Frequently Asked Questions
1. What is Pelvic Floor Physiotherapy?
It is physiotherapy for the pelvic floor! Pelvic Floor aka Pelvic Health Physiotherapists have specialized post graduate training which includes, using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. We will assess your ability to contract and relax these muscles and their synergy with the other core muscles. We will also assess the joints and muscles of your lower back, hips and sacroiliac (SI) joints since problems here can stress your pelvic floor muscles.
2. What conditions can a Pelvic Floor Physiotherapist treat?
Just about any women's health issue:
- Pre and Post natal aches and pains
- Diastasis Rectus Abdominis (DRA) aka mummy tummy
- leaking when you cough , laugh or jump.....or
- not getting to the bathroom in time
- Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
- Pelvic organ prolapse
- Constipation, straining, pain with bowel movements
- Pain in your low back, pelvic region, hips, genital area, or rectum
- Pain during or after intercourse, orgasm, or sexual stimulation
- Uncoordinated muscle contractions causing the pelvic floor muscles to spasm
We are also regular physios, so we can treat all of your other aches and pains as well.
We also have a penchant for prevention, and love to do pre-conception/pre-pregnancy screens
3. Will I need an internal exam and why is it necessary?
An internal pelvic assessment is the best way to properly acess what is happening with the muscles, organs and connective tissue in the pelvis. We can acess tone ,strength, pelvic floor muscle coordination and function. It may be highly recommended for your particular problem. However, if you are uncomfortable with this, speak with your Physiotherapist about the pros and cons for you, and together you can decide if it is something that can wait, something that really should be done sooner, or if you can be successfully treated with the many external treatment options we have available. You can always grant or remove consent at any time during your treatments.
4. Do I have to have an internal exam?
NO, an internal exam is not mandatory. It is the gold star assessment when it comes to pelvic dysfunction. We liken it to going to the dermatologist for a rash and not removing the clothing covering the rash. However we can often get a pretty good idea of what is happening through our history and evaluation. We will gather as much information as we can to adequately treat you. It may require a few additional visits, but your overall comfort and compliance with treatment is our biggest concern. Remember you may give or remove consent at any time. If you are concerned with having an internal, speak to your physiotherapist, together you can decide when the best time would be, if at all. We have treated many women whose pain conditions have required starting with external treatment.
5. What if I have my period? Should I cancel my appointment?
Our therapists are able to assess and treat the pelvic floor even if you currently have your period. It can actually be beneficial as the pelvic floor muscles and pelvic organs can be affected by the hormonal fluctuations, especially if you notice a cyclical relationship to your problem. If you feel uncomfortable having your assessment during your period the therapist can either proceed with the assessment or treatment externally or you can reschedule your appointment, provided you give 1 business day’s notice.
6. Is my physiotherapist specially trained to do an internal exam?
Yes. All of the Physiotherapists at PhysioExcellence have undergone and continue to seek post graduate training to provide internal assessment and treatment services. The College of Physiotherapists of Ontario requires physiotherapists to be listed in the roster in order to perform internal assessments and treatments. All PhysioExcellence Pelvic Floor Physiotherapists have taken extensive training above and beyond the minimum requirements and are on the roster with the College. http://publicregister.collegept.org/PublicServices/Start.aspx
7. How should I prepare for my assessment and what should I bring with me to my first appointment?
As the patient coordinator, I will send you some forms to collect relevant personal information about you and your medical history. Along with this, please bring any reports from special investigations or testing such as urodynamic or MRI reports. Don’t worry if you don’t have them, we can always request them from your MD at a later time. You may bring a change of clothes like a tank top and shorts if your main concerns are hips, back or shoulder. There isn’t much to prepare for the internal assessment, you will be asked to undress from the waist down, we have gowns for you to change into, but many women opt to just wear their skirts. You will always be draped to your comfort level.
8. How long is the assessment and subsequent treatment sessions?
Your initial assessment is one on one in a private room. It will be approximately 60 minutes with your Pelvic Floor Physiotherapist. Follow up visits will be determined during your assessment, as they are catered to your particular needs but generally between 30 to 40 minutes per session. We highly recommend booking your appointments ahead to ensure your preferred time.
9. How often should I come and many sessions will I need?
Based on your exam findings, your pelvic floor physiotherapist will work with you to put together a treatment plan that is specific to your particular goals, symptoms and dysfunction. Every person is unique and even two people with the same diagnosis may require a different treatment plan.
10. Can I bring my baby with me?
Yes. PhysioExcellence welcomes you to bring your baby with you for your appointment; you can even nurse during certain treatment techniques.
11. Will my extended health insurance cover pelvic floor physiotherapy?
Pelvic floor physiotherapy falls under the domain of physiotherapy, regardless of the area being treated. If you have insurance coverage for physiotherapy then pelvic floor physiotherapy will be included. But we encourage you to follow up with your insurance provider to confirm coverage. Please note that some insurance plans require a physician prescription in order to be reimbursed for physiotherapy services, even though you do not need a referral to see the Physiotherapist.