What is Pelvic Floor Physiotherapy and Why is it Important?
Awareness is spreading around pelvic floor health and the volume of individuals seeking Pelvic Floor Physiotherapy is growing year over year, but what is this niche service and why is it so important?
Pelvic Floor Physiotherapy (PFPT) is a specialized area of Physiotherapy that focuses on issues involving the muscles, ligaments, and connective tissues in the pelvic region. Pelvic Health takes a holistic approach, meaning that the assessment and treatment does not only focus on the pelvic area but involves the whole body as a system that works together.
Pelvic Floor Physiotherapists are Registered Physiotherapists (PTs), many with postgraduate Masters or Doctoral degrees in Physical Therapy, who go on to advance their skills through additional education in Pelvic Health.
Majority of the conditions that are treated through Pelvic Floor Physiotherapy involve the pelvic floor muscles.
The pelvic floor is a group of muscles that form a hammock-like structure at the base of the pelvis. Functions include supporting the pelvic organs (bladder, uterus, and rectum), controlling bowel and bladder continence, core stabilization, sexual health, and pumping lymphatic fluid through the pelvic region (in fact, it is the second biggest lymphatic fluid pump in the body). The pelvic floor muscles play a role in childbirth, as they are situated around the vaginal canal where the baby must pass through. Given the direct involvement of these muscles during the birthing process, care during and after pregnancy is especially important for maintaining the vital functions mentioned above.
What types of conditions do Pelvic Floor Physiotherapists treat?
When the pelvic floor muscles aren’t functioning properly, issues can arise such as:
Pelvic pain: Discomfort or pain in the pelvic region, which may be constant or intermittent.
Urinary problems: Urinary incontinence (involuntary leakage of urine), difficulty emptying the bladder, and/or a frequent urge to urinate including waking up in the night to pee.
Bowel issues: Constipation, straining during bowel movements, fecal incontinence, and/or difficulty controlling gas.
Sexual dysfunction: Pain during intercourse or other sexual activities, involuntary contraction of the pelvic floor muscles that prevents penetration, lack of or decreased sensation during sex, urinary incontinence during sex, and/or frequent post-coital UTIs.
Muscle spasms: Involuntary contractions or spasms of the pelvic floor muscles.
Factors known to contribute to pelvic floor dysfunction include:
Pregnancy and childbirth: The pelvic floor muscles can be stretched or weakened during pregnancy and delivery.
Chronic constipation or straining during bowel movements: This can lead to increased pressure on the pelvic floor.
Obesity: Excess weight can strain the pelvic floor muscles.
Surgery: Certain surgical procedures, especially those in the pelvic area, may impact the function of the pelvic floor.
Trauma or injury to the pelvic area: Accidents or injuries can affect the pelvic floor muscles and surrounding structures.
Where do Pelvic Floor Physiotherapists see patients?
Pelvic Floor PTs work in both inpatient and outpatient settings, meaning they can work in hospitals, rehab facilities, as well as private clinics.
What happens during a Pelvic Floor Physiotherapy appointment?
During a typical PFPT session, the Physiotherapist will perform a thorough assessment of the pelvic floor muscles and surrounding structures. This may involve internal and external examinations to evaluate muscle tone, strength, flexibility, and coordination. The PT will also assess other areas of the body relevant to the presenting issue (eg. hips, low back, core, neck). Based on the assessment, the PT will develop a treatment plan. Follow up usually involves 6-8 sessions, but can extend to a year or more depending on the issue being treated.
How is pelvic floor dysfunction treated?
Pelvic floor dysfunction is often treated using a holistic, whole-body approach, including:
Individualized exercise prescription and training to target involved areas of the body.
Education and Lifestyle Modification: Guidance on managing stress, water intake, posture, breathing, lifting techniques, microbiome and nutritional support, and more to support pelvic health.
Manual Therapy: Hands-on techniques to release tension and improve mobility in the pelvic floor and other areas of the body.
Biofeedback: Using technology to provide visual or auditory feedback to help individuals learn to control and coordinate their pelvic floor muscles.
Behavioral Strategies: Techniques to address habits or behaviors that may contribute to pelvic floor dysfunction, such as voiding habits.
Is Pelvic Floor Physiotherapy only for women?
This is a great misconception! Men can greatly benefit from Pelvic Floor Physiotherapy for conditions such as pelvic pain, bladder pain syndrome (interstitial cystitis), overactive bladder syndrome, nocturia, erectile dysfunction, non-bacterial chronic prostatitis, and post-prostatectomy issues among others. It is important for men to vocalize their symptoms to their healthcare provider and seek the necessary treatment (eg. referral to a Urologist and Pelvic Floor PT) in order to address these conditions that can worsen with time.
Is Pelvic Floor Physiotherapy covered by insurance?
