Pelvic Floor Physiotherapy

At Trent Health in Motion, we provide pelvic physiotherapy at our state-of-the-art facility in Peterborough, ON. Physiotherapists are trained in pelvic health care and have taken additional post-graduate courses in the assessment and treatment of pelvic floor dysfunction. Their comprehensive training has provided them with evidence-based, conservative treatment options (outside of medication and surgical intervention) for many common pelvic health concerns.


Our Pelvic health physiotherapists in Peterborough use specialized assessment, soft tissue techniques, and education to treat conditions such as urinary and fecal incontinence, prolapse, pelvic pain, post-surgical concerns, pre-and post-partum pains, painful intercourse and many others.

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What Is the Pelvic Floor and What Does It Do?

The pelvic floor is a group of muscles and connective tissues located at the bottom of your pelvis, just between your tailbone and pubic bone, and between the bones that you sit on.

The Five Main Jobs of the Pelvic Floor

  • Avoids leaking urine and stool
  • Supports your internal organs
  • Improves sexual function
  • Helps to move fluids back up your body
  • Plays a vital role in your core function

Everyone has a pelvic floor and can experience difficulties in any of the above-mentioned areas if it is not working as effectively as it could.

Who Can Benefit From Pelvic Health Physiotherapy?

We work with both male and female clients who might be experiencing:

  • Incontinence (leaking urine and stool)
  • Unusual urinary urgency and frequency
  • New or persistent pain in the lower back, hip, pelvic, sciatic, tailbone, or genitals
  • Pelvic Organ Prolapse (sensations of ‘pressure’ or ‘heaviness’)
  • Pre- and post-partum pains (vaginal and cesarean births)
  • Dyspareunia (painful Intercourse)
  • Post-operative management (post-prostatectomy, prolapse repair, etc.)
  • Chronic constipation
  • Chronic Nonbacterial Prostatitis
  • Other like conditions

If you have any concerns not listed above, please contact the clinic to find out how pelvic physiotherapy can help.

What Can I Expect in an Assessment/Treatment Session?

Assessment

During an assessment, you will be given the time to tell your physiotherapist all about you, your medical history, and how your present-day symptoms have impacted your life. Any questionnaires that are completed before your appointment will also be reviewed to help create an individualized, evidence-based treatment plan that will help you reach your goals. Your therapist will also complete a physical assessment which may include an evaluation of your breathing, posture, and strength/movement levels. Your therapist may also use internal and external techniques to evaluate the function of the muscles, joints, connective tissues, nerves, and ligaments in your pelvic girdle, lower back, and hips.

Treatment

Treatment can include education, manual therapy, individualized exercises, and connective/soft tissue release techniques. Internal treatment techniques are only performed with your consent during follow-up appointments. By performing internal treatment techniques, your pelvic health physiotherapist can provide more accurate feedback to ensure you are using the optimal technique during exercises to achieve relaxation or strengthening of the pelvic floor muscles.

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Important Note

Our pelvic health physiotherapists have undergone advanced training, passed a practical evaluation, and are registered with the College of Physiotherapists of Ontario to perform internal assessments and treatment techniques. An internal assessment/treatment (with one or two fingers inserted vaginally and/or rectally) is used to evaluate and treat the muscles, ligaments, and connective tissues of the pelvic floor. Evidence-based, best practice guidelines recommend an internal examination, as this is the only way to accurately know the state of the pelvic floor muscles, how well they are functioning, and to effectively prescribe pelvic floor muscle training exercises. Still, an internal examination is never conducted without the client’s consent. If you are concerned or uncomfortable with an internal examination, please discuss this with your pelvic health physiotherapist who will review the risks, benefits, and alternative options. Your comfort and consent will always be a priority.

Research and Pelvic Floor Physiotherapy

  • Incontinence

    • 3.5 million Canadians (one in four women and one in nine men) have urinary incontinence.
    • 50% of women experience some urinary incontinence at some point in their life.
    • The Cochrane Collaboration recommends that supervised pelvic floor muscle training be included in the first line of treatment for urinary incontinence, which is characterized by leaking urine when sneezing, laughing, coughing, etc.).

    Dumoulin C, Cacciari LP, Hay‐Smith EJ. Pelvic floor muscle training versus no treatment or inactive control treatments, for urinary incontinence in women. Cochrane database of systematic reviews. 2018(10).


    Hannestad, Rortveit, Sandvik, Hunskaar. A community-based epidemiological survey of female urinary incontinence: The Norwegian EPINCONT Study. Journal of Clinical Epidemiology. November 2000; 53(11): 1150-1157.

