When Your Pelvic Floor Is Asking for Support: Understanding Pelvic Floor Physiotherapy
Your pelvic floor isn't something most of us think about very often.
Until something changes.
Maybe you leak a little when you sneeze, cough, or exercise. Maybe running doesn't feel the same after having children. Maybe you feel pressure or heaviness after being on your feet all day. Maybe you're constantly looking for the bathroom. Or maybe something just doesn't feel quite right.
These are common concerns—but that doesn't mean you have to simply live with them.
Pelvic floor physiotherapy is a specialized area of physiotherapy that assesses and treats problems involving the pelvic floor muscles, bladder and bowel function, pelvic support, and how the pelvic floor works with the rest of the body.
Your pelvic floor is part of your movement system, and like any other part of your body, it can benefit from assessment and support when something isn't working the way you'd like it to.
What Exactly Is the Pelvic Floor?
The pelvic floor is a group of muscles and connective tissues that sit at the base of your pelvis.
These muscles play several important roles, including supporting the pelvic organs, contributing to bladder and bowel control, and working with your core and other muscles to help stabilize your body during movement.
The pelvic floor also needs to do something that makes it a little different from many other muscles in your body:
It needs to be able to contract when you need support—and relax when you need it to.
That's why pelvic floor health isn't simply about having "strong" muscles.
Sometimes the issue is weakness.
Sometimes the muscles are working too hard and have difficulty relaxing.
And sometimes the problem is related to coordination, pressure management, movement patterns, or other factors.
Pelvic Floor Concerns Aren't Just a Postpartum Issue
Pregnancy and childbirth can certainly affect the pelvic floor, but pelvic floor concerns can happen at many different stages of life.
You may notice changes:
During or after pregnancy
Following childbirth
When returning to exercise
With running or jumping
During perimenopause or menopause
After pelvic or abdominal surgery
With changes in bladder or bowel habits
As your activity level changes
You don't have to have given birth to experience pelvic floor symptoms.
And you don't have to wait until your symptoms become severe before having them assessed.
What Are Some Signs Your Pelvic Floor May Need Attention?
Pelvic floor concerns can look different from person to person.
You might notice:
Leaking urine when coughing, sneezing, laughing, or exercising
A sudden or frequent urge to urinate
Difficulty controlling your bladder
A feeling of pressure, heaviness, or dragging in the pelvis
Difficulty controlling bowel movements or gas
Changes in bowel habits
Discomfort during certain activities
Difficulty returning to exercise after pregnancy or injury
A feeling that something has changed but you're not sure why
None of these symptoms automatically mean that you have a pelvic floor disorder.
But they are worth paying attention to.
You Don't Have to "Just Live With It"
One of the most common things we hear is:
"I thought this was normal after having kids."
Or:
"I assumed it was just part of getting older."
Or even:
"I was too embarrassed to bring it up."
Pelvic health can feel like a private topic, which means people sometimes wait a long time before asking for help.
But common doesn't necessarily mean something you have to accept as your normal.
A pelvic floor physiotherapist can provide a private, individualized assessment and help you understand what may be contributing to your symptoms.
What Happens During Pelvic Floor Physiotherapy?
Pelvic floor physiotherapy is not simply about doing Kegels.
Your physiotherapist will first want to understand what's happening and how it's affecting your everyday life.
An assessment may look at:
Your symptoms and health history
Bladder and bowel habits
Pregnancy and birth history, when relevant
Breathing and pressure management
Core and pelvic floor coordination
Strength and mobility
Movement patterns
Your goals and activities
Depending on your concerns and your consent, an internal pelvic floor assessment may also be discussed.
You are always part of the decision-making process.
Your physiotherapist can explain what an assessment involves and why a particular component may be recommended.
What Can Pelvic Floor Physiotherapy Help With?
Treatment depends on what your assessment shows.
Your plan may include education, exercises, breathing and pressure-management strategies, mobility work, strengthening, coordination training, activity modifications, or other individualized strategies.
For some people, the focus may be building strength.
For others, learning how to relax and coordinate the pelvic floor may be more important.
And sometimes additional support may be appropriate.
Where Do Pessaries Fit In?
You may have heard of a pessary but aren't quite sure what it is.
A pessary is a removable medical device that is placed in the vagina to provide support to pelvic structures.
Pessaries can be used for some people experiencing pelvic organ prolapse symptoms and, in certain circumstances, may also be considered as part of managing symptoms such as stress urinary incontinence.
They aren't right for everyone.
That's why pessary fitting and management should be individualized and considered alongside the person's symptoms, anatomy, goals, and overall pelvic health.
