PELVIC FLOOR TREATMENT
What To Expect in a Pelvic Floor Physiotherapy Assessment
A session in pelvic floor physiotherapy includes a subjective exam (questions on bladder, bowel and sexual function, analysis of your pain or chief complaint and a complete medical history, as well as questions on your lifestyle habits: physical activity, diet, water, alcohol and caffeine intake), an objective exam that includes an assessment of your back, hips and an internal Pelvic Floor Exam.
During an internal pelvic floor examination, our physiotherapist gently assesses the muscles and tissues inside the pelvic region. This exam helps us evaluate the strength, tone, coordination, and endurance of the pelvic floor muscles. We are also looking for signs of muscle tightness, trigger points, tenderness, or areas of weakness.
Additionally, we assess muscle relaxation (the eccentric muscular activation) and the ability to contract and release (the concentric muscular activation) of the pelvic floor musculature effectively.
Consent is ongoing. At anytime, should you feel uncomfortable or would like to opt out of the internal exam, do not hesitate to let your therapist know; you comfort is our top priority.
The exam allows us to identify dysfunctions under 2 main categories such as:
muscle overactivity (tightness and inability to relax)
underactivity (weakness or poor muscle control)
which are key to creating a tailored treatment plan.
Underactive Pelvic Floor Symptoms:
Urinary incontinence with coughing, sneezing, laughing, or exercise
Heaviness or pressure in the vaginal or rectal area
Fecal incontinence or urgency
Urinary urgency or urge incontinence
Waking frequently at night to urinate
Treatment:
Pelvic floor muscle strengthening exercises
Biofeedback to enhance muscle activation
Coordination training for muscle control
Body mechanics and posture training
Toileting program and position education
Strengthening of hips, core, and back to support pelvic stability
Overactive Pelvic Floor Symptoms:
Pelvic pain or discomfort
Pain with sexual activity
Difficulty emptying the bladder
Urinary frequency and urgency (overactive bladder)
Burning with urination
Constipation
Conditions such as endometriosis-related pain
interstitial cystitis
vulvodynia
vestibulitis
vaginismus
Treatment:
Down training techniques to relax the pelvic floor muscles
Myofascial release and soft tissue mobilization
Vaginal or rectal electrical stimulation (E-Stim) for muscle relaxation
TENS therapy for pain relief
Visceral mobilization
Posture correction and relaxation training
Dilator training to reduce muscle guarding and pain
Breathing training
This structured approach ensures the treatment is targeted specifically to your needs, helping to restore pelvic floor function, reduce pain, and improve quality of life.