By: Leah Forrestall
The Pelvic floor is a network of muscles, ligaments, and fascia that act as a support system (like a hammock). It has many layers and is very innervated with nerves and blood vessels. Everyone has one and it only varies slightly between males and females!
What does the Pelvic Floor Do?
The Pelvic floor is in charge of a number of very important and essential tasks!
- Support: as the bottom of the core it is in charge of holding many organs in place against gravity and pressure
- Sexual: assists in orgasm (hallelujah!) and helps bring blood to the penis and vagina to maintain arousal and provide tone to the vaginal/rectal canal
- Sphincteric: controls opening of the urethra, vagina, and rectum to help maintain healthy urine and fecal function
- Stability: help to maintain stability in the hip, pelvic, and SI (sacroiliac) joints as well as offloading the low back
- Sump-Pump: Helps as a lymphatic and blood pump to decrease congestion in the pelvis
Where is my pelvic floor and how do I identify it?
Your pelvic floor is located at the base of your pelvis. If you think of your “core” as a cube, the pelvic floor is the bottom of the cube, the diaphragm (breathing muscle) is the top, and your abdominal, spinal and deep core muscles are the sides of the cube. It’s like a “hammock” at the bottom of your pelvis, and unfortunately, it gets forgotten about far too much!
What does Physio for your Pelvic Floor entail?
Depending on what brings you in to see a pelvic floor physio your experience may vary slightly.
Just as your typical physio appointment would go, your therapist will take a detailed subjective history of your presenting condition. This part typically takes up most of the first appointment.
We ask you about everything from when your presenting concerns started to what your bowel movements look like (check out the Bristol Stool Chart .. this always brings some light-hearted laughs to the appointment!) to how your sleep schedule typically is.
Once we’ve chatted in detail about your pelvic and general health we will discuss physical assessment options. This may include the recommendation of an internal pelvic floor exam. Yup, we said internal! We promise this is not as bad as it sounds. We use gloves and lubrication to insert 1-2 fingers vaginally (and sometimes rectally, in specific cases) and walk you through what we’re doing the whole time. We try to make you feel as calm and comfortable as possible! Of course, this is with your informed consent and you can choose to opt-out of this (but it does make our job as therapists easier to feel what’s happening within the pelvic floor and give you the best feedback). On the flip side, internal exams are not always indicated and we may only need to assess things such as your hip, glute, and back movements/strength.
Treatment will vary as well depending on your unique condition. This will include TONS of education! We teach you about your anatomy, your habits, your physical and mental health. We teach you things to do to improve your bladder and bowel habits and your sexual health! We educate you on your pelvic strength and/or tension and what you should do to strengthen or lengthen (Surprise! It’s not just teaching you to do kegels until the cows come home! Kegels may not be for you!). We can provide you with internal cues to contract or relax your pelvic floor better and use tools to give you feedback on your pelvic floor contractions.
Pelvic floor physio for each person varies but all treatments include teamwork between you and your therapist to achieve your unique goals. And we promise you’ll learn loads along the way!
How do I know if I need Pelvic Floor Physio?
Pelvic floor physio is for ANYONE with a pelvis!
There are various reasons you may need to see a Pelvic Floor Physiotherapist, such as: uncontrolled urinary leakage or urgency (incontinence), prolapse management (pressure), pre and post-partum management, constipation, nerve irritation or damage, and pain (with or without intercourse, urination and/or orgasm) in your pelvis, low back, or hips. You can also see pelvic floor physio for post-surgical management from a c-section, hernia repair, and prostate removal. Pelvic Floor Physio is also great as a prevention strategy prenatally to incorporate evidence-based strategies and education to help you during and after your pregnancy, as well as during labour.
How do I see a Pelvic Floor Physio at Synergy?
You can book with our Certified Pelvic Health Physiotherapists through our website or by calling our clinic!
Physiotherapist - BSc Hons (Kin), MSc PT
Author, Leah Forrestall is a Pelvic Floor Physiotherapist practicing out of our Danforth location. You can book with her by clicking HERE or by calling 416-551-8715.