Tag Archives: Pelvic health

Pelvic Health, Pelvic Health Physiotherapists, Pelvic health physiotherapy, pelvic pain

Men’s Pelvic Health: Pelvic Physiotherapy

April 24,2026 Amanda Quek

For most people, the concept of pelvic health is entirely focused on women’s health. We want to change that mindset. Just like everyone has core muscles, everyone has pelvic floor muscles as well. No matter who you are, dysfunction in these muscles can affect your bladder, bowel, and sexual function, or cause pain with daily movements.

Today, we want to discuss pelvic physiotherapy for men, the issues that are exclusive to them, and raise awareness about men’s pelvic health.

What is pelvic health physiotherapy?

Pelvic health physiotherapy is a specialty that specifically focuses on the pelvic floor, including the associated issues.

In Ontario, specially trained and registered physiotherapists can perform internal assessments (through the rectum) to check for the function, tone, strength, and coordination in the pelvic floor. Some of the pelvic floor muscles are so deep inside the body, this is the only way to assess and treat them. Unlike our other muscles, they can’t be seen or palpated from the outside.

What are typical pelvic health dysfunction signs and symptoms?

Man holding his genitals area, demonstrating a desperate need for urination (incontinence)

It may feel like pain, just like in other joints. But there are some specific things to watch out for that are highly associated with pelvic problems. These include:

Urinary issues: Including frequent or painful urination, leakage or “dribbling”, etc.
Bowel dysfunction: Incontinence, constipation, pain while having a bowel movement etc.
Sexual dysfunction: Erectile dysfunction, testicular pain, pain with ejaculation etc.
Pelvic issues: Pain in the lower abdomen, groin, perineum, hips, lower back etc.

What are some common conditions treated in men’s pelvic health?

Erectile dysfunction: Pelvic muscles may be too tight or too weak, altering blood flow to the area
Chronic pelvic pain syndrome: persistent pain in the genitals or perineum area
Post-micturition dribble: urine that stays in the urethra and leaks after peeing, usually due to pelvic muscle weakness
Post-Prostactectomy: The side effects of prostate removal include incontinence and erectile dysfunction which may be improved with pelvic physiotherapy

What does a men’s pelvic health physiotherapy assessment look like?

First, your physiotherapist will ask you detailed questions about your condition, health history, and current lifestyle. Be prepared to answer questions about medical history, sexual function, badder and bowel function, and exercise habits. This gives your practitioner a view of your overall condition and will help them decide where to begin with the physical assessment

Next, they will do the external physical assessment. This includes screening the lumbar spine, hips, abdomen, glutes and everything surrounding the pelvic floor. They will identify any contributing factors to the issue.

Finally, with your consent, they will perform the internal exam which for males, is a digital rectal exam (DRE). The practitioner will use a lubricated, gloved finger to palpate your pelvic floor muscles, looking for how strong, coordinated, or tense the muscles are. This provides crucial information about how the pelvic floor functions and directly informs how treatment will proceed. For example, a tense pelvic floor treatment is very different from weak or uncoordinated one.

Finally, your therapist will summarize their findings and present a treatment plan to you for your input. The treatment may include manual therapy, lots of education and advice on lifestyle factors/triggers, deep breathing techniques, pelvic floor exercises, and integration into your normal activities. Your practitioner will ensure you understand what is needed from you, and how often they would like to see you.

Curious about male pelvic health?

Look for PhysioNow! We have specially trained Pelvic Health Physiotherapists who can answer your questions and address your concerns. Male pelvic health needs to be better understood, we highly encourage you to get treated and spread the word! Book with PhysioNow for a free consultation or your first assessment and treatment. Or, contact us at P: 289-724-0448 or Email: applewood@physionow.ca for more information.

Pelvic Health, Pelvic health physiotherapy, Pelvic Organ Prolapse, pelvic pain

Pessaries: Pelvic Physiotherapy Tools

March 31,2026 Sharon Tierney

Pelvic health physiotherapy is a specialization that focuses exclusively on the pelvic floor. This includes conditions such as incontinence, pelvic pain, sexual dysfunction, pelvic organ prolapse and more!

Treatment of the pelvic floor muscles and structures is both like, and unlike the other areas of the body. For example, just like any other muscle, they can be strong or weak, lengthened or tight, hypermobile or hypomobile. On the other hand, treatment of the pelvic area may require some unique techniques and unique tools during treatment. One of these tools is called a pessary.

What are pessaries used for?

A pessary is a medical device typically used to help manage pelvic floor dysfunction, particularly in conditions like pelvic organ prolapse, urinary incontinence, and stress incontinence. It’s a device that is inserted into the vagina to support the pelvic organs and help alleviate symptoms. Oftentimes, it is the missing piece for many individuals managing pelvic floor prolapse, stress incontinence and even plays a role in prevention of recurrent UTI`s (urinary tract infections).

