What is the Pelvic Floor?
Your pelvic floor is made up of a group of muscles that attach from your pubic bone in the front to your tailbone in the back. They also run side to side from your two sit bones (ischial tuberosities). These muscles create a bowl of muscles that must be able to contract and relax in order to serve 5 main functions:
- The pelvic floor muscles help to hold up the organs within our pelvic cavity such as the bladder, uterus, and rectum.
- The pelvic floor muscles control the opening of the urethra, vagina, and rectum thereby maintaining our ability to prevent leakage of urine and/or feces.
- The pelvic floor muscles provide tone and blood flow during sexual function.
- Proper functioning of the pelvic floor muscles helps support the hips and low back.
- The pelvic floor muscles play a role in maintaining blood and lymphatic flow within the pelvis.
Did you Know?
According to the Canadian Continence Foundation (2016), as many as 3.3 million Canadians — nearly 10% of the population — experience some form of urinary incontinence. Reports from the Canadian Urinary Bladder Survey state that 16% of men and 33% of women over the age of 40 have symptoms of urinary incontinence but only 26% have discussed it with their doctor.
The Cochrane Collaboration (2010) concluded that “physiotherapists with specialized training in pelvic floor rehabilitation should be the first line of defense, before surgical consultation, for stress, urge, and mixed incontinence”
What is pelvic floor dysfunction?
Pelvic floor dysfunction refers to a wide range of symptoms that can occur when the pelvic floor muscles are weak, too tight, or when the bones in the pelvic region are not moving properly. As a result, symptoms can include one or some of the following:
- – Inability to prevent bowel and/or bladder leakage
- – Constipation
- – Genital pain
- – Urgency (a strong urge to urinate or defecate that is difficult to control)
- – Pain with sexual intercourse
- – Pelvic organ prolapse
- – Chronic low back/sacroiliac joint pain
What affects the function of the pelvic floor?
Risk factors for pelvic floor dysfunction include childbirth and pregnancy, hormonal changes such as menopause, excessive and repetitive heavy lifting or straining to empty the bowel and/or bladder, and pelvic surgeries
What is involved during a Pelvic Physiotherapy Assessment?
When you come in for a pelvic physiotherapy assessment, you will be greeted by a pelvic health physiotherapist who has obtained the appropriate post-graduate training needed to evaluate your pelvic floor function. To ensure your privacy, the assessment and subsequent treatments are always held in a private treatment room.
There is a thorough gathering of information including a detailed description of your symptoms and medical history. The physical therapist will then assess how well you are able to move in your low back, hips, and sacro-iliac joints, as these areas can place stress on your pelvic floor muscles.
With your informed consent, an internal vaginal and/or rectal examination may take place in order for the therapist to thoroughly assess the function of the pelvic floor muscles and therefore, plan out an appropriate treatment plan.
After the physical examination, education on findings and a proposed treatment plan tailored to your specific needs and goals are discussed.
You will always see the same therapist, and every treatment/assessment will be discussed and explained to you fully.
Who can benefit from pelvic floor physiotherapy?
Women and men of all ages and for a wide variety of issues can benefit from pelvic floor physiotherapy. Athletes who have issues with incontinence, women during the prenatal and postpartum phase, pre and postmenopausal women, men who experience bladder and bowel dysfunction, rectal pain, and difficulty with sexual intercourse, women and men who suffer from chronic constipation or pain during sexual intercourse.
How do I know if I need pelvic floor physiotherapy?
If your day to day life is negatively impacted by issues such as urinary incontinence, difficulties in urination, bowel incontinence, constipation, abdominal pain, low back/SI pain, sexual dysfunction, pelvic pain or coccyx pain, vaginal or rectal pain, penile or testicular pain, and post pelvic surgery then you would benefit from being assessed by a pelvic health physiotherapist.
Do I need a referral?
No. You do not need a referral from your doctor to be assessed by a pelvic health physiotherapist. In Ontario, registered physiotherapists are considered primary healthcare practitioners. However, if you have coverage for physiotherapy treatment through an extended health benefit plan, the insurance company may require you to provide a physician’s prescription.
My doctor referred me somewhere else for physiotherapy, can I come to ALPHA Health Services instead?
Absolutely! Clients have the right to choose a physiotherapy location and practitioner that feels right for them. Your comfort level with your physiotherapist is extremely important. This helps promote communication and compliance which will only help support your recovery. Please ensure that when you are referred for pelvic physiotherapy that you are seeing a pelvic health physiotherapist who has acquired specialized post graduate training to perform an internal examination. At ALPHA Health Services, with your consent, we will provide your physician with your assessment findings and treatment plan. This enables and promotes open communication between your pelvic health physiotherapist and physician.
What should I bring to the assessment?
You can bring any diagnostic imaging, test results, and the doctor’s notes you may have. The pelvic health physiotherapist will review these documents with you during your initial assessment.
Is pelvic floor physiotherapy covered by OHIP?
The pelvic health physiotherapy services at ALPHA Health Services are not covered under OHIP. However, Leeanna is a registered and licensed physiotherapist and many extended health benefits provide coverage for these services.
Can you bill my extended health insurance company directly?
Unfortunately, at this time, we are unable to bill your insurance company directly. You are required to pay us directly and we will provide you with an official receipt with all the required information (including your therapist’s license number) to collect your reimbursement. If any other information is required by your insurance company, please let your therapist know and we will be glad to provide it.
Who does the pelvic floor assessment?
Leeanna Maher is a registered physiotherapist and has taken extensive post-graduate training in pelvic health rehabilitation. She is passionate about working with patients who have pelvic dysfunction to help them lead a healthy, pain-free life. She works with patients of all ages, with various pelvic floor dysfunction.
Are there exercises I can do at home, or do I always have to come to the clinic for treatment?
During the initial assessment, Leeanna will discuss her findings with you and put together a treatment plan based on your personal goals. Every person is very unique with respect to their treatment. Some clients require ongoing visits to the clinic and others only need to check in every few weeks. For every client, though, treatment always includes the education and progression of home exercises in order to maintain and progress the gains made in clinic.
What if I have more questions?
Email us at firstname.lastname@example.org. Your email will be directed to Leeanna Maher, who will be able to answer your pre-assessment questions.
Pelvic Floor Initial Assessment: $140
45 Minute Treatment: $120
30 Minute Treatment: $90