Pelvic Physiotherapy is a specialized service provided by registered, skilled and qualified physiotherapists who have additional traning and certification to treat this region of the body. They take a full history, perform orthopaedic assessments and most importantly, they perform an internal examination of the pelvic floor muscles (vaginal and sometime rectal, if needed). This internal exam is key in distinguishing between a weak or tight pelvic floor and providing the correct treatment plan. Pelvic physiotherapy is not exclusive to pregnant and postpartum women, although it is during those times that it is most often utilized.
The pelvic floor is made up of a group of small muscles that support and hold up the bladder, bowels, rectum and uterus as well as their associated ligamnets, fascia and nerves. They work with the deep abdominal/back muscles and the diaphragm to stabilize and support the spine. Like all muscles, they need to be strengthened when weak and relaxed when too tight in order to perform optimally.
Pelvic floor issues occur when the pelvic floor muscles are stretched, weakened or too tight. Some of the common symptoms associated with pelvic floor dysfunction and indicate a need for phsyiotherapy include pain or discomfort with intercourse, pain with urination, unexplained pain in the low back and pelvis, feeling of heaviness or pressure in the pelvis, constipation and painful cramps during or before periods.
Certain situations put a woman at risk of developing pelvic floor issues including: pregnancy, delivery of a baby, menopause, gynaecological surgery, as well as heavy lifting, and sometimes even an intense exercise program.
Pregnancy and Your Pelvic Floor
The nature of pregnancy is demanding on the pelvic floor. The extra weight from the growing uterus and baby adds additional stress to these muscles. Often women are told to just do Kegal exercises while pregnant and while this exercise is a great way to strengthen the pelvic floor muslces, more often than not, those muslces are already tight and doing Kegals (especially in the 3rd trimester) only makes things tighter and can set you up for a more difficult postpartum. Your pelvic physiotherpaist can properly assess, educate, treat (both internally and externally) and provide you with the right exercises you should be doing to prepare for childbirth and better postpartum recovery.
Pregnancy and childbirth create a significant amount of tension in the pelvis and the pelvic floor muscles need to be rehabilited postpartum. Just like any other muscle group, they have trigger points and referral patterns that can refer pain inot your low back and gluteal muscles. Pelvic health physiotherapy is designed to address tight or weak muscles and should be a therapy every woman considers during pregnancy, after the birth of a child and/or if experiencing pelvic related health issues at any time in her life. Its importance should not be underestimated, in France for example, every woman is prescribed government-funded pelvic floor physio postpartum highlighting it’s essential place in women’s health.
If you’re pregnant and have never been assessed we encourage you to have at least one visit with our pelvic floor physiotherapist before your baby arrives. This can be a game changer and prevent a lot of problems from occurring.
If you just had you baby, we encourage you to wait till you’ve been cleared by your midwife or OB (usually around 6 weeks postpartum) before making an appointment with our pelvic floor physiotherapist.
We cannot stress enough how vital it is to restore proper function the muslces in the pelvic floor after pregnancy and childbirth. Pelvic floor dysfunction can contribute to pelvic organ prolapse, incontenence, chronic pevic pain and difficulties with bladder or bowel function. Many of these are preventable if addressed and treated early on.