5 Things to Know About Pelvic Floor Physiotherapy

Written by Telma Hembruff – Physiotherapist, Pelvic Health Specialist, Clinical Pilates Instructor
The goal of Pelvic Floor Physiotherapy is to improve pelvic floor function through exercises, lifestyle modifications, education and hands on treatment to decrease and eliminate your symptoms. This therapy involves assessing and treating a group of muscles that are involved with urinary, bowel, and sexual function. If these muscles aren’t functioning properly this can lead to symptoms such as incontinence, increased urgency and/or frequency, retention (not being able to empty your bladder or bowels), and pelvic pain.

Here are 5 facts to know about your pelvic floor health.

1. It’s not all about the kegels
When your pelvic floor muscles are weak, this can lead to symptoms such as incontinence, prolapse, as well as urinary urgency and frequency. If the pelvic floor is found to be weak, Kegels or pelvic floor strengthening exercises play an important role in helping improve these symptoms.
However, depending on what your symptoms are, kegels aren’t always the best solution. Just like any other muscle, the pelvic floor muscles can become tight. In this case you may experience symptoms such as pelvic pain, feeling of incomplete bladder or bowel emptying, weak or hesitant stream, and pain during or after sexual intercourse. The key is to have a strong pelvic floor, not a tight pelvic floor. In the case of the pelvic floor being too tight, exercises focused on relaxation and gentle stretches can help release the pelvic floor muscles to allow for improvements in your symptoms.
2. The pelvic floor is part of your core
The core involves a lot more than just our abdominal muscles. The core refers to an area that begins at the diaphragm and ends at the pelvic floor.  As such, the components of your core include your abdominal muscles, low back muscles, pelvic floor muscles, and the diaphragm. Together these muscles work together to support your abdominal contents. As such we want all parts of your core to be functioning properly. During Pelvic Floor Physiotherapy, we will assess all parts of the core and work on exercises to build up good core function.


3. Anyone can benefit from Pelvic Floor Physiotherapy
Anyone can have pelvic floor dysfunction and can benefit from Physiotherapy. While there are certain groups that may have a higher chance of getting pelvic floor symptoms, anyone can experience these symptoms. Here are few examples of which populations may benefit from pelvic floor physiotherapy
  • Prenatal and Postpartum – This is one of the most common times where pelvic floor concerns arise. With a growing baby, going through labour, and recovery postpartum, women’s bodies go through a lot of change in a short period of time. Individuals might experience pain around their low back, tailbone, pelvis, and hips. They may also experience symptoms such as incontinence, heaviness, urgency and frequency, and pain with sexual intercourse. These are all symptoms that can be improved with Pelvic Floor Physiotherapy
  • Post menopause – When going through menopause women’s estrogen levels will decrease significantly. It turns out that estrogen is important in maintaining optimal function in the pelvic floor region. Thus, when going through menopause individuals may experience symptoms such as heaviness/bulging, incontinence, increased urgency and frequency, and pelvic pain. Pelvic Floor Physio plays an important role in improving these symptoms in combination with treatments from your doctor
  • Men – While any male can experience pelvic floor symptoms, the most common causes of pelvic floor dysfunction with men include chronic pelvic pain, chronic prostatitis, post surgical, and post prostatectomy. Common symptoms that men may be experiencing include the feeling of incomplete bladder or bowel emptying, slow/weak stream, incontinence, pelvic pain, and erectile dysfunction. These symptoms can be diminished through education, manual techniques and exercises.
  • Post surgery – After undergoing an abdominal or pelvic surgery it is common to experience pelvic floor concerns. This may be due to the surgical procedure itself or due to prolonged catheterization. Commonly, post surgery physiotherapy treatment will work towards decreasing pain, improving scar mobilization

4. What to Expect during Pelvic Floor Physio sessions

What to expect during an initial session

During the assessment, your Physiotherapist will take a detailed history. This will be followed by an external exam which commonly includes assessing posture, flexibility and strength around your low back, hips, and pelvis. Afterwards, an external and internal exam may be completed to assess the pelvic floor muscles. This will be done vaginally and/or rectally with women, and rectally with men. While an internal exam will likely be recommended and will provide useful information about your pelvic floor muscles, it is not necessary if you are experiencing acute pain or are uncomfortable with the procedure.
Based on the assessment findings, an individualized treatment plan will be implemented. Treatment may include advice and education, exercises, and manual therapy.

What to expect during a follow-up session

During follow-up sessions, the focus will be on treatment for your symptoms. While treatment will vary between individuals; common treatments include going through exercises, advice and lifestyle modifications, manual therapy, electrotherapy, and relaxation techniques. There may be other assessments that the Physiotherapist will complete during follow-up sessions. These tests will allow the therapist to get a full picture of your concerns and to follow the progression of your symptoms.

5. Will it be painful?
The Physiotherapist’s goal is to improve your symptoms, so while there may be some discomfort with some of the treatment approaches, the aim is to not create a painful response.
During the assessment, the Physiotherapist will be looking for what may be causing the symptoms. For instance, you may get pain in your low back with bending over, and the Physiotherapist may ask to see this movement to assess how your back is moving and why you may be getting pain with that movement. While there may be some reproduction of pain symptoms, this should not aggravate your symptoms or give you further pain following the session.
During treatment sessions, there may be some hands on techniques utilized to provide relief to your symptoms that may create some mild discomfort, but they should not be painful. The same principles apply for home exercises and techniques provided to you by the Physiotherapist. Some mild discomfort may occur during the exercises, but you should not be feeling pain during or after the home exercises.
Pelvic floor dysfunction affects both men and women and is more common than you may think. Our Pelvic Floor Physiotherapists at both our Cambie & Kerrisdale locations help to treat and resolve many pelvic health disorders.