Pelvic Floor Physio

Have you been told that bladder leaks are normal after having children or with aging?  Incontinence refers to the involuntary leakage of urine or feces.  It is a condition that can affect people of all ages and genders but is especially prevalent among women, particularly after childbirth and during pre and post menopause.

While leakage may be common, it doesn’t mean it’s normal.  Pelvic floor physiotherapy and pelvic floor muscle training is a tool commonly used to treat incontinence in both females and males.  In fact, it is the single most effective treatment for incontinence (yes, even more effective than surgery in the long term!)  If you have any of these symptoms, you may be experiencing incontinence:

• An involuntary loss of urine (yes, even “just a few” drops!) 
• Leakage triggered by physical activities such as coughing, sneezing, laughing, or exercising
• A sudden, intense urge to urinate, followed by involuntary leakage
• Frequent or constant dribbling of urine due to a bladder that doesn’t fully empty when using the restroom
• Urine leakage occurs due to physical or cognitive impairments that prevent you from reaching the bathroom in time

Our pelvic floor physiotherapists work with you closely to understand when, how, and why bladder leaks are happening.  Based on this information, they will create a personalized treatment plan that aims to alleviate symptoms and restore function so that you can start living life, leak-free!

Perimenopause is a transitional period leading up to menopause marked by hormonal changes, typically fluctuations in estrogen and progesterone levels.  There is a wide spectrum regarding the onset of perimenopause.  Some may begin to notice signs of perimenopause in their forties while others may notice signs as early as their mid-thirties.

The symptoms of perimenopause can vary widely from person to person.  Common symptoms include:

• Irregular periods
• Hot flashes & night sweats 
• Mood changes
• Sleep disturbances
• Vaginal dryness 
• Decreased libido
• Urinary issues
• Weight gain

Seeing a pelvic floor physiotherapist offers numerous benefits for mid-life health including:

• Improved blood flow and circulation
• Optimizing pelvic floor muscle function
• Education regarding vaginal dryness, sexual health, and wellness
• Pelvic floor muscle training to prevent incontinence 

We work collaboratively with you, and your other healthcare providers, to create a supportive, informed team that is there to guide you through (peri)menopause and beyond.

Pelvic pain refers to discomfort in the lower abdomen and pelvic region.  It can be acute (short-term) or chronic (lasting six months or more).  Pelvic pain can affect all genders. There are many different causes of pelvic pain and it is often misdiagnosed and poorly understood. 

The symptoms of pelvic pain can vary widely.  Symptoms may include:

• Constant or intermittent pain
• Sharp or dull ache
• Localized or diffused pain
• Pain during activities (for example during intercourse, physical activities, or bowel movements)

Our team can help you understand why things hurt while providing tools and techniques to help you navigate your pain.  By understanding and addressing the underlying issues contributing to pelvic pain, pelvic floor physiotherapy can help you alleviate symptoms, improve function, and help you get back to doing the things you love.

Pelvic organ prolapse (also known as ‘POP’) occurs when one or more of the pelvic organs descend into or outside the vaginal canal.  This is often due to weakness or changes to the pelvic floor muscles. 

The symptoms of pelvic organ prolapse can vary but may include:

• A feeling of heaviness or pressure in your vagina/rectum (often amplified at the end of the day)
• A feeling that something is ‘falling out’ of your vagina
• Not being able to keep in a tampon
• Urinary issues (leakage or retention)
• Bladder & bowel leakage
• Inability to have a complete bowel movement, or still feeling full after
• Pain with sexual activity
• Visible protrusion

Research suggests that pelvic floor physiotherapy is an effective first line of defense to help with pelvic organ prolapse and in many cases is an appropriate alternative to invasive surgeries.  Our physiotherapists work with you to create a functional treatment plan to help alleviate symptoms, improve pelvic floor strength and function, and restore your quality of life.

Does sexual activity hurt?  Pain with sexual activity is a condition where individuals experience discomfort or pain during, or after, sexual activity.  This can occur for various reasons, ranging from physical to psychological factors. Both women and men can be affected.  Pelvic health physiotherapists are trained to assess, diagnose, and treat a variety of sexual health conditions related to painful sex including:

• Dyspareunia
• Vestibulodynia
• Vulvodynia
• Vaginismus
• Gynecological cancers
• Pelvic scar tissue
• and more

The symptoms of pain with sexual activity may include:

• Discomfort at the vaginal opening or during initial penetration
• Pain during deeper penetration which can be felt in the lower abdomen or pelvis
• Sensations of burning, stinging, or aching during or after intercourse
• Throbbing or sharp pain
• Emotional ramifications (feelings of anxiety, fear, or dread associated with sexual activity due to the anticipation of pain)

Sex shouldn’t be painful!  Seeing a pelvic floor physio can help you on your road to pain-free physical intimacy.

The pelvic floor does not function in isolation.  It is linked to so much more in the body!  Orthopedic pelvic floor conditions speak to issues related to the musculoskeletal system of the pelvic region.  The muscles, ligaments, and bones which support the pelvic organs may be affected.  Such conditions can develop from a variety of factors including injury, childbirth, surgery, or persistent stress on the pelvic structures.

