Pelvic health

Pelvic health physical therapy is a specialized branch of physiotherapy involving the assessment and treatment of both the external and internal pelvic floor muscles.

The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum (tailbone), which act like a hammock or sling. They also wrap around your urethra (where urine comes out), rectum, and vagina (in women).

A pelvic health physiotherapy assessment is a great way to gain more knowledge and empowerment about your pelvic anatomy and function regardless as to if you are experiencing symptoms or not, and is also a great way to prepare your body for childbirth during pregnancy and recovery after pregnancy. 

If you are experiencing any of the following, a pelvic health physiotherapy assessment is recommended: 

• Incontinence (urinary or fecal leakage)
• Urinary frequency or urgency 
• Overactive bladder
• Pelvic organ prolapse 
• Bowel issues (chronic constipation, straining, or pain)
• Pelvic pain
• Painful intercourse 
• Abdominal separation (diastases rectus abdominus)

Appointments are highly individualized based on your needs. 

A thorough history will be taken in order to aid in determining the cause of your symptoms.  A detailed external examination will be conducted to assess your hips and spine, abdominal wall, posture, and breathing pattern.  And with your informed consent an internal vaginal and/or rectal exam will be performed in order to asses the strength, tone, tenderness, and function of the pelvic floor.  

Finally, an appropriate treatment plan will be established which may include: ongoing education, manual therapy, exercise and muscle training, relaxation and breathing techniques, treatment modalities, and modification of your daily activities. 

No!  Kegels (pelvic floor strengthening) are not for everyone, and even when indicated these exercises are often not done correctly because many of us lack the awareness of where these muscles are and how to properly contract them.  

Kegels are in fact not always indicated and can sometimes aggravate your symptoms.

No, a referral from a doctor is not required to access physical therapy services.  

That said, some extended health benefit plans require a doctors referral for reimbursement - so do check with your extended health benefit company.  

Additionally, internal pelvic floor assessments will only be conducted in the early postpartum period with clearance from your physician (generally given at the six week mark).