What Is Down There Care? Pelvic Floor Physio Explained.

Bowmanville Pelvic Floor Physiotherapy Explained

So you’ve been told by your family doctor or OB that you should see a pelvic floor physiotherapist.  Who are we? What do we treat? What do we do? What should I mentally prepare for?

These are all valid questions and concerns, especially with anything involving ‘down there care’. I’m here to give you all the details on what I do and how I can be an integral part of your health, fitness and sex life!

What is a Pelvic Floor Physiotherapist (PF PT)?

So besides being a regular old registered physiotherapist, I have done additional training after my Masters degree to become certified in pelvic health through nationally accredited Pelvic Health Solutions. I have rostered with the College of Physiotherapists of Ontario so that I am able to provide external and internal care to my female clients.

As a PF PT I am able to assess, diagnose, and treat any issue involving the pelvic girdle. The pelvic girdle encompasses everything from your rib cage to your knees because this entire area is influenced by the pelvic floor muscles functioning.

To make me an even more badass PF PT, I have gone on to learn from Antony Lo, Julie Wiebe and Brianna Battles in rehabilitation of the pelvic floor for the female athlete and become a fully certified pregnancy and postpartum fitness coach. This has allowed me to treat high level athletes with pelvic floor dysfunction beyond the typical mat exercises that you would see in a traditional rehab setting.

What Do We Treat?

I can treat a wide variety and severity of issues related to the pelvic floor. Here is a brief list, however it isn’t all-encompassing so if you have an issue you’d like to ask about, contact me directly:

  • Pregnancy fitness (modifications/scaling recommendations and assessment surrounding your activity of choice)

  • Postpartum fitness ramp up (programming to get you back to doing what you love)

  • Treatment of diastasis recti abdominis (thinning of abdominal wall tissue)

  • Stress urinary incontinence (leaking with cough/run/laugh/jump/lift)

  • Urgency incontinence (frequent peeing/unable to make it to the bathroom in time)

  • Pelvic heaviness/pelvic organ prolapse symptoms

  • Pelvic pain and/or painful sex

  • Chronic low back or hip pain

  • Pubic symphysis and/or tailbone pain/dysfunction

  • Birth prep (breathing, perianal massage, pressure management)

What is Involved in an Initial Visit for PF PT?

A first visit can be broken down into these parts:

1. Small Talk

We discuss your pelvic health history, past and current concerns and the goals and goal timeline that you hope to achieve through PF PT. 

2. Movement Analysis

I will get you to do a series of movements, the difficulty of the movements that I choose will depend on your current functioning, comfortability with movement and your future goals.

3. Passive Exam

This is where you get to relax - I will check movement and functioning in the muscles surrounding the pelvic floor (i.e. the hips, low back, knees, trunk, rib cage). I will also look at your muscle tension and strength testing. I always do a quick ‘core screen’ to determine what your strategies are for bracing the core and breathing.

4. Internal Exam (Maybe)

PF PT can involve an internal examination if I believe that it would be beneficial with what I’ve seen up until this point in the assessment. Some indications for an internal would be: 

  • Suspecting a pelvic organ prolapse

  • Seeing abnormal bracing patterns with the core

  • Reports of pelvic pain/painful sex

  • Stress incontinence (leaking with jumping/coughing/running, etc)

  • Unable to ‘connect’ with the pelvic floor and feel weakness throughout

In saying this, if you are not comfortable with this part of the assessment it is no way necessary to see improvement! There are tons of tools that I have to help you reach your goals, an internal assessment is just one of them.

5. Debrief & Homework

Just like normal physiotherapy, I do 1% of the work but it is up to you to do the other 99%. I give you the education, skills and exercise programming that you need to reach your goals but I am not a babysitter. You will leave your appointment with lots of new knowledge and a detailed and goal-oriented program to do independently. I usually follow up with ladies anywhere from weekly to monthly depending on the situation.

That’s it! Do you feel ready?! I can’t wait to work with you to help you achieve your personal and fitness goals while healing your pelvic floor. Let’s do this thing.

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