What is Pelvic Floor Physiotherapy
Pelvic floor physiotherapy is the rehabilitative focus on the internal and external muscles of the pelvis and/or pelvic floor after experiencing injury or dysfunction. Some common conditions include:
Birth Preparation Pubic Symphysis Dysfunction
Postpartum Management Diastasis Rectus Abdominis
Urinary Urgency/ Frequency Incontinence (Leakage)
Coccydynia (Tailbone pain) Sacroiliac Joint Dysfunction
Pelvic Organ Prolapse Pelvic Pain/ Lower Back/ Abdominal Pain
Pudental Neuralgia Perineal Tears
Post Abdominal or Pelvic Surgery
- Hysterectomy
- Hernia repair
- Caesarian section
Sexual Pain
- Vaginismus
- Dyspareunia (painful intercourse)
- Vuvodynia
- Vestibulodynia
Bowel Dysfunction
- Fecal incontinence
- Chronic constipation
- Flatulence control
- Pain with bowel movements
- Rectal proplase
- Bloating
What To Expect At Your First Appointment
Day one is all about trying to get to know you as much as possible and determining the drivers behind your concerns. Whether you are experiencing bladder leaking, constipation, pelvic pain, etc., it’s important to learn about your medical, family and social history.
Upon arrival at our clinic, you will have a little bit of paperwork to fill out. If you can, arrive 10 minutes early so we can make the absolute most of your appointment.
Next, you will meet your pelvic health physiotherapist and be led back to a quiet private room. Here they will begin by discussing what has brought you into the clinic. We will ask you questions about:
- Current complaint
- Medical and urogynecology history
- History of pregnancies and delivery for women
- Bowel and bladder habits
- Fluid and diet habits
- Work and activities
- Goals
After getting to know you a little better, we will begin a thorough external and internal physical exam. An internal examination is necessary to truly determine the status of the pelvic floor muscles as they are located deep within our pelvis. That being said, if you are not comfortable with an internal exam, you will always have the opportunity to discuss the benefits and risks of this with your physiotherapist beforehand.
You will be asked to disrobe from the waist down, get comfortable lying down on your back and drape yourself with a cotton sheet.
Using gloves, we will begin with the external component. This will include looking at:
- Breathing patterns
- Rectus diastasis or abdominal muscle separation
- Tenderness along the abdomen, low back, thighs and groin
- Connective tissue mobility in the abdomen, low back, thighs and groin
- Reflexes
- Evaluation of prolapse
- Observe how your muscles respond to cues like “cough”, “stop the flow of urine”, “stop the pass of gas” and “do a pelvic floor contraction”
Using gloves and lubricant, the internal exam for women can be either vaginally and/or rectally depending on the case and comfort level. For men this will be a rectal exam. No speculum or other instruments will be used and it will typically take about 10 minutes. It’s so important to remember that you always have the right to stop the evaluation at any point or refuse an internal exam at any point.
Internally, we will assess:
- Pelvic floor strength and endurance
- Ability to relax the pelvic floor muscles
- Tension and tender points within the pelvic floor
- Response to those same cues: “cough”, “stop the flow of urine”, “stop the pass of gas”
Once this has all been evaluated, we will spend some time debriefing on what we’ve found. We’ll discuss pelvic anatomy and the function of the pelvic floor. Together, we will review different treatment options and come up with a plan that works best for you.
Common Additional Questions
Do I have to have an internal exam?
NO, an internal exam is not mandatory. It is the gold star assessment when it comes to pelvic dysfunction. However, through our history and evaluation, we can often get a good idea of what may be going on. It may require a few additional visits, but your overall comfort and compliance with treatment is the biggest concern.
Remember, you may give or remove consent at any time. If you are concerned about having an internal, speak to your physiotherapist, and together you can decide when the best time would be, if at all.
What if on the day of my appointment I have my period?
Our therapists can assess and treat the pelvic floor even if you are currently having your period. If you feel uncomfortable having your assessment during your period or it is really heavy, the therapist can either proceed with the assessment or treatment externally or reschedule your appointment, provided you give 1 business day’s notice.
Can I bring my children?
If you have an infant, you are welcome to bring them with you; however, coming to sessions solo is preferred so we can concentrate on you. Please be aware that if you bring your baby, we may have to curtail the amount of work we can do within the session if you need to tend to baby and pause treatment.
Patients are often scheduled back-to-back, and sessions must end on time to honour the time of the next patient. Please remember that you are responsible for the safety of your baby while on the premises.
Do I need to have a doctor's note or referral?
No. You do not need a doctor’s referral to access pelvic floor services; however, some insurance companies may need a referral for reimbursement. Please contact your insurance company to determine if you need a doctor’s referral to access your physiotherapy benefits.
If I am pregant, can an internal exam be performed on myself?
Yes. As long as you do not have a high risk pregnancy, are still cleared for intercourse and have not been indicated otherwise by your doctor, an internal exam is perfectly safe. However, best practice guidlines recommend refraining from performing an internal exam once the pregnancy has reach 34+ weeks to reduce risks of inducing premature labour.
My Why
Finesse Physiotherapy began with a passion for women's health and a recognition of the importance of having a holistic, patient-focused approach to treatment. This physiotherapy setting is where comprehensive care and compassion meet.
Finesse Physiotherapy's Commitment to You
At Finesse Physiotherapy, your well-being and comfort is the priority. The physiotherapist will listen, understand, and tailor their approach to meet your unique needs, ensuring you feel supported every step of the way.