Episode 1: What to Expect at Pelvic Floor Physio

Episode 2: Overview of the Pelvic Floor Assessment

Episode 3: Role of Pelvic Floor Physiotherapist

Episode 4: Just Breathe...

Episode 5: Pelvic Floor Physiotherapy During Pregnancy

Episode 6: Pelvic Floor Physiotherapy Post-Partum

Episode 7: Emotional Impact of Perineal Lacerations

Physical therapy helps people to restore, maintain and maximize their strength, function, movement, and overall well-being after suffering from an injury or health condition.
 
Suzanne Funk is a Physical Therapist has received additional post-graduate training in the area of pelvic floor dysfunction and provides services to both males and females in this specific area.  This includes pre and post-natal pelvic floor assessment and treatment, pelvic pain, incontinence (urinary and fecal) and pelvic organ prolapse. 

WHAT IS PELVIC FLOOR PHYSICAL THERAPY
 
Pelvic Floor Physiotherapy is becoming more established in the literature as an effective treatment for Pelvic Floor Dysfunction; including Incontinence, Pelvic Pain, Sexual Pain, Prolapse, and Post-Partum concerns including unresolved pain associated with perineal obstetrical lacerations and c-section scars.
As Physical Therapists in Saskatchewan providing treatment in the area of urogenital or rectal dysfunction we must complete educational programs recognized by the Saskatchewan College of Physical Therapists in order to provide treatment in this area.
 
Pelvic Floor Dysfunction can be caused by:

• HYPOTONICITY  or Weak pelvic floor muscles: contributing to stress incontinence, urge incontinence and pelvic organ prolapse. Incontinence is NOT a normal part of aging
• HYPERTONICITY or Tense pelvic floor muscles: contributing to urinary and fecal urgency, urge incontinence, chronic pelvic pain, dyspareunia, vaginismus, vulvodynia
• Tissue Changes: tight or loose tissues (muscles, skin, ligaments and fascia) contributing to pain, pelvic organ prolapse, incontinence

 
Kegels are NOT always indicated for pelvic floor problems. Sometimes they are not appropriate, and often they are NOT performed correctly.
 
The Cochrane Collaboration 2010 concluded that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence in women.
 
Many people with pelvic pain have pelvic floor dysfunction, but specifically hypertonic muscles, or muscles that are too tense. The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women).
 
These muscles must be able to contract to maintain continence and relax to allow for urination, bowel movements, and in women, sexual intercourse.
 
When these muscles have too much tension (hypertonic) they will often cause pelvic pain or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they will contribute to stress incontinence and organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.
 
Hypertonic muscles can cause the following symptoms:

• Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
• Constipation, straining, pain with bowel movements
• Unexplained 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
• Pelvic floor dysfunction is diagnosed by specially trained doctors and physiotherapists by using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. They will also assess your ability to contract and relax these muscles. Your bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since these joints can stress your pelvic floor muscles.

If an internal examination is too painful, the connective tissue of your abdomen, thighs, groins and low back are often very tight. The connective tissue forms the container of the muscles, and this tissue often needs to be relaxed before any internal work can be done.
 
When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and strengthening exercises are prescribed, if appropriate.
  
Persistent pain education is an important part of treating pelvic floor dysfunction since the pelvic area is an area that we often hold our stress. Anxiety, stress and our thoughts, attitudes and beliefs can perpetuate the pain in our pelvis; understanding how our pain system works has shown to be an effective way of reducing the threat of ongoing pelvic floor dysfunction.
 
Adapted from http://pelvichealthsolutions.ca/for-the-patient/what-is-pelvic-floor-physiotherapy/


​

Episode 8: Tense Pelvic Floor and Stress Urinary Incontinence

Our Responsibilities

Episode 9: To Kegel or NOT to Kegel...That is the Question!

 Please call 306-347-1999 with questions or to book an appointment.