Pelvic Floor Physiotherapy Q+A

by Tesca Andrew-Wasylik

WHAT IS PELVIC FLOOR PHYSIO?

Pelvic floor physio takes a close up look, and I mean, a real close up look at your pelvic floor and the different structures within and around it. It is most often an internal assessment (as I said, real close!) done by a trained professional, however it does not always have to be internal. There is still a lot that can be assessed on the surface level but it makes it very difficult to get a sense of the whole picture.

WHAT MADE YOU SPECIALIZE IN PELVIC PHYSIOTHERAPY?

I had been dealing a lot with my own issues ranging from pelvic pain, sport-related incontinence when I was a professional volleyball athlete (...double-unders anyone?), and irregular/heavy/think you're dying from the inside-out menstrual issues. I never really received the answers to my questions of was this normal (it isn't), and was there anything I could do for it (there is). I found pelvic physio through my own research and knew from that moment I wanted to specialize. I truly believe everyone should see a pelvic physio regardless of being symptomatic or not because you learn about one of the most important aspects of your body. I typically describe pelvic physio and its benefits as "empowering". It gives you the tools to manage symptoms from the inside out. My philosophy is to approach my practice from a bio-psycho-social perspective and I will always do my best to describe why you're experiencing your symptoms, how to manage them, and what you can do for yourself to improve your symptoms.

WHO CAN BENEFIT?

Pelvic physio is for all! While I specialize in treating the female population, the benefit of understanding the role of the pelvic floor in relation to many of the inner workings of your body is crucial for everyone. Pelvic floor physio for pre- and post-natal individuals is crucial for recovery and rehab. Did you know in France that any woman who has delivered a baby gets a prescription for 10 free physical therapy sessions to re-educate their pelvic floor? While we wait for Canada to catch up to that level of care, it is covered under extended health benefits for private insurance. I see prenatal patients in their second trimester and postnatal patients typically after their 6 week check up. I cover how to connect to the pelvic floor either in preparation for labour or return to activity post-delivery. If you are experiencing any symptoms with leaking, hip and low back pain, sciatica, abdominal separation (diastasis rectus abdominus), pubic symphysis pain or SIJ pain, pain with intercouse, mommy thumb (De Quervain's Tenosynovitis), or would like guidance with what exercises are appropriate I can help! Many symptoms are common NOT normal and respond well to pelvic physio.Outside of pre and postnatal I work with many other individuals dealing with increased frequency of urination, incontinence, constipation, abdominal separation (diastasis rectus abdominus), pain with PAPs, persistent pelvic pain, pelvic girdle pain, interstitial cystitis, and even chronic hip and low back pain!

WHAT IS THE FIRST APPOINTMENT LIKE?

At your first appointment, we talk about what I assess externally and internally, what your physical activity goals are, and address any concerns that you may have. There is an external assessment, as well as an internal exam. The internal exam is a vaginal examination and rectal if warranted. If you are not comfortable with the internal portion, there is still lots that we can assess externally however it does not give as full of a picture. I introduce the anatomy of the pelvic floor, explaining where the pelvic floor is, its functions, and why it's important. We take a look at the tissue health, tone of your pelvic floor, and assess the muscular strength and coordination of your inner core muscles. After the assessment, we will discuss an individualized plan and what to expect for follow up sessions. 

SORRY...DID YOU SAY "INTERNAL EXAM"?  

You got it! As a pelvic physio I have received post-graduate training in internal assessment and treatment of the pelvic floor. While this can cause some nerves, please know that at any point you can choose not to have the internal exam. I also remember my first assessment and feeling very strange and vulnerable. The usual response I receive after the assessment from a lot of people are, "Wow, that wasn't as scary as I thought at all!" Your therapist connection is huge. I will always try to make the appointment as comfortable as possible and start with education of the pelvic floor and its anatomy so you know exactly what I am evaluating, why, and how it relates to your issues. There are no instruments used internally and involves a digital (gloved finger) for examination that is at your pace and only done if you consent to an internal assessment. I emphasize the importance of communication and as said before at any point you want to stop, we do, no questions asked.  

HOW LONG DOES IT TAKE FOR ME TO SEE RESULTS?

It is dependent on the issue that we are dealing with, but I usually see changes within 3-5 visits.