A Pessary Isn't a Replacement for Physiotherapy
For some people, a pessary may be one tool within a broader pelvic health plan.
It can provide additional support during certain activities, while pelvic floor physiotherapy can address movement, strength, coordination, pressure management, and other contributing factors.
As part of her ongoing pelvic health care, Shobi, our pelvic health physiotherapist at Good Wellness, will be completing pessary certification at the end of October.
Once certified, she will be able to incorporate pessary assessment and fitting into care for appropriate patients.
You Don't Need to Wait Until Things Get Worse
Pelvic floor symptoms can be easy to ignore.
You might stop running.
You might cross your legs when you sneeze.
You might avoid jumping on the trampoline with your kids.
You might plan your day around where the bathrooms are.
You might simply tell yourself that this is what happens after having children.
But those little adjustments can add up.
If something has changed the way you move, exercise, work, or enjoy your day, it's worth paying attention to.
Pelvic Floor Health Is Part of Whole-Body Health
Your pelvic floor doesn't work on its own.
It works with your breathing, abdominal muscles, spine, hips, and the rest of your body during movement.
That's why pelvic floor physiotherapy isn't simply about one group of muscles.
It's about understanding how your body is functioning as a whole and finding strategies that fit your life.
Whether you're postpartum, returning to exercise, navigating changes with age, dealing with bladder or bowel symptoms, or simply noticing that something doesn't feel quite right, you don't have to figure it out on your own.
Pelvic Floor Physiotherapy at Good Wellness Clinic
Good Wellness Clinic provides pelvic floor physiotherapy in Barrie, Ontario with Shobi, our pelvic health physiotherapist.
Shobi works with women at different stages of life who are experiencing pelvic floor, bladder, bowel, postpartum, or movement-related concerns.
Her approach starts with understanding what's happening, how it's affecting you, and what you want to be able to do.
Pelvic health concerns are common, but you don't have to simply accept them as part of life.
Sometimes the first step is simply having a conversation and understanding what's going on.
Your body is allowed to change. And you're allowed to ask for support when it does.
Frequently Asked Questions About Pelvic Floor Physiotherapy
What does pelvic floor physiotherapy treat?
Pelvic floor physiotherapy can help address a range of pelvic health concerns, including urinary leakage, bladder urgency or frequency, pelvic pressure or heaviness, bowel control concerns, postpartum changes, and difficulties returning to exercise. Treatment depends on the individual's symptoms and assessment.
Do I need pelvic floor physiotherapy after having a baby?
Not everyone needs pelvic floor physiotherapy after having a baby. However, pregnancy and childbirth can affect the pelvic floor, and an assessment may be helpful if you're experiencing leaking, pelvic pressure, discomfort, changes in bladder or bowel function, or difficulty returning to exercise.
Can pelvic floor physiotherapy help with urinary leaking?
Pelvic floor physiotherapy may help with certain types of urinary incontinence. Assessment can help determine what may be contributing to the leakage and whether pelvic floor exercises, coordination, breathing, pressure management, activity modifications, or other strategies may be appropriate.
What happens during a pelvic floor physiotherapy assessment?
Your physiotherapist will discuss your symptoms, health history, activities, and goals. Depending on your concerns, the assessment may include movement, breathing, core and pelvic floor coordination, strength, and mobility. An internal assessment may be discussed when appropriate and with your consent.
Do I need an internal pelvic floor assessment?
Not necessarily. Whether an internal assessment is appropriate depends on your symptoms, goals, and the clinical situation. Your physiotherapist can explain why it may be recommended and answer any questions you have before proceeding.
What is a pessary?
A pessary is a removable medical device placed in the vagina to provide support to pelvic structures. Pessaries may be considered for some people experiencing pelvic organ prolapse symptoms and, in certain circumstances, stress urinary incontinence.
Who can benefit from a pessary?
A pessary may be an option for some people with pelvic organ prolapse symptoms or certain types of urinary incontinence. Whether it's appropriate depends on individual symptoms, anatomy, goals, and overall pelvic health. A qualified healthcare professional can assess whether pessary care may be suitable.
Do I need a referral for pelvic floor physiotherapy in Ontario?
Physiotherapy does not generally require a physician referral in Ontario. However, some extended health insurance plans may have their own requirements for coverage, so it's worth checking your individual plan.
Ready to Talk About Your Pelvic Health?
If you've noticed changes in your bladder, bowel function, pelvic pressure, exercise, or everyday movement, you don't have to wait until they become more disruptive.
Book a pelvic floor physiotherapy assessment with Shobi at Good Wellness Clinic in Barrie.
