Is focused on the muscles of the pelvic floor. Pelvic floor muscles are a group of muscles that extend from the pubic bone to the tailbone. These muscles form a sling between the legs and are responsible for supporting the low back, hip joints and pelvic organs (bladder and rectum in men, bladder, uterus and rectum in women). They play a very important role in urination, bowel function and sexual function. Just like other muscles, they can become weak, overactive or injured too.
Injury to the pelvic floor may occur after pregnancy, delivery (vaginal or caesarean), menopause, pelvic/abdominal surgeries, bad falls, chronic infections, gastro-intestinal problems, cancer treatments, prostate changes, sport, exercise, stress, sitting for long periods of time, trauma…the list goes on. Any injury to the pelvic floor could lead to conditions like urinary incontinence, urinary urgency (feeling like you have to urinate too often), constipation, pelvic organ prolapse (when internal organs begin to lower too much in the pelvic cavity), sexual dysfunction or pelvic pain disorders. Many of these health issues go unrecognized and untreated due to their embarrassing nature.
A pelvic floor physiotherapist can use familiar physiotherapy techniques on the pelvic floor and core muscles. These muscles can be stretched and strengthened or trained to relax, coordination can be improved, and sometimes things like ice, heat, ultrasound treatment, electrical stimulation, biofeedback or medical taping techniques are helpful.
Pelvic floor physiotherapists can work on the pelvis and core externally, much like typical physiotherapy, but they might also recommend internal assessment and treatment. Sometimes when the problem is on the inside, it is best to treat it from the inside. In Canada, a physiotherapist must have advanced training to be able to perform an internal pelvic exam. An internal pelvic exam can take place vaginally or rectally. While an internal exam can offer a great deal of information regarding your condition, not everyone is appropriate for an internal exam and patients can always refuse an internal exam. Even without an internal exam, there are a variety of physiotherapy treatment options available for pelvic floor conditions. All treatment options are agreed upon by the physiotherapist and the patient before implementation. Combined with a home exercise program, behavioral modification and patient education, the physiotherapist helps to guide patients through the management of pelvic floor conditions.