Pelvic Floor

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Restoring Full Pelvic Functionality and the Freedom to Live Your Life

Do you want to feel and live a normal life? That’s what pelvic floor physiotherapy is meant to deliver.

Or do you want to keep living like this: Waking up to go to the bathroom multiple times per night. Unable to run, jump, laugh, or cough without leaking in your pants. Inability to function sexually. Chronic pelvic pain and discomfort.

For far too long, women and men suffering from issues related to their pelvic muscles have been conditioned to accept that this is just how life will be from now on.

None of this is normal. None of this is how it is ‘supposed’ to be. And none of it has anything to do with aging. You should not be experiencing these frustrations just because you had a baby or are getting older or had a prostatectomy.

The Ultimate Guide to Pelvic Floor Physiotherapy

The good news is, you can do something about your pelvic health. Physiotherapy has advanced far beyond what typical medical doctors tend to do when working with a patient suffering from pelvic floor problems. Doctors sometimes recommend outlandish surgeries, or misdiagnose the real problem, or just tell you to do Kegels. As you’ll see later, Kegels can be part of the solution, sometimes. But very often these simply don’t solve the root causes of your pelvic floor issues.

As just one example, Kegels will usually not be enough to fix prolapse, a common pelvic condition that we’ll discuss in a moment.

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This appointment is your opportunity to tell us what hurts and discover whether physiotherapy is a good fit for you! During this session, you will talk with a physiotherapist on a phone call (or online) and create the right care plan specifically for your pain. There is no obligation, this session is only to find out if physiotherapy can help you getting back to doing the things you love in life.

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Improve the way your body moves so you can continue to do the things you love. PainHero is Canada’s largest network of physiotherapists, chiropractors, and registered massage therapists. Our mission is to make it easy for you to find the top clinics in your community. We handpick the top clinics using our 50 point inspection based on patient reviews, complaints, and patient outcomes. 

Whether you’re seeking pain relief or preventative care, you can expect our patient-centric approach to be new and different from any healthcare experience you’ve had before. Perhaps even life-changing.  

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The Ultimate Guide Pelvic Floor Physiotherapy

Who Is Affected by Pelvic Floor Disorders?

For starters, what is often perceived as a women’s pelvic health issue can affect men as well. But more women than men deal with pelvic floor disorders, primarily because of childbirth.

One third of women experience incontinence at some point in their lives. Over half experience prolapse, and one fourth deal with sexual pain. By age 80, almost half of women are dealing with some sort of pelvic floor disorder.

Childbirth can cause pelvic health problems because it can overstretch the pelvic muscles and disconnect the abdominal muscles.

Also, if you’ve had surgery or an injury, that too can lead to pelvic disorders. Beyond those common causes, pelvic floor problems can also be caused by hormonal changes, too much sitting, too much stress, and improper breathing patterns. All of these things can weaken the pelvic floor muscles and lead to the sorts of problems you may be experiencing.

And for men, in addition to the causes just listed, it is common to deal with incontinence after having a prostatectomy. But it doesn’t need to stay that way, and pelvic floor physiotherapy provides a way out.

Check out this great post where Athlete’s Care dives deep into who is at really at risk of pelvic floor problems:

 

What is the Pelvic Floor?

The pelvic floor is a set of muscles that are shaped kind of like a bowl. They stretch from your tailbone in the back to the pubic bone in the front. Together, these muscles support your internal organs in that area, such as the bladder, the rectum, and the uterus for women and prostate for men.

The pelvic floor muscles have a few openings within them that allow your body to remove waste in a controllable manner using sphincter muscles. When you urinate, for example, you know how to make your body completely empty itself. The same is true when you empty your bowels. The muscles you’re using for those tasks are your pelvic floor muscles.

Pelvic floor muscles also help your body maintain correct posture, stability, and coordination.

Healthy pelvic muscles therefore play a role in preventing low back pain, hip pain, and pelvic girdle pain. And the reason we’re learning how great a role pelvic floor muscles play in the rest of your body is because they also facilitate the pumping of blood and lymph back up to the heart from the lower parts of your body.

So a poorly functioning pelvic floor can affect circulation.

To get familiar with your pelvic muscles, you can use some breathing and posture techniques.

For instance, when you inhale deeply, your diaphragm flattens and your ribs expand. You can feel this. When this happens your organs lower down toward your pelvis, and a healthy pelvic floor makes room for this to happen.