Most insurance companies offer coverage for PFPT, as it a carefully regulated health care profession under the medical sciences. Pelvic Floor Physiotherapy is conservative and non-invasive. It can be a primary form of care, meaning you do not need a prescription from your doctor to see a PT (unless your insurance company requires it). PFPT can complement medical treatments as an essential component of a holistic approach to pelvic health. Individuals experiencing pelvic floor issues who are unsure about treatment options should consult with their healthcare provider to determine if PFPT is appropriate for them.
Looking to book a one-on-one session? My booking for private appointments will re-open in Fall/Winter 2024. If you are expecting, have recently given birth, or are experiencing pelvic floor issues, learn more about my online perinatal, postnatal, and rehabilitative yoga programs that can be done from the comfort of your home.
The 12 Best Things About Pregnancy That No One Tells You About
There were so many expectations I had for my pregnancy that I didn’t even realize until it was happening to me.
My perception of how pregnant women feel about their bodies during and after pregnancy was predominantly negative — this was based on my experiences and what I had unknowingly absorbed through social media, research, and work. How much these experiences were permeating my view of my own pregnancy is what surprised me. It impacted my reaction to pregnancy, caused me a lot of undue distress when I was already suffering (physically from my first trimester sickness), and prolonged the time I needed to process what was happening.
Essentially, I spent my first trimester in mourning — I had finally gotten to a place where I was happy with the way I looked and, because of these permeating thoughts, I was preparing myself to say goodbye to my body that I now loved.
Don’t get me wrong, I’ve always wanted to have a baby, and despite how terrible my first trimester was not once did I wish I wasn’t pregnant. But you can be grateful for your baby while also experiencing shock and needing time to process the major changes that are happening in your life. This processing period for me just happened to be in a foreign country with my wedding only 4 weeks away. I was lonely, I was experiencing excessive pressure to feel and look a certain way for my wedding, and I had no one to talk to.
I wasn’t just mourning my body, I was also saying goodbye to me. I didn’t feel there would be anything left of me after the baby arrived, and yet I still had so much I wanted to do and accomplish. This was a really sad way of viewing my pregnancy.
During that time, I wish I had something more positive to focus on for the future of my debut into motherhood. There are so many beautiful things about pregnancy that aren’t talked about enough and there are so many things I was worried about are just simply not true. Knowing these things would have saved me a lot of grief and help me through a tough first trimester. Here are the 12 best things about pregnancy every first time mom should know:
Your relationship with your body will change and develop in the most beautiful way
If you’re like me and you’ve had a tumultuous journey to self-love, pregnancy may actually have the opposite effect on your relationship with your body than what you thought. I was under the impression that I would immediately start gaining weight everywhere — this is not the case. You likely won’t notice any visible signs of being pregnant until after week 12, and you can probably hide your pregnancy with a big sweater up until week 25-30. This varies for everyone, depending on your starting weight, what your level of fitness was before your pregnancy, and what your exercise and eating habits have been like during pregnancy. But if you eat well and exercise regularly, most of your weight gain will be in fluid volume, breast tissue, placenta, uterine tissue, and baby. You may even lose weight during the first trimester from being sick (I lost 7lbs but gained it back and more during my second trimester). I have my days when I feel down and I can’t stand how out-of-control my boobs are — the tipping point is usually me not fitting into one of my favourite sports bras — but those days are few and far between and I have really come to love my curves and round belly. You also gain a new appreciation for how incredible your body is when you see that first ultrasound and see the tiny human you are growing.
2. Everyone loves a baby bump
To reiterate my previous point, there is something so beautiful about that little bump — photo-ops and selfies become even more fun, now you have bumpdates and you get to track your growth week-by-week. Not only is this exciting for you, but it’s exciting for your friends and family who are seeing you change each week. Bump comments aren’t always warranted, but your friends and family LOVE that bump and just know that they probably mean well with their unfiltered “compliments”.
3. You no longer have to worry about looking bloated, even if you are.
It goes without saying, eat the pasta. No one will notice. You can also sleep peacefully knowing that your body is burning a little extra calories at rest, so you don’t have to ride the guilt train every time you indulge.
4. Carbs are necessary
I learned this the hard way. I was on a low-carb diet for a long time leading up to my wedding but when I became pregnant my body just wasn’t having this. After suffering several hypoglycaemic episodes, I realized that I needed more carbs if I wanted to keep going on long walks and recover properly from exercise. I had to carry around snacks with me wherever I went. I kept apples and biscotti on my bedside table and I even sometimes took bread rolls from the restaurants we’d go to if we were going to be out for a while. Now I’ve learned how to incorporate healthy carbs with each of my meals and I can enjoy them without any guilt. Justin makes me pasta limone at least once a week, among other enjoyable meals involving soba noodles, sweet potato, rice, oats, bread, and lots of fruit (especially watermelon). I feel even better than I did when I was eating low-carb!
