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Pelvic Floor Physiotherapy

 What is it?

It is a form of physiotherapy for your pelvic floor muscles. The pelvic floor muscles connect the pubic bone to the tailbone, and they have five major functions.

  1. Sexual function
  2. Support of pelvic organs
  3. Controlling urine and bowel movements
  4. Provide stability in the hips, pelvis and lower back joints
  5. Acts as a pump for blood flow between the upper and lower body

When these muscles are not functioning properly, a number of conditions and dysfunctions can arise.

In pelvic floor physiotherapy, we assess the pelvic floor musculature and structures through an internal vaginal and rectal exam.  If the muscles are overactive or weak, problems with urine leakage, prolapse, and painful sex can arise. Pelvic floor physiotherapy addresses these issues and prevents further problems in the future.

 

Pelvic Floor Physiotherapy can be helpful in the treatment of:

  • Urinary incontinence
  • Prolapse
  • Diastasis Rectus Abdominus
  • Pelvic Pain
  • Pain during sex (dyspareunia)
  • Pain in genital area (vulvodynia)
  • Interstitial cystitis
  • Prostatitis
  • Constipation
  • Post-operative rehabilitation from surgery in abdomen or pelvis
  • Post-partum pain/complications
  • Unexplained back, hip or tailbone pain

 

Conditions that are treated with Pelvic Floor Physio

 

 * Urinary Incontinence


 

What is it?

Urinary incontinence is the loss of urine when it is not intended. 1 in 2 women will experience some urinary incontinence in their lifetime, and 1 in 3 will develop it regularly. Men are also affected, and 1 in 9 will experience incontinence. While it is common, it is not normal, any many cases can be helped or resolved with pelvic floor physiotherapy.

Types of Incontinence

  • Stress
    • Loss of urine (usually a small amount) when intra-abdominal pressure increases
    • Typically as a result of laughing, coughing, sneezing, exercising, transitional movements or lifting
  • Urge
    • Urine loss associated with an uncontrollable urge to urinate
  • Mixed
    • A combination of stress incontinence and urge incontinence

Assessment

  •  A thorough history, external and internal exam to determine the nature of the incontinence and why it is occurring

Treatment depends on the reason the leakage is occurring, but may include

  • Exercise Prescription (e.g. Kegels, core work)
  • Muscle Release
  • Downtraining and Reverse Kegels
  • Education regarding bladder irritants and constipation
  • Urge Delay Techniques
  • Relaxation and Breathing Exercises

The Cochrane Collaboration 2010 concluded that physiotherapists with specialized training in pelvic floor rehabilitation should be the first line of defense, before surgical consultation for urinary incontinence in women. 

 Call today to book and assessment with a physiotherapist (613)-546-5148

 

* Pelvic Organ Prolapse


What is it?

Pelvic organ prolapse is a functional problem in which the bladder, uterus or rectum is protruding at or near the vaginal opening.  The prolapse severity is graded on a scale from 1-4.

Signs and Symptoms

  • Pressure or heaviness near the vagina or deep in the pelvis
    • This pressure is usually aggravated by standing and relieved by lying down
  • Feeling like “insides are falling out”
  • Pain with intercourse
  • Straining to have a bowel movement
  • Difficulty emptying bladder or bowel
  • Can be asymptomatic

Assessment

  • Prolapse is diagnosed through a thorough patient history, external, and internal vaginal and rectal exam.

Treatment

  • Exercise prescription targeted at increasing the strength, endurance and function of the pelvic floor musculature
  • Core training
  • Education regarding constipation
  • Pain/pressure relief techniques and positions
  • Breathing re-training and exercises

If you have recently undergone surgery for prolapse, physiotherapy is proven to be beneficial rehabilitation post-operatively. A 2013 research study showed that women who have physiotherapy after their surgery build better muscle strength, control and relaxation and regain a better quality of life. 

 Call today to book and assessment with a physiotherapist (613)-546-5148

 

* Constipation


 

What is it?

Constipation can mean straining to have a bowel movement, infrequent bowel movements, or a sense of incomplete emptying after a bowel movement.

Constipation can have a significant negative impact on your pelvic floor function and can sometimes be the cause of urinary incontinence, pelvic pain, and pelvic organ prolapse.

Treatment

Constipation is treated in a number of ways:

  • Education is key! Your healthcare practitioner will talk about the following:
    • Proper fluid and fibre intake
    • Proper toileting positions
    • The importance of exercise to help move the bowels
  • Exercise prescription
  • Massage techniques to promote movement of the bowels through the intestinal track

You should never resist the urge to have a bowel movement, and you should always be seated with your feet supported.

Call today to book and assessment with a physiotherapist (613)-546-5148