How do I know if I need a pessary for my condition?

A pelvic floor physiotherapist specializes in assessing, diagnosing, and treating pelvic floor dysfunctions. They use various techniques, including exercises, manual therapy, and education, to help individuals strengthen or relax the pelvic floor muscles. Their expertise can support individuals in improving bladder and bowel control, sexual health, and overall pelvic function.

During a session, they will do a comprehensive examination to identify the root cause of your condition. They will use this information to create a unique treatment plan for you to address your needs and goals. Your Physiotherapist will discuss this plan with you including if they think you would benefit from a pessary, and what kind of pessary.

Types of pessaries

There are different types of pessaries that can be used for different pelvic floor conditions. Decisions on which type is needed are determined by the type and severity of the condition, as well as how well you can manage them on your own. These include but are not limited to:

Ring pessary: It is commonly used for stress incontinence and mild pelvic organ prolapse. Benefits include being very easy to put on and take off by yourself

Gellhorn pessary: It is used for moderate to severe pelvic organ prolapse

Cube pessary: Used for third dergree pelvic organ prolapse

Donut pessary: Used for prolapses needing more support

Inflatable pessary: These are more like custom fit and are used for advanced prolapse conditions

Gehrung pessary: For rectocele (rectum prolapse) and cystocele (bladder prolapse)

Why do I need a pessary if I am already doing pelvic floor physiotherapy?

Pessaries are a teammate in your pelvic floor rehabilitation. Namely, pessaries stops the leak and heavyness instantly. This gives you the confidence to return to activities such as running, lifting and long term muscle strength training.

A pessary gives support to the prolapsing organ and let your muscle train effectively during exercises. Also, it helps to prevent the prolapse from getting worse due to repeated intra-abdominal pressure (such as when you brace during exercises). From the top down, pessaries help your brain find your pelvic floor muscles making your rehabilitation exercises more targeted and successful.

Additionally, your physiotherapist will do the following:

1. Assessment and fitting of pessaries: A pelvic floor physiotherapist may assist in the fitting of a pessary. They can determine if it’s the right solution for you and help with proper size, shape, type and insertion and comfort.

2. Pelvic floor rehabilitation: After fitting a pessary, a pelvic floor physiotherapist can guide you through exercises and techniques to strengthen or relax the pelvic floor muscles. This can enhance the benefits of the pessary and help with the underlying causes of pelvic floor dysfunction.

3. Education: Your physiotherapist will educate you on pelvic floor health, how to care for the pessary, and when to seek further help. Your therapist will teach you how to insert, remove, and clean it so that you can have a total control of your care.

Pessary myths

1. Have to wear it all day

You don’t have to wear a pessary all day, wear it only for high impact actvities or if you are on your feet for long durations

2. It is only for old women

People of all ages wear pessaries including postpartum womenand those who wish to delay surgeries

3. I can`t have sex with it

While some types of pessaries must be removed, many common types such as ring pessaries are safe to keep in

Looking for pelvic pain, prolapse, or pessary help?

Then look for PhysioNow! A pessary does not fix the prolapse but it manages the symptoms in a way that you can eliminate the need to do the surgery. With an active physiotherapy program paired with the pessary, you can actively rehabilitate your body with the best possible support. Physionow has expert pelvic health physiotherapists ready to help you. We have 10 locations across the west GTA from Burlington, Oakville, Mississauga to Etobicoke, to assist you. Start your road to recovery, book with PhysioNow today for your first assessment and treatment!

Exercise, Health and Wellness, Pelvic Health, Pelvic health physiotherapy, Pregnancy

Exercising during Pregnancy: It’s Physiotherapist Approved!

September 9,2025 Sharon Tierney Leave a comment

Pregnancy is an exciting journey, but it can be nerve wracking as well when it comes with many changes in the body. Unfortunately, these changes usually have side effects which include nausea, discomfort, fatigue, soreness, and pain. This alongside a disruption in your normal lifestyle can be very hard to adapt to. Many will wonder whether there is anything that can help. As a result, a common question that comes up with expecting mothers is it safe to do exercises and if yes, what can I do?

The good news is that, with the right guidance, doing exercises not only safe but also beneficial for mom and baby! Physiotherapists are experts that specialize in movements and body mechanics. Thus, this means they can recommend safe, effective, and individualized exercise programs to help through your pregnancy.

Why does exercise matter during pregnancy?

