You may have heard about pelvic floor physiotherapy and might be wondering what it is all about. Well, it’s something that is gaining traction in Canada and around the world! This increasing awareness makes us do the happy dance because we’re so passionate about pelvic health. But it’s even better news for women, men and children who have been living with pelvic health problems for far too long.
Pelvic floor physiotherapy is all about promoting health and wellness, restoring function, relieving pain, optimizing movement, and preventing pelvic health problems from occurring in the first place.
Pelvic floor physiotherapists are rehab professionals who have specialized post-graduate training to assess, diagnose, and treat the pelvic floor muscles. They not only treat the muscles, but they also treat all structures associated with the pelvic region of the body including ligaments, pelvic and spinal joints, hips, the low back and abdominal wall, the pelvic organs, and the inner core. Pelvic floor physiotherapy should really be termed “pelvic health physiotherapy” since treatment ultimately focuses on the health of the whole person.
What exactly is the pelvic floor?
The pelvic floor is a sling of muscles that sits 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 pelvic organs. The pelvic floor has several roles including:
- Supporting the pelvic organs (the bowel, bladder, uterus in women and prostate in men)
- Counteracting downward forces generated from lifting, straining or other unmanaged intra-abdominal pressures
- Allowing for pleasurable sex and orgasm
- Housing sphincter muscles that control normal bowel and bladder emptying
- Progressively expanding and opening during 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 inner core unit (trasversus abdominus, multifidus and diaphragm).
What should you expect from a pelvic floor physiotherapy assessment?
Our goal at The Mama’s Physio is to create a seamless experience for our clients from start to finish. Our comprehensive assessment is completed in a private office where we’ve thoughtfully designed the space to be warm and comfortable – one where you feel safe discussing your most personal health concerns. We don’t like to rush you, so our initial consultations are booked for either 60 or 75 minute blocks. While you are with us, you can expect the following:
Confidentiality –We maintain the highest level of privacy and confidentiality, especially given the personal and sensitive nature of pelvic health problems. Before we get started with anything, we review our informed consent forms and address any questions you may have about the process.
Empathy – Our physiotherapists are not only skilled clinicians but are genuinely caring and compassionate. We have each had our own “adventures” with various aspects of pelvic health with so we totally get it and are not here to judge.
Careful Listening – Prior to your visit, we ask you to complete a fairly detailed questionnaire about your health and wellness history. During the initial consultation, we review your questionnaire and ask you to share your story. We usually jot down some notes and then ask further questions to gain a deeper understanding. We ask about your goals, desires and intentions and how your condition is impacting your life.
Holistic Approach – We recognize that true health is a balance of the body, mind, heart and spirit. We adopt an approach to care that considers the whole person, not just one part. Our is treatments are based on the most up-to-date research in women’s healthcare, pain sciences, and psycho-social body of evidence. Therefore some of the ideas we share may come as a surprise, but our clinical experience shows that a bio-psycho-social framework to physiotherapy assessment and treatment works the best in the long run.
Head-to-Toe Physical Examination – We use our orthopaedic skills to assess your overall body function. We may analyze your movement, range of motion, breathing, alignment, muscle strength and endurance, muscle tone, tension or length, motor control, fascia and connective tissue, and nerve function. We take care to examine the areas that connect to your pelvis including the low back, hips and abdominal wall. And we also explore the relationship between the pelvic floor and areas higher up and lower down (ie. the thorax, feet and even the brain). If pelvic floor physiotherapy treatment is to be a success, it is essential to examine the bigger picture.
External Perineal Examination – Once we have obtained informed consent to complete the pelvic floor examination, we then examine the external structures of the pelvic floor. This includes the skin, the perineum, the bony frame, vulvar tissues and a prolapse assessment. Clients are draped with a sheet and there is absolutely no speculum or stirrups involved.
Internal Pelvic Floor Examination – An internal exam is typically recommended so you have the most accurate information about your pelvic floor state. If you provide your informed consent for an internal, we then proceed to check the position, texture, tone, range of motion, strength, endurance, and function of the pelvic floor muscles. We let all our clients know that they have the power to stop the internal exam at any time and for any reason – no explanation needed.
Clear Communication – Once we have gathered all the puzzle pieces together, we share our findings and get you started on a couple strategies for home practice. If you have questions, we welcome you to ask away. Ensuring you have clarity on the what and the why is a major priority for us.
Hope – You come to our office with a specific question or need. It’s our goal that you leave feeling hopeful that improvement is possible and that with some guidance you will be able to attain your goals.
What conditions do pelvic floor physiotherapists treat?
At The Mama’s Physio our certified pelvic floor physiotherapy team has the privilege of working with women of all ages and stages. We treat women who have urological, gynecological, obstetric, sexual, gastrointestinal, anorectal, orthopaedic, neurological, myofascial, visceral, and persistent pelvic pain conditions. These include:
- Urinary incontinence – stress incontinence, urge, or mixed incontinence
- Urinary urgency, frequency or hesitancy
- Bowel issues such as constipation or faecal incontinence
- Prolapsed bladder, uterus or rectum
- Heaviness or pressure in the pelvic region
- Diastasis recti or other abdominal wall dysfunction
- Weakness of core muscles
- Pelvic inflammatory disease
- Persistent pelvic pain
- Painful bladder syndrome – interstitial cystitis
- Pain with sex – dyspareunia
- Painful periods – dysmenorrhea
- Vulvar pain – vulvodynia or vestibulodynia
- Pudendal neuralgia
- Persistent low back, hip, groin, or abdominal pain
- Pregnancy related mobility or pain problems
- Sciatica, sacroiliac joint or pubic symphysis dysfunction during or after pregnancy
- Childbirth preparation and pre-natal education – with focus on prevention of pelvic floor dysfunction
- Pre and post operative rehabilitation for any type of abdominal or pelvic surgery
- Scar tissue restricting the abdomen, pelvic floor or vulvar region
What does pelvic floor physiotherapy treatment involve?
Based on your assessment findings, we put forward a plan that has been carefully though out. Follow up visits are typically 45 or 30 minutes and focus on your unique challenges and goals. Treatment combines any of the following:
- Providing education on your condition and what to do about it – lifestyle recommendations
- Alignment and posture awareness and education
- Looking at breathing mechanics
- Flexibility or mobility exercises
- Learning if kegels are appropriate for you and if so, how to do them correctly
- Pelvic floor strengthening OR lengthening
- Manual work and normalize pelvic floor muscle tension or stiffness
- Connective tissue mobilization
- Childbirth education as it relates to pelvic floor and abdominal wall
- Core strengthening exercises
- Bowel or bladder retraining
- Internal or external manual (hands-on) therapy
- Development of a home program to practice
- Nervous system re-wiring
- Referral to other members of the healthcare team
- So. Much. More.
The Mama’s Physio is a highly sought-out Pelvic Health Physiotherapy practice in London, Ontario. If you’re ready to take that next step to improve your pelvic (and overall) health, go ahead and book a consultation online in three easy steps.
We’d love to help.
Ibukun Afolabi – MScPT, BA(Hon.)Kin, Founder and Owner of The Mama’s Physio, is a pelvic health physiotherapist, entrepreneur, speaker, and postpartum doula-in-training. More importantly she is a wife to an incredible man and mama to four little ones. Ibbie became interested in how childbirth impacts women’s long term health when she was pregnant with her first child. Having experienced the benefits of pelvic health during the pre and post natal phase – and having treated hundreds of women of all ages – she is a big believer in the capacity of women to heal and be whole – body, heart, mind, and spirit.