Pelvic Floor Physio

What is the pelvic floor?

And how does it affect my pelvic health?

The pelvic floor is a set of muscles and tissues shaped like a hammock and located within the pelvis at the base of the spine. It supports our internal organs, including the bladder, bowel, rectum, and uterus.

Pelvic floor tissues are also important for the stability of our hips and back and sexual function in men and women. Symptoms of pelvic floor dysfunction can include: incontinence, painful intercourse, constipation, nighttime urination, and chronic and/or unexplained pain and tightness in the low back or hips.

Does pelvic floor physiotherapy work?

Yes, pelvic floor physiotherapy is generally effective.

It is designed to improve the strength and function of the pelvic floor muscles, which can help with a variety of issues, including urinary and fecal incontinence, pelvic organ prolapse, and pain during sexual intercourse.

The effectiveness of this therapy can depend on several factors, including the specific condition being treated, the severity of symptoms, and your commitment to consistently performing the exercises.

Research has shown that pelvic floor muscle training can be particularly effective for women with stress urinary incontinence or for pre- and postnatal care.

Men may also benefit from pelvic floor exercises, especially after prostate surgery.

To achieve the best results, it's often recommended that individuals work with a physiotherapist who specializes in pelvic health. These professionals can provide personalized exercise programs, ensure that the exercises are done correctly, and monitor progress. This tailored approach helps maximize the benefits of the therapy.

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What is pelvic floor physiotherapy?

Pelvic floor physiotherapy (also called pelvic health physiotherapy or pelvic physiotherapy) is the assessment and treatment of various conditions that involve the pelvic floor or symptoms that manifest in this area.

Pelvic floor therapists have advanced and specialized training to perform and internal assessment (vaginal and/or rectal) of the pelvic floor to determine if it could be contributing to symptoms.

Therapists understand the sensitive nature of these symptoms and utilize a compassionate and professional treatment style to address your unique needs/concerns.

Treatment can include manual therapy to facilitate muscle lengthening/relaxation and strengthening as indicated.

pelvic floor dysfunction symptoms

Urinary Issues

Bowel Dysfunctions

These can include urinary urgency, frequency, incontinence, or incomplete emptying. Individuals may experience a sudden urge to urinate or may find they need to go frequently throughout the day and night.

Bowel Dysfunctions

Symptoms can involve constipation, straining to defecate, pain during bowel movements, or a feeling of incomplete evacuation after defecation. There may also be instances of fecal incontinence.

Pelvic Pain

Bowel Dysfunctions

Sexual Dysfunction

This can manifest as pain in the pelvic region, lower back, genitals, or rectum. The pain may be consistent or vary in intensity and can be exacerbated by sitting for long periods or during sexual activity.

Sexual Dysfunction

Pelvic Organ Prolapse

Sexual Dysfunction

Men may experience erectile dysfunction or pain during ejaculation, while women might encounter pain during intercourse, difficulty achieving orgasm, or general discomfort in the genital area.

Pelvic Organ Prolapse

This occurs when pelvic organs, such as the bladder, uterus, or rectum, slip down from their normal position and protrude into the vagina or anus. Symptoms may include a bulging sensation, discomfort, and difficulty with bowel movements and urination.

Muscle Spasms

Pelvic Organ Prolapse

Uncontrollable spasms or contractions of the pelvic floor muscles can cause significant discomfort or pain. These spasms may occur spontaneously or be triggered by activities that put pressure on the pelvic area.

When should I come in for a pelvic floor assessment?

Pre and Post-partum

"Pre-partum" refers to the period before giving birth, while "post-partum" is the period after giving birth. If you're experiencing any discomfort or issues related to your pelvic health during these times, it's a good idea to come in for a check-up.

Return to exercise post-partum

Returning to exercise post-partum means gradually resuming physical activities after giving birth. It's important to start slowly and listen to your body, ensuring you're fully healed and ready to exercise again.

After a Cesarean Section

After a Cesarean section, returning to exercise requires extra caution. It's essential to wait until your doctor gives you the green light, usually around 6-8 weeks post-surgery, and start with gentle activities like walking to ensure your body heals properly.

Vulvar pain

Vulvar pain is discomfort or pain around the external female genital area. If you experience persistent or severe vulvar pain, it's important to seek medical advice to determine the cause and get appropriate treatment.

Diastasis Recti

Diastasis Recti is a condition where the abdominal muscles separate along the midline, often occurring during or after pregnancy. If you notice a gap or bulge in your stomach, it's important to consult a healthcare professional for appropriate exercises and treatment.

