they can be helped with conservative treatment.

  • Even though you are pregnant or have had a baby, you do not need to "deal with" any of the following at any stage:

    • Peeing your pants

    • Constantly going to the bathroom

    • Back or pelvic pain

    • Constipation

    • Not being able to be as active or strong

  • Pelvic health physiotherapy while you're pregnant or prior to planning for pregnancy is an optimal time to start helping yourself learn and prevent issues from arising! You do not have to wait until you are post-partum.

  • You do not need to have been pregnant/had a baby to have pelvic floor dysfunction!

  • Pain with intercourse/sex often arises from over-tightness of the pelvic floor (and less likely what feels like something hitting your cervix, ovaries or intestines)

    • Same goes for menstrual cramps, this can also often arises from over-tightness of the pelvic floor!

    • Many pelvic pain conditions (such as endometriosis) can be helped and managed with pelvic floor physiotherapy

  • You are not experiencing bladder leakage because you are "getting old" or "hitting menopause", you can work on your pelvic floor at any age to regain and maintain continence.

  • Kegel's are not always the answer, often there might be a different way you might need to learn contract your pelvic floor. In some cases, you are making a tight pelvic floor tighter, which could make your symptoms worse.

  • Pelvic floor physiotherapy is not just about the internal examination, it's about the whole body.

  • Preventative Care: the most powerful tool, and it is so under-utilized and under-recognized - let's change that!

What can it help with?

  • Acute, persistent and/or unexplained pain of the:

    • Low Back

    • Hips/Pelvis/Groin

    • Coccyx (tailbone)

    • Knees

  • Bladder and/or Bowel Incontinence

    • Stress Incontinence: with coughing, sneezing, laughing, jumping, running, etc.

    • Urge Incontinence: with rushing to the bathroom

    • Includes children struggling with day and/or night bladder accidents

  • Bladder and/or Bowel Urgency or Frequency

    • A sudden urge that results in rushing to the bathroom

  • Bladder and/or Bowel Dysfunction

    • Pain with full bladder, urination

    • Stream dysfunction (difficulty initiating, stop/starting, post-void dribbling)

    • Pain with bowel movements, Constipation, Hemorrhoids

  • Pain/pain conditions in the pelvic area - with or without sexual activity

    • Painful menstrual cramps or pain with ovulation

    • Endometriosis

    • Interstitical Cystitis

    • Cliterodynia

    • Vaginissmus (pain with insertion)

    • Vulvodynia (vulvar/vestibule pain)

    • Lichen sclerosus/planus

    • Testicular/Penile pain

    • Chronic prostatitis

  • Pelvic Organ Prolapse (bladder, uterus, rectum)

  • Post-Surgical or Intervention Rehabilitation

    • C-Section

    • Hysterectomy

    • Prostatectomy

    • Radiation Treatment of Pelvic Organs

  • Preventative Care for Pregnancy, Labour and Delivery

    • Strengthening

    • Preventative Care

    • Labour and Delivery Strategies

  • Post-Partum Rehabilitation

    • Rectus Diastasis

    • C-section Rehabilitation

    • Episiotomy/Tearing Care

What can you expect from the Initial Assessment and how can I prepare?

At the Initial Assessment:

  1. You will be able to tell us your story, share your concerns and name your goals!

  2. We will listen and learn about all you have to share within your comfort.

  3. We will be able to discuss the anatomy of the pelvis, pelvic floor and all that relates to it - as specific to you as possible. I will do my best to answer your questions and address your concerns.

  4. If you are comfortable, we will perform an objective assessment:

    1. External: we will assess how you move naturally, your joint/muscle/nerve mobility, how these systems integrate together to contribute and impact your symptoms

    2. Internal: with a glove and lubricant, an internal digital examination (vaginal and/or rectal) is performed to be able to assess the pelvic floor muscle tone, strength/coordination and reproduction of your symptoms

  5. You will hopefully leave feeling informed, empowered and heard

Please note:

  • The internal examination is not mandatory and is only done with your consent. It allows us to give us the full clinical picture of the pelvic floor, but this does not have to be done on the first day, the second day, or ever at all. There is lots that can be done externally to help the pelvic floor (all connected, body is one whole)!

  • We can try our best to plan our lives, but we can't always plan Mother Nature! We do perform internal examinations even when women are on their period, but you have our full respect if you are not comfortable with this and we can focus on many external components to your care.

How can you prepare?

  • Wear comfortable, stretchy clothing for the external examination that will allow you to freely move (you are welcome to bring a change of shorts as well)

  • Reading this blog post is awesome prep - way to go!

  • Any form of self-care you feel necessary in preparation for an internal examination so that you can feel as relaxed and comfortable as possible in our session!

What can you expect from treatments moving forward?

Treatment is tailored specifically to your assessment findings and your goals from the sessions, this is different for everyone. Some individuals will require treatments that require internal examinations, some don't!

Last thing...

We recognize that this is often a vulnerable, taboo, emotional and sometimes difficult topic to talk about and address. Your comfort and choice with your own body is the most important piece for us, so you have choice to continue or stop at every single stage of our session. Your voice is important.

More questions?

Please feel free to reach out via the contact form on the "Contact Us" tab of our website

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