Is usually the reaction when I refer a woman to a pelvic floor physiotherapist. YES! And, they can improve your quality of life in monumental ways. Serious.
If you’ve been reading my work or training with me for while you know I tend to go on and on (and on) and pelvic floor physiotherapy. It’s fascinating, and I believe a major missing piece of the puzzle for so many women in pregnancy and post-pregnancy.
Especially in North America. In some other countries of the world, women are automatically given pelvic floor “re-education” sessions with doctors and physio’s following the birth of their babies. All paid for.
Here? Most don’t know it even exists.
This means so many women live for years and years in pain, carrying extra pairs of underwear with them wherever they go, having worsening symptoms with subsequent pregnancies, avoiding exercise classes and social events because of potentially embarrassing situations.
All when there is so much treatment that can be done! A trusted pelvic floor or women’s health physio can be a really important tool to keep close.
To give you a clearer idea of why you might see a physio, what will happen at your first appointment, and why kegels are not the whole story, I called in one of my fave Calgary pelvic floor physio’s, Samantha Cattach, to give you the run down.
Take it away, Sam!
What is pelvic health physiotherapy?
Pelvic health is a growing field of physiotherapy that focuses on the prevention and treatment of pelvic floor dysfunction.
While both men and women can experience pelvic floor issues, women are often more at risk due to our anatomy and the extra loads placed on the body by pregnancy and childbirth.
And while “Kegels” have become a blanket prescription as the cure for all pelvic floor problems, unfortunately, it is not quite that simple.
For a large majority of us, doing these repetitive, isolated pelvic floor contractions can actually be more harmful than helpful.
Rarely are our muscles just ‘weak’ but more commonly they are hypertonic (tight) or too short.
One of my roles as a pelvic health physio is to provide education and treatment for the pelvic floor and core muscles and how they function as part of the whole body.
Their main roles include providing support your pelvic organs, optimizing bladder, bowel and sexual function and contributing to core stability for your pelvis and spine.
Here are some of the conditions I commonly see:
- Education and preparation during pregnancy to optimize labour and delivery and decrease the risk of postpartum complications
- Treatment of pregnancy-related pelvic girdle pain, including pubic symphysis and sacroiliac joint pain
- Bowel and bladder issues (eg. incontinence, urgency, constipation or pain)
- Postpartum proactive check-ups and pelvic floor rehabilitation for optimal recovery prior to returning to pre-pregnancy workouts
- Perineal tearing
- Diastasis Recti – abdominal separation
- Urinary urgency, frequency and incontinence
- Bowel incontinence or constipation
- Pelvic organ prolapse
- Pelvic pain (eg. SIJ, lower back, tailbone pain)
- Prolonged discomfort or pain with intercourse
What should you expect at your pelvic health physio visit?
As we are physiotherapists first and foremost, the structure of a pelvic health visit is similar to an orthopaedic or musculoskeletal visit in a private room.
The visit begins with taking a detailed history of your current symptoms and past history of pregnancies, injury, pain and bladder and bowel function.
This is then followed by a physical assessment which may or may not include an internal exam at the first session.
The internal exam generally does not involve a speculum, rather just a gloved finger.
This allows us to assess for prolapse, how well the pelvic floor muscles are able to contract and relax, as well as the muscle tone and any possible restrictions from scar tissue.
The internal component can also be used to treat and retrain the pelvic floor muscles.
While both the history taking and the physical assessment are very important, as the patient you do not have to do any assessment that you are not comfortable with.
I always include some education and will often begin a home program on the first visit.
However, it is also important to know that every therapist has their own approach, even though we have similar training!