What is your pelvic floor? The pelvic floor is a group of muscles that sit at the base of the pelvis and provide support for some important organs such as your bladder, rectum, and uterus. Your pelvic floor performs an important role in bowel and bladder function, sexual function, birthing, and stability of your spine.
What is pelvic floor physiotherapy? Pelvic floor physiotherapy is the assessment and treatment of the pelvic floor, with the aim to improve or optimize its function, which is very similar to any other physiotherapy! An assessment typically includes:
- A detailed subjective history with special attention to gynecological history, prostate/penile health, bladder symptoms, and digestion and bowel function, as it applies;
- An external exam to assess muscle length, strength, and function of the hips, back, pelvis, and abdomen;
- An internal vaginal and/or rectal exam to assess muscle length, strength, endurance, reflexes, and function of the pelvic floor.
Once the assessment has determined the root cause of your problems, a treatment plan can be put in action to address the contributing factors. Treatment may include:
- Exercises specific to you (such as stretching, strengthening, breathing)
- Lifestyle modifications
- Mindfulness practice
- Self-treatment techniques
- Manual therapy
Our goal through Pelvic Floor Physiotherapy at Active Solutions Health + Sport is to provide a safe and supportive environment for all people in all stages of life to take control of their pelvic health. In using a biopsychosocial approach and a trauma-informed lens, we aim to help you improve your quality of life and feel empowered with knowledge of your own body and its capabilities.
Conditions we treat:
- Urinary incontinence and bladder control issues
- Fecal incontinence
- Pelvic organ prolapse (prolapse of the bladder, uterus, or rectum)
- Hip, low back, and pelvic pain
- Pregnancy related pain
- Diastasis recti
- Pelvic scar tissue
- Dyspareunia and Vaginismus (painful intercourse)
- Interstitial cystitis (painful bladder)
- Dysmenorrhea (painful periods)
- Prostatectomy-related pain and dysfunction
- Pudendal neuralgia
Common questions, comments, and concerns:
1. When is a good time during my postpartum recovery to see a pelvic floor physiotherapist? 6-8 weeks after baby is born is typically when an assessment is recommended to assist in your recovery and address your concerns.
2. I already do kegels regularly – what more can be done? Kegels are not for everyone and may actually be making your issue worse! Even when they are indicated, they are very often not done correctly. An internal exam provides us with the information to decide whether your pelvic floor is hypertonic (too much tension, possibly tight) or hypotonic (not enough tension, possibly weak) and whether kegels are an appropriate exercise for you. Further, internal palpation is key to ensuring kegels are being done correctly!
3. Do you really have to do an internal exam?The information gathered during an internal vaginal or rectal exam is invaluable to properly diagnosing the issue and guiding you on the quickest recovery possible. The process can understandably make you feel nervous and vulnerable! We recognize this, and do everything we can to make you feel comfortable; we take it slow, provide explanations along the way, check in on your comfort regularly, give you the option to watch and participate with a mirror, and will never proceed if you don’t feel completely comfortable doing so.An alternative is to do an external assessment and provide you with education and exercises based on this and your subjective history.
4. What if I’m menstruating?Totally fine! Our bed set-up is ready for your assessment, whether you are menstruating at the time or not, and our pelvic floor physiotherapist is comfortable to assess during menses. If you are not comfortable doing so, we can proceed without an internal exam.
*DID YOU KNOW: many extended medical benefit plans cover all or some of the cost of visiting a registered physiotherapist – check your plan to find out whether you are covered.