What does an Initial Physiotherapy Assessment include?
Initial Physiotherapy Assessments are 75-90 min in length and include a history taking, review of current symptoms and/or goals. The assessment may include an observation of posture, breathing and functional movement or a specific exercise. It may include an evaluation of your spine, pelvis and/or lower extremities and/or external vulvar and perineal evaluations, and/or internal vaginal and/or anorectal evaluation.
Education is provided regarding symptoms, anatomy and physiology and home exercise prescription or self treatment techniques.
What does a subsequent physiotherapy session include?
The subsequent visits are 45-60 min in length and often include a review and/or progression of the home treatment or exercise program, a brief re-assessment and relevant manual therapy treatment (spine, pelvis, lower extremity, pelvic floor external/and or internal treatment).
Do I need to bring anything to my appointment?
Any medical information regarding your symptoms, diagnosis or referral if it has not been faxed ahead of time or information from allied health professionals. Please wear or bring athletic or loose fitting comfortable clothing (sports bra, yoga pants/shorts).
What is my pelvic floor (diaphragm)?
Your pelvic floor (diaphragm) is made of 3 layers of muscles at the bottom of your pelvis. It it is located sideways between your sit bones, and back to front from your tailbone to pubic bone. These muscles are responsible for maintaining continence (urine and feces), relaxing so we can empty our bladder and bowels, provide support to our internal pelvic organs (bladder, uterus, and rectum), and in response to the diaphragm (breathing muscle). The pelvic floor, along with the diaphragm, transverse abdominus, spinal and hip muscles to stabilize the trunk during static or dynamic movement. The pelvic floor has to tighten so you don’t leak urine or feces, relax to empty, lengthen and “get out of the way” to deliver a baby, and bounce up and down in response to your breath. The pelvic floor needs to be all to move both slowly and quickly.
How are my pelvic floor (diaphragm) muscles assessed?
Pelvic floor (diaphragm) muscle function can be assessed a few different ways: through clothing (least accurate), by observation and with external palpation of the vulva, perineum and anus (moderately accurate), and/or internally with vaginal and/or anorectal palpation (very accurate). It is always up to the client regarding their comfort level and or appropriateness for the muscular assessment. If you are unsure if you are a candidate discuss with your medical care provider prior to attending or before your next session.
The pelvic floor muscles are just PART of a team of muscles forming your core, which includes the respiratory diaphragm (breathing muscle), as well as the abdominal, spinal and hip muscles. If you are not appropriate for or do not desire external or internal evaluations, you can still attend pelvic floor physiotherapy. There is a lot of education information provided regarding bowel and bladder health, and many things that can be assessed in addition to the pelvic floor muscles such as breathing, posture, movement patterns, lifting mechanics and a thorough assessment of the spine, pelvis, abdomen, and hips.
What is abdominal separation or “Diastasis Recti”?
Diastasis recti is stretch of the connective tissue called the “Linea alba”, that connects the sides of the six-pack muscle (rectus abdominus), that occurs most commonly in pregnancy. Sometimes it is present BEFORE pregnancy, in children and even men. The stretch of the connective tissue is very natural during pregnancy, to allow more room for the growing baby. It may appear as a coning, peaking or doming along of the mid-line of the abdomen, anywhere from the pubic bone to the sternum. It can be a sign that someone isn’t managing pressure in their abdomen well, or tolerating certain postures or movements.
What is Pelvic Organ Prolapse (POP)?
Pelvic Organ Prolapse is a descent of the one or some of the abdominal organs (bladder, uterus, rectum or small intestine), down into the vaginal canal. It most commonly occurs post delivery, anytime postpartum, with subsequent pregnancies or around menopause. It presents on a grading scale from 1-4, with 1 being the most minimal amount of prolapse and grade 4 being the most significant amount of prolapse. It may present as feelings of dragging or heaviness in the vagina or rectum, or the sensation that there is a tampon in or that you are sitting on a golf ball. Urinary incontinence and urgency may appear as well, a long with uncomfortable sex and/or incomplete emptying or difficulty with emptying your bowels. Be sure to discuss any concerns or symptoms with your medical care provider.
My period came. Should I still attend?
That is up to you and your comfort level. Internal evaluations can be avoided if you would prefer during your session, or your appointment can be re-scheduled.
Who benefits from a pelvic floor physiotherapy appointment?
ANYONE WHO HAS A PELVIC FLOOR. You do no have to have bladder or bowel symptoms, pelvic pain, are pregnant or ever want to become pregnant to attend pelvic health physiotherapy. Come learn about the anatomy, function and overall bowel and bladder health. You don’t know, what you don’t know!
For a more detailed explanation, click on the services menu for each area: prenatal physiotherapy, postpartum physiotherapy and women’s pelvic health physiotherapy.
I’m pregnant, when should I attend physiotherapy?
- General Trimester checks: 1st visit between 12-20 weeks, 2nd visit between 21-27 weeks, and 3rd visit between 28-36 weeks
- Third Trimester: 1st visit between 28-31 weeks, 2nd visit between 32-36 weeks. If you are attending 35 + weeks, it is recommended to schedule a 90 or 120 minute extended length initial assessment.
I’m postpartum, when should I attend physiotherapy?
- Around 6 weeks is ideal. If you are experienced a significant birth trauma (3rd + degree tears, instrument deliveries, issues with bladder control and emptying, difficulty with post Caesarean birth pain), you may beefit from attending as early as 2-4 weeks postpartum.
- Once postpartum, you are considered so for life! Anytime after having a baby, whether it is within the 1st year, or 10 years later.
I’m neither pregnant OR postpartum, or plan to ever be, when should I attend physiotherapy?
Urinary frequency, urgency & incontinence, pelvic organ prolapse (POP), pre & post surgery, pelvic girdle pain, pain or discomfort with sexual intercourse, painful scar tissue, coccydynia (tailbone pain), fecal urgency & incontinence, constipation. Discuss any symptoms with your medical care provider.
Is “pelvic floor physiotherapy” covered by my insurance company?
Generally speaking, if you have insurance coverage for physiotherapy it will be covered under that. Some companies (Blue Cross) have specific coverage for pelvic heath physiotherapy. It is best to check with your individual insurance company prior to attending.
Do you offer direct billing?
Direct billing is available for WCB, MPIC, DVA/DND/RCMP. Disability claims may be eligible for direct billing, please discuss with your insurance provider and the clinic before booking. Direct billing NOT available to private insurers: Blue Cross, Sunlife, Canada Life etc. payment is taken at the time of each session and official clinic receipts are printed and/or emailed for the client to submit to their private insurance company.