1984 Regent Street South, Suite 118, Sudbury, Ontario


Frequently Asked Questions

Questions about pelvic health physiotherapy? Read the most asked questions to find out more.

  • How do I know if I need a Pelvic Physiotherapist?
  • What is pelvic floor physiotherapy?
  • My doctor told me to do some kegels to improve my condition, but its not working. Why?
  • What’s your expertise?
  • Is a referral needed for pelvic health physiotherapy?
  • What can I expect on my first visit?
How do I know if I need a Pelvic Physiotherapist?

Do you have to rush to the bathroom more than 5-7 times per day?

Do you wake up frequently at night to go to the washroom?

Has your doctor told you you have a prolapse?

Are you pregnant and dealing with pain and difficult mobility?

Do you have chronic low back or hip pain that didn’t improve with other treatments?

 

If you answered yes to any of these, chances are, you could benefit from a pelvic health physiotherapist.

 

What is pelvic floor physiotherapy?

Pelvic floor physiotherapy is a branch of orthopedic manual therapy that involves the assessment and treatment of dysfunctions of the muscles, joints, tendons, ligaments, nerves and fascia of the pelvic girdle, low back and hips. During assessment and treatment, the therapist uses both internal and external techniques to properly assess and treat the pelvic floor, and associated structures.

Some of the treatment techniques used can include techniques of  manual therapy, education, behavior modification, acupuncture and exercise.

My doctor told me to do some kegels to improve my condition, but its not working. Why?

Kegels aren’t for everyone. Pelvic Floor dysfunction can be caused by

HYPOTONIC (weak) pelvic floor muscles that can contribute to stress urinary incontinence, urge incontinence and pelvic organ prolapse. Incontinence is common, but it is NOT normal. Kegels are indicated for weak pelvic floor muscles.

OR

HYPERTONIC (tight) pelvic floor muscles that can contribute to conditions like Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatitis. Kegels may make these conditions worse.

Kegels are NOT always indicated for  all pelvic floor problems. Sometimes they do more harm than good, and often they are NOT performed correctly.

Being assessed by a Pelvic Health Therapist will allow you to determine whether or not you should be doing Kegels and teach you how to do them properly.

What’s your expertise?

I have taken several courses through Pelvic Health Solutions:

Courses completed through Pelvic Health Solutions:

Level I: The Physiotherapy Approach to Female and Male Urinary Incontinence – 2011

Level II: The Physiotherapy Approach to Female and Male Pelvic Pain – 2011

Level III: Treating Pain: A New Model Of Care – 2014

Pregnancy And The Pelvic Floor – 2011

Pelvic Girdle Pain, Coccydynia And The Pelvic Floor – 2011

Gastrointestinal Disorders And The Pelvic Floor – 2015

Pelvic Neurodynamics – 2015

Other related courses:

Female and Male Sexual Medicine: A Rehabilitation Perspective (Herman and Wallace) – 2016

Cognitive Behavioral Therapy Immersion (Wilfrid Laurier University) – 2016

Is a referral needed for pelvic health physiotherapy?

You do not need a doctor’s referral to be assessed or treated by a physiotherapist, or a pelvic health physiotherapist. However, some third party insurers may require a referral to reimburse you for the costs of your treatment. Check with your benefits provider to find out. Pelvic Health Physiotherapy is covered under Physiotherapy with insurance benefits.

What can I expect on my first visit?

Before your first visit, you will be sent questionnaires, or you can download them here. It is very important that you fill out the appropriate questionnaires before your first appointment as they will provide valuable information on the factors that can be influencing your condition. You may feel some of the questions are on a more personal level, but this information can help me effectively treat you. Some of the questions perhaps will not apply, if this is the case, you can simply skip them or they can be reviewed on the first appointment. If you are not comfortable answering some questions, that is perfectly ok too. I strive to create a safe and caring environment without judgement or bias. I am here for YOU and to address your concerns and you may feel more comfortable in answering them later on as we build a better rapport.

The first thing that will occur is a review of the questionnaires and I will ask you more questions to gather subjective information to better outline your concerns and your goals for treatment.

After that, a musculo-skeletal assessment of your back, pelvis and hips will be completed to look and mobility, flexibility and postural influences. Then you will be asked to disrobe from the waist down and cover up with the sheet after I have left the room. The assessment will then continue as the connective tissue around your abdomen, hips, groin and inner thighs are felt for any tension or trigger points. Connective tissue is the webbing of tissue that is between the muscle and the skin. Restrictions in this tissue from underlying abdominal or pelvic organ dysfunction, injuries, postural changes or surgical scars can directly influence your pelvic floor. After that, an observation of the perineum will be done to assess the integrity of the skin, the activation of the pelvic floor and other potential problems like scarring from childbirth or surgeries. External palpation of the perineum will be the next step to look for any tension or trigger points of the external pelvic floor muscles. Finally, an internal exam is completed to assess the state of your pelvic floor muscles and determine if they are weak and lengthened or short and tight. This is the most important part of the assessment as it will guide the outlining of your treatment and exercise program. Find out why it is important to have an internal done and why you should accept nothing else when it comes to pelvic issues here. Special tests to determine if a prolapse is present are next. In some cases, a rectal exam is also necessary to determine if a rectocele is present and to assess muscles that are closer to the tailbone and can affect some pain conditions. In men this is always necessary as it is the only way to effectively assess the pelvic floor muscles.

REMEMBER that YOU are in full control of the assessment at ALL times. Your consent is required for me to perform any part of this assessment. I will explain everything as I go along and ask for your consent at every step. If you are uncomfortable at all, you can and should ask me to stop. If there is anything I can do to make the assessment/treatment easier for your, please let me know as well.

At the end of the assessment we will determine goals for treatment together, and I will provide you with ample education and information on my findings and what they mean. You will be given some exercises to do at home and possibly some lifestyle modifications that can help resolve your symptoms. Sometimes small changes can make a significant difference. You will also be given lots of opportunities to ask questions.

About

Céleste Bouffard is a Pelvic Health Physiotherapist, serving the Greater City of Sudbury and surrounding areas.

Copyright © Céleste Bouffard 2017 The Social Launch