• What is Pelvic Floor Physiotherapy?

    January 21, 2020 | By Tony Yong

    Pelvic Floor Physiotherapy Edmonton

    I was out with a friend having a coffee and meeting her new baby and as can be expected, we got talking about birth and how she’s doing after.  She mentioned how she deals with some pain as well as issues going to the bathroom and that she was very frustrated as she had never dealt with these issues before.  I could feel her frustration as well as a sense of helplessness and I asked her if she had ever considered getting pelvic floor physiotherapy.  She mentioned that she had never heard of this and asked what is Pelvic Floor Physiotherapy?

    Wikipedia describes the pelvic floor in detail on this page.

    Pelvic floor physiotherapy is all about promoting health and wellness, restoring function, relieving pain, optimizing movement, and preventing pelvic health problems from occurring in the first place.

    Pelvic floor physiotherapy has been gaining traction in Canada of late which is great news for women, men, and children who have been living with pelvic health issues for far too long.

    Pelvic floor physiotherapy is performed to assess, diagnose and treat the pelvic floor muscles.  It is important to not only treat the muscles, but also all structures associated with the pelvic region of the body including ligaments, pelvic and spinal joints, hips, the lower back and abdominal wall, the pelvic organs, and the inner core.


    What is the pelvic floor?

    The pelvic floor is a grouping of muscles that sits across the bottom of the bony pelvis like a hammock. It is part of a complex system that includes muscles, ligaments, nerves, connective tissue, lymphatics, blood vessels, and pelvic organs.

    The pelvic floor has several roles which include:

    • Supporting the pelvic organs – the bowel, bladder, uterus (in women) and prostate (in men)
    • Act to counteract downward forces generated from lifting, straining or other unmanaged intra-abdominal pressures
    • House sphincter muscles that control normal bowel and bladder emptying
    • Progressively expanding and opening during physiological childbirth
    • Acting as a ‘sump pump’ to keep the pelvic region decongested
    • Providing expectant control for movement as it works with the rest of the inner core


    What you can expect from a pelvic floor physiotherapy assessment?

    At Innovation Physical Therapy, our comprehensive assessment is completed in a private office where we ensure that you feel safe discussing your most personal health concerns.  The initial consultations are booked for either 60 or 75 minutes so as to not rush the patient.

    With Innovation Physical Therapy, you can expect the following:


    Confidentiality – Given the personal and sensitive nature of pelvic health problems, we commit to the highest level of privacy and confidentiality. Before starting, we review the consent forms and address any questions you may have about the process.

    Empathy – We take pride in the fact that our physiotherapists are not only skilled clinicians but are also caring and compassionate. We are focused on a judgment-free environment as we all know someone who has experienced pelvic health issues or have experienced this ourselves.

    Active Listening – To better understand the situation being experienced, we ask you to complete a fairly detailed questionnaire about your health and wellness history prior to your first visit. We will review your questionnaire and ask you to share your story during the initial consultation.  We will look to gain a deeper understanding and will ask about your goals, desires and intentions and how your condition is impacting your life.

    Physical Exam – Using our orthopedic skills, we will look to assess your overall body function. Things that we may look to analyze include:

    • Your movement
    • Range of motion
    • Breathing
    • Alignment
    • Muscle strength & endurance
    • Muscle tone
    • Tension or length
    • Motor control
    • Fascia and connective tissue
    • Nerve function

    We take extra care to examine the areas that connect to your pelvis including the lower back, hips and abdominal wall. We also explore the relationship between the pelvic floor and areas higher up and lower down (ie. the thorax, feet and even the brain). If pelvic floor physiotherapy treatment is to be a success, it is essential to examine the bigger picture.

    External Perineal Examination – Once we have obtained informed consent to complete the pelvic floor examination, we then examine the external structures of the pelvic floor. This includes the skin, the perineum, the bony frame, vulvar tissues, and a prolapse assessment.   Clients are draped with a sheet and there is absolutely no speculum or stirrups involved.

    Internal Pelvic Floor Examination – An internal exam is typically recommended so as to have the most accurate information about the state of your pelvic floor. If you provide your informed consent for an internal exam, we will proceed to check the position, texture, tone, range of motion, strength, endurance, and function of the pelvic floor muscles. We let all of our clients know that they have the power to stop the internal exam at any time and for any reason – no explanation needed.

    Clear Communication – Once we have gathered all the necessary information, we share our findings and get you started on strategies for home practice.  We welcome you to ask any questions that you may have any time as we are focused on ensuring that you have clarity on what we are doing throughout the entire process.

    Hope – You come to our office with a specific question or need. It is our goal that you leave feeling hopeful that improvement is possible and that with some guidance you will be able to attain your goals. As our tagline states, we want you to Love Getting Better!


    What conditions does pelvic floor physiotherapy treat?

    At Innovation Physical Therapy, our certified team has the privilege of working with women of all ages and stages. We treat women who have urological, gynecological, obstetric, sexual, gastrointestinal, anorectal, orthopedic, neurological, myofascial, visceral, and persistent pelvic pain conditions. These include:

    • Urinary incontinence – stress incontinence, urge, or mixed incontinence
    • Urinary urgency, frequency or hesitancy
    • Bowel issues such as constipation or fecal incontinence
    • Prolapsed bladder, uterus or rectum
    • Heaviness or pressure in the pelvic region
    • Diastasis recti or other abdominal wall dysfunction
    • A weakness of core muscles
    • Pelvic inflammatory disease
    • Persistent pelvic pain
    • Endometriosis
    • Painful bladder syndrome – interstitial cystitis
    • Pain with sex – dyspareunia
    • Painful periods – dysmenorrhea
    • Vulvar pain – vulvodynia or vestibulodynia
    • Vaginismus
    • Coccydynia
    • Pudendal neuralgia
    • Persistent low back, hip, groin, or abdominal pain
    • Pregnancy-related mobility or pain problems
    • Sciatica, sacroiliac joint or pubic symphysis dysfunction during or after pregnancy
    • Childbirth preparation and prenatal education – with focus on prevention of pelvic floor dysfunction
    • Pre and post-operative rehabilitation for any type of abdominal or pelvic surgery
    • Scar tissue restricting the abdomen, pelvic floor or vulvar region


    What does pelvic floor physiotherapy treatment involve?

    Based on your assessment findings, we will put forward a plan that has been carefully considered. Follow up visits are typically 30 to 45 minutes and focus on your unique challenges and goals. The treatment combines any of the following:

    • Providing education on your condition and what to do about it (lifestyle recommendations, etc.)
    • Posture and alignment awareness and education
    • Looking at breathing mechanics
    • Flexibility or mobility exercises
    • Learning if Kegels are appropriate for you and if so, how to do them correctly
    • Pelvic floor strengthening or lengthening
    • Manual work and normalize pelvic floor muscle stiffness or tension
    • Mobilization of connective tissue
    • Childbirth education as it relates to the pelvic floor and abdominal wall
    • Exercises to strengthen your core
    • Bladder or bowel retraining
    • Internal or external manual (hands-on) therapy
    • Development of a home program to practice
    • Brain-training & nervous system re-wiring
    • Referral to other members of the healthcare team
    • More…


    Pelvic health is an important aspect of living comfortably and Innovation Physical Therapy is dedicated to ensuring that you achieve the comfort that you deserve.


    For any questions or advice related to Pelvic Floor Physiotherapy, contact one of our trained physiotherapists at Innovation Physical Therapy!