Pelvic Floor Therapy

Pelvic floor therapy is gaining attention and is becoming more normalized, but do you actually know what it is?

Pelvic floor therapy is an evidence-based support for many really common conditions of the pelvis - think, incontinence, pelvic organ prolapse, pelvic pain etc. It is often conducted by a physiotherapist, but naturopathic doctors can also be trained in this area of health.

This kind of therapy can be helpful for adults of any age or phase of life and can be especially helpful for those who are postpartum, menopausal and/or athletes.

As with naturopathic medicine, we always start with a deep dive into your history, symptoms, goals and try to identify what could be contributing to how you are feeling. We may ask you questions about pain, bladder/bowel habits, sexual function, sleep, stress - you name it. We then go on to a physical assessment.

Part of this involves looking at your breathing, posture, movement patterns and strength - nothing in the body acts in isolation, including the pelvic floor. To get the most amount of information, and best monitor how you are improving (giving you feedback!), we then typically do an internal assessment - either vaginally, rectally or both.

It can seem really strange - or might make you feel nervous - to think about having an internal exam to assess these muscles. This is normal and we make sure to walk you through the whole process to make you feel comfortable and informed.

Although this is the gold-standard for assessing and treating the pelvic floor, we do not have to do an internal exam if you aren’t comfortable! Your ongoing consent, comfort, and privacy are our top priority. We can talk through our options together and find a way to move forward that feels right to you.

What is the pelvic floor and what are we assessing?

The muscles of the pelvic floor attach to the front, back and sides of your pelvis. They essentially form a bit of a hammock and wrap around your urethra, rectum and vagina, to support your organs, maintain sphincter tone (prevent leaks), stabilize the pelvis, contribute to sexual satisfaction, and support pressure to help with bringing blood back to the trunk. For muscles we don’t often think about - they are pretty important!

Although many folks are instructed to (or assume they should) be doing kegels, that’s not necessarily helpful for everyone. Some can have under-activity or weak pelvic muscles which can lead to symptoms of incontinence or prolapse, while others can actually have over-activity or “tightness” which can contribute to chronic pain and urgency. In second group of people, activating these muscles more can actually make symptoms worse.

Treatment plants often involve exercises, but they also often involve working on digestion, lifestyle habits, stress support and more.

Thinking that pelvic floor therapy might be beneficial to you? Book a meet and greet with Dr. Fiona to chat through how this might work for you!