Pelvic floor physiotherapy is a specialized area of physical therapy that focuses on the muscles, ligaments, and connective tissues that support the pelvic organs. These muscles play an important role in bladder and bowel control, core stability, posture, sexual function, and overall movement. Pelvic floor physiotherapy helps people who are experiencing pain, weakness, tightness, or coordination problems in this area improve their function and quality of life.
At this time, pelvic floor services at Evolution are focused on female incontinence with a plan to expand our services offered soon.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles that sit at the bottom of the pelvis, forming a supportive “sling.” These muscles support organs such as the bladder, bowel, and (in people with a uterus) the uterus.
The pelvic floor also works closely with the abdominal muscles, back muscles, and diaphragm to help with:
- Bladder and bowel control
- Posture and balance
- Core strength
- Breathing and movement
Like any muscle group, the pelvic floor can become too weak, too tight, or poorly coordinated, which can lead to symptoms.
What Is Incontinence?
Incontinence is the unintentional leakage of urine or stool. It can happen during activities like coughing, laughing, running, or lifting, or it may occur with a strong, sudden urge to go to the bathroom.
Common types of incontinence include:
- Stress incontinence: leakage with physical effort or pressure
- Urge incontinence: leakage associated with a strong urge to urinate
- Mixed incontinence: a combination of both
Pelvic floor physiotherapy is often a first-line, non-surgical treatment for incontinence and can be very effective when done consistently.
What Does a Pelvic Floor Physiotherapist Do?
A pelvic floor physiotherapist is a licensed physiotherapist with extra training in assessing and treating pelvic health conditions. Their goal is to help the pelvic floor muscles work properly—whether that means strengthening, relaxing, or improving coordination.
Treatment may include:
- Education about pelvic floor function
- Exercises tailored to your specific needs
- Breathing and posture work
- Movement and lifestyle strategies to reduce symptoms
- Manual therapy
What to Expect at a Pelvic Floor Physiotherapy Visit
Your first appointment usually begins with a detailed conversation about your symptoms, medical history, daily activities, and goals. This helps the physiotherapist understand what may be contributing to your concerns.
A physical assessment may follow, which can include checking posture, breathing, and how your core and pelvic muscles work together. This may include an internal assessment of the vagina and/or rectum, but this is always at your discretion. The physiotherapist will always explain what they are doing, ask for consent, and make sure you feel comfortable. You are encouraged to ask questions and share any concerns.
After the assessment, you’ll receive a personalized treatment plan. This often includes exercises or strategies to practice at home, as progress typically happens over time with regular practice
Frequently Asked Questions
What should I wear to my appointment?
You should wear comfortable clothes that you are able to move around in.
Can I still come to my appointment if I’m menstruating?
Yes, you can still come for your appointment and all the same assessment/treatment techniques can be used. We can modify the session as needed for your comfort.
How long are appointments?
The initial assessment is approximately 1 hour. The length of follow up visits may vary depending on your physiotherapist’s recommendations, but will likely be about 45 minutes.
Isn’t urinary incontinence normal after childbirth or with aging?
No! While it may be common, urinary leakage is a sign of dysfunction and is treatable!
Do I need to have an internal assessment?
It is completely your decision if you would like to have an internal exam and you always have the right to change your mind both within a session, or from session to session. The benefit of the internal exam is it allows for direct palpation of the pelvic floor muscles to assess for tone and tenderness, strength, and coordination for more accurate treatment. It is possible to do exclusively external assessment and treatment, but it may be less specific.