Fortunately, lots of research has gone into this topic, and the science supports it. The American College of Gynecologists and Obstetricians actually recommends 150 minutes of moderate aerobic exercise each week. In fact, if you were already active before the pregnancy, it is recommended to continue at that same level as long as your or comfortable. The possible benefits of staying active during pregnancy include:

Easing back pain
Decreases risk of pregnancy complications like gestational diabetes, preeclampsia and cesarean births
Improving circulation, can be beneficial in the case of swelling
Helping your body to prepare for labour with better endurance and flexibility
Supports mental well-being by reducing stress and improving sleep
Help with the recovery after delivery and return to your normal weight

However, it is important to understand that not all exercises are safe. For example, extreme and contact sports or hot yoga are not recommended due to risks of trauma and overheating respectively. Your physiotherapist can help you to create a program that is personalized for you, depending the trimester, and previous physical fitness, and medical history.

What do I need to know before exercising during pregnancy?

There are still some risks with exercising, but the benefits far outweigh the risk as long as we follow some safety tips.

Initially, get a clearance from your ob-gyn or doctor to continue exercises
Avoid overheating and dehydration
Listen to your body and stop if you feel dizzy, breathless, or experience pain
You may benefit from belly belts and a supportive sports bra for comfort

What are some safe exercises recommended by physiotherapists?

1. Walking or biking

Walking and biking are one of the safest and most accessible exercises during pregnancy. It helps to keep your body active without putting too much stress on your joints.

2. Prenatal yoga and stretching

Gentle yoga can help to reduce pain in your back and hip area which is very common in pregnancy. It can also help with flexibility, posture correction and with stiffness. Experienced physiotherapists can teach appropriate poses and stretches, and modifications as needed.

3. Pelvic floor exercises

It is crucial during pregnancy to strengthening the pelvic floor muscles. These exercises support the pelvic structures, and help to reduce the chances of getting incontinence (inability to control urination) during and after pregnancy. A trained pelvic health physiotherapist can teach you how to activate the right muscles.

4. Core and stability training

Safe core exercises, such as pelvic tilts or modified planks, strengthen the abdominal and back muscles. This helps support the shifting posture of the body to accommodate the growing belly.

5. Swimming or water aerobics

Performing exercises in water can help swelling and helps to take the extra weight off the body for a bit. The water supports your weight while also providing great resistance for a full body workout.

6. Light resistance training

It’s safe to use weights or resistance bands to maintain muscle tone and to prepare the body for the physical demands of childbirth and postpartum care. A supervised exercise program can help you to maintain controlled movements, good form, and proper breathing.

What are exercises to avoid during pregnancy?

• Standing for long period of time in same position

• Exercises lying flat on your back for long periods in your second and third trimester as it can restrict blood circulation to fetus

• Heavy weightlifting or straining movements

• Activities where there is a risk of fall or contact ex. skiing, basketball, soccer

What is the role of a physiotherapist in exercising during pregnancy?

Physiotherapists can also give advice on how to make life easier at home. For example, special pregnancy pillows to increase comfort while sleeping.

Every pregnancy is different, a physiotherapist can:

• Help to assess your posture, movement, and areas of weakness

•Teach safe exercises program which is safe for you and adjust them based on your trimester

•Help manage common pregnancy complications like back and pelvic pain, sciatica pain

•Provide education on what to expect and how to set yourself up for success before, during, and after pregnancy

Ready to get started?

If you or anyone you know is pregnant and confused with what to do or how to start exercises safely look for PhysioNow! We have 10 clinics across the GTA to support you from Burlington, Oakville, Mississauga to Etobicoke. We offer private treatment rooms, free and accessible parking, and extended hours including evenings and weekends for your convenience. Book an assessment and treatment with our experienced physiotherapy team today to receive a safe, personalized plan that supports both you and your baby!

Pelvic Health, Pelvic health physiotherapy, pelvic pain

5 Ways Pelvic Health Physiotherapy Can Change Your Life

May 29,2025 Sharon Tierney Leave a comment

Pelvic Health Physiotherapy is an underappreciated part of the Physiotherapy profession. Most people would assume that this applies only to women, especially to pregnant women, but we are here to emphasize that pelvic health is for everyone! There is a wide variety of problems pelvic health physiotherapy can help with. Alternatively, it can be done proactively as part of preventative health measures.

We will describe 5 different ways that pelvic health can change your life!

1. No more leaking or urgency issues!

Urinary or fecal incontinence is the term for a loss of function, or accidental leaking/passing of urine or stool. It is a fairly common condition that can affect everybody, especially in a geriatric population but more common in women. A pelvic physiotherapist can help you find the cause and give you a personalized plan to resolve it. For milder cases, you may only need a couple sessions of learning how to activate and strengthen your pelvic floor muscles to see a difference! Regain your confidence and control over your life, you won’t have to worry about exercising, working out, or constantly needing a bathroom nearby.

