PELVIC FLOOR TREATMENT

What To Expect in a Pelvic Floor Physiotherapy Assessment 

A session in pelvic floor physiotherapy includes a subjective exam (questions on bladder, bowel and sexual function, analysis of your pain or chief complaint and a complete medical history, as well as questions on your lifestyle habits: physical activity, diet, water, alcohol and caffeine intake), an objective exam that includes an assessment of your back, hips and an internal Pelvic Floor Exam.

During an internal pelvic floor examination, our physiotherapist gently assesses the muscles and tissues inside the pelvic region. This exam helps us evaluate the strength, tone, coordination, and endurance of the pelvic floor muscles. We are also looking for signs of muscle tightness, trigger points, tenderness, or areas of weakness. 

Additionally, we assess muscle relaxation (the eccentric muscular activation) and the ability to contract and release (the concentric muscular activation) of the pelvic floor musculature effectively. 

Consent is ongoing. At anytime, should you feel uncomfortable or would like to opt out of the internal exam, do not hesitate to let your therapist know; you comfort is our top priority. 

The exam allows us to identify dysfunctions under 2 main categories such as:

• muscle overactivity (tightness and inability to relax)

• underactivity (weakness or poor muscle control)

which are key to creating a tailored treatment plan. 

Underactive Pelvic Floor Symptoms:

• Urinary incontinence with coughing, sneezing, laughing, or exercise

• Heaviness or pressure in the vaginal or rectal area 

• Fecal incontinence or urgency 

• Urinary urgency or urge incontinence 

• Waking frequently at night to urinate 

Treatment: 

• Pelvic floor muscle strengthening exercises 

• Biofeedback to enhance muscle activation 

• Coordination training for muscle control 

• Body mechanics and posture training 

• Toileting program and position education 

• Strengthening of hips, core, and back to support pelvic stability 

Overactive Pelvic Floor Symptoms: 

• Pelvic pain or discomfort

•  Pain with sexual activity

• Difficulty emptying the bladder 

• Urinary frequency and urgency (overactive bladder)

• Burning with urination 

• Constipation 

• Conditions such as endometriosis-related pain

• interstitial cystitis

• vulvodynia

• vestibulitis

• vaginismus 

Treatment: 

• Down training techniques to relax the pelvic floor muscles 

• Myofascial release and soft tissue mobilization

• Vaginal or rectal electrical stimulation (E-Stim) for muscle relaxation

• TENS therapy for pain relief 

• Visceral mobilization 

• Posture correction and relaxation training

• Dilator training to reduce muscle guarding and pain 

• Breathing training 

This structured approach ensures the treatment is targeted specifically to your needs, helping to restore pelvic floor function, reduce pain, and improve quality of life.