Pelvic Health Physiotherapy

person during a physiotherapy session Pelvic health physiotherapy is a specialized area of physiotherapy that assesses and treats both women and men with problems in and around the pelvis.

Part of this includes the pelvic floor, which is made up of joints, ligaments, nerves, and muscles. The muscles attach to the front, back and sides of our pelvic bone and sacrum.

Why Is This Important?

Everything that happens in our pelvic floor is the basis of human need. They help control bladder and bowel function, provide support to our pelvic organs, and are involved in our sexual function. They are also part of our deep “core muscles” that work together with the back, abdominals, and diaphragm providing stability and support for a healthy back. Like any other muscles in our body, they too can become weak or tight leading to pain and dysfunction.

Weakness can contribute to urinary incontinence, prolapse, or a weak core. Tightness can cause issues such as urge incontinence, constipation, pelvic pain, or pain with intercourse, just to name a few. Sometimes this can be caused by pregnancy, childbirth, strenuous activity, low back or hip pain, or post surgery.

Did You Know?

Research has shown that the treatments carried out by a physiotherapist for pelvic floor problems are highly successful for both pelvic pain and incontinence. The Cochrane Collaboration 2010 concluded, “physiotherapists with specialized training in pelvic floor rehabilitation should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence.”

In Europe, internal examination of the pelvic floor has been the gold standard by which treatment of the pelvic floor has been carried out for more than 30 years. Women in France and other government-funded European countries are given 10 free physiotherapy sessions after childbirth to help ‘re-educate’ their pelvic floor.

Conditions We Treat

Urinary Dysfunction

Stress Incontinence
Urinary Urgency
Urinary Frequency
Nocturia

Bowel Dysfunction

Constipation
Pushing or Straining with Bowel Movements
Feeling of Incomplete Bowel Movements
Irritable Bowel Syndrome
Hemorrhoids

Pelvic Pain

Vaginal Pain
Vulvar Pain
Vulvodynia
Dysmennorhea
Endometriosis
Tailbone Pain
Low Back Pain
Hip Pain
Interstitial Cystisis
Pudendal Neuralgia

Sexual Dysfunction

Dyspareunia (pain with sex)
Genito-Pelvic Pain/Penetration Disorder
Vaginismus
Pain with Orgasm

Pregnancy & Postpartum

Prenatal exercise: tailored, one-on-one
Postpartum Painful sex
Sacroiliac Joint Dysfunction
Pubic Symphysis Dysfunction
Diastisis Recti
Vaginal and/or C-section scars
Pelvic Organ Prolapse

Genitourinary Syndrome of Menopause

Incontinence
Painful sex
Pelvic Organ Prolapse
Pelvic issues and/or pain

Frequently Asked Questions

How do you test for this?

Like any other body part, such as the shoulder or ankle, assessment findings work best when we can see and test it. Because these muscles are located internally via the vagina or rectum an internal exam is performed using 1-2 gloved fingers.

This allows us objectively to test for strength, tightness, or timing coordination dysfunction providing valuable information for diagnosing and treatment.

Are kegels the solution?

Most of us have heard of Kegels however they are not the answer for everyone. Depending on your condition they can do more harm than good by worsening symptoms, and often they are performed incorrectly.

Pelvic health physiotherapists can determine if they are appropriate for you and if so, how to do them correctly and when.

What is treatment like?

Treatment varies from person to person. It can include:

Connective tissue massage, gentle trigger point release to normalize tight & painful muscles
Strengthening exercises
Bladder and bowel re-training
Manual therapy techniques to joints
Alignment and posture awareness/breathing mechanics
Home exercise program
Nervous system re-training (examples: for muscle coordination, reducing pain, stress management)

Feel Better at Lorne Park Integrated Health