2. Reduce lower back and pelvic pain

Pelvic pain can present in many different ways, including radiating to your hips, lower back, or groin. It can affect you during your daily life such as lying down, getting in and out of the car, during sexual intercourse or more. Your pelvic physiotherapist can identify the issues whether its muscular tightness, weakness, improper postures or lifting techniques. Then, they will show you how to relieve your discomfort using exercises, postural education, manual therapy and more. Just like any muscles, the pelvic floor needs to be taken care of!

3. Improve sexual dysfunction or function

Pain or dysfunction during intercourse is something that both men and women may experience. The important thing to note is that treatment is readily available through pelvic health physio! Issues may arise from irregular tone in the muscles which can affect aspects like arousal, sensation, and performance. Common issues that may improve with treatment include vaginismus, dyspareunia, erectile dysfunction, and poor ejaculatory control.

4. Improve core strength and posture

The pelvic floor is a crucial part of the core. While most people think about the abdominals and the back muscles as forming the core, they overlook the pelvic muscles. These muscles all work together for stabilization of your spine and pelvis. Without them, back pain, poor posture, and muscular imbalances can develop and lead to long term pain and discomfort. With pelvic retraining, feel confident in your body and your ability to move.

5. Prepare and recover from pregnancy

Prenatal physiotherapy care can help you and your partner prepare the pelvic floor for the increased demands it will soon experience. As a result, pre and post-natally, it is easy for an untrained pelvic floor to become overwhelmed and start to encounter issues. It will also include education and strategies that your birth partner can assist you with at home, and so you both know what to expect. Overall, pelvic health physiotherapy can help to minimize the stress and symptoms of pregnancy, making your experience as smooth as possible!

Looking for more help?

Look for PhysioNow! Our clinic has many experienced clinicians who have undergone their specialty training in Pelvic Health and are ready to assist you! With 10 clinics across the GTA from Burlington, Oakville, Mississauga, to Etobicoke, we make it easy for you to come see us. We have private treatments to ensure your comfort and safety during the duration of your treatment. If you want more information, please feel free to contact us at 289-724-0528. Book with PhysioNow today for your first assessment and treatment!

Pelvic Health, Pelvic health physiotherapy, Pregnancy

Pregnancy Pains: Sacroiliac Joint Dysfunction

April 8,2025 Sharon Tierney Leave a comment

Pregnancy is a time of immense physical and emotional changes. As your body adapts to the growing baby, many women experience various discomforts and physical challenges. One of the less discussed, but relatively common issues is sacroiliac joint dysfunction (SIJD). Unfortunately, this condition can significantly impact a woman’s comfort and mobility during pregnancy.

What is sacroiliac joint dysfunction (SIJD)?

Firstly, the sacroiliac joints are located at the base of the spine where the sacrum (the triangular bone at the end of the spine) meets the bones of the pelvis. Importantly, these joints play a role in transferring weight and forces between the upper and lower body and across sides of the body. Ultimately, this joint contributes to your ability to move and weight bear effectively. Sacroiliac joint dysfunction occurs when there is an imbalance, irritation, or dysfunction in one or both of these joints, causing pain and discomfort.

During pregnancy, the body undergoes numerous hormonal, structural, and biomechanical changes to accommodate the growing fetus. These changes can strain the sacroiliac joints, leading to dysfunction.

What are the causes of SIJD during pregnancy?

Several factors contribute to sacroiliac joint dysfunction during pregnancy:

Hormonal changes: One of the primary hormones responsible for SIJD during pregnancy is relaxin, a hormone that increases the flexibility of ligaments and joints in preparation for childbirth. While this is necessary for labor and delivery, it can cause excessive movement or instability in the sacroiliac joints, leading to SIJD
Weight gain: Additionally, as the baby grows, your body naturally gains weight. This can alter your posture and create additional stress on the sacroiliac joints, particularly in the later stages of pregnancy. Ultimately, the extra weight can make the joints less stable and more prone to irritation.
Postural changes: As your belly grows, your center of gravity shifts, and your posture changes to compensate. This can cause misalignment in the pelvis and place uneven pressure on the sacroiliac joints, contributing to dysfunction.
Increased blood flow and fluid retention: Pregnancy also increases blood flow to the pelvis, which can cause swelling and fluid retention around the sacroiliac joints. Unfortunately, this added pressure can exacerbate discomfort and lead to joint dysfunction.

What are the symptoms of SIJD?