Likewise, when you exhale, your diaphragm lifts back up while the abs and pelvic floor muscles contract and shorten. Getting familiar with these muscles is the first step toward strengthening and healing them.


Check out this great post that talks more about what exactly your pelvic floor is:

Why Is Your Pelvic Floor Important?

If you’re suffering from any pelvic floor disorders, you already know why. You may be dealing with urinary leakage, painful intercourse, sexual dysfunction, or perhaps chronic pain in your low back or pubic area.

Your pelvic muscles can become too weak, which is known as hypotonicity, or too tight, which is hypertonicity. Each of these leads to a different set of possible problems. But both are correctable with pelvic health physiotherapy.

If you don’t resolve these issues now, you may end up suffering greatly in your later years of life from things like persistent back pain, pelvic organ prolapse, and a decreased quality of life. Sometimes surgery becomes necessary.

We want to save you from all that! Pelvic floor physiotherapy works to resolve your pelvic health issues now so that you can enjoy the rest of your life free from pain, discomfort, embarrassment, and disappointment.

With a strong and fully connected pelvic floor, you will be able to exercise freely without pain, and without urinary leakage. You’ll sleep through the night. And you’ll have more strength and muscular efficiency, reducing your chances of injury.

Doesn’t that sound good? Then let’s get into some details.

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Find out whether physiotherapy can help you get back to doing the things you love in life. 

7 Common Conditions Related to Your Pelvic Floor

You’ve seen the symptoms. Now let’s look at some of the medical conditions they can lead to. 

1. Pelvic Organ Prolapse

This is the condition described above as a ‘bulge.’ The Battle of the Bulge’ may be known to many as part of World War 2, but for women dealing with prolapse, it’s a nonstop reminder that they need pelvic health physiotherapy. 

Organs have weight. They put constant pressure on your pelvic floor muscles. If those muscles aren’t up to the task, you’ll feel the weight bulging through in places you don’t want it. This is prolapse.

Check out this post by Donald Physiotherapy to learn more about Pelvic Organ Prolapse:

2. Urinary Incontinence

This keeps showing up on all these lists because it’s the most common effect of poor pelvic health. You lose the ability to control your sphincter that regulates flow from your bladder.

Pelvic floor physiotherapy offers the pathway to lasting, lifelong freedom from this frustrating and embarrassing condition.

Check out this UI infographic (courtesy of SOS Physiotherapy):

 3. Fecal Incontinence

The reasons for this are similar to those for urinary incontinence. But the aftereffects are quite different, as you can imagine. Regaining strength and ability to control your sphincter through pelvic floor physiotherapy is the best way to overcome this condition.

Check out this post (and read the caption) to learn more about incontinence for men by the Cheerful Pelvis:

4. Dyspareunia

This is the medical word for painful intercourse, and though more common with women, it can occur in men as well. There are a whole host of possible causes for this condition, with pelvic floor dysfunction being just one of them.

5. Pelvic Congestion Syndrome

Remember earlier when we discussed how a healthy pelvic floor facilitates the flow of blood and lymph back up to the heart? When that process doesn’t function like it should, pelvic congestion syndrome is the result.

You may be suffering from this condition if you’ve had pelvic pain for more than six months, especially if you have had more than one pregnancy. You can learn more about it here.

6. Rectus Diastasis

This is when the abdominal wall muscles separate from each other. You’ll often see a rounded belly from this condition. This is common during or after a pregnancy. Unlike other items on this list, this condition is not caused by pelvic problems, but it instigates them.

Patients with rectus diastasis tend to lose pelvic floor functionality over time, which eventually leads to incontinence and prolapse. Fun stuff. And not something you want to keep living with!

7. Persistent Pelvic Pain

This can take a variety of forms such as tight muscles, nerve sensitivity, and joint dysfunction.

This post goes in depth to educate about chronic pelvic pain and why it happens, courtesy of The Cheerful Pelvic:

What Is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy works to improve the strength, stability, and function of the pelvic floor muscle group. These muscles, shaped like a bowl, rest more or less between your hips, connecting the front of your body to the back, and supporting the organs above them.

As opposed to using drugs or surgery, pelvic floor physiotherapy, or pelvic health physiotherapy, uses all natural techniques to strengthen the muscles and restore control of them to the patient.