Common orthopedic pelvic floor conditions include:

• Pelvic floor muscle dysfunction
• Pelvic girdle pain
• Pelvic organ prolapse
• Post-surgical pelvic rehabilitation

The symptoms of orthopedic pelvic floor conditions can vary depending on the specific issue but may include:

• Pelvic pain
• Persistent low back or hip pain
• Tailbone pain/coccydynia
• SIJ pain

By addressing the musculoskeletal components of the pelvic region and providing holistic, comprehensive care, pelvic floor physiotherapy can help you improve your pelvic health and regain function in your daily activities.

Endometriosis is a persistent medical condition where tissue similar to the lining of the uterus, grows outside the uterus and can attach anywhere within the body. This can cause inflammation, scarring, and the formation of adhesions. Endometriosis signs and symptoms are often misdiagnosed or ignored which is why the average time from symptom onset to diagnosis is anywhere from 7-10 years. Endometriosis symptoms can vary widely among individuals but common signs include:

• Pelvic pain
• Menstrual irregularities
• Pain with intercourse
• Pain with bowel movements or urination
• Fertility difficulties
• Other physical symptoms such as fatigue, diarrhea, constipation, bloating and nausea

We understand the disruption endometriosis can bring to your life.  Pelvic floor physiotherapists can offer a holistic approach to managing your symptoms, acting as a medical advocate for you, and improving overall pelvic health through pain management strategies, pelvic floor training, biofeedback, education, and emotional support.

Painful bladder syndrome (also known as interstitial cystitis) is a persistent condition marked by pain, pressure, or discomfort in the bladder and pelvic region. Interstitial cystitis (IC) affects all genders although 90% of individuals diagnosed with IC identify as women. In males with IC, it can commonly be misdiagnosed as generalized pelvic pain or prostatitis. 

Symptoms of painful bladder syndrome can vary from person to person and may include:

• Bladder pain
• Frequent urination
• Urgent need to urinate
• Pain during urination
• Pain during sexual activity 
• And other physical symptoms such as pelvic pain, lower abdomen discomfort, and in some cases, urinary incontinence

By addressing the muscular and functional elements of the pelvic region, pelvic floor physiotherapy can help you integrate pain reduction strategies, improve your bladder function, and enhance your quality of life living with interstitial cystitis.

When we use the term ‘bowel health,’ we are referring to the proper functioning of the bowels.  Regular, pain-free bowel movements are indications of appropriate bowel function.  Our physiotherapists commonly help individuals maintain or improve their bowel health through education, improving pelvic floor muscle control and coordination, and lifestyle modifications.

Poor bowel health can present through various symptoms.  Some common symptoms include:

• Irregular bowel movements
• Cramping, bloating, or other abdominal pain
• Constipation
• Loose stools
• Hemorrhoids
• Anal fissures
• Changes in stool consistency
• Rectal pain or bleeding
• Fecal incontinence
• Excessive gas

Pelvic floor physiotherapy addresses both the muscular and functional aspects of bowel health, offering a holistic approach to managing symptoms and improving quality of life. By improving the pelvic floor muscles, we can help you achieve better bowel control, reduce discomfort, and learn strategies for maintaining optimal bowel health.

Pelvic floor physiotherapy can significantly aid in hysterectomy recovery.  It is important to understand that your cervix sits at the top of your vaginal canal and works to “hold up” or maintain the shape and structure of the vagina.

After a hysterectomy, your uterus and cervix are removed, eliminating that top structural support for the vaginal canal.  Pelvic floor physiotherapy can help by ensuring your pelvic floor muscles remain a stable base of support for your remaining organs such as your bowel, bladder, and intestines.  This specialized therapy focuses on:

• Improving pelvic floor function, stability, and strength
• Reducing post-operative pain
• Scar tissue management and massage
• Regaining core strength
• Improving posture
• Preventing post-operative complications such as: pelvic organ prolapse, incontinence, pain with sexual activities, and vaginal dryness

Through tailored exercises and techniques, our pelvic floor physiotherapists can help you manage post-operative pain, prevent complications and support the healing process, leading to a smoother and more comfortable recovery.

Everyone has a pelvic floor and that means everyone can experience pelvic floor dysfunction.  Yes, even those of you with penises!  Some common examples of pelvic floor issues that those with penises experience are:

• Chronic prostatitis
• Constipation
• Pain with sexual activity
• Erectile dysfunction
• Urinary incontinence
• Pelvic pain

Pelvic floor physiotherapy can be highly beneficial in treating these conditions, helping to alleviate pain, improve bladder and bowel control, and enhance overall quality of life.

We also hold space and provide care for those who have experienced miscarriage, stillbirths or are undergoing IVF procedures. We recognize these journeys require the utmost empathy and support, and we are here to assist your physical and emotional recovery. Similarly, we also help those navigating endometriosis and interstitial cystitis / painful bladder syndrome.