Pelvic Floor Physiotherapy
Contrary to popular belief, you don’t need to live with incontinence, pelvic pain and low back pain as a side effect of motherhood. If you’re experiencing bladder control issues or pelvic floor pain when you sneeze, cough, or in the middle of your fitness routine, we can help.
Pelvic floor physiotherapy treatments address the pain and discomfort associated with weak or imbalanced pelvic floor muscles. Even if you’ve been doing your Kegel exercises on a regular basis, you might still have trouble with lower back pain or abdominal pain or discomfort during sex. That’s where we come in.
Pelvic Floor Physiotherapy While Pregnant
While you may not have any incontinence, you may find that your entire pelvic area (inside and out) just feels different than it used to. Perhaps sex doesn’t feel the same as it did before you got pregnant. Maybe you are getting up to pee a few too many times every night. (FYI more than 3x/night while pregnant is too many times!) In addition to symptomatic relief, many of our patients don’t realize that prepping the pelvic floor for delivery is just as important as taking a childbirth education class, learning effective breathing techniques for labour and making a good birth plan.
During labour, the birthing person’s job is to dilate, and the baby’s job is to rotate. It’s a fancy little dance. The baby’s head comes down through the pelvis, hits the pelvic floor and rotates on the pelvic floor to get out of the mother’s body. It makes sense that we would want to make sure that the pelvic floor is even and balanced in order to have an easier delivery. We call it “preparing the runway for a smooth landing”.
Postnatal Pelvic Floor Physiotherapy
Most of our patients are aware that pelvic floor physiotherapy is 100% necessary for every woman after having a baby.
Vaginal birth is a trauma to the pelvic muscles, and much like if you had any other kind of muscle trauma, you need some rehab for your pelvic floor! Peeing even a single drop while you sneeze/cough/laugh/jump, pain during sex, a feeling of “fullness” in the pelvis, chronic low back pain; these are all signs that you probably need a pelvic floor physio.
Even with a caesarean delivery, you still need a pelvic physio. The weight of your baby, fluid, placenta and uterus, all put strain on your pelvic floor and it will require rehab afterward. Heck, even if you feel great after having a baby, it’s worth having someone make sure that humpty dumpty has been put back together again. A pelvic floor specialist can help.
Lastly, if you are considering returning to any kind of exercise after birth, it’s worth getting looked at to make sure that you’re good to go. We can help you make sure that all of your parts are where they belong and that you won’t do more harm than good with your baby bootcamp.
Pelvic floor physiotherapy treatments can prevent and/or treat:
- Incontinence and bladder control issues
- Low back pain
- Pelvic pain and discomfort
- Abdominal pain
- Caesarean section (c-section) scarring
- Episiotomy and tearing complaints
- Pain during or after postpartum sexual intercourse
- Diastasis Rectus Abdominus
Your First Pelvic Floor Physiotherapy Visit
Most people aren’t really sure what they’re in for, but they sign up anyway because someone told them that it was a good thing to do. Let’s dispel a few of the myths and answer some questions here.1. First and foremost, we take a very thorough history to get a clear idea of what your pelvic history (prior to pregnancy) was like.
For example: have you ever leaked while doing crossfit? Do you have a history of chronic pelvic pain? Has sex ever been painful? Has everything always been hunky dory? These are all useful questions.2. Moving on, we get to what your current symptoms are (if any).
For example: have you ever leaked while doing crossfit? Do you have a history of chronic pelvic pain? Has sex ever been painful? Has everything always been hunky dory? These are all useful questions.3. We go through a very thorough explanation of what the pelvic floor is.
(for those that don’t know: it’s the muscles INSIDE your pelvis).4. Then we move on to an assessment.
The preferred method of assessment and treatment is an internal vaginal exam. Fear not! It’s not like a pap smear; there’s no stirrups, no speculum, no one staring at your lady bits. It’s remarkably comfortable (if a little weird, admittedly.)
Because the pelvic floors muscles are internal and not visible from the outside, the therapist can’t actually accurately assess and treat pelvic dysfunction without a proper internal evaluation. We say that it’s like seeing a physio for shoulder pain but wearing a parka. You would have a hard time getting an accurate diagnosis without actually assessing the function of the muscles themselves.
There are some external techniques that can be beneficial in some pelvic dysfunction, but the most effective and accurate treatment is internal.5. The actual treatment of the pelvic floor.
Treatment is similar to just about any other physiotherapy treatment. We perform muscle testing to determine the strength of your pelvic contraction, then assess for areas of tension and tightness in your pelvic floor. We also look for muscle knots and trigger points that might causing dysfunction and pain.
That’s it! Like all other physiotherapy treatments, you will be sent home with an individualized home exercise program to work on goals for your treatment. This may include pelvic contractions, stretches, abdominal work, and relaxation techniques.
Frequently Asked Questions
Absolutely, yes! In truth, everyone could benefit from pelvic floor physiotherapy. Think of it like getting a massage — you may not have a current “issue" going into treatment, but in our experience, everyone has something that can be worked on to make them stronger and more balanced. That said, the most common indications that you need a pelvic floor physio are incontinence (urinary or fecal), pain with intercourse, pelvic pressure and heaviness, and/or prolapse. It is advised that all pregnant mothers come in DURING their pregnancy for labour preparation and after delivery for rehabilitation.Does treatment differ if you had a vaginal birth vs a c-section. If so, how?
We do an internal treatment for both, however, we spend more time on the scar tissue and releasing connective tissue over the abdominal cavity with Caesarean sections. It's major surgery and needs to be viewed as such. During the surgery, both the abdominal musculature and connective tissue are cut, which can cause extreme weakness and tension in both structures. This can create a lot of mechanical issues over time, such as lower back pain, pelvic dysfunction, hip pain, and more. The c-section scar itself may create tension and tightness, so we perform gentle scar tissue release and teach patients how to continue doing this at home. We also do core retraining to strengthen the integrity of the abdominal muscles after the surgery.
If I had a baby many months/years ago, is it too late to now start pelvic floor physiotherapy?
Yes! Whether you had a baby a year ago, 20 years ago, or are just starting to try to get pregnant, it's never too late to get started with pelvic floor physiotherapy.
How many sessions are typically required?
The number of pelvic physiotherapy treatments will depend on the mama. Each treatment plan is individualized — similar to other physiotherapy treatments. Sometimes it's just once a month, while in other cases it may be weekly, depending on the initial assessment and symptoms .Do you provide 'homework' between the pelvic therapy sessions?
Yes. The appointment is devoted to manual therapy and treatment, so we always send people home with some guidelines to follow or exercises that are specific to their situation, which may take just a few minutes per day to complete.Are kegels enough to keep your pelvic floor strong?
Believe it or not, kegels are not for everyone! A lot of people are doing kegels unnecessarily or improperly and they may be causing more harm than good. This is why it is so important to have a proper assessment by a pelvic floor therapist.
Are you going to tell me that I can't run or do cross-fit anymore?
Not at all! We may make modifications while you are recovering, but we know that exercise (not to mention, your favourite activities) are important for a mama’s physical and mental health. Instead of writing off your favourite activities, we may work towards a modified goal while we get you to where you want to be.
Complementary Services & Treatments
We provide a holistic approach to treatment, and have a wide variety of services that compliment each other. Click on the links below for more information about how our other services can help you on your path to motherhood.