WHAT IS PHYSIOTHERAPY FOR SUSPECTED PELVIS?

Pelvic floor physiotherapy is a specialized branch of orthopedic physiotherapy that focuses on the assessment and treatment of pelvic floor conditions and dysfunctions.

The pelvic floor is made up of muscles, connective tissue, joints, nerves and ligaments. Their architectural design creates support at the pelvic floor and works to support the abdominal organs, stabilize the pelvis and coxofemoral joints, and maintain urinary continence and sexual function.

Pelvic floor dysfunction occurs when these muscles weaken or contract, preventing them from performing their normal functions. Pelvic floor dysfunctions can lead to symptoms such as pain in the lower back, hips or pelvis, pelvic pressure or heaviness, constipation, urinary incontinence and pain during intercourse.

Pelvic floor physiotherapy treats these irregularities and symptoms by re-strengthening these structures in order to improve their function and strength.

What conditions

treated and/or improved with SUSPECTED PELVIC PHYSIOTHERAPY?

Stress urinary incontinence: Involuntary loss of urine with an increase in intra-abdominal pressure. You may have discharge when you laugh, cough, sneeze, or with physical activity (jumping, running, walking). Urge urinary incontinence: The involuntary loss of urine after a strong urge to urinate that cannot be controlled. Mixed urinary incontinence: A combination of stress incontinence and urge incontinence. It is very common to have mixed incontinence as opposed to pure stress or pure urge incontinence. Overactive bladder: Frequent urination, more than 5-8 times a day. Urinary Hesitancy/Dysynergia: Difficulty initiating urine flow or bowel movements. This may be the result of poor pelvic muscle coordination. Constipation: When bowel movements are infrequent or difficult to pass. Symptoms may include bloating or abdominal pain and an inability to empty the bowels completely. Endometriosis: A condition in which endometrial tissue grows outside the uterus. This appearance can be accompanied by pelvic pain, heavy and painful periods, pain during sexual intercourse, as well as urinary and bowel dysfunction. Pudendal Neuralgia: The pudendal nerve supplies sensory, motor, and autonomic function to the external genitalia, bladder, and rectal muscles. With pudendal neuralgia, the nerve is mechanically compressed, blocked or irritated causing pain and dysfunction in the pelvic region. Prolonged sitting, difficult labor and cycling are common causes of pudendal neuralgia. Interstitial cystitis: A condition affecting the urinary bladder that includes uncomfortable sensations and symptoms such as pain, pressure, burning, urinary frequency, and urgency. With this condition, there may be identifiable bladder disease (such as Hunner's lesions). Levator ani syndrome: The levator ani muscles are the deep muscles of the pelvic floor. These muscles can go into spasm resulting in pain within the perineum, rectum or tailbone. Dyspareunia: Pain experienced during intercourse. Pelvic pain can occur before, during and after intercourse. Symptoms can be experienced superficially at opening, with deep penetration or with orgasms. Coccydynia: Pain experienced inside the tailbone or coccyx. Symptoms increase with prolonged sitting. Vulvodynia: A non-specific, unprovoked, generalized pain around the opening of your vagina (vulva) with no identifiable physical findings. Vaginismus: An involuntary contraction of the pelvic floor muscles to prevent vaginal penetration. This may limit gynecological examinations, tampon insertion or sexual intercourse. Pelvic organ prolapse: Occurs when one or more pelvic organs (uterus, bladder, rectum) protrude into the vaginal canal. This is due to weakening of the pelvic muscles and connective tissues that function to provide support to the pelvic organs.

Frequently Asked Questions

Is an internal examination required?

Yes, with your consent, an internal examination is required for a complete evaluation of the pelvic floor. Internal examination is an integral aspect of pelvic floor assessment and treatment and is considered the gold standard in pelvic health physiotherapy. Research has shown that physical therapists with specialized training in pelvic rehabilitation, including internal palpation, are very successful in treating pelvic floor dysfunction. Pelvic floor physiotherapy should be the first line of defense – before surgery or any other medical intervention – for pelvic pain, incontinence and pelvic organ prolapse.

How many sessions are required?

It will take 5-8 sessions before results are seen.

What are the contraindications for pelvic floor assessment and treatment?

