Pelvic Health Physiotherapy Guelph

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WHAT IS PELVIC HEALTH PHYSIOTHERAPY?

Pelvic Health Physiotherapy is a niche of Physiotherapy that focuses on issues concerning the pelvis and core. These issues may include, but are not limited to:

  • Bladder concerns
  • Bowel concerns
  • Pregnancy related pain
  • Exercise through pregancy and birth prep
  • Recovery after childbirth (both vaginal and caesarean)
  • Pelvic pain
  • Sexual pain
  • Pelvic organ prolapse
  • Pre and post abdominal or pelvic surgeries
  • Low back pain

Read more about these in our Pelvic Health blog.

Our Pelvic Health Physiotherapists have training in advanced concepts in Physiotherapy including:

Pelvic Health Solutions

The Female Athlete Series

Sex and Sexuality in Physiotherapy Practice

Trauma and the Pelvic Floor

 Integrative Approach to Chronic Pelvic Pain with Endometriosis 

Julie Wiebe Piston Science

Pelvic Organ Prolapse Management and Pessary Fittings

Trans and Non-Binary Pelvic Health Concerns

WHAT CAN I EXPECT?

What happens in a Pelvic Health Assessment?

Many things are similar to a ‘regular’ Physiotherapy assessment – a thorough history including current lifestyle and support factors, looking at clothed movement and palpating (touching) muscles and joints externally, depending on your concerns.

Pelvic Health Physiotherapists have taken many additional courses which allows them to perform internal pelvic floor assessment and treatment, when appropriate and with your consent.

The pelvic floor muscles are at the bottom of the pelvis and run from the pubic bone at the front to the tailbone at the back, as well as attaching to the sit bones and the hips at the side. The best way to assess these muscles to find out if they are strong, flexible, sensitive/tender or extra stretchy (just like any other muscle in the body) is through an “internal digital exam” which means inserting a gloved finger into the vagina or rectum, depending on your concerns and anatomy.

Is the Internal Exam Necessary?

This internal exam is how we can get the most accurate information about what is going on for you, however it is always completely optional.

Reminder: any internal or external exam is always optional and based off of your consent – even at the doctors office, even at the hospital, even during birth. Consent means you are given the pros, cons/risks and alternatives to undergoing (or not undergoing) an assessment, test or treatment and that you are able to make a decision based off of your wishes and desires, without being under duress or feeling pressured. You are able to withdraw your consent (stop the assessment, test or treatment) at any time. There is continual dialogue occurring between you and your Pelvic Health Physio during an assessment to ensure you are both staying on the same page and working towards YOUR goals in a way that YOU are comfortable with.

How is this different than a vaginal pelvic exam you get at the doctor’s office?

Your Pelvic Health Physio does not use a speculum (plastic or metal device that opens the vaginal canal). They will not be performing a PAP smear. The goal is to help address your concerns while always working within your comfort level. This means you do not need to “put up with” discomfort until it is “over with” like many do with a PAP, intercourse or other internal exams. In fact, we want to address and decrease any discomfort you may have, physical or emotional, to help you address your concerns.

Unfortunately, clients commonly have a history of trauma, negative experience or abuse that involves the vulva, vagina or rectum. Not everyone is comfortable disclosing that this has occurred, whether to your Physio or others in their healthcare team. This is an important piece that we always keep in mind as we progress through the internal portion slowly, always communicating and working within your comfort.

What else can Pelvic Health Physio treatment include?

Pelvic Health Physio treatment plan will be a collaborative effort based around your goals and may include:

  • breathing and movement strategies,
  • pelvic floor strengthening or relaxation exercises,
  • gentle internal or external touch performed by you, your Physio or a partner at home,
  • lifestyle modifications around sleep, stress management, nutrition and coping strategies,
  • specific exercise progressions to transition toward your goal,
  • loading strategies to strategically improve your body's ability to tolerate movement,
  • performance-based strategies to improve your sport or activity of choice.
CONDITIONS

Conditions typically addressed through Pelvic Health Physio include:

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A woman pressing dumbbells on an exercise ball doing physiotherapy.

COMMON QUESTIONS

How long are your appointments?

Initial assessments are 1 hour in person, or as two 30-minute appointments, with the first half being virtual to gather your health history and the second half in person to do the physical assessment.

Pessary Fitting appointments are booked for 90minutes but may only take 1 hour – fees will be adjusted accordingly. Fees are available on our booking page.

Can I claim Pelvic Health appointments under Physiotherapy for insurance purposes?

Yes! Pelvic Health Physiotherapists are Registered Physiotherapists in Ontario and you can claim all appointments under Physiotherapy with your private insurance provider, whether you are being seen for an orthopedic, pelvic health or pessary fitting appointment.

Do you offer services to those in the LGBTQIA2+ community?

Although the majority of our Pelvic Health Physios' training and clinical experience has involved cisgender women, they are allies to the LGBTQIA2+ community. The majority of the principles and concepts in the holistic, biopsychosocial approach that they use with their clients can be applicable and useful to anyone, however there are specific considerations to take into account when someone is undergoing gender affirmation therapy or surgery. Our Pelvic Health Physio Jenny has taken courseowork in Physiotherapy techniques that can be helpful with chest feminization or masculinization surgeries, as well as post-op vaginoplasty including dilator use. Feel free to email her at jenny@defysportsperformance.com if you have any questions. If she cannot address them adequately for you then she will refer you to another trusted local practitioner with additional education and insight.

Do you offer Pelvic Health Physiotherapy to those with male anatomy?

Yes, our Pelvic Health Physiotherapists can help with pelvic concerns with any genital anatomy, although the bulk of their experience is with cisgendered women.

Do I have to do anything to ‘prepare’ for a pelvic health assessment?

Whatever makes you feel comfortable. Your choice of “hair style” or personal grooming tends not to impact the assessment. You do not need to shower or “clean up” before an appointment.

Can I have a pelvic health assessment on my period?

Yes, you can! Vaginal tissues do change in response to our hormones so it can be valuable to be assessed during your period, especially if you have more symptoms related to your menstrual cycle. We will have you remove your tampon or diva cup, if you use one, before the internal and you can replace it afterwards. Internal exams are always done with your consent, so if you aren’t feeling it while you are on your period then we can always refrain and revisit another day if needed. There is always lots we can do from an external perspective on these days.

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