The Running Physio
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TRP's Running Blog

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What The Health!? What You Need To Know About Pelvic Physio

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The importance of pelvic health for every one and why it’s important to take a trip down unda’!

When’s the last time you took a look down there, like, I mean really took a look? Did you know that pelvic health is more than just for pre-natal and post-natal issues? Pelvic therapists are specialists in more than just kegels! In fact, it’s like learning about a whole other part of your body that plays many important roles but it is quite often neglected. Today we’re going to be answering some of the burning (hopefully not, actually) questions you have!

What is pelvic floor physio?

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Pelvic floor physio takes a close up look, and I mean, a real close up look at your pelvic floor and the different structures within and around it. It is most often an internal assessment (as I said, real close!) done by a trained professional, however it does not always have to be internal. There is still a lot that can be assessed on the surface level but it makes it very difficult to get a sense of the whole picture.

Who can benefit? Is it only for expecting mothers?

I would say it is a must for expecting mothers, but is absolutely for EVERYONE (boys, that means you too – yes you also have pelvic floors). The benefit of understanding the role of the pelvic floor in relation to many of the inner workings of your body is crucial. I work with a lot of pre- and post-natal individuals where we learn how to connect to the pelvic floor either in preparation for labour or return to activity post-delivery. But I also work with so many other individuals who are dealing with increased frequency of urination, incontinence, abdominal separation (diastasis rectus abdominus), pain with sex and/or pelvic exams, persistent pelvic pain, pelvic girdle pain, interstitial cystitis, and even low back pain!

How does an appointment go?

At your first appointment, we talk about what I assess externally and internally, what your physical activity goals are, and address any concerns that you may have. There is a simple external exam, as well as an internal exam. The internal exam is a vaginal examination and rectal if warranted. We also go over the anatomy of the pelvic floor, explaining where the pelvic floor is, its functions, and why it’s important. We take a look at the tissue health, tone of your pelvic floor, and assess the muscular strength and coordination of your inner core muscles. 

After the assessment, we will discuss a plan and what to expect for follow up sessions. 

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I’m not sure about this whole “internal exam” thing. Should I be nervous?  

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That’s a fair question. There is nothing to be nervous about, but I do remember my first assessment and feeling very strange and vulnerable. The usual after thoughts I receive from a lot of people are, “Wow, that wasn’t as scary as I thought at all!”

Your therapist connection is huge. Remember though, your therapist has been in your shoes and remembers what it’s like. We will always try to make the appointment as comfortable as possible. I always start with a little bit of education, so you know exactly what I am evaluating, why, and how it relates to your issues. The best way I can explain it is that it’s very similar to when you see your doctor for a physical check up/PAP however there are no instruments used internally at all. It is a digital (gloved finger) examination that is at your pace and only done if you consent to an internal assessment. I emphasize the importance of communication and at any point you want to stop, we do, no questions asked.

 

Is there any link between pelvic floor dysfunction and other types of pain?

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I hate to do the ol’ “Back bone connected to the hip bone, Hip bone connected to the thigh bone” but yes, the pelvic floor has big relations to low back and hip issues. So much so that a study was done about it! If you’re curious - check it out here.

Some other potential connections that can connect to pelvic floor heath are the gastrointestinal system and stress.

 

How long does it take for me to see results?

It is dependent on the issue that we are dealing with, but I usually see changes within 3-5 visits.

What made you want to specialize in this kind of physiotherapy?

I had been dealing a lot with my own issues ranging from severe pelvic pain, sport-related incontinence (double-unders anyone?), and irregular/heavy/think you’re dying from the inside-out menstrual issues. I was tired of having a 5 minute appointment with doctors that never had the time to listen to my story and would give me a prescription for a drug when I asked for other options. Not one specialist mentioned anything about pelvic physio but I found it through my own research and that’s actually what sparked me wanting to become a physio in the first place. If I could describe pelvic floor rehab in one word, it would be “empowering”. It gives you the tools to manage symptoms from the inside out. I understood so much more as to why I was having pelvic pain, how to manage my pain, and what I could do at a bio-psycho-social level.

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Lauren Roberts