The symptoms of SIJD can vary from woman to woman, but the most common signs to watch for include:

Pain location: In the lower back and pelvis on one or both sides of the sacroiliac joint. It may radiate to the buttocks, hips, groin, or thighs
Difficulty with certain movements: For example, standing, walking, bending, getting in and out of bed or climbing stairs. Also, static positions like prolonged sitting or standing can be difficult
Relieving positions: Usually, pain improves when lying down or shifting positions.
Instability: Some women may feel as if their pelvis is “out of alignment” or unstable, and may even experience a feeling of the joint “moving” in and out of place.

How do I manage SIJD during pregnancy?

Exercises before, during, and after pregnancy can make a big difference in your pain and discomfort levels. Alway check with a health care professional before starting a new routine.

While SIJD can be uncomfortable, the good news is that there are several strategies that can help alleviate the pain and discomfort associated with this condition during pregnancy.

1. Prenatal exercises and strengthening

Gentle exercises that focus on strengthening the muscles around the pelvis and lower back can help provide stability to the sacroiliac joints. Focus on exercises that strengthen the core, hips, and glutes, as these muscles support the pelvis. For example, yoga, swimming, and walking are great low-impact options.

2. Pelvic tilts and stretching

Pelvic tilts are an excellent way to relieve pressure on the sacroiliac joints and strengthen the muscles around them. Furthermore, stretching the hip flexors, hamstrings, and lower back can also help reduce tension and improve flexibility in the pelvis.

3. Proper posture and body mechanics

Maintaining good posture is crucial to prevent further stress on the sacroiliac joints. Avoid slouching, and try to stand with your hips in alignment with your shoulders. When lifting, be sure to bend your knees rather than your back and avoid twisting motions while lifting.

4. Use of supportive devices

Pregnancy support belts or pelvic belts can help stabilize the pelvis and alleviate strain on the sacroiliac joints. These belts gently lift and support the growing belly, reducing pressure on the joints.

5. Physical therapy

A Pelvic Health Physical Therapist can provide personalized exercises, stretches, and manual therapy techniques to help reduce pain and restore pelvic stability. Manual therapy techniques such as joint mobilizations can sometimes help relieve pain in the sacroiliac joint.

Looking for help?

Then talk to us at PhysioNow! We have many experienced Registered Physiotherapists and Pelvic Health Physiotherapists to help you with your pregnancy pain. With 10 great clinics across the GTA from Burlington, Oakville, Mississauga and Etobicoke, we can get you on the road to recovery in no time! Book with PhysioNow today for your first assessment and treatment.

Pelvic Health, Pelvic health physiotherapy, pelvic pain

Prostatitis Solutions: Pelvic Floor Physio for Men

January 30,2025 Sharon Tierney Leave a comment

Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition found in men. This condition involves inflammation of the prostate gland. Usually, this leads to pain, discomfort especially involving urination, bowel movements, and sexual dysfunction. While part of the management of this condition involves medical management, Pelvic Physiotherapy plays an important role in recovery as well.

Types of Prostatitis

Acute bacterial prostatitis is an infection of the prostate. This type of prostatitis causes chills and fever. In this case, you need your doctor’s attention promptly!
Chronic bacterial prostatitis is a persistent bacterial infection
Chronic pelvic pain syndrome (CPPS) or nonbacterial prostatitis has the same long-term symptoms but the cause is not from a bacterial infection. This type can be managed with physiotherapy treatment, and will be the main focus of this article.

What are the symptoms of prostatitis?

• Pain in the testicles, or tip, shaft or base of the penis
• Pain at the perineum (the area between the testicles and penis)
• Urination causes pain
• Increased pain in sitting
• Pain or discomfort with sexual arousal, or during or after ejaculation
• Pain or discomfort above the pubic bone
• Urinary frequency
• Urinary urgency
• Pain before, during, or after a bowel movement
• Decreased interest in sex

How is nonbacterial prostatitis found and treated?

First, investigations in this case show that bacteria and yeast are negative. The physical examination does not usually show anything unusual. However, the prostate may be swollen. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, painkillers, and medications prescribed are often not effective. Many men have been told that they must learn to live with the symptoms because a cure is not available.

Pelvic Floor Physiotherapy is essential for recovering from prostatitis that is not the result of an infection. This involves an assessment by a Rostered Pelvic Floor Physiotherapist.

The Pelvic Health Physiotherapist creates an individualized treatment program. Treatment is based on the level and type of pelvic floor dysfunction, symptoms, and response to the treatments.

The following treatment programs and techniques may be involved in Pelvic Physiotherapy for prostatitis:

Muscle relaxation and strengthening techniques

Trigger point release therapy is also known as myofascial trigger point release. It is often helpful for treating CP/CPPS symptoms that are associated with stress and tension of the pelvic floor muscles.

Trigger point release therapy is often combined with paradoxical relaxation therapy. This exercise method involves autonomic self-regulation. This decreases pelvic floor muscle tension by teaching you how to self-release this tension. Paradoxical relaxation involves a specific breathing technique to help relieve anxiety.

