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:
pelvic health physiotherapy
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:
Conditions typically addressed through Pelvic Health Physio include:
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.
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.
Although the majority of Jenny’s training and clinical experience has involved cisgender women, Jenny is an LGBTQIA2+ ally. The majority of the principles and concepts in the holistic, biopsychosocial approach that she takes with any of her 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. She is familiar with 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 firstname.lastname@example.org if you have any questions. If she cannot address them adequately for you then she will refer you to another local practitioner with additional education and insight.
Yes, our Pelvic Health Physiotherapist Jenny can help with pelvic concerns with any genital anatomy, although the bulk of her experience is with cisgendered women.
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.
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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