Pelvic Physiotherapy

What is Pelvic Health?

Pelvic Health is the function of organs and tissues in the pelvic region. Concerns in this region include pelvic pain, urinary or fecal incontinence, urinary urgency, pelvic organ prolapse, sexual dysfunction (e.g. pain with penetration, erectile dysfunction) and more. These are common across the lifespan and can affect a person’s day to day life. Unfortunately, these symptoms and conditions are not often talked about so many people can suffer in silence, not knowing that there are very effective solutions available.

Pelvic Physiotherapists are specifically trained in pelvic Floor Rehabilitation, to assess the symptoms you are having, make recommendations and provide treatment to improve your Pelvic Health.

What is the Pelvic Floor?

The Pelvic Floor is the term used to refer to the group of muscles in the bottom of the pelvis which are shaped like a hammock. The Pelvic Floor muscles run from the pubic bone in the front to the tailbone at the back.

Why is the Pelvic Floor important?

The Pelvic Floor is important because of its 5 key functions:
  1. ORGAN SUPPORT: The pelvic floor muscles support the bladder, uterus, rectum and important abdominal organs against gravity and any added downward pressure. With excess strain on the pelvic floor (e.g. during pregnancy, straining on the toilet) or with weakening of the pelvic floor (e.g. with age, hormonal changes, birthing, etc.), the pelvic organs can start to protrude near the vaginal opening, This is referred to as pelvic organ prolapse.
  2. CORE SUPPORT: The pelvic floor is one of the four muscles making up our inner ‘core,’ which provides support for our pelvis and lower back. If weak or tense, or if the abdominals have ‘separated’ during pregnancy, this can contribute to low back, hip and pelvic pain.
  3. SPHINCTERIC FUNCTION: The pelvic floor muscles control the openings of the urethra, where urine comes out, and the rectum, where feces and/or gas come out. They prevent leakage and allow easy release of urine, feces and gas at the appropriate time.
  4. SEXUAL FUNCTION: Excess tension or sensitivity in the pelvic floor can contribute to painful intercourse and overall decreased enjoyment.
  5. CIRCULATION: The pelvic floor muscles act as a a ‘sump pump’ to pump blood back up towards the heart. Just like the calf muscles in your leg act to pump blood and lymphatic fluid back up towards our heart, the pelvic floor muscles act as a blood/lymph pump for the pelvis. A loss of this ‘sump pump’ action can contribute to swelling or pelvic congestion.

What can be done?

Kegels, which are contractions or strengthening of the pelvic floor muscles, may or may not be the correct treatment for a pelvic health issue. If Kegels are indicated, your Pelvic Physiotherapist will ensure that you know how to do them effectively, as often people practice them incorrectly.

For some pelvic health issues, Kegels can worsen the problem. In these cases, your Pelvic Physiotherapists will teach you other exercises, and provide other treatments and education to address your symptoms.

Pelvic Physiotherapy is generally recommended as the first line of defense for incontinence, prolapse, pelvic pain and more, rather than jumping into medications and surgery. Pelvic Physiotherapy is quite safe and has little risk of side effects.

Pre/Post-Partum Care

During pregnancy, as your body changes month by month, you will experience physical and hormonal changes which may cause challenges. You may experience postural changes, low back pain, urinary and bowel symptoms, balance issues, and more. These can be treated by the Pelvic Physiotherapist with the goal to relieve discomfort and support you in your pregnancy.

A Pelvic Physiotherapist can also support you in preparing your body for labour and delivery through exercises, relaxation and breathing techniques, manual therapy and education.

Research shows a good exercise program can prevent or reduce the risk of constipation, gestational diabetes hypertension placental damage, diastasis recti during pregnancy, and the need for cesarean or other medical intervention during labour. A proper exercise program can reduce active labour time during delivery and improve bladder control. It also lowers the risk of loss of bone density, and speeds up restoration of pre-activity fitness postpartum. A Pelvic Physiotherapist can support you in exercising safely throughout pregnancy.

Int eh postpartum period, a Pelvic Physiotherapist can help you recover from delivery. They will address any pelvic floor challenges such as scarring, incontinence and prolapse, and guide you in returning to your regular activities and exercise.

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Menopause and the following years can be marked by changes in the pelvic floor and surrounding regions, which can be helped by Pelvic Physiotherapy.

Decreasing estrogen levels during and after menopause affects the function of the pelvic floor and bladder. This can result in a range of symptoms known collectively as “Genitourinary Syndrome of Menopause” (GSM), which include vaginal dryness, burning, itching, vaginal/pelvic pain, urinary urgency, painful urination, recurrent urinary tract infections, discomfort with sexual activity, and overall decreased quality of life. During this period of life women may also experience pelvic floor weakness, urinary incontinence and pelvic organ prolapse.

Many of these challenges can be helped by pelvic Physiotherapy.

Pelvic Floor Pilates Class

In addition to one-on-one Pelvic Physiotherapy, we also provide group classes for rehabilitating the Pelvic Floor. Pelvic Floor Pilates is a small group class for women focused on rehabilitating the pelvic floor and core muscles through exercise and education. It is held one day per week, for 6 weeks, and is taught by a Pelvic Physiotherapist.

Pelvic Floor Pilates is a pelvic physiotherapy program. Therefore, it includes an individual Pelvic Physiotherapy assessment before starting the class, and a follow-up individual Pelvic Physiotherapy session at the end of the program. The individual sessions ensure that the class is the right fit for you, helps us understand what your specific challenges are, and demonstrates progress you have made over the program.

The cost of the sessions are as follows:

  • $140 for Individual Pelvic Physiotherapy assessment before the program
  • $40 per class
  • $95 for Individual Pelvic Physiotherapy follow-up session at the end of the program

As this is a physiotherapy program, we will provide you with receipts which you can submit to your personal insurance.

Men’s Pelvic Health

Men also have Pelvic Health challenges which can be helped through Pelvic Physiotherapy, though this is often overlooked.

The anatomy and function of the Pelvic Floor muscles of men is similar to that of women, as described above, with minor differences internally, and the main differences being in the external genitalia.

Men may experience urinary and fecal incontinence, urgency and frequency. Men may also experience bladder control challenges after a Prostatectomy surgery or after catheterization. Chronic Pelvic Pain Syndrome, also known as Prostatitis, and other types of pelvic pain in the genital region, rectum or with intercourse can be due to pelvic floor dysfunction.

These challenges and more can be helped by Pelvic Physiotherapy.


If you have any questions, please call the clinic to speak with one of our Pelvic Physiotherapists, Bella and Hagit.