Alternatively, weakness in the pelvic floor may be contributing to the issue. In this case, strengthening with specific exercises is important. It will help increase the support in the pelvic floor and lead to better function of the overall system.

Education and holistic care

Total body (exercise, chronic stress management, diet, lifestyle) changes help relieve pain. Education on posture, stress reduction techniques (ex. mindfulness) and proper body mechanics are important to relieve pressure on the pelvic area. Ultimately, following this advice is important for keeping yourself pain and symptom free in the long-term. Additionally, some foods have been associated with irritation including:

• Spicy foods
• Hot peppers
• Alcoholic beverages
• Acidic foods
• Wheat
• Gluten
• Caffeine

Check out this patient’s experience.

If you are experiencing issues with prostatitis or other types of pelvic pain, look for PhysioNow! We have fantastic Pelvic Physiotherapists to get started on your recovery from Prostatitis. We have 10 fully accessible locations across the GTA from Burlington all the way to Etobicoke. Book with PhysioNow today for your first assessment and treatment!

General Category

Pelvic Floor Problems: How Do You Know?

July 4,2024 Sharon Tierney Leave a comment

What is the Pelvic Floor?

Pelvic floor muscles attach to the pelvis bone

The pelvic floor is a group of muscles, ligaments, and connective tissues that span the bottom of the pelvis. Importantly, these structures support the pelvic organs, including the bladder, rectum, and in women, the uterus and vagina. The pelvic floor plays a crucial role in maintaining continence (control over bladder and bowel movements), supporting pelvic organs, and contributing to sexual function.

What are the most common signs and symptoms of pelvic floor
dysfunction?

There are several signs and symptoms for pelvic floor dysfunctions. They can be further subdivided into categories of urinary, bowel, sexual and pain-related issues.

Urinary Symptoms

Pelvic floor dysfunction may lead to incontinence

1. Urinary Incontinence: Unintended leakage of urine, which can occur during activities like coughing, sneezing, or exercising (stress incontinence) or with a sudden, intense urge to urinate (urge incontinence).
2. Urinary Frequency and Urgency: Needing to urinate more often than usual or experiencing a strong, sudden need to urinate.
3. Incomplete Emptying: Feeling that the bladder isn’t completely empty after urination.

Bowel Symptoms
1. Fecal Incontinence: Involuntary leakage of stool or gas.
2. Constipation: Difficulty in passing stools, which might require straining.
3. Incomplete Evacuation: Feeling of not fully emptying the bowel after a bowel movement.

Sexual Symptoms

1. Painful Intercourse: Discomfort or pain during or after sexual intercourse.

Pain and Discomfort
1. Pelvic Pain: Persistent or recurrent pain in the lower abdomen, pelvic region, or genital area.

2. Lower Back Pain: Discomfort or pain in the lower back that might be related to pelvic floor dysfunction.
3. Pressure or Heaviness: A sensation of pressure, heaviness, or a bulge in the pelvic area, often related to pelvic organ prolapse.

What are the most common reasons for pelvic floor dysfunction?

Pelvic floor dysfunction (PFD) can result from a variety of causes, often related to factors that weaken or damage the pelvic floor muscles and connective tissues. Here are some of the most common reasons:
1. Pregnancy and Childbirth: Stretching, straining of pelvic floor muscles during pregnancy can lead to weakness and tearing of pelvic floor muscles.
2. Surgery: Surgeries such as hysterectomy, prostatectomy can weaken and affect your pelvic floor muscles.
3. Aging: Hormonal changes such as decreases in estrogen through general aging can also lead to weakening of pelvic floor muscles.
4. High Impact Chronic Strain: Frequent heavy lifting, chronic coughing, and bronchitis can also put excessive strain on pelvic floor muscles.
5. Neurological Condition: Conditions like diabetes induced neuropathy, multiple sclerosis, or spinal cord injuries can affect the nerves controlling the pelvic floor muscles.
6. Trauma and Injury: Injuries to the pelvic region due to physical trauma or stress can damage the muscles and nerves involved in pelvic floor function.
7. Lifestyle Factors: A sedentary lifestyle can lead to muscle weakening and tightening, leading to dysfunction in the pelvic floor.

Pelvic Physiotherapy

Pelvic floor physiotherapy is a specialized branch of physiotherapy involving internal and external assessment /treatment of pelvic floor muscles. These muscles are located between the hip bones, sacrum and support pelvic organs such as bladder, colon and uterus.

How physiotherapy can help with pelvic floor dysfunction?

