Women’s Pelvic Health

Who Are Pelvic Health Physiotherapists?

Pelvic health physiotherapists are registered physiotherapists who have completed extensive additional training in assessing, diagnosing, and treating the pelvic floor region. Weak, tight or damaged pelvic floor muscles can contribute to incontinence and/or pelvic pain.

How Can Physiotherapy Help?

  • Education specific to your condition(s)
  • Optimize strength, endurance, timing, and coordination of the pelvic floor muscles
  • Bladder irritant education
  • Individualized exercise program
  • Evoke the relaxation response
  • Poor habit recognition & retraining
  • Dietary management
  • Promotion of normal bladder and bowel habits

Conditions Pelvic Floor Physiotherapy Can Treat

  • Incontinence (accidental leakage – urinary & faecal) overactive bladder
  • Pelvic organ descent and prolapse
  • Pregnancy related issues – eg. rectus diastasis
  • Frequent urination or immediate uncontrollable urge to urinate
  • Unrelenting low back pain and/or groin pain
  • Colorectal conditions and constipation
  • Interstitial Cystitis (IC)
  • Pelvic Pain (provoked vestibulodynia, vaginismus, coccydynia, vulvodynia)
  • Dyspareunia (painful intercourse)
  • Dysmenorrhea (menstrual pain)
  • Pelvic Congestion Syndrome (PCS)
  • Irritable Bowel Syndrome (IBS)
  • Endometriosis
  • Genitourinary Syndrome of Menopause (GSM)
  • Clitoral Phimosis
  • Lichens Simplex, Lichens Sclerosis, Lichens Planus
  • Persistent Genital Arousal Disorder (PGAD)
  • Bladder Pain Syndrome (BPS)
  • Sacroiliac & pubic symphysis dysfunction
  • Pelvic pain/pressure/heaviness
  • And more!!

Am I At Risk?

Pelvic Floor Dysfunction Risk Factors

  • Pregnancy and birth
  • Obesity
  • Over 40 years old
  • Obstetric trauma (forceps, suction, tearing)
  • Having had more than one child (multiparous)
  • Certain medications
  • Chronic straining
  • Female (85% of urinary incontinence occurs in women)
  • Gynaecological or urinary surgery
  • Smoking
  • Post menopausal (hormone changes)

“Kegels” are NOT
“One Size Fits All”

Many people have heard of the term “Kegel” before. In the 1940’s Dr. Kegel decided women needed to exercise their pelvic floor, giving us the term “Kegels”.

It’s important to understand that not everyone should be doing Kegels… even if they are experiencing urinary leakage or pelvic pain. This is because the cause might not necessarily be weakness. On top of that, studies show that verbal cueing and imagery does not ensure women complete Kegels properly. Most people end up doing “Kegels” wrong and some shouldn’t be doing them at all.

So what does “Kegels are not one size fits all” mean? The reason for your pelvic floor dysfunction could be due to weakness, tightness, uncoordination, a timing issue, poor habits, or a combination of these factors. Therefore, if you started doing “Kegels” without knowing what the cause is, you’d likely be unsuccessful and could make things worse. You also wouldn’t be addressing the cause of the dysfunction which can lead to a lot of frustration!

What Can I Expect From A Pelvic Health Physiotherapy Assessment?

Detailed review of your past medical history and current history

An assessment of the pelvic muscles, ligaments, alignment and mechanics in order to determine musculoskeletal contribution to pelvic dysfunction

Usually includes an external and internal (vaginal & rectal) examination of the pelvic floor and surrounding muscles (please note, this is not mandatory and completely up to you)

One-on-one assessment and follow up treatments with a registered pelvic health physiotherapist

Why An Internal Exam?

1. Up to 50% of women are not able to do an effective pelvic floor muscle contraction (this is key to a pelvic floor muscle training program).

2. Palpation is required to assess tone, strength, endurance, and determining motor control strategies of the pelvic floor muscles.

3. Some pelvic floor muscles require muscle relaxation and coordination, not strengthening. This can only be determined by an internal examination.

Want to learn more? Book a pelvic health physiotherapy appointment with me! Please see contact information for details.