Just like someone who breaks an arm and needs to re-strengthen the muscles after the arm has sat immobilized in a cast for months, a weakened or overly tight pelvic muscle group needs to be re-strengthened if it’s ever going to work properly again.

Much of pelvic floor physiotherapy has been misunderstood, ignored, or over-simplified. Too many boil the entire field down to Kegels, especially when the subject is women’s pelvic health.

Don’t know if you will benefit from Pelvic Floor Physiotherapy or not? Watch this quick video to learn what a strong pelvic floor looks like (courtesy of MOOV Physiotherapy):

 

What Does a Pelvic Floor Physiotherapist Do?

The physio who works with you on your pelvic floor muscles will use a variety of techniques, both external and internal. Ample time is taken at the start to conduct an assessment of what’s going on. You will spend some time telling your story.

The assessment can cover a wide range of topics, including your history of pain and previous treatments, body mechanics, posture, anxiety and stress, coping strategies whether healthy or not, sexual function, bladder and bowel function, digestion, any trauma you’ve experienced, and much more.

Then, using various exercises, hands on treatment, and perhaps acupuncture, as well as educating you on things you can do on your own and lifestyle changes you can make, your physiotherapist will work to help you regain full function of your pelvic floor muscles. This often also affects your balance and posture.

You’ll also get coaching on how you can resume activities such as exercise, intimacy, and movement without pain or discomfort.

What Are the Benefits of Pelvic Floor Physiotherapy?

Quite simply, you get your life back.

If you’re suffering from pain during intercourse, urinary or bowel incontinence, low back pain caused by your pelvic floor muscles, prolapse, or any of the other problems we’ve discussed, how would you feel if you were able to repair and resolve the root cause?

You’d be jumping for joy.

Anything that is muscular-related should be treated on the muscular level. The pelvic floor muscle group is just that – a group of muscles. You can rebuild their strength and functionality. And when you do, you’ll see changes in these other areas of your life where in many cases, people have just given up.

5 Things to Look for In a Pelvic Floor Physiotherapist

Finding a physiotherapist for pelvic floor issues is not like visiting the dentist. You need to find one who you trust to work with you on what may become a fairly intimate level, and who can actually help you. Here are five things to look for:

1. Assesses and Treats the Whole Body

If all they talk about is Kegels, which we’ll also talk about in a bit, this is not the physiotherapist for you. Modern pelvic floor physiotherapy involves far more than that. You want someone well versed in the treatments, exercises, and knowledge of the field, and who knows how to assess your situation using a whole-body approach, based on the interconnectedness of your body systems.

This is the single most important thing to look for in a pelvic health physiotherapist.

2. Training in Chronic Pain or a Biopsychosocial Approach

So many pelvic floor patients, especially women, come to their physiotherapists with a history of not being believed. Or, their problems are explained away as easily fixable or something they’ll just have to live with. You need a physiotherapist who understands your hesitation and fear because of so many past failures.

And you want one who understands the biology and the psychology of chronic pain.

3. Training in Sports or Orthopaedics

One or both of these are helpful as well, because the pelvic floor muscle group interacts with your other muscles and bones, particularly your spine. This hits again on the interconnectedness of your body systems. You want a pelvic floor physiotherapist with expertise in how this one muscle group relates to your whole body. The pelvic floor is not an isolated muscle group.

4. Offers Trauma-Aware Care

Particularly for women’s pelvic health, some pelvic problems are the direct or indirect result of trauma. Sometimes this trauma may have happened many years ago, but the physical and emotional affects still persist.

A pelvic floor physiotherapist will be engaging with parts of your mind and body that will bring those emotions and past experiences to the surface. That’s hard. You want someone who knows how to navigate those memories and experiences with you in a trusting and caring manner.

5. Offers First-Time Phone Calls

After reading all this, you may be feeling nervous. A good pelvic floor physiotherapist understands your uncertainty and anxiety about coming in. Doing the first meeting on the phone is a good way to bridge this gap and help you decide if you’re willing to do more.

Look for a specialist who gives this as an option if you’d describe yourself as ‘nervous’ about seeking pelvic health physiotherapy.

5 Steps to Improve Your Pelvic Floor Right Now

Much of pelvic floor physiotherapy begins with simply getting in touch with these parts of your body. Most of this is internal, and the muscles are not obvious like a leg or shoulder muscle. Posture and breathing play a large role in pelvic health physiotherapy.

