What is Pelvic Health Physiotherapy?
Pelvic health physiotherapy is an evidence-based treatment for common conditions within the pelvis such as incontinence, pelvic organ prolapse, and pelvic pain. A comprehensive subjective and objective evaluation is conducted to identify all the factors that are contributing to your symptoms. A treatment plan will be formulated with personalized short and long-term goals.
The subjective assessment can include reviewing your past medical history and asking appropriate questions pertaining to pain, bladder and bowel, and sexual function with the use of validated and reliable outcome measures.
The objective assessment will look at global contributors such as breathing, posture and alignment, movement patterns, overall strength and conditioning, the lumbar and thoracic spine, and the pelvic floor muscle function.
The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum, which act like a hammock or sling. They also wrap around your urethra (where urine comes out), rectum, and vagina (in women). The pelvic floor muscles must be able to contract to maintain continence and relax to allow for urination, bowel movements, and in women, sexual penetration.
Pelvic health conditions We can help treat
- Prenatal and postnatal issues for women
- Incontinence (urinary and fecal)
- Pelvic Pain
- Pelvic organ prolapse
- Urinary Symptoms (Urgency, frequency)
- Bowel disorders (IBS, constipation)
- Post surgical rehabilitation
- Cancer rehabilitation
Treatment Techniques
Your treatment may consist of the following:
- Manual Therapy: In addition to teaching you how to control and exercise your pelvic floor muscles, your physical therapist may conduct manual therapy to treat you.
As one of the tools and techniques for the pelvic floor, manual therapy involves the PT using hands-on pressure and massage, either externally or internally, on the muscles of the pelvis.
Manual therapy is useful for improving blood flow to the affected muscles, as well as helping those muscles to stretch and relax. This approach may also utilize certain tools to help stretch, educate, and massage muscles back into a healthy state.
- Relaxation Techniques: Sometimes, treating the pelvic floor involves helping tense muscles to relax. Relaxation techniques can be effective in relieving muscle tension and related pain and other issues.
- Biofeedback, with the use of a sensor pressure probe that is inserted into your vagina or rectum, to sense the strength of contractions of the pelvic floor muscles to help you be aware of when you are contracting or relaxing these muscles
- Electrical stimulation to help elicit pelvic floor muscle activation
- Pelvic floor therapy devices like vaginal dilators, which are cylindrical objects of varying widths that are inserted into the vagina to gently stretch the pelvic floor muscles and allow them to relax with insertion.
- Weighted cones, which can be inserted into the vagina or rectum, and used during contraction exercises to provide increased resistance
Treatment Techniques
Your treatment may consist of the following:
- Function dry needling, which relies on thin needles inserted at trigger points to reduce pain and restore function4
- Biofeedback, with the use of a sensor pressure probe that is inserted into your vagina or rectum, to sense the strength of contractions of the pelvic floor muscles to help you be aware of when you are contracting or relaxing these muscles
- Electrical stimulation to help elicit pelvic floor muscle activation
- Pelvic floor therapy devices like vaginal dilators, which are cylindrical objects of varying widths that are inserted into the vagina to gently stretch the pelvic floor muscles and allow them to relax with insertion.
- Weighted cones, which can be inserted into the vagina or rectum, and used during contraction exercises to provide increased resistance
Clinical specializations
Rostered with the College of Physiotherapists of Ontario to perform pelvic internal examinations
- Pelvic Health Level 1: The Physical Therapy Approach to Female and Male Urinary Incontinence
- Pelvic Health Level 2: Female and Male Pelvic Pain
- Pelvic Health Level 3: Biopsychosocial Reframed Clinical Skills for Treating Pain