5. You will have so many exciting events to plan and moments to look forward to
Gender reveals, baby showers, babymoons — I have to admit I was less than enthusiastic about planning more events after 4 years of wedding planning, and I felt a little bit self-indulgent about having so many events in one year, but I realized that these are beautiful reasons to celebrate that shouldn’t be wasted. I don’t want to look back in 10 years and wish that I had celebrated these moments more. My favourite moments so far have been building my registry (overwhelming but fun as a FTM) and attending ultrasounds with Justin.
6. You get to wear crocs without judgement
Since getting pregnant, I willingly wear my crocs everywhere. They have become my number one choice of footwear and I suspect my love for them will only grow stronger with a newborn. They slip on, they are comfortable, they are supportive, they help prevent back pain, they are breathable in the Summer, and you can walk forever in them without getting blisters. You can even wear them with socks if it’s a little chilly out. I’m a fan.
7. Not drinking becomes socially acceptable (and encouraged)
At first, watching all my friends who had traveled to Europe for my wedding actually enjoy their time — exploring new cities, going to beach parties, trying new restaurants, drinking delicious cocktails — made me so upset. I had major FOMO leading up to my own wedding. Part of me felt like I wasn’t even there. During our honeymoon, I spent most of it sick in bed instead of exploring the Tuscan countryside and drinking Italian wine. Slowly, after I returned home and settled into my routine again, I started to think about social drinking less and less. By my second trimester, I felt as though I had detoxed my body from any lingering effects of alcohol and my mind felt so clear. No hangovers, no brain fog, no lost days, no empty calories. I found myself actually happy that I didn’t have to drink, and I didn’t have to explain to anyone why I wasn’t drinking. It became easier for me to establish a healthy wellness and fitness routine because I had greater consistency with how I felt when I woke up in the morning. Currently, I’m wondering if I will ever go back to drinking alcohol regularly after the baby now that I’ve experienced how much clarity I have without it. Plus, I hear hangovers with a newborn are not for everyone.
8. You have an excuse for just about everything
Most of the time, pregnancy excuses are legitimate. Being pregnant makes life harder in a lot of ways, from tying your shoes to picking a cute outfit that actually fits you. Not feeling up to a dinner with your friends on Friday night? You have an excuse. Need to yawn in the middle of a conversation? You’re tired, you’re growing a human! And you won’t be judged for leaving an event early either. You will find yourself prioritizing your sleep and it’s not a bad thing!
9. Everyone around you becomes more supportive and your true friendships will grow
Since getting pregnant, my husband has offered to cook almost every night. My friends offer to come to my house for girl’s nights so I don’t have to make any trips downtown. My parents and in-laws are so excited about the baby and they understand when I need to go to bed early or if I’m not up to participating in family events. I have to say, having this level of love and understanding from everyone around me is so nice. Since a lot of my friends are either still single or haven’t had kids yet, I was afraid that I would be left out from all the social events or that we wouldn’t have anything in common anymore. Instead, our girl-time has evolved into more brunch and walks and coffee dates and I enjoy hearing about all the drama in their lives as I wolf down French toast.
10. Your work will develop and evolve with you
During my first trimester, I spent a lot of time focusing on my lack of career success up until that point. Looking back, I don’t blame myself for feeling this way — I wasn’t even capable of walking across the kitchen without getting dizzy or nauseous, let alone do a workout or look at a screen. Yes, you may miss out on some career growth during your mat leave and your pregnancy, but if you love what you do and feel fulfilled by your work then your work will continue to grow with you. I can’t predict every scenario here, but trust in yourself that you will make the right decision for you. Remember, being a mom is more than a full-time job and deserves just as much credit.
11. You are going to experience the gift of being a mother
You’re going to be a mama! Potentially for the first, second, or fifth time, but no matter how many times you have experienced it, every baby is a gift. From the first small kicks inside my belly, the very beginnings of our relationship, I felt an overwhelming sense of love for the bond that I now share with this tiny human.
12. You are not going to lose yourself
Pregnancy isn’t the end of the life you once knew, no matter how many times people will tell you that. You don’t have to lose yourself in the process. You can use this experience to evolve and become an even better version of yourself. Continue to prioritize yourself and your needs and give yourself the love and care you deserve so that you can be the best mom, friend, sister, daughter, and partner to those you love.
Everyone’s experience of pregnancy is going to be different. You may really miss having a glass of wine with dinner, you may not love the way your body looks, and, let’s face it, you may think crocs are just plain ugly.
It goes without saying that there are so many challenging aspects of pregnancy — the crying spells, the morning-noon-and-night sickness, the indigestion, and the constant fatigue. Taking moments to process all the difficult parts is just as important as taking the time to appreciate all the good parts. I’m a strong proponent of feeling your feels, the good and the bad. But offering yourself a different perspective on occasion can get you through some incredibly tough moments of your pregnancy, and you may find yourself enjoying it a little more than you expected.
