Pelvic Health Physiotherapy for all genders — women, men and 2SLGBTQIA+

We work inclusivly with people of all genders and welcome you to share anything that you feel is relevant for our therapist to know so we can provide the best possible care.

Our therapists have up to 18 years of clinical expereince in pelvic health.  

Our treatment approach

As a team, we aim to provide an integrated, inclusive, whole- person approach. Our treatments are based on  evidence-informed and trauma-informed approach that blends orthopedic manual therapy, visceral mobilization, Integrated Systems Model (ISM- Diane Lee), pain science and central nervous system desensitization,  Hypopressives, scar tissue mobilization, cupping, pessary fitting, specific neuromuscular  re-education of the core muscles, and functional strengthening exercise integration. We strive to facilate the optimal function of your core by re-educating the foundations: posture, breathing, neuromuscular control, mindfulness, strength, and integration into functional activiites. Through ongoing assessment and re-assessment, we aim to identify the key “driver (s) ” of the symptoms in order to produce efficient, long-lasting results. 

We strive to provide our patients with all the tools they need to nourish their pelvic health. 

We are excited to work with you to help you get back to doing what matters most to you!

Common conditions treated include: 

• urinary disorders (stress incontinence, urge urinary incontinence, insensible urinary incontinence, overactive bladder, painful bladder syndrome, nocturia, incomplete bladder emptying)
• pelvic organ prolapse (vaginal heaviness, bulging, urinary and fecal incontinence, incomplete emptying of bladder and bowels)
• anorectal disorders (fecal incontinence, rectocele  and rectal prolapse, constipation, straining, dyssynergic defecation, fissures, haemorrhoids, flatus incontinence)
• pelvic pain (vaginismus, dyspareunia, endometriosus, chronic non-bacterial  prostatitis, coccydynia, pubic symphysis dysfunction, central sensitization, chronic pelvic pain syndrome, pudendal neuralgia)
• sexual dysfunction (painful sexual activity, erectile dysfunction)
• low back and hip pain
• genitourinary syndrome of menopause (urinary incontinence, painful sexual activity, vaginal stenosis, recurrent urinary tract infections related to incomplete bladder emptying)
• post-op vaginoplasty and pelvic health conditions related to gender affirming  practices including binding and tucking
• pre and post-pelvic and abdominal surgery rehab  (c-section, hysterectomy, prolapse repair, abdominoplasty, vaginoplasty, prostatectomy, post-surgical scar tissue)

What to expect for your first pelvic health physiotherapy appointment

We are committed to doing our best to cultivate a safe, inclusive environment that fosters a sense of connection, hope, and inspiration, where you feel supported and empowered at all times.

When you arrive for your first appointment, we’ll start by listening to your history of symptoms, and your goals. We can then talk about the key points of the assessment that will help us to better understand what factors are contributing to your symptoms.

What does a typical pelvic health assessment include?

A pelvic health assessment may include any or all of the following:

• a detailed description of what an internal assessment would look like, using the pelvis model and educational slides and taking the time to answer any questions you have
• a discussion about informed consent – you have the option of deciding which parts of the assessment you would to do and you can decide at any point to withdraw your consent. If you feel anxious about the internal assessment, we can always opt to defer it to another time, and focus on other related treatment strategies that don’t involve an internal assessment
• a postural and gait assessment
• functional movement assessment (ie squatting, bending, twisting, standing on 1 leg)
• an assessment of the way your breathe
• palpation of your diaphragm and hip flexor muscle tension, thoracic mobility, visceral mobility of the bladder, scar tissue mobility, abdominal midline integrity, deep abdominal muscle co-activation
• core tests to see how your core muscles are engaging. The pelvic floor muscles are just the bottom of the abdominal canister or box, so we need to understand how all these muscles work together!
• an assessment of how you are moving through your rib cage, low back, hips, sacroiliac joints
• an assessment in standing of your pelvic floor function – ie coughing and jumping
• an internal pelvic floor assessment (vaginal, anorectal, genitals, front hole, back hole)
• a discussion of the assessment findings,  treatment options and treatment plan and the opportunity to ask any questions that want
• 1-2 exercises to start at home

What does a pelvic floor internal assessment look like? 

We do our best to make you feel as comfortable as possible by offering the option to change into a slip (skirt) that we provide or to use drapes. We have blankets and you can keep your wooly socks on to stay cozy! We’ll talk you through every step of the assessment and you can withdraw your consent anytime.

We’ll ask you if you are comfortable lying down on your back on a padded treatment table with your knees bent, so that we can observe the perineal tissues.Your physiotherapists will observe the perineum as you perform a pelvic floor contraction, a cough and a gentle bearing down (straining) maneuver). Using a gloved hand, we can then apply gentle pressure to different points on the perineum to feel for tightness or tension in the pelvic floor muscles and connective tissues and can also observe the genital openings at rest and with contraction of the pelvic floor muscles. By applying some water-based lubricant (you are welcome to bring your own lube!) to gloved fingers, we can palpate at the vaginal/front hole opening for perineal or episiotomy scar tissue or adpative connective tissue tightness. By gently inserting one or two fingers, we can palpate the pelvic floor muscles internally for tension, adaptive connective tissue tightness, descent of the anterior/posterior and cervix/vault with coughing and bearing down, as well as strength and motor control related to speed, relaxation, graded contractions, coordination with other muscles of the abdominal cansister.

We’ll then review and explain in detail the findings and how they may be contributing to your symptoms and other related problems such as low back and hip pain.

We can then talk about education and exercise and a treatment plan moving forwards.

We try to give you as many tools as possible to help you manage your condition.

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We are happy to answer any questions! Please book a complimentary phone consultation online or by calling 613-291-2956 with any of our pelvic health physiotherapists if you have any more questions.

To read more about pre and postnatal pelvic health physiotherapy, click here.

To read more about our pessary fitting services, click here.

To read more about our complimentary treatment modalities, including anorectal balloon therapy and Hypopressives, click here.