During your pelvic floor physiotherapy assessment I will take a detailed subjective and medical history to better understand your condition. If it is appropriate, we will discuss the value of doing an external and internal examination of the pelvic floor - this may involve a vaginal and/or rectal exam. This can help to determine the state of the pelvic floor, both the strength and coordination of these muscles.

I may also assess your lower back, pelvis, hips and surrounding muscles as these muscles and joints work together and can influence your pelvic floor. From there, we will discuss treatment options best suited for you and your specific needs.

After you have been assessed and we have determined an appropriate treatment plan, treatment may include but is not limited to:

1) Education: understanding your diagnosis, and how your lifestyle choices may be influencing your condition, is the first step to improving the function of your pelvic floor and managing your symptoms. Controlling your diet, monitoring your bowel and bladder habits and postural awareness can all contribute to your pelvic health.

2) Manual therapy: hands-on techniques may be used to stretch, mobilize and release tension in the soft tissue of the pelvic floor and surrounding tissue of the lower back, abdomen and lower extremities.

3) Exercise: exercises to strengthen, lengthen and improve the coordination of the pelvic floor and surrounding musculature to improve function. Internal examination and retraining of the pelvic floor is considered the gold standard in pelvic health.

4) Acupuncture: used to alleviate pain and improve neuromuscular function, your therapist can further discuss this option during your treatment if they feel it is appropriate for you.

Physiotherapy is direct access in Ontario, meaning you do not need a referral to see a pelvic physiotherapist. However, some insurance companies require a referral from a physician in order to access your extended health benefits for physiotherapy. I always advise checking with your insurance company prior to scheduling an appointment.

The short answer is no!

You decide what part of the assessment and treatment feel comfortable for you. I will always review the risks and benefits of any physical assessment or treatment and you get to decide what feels right for you.

An internal examination allows me to palpate (feel) the pelvic floor muscles and is considered the gold standard in assessing the pelvic floor. However, there are alternative treatment strategies we can use if an internal exam doesn’t feel right for you.

Consent is an ongoing process. Meaning you may decide you want to try an internal exam at a later date. Or you may decide you no longer want to continue with internal exams. We maintain open communication throughout your treatment plan to ensure you feel comfortable!

If your extended health insurance has coverage for physiotherapy then you have coverage for pelvic physiotherapy (which is an extension of physiotherapy). At the end of your assessment or treatment you will be provided with a receipt that you can use to submit to your insurance coverage.

It is important to bring any diagnostic tests or imaging that may be informative about your condition. If another health practitioner has referred you it can be helpful to bring that referral form, although not necessary. For your assessment it can be helpful to wear comfortable clothing that you can move in (i.e. tank top, shorts/sweatpants) as your therapist will be assessing how your whole body moves.

Everyone is different and the number of treatments you will need depends on your condition and your treatment goals. We can work together to find a treatment plan that works best for you and your specific needs

We can treat you throughout the duration of your pregnancy! Typically any internal examination of the pelvic floor muscles is reserved for the second trimester. I recommend doing birth prep education around 35 weeks of pregnancy.

We can work together when you feel ready after your delivery. Prior to 6 weeks we can work on gentle movement, stretches and strategies for managing any postpartum aches and pains you may be experiencing. In order for me to complete an internal examination of the pelvic floor muscles you have to have seen your care provider and been cleared for sex.