Pelvic Floor Physiotherapy
Urinary and Fecal Incontinence | Pelvic Pain | Post Partum
A Hypotonic Pelvic Floor?
Pelvic floor muscle dysfunction tends to fall into two broad categories: hypotonic and weak muscles, or hypertonic and painful muscles. A hypotonic or weak pelvic floor may present with symptoms of urinary urgency, frequency and leakage with coughing, sneezing, laughing or high-impact activities. This dysfunction may develop during or after pregnancy, with hormonal and age-related muscle fibre density changes post-menopause, with damage to the internal urethral sphincter post prostatectomy, post abdominal surgery, or develop idiopathically due to abnormal core stabilization strategies. Recent evidence shows that pelvic floor hypotonicity is also frequently concurrent with hip labral tears and low back pain.
Why Treat the Pelvic Floor?
Pelvic floor physiotherapists are uniquely trained to assess and treat the strength of the pelvic floor musculature via an internal vaginal and rectal exam. You may be familiar with the term “Kegels”, named after the pioneering gynaecologist who developed the basis of the pelvic floor strengthening techniques prescribed today. While Kegel exercises are widely prescribed for the management of urinary incontinence and pelvic organ prolapse, without internal palpation they are often either ineffective as a result of improper muscular contractions, or may even be pain-provoking in cases of pelvic musculature hypertonicity.
A Hypertonic Pelvic Floor?
Pelvic floor muscle hypertonicity can contribute to a host of painful syndromes including: chronic pelvic pain, chronic constipation, dyspareunia, vaginismus, vulvodynia, pudendal neuralgia, interstitial cystitis, chronic prostatitis, and even sacroiliac, low back and hip joint dysfunctions that may cause other orthopaedic symptoms. The causes for pelvic floor hypertonicity are multifactorial, but abdominal or pelvic trauma (including childbirth) and/or surgery, recurrent bladder, vaginal or bowel infections, hormonal changes, traumatic life events and even adaptive overuse from sport or daily life may contribute to its development.
How a Physiotherapist can Help?
A pelvic floor physiotherapist will assess the status of the pelvic floor anatomy and associated joints to design a treatment plan specifically tailored to client dysfunction. This may include carefully cued and controlled Kegel exercises and/or pessaries, such as Uresta for the hypotonic pelvic floor, myofascial release and strengthening to balance the pelvic ring for the hypertonic pelvic floor, and specific exercise programs to treat dysfunction and speed recovery during and after pregnancy.
Pelvic Floor Physiotherapy at Life Therapies
Jagisha Sekhri, Registered Physiotherapist, offers Pelvic Floor Therapy at the clinic.