Physiotherapy can be highly effective in treating pelvic floor dysfunction (PFD). Pelvic floor physiotherapists are specially trained to assess and treat issues related to the pelvic floor muscles, which can significantly improve symptoms and quality of life.

First, a comprehensive evaluation by a pelvic floor physiotherapist will include a detailed physical examination to identify the specific issues with your pelvic floor muscles. Then, based on the evaluation, the physiotherapist will develop a tailored treatment plan that addresses your specific symptoms and underlying causes. For example, this may include muscle re-education, bladder retraining, and training of the pelvic floor muscles.

Need help?

If you are experiencing pelvic pain or bowel or bladder dysfunction, look for PhysioNow. We have qualified pelvic floor physiotherapists that are ready to assist you with your issue. Book with PhysioNow today for your first assessment and treatment. With 9 clinics across the GTA including Burlington, Oakville, Mississauga and Etobicoke, we can find a location that suits you!

Leakage of urine, Pelvic Health, Pelvic health physiotherapy

Incontinence: What To Do When You Can’t Control Your Bladder

April 16,2024 Sharon Tierney Leave a comment

What is urinary incontinence?

Urinary incontinence is when person leaks urine by accident due to loss of control of the bladder muscles. The severity of incontinence may vary from occasional incidents, like leaking while coughing or laughing, to more severe like having sudden strong urges where you are unable to make it to the toilet in time.

How does the bladder function normally?

These organs make up our body’s urinary system, which is how our body creates and removes urine from the body

Normally, the brain and the bladder work in close partnership to control urination. First, urine gets stored in the bladder until it receives the signal from brain to empty it. The bladder is one of the pelvic organs, meaning that the pelvic floor muscles provide support to it and hold it in the proper position. Usually, the bladder muscle stays in the relaxed position while it holds urine. At the same time, the urethra, which is the tube that carries urine out of the body is closed by a sphincter (controlled by the bladder muscle), so that urine doesn’t leak. Once you receive the signal from the brain, the bladder muscle contracts, opening up the sphincter and lets the urine out of the urethra.

What are the different types of urinary incontinence?

Stress Incontinence

Stress incontinence is where the leaking occurs with several activities of daily routine like coughing, sneezing, running, laughing, jumping, exercising or lifting heavy. These activities exert lots of pressure on the bladder due to weak pelvic floor muscles, results in urine leakage. As expected, the chances of leaking increase the fuller the bladder is. This is one of the most common types of incontinence, especially in elderly women. However, unlike some people believe, urinary incontinence is not a normal sign of aging. Instead, it is a problem which should and can be properly treated.

Risk factors for stress incontinence:

Postpartum women are at a high risk due to damage to tissues or nerves that may occur during delivery. Women with vaginal and forceps delivery are also at higher risk than with c-section
or vacuum delivery. Additionally, men after prostate surgery can develop this. For example, the removal of the prostate gland in cancer patients may weaken the sphincter muscles which lies below the prostate gland.

Othe contributing factors include:

Chronic illness with high frequency of coughing
Smoking which can cause frequent coughing
Obesity: Excess body weight puts more pressure on pelvic organs and can lead to stress incontinence
History of pelvic organ prolapses: Depending on the level of prolapse, mild bladder prolapse can cause occasional incontinence.

2) Urge incontinence

It is a type of incontinence that causes the sudden urge to void the bladder and results in involuntary leakage of urine. In other words, you may leak the urine before you reach the bathroom.

Urge incontinence is most commonly associated with an overactive bladder. The muscles in the bladder squeeze more frequently than normal. As a result, you feel like you have to use the bathroom frequently even though the bladder is not actually full.

Risk factors for urge incontinence:

Diabetes: Uncontrolled blood sugar levels can lead to increased chance of urinary tract infection and frequent urges to urinate. People with uncontrolled sugar levels may have damaged the nerve controlling the bladder, leading to urge incontinence.
Hysterectomy: Damage to the nerve around the bladder during this procedure can lead to incontinence
Spinal cord damage due to direct trauma or injury
Stroke
Prostate problems like prostate cancer or an enlarged prostate

How can incontinence be treated?

Incontinence can be treated through consultation with a specialist. It is important to gain the proper education and understand the condition of incontinence. A pelvic health physiotherapist can help you understand the basic function of the urinary system. With this understanding, they can teach you different techniques to control the leakage, frequency, and urgency of it.

For example, some of these techniques may include:

Toileting positioning education regarding proper liquid intake and its importance
Breathing exercises
Double voiding methods
Keeping a log of urinary leakage (bladder diary)
Pelvic floor strengthening exercises
Electrical stimulators
Internal manual techniques

How do I get help?

