Pelvic Health FAQ
We are glad to provide a comprehensive FAQ to help you with any questions you may have pertaining to pelvic health and subsequent physiotherapy treatment. Please feel free to reach out and contact our clinic if you have any additional questions.
What can I expect at the first pelvic health physiotherapy visit?
Your first pelvic floor appointment will last between 60-90 minutes; it will include a discussion of your health history and the reason(s) for your visit, a thorough orthopedic assessment of the spine, pelvis, abdomen and hips, and an internal vaginal and/or rectal examination. Once the comprehensive assessment is completed, your physiotherapist will inform you of their findings, provide education regarding the pathophysiology and anatomy of their findings, and discuss a treatment plan.
All pelvic health exams are completed in a private room, one-on-one with the physical therapist.
What does an internal pelvic exam entail?
A complete internal pelvic exam consists of a vaginal exam and/or an anorectal exam. It is important for your physiotherapist to get information about both the front and back portions of the pelvic floor in order to provide the most comprehensive evaluation of the function of this area so as to better guide treatment.
What if I don't want to have an internal exam/treatment?
While a complete internal pelvic exam is always recommended in order to provide your physiotherapist with the most comprehensive overview of the function of the pelvic floor and help guide treatment, it is always your choice when it comes to your health. You and your pelvic floor physiotherapist will discuss the reason(s) for your visit, the anatomy and function of the pelvic floor, and what the assessment/treatment options may entail. After this, if you remain uncomfortable with having a pelvic exam, alternative options will be considered and discussed.
Similarly, if at any point during the pelvic exam or subsequent pelvic floor treatments you wish to withdraw your consent, that is no problem. Simply let your therapist know that you do not wish to continue, and you can discuss alternative options.
My doctor/midwife already did a pelvic exam. Why do I need another?
Your doctor or midwife may complete a pelvic exam to rule out the presence of any medical conditions (ex. malignancy, infection).
Your pelvic health physiotherapist will be more focused on the function of the pelvic floor as it relates to strength and recruitment, coordination with the rest of the body, the alignment and mobility of the joints, the presence of scar tissue or adhesions, and the position of the pelvic organs.
Can I still come to my appointment if I have my period?
Yes! In some cases it may be beneficial for your physiotherapist to assess the effect of menstruation on your symptoms, especially if you’ve noticed a correlation between your symptoms and your menstrual cycle. However, if you feel uncomfortable you can reschedule
your appointment.
Can I bring my baby with me?
Yes!
Can I have an internal exam while I’m pregnant?
Yes! Your pelvic floor physiotherapist will be happy to conduct any exam after your first trimester. However, if your doctor or midwife has told you to avoid sexual intercourse during your pregnancy, we will not complete an internal exam.
When is it unsafe to have an internal exam?
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
How soon should I see you after giving birth?
We recommend a follow up after your 6 week check-up with your doctor or midwife.
I already tried kegels and they didn’t work. Now what?
In many cases, kegels can make things worse! In many instances, the pelvic floor muscles are already too tight. A kegel is only effective if the pelvic floor muscles can first relax, and continuing to do kegels with a tight pelvic floor can worsen your symptoms.
It may be the case that the kegel is also being performed incorrectly. While you may feel as though you’re completing a kegel, you may actually be compensating with other muscles around the pelvic floor.
Pelvic floor physiotherapy is so much more than a kegel, and your physiotherapist will help you determine which exercises are most appropriate for you!
How many visits will I need?
This will depend completely on your condition(s) and their complexity. In general, you can expect to require 6-12 treatments. If you have a complex pain condition, you will likely require more visits.