Here’s a 5-step breathing process you can start using right now to begin to strengthen and get in touch with your pelvic floor muscles.

Step 1

Sit down

Step 2

Breathe in, focusing on your lungs as they fill up

Step 3

Breath out, and feel your abdomen contract as it empties

Step 4

Narrow your ribs back to their original position

Step 5

Do this 5-10 times per day

This is a simple breathing exercise. Why is it helpful? Because pelvic muscles are affected by your body’s alignment.

Pelvic Exercises for Women

Here are five exercises you can start using today to strengthen your pelvic floor muscle group.

1. Kegels

Okay! We’ve been hearing all about these. If you don’t know what they are, here’s the simple explanation:

When you urinate or have a bowel movement, you use muscles to make yourself go. When you flex or relax those muscles, you are essentially doing Kegels. But people with weak pelvic floor muscles need to do this much more often.

You can do Kegels anytime, anywhere. Standing or sitting. Just tighten your pelvic muscles as if you’re trying to prevent yourself from urinating. Hold that position for five seconds, and release. Then repeat it ten times.

Do this every day for a while, and you will strengthen your pelvic floor muscles. This will address some pelvic floor problems. Just not nearly all of them despite what some doctors say.

Read the caption on this post to learn more about Kegels, courtesy of The Cheerful Pelvis:

2. Quick Contraction

This is kind of like a Kegel except you don’t hold it for five seconds. Just squeeze and then immediately release the pelvic floor muscles. Repeat this 5-10 times.

3. Bridges

For this one, lay on your back with your knees bent and feet flat. Then you lift your buttocks off the floor so only your shoulders and head are touching the ground.

Hold this position for 5-10 seconds and relax back down to the floor. Repeat this up to ten times, and then do two additional sets after resting.

Take a quick look at this post by Durham Pelvic Health and read the caption for more tips on how to do bridges effectively:

4. Squats

Stand up with your feet spread out about the width of your hips, flat on the floor. Squat down and bend your knees, keeping your back leaning forward and your chest up.

Focus on tightening your buttocks, pelvic floor, and abdominals. Then rise back up. Repeat this ten times, and then do two additional sets after resting.

5. Posture

Sit down and practice good posture and alignment. Your ear should be over your shoulder and your back should be straight. Your back should not be arched, nor slouched, and your hips should not look rounded when viewed from the side.

Practice sitting in this position for a while and train your body to do it this way all the time.

Try these postural exercises to help strengthen your back and core muscles to support your body throughout the day (courtesy of Physiomobility):

Pelvic Exercises for Men

Though there are certain pelvic floor disorders unique to men and women, the amazing thing is that the basic exercises are the same.

The same five exercises listed above for women work just as well for men too.

If you’ve had a prostatectomy and are now suffering incontinence, or if you have erectile dysfunction, pelvic pain, chronic constipation, or frequent urination at night, you probably have a pelvic floor problem.

Try to make yourself a plan to do the five exercises listed above for a couple months and see if you notice any improvements. If it doesn’t seem to resolve the problem, look for a pelvic floor physiotherapist using the 5 criteria listed earlier.

Common Injuries Successfully Treated with Pelvic Floor Physiotherapy

Frequently Asked Questions

If you have tight muscles then Kegels are NOT the thing for you…there is no need to contract muscles that are already short or tight. BUT if you have weak muscles then Kegels (when done properly) can be helpful.

Sure can! Painful intercourse can stem from a number of issues. Generally speaking, pelvic floor muscles are tight with painful intercourse. This can be from stress, your posture, previous childbirth(s) etc. It’s best to have a full assessment with a pelvic floor physiotherapist to explore your specific situation.

Short answer: No, you don’t and there are tons of techniques we can use to help you externally. Long answer: Having an internal exam from a trained pelvic floor physiotherapist will provide the most information about your specific pelvic issue allowing a more complete understanding to move forward with a treatment plan of action.

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IMS treatment is one of several possible methods for relieving pain that do not rely on prescription medications and all the side effects and baggage they come with. Not to mention that most drugs can only mask pain, but rarely address root causes. Find a clinic if you are suffering from muscle tightness, soreness, or pain to improve your quality of life, today.