Our physiotherapy clinic PhysioNow has 9 locations to serve you across the GTA, from Burlington to Etobicoke

At PhysioNow, our pelvic floor physiotherapists can guide you in your recovery from incontinence and other pelvic-related conditions. With locations across the GTA including Burlington, Oakville, Mississauga, and Etobicoke, we will have a location suited to you. Book with PhysioNow today for your first assessment and treatment.

General Category, Pelvic health physiotherapy, Physiotherapy, Pregnancy

Why You Should Do Pelvic Floor Muscle Training During Pregnancy

September 19,2023 Sharon Tierney Leave a comment

Pelvic floor muscle training, when done in a structured way, helps to prevent certain complications during pregnancy and labour. These changes occur due to hormonal and anatomical changes. The complications that usually occur are incontinence, perineal tears, pelvic organ prolapse, less active pushing required during second stage of labour.

Why is pelvic muscle training important?

Pelvic Floor Muscles

The pelvic floor is a set of muscles attached to the spine at the back and to the pubic bone at the front. Importantly, these muscles are the key supporter for the uterus, bladder and bowel. Some activities of daily living help women maintain their pelvic floor strength to functional level. Unfortunately, pregnancy and childbirth lead to the potential injury and weakening of these muscles. As a result, pelvic floor dysfunction is common after childbirth. This includes urinary incontinence, pelvic organ prolapses, dyspareunia and perineal tears. Significantly, this reduces the quality of life in women and cause them to withdraw from fitness.

Structured pelvic floor training help to prevent or reduce these complications. First, it helps to elevate pelvic organs and the resting position of bladder to improve incontinence and prolapse. Also, training during the antenatal phase reduces the active pushing required during the second stage of labour. Additionally, it improves incontinence by improving co-contraction of the pelvic floor muscles as the abdominal pressure increases. Overall, correct pelvic floor muscle contraction is the key factor to achieving the benefits of pelvic floor muscle training.

What happens to the pelvic floor during pregnancy and childbirth?

First, pregnancy usually leads to the decrease in levator ani strength (one of the major pelvic floor muscles) and anatomical changes occur such as downward movement of the bladder neck, increase in bladder neck mobility, downward movement of pelvic organs, and decrease in urethral resistance due to increased pressure from the growing uterus. As the gestational age increases, so too does the weight of the uterus leading to the pelvic floor being oppressed. As a result, there can be damage to the muscles and nerves.

Secondly, during pregnancy a large amount of progesterone is secreted to maintain pregnancy. Notably, progesterone is a smooth muscle relaxant. The pelvic floor has high amounts of smooth muscle, meaning progesterone may decrease pelvic floor support and urethra tension. In conclusion, the mechanical and hormonal changes of pregnancy may have an irreversible effect on the pelvic floor. They need to be addressed at the right time through pelvic floor muscle training which is achieved through pelvic health physiotherapy.

Also, during labor, when there is vaginal surgical delivery (episiotomy), a large fetal head or a long second stage of labour, it will lead to damage in the pelvic floor muscles if they are too tight or the perineal area has less flexibility. Vaginal surgical delivery, large fetal head circumference and a prolonged expulsive stage are risk factors for a labour-associated pelvic floor injury.

Effect of pelvic floor muscle training during pregnancy and after childbirth

Firstly, training during pregnancy helps to prevent developing urinary incontinence and can significantly improve the strength of pelvic floor muscles.
Secondly, exercises with a perineometer in the post-partum period are helpful in restoring the function and tone of the muscles. Importantly, this aids in preventing early cystocele and rectocele by limiting the movement downwards and improving the vaginal muscles for the retention of contraceptive diaphragm. The “Perineometer,” is an instrument that provides a visual guide to the patient during her exercises.
Perineometer for pelvic muscle training
Next, training improves the neuromuscular activity of the pelvic floor in many motor tasks after a partial denervation of nerves in after the first pregnancy.
Furthermore, training helps to treat nonspecific low back pain and pelvic girdle pain during pregnancy as pelvic floor muscles provide stability to the spine.
Additionally, training helps to shorten the second stage of labour and reduce perineal tears by improving the flexibility, strength and motor control. Overall, this may reduce the need of assisted delivery through forceps and episiotomy.
Lastly, female sexual dysfunction after delivery can be treated by pelvic floor muscle training as it increases the flexibility of the pelvic floor to help the vagina feel looser and relax.

Considering all the positive effects of pelvic floor muscle training during and after pregnancy, it is highly recommended to see a trained pelvic floor physiotherapist. They will guide and train the pregnant women at the right time to prevent or treat any of the pelvic floor disorders.

If you are experiencing pelvic pain or are interested in pelvic floor muscle training, PhysioNow has experienced pelvic health physiotherapists that would love to assist you. Book with PhysioNow today for your first assessment and treatment!