What is the Pelvic Floor?
The pelvic floor is made up of muscles, ligaments, nerves and connective tissues and is an essential component of your “core” muscles. They help to support your lower back (preventing low back pain with function), maintain continence of bowel/bladder, allow for sexual function and pleasure and provide support for internal organs (bowel, bladder, uterus).
Understanding the function of these muscles and how we can make them perform better has a massive return on the full body and your overall life.
Rehabilitation to the Pelvic Floor?
Pelvic floor physiotherapy intends to strengthen the pelvic floor muscles to treat pelvic floor dysfunction in females and males. Treatment is recommended for patients experiencing a range of symptoms such as Urinary leakage, hip, back or pelvic pain, constipation or pain during intercourse are just some of the conditions that pelvic floor physiotherapy can help with.
Why visit a Pelvic Floor Physiotherapist?
Pelvic floor physiotherapy aims, as its name suggests, to rehabilitate the all-important muscles lining your pelvic floor. These are the muscles you use whenever you control an urge to urinate or defecate; they support the uterus, bladder and rectum.
Pelvic Floor physiotherapists have specialized training in treating range of conditions:
- Urinary incontinence or painful urination (Leaking with coughing/sneezing/running)
- Constipation, straining, or pain with bowel movements
- Pain during or after intercourse
- Unexplained pain in your pelvic region, lower back, hips, or genital area
- Muscle spasms in the pelvis
- Pelvic organ prolapse
- Pelvic Pain
- Dysmenorrhea (pain before or during menstrual periods)
- Dyspareunia, or pain associated with intercourse, can be experienced during penetration
- Vulvodynia- is a broad category of pelvic pain that can be broken down into smaller subset diagnoses. They include: 1) Vestibulodynia (pain at the vestibule or “entrance” of the vagina); 2) Vulvodynia (pain in the superficial tissues of the vulva, particularly the labia majora and minora) and 3) Clitordynia (pain at the clitoris)
- Sacro-iliac Joint or Pelvic Girdle Pain
- Interstitial Cystitis, also known as Painful Bladder Syndrome
- Hypotonicity (Weak pelvic floor muscles)
- Hypertonicity (Tight pelvic floor muscles)
- Anal incontinence ( unwanted passage of gas (flatal incontinence) or solid or liquid feces (fecal incontinence)
- Urinary incontinence
- Postpartum incontinence
- Inflammatory bowel disease or irritable bowel syndrome
- Rectus Diastasis (a separation in the rectus abdominis, also known as the “6-pack” muscle. It most often occurs during pregnancy)
What to Expect on Your First Visit
Prior to seeing your physiotherapist, you will be asked to fill out a health intake form, as well as one or more questionnaires regarding your current condition. This gives your physiotherapist a better understanding of your health history and how pelvic health dysfunction is affecting your life.
Pelvic floor physiotherapy session are held in a private, comfortable room where your privacy is a top priority.
Your certified pelvic floor physiotherapist will begin by asking a series of questions regarding your health history and your current condition.
Following this discussion, your physiotherapist may recommend performing an external and/or internal (vaginal and/or rectal) examination. During the internal exam, the ability to contract and relax the pelvic floor muscles will be assessed, as well as how these muscles work together with the rest of your body. Assessing the joints, mobility and strength of the lower back, hips, and sacro-iliac (SI) joints are also an important part of the pelvic floor assessment.
Based on the information given on your health history, your description of symptoms and an examination, your pelvic floor physiotherapist will then recommended the most effective course of treatment for your needs.
Why is an Internal Exam Important?
An internal exam is not mandatory; however, it is the gold standard to assess how your pelvic floor muscles and the connective tissues within your pelvis are working. The pelvic floor muscles are internal muscles and are difficult to properly assess externally. Although it is common for people to blame pelvic issues on weak pelvic floor muscles, that is not always the cause of the problem-- sometimes, these muscles can be tight which can be the root of the problem. Without an internal exam, it is impossible to know exactly what is going on.
Research has found that verbal and written instructions of pelvic floor exercises (think: Kegels) are not enough. People are not understanding how to activate their pelvic floor muscles and are often doing exercises incorrectly. An internal exam allows your physiotherapist to recommend the appropriate exercises for you individually and to help ensure you are performing them correctly.
Men’s Pelvic Floor Conditions
For men- What can I expect from a pelvic floor physiotherapy appointment?
You will be asked about your issue and how it impacts your life. The physiotherapist will also ask questions about previous and current medical conditions, past or up-coming surgeries, medications that you are taking, bladder and bowel habits, as well as sexual function.
There is an external and internal exam
During the external assessment, the physiotherapist will assess your posture, breathing, flexibility of the spine, pelvis, hips and knees, and the strength of your core, buttocks, and muscles around your pelvic floor and tailbone.
Sometimes is also necessary for an internal assessment for men. This is a rectal exam to examining the muscles, tissues and skin of the thighs, buttocks, abdomen and pelvic floor internally. No instruments are used during the exam. The physiotherapist will assess for muscular strength, endurance and tonus.
Even If an internal exam or internal treatment is recommended, clients still have the right to refuse an internal exam during the assessment or follow-up treatments. The physiotherapist will discuss it with you.
After the assessment, a personal tailored treatment plan is developed. The treatment can be with an education component, manual therapy, home exercises programs, therapeutic ultrasound, electrotherapeutic modalities, tape techniques or any other physiotherapy technique.
Treatments follow-ups are usually between 30 and 45 minutes.
Frequently asked questions:
Do I need a referral?
You don't need a physician’s referral to see a pelvic floor physiotherapist. However, some health insurances require a referral.
Can I visit a Pelvic Floor Physiotherapist while I am Pregnant?
Yes. Though If you have been told by your doctor or midwife that you are restricted from having sexual intercourse during your pregnancy, an internal exam will not be completed. If you are on no restrictions, it can often be very beneficial to have an internal exam during pregnancy so that you can better prepare your muscles for delivery and post-delivery. If you have been placed on restrictions and/or are uncomfortable with an internal assessment or treatment, there are still many other ways we can treat pelvic floor dysfunctions. Your physiotherapist can discuss this further with you.
How long are my appointments?
Initial assessments are approximately 60 minutes in length. Follow-up appointments can range anywhere from 30-45 minutes depending on your needs.
Late Client Policy
The goal of the physiotherapist is to make every physiotherapy assessment or treatment session efficient, enjoyable and stress-free. Late patients impact the quality of care by reducing patient time with the physiotherapist. If you’re late, The physiotherapist will make every effort to see you for the remainder of the scheduled time. However, the full fee will be charged for this appointment. Thank you for your understanding and cooperation.
Pelvic Floor Physiotherapy- Pricing
60 minute initial assessment - $140
45 minute subsequent visit- $110
30 minute subsequent visit- $85
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