Pelvic floor physiotherapy includes the assessment and treatment of various conditions that involve pelvic floor dysfunction, or symptoms that manifest in this area.
It can be a crucial part of an individual’s complete medical care. The pelvic floor includes muscles, ligaments, nerves and connective tissue. It plays an important role in the body by providing support for the bladder, genitals, uterus and anus. Pelvic floor pain or dysfunction can impact both women and men, at all ages and stages of life.
Chronic Pelvic Pain: Pain within or around the pelvic region, often without any positive physical diagnosis or medical explanation
Pubic Symphysis Dysfunction: Instability and pelvic pain associated with joint loosening surrounding the pelvic bone
Urgency: An inability to control a strong, compelling urge to urinate or defecate.
Nocturia: Waking at night repeatedly to urinate
Painful intercourse: Pain that develops in anticipation of, during, or following intercourse
Constipation: The difficult passage of hard stools less than three times a week, one week out of four.
Frequency: Having to urinate so frequently that your normal routine if affected
Incontinence: Leakage of urine, gas or feces that is difficult to control
Pressure and heaviness: A sensation of pressure or heaviness in the pelvic or abdominal region that causes regular or intermittent discomfort
Burning: A burning sensation in or around the urethra, that may or may not be associated with urination
Coccyx Pain: Pelvic pain associated with periods of sitting
Post-natal discomfort: Post-natal pain, tears, and minor organ prolapse that often the follow the delivery of a baby
What’s involved in Pelvic Floor Physiotherapy?
Before pelvic floor treatment begins, your pelvic health physiotherapist will take your full medical history and thoroughly discuss your current problems and symptoms.
With informed consent, your pelvic floor physiotherapist will perform a complete physical assessment of the joints and tissues affecting the area. This may include both internal and external examinations to identify the affected tissues that may be contributing to your urinary, bowel or pelvic pain symptoms.
Common areas that refer pain to the pelvic region include: the abdomen, lower back, hips, pubic symphysis (the front part of your pubic bones) and sacro-iliac joint (the joint formed by the sacrum and ilium from your low back to your coccyx).
Based on your examination, your pelvic health physiotherapist will work with you to put together a plan of care that is specific to your particular goals, symptoms and dysfunction.
Since every person has a unique case, it is important that your treatment is customized to address your specific needs.
There are various modes of pelvic floor treatment that are well supported by the scientific literature and can be effective as part of your care. Some of these treatment options include:
Education is power! You cannot under-estimate the importance of knowledge. Understanding the anatomy and physiology of the pelvic floor, posture education as well as knowing how to deal with chronic pain symptoms are vital to your recovery. Many clients have improved their symptoms by simply understanding how various aspects such as lifestyle, diet, urinary and bowel hygiene can affect the pelvic floor.
PERSONALIZED EXERCISE PROGRAM
As with other musculo-skeletal joints in the body, an individualized exercise program including stretching, strengthening, proper posture and breathing techniques are essential for overall pelvic health. Areas within the pelvic floor and other muscles surrounding the pelvis, thorax and lower limbs will be targeted.
It is important to review your voiding patterns with your therapist to ensure appropriate bladder and bowel habits. This is essential in helping to normalize your overall pelvic function.
This is presently the preferred method when treating pelvic floor dysfunction. It involves various hands-on techniques such as: stretching, facilitation, soft tissue massage, mobilization as well as connective tissue, myofascial and trigger point release techniques to the affected muscles and tissue.
OTHER TREATMENTS TO MINIMIZE PAIN
This may include the use of heat, cold, trans-cutaneous electrical nerve stimulation (TENS), interferential current (IFC), guided imagery, breathing and relaxation techniques. Your therapist will be happy to discuss these other options with you.