Pelvic Health Physiotherapy 

The pelvic floor is a group of muscles, lymphatics, nerves and connective tissue located inside the bottom of the pelvis. Everyone has a pelvic floor; females and males of all ages! Imagine a hammock at the bottom of your pelvis, holding you together!

A healthy pelvic floor works to:

• Support the pelvic organs (bladder, uterus, bowels); as it is a basket of muscles at the bottom of our pelvis that support organs against gravity, as well as intra-abdominal pressure
• Using sphincters that connect the inside of the body to the outside world, the pelvic floor helps hold in and let out urine, gas or feces as necessary
• Maintains sexual function and satisfaction (orgasms), blood flow to the sexual organs as well as structure and rigidity of the vaginal walls and the penis
• Works with other muscles that attach to the pelvis to support our daily movement & exercise
• Supporting the sacroiliac joint, pubic symphysis, sacrococcygeal joints, and offloading the lumbar spine and hip joints
• Houses & holds a growing baby and allows for childbirth; but can also be a physical (mechanical) barrier to fertility – which may need addressing

Contact your pelvic health physiotherapist if you experience any of the following symptoms:

• Leaking urine from the bladder, feces or gas from the rectum (with exercise or intra-abdominal pressure such as laughing or coughing OR without cause)
• Feel a sudden urge to empty the bladder or bowel that is difficult/impossible to control; or almost-making it to the bathroom but not quite
• Incomplete bladder or bowel emptying or feeling incompletely emptied
• Post void dribbling of urine in males or females
• Pressure or heaviness in the abdomen or pelvis (pelvic organ prolapse)
• Painful and/or uncomfortable sexual intercourse

During pregnancy:

• To identify/address signs of a pelvic floor that needs some attention
• Due to pelvic, hip, low back, or sacroiliac (SI) joint pain
• To work on pelvic floor muscle strength and relaxation in preparation for labor and post-partum well-being
• To maintain SAFE exercise during pregnancy
• Birth prep: specific exercises, manual techniques, pain management and education for all stages of labor
• Preparing to push techniques to lessen pelvic injury to mum!
• Exercises to allow mum’s body space for baby to turn/engage in the most optimal position for labor

Post-partum:

• Post-partum health check! Ensuring stitches are healing well, ensure no pelvic organ prolapse occurred, to ensure there is no abdominal separation & many other investigations
• Scar tissue mobilization and healing after C-section or vaginal delivery (post episiotomy or perineal tearing)
• Rehab of pelvic floor and abdominal muscle strength and mobility
• To improve pelvis, hip, or low back pain
• To improve/heal an abdominal diastasis recti (DRA) (belly separation)
• Safe return to exercise (strength training, running, etc) and guidance as to proper exercise for healing of abdominal separation (DRA)
• Resumption of comfortable sexual intercourse
• Education and management toolkits to decrease the risk of pelvic dysfunction in the future

Other:

• Erectile dysfunction
• Penile or scrotal numbness, tingling or pain
• Post-orgasm pain (men or women)
• Post-prostatectomy rehab
• Painful bladder syndrome
• Interstitial cystitis
• Lichen sclerosis, lichens planus management
• Endometriosis – help with mechanical treatment of connective tissue, ensuring no pelvic floor restriction
• Diastasis Recti (DRA) (abdominal separation in women or men)
• Vulvodynia/Vestibulodynia
• Painful intercourse
• Chronic pelvic pain
• Chronic low back, pelvis or hip pain
• Acute or chronic constipation/fissures/ hemorrhoids

  & many, many more!

Depending on the specific patient needs, appropriateness of treatment, type of dysfunction and patient’s level of comfort, each visit will include some or all of the following:

• A thorough, in-depth subjective assessment (discussion of past medical history, current injury details, family history, social and work environments, etc) and objective assessment (muscle strength, joint range of movement, nerve tension testing, special joint/muscle testing, etc) as well as an internal vaginal, and/or rectal exam if necessary, and provided the patient has given verbal and written consent
• Manual therapy – hands on, one-on-one physical work on the area of dysfunction and/or contributing areas
• Physical/Electrotherapeutic Modalities (ie: Ultrasound, Muscle Stim, TENS)
• Medical Acupuncture 
• Education & advice regarding ergonomics, posture, alignment and body mechanics
• Taping (Rocktape  or Leuko-tape for posture, swelling, muscle activation or disengagement and sport specific taping)
• Exercise prescription