Pelvic floor evaluation and treatment includes an internal palpation examination to test the integrity of the pelvic floor muscles. There are certain conditions that limit internal palpitations. Please notify your pelvic floor therapist immediately if you have any of the following contraindications. Contraindications for evaluation and treatment of the internal pelvic floor:

Active infection
Active rectal bleeding
Radiation injury less than 6-12 weeks
Seed implants of radioactive materials
Less than 6 weeks after surgery: After labor and delivery; C-section or vaginal
Postoperative less than 6 weeks (12 weeks after prolapse repair)
If instructed by a doctor to refrain from penetrative intercourse

What should I expect at my first session?

With pelvic floor therapy we will assess the integrity of the pelvic floor muscles in relation to your core and symptoms. Your certified pelvic floor physical therapist will use internal and external “hands-on” or manual techniques to assess the integrity of the pelvic floor muscles, in addition to the associated joints, connective tissue, ligaments, and muscles within the back and sacroiliac joint. The pelvic floor exam will, with your consent, have a gold standard internal vaginal and or anal exam. Before an initial assessment, you will be sent forms and questionnaires to complete. Please complete these forms to the best of your ability and bring them with you. These forms will identify and illuminate specific symptoms in addition to contributing factors to your condition. Based on the collected information, a complete, detailed subjective and objective assessment will be made. Based on your symptoms, condition and goals, a tailored and individualized treatment plan will be created to help manage pain and discomfort within your pelvic region. Time frame: An initial assessment takes 60-75 minutes.

What if I tried doing Kegels and they didn't work?

Kegels are not for everyone! Sometimes they can even make your symptoms worse and even when they are indicated they are often not done properly. Pelvic floor dysfunction can be caused by:

Hypertonicity: The pelvic floor muscles have too much tension or high tone. These tight pelvic muscles can lead to symptoms of pelvic pain, painful intercourse, bowel and bladder urgency, and constipation.
Hypotonicity: The pelvic floor muscles have low tone which contributes to the symptoms of stress incontinence and pelvic organ prolapse.

Please note, in most cases you may have a combination of muscles that are too tense and too relaxed. A kegel is a contraction (increasing tone) of your pelvic floor muscles. Doing a kegel, if not indicated, can make symptoms worse, e.g. pelvic floor muscles that are high or a combination of tones. An internal examination by a pelvic floor therapist will determine if kegels are indicated and retrain the pelvic floor muscles to function optimally.

How do I know if I need a pelvic physiotherapist?

If you're wondering if your pelvic floor needs help, feel free to answer the following questions

Urinate more than 5-8 times a day?
Do you feel like your bladder is not completely empty after urination?
Do you have an uncomfortable urge to urinate that won't go away?
Do you leak urine (coughing/sneezing/laughing/dancing/on the way to the toilet)?
Do you feel pressure and or heaviness in your pelvis?
Do you have bowel movements that are hard to pass or less frequent than every three days?
Do you have pelvic pain?
Do you experience painful relationships?
Do you have pain with pelvic/speculum exams?
Do you experience pain within your hips, back, sacroiliac joint and/or pelvic pain?
Are you pregnant?
Have you been diagnosed with any pelvic floor conditions eg. Dyspareunia?

If you answered yes to any of the above questions, problems with your pelvic muscles, connective tissue, ligaments, or nerves may be contributing to your symptoms and/or pain. You may be a candidate for an evaluation by a board certified pelvic floor physical therapist with impeccable training to assess the integrity of your pelvic floor muscles in relation to your core and symptoms.

Is pelvic floor physical therapy covered by OHIP or my insurance?

Pelvic floor physiotherapy is a specialized training under Physiotherapy. If you have Physiotherapy coverage on your insurance, Pelvic Floor Physiotherapy is covered. Please check your individual plans for more details. The Sports Medicine Clinic will provide you with a receipt to submit to your insurance company for reimbursement. Pelvic floor physical therapy is not covered by OHIP plans.

Do I need a referral to see the naturopath for pelvic floor physiotherapy at the Sports Medicine Clinic?

You do not need a referral for pelvic floor physiotherapy. Some selected insurance companies require a referral note from a family doctor before a claim for physiotherapy can be honoured. Please contact your insurance company to gain a comprehensive understanding of your full benefits and coverage package.

Is "Sports Medicine" Wellness Albania accepting new patients for PHYSIOTHERAPY OF SUSPECTED PELVIC?

Yes! Please call +355.694035501 or send us Email today to book your appointment.