By Cora Tomowich, MScPT, Hons BKin
Hi there and welcome to my brief chat about pelvic floor physiotherapy. Before coming for the first visit, many patients have a few questions about what pelvic floor physiotherapy is and how a typical session is conducted. So, I thought I would now take this opportunity to answer some of your most frequently asked questions:
1. What is pelvic floor physiotherapy?
Pelvic floor physiotherapy is a special form of manual therapy that involves internal and external, hands-on techniques to evaluate and treat pelvic floor muscles and overall deep core functioning.
2. Who is the pelvic floor physiotherapist?
My name is Cora and I am the pelvic floor physiotherapist here at Darou Wellness. If you would like to learn a bit more about me, check out my bio here: http://darouwellness.com/cora-tomowich-mscpt-hon-bkin/
3. Does my insurance cover pelvic floor physiotherapy?
If you have physiotherapy coverage as part of your extended health benefits, pelvic floor assessments and treatments are covered.
4. What conditions does pelvic floor physiotherapy treat?
It is my personal opinion that, in order to prevent complications or dysfunction, everyone should have their pelvic floor assessed. Some of the most common conditions treated with this type of therapy include but are not limited to:
- Incontinence or leakage
- Constipation or retention
- Acute or chronic pelvic pain
- Pain with intercourse or use of a tampon / Diva Cup
- Painful Bladder Syndrome / Interstitial Cystitis
- Chronic Non-Bacterial Prostatitis
- Sexual or erectile dysfunction
- Piriformis syndrome
- Low back or hip pain
- Rectus diastasis or “Mummy Tummy”
5. What does the initial examination involve?
An initial assessment or examination will include a detailed discussion of your health history followed by an evaluation of external and internal abdominal, low back, and pelvic musculature using vaginal and/or rectal palpation techniques.
6. Do I have to have an internal examination?
No, an internal exam is not mandatory. It is possible to get a general idea of what is going on from just your health history and an external examination. An internal exam is, however, the best way to accurately determine your specific needs. Much like going to a dermatologist for a rash, it is better for diagnosis and treatment if you remove your clothes to uncover the affected area.
7. If I am pregnant, should I avoid an internal examination?
No, it is not necessary to avoid an internal examination when pregnant. If your doctor or midwife has not told you to avoid intercourse during pregnancy, an internal exam should be safe. If unsure, speak with your doctor or midwife directly prior to having an internal exam.
8. After I have my baby, how long should I wait before having an internal exam?
You should wait approximately 6-8 weeks after delivery before having an internal pelvic floor exam. This is true for vaginal deliveries and C-Section births. It is important to allow your body time to heal. During this time, you will also see spontaneous healing of a rectus diastasis, which should be checked at your follow-up appointment 6-8 weeks post-partum.
9. If I have my period, should I avoid an internal examination?
No, you do not need to cancel or reschedule your appointment because of your period. Internal work can actually be quite helpful for normalizing muscle tone during your cycle as the pelvic floor can be affected by hormonal changes. If you feel uncomfortable having internal work during your period, your therapist can either proceed with only external work or you can reschedule your appointment with 24-hours notice.
10. When is it unsafe to have an internal examination?
Internal examinations and treatments should be avoided if you have:
- Active hemorrhoids or infections
- Rectal bleeding
- Seed implants
- Radiation injuries less than 6-12 weeks old
- Undergone pelvic surgery less than 6 weeks ago
- Undergone prolapse repair surgery less than 12 weeks ago
- Been told by your doctor or midwife that you must abstain from intercourse or internal examinations during pregnancy
I hope that helps to answer at least a few of your questions… feel free to contact us anytime if you have questions related to your specific needs, we’d love to hear from you!