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Pelvic floor physiotherapy
Female pelvic health professionals to help you recover faster. Book your pelvic health physio in Markham or Stouffville.
What is the pelvic floor?
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.
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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
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 webinar video
Check out this 30 minute webinar that answers the most common questions about pelvic health, including how it works, its dysfunctions, and what pelvic floor physiotherapy looks like (internal and external)
Pelvic floor physiotherapy exercises
Kegels (Pelvic Floor Muscle Training)
A proper Kegel is a gentle lift of your pelvic floor muscles, not a hard squeeze, not clenching your butt, and not holding your breath.
To find the right muscles, imagine stopping the flow of urine or holding in gas; that subtle lift is the contraction you want.
Breathe normally as you do it: inhale to relax, then exhale and gently lift the pelvic floor upward and inward. Hold for 3–5 seconds, then fully relax for the same duration. You should feel the work deep in your pelvis, not in your abdominals, thighs, or gluteal muscles.
Keep the effort light, controlled, and consistent. If you’re unsure you’re doing it correctly or experience symptoms such as leakage, heaviness, or pelvic pain, a pelvic floor physiotherapist can assess your technique and guide you with a personalized plan.
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.
What is my pelvic health prognosis?
Many factors influence the timeline and course of healing from pelvic pain, including severity, chronicity, general health, motivation, and overall physical and mental well-being. A general guideline for tissue healing suggests that 6-8 hour-long treatment sessions are needed. A pelvic floor physiotherapist in Markham will be able to assess your unique circumstances and offer the most realistic expectations for recovery.
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 for assessing pelvic floor tissues is a manual internal examination (vaginal and/or rectal) to determine whether the pelvic floor is contributing to symptoms. During an assessment, pelvic floor physiotherapists in Markham or at our Stouffville physio clinic will need to temporarily reproduce your symptoms to determine which tissues may be at fault.
Due to the sensitive nature of pelvic health symptoms, some clients might feel emotional stress before 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 may include urinary or fecal incontinence, difficulty holding gas, a sensation of heaviness or bulging in the pelvic area, lower back pain, or a sense 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.