  • Prolapse

    • 50% of parous women experience pelvic organ prolapse.
    • The likelihood of experiencing prolapse increases with age.
    • The International Continence Society recommends supervised pelvic floor muscle training as the first line of treatment and prevention for pelvic organ prolapse. Pelvic floor muscle training has been shown to reduce the level of symptoms associated with prolapse.

    Abrams P, Cardozo L, Wagg A, Wein A. (eds) Incontinence 6th Edition. ICI-ICS. International Continence Society, Bristol UK, ISBN: 978-0956960733. 2017


    Beck RP. Pelvic Relaxation Prolapse. Principles and Practice of Clinical Gynaecology, 2nd edn (eds N.G Kase & A.B. Weingold). Churchill Livingstone, Edinburgh. 1983: 677-685..


    Hagen S, Stark D. Conservative Prevention and Management of Pelvic Organ Prolapse in Women. Cochrane Database Syst Rev.;(12)CD003882 doi: 10.1002/14651858.CD003882.pub4. 2011.


    Symmonds RE, Williams TJ, Lee RA, Webb JM. Post Hysterectomy Enterocele and Vaginal Vault Prolapse. American Journal of Obstetric Gynecology. 1981; 140:852-9.

  • Labour and Delivery

    Several studies have found that women who engage in supervised pelvic floor muscle training within 20 to 36 weeks of their pregnancy are more likely to benefit from a reduced second stage of labour (‘pushing stage’) compared to those who did not.


    Du Y, Xu L, Ding L, Wang Y, Wang Z. The Effect of Antenatal Pelvic Floor Muscle Training on Labor and Delivery Outcomes: A Systematic Review With Meta-Analysis. International urogynecology journal. 2015 Oct 1;26(10):1415-27.


    Salvesen KÅ, Mørkved S. Randomised Controlled Trial of Pelvic Floor Muscle Training During Pregnancy. Bmj. 2004 Aug 12;329(7462):378-80.

  • Persistent Back/Pelvic Pain

    A 2018 study found a strong association between persistent pain (especially increased pressure-pain sensitivity) in the lower back/pelvic area and the presence of pelvic floor muscle dysfunction.


    Dufour S, Vandyken B, Forget MJ, Vandyken C. Association Between Lumbopelvic Pain and Pelvic Floor Dysfunction in Women: A cross sectional study. Musculoskeletal Science and Practice. 2018 Apr 1;34:47-53.

Frequently Asked Questions

  • Why is an internal examination recommended?

    Evidence-based guidelines recommend an internal examination since this is the only way to accurately know the state of your pelvic floor muscles, how well those muscles are functioning, and to effectively determine appropriate pelvic floor muscle training exercises. An internal exam allows for a direct evaluation of the pelvic floor muscles and how they are functioning.


    This information is used to create a more accurate, targeted treatment plan than what external techniques could provide. An internal exam does not involve equipment commonly seen in medical examinations (e.g. a speculum) — rather, it is performed using one or two fingers. By performing internal treatment techniques, your pelvic health physiotherapist can provide accurate feedback to ensure that you are getting the optimal exercise techniques for your specific needs

  • Is pelvic health physiotherapy only for women who are expecting or have had children?

    No. Women who have not had children and even males have a pelvic floor and may experience pain or discomfort with pelvic dysfunction. We are here to support and help all individuals get through the different stages in their life.

  • Can I still attend my assessment/treatment if I am on my cycle?

    Yes, our physiotherapists are comfortable and capable of treating clients during this time. If an internal exam is performed, extra protection will be used for your comfort. Still, other treatment options are usually available if you are uncomfortable having an internal examination during this time of the month.

  • Is it painful?

    An internal examination should not be painful. There may be mild pressure or discomfort if there is a tension point that needs to be released. It is essential that you communicate all these feelings/sensations to your therapist so that the proper treatment techniques can be prescribed.

  • Is it safe for pregnant women to undergo internal exams?

    Generally, an internal examination is safe as long as you have not been advised by a physician or midwife to abstain from intercourse or internal examinations. If you have any concerns, speak with your midwife or physician about this.

  • Can I complete my pelvic health assessment or treatment session virtually?

    Absolutely! Pelvic health physiotherapy is well-suited to virtual care. A key part of physiotherapy is learning more about the strategies, exercises, and techniques that you can do at home to see changes in your symptoms.


    For individuals with a busy schedule, a longer commute time to the clinic, or who require childcare to attend appointments, virtual care can be a great fit. If there is a need for in-person care, your physiotherapist can discuss this with you.

Book With a Pelvic Floor Physiotherapist Near You

Trent Health in Motion provides pelvic floor physiotherapy in Peterborough — right at our state-of-the-art facility. We also provide online services for your pelvic health concerns through telehealth.


To book an appointment with our RMTs and to address any pelvic health-related concerns, call us at 705-741-4758 or click the button below. We look forward to working with you and helping you achieve optimum health.

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