Tag Archives: sex

What is a pelvic floor physiotherapist?

Pelvic health physiotherapists have additional post graduate training in assessment and treatment of pelvic dysfunctions such as urinary and fecal incontinence, pelvic organ prolapse, and pelvic girdle pain syndromes such as vulvodynia, vestibulodynia, dyspareunia (pain during sex), SI joint dysfunction, and piriformis syndrome.  When I told my husband I was taking the internal pelvic health course his reaction was” you want to do what? Really?” So what is it that I do? I teach my patients how to properly use their pelvic floor to regain core strength and get back to their beloved activities (back to pain free living).

So how do I do that?

The same way I retrain an injured hamstring – manually testing the muscles’ strength, releasing any trigger points, facilitating a stronger more efficient contraction, re-patterning the correct strategies and giving you a home program to get yourself better. What does that all mean you ask? Well, it means I get my hands on it and in it!

ImageAnd how exactly do I do that?

The pelvic floor muscles are often described as a hammock in your pelvis from front to back, although I prefer Katy Bowman’s terminology of a trampoline. I asses vaginally and rectally which allows me to feel the muscles contract and relax against my finger, I can also feel for scar tissue from trauma (pregnancy, birth, surgery, fractured pelvis, tailbone or coccyx), and I can feel the movement of the coccyx.  I can tell which muscles are working well and which ones need help. I can see if there is any pelvic organ prolapse and the effects of movement and loading on the muscles and tissues. Treatment involves identifying the cause of the dysfunction and finding the solution that will work best for you.

Who should see a pelvic floor physiotherapist?

Do you suffer from things like diastasis recti (aka mummy tummy)? doming or tenting of your belly when you exercise? scars from an episiotomy, c-section or perineal tear? pressure or pain in your vagina or rectum? pelvic organ prolapse? pain during sex? pelvic girdle pain? leaking when you cough or sneeze or laugh or jump or run? feel like you can’t make it to the bathroom in time?  If you answered ‘yes’ to any of these then YOU should see a pelvic floor physiotherapist.  We also like to work on the prevention side of things pre-conception, during pregnancy and post natally.

And it’s not only about the women. Men have a pelvic floor too! Men who have urinary incontinence, pelvic girdle pain, or difficulty maintaining an erection can also benefit from seeing a pelvic health physiotherapist.

girl running

How do you find a pelvic floor physiotherapist?

We are located in downtown Toronto. There are a handful of us in the GTA. We are all listed on the Women’s Health Division website (Find a physiotherapist – Women’s Health Division http://www.physiotherapy.ca/PublicUploads/229746WHD_%20Povince.pdf) and all physiotherapists that do internal work must be rostered with the college of Physiotherapists of Ontario http://publicregister.collegept.org/PublicServices/Start.aspx

Have you had your pelvic floor assessed? Tell us about your experience.

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Hey your pubococcygeous is really cut! The Role of the Pelvic Floor

It’s no secret that the pelvic floor is my favorite group of muscles. I often get asked why, since you can’t see what its doing; it’s hard to even know it’s there. It’s not like someone will come up to you and say “hey your pubococcygeous is really cut!” Nevertheless this muscle is a superstar. It works backstage and ensures all those other “famous” muscles can look good. Here’s just what it does:
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1. Continence
When you get the urge, the pelvic floor muscles help control whether or not you make it to a bathroom in time. They also stop that little leak when you cough, sneeze, run or jump.

2. Respiration
The pelvic floor muscles work together with the diaphragm, helping air in and out by lengthening (eccentric contraction) during inspiration and shortening (concentric contraction) during expiration

3. Support
a. The pelvic floor muscles are key in keeping our organs in where they belong. Low tone and/or weakness in the pelvic floor increases your risk of pelvic organ prolapse.

4. Control/Stabilization
a. The pelvic floor muscles are part of the deep system of core stabilization. They work with the abdominals and multifidus to control movement of the lumbopelvic unit during load transfer.Image

5. Sex
a. The pelvic floor muscles are integral in sexual satisfaction. Too tight and sex can be painful (dyspareunia), too lax and the woman may not feel any stimulation whereas the man may not be able to maintain an erection.

So how do you know if your pelvic floor muscles need a tune up? Well, if you leak urine (even just a drop) when you cough, are a upper chest breather, have or suspect a prolapse, have pelvic pain or feel weak in your core, have pain during sex or a loss of sensation during sex, are pregnant, have just had a baby, are going through menopause or are just one of those health conscious people who like to know everything is working the way it should. Make an appointment to see a pelvic health physiotherapist now!