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Pelvic Health Physiotherapy

What is Pelvic Health Physiotherapy?

Pelvic Health Physiotherapy is a specialized form of physiotherapy for conditions associated with the pelvis, hip, abdomen, back, and beyond. This includes

  • SI joints, coccyx (tailbone), pubic symphysis, low back, hips and abdominal wall
  • Vulva and vaginal area, perineum, penis and scrotum, and colorectal regions
  • Pelvic organs: bladder, uterus, prostate, and colon
  • Muscles of the pelvic floor, hips, back, and abdomin
  • Endopelvic fascia and linea alba


Pelvic Health Physiotherapy Assessment

The assessment begins with a thorough subjective history. We will ask many questions about your:

  • Medical history
  • Surgical history
  • Previous/current injuries
  • Previous Imaging (x-ray, ultrasound, MRI, etc)
  • Pregnancy/birth/fertility
  • Sleep
  • Stress/Mental health
  • Eating habits
  • Bladder and bowel function/habits
  • Medications and supplements
  • Sexual activity
  • Other healthcare providers you are seeing

Next, we conduct a physical exam. The body functions as a system; therefore a Pelvic Health Physiotherapy Assessment includes a thorough exam of:

  • Posture/alignment of the whole body
  • Breathing patterns
  • Full body movement screen
  • Functional activity screen
  • Neurological screen

Assessment also involves the evaluation of the pelvic floor muscles. Pelvic floor muscles can be directly assessed and treated by a manual digital exam. The manual digital exam is conducted using non-latex gloves and lubricant vaginally and/or rectally. In Ontario, internal vaginal/rectal assessments and treatments are a controlled act. Pelvic Health Physiotherapists must be registered and rostered with the Ontario College of Physiotherapists to perform this controlled act.

If an internal exam is not possible, or a client chooses not to have one, there is still lots we can do! While an internal exam can provide useful information, is not required to participate in Pelvic Health Physiotherapy.

 

What Conditions do Pelvic Health Physiotherapists treat?


Pain:

  • Pelvic (SI joint, tailbone, pubic symphysis), back, abdominal, hip, or groin pain
  • Endometriosis
  • Menstruation
  • Difficulty inserting a tampon
  • Vulvar and/or vaginal pain
  • Bladder pain (Interstitial Cystitis)
  • Post-Prostatectomy pain
  • Abdominal pain associated with abdominal scar (c-section, other abdominal surgery)


Incontinence, Frequency, Urgency:

  • Urinary incontinence (leaking urine)
  • Fecal incontinence (leaking stool/feces, gas)
  • Urinary frequency or urgency with or without leaking
  • Bowel frequency or urgency with or without leaking
  • Post-Prostatectomy incontinence
  • Constipation


Prolapse or heaviness:

  • Uterine prolapse (uterus descends down in vagina)
  • Rectal Prolapse (rectum descended through anus)
  • Urethrocele (bladder bulges into anterior wall of vegina)
  • Rectocele (rectum bulges into posterior wall of vagina)


Sexual Difficulties:

  • Painful intercourse


Pregnancy and Postpartum:

  • Preparing for a vaginal birth
  • Exercise during pregnancy
  • Pregnancy-related back/pelvic/hip pain
  • Vaginal tearing and/or episiotomy
  • C-section scar management
  • Abdominal separation (diastasis recti)
  • Returning to activities/fitness postpartum