Physiotherapy is a profession that uses hands on skills, education and exercise to help people address issues with the way their body is moving, functioning and feeling.
Pelvic floor physiotherapy is really no different.
Pelvic floor issues can and should be addressed like any other muscle issue — with conservative pelvic floor physiotherapy first, before long term drugs or surgery are considered.
Assessment involves a detailed history, discussion of your current issues and goals, and an analysis of your bladder and bowel habits. The physical assessment is an internal vaginal exam (if you are pain free and comfortable with this) without apparatus, so it is much less invasive than a PAP. The position and tone of your muscle is checked, along with its strength and its ability to relax. Prolapse, reflexes and how the muscle works with your breath and core stability system are also assessed. For some women, a rectal exam to assess the more posterior pelvic floor muscle or bowel function is indicated. Obviously for men all exams a rectal. Associated issues like posture, back and hip movement and core control are also assessed.
Following assessment, we discuss any findings and how they relate to your issues or potential future issues, and formulate a treatment plan.
Treatment may include
- Pelvic floor exercises that are specific to you and as such are much more effective than generic ‘Kegels’
- Hands on treatment such as joint mobilization, massage, and muscle facilitation
- Education and advice for relevant lifestyle and behavioural changes
- Posture correction
- Whole body exercises, often Pilates based
Each assessment and treatment program will be specific to you, your needs and your comfort level. These are delicate issues, which can involve past trauma. Your rehabilitation is respected as a sacred and highly personal process, and always within the realm of what you are ready for and capable of. A dialogue of how you are finding the work, and any difficulties you are having emotionally or practically will be invited at all times.
A Pelvic Floor Physiotherapy assessment is indicated if you have any of the following:
- Pain in the pelvic floor / perineum
- Bladder or bowel urgency or frequency
- Bladder or bowel leaking
- Prolapse / heaviness in perineum
- Poor core stability
- Post delivery / C-section
- Diastasis rectus abdominus or muscular abdominal pain
- Low back / pelvic / hip pain (chronic or related to pregnancy)
- Tail bone pain (coccydynia)
- Poor sexual sensation
- Pain on vaginal penetration
- Recurrent bladder infections / Interstitial cystitis
Check out my physiotherapy schedule.
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