At dinner parties and when meeting new people, the inevitable question arises: “so…what do you do?” As pelvic floor physiotherapists, there are many ways to answer this question – and depending on the crowd, we can have a lot of fun delivering the answer. Reactions range from blank stares to shock and horror to genuine curiosity about what we do (and of course the odd inappropriate joke).
Although pelvic floor physiotherapy is gaining traction in Canada, we still have a long way to still go. If you’re part of the majority who has never heard about pelvic health physiotherapy, here are 5 things you ought to know.
1) We’re like any other physiotherapist.
Pelvic floor physiotherapy (sometimes called pelvic health or women’s health physiotherapy) is just like any other physiotherapy in many ways. We are primary health care providers who are concerned about rehabilitation, pre-habilitation, optimizing movement, maximizing function, eliminating pain, and improving quality of life. We are highly qualified professionals who use orthopaedic and other manual skills to assess, diagnose and treat everyone, including women, men and children.
2) We’re unlike every other physiotherapist.
In addition to our basic physio skills, pelvic floor physiotherapists have graduate level training that allows us to perform manual internal examinations that access the pelvic floor vaginally or rectally. Doing so allows for greater success in assessing and treating conditions that manifest in the abdominal-lumbo-pelvic-hip region of the body. These include urological, gynecological, obstetric, sexual, gastrointestinal, anorectal, orthopaedic, neurological, myofascial, visceral, and pain conditions. We take the context of the whole body into consideration when treating the pelvic area.
3) The most robust research backs us up.
The 2010 Cochrane Collaboration concluded that physiotherapists with specialized training in pelvic floor rehabilitation should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence in women. Many other excellent studies have been published which provide strong evidence for the efficacy of pelvic physiotherapy for prolapse, pre and post-natal conditions, core dysfunction, pelvic pain and bowel/bladder dysfunction.
4) Pelvic floor physiotherapists are unique among health care professionals.
There are only a handful regulated health professionals who are trained to complete internal assessments. GPs, specialists, naturopathic doctors, nurse practitioners and midwives all do a lovely job of diagnosing pathology that may arise in the pelvic region. And we work closely with other health professionals to rule out problems that physiotherapy may not be able to address. Because we often have more time to spend with clients, pelvic floor physiotherapists are perfectly situated to address function. Rather than focusing on pathology only, we ask the question “how does this condition impact your daily life activities and what can we do to improve that?”
5) The pelvic floor doesn’t have to be a mystery.
The pelvic floor is a sling of muscles that sits like a hammock across the bottom of the bony pelvis. It is part of a wonderfully complex system that includes muscles, ligaments, connective tissue, nerves, lymphatics, blood vessels and of course, organs (the bowel, bladder, uterus in women and prostate in men). The pelvic floor has several roles including:
- Supporting the pelvic organs
- Counteracting downward forces generated from lifting, straining or other pressures
- Allowing for a pleasurable sexual experience
- Providing sphincteric control for normal bowel and bladder emptying
- Progressively expanding and opening to allow for physiological childbirth
- Acting as a sump pump to keep the pelvic region decongested
- Providing anticipatory control for movement as it works with the rest of the core muscles
It truly is a phenomenal set of muscles. Since pelvic floor physiotherapist are experts at treating muscular dysfunction, it make sense to see us for a comprehensive assessment of a pelvic health condition such as:
- Urinary incontinence
- Urinary urgency, frequency or hesitancy
- Bowel issues such as constipation or faecal incontinence
- Prolapsed bladder, uterus or rectum
- Pelvic pain
- Diastasis recti or other core and abdominal wall dysfunction
- Pelvic inflammatory disease
- Pain with sex (dyspareunia)
- Pubic symphysis dysfunction
- Pelvic girdle pain, sciatica, or SI joint pain during or after pregnancy
- Any pre or post-natal condition
- Childbirth preparation and pre-natal education
- Painful bladder syndrome (interstitial cystitis)
- Persistent low back, hip, groin, or abdominal pain
- Scar tissue restricting the abdomen, pelvic floor or vulvar region
- Post surgery for hysterectomies or any other pelvic surgery
- And more!
If you have questions about your pelvic health or how pelvic floor physiotherapy may benefit you, please don’t hesitate to give us a call or book a consultation with one of our knowledgeable therapists. We’d be happy to help!