Pelvic Health

What is Pelvic Health Physiotherapy?

Pelvic health physiotherapy is the assessment and treatment of various conditions and issues relating to pelvic floor muscles and surrounding pelvic girdle area. The pelvic floor is a group of muscles that attach from our coccyx (tailbone) to our pubic bone and ischial tuberosities (sits bones).  They provide support for our internal organs such as bladder, uterus, and rectum.

A pelvic health physiotherapist has been trained to do an internal and external evaluation of the pelvic floor muscles and is Rostered with the College of Physiotherapists to perform this type of assessment and treatment.  Please check out the college of physiotherapists for a qualified physiotherapist near you http://www.collegept.org/Home

Who should see a pelvic health physiotherapist?

We can see women and men who have any of the following issues or conditions:

  • Incontinence, urgency or frequency of the bowel and/or bladder
  • Pre- and post-partum pelvic pain
  • Organ prolapse
  • Sexual pain and dysfunction
  • Persistant pelvic pain
  • Diastasis recti
  • Vaginismus
  • Constipation
  • Men’s pelvic health including: post prostatectomy, prostatitis, chronic pelvic pain syndrome (CPPS) or chronic non-bacterial prostatitis
  • Back and sacroiliac joint pain that has not responded to previous treatments
  • Overactive bladder
  • Many other pelvic conditions

What is involved with an assessment?

The assessment typically involves a questionnaire to be filled out prior to arrival so that you will have an awareness of some of the questions and topics we will be discussing. The subjective exam will be an opportunity for you to discuss your concerns and what brings you to physiotherapy. The objective exam may involve a postural, lower back, hip, sacroiliac joint, pubic symphysis assessment. With your consent, an external and internal assessment may be conducted which will be discussed in greater detail during the assessment.

What does a treatment consist of?

Depending on the Assessment findings, the following are some treatment options:

  • Pelvic floor muscle strengthening
  • Connective tissue mobilization
  • Myofascial trigger point release
  • Biofeedback
  • Electrical muscle stimulation
  • Home exercise program
  • Education
  • Bowel or bladder diary
  • Guided relaxation techniques
  • Mobilization/manual therapy of the lumbar spine, hips, coccyx, sacroiliac joints

Should I consult with a Pelvic Health Physiotherapist during pregnancy?

If you are experiencing any of the following, consult with a Pelvic Physiotherapist:

  • pain in your pubic bone, groin, back, pelvis, buttocks, or legs
  • leaking urine, gas, or stool when you laugh, cough, sneeze, or walk
  • pain with intercourse
  • bulging or tenting of your abdomen when you lift your head off a pillow
  • pelvic girdle pain with doing your everyday tasks such as rolling over, walking, or getting in/out of a vehicle
  • develop vaginal varicose veins
  • any concerns or questions about preparing for labour and delivery

What does the research say about Pelvic Floor muscle training during pregnancy?

Women who did pelvic floor muscle training (PFMT) between 20 and 36 weeks of pregnancy had a lower rate of prolonged second stage labour than women who did no training, less pregnancy-related low back and pelvic pain than those who did no training, less likely to have urinary incontinence at 36 weeks of pregnancy and 3 months post-partum

  • The National Institute for Health and Clinical Excellence (UK, 2006) recommends that all women should be taught by a therapist how to perform pelvic floor exercises during their first pregnancy.
  • Postnatal Pelvic Floor muscle training significantly reduces urinary incontinence compared to routine postnatal care (Glazener et al 2001, Chiarelli and Cockburn 2002)

Should I consult with a Pelvic Health Physiotherapist Post-Partum?

If you are experiencing any of the following after pregnancy 6 weeks post-partum, consult with a physiotherapist:

  • Diastasis recti- separation of the rectus abdominal muscles
  • Leaking urine, stool or gas when you cough, sneeze, laugh, exercise, etc
  • Pain with intercourse
  • C-section scarring, episiotomy or tearing
  • Heaviness in your abdomen, pelvis, rectum or vagina
  • Pelvic girdle pain
  • Difficulty emptying your bowel or bladder
  • constipation

Is this type of therapy covered by extended health benefits? Do I need a Doctor’s referral?

This is covered through physiotherapy benefits. A doctor’s referral is not necessary to see a registered physiotherapist but it may be required by your insurance company. We always advise our patients to check with their provider so they know how much they are covered for.