Pelvic Health Physiotherapy

The goal of Pelvic Health Physiotherapy is to improve your pelvic floor function through education, exercises, lifestyle modifications, and hands-on treatment to decrease and eliminate your symptoms. More details to come!

What to expect for your first pelvic health physiotherapy appointment

When you arrive, we will listen to your story, your history of symptoms and your goals. Using the pelvis model and some educational slides, we’ll talk about some of the things we will be looking for during the assessment such as observing and palpating the perineal region for tension, observing the tissue quality, palpating at the vaginal opening for scar tissue, palpating the vaginal muscles gently for tension and tightness and feeling to what extent the pelvic floor muscles can squeeze and lift. When you cough and bear down, we can palpate for vaginal bulging or tissue descent. We also want to look at how well the pelvic floor muscles coordinate with the way you breathe and the way your abdominals engage as well as specific pelvic floor coordination exercises such as speed, relaxation and graded elevator contractions.

When it is time to start the assessment, we will look at some mobility tests to see how you are moving through your low back, pelvis and hips. We will observe your posture and breathing pattern and how you walk and squat. We’ll look at the mobility in your rib cage, diaphragm, hips and pelvis and assess your abdomen for scar tissue, fascial tightness or midline weakness. We’ll look at a few 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!

Once we are ready for the pelvic floor assessment, you can change into a slip (skirt) or use a drape. Our treatment rooms rooms are private and calm and we want you to feel as comfortable as possible. You can keep your wooly socks on to stay cozy!
We’ll explain step-by-step what we are assessing and we can do as little or as much as you feel comfortable. At any point, you can let us know if you are uncomfortable or prefer to assess the pelvic floor in other ways, eg external palpation around the tail bone and sitting bones. There are many ways to assess the pelvic floor! You are also welcome to bring your own lube!

A typical pelvic floor assessment may take 10-20 minutes. If you are comfortable having an internal pelvic floor muscle examination, we can very gently insert one or two fingers vaginally and/or anorectally to assess the pelvic floor muscle tone, length, strength and endurance, coordination, scar mobility and function of the pelvic floor region. We can also have you cough and bear down and perform positions and movements in standing that are related to your symptoms. The amazing thing is at the end of the assessment, you will have a whole new understanding of these amazing muscles! The assessment help us to understand the key contributing factors to your symptoms and to set specific treatment goals. The results of pelvic health physiotherapy are excellent! Most of our clients leave feeling very relieved, reassured, informed and inspired!

We are happy to answer any questions you have and we look forward to seeing you!

We treat the following pelvic health conditions:

Urinary symptoms

  • urinary urgency
  • urinary incontinence
  • urinary frequency
  • overactive bladder syndrome
  • nocturia
  • straining to void
  • incomplete bladder emptying
  • bladder pain syndrome
  • urinary incontinencence post-prostatectomy

Pelvic organ prolapse symptoms

  • vaginal heaviness or bulging
  • difficulty emptying your bladder or bowels

Prenatal and postnatal pelvic floor conditions

  • urinary incontinence
  • pelvic organ prolapse
  • low back and pelvic pain
  • coccydynia
  • diastasis rectus abdominus
  • scar tissue
  • pelvic floor muscle weakness

Genitourinary Syndrome of Menopause

  • vaginal dryness
  • vaginal stenosis
  • urinary incontinence
  • recurrent urinary tract infections
  • pain with sexual activity

Sexual dysfunction syndromes

  • dyspareunia
  • vaginismus
  • vaginal stenosis
  • chronic non-bacterial prostatitis
  • erectile dysfunction

Pelvic pain symptoms

  • chronic pelvic pain syndrome
  • pudendal neuralgia
  • painful scar tissue
  • lumbopelvic-hip pain

Anorectal symptoms:

  • chronic constipation and straining
  • dyssynergic defecation
  • fissures and hemorrhoids
  • fecal urgency
  • fecal incontinence
  • flatus incontinence

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

To read more about ano-rectal balloon techniques for constipation and fecal urgency/incontinence, click here.

To read more about biofeedback and electrical muscle stimulation for the pelvic floor, click here.