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

Your therapist 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, your therapist will discuss with you the treatment options that will be best for you.

After you have been assessed and you and your therapist 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. We always advise checking with your insurance company prior to scheduling an appointment.

No! To do any physical examination, I need to have your consent. An internal examination allows us to palpate (feel) the pelvic floor muscles but is in no way mandatory. We may choose to use other treatment strategies to address your concerns, postponing an internal examination for a future treatment session. Or you may choose to forgo any internal examination.

Ultimately, it’s up to you!

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. Working together with your therapist you can determine a treatment plan that is appropriate for you.

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 36 weeks of pregnancy.

I typically see patients after they have been discharged by their care provider around 6 weeks postpartum. This allows us to complete an internal examination and assess the pelvic floor as needed at your first postpartum visit.