Pelvic Floor Physiotherapy

At Your Appointment

Pelvic floor physiotherapy sessions are conducted in a quiet, private room, comfortable, and professional environment. On your first visit, your physiotherapist will conduct an assessment which includes a thorough health history and physical examination.

The physical examination often includes an internal evaluation, via the vagina and/or rectum to assess the pelvic floor muscle function, remember the muscles are located inside the pelvic bowl. A treatment plan will be developed based on your specific assessment findings. Individualized goals will be set and aimed at improving pelvic floor and core muscle function, and improving symptoms.  

Treatment Modalities

Several possible treatment methods may be used during your sessions which typically last about 45 minutes.

• Therapeutic Exercise Programs

  Exercises directed at improving pelvic floor function -modified “kegels” to address muscle strength, speed, endurance and muscle awareness and co-ordination. Core stabilization exercises and breathing pattern co-ordination exercises also play an important role and may be prescribed.

• Manual Therapy Techniques

  These techniques are aimed at improving the quality of muscle contraction and improving muscle awareness, by facilitating contraction or relaxation of the muscles. Certain techniques may also be aimed at improving muscle and soft tissue flexibility.

• Biofeedback

  Manual biofeedback:

  Research and anecdotal therapists' clinical experience have found manual biofeedback to be the primary and successful form of biofeedback, over mechanical/computer based.  It permits greater client body awareness, while also being replicable at home, and a successful tool for pelvic physiotherapy care.  

  Mechanical/computer biofeedback:

  A single-user internal probe is used to monitor the pelvic floor muscle signal (by measuring electrical activity in the muscles) then provide visual feedback to the client).  This treatment technique was used as a key element to pelvic floor physiotherapy over 10 years ago, though its use has been traded with equal success, for manual biofeedback.  Recent studies have lacked significant evidence supporting mechanical biofeedback as the superior treatment method. Readings can fluctuate depending on many parameters, and can not be replicated outside of the clinic. Pelvic Physiotherapists have integrated many other tools (including manual biofeedback) into their treatment of pelvic floor dysfunctions with equal amounts of success.  However, it remains a viable tool when manual biofeedback fails to obtain all client goals.   (Note - this service is not available in-clinic).

• Electrical Muscle Stimulation

  In cases where patients are having difficulty identifying and contracting their pelvic floor muscles, internal electrical muscle stimulation can help to induce a contraction.

• Education

  Education regarding factors which influence pelvic floor function such as behaviour and lifestyle habits, hormonal influences etc. will be provided. When required, a bladder retraining program may be taught to normalize voiding frequency and diminish urgency and it’s triggers. Specific education and advice will be provided for those patients experiencing pelvic pain.

More Information 

• Urinary Incontinence

  Incontinence is commonly known as bladder leaking, and is defined as any amount of involuntary loss of urine from the bladder. Types of incontinence include:

  Stress Incontinence

  Urine loss is due to an increase in the body’s intra-abdominal pressure such as during activities like sneezing, coughing, laughing, lifting or during physical exertion.

  Urge Incontinence

  Urine loss is associated with a sudden uncontrollable urge to empty the bladder, and often associated with increased frequency of urination.

  The Canadian Continence Foundation estimates that approximately 3.3 milllion Canadians experience some degree of incontinence, as high as 1 in 4 women. Because this subject remains taboo and can be embarrassing, it is thought to be significantly under-reported.

  Bladder leaking is prevalent, but not a normal part of life as we age. You are not alone. Strengthening of the pelvic floor and core muscles can improve the closure of the urethra and support the bladder, and reduce the symptoms incontinence. A pelvic floor physiotherapist can tailor a treatment program to suit your specific needs.

• Pelvic Organ Prolapse

  Sometimes known or felt as “heaviness in the vagina”.  Weakening of the pelvic floor muscles can diminish support of the body’s internal organs such as the bladder, uterus and rectum. This may result in a dropping of the bladder, uterus, or rectum into the vagina,

  Pelvic floor muscle training cannot reverse the prolapse itself but can significantly reduce the symptoms by improving muscle tone and supporting the organs like a shelf from below. Correcting poor patterns of abdominal use can also help.

• Pelvic Pain

  Women may experience a burning/sharp pain during intercourse (dyspareunia), have difficulty during yearly medical examinations or with using tampons during menstruation. Men may experience pain in the pelvic region or lower abdomen, groin, sacrum, or tailbone, as well as pain during/after ejaculation.  

  A terrible cycle of pain can develop where the experience of pain can lead to increased tension/guarding in the pelvic floor muscles which leads to increased pain, which leads to increased muscle tension/guarding which leads back to more pain.

  Pelvic floor physiotherapy can help to empower patients to break the cycle of pain. The goal of treatment is to increase muscle and soft tissue flexibility, increase muscle awareness and control, which then decreases tension and improves relaxation in the pelvic floor muscles. Education about the structure of the pelvic floor and its relationship to the pain and how the body subsequently responds, is very important. Internal and external manual therapy techniques and home exercises may be used to release the high tension/tone.

  Computer biofeedback can provide visual feedback on how to correctly contract and more importantly, release the muscles. Home exercises focus on “reverse” kegels, emphasizing the relaxation portion of muscle contraction.

• Pediatric Pelvic Floor Care

  Our pelvic floor physiotherapy approach with children differs from our adult clients.  Depending on the child/parent’s concerns, a thorough history is taken.  We DO NOT usually perform an internal pelvic exam as part of our assessment/treatment.  Treatment usually includes:

  • Education for the child & parent
  • Strategies, tips, and tricks to change daytime, nighttime, or school behaviours
  • Exercises based on assessment findings and each child’s body utilizing a whole body approach, not just pelvic floor muscles