Pelvic Health Services

Pelvic Health physiotherapists specialize in the pelvic region - the area and organs around and inside our pelvis. 

What is the Pelvic Floor?  

The pelvic floor is the area and organs around and inside our pelvis.  The pelvis contains the muscles and organs that are involved with bladder, bowel and sexual functions. All of these work closely together to function well. Sometimes the muscles may not function as well as they should, and this can lead to problems. Problems can occur for many different reasons, such as: 

•  muscles can be weak or too tight  

• hormonal changes 

• changes to our body during and after pregnancy 

• trauma  

• changes related to menopause  

But we know that our pelvic is just one part of our body. It is connected to our back and our core. It is impacted (or influenced) by our posture, how we breathe and how we are feeling, physically and emotionally. And so, we assess the whole body and person, not just ‘down there’.  

We also know that, while we might have a lot of knowledge about the body and how it functions, you are the expert in yourself and your needs. So pelvic health physiotherapy is your personal journey, you decide the path as we are there as companions.   

This is where pelvic health physiotherapy can help.

For women that have conditions related to the pelvis, abdominal and low back region such as incontinence, pelvic organ prolapse, and pelvic pain.

It is offered in the MSDC or CMC depending on the communities. The evaluation and treatments are done in a closed and safe space.

The first session involves a lot of talking! We invite you to a safe space for you to talk about your concerns and your wishes. This can be done in person or online. In can be done in the clinic or while going for a walk. Take the time you need and when you feel ready, we start the physical examination which has two parts (it could be on your first, second or even third visit) 

1. External: this involves looking at your posture, how you are breathing and feeling how flexible your back and hip joints are. We check your abdomen and pelvis muscles for any tightness, pain and assess their strength and endurance. This can also involve checking if certain activities reproduce your symptoms, like coughing and jumping. 
    
2. Internal: this involves observing and feeling the muscles around your genital area, both outside and internally. To do the internal examination for women, we insert 1-2 fingers inside your vagina to feel how your muscles are working. Just like the muscles in your shoulder can be weak or stiff, so can the muscles around your vagina.  For men, we go through the anus. The internal exam gives us a lot of useful information to help you.  It is also useful to help you put words to what you feel.  Are you not ready for an internal exam?  That’s ok. There are still lots of other options to help you and we will respect your decision. 

What is important to remember is that you decide what type of examination you want to have. Remember, this is your journey, and we follow your lead. 

Once the examination is over, we will go over our findings with you. Knowledge is power and we feel it is important that you fully understand what could be causing your symptoms. We will go over our recommendations which could include breathing exercises, specific pelvic floor muscle exercises (the ‘kegels’), posture and lifestyle adaptations. Sometimes a referral to a specialist might be beneficial such as a gynecologist or nutritionist. We will discuss this with you so that you can make an informed decision on what you would like to do. 

We’ll also plan together what type of follow up you would like and how. 

The goal is for you to be symptom free and be able to do the activities that are meaningful to you.

What should I wear?

We recommend lose clothes to be able to move around freely, e.g. a T-shirt and tracksuit bottoms or shorts. 

What if I’m going through my menstrual cycle? 

Don’t worry! There’s plenty we can do in the external examination. We’ll book another appointment when your cycle has ended. 

You can either speak to a nurse or doctor to get a referral or contact the Pelvic Health Team directly.