Post-operative gynecological, abdominal or urinary procedures

After undergoing gynecological, abdominal, or urinary procedures, it's crucial to monitor your recovery closely. If you experience any unusual pain, swelling, or complications, seek medical advice to ensure proper healing and address any issues.

Painful intercourse

Painful intercourse, also known as dyspareunia, is discomfort or pain experienced during sexual activity. If you encounter this issue, it's important to consult a healthcare provider to identify the cause and explore possible treatments.

Incontinence (leakage)

Incontinence, or leakage, is the involuntary loss of urine. If you experience this, it's important to seek medical advice to determine the cause and find effective treatments to manage or reduce the symptoms.

Chronic constipation

Chronic constipation is a persistent difficulty in passing stools, often resulting in infrequent or painful bowel movements. If you suffer from this condition, it's important to consult a healthcare professional to explore underlying causes and receive appropriate treatment.

Chronic and/or unexplained pain in the back and hips

Chronic and/or unexplained pain in the back and hips can indicate various underlying issues, such as muscle strain, joint problems, or nerve conditions. If you experience persistent pain in these areas, it's important to seek medical evaluation to identify the cause and receive proper treatment.

Nighttime urination

Nighttime urination, also known as nocturia, is the need to wake up and urinate during the night. If this disrupts your sleep regularly, it's important to consult a healthcare provider to determine the cause and explore possible treatments.

Urgency or Frequency

Urgency or frequency in urination means feeling a sudden, strong need to urinate or needing to urinate more often than usual. If you experience these symptoms, it's important to consult a healthcare provider to identify the cause and find appropriate treatments.

What IS pelvic floor treatment?

Our pelvic floor physiotherapists in Markham and Stouffville help men and women rehabilitate their pelvic floor muscles.

These muscles can be weakened by childbirth, surgery, heavy lifting, obesity, chronic constipation or cough and/or menopause.

A pelvic health assessment includes a detailed subjective history to better understand your symptoms related to bowel and bladder function, sexual activity, sleep, stress and general health.

A pelvic floor physiotherapist is also interested to learn about your goals and expectations for rehabilitation. The gold standard to assess pelvic floor tissues is a manual internal examination (vaginal and/or rectal) of the pelvic floor to determine if it could be contributing to symptoms. This examination occurs in a private treatment room and clients are draped throughout the appointment.

Pelvic floor physiotherapists work with you to understand the contributing factors to your symptoms, and develop a treatment plan that includes manual therapy (soft tissue techniques to increase proprioception and muscle relaxation), therapeutic exercise and modalities as indicated.

Pelvic floor physiotherapy exercises

Kegels (Pelvic Floor Muscle Training)

This exercise involves tightening and holding the muscles that control urine flow. It's done by contracting these muscles, holding for a few seconds, and then releasing. This can be performed while sitting, standing, or lying down.

Bridge

Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Lift your hips towards the ceiling while keeping your back straight and tightening your pelvic floor muscles. Hold the position for a few seconds before lowering back down.

Squats

Stand with your feet slightly wider than hip-width apart and toes pointed slightly outwards. Bend your knees and lower your hips as if sitting in a chair, while keeping your chest upright and engaging your pelvic floor muscles.

Bird Dog

Start on all fours, hands under shoulders and knees under hips. Extend one arm and the opposite leg simultaneously, keeping your back straight and engaging your pelvic floor muscles. Alternate sides.

Split Tabletop

Lying on your back with your knees bent and feet lifted in a tabletop position, slowly open your legs to the sides as far as comfortable, then bring them back together. Focus on engaging your pelvic floor muscles as you move.

Pelvic Tilt

Lie on your back with your knees bent and feet flat on the floor. Flatten your lower back against the floor by contracting your pelvic floor muscles and tilting your pelvis slightly upward. Hold for a few seconds before returning to the starting position.

What are the benefits of pelvic floor physiotherapy?

There are many benefits to seeing a pelvic floor physiotherapist in Markham including a noticeable improvement in the control over your bladder and bowel function. Treatment may also help reduce the risk of prolapse or the 'sagging' of internal organs. In women, visiting a pelvic floor physiotherapist will help facilitate a faster and more holistic recovery from childbirth and surgery and in men, it offers better recovery after prostate surgery. Finally, pelvic floor therapy can improve sexual function and sensation in both men and women.

Is pelvic floor therapy painful?

The gold standard to assess pelvic floor tissues is a manual internal examination (vaginal and/or rectal) of the pelvic floor to determine if it could be contributing to symptoms. During an assessment, pelvic floor physiotherapists in Markham or at our Stouffville physio clinic will have to temporarily reproduce your symptoms in order to determine the tissues that could be at fault.

Due to the sensitive nature of pelvic health symptoms, some clients might feel emotional stress prior to an examination. Keep in mind, pelvic floor therapists are trained to utilize a compassionate and professional approach throughout your appointment.

Frequently Asked Questions

Please reach out to us if you cannot find an answer to your question.

Is pelvic health physiotherapy covered by OHIP?

Pelvic floor physiotherapy is generally not covered by the Ontario Health Insurance Plan (OHIP), as OHIP typically covers only basic medical and emergency health services. However, many private health insurance plans do offer coverage for physiotherapy services, including pelvic floor physiotherapy. Coverage details can vary widely, so it's advisable for individuals to check their specific health insurance policy or consult with their insurance provider to understand the extent of their coverage.

What does pelvic floor physiotherapy entail?

Pelvic floor physiotherapy involves exercises and techniques designed to strengthen the pelvic floor muscles, which support the bladder, bowels, and reproductive organs. Therapy may include exercises like Kegels, manual therapy, and education on pelvic health. It aims to improve symptoms such as incontinence, reduce pain, and enhance overall pelvic function.

What happens at pelvic floor physiotherapy?

At pelvic floor physiotherapy, a specialized physiotherapist assesses your pelvic floor function through questions and possibly a physical exam. You'll learn exercises to strengthen or relax pelvic muscles, like Kegels or breathing techniques. The session might include biofeedback and education on lifestyle adjustments to manage symptoms effectively.

Can't I just do a bunch of Kegels?

Kegels were popularized in 1948 when Dr. Kegel invented a series of exercises to strengthen the pelvic floor after childbirth to reduce incontinence. While they are still useful for someone who has a weak pelvic floor, it is challenging to know the general condition of your pelvic floor without proper examination. You could actually do more harm than good with kegels if your pelvic floor muscles are short and/or tight. Additionally, research has shown that manual examination is the only way to ensure the correct performance of Kegel exercises. Be sure to check with a pelvic floor physiotherapist before starting any pelvic floor strengthening program!

How to tell if Pelvic floor is tight or weak

You can observe various signs to determine whether your pelvic floor is tight or weak.

Symptoms of a weak pelvic floor might include urinary or fecal incontinence, difficulty holding gas, a sensation of heaviness or bulging in the pelvic area, lower back pain, or feelings of pelvic organ prolapse.

Conversely, a tight pelvic floor may present with difficulty in completely emptying the bladder or bowels, pain during urination or bowel movements, constipation, pain during or after sexual intercourse, and unexplained pelvic pain.

If you experience any of these symptoms, consulting with a healthcare provider, particularly a pelvic floor physiotherapist, is advisable. They can conduct a thorough assessment, including a manual examination of the pelvic muscles, to accurately diagnose the condition and recommend appropriate treatments or exercises.

Pelvic floor physiotherapy

What is the pelvic floor?

And how does it affect my pelvic health?

Does pelvic floor physiotherapy work?

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What is pelvic floor physiotherapy?

pelvic floor dysfunction symptoms

Urinary Issues

Bowel Dysfunctions

Bowel Dysfunctions

Bowel Dysfunctions

Bowel Dysfunctions

Bowel Dysfunctions

Pelvic Pain

Bowel Dysfunctions

Sexual Dysfunction

Sexual Dysfunction

Pelvic Organ Prolapse

Sexual Dysfunction

Pelvic Organ Prolapse

Pelvic Organ Prolapse

Pelvic Organ Prolapse

Muscle Spasms

Pelvic Organ Prolapse

Pelvic Organ Prolapse

When should I come in for a pelvic floor assessment?

Pre and Post-partum

Return to exercise post-partum

After a Cesarean Section

Vulvar pain

Diastasis Recti

Post-operative gynecological, abdominal or urinary procedures

Painful intercourse

Incontinence (leakage)

Chronic constipation

Chronic and/or unexplained pain in the back and hips

Nighttime urination

Urgency or Frequency

What IS pelvic floor treatment?

Pelvic floor webinar video

Pelvic floor physiotherapy exercises

Kegels (Pelvic Floor Muscle Training)

Bridge

Squats

Bird Dog

Split Tabletop

Pelvic Tilt

What is my pelvic health prognosis?

What are the benefits of pelvic floor physiotherapy?

Is pelvic floor therapy painful?

Frequently Asked Questions