Pelvic floor physiotherapy deals with meeting goals that have to do with the functioning of a client’s pelvic floor. The pelvic floor is the group of muscles, organs and connective tissue that sit inside the bony pelvis. In mountain biking terms, it is the human bottom bracket.
Just as with a limb problem, pelvic floor physiotherapy works best when a thorough examination and palpation (evaluation through touch, of muscle and connective tissue tension) of structures. However, I recognise that the pelvic floor is unique in its personal, psychological and emotional role in the body. While I am licensed to do internal exams, no such assessments take place unless the client entirely consents to the process. A good deal of what is happening with the pelvic floor can be assessed externally, and there is another portion of pelvic floor problems that are related to the legs and ribcage, so if an external or slower approach is needed, a lot can still be accomplished.
Pelvic Floor FAQs
Do you look after men with pelvic floor problems? Yes! Prostate conditions, heavy lifting, stress and even mountain biking are some of the things that can take a toll on the male pelvic floor.
What about nonbinary or transpeople? Of course. It is my pleasure to be of help with whatever pelvic floor concerns you have, including post-operative rehab.
What should I wear to an appointment? Specifically for a pelvic floor physio appointment, if you expect that an internal exam will take place, it’s good to plan a longer shirt and socks in order to stay as comfortable as possible for the internal portion where leg coverings and underwear are removed. Some clients like to bring a bathrobe, which is fine. All internal exams are conducted such that the client is under blankets.
What if I have gas during the appointment? It means you are human. You can excuse yourself to the bathroom, let nature take its course, or use the code phrase, “I think your phone is ringing” if you would like me to leave the room. Holding in gas can significantly alter assessment findings, so that’s the only thing you shouldn’t do.
What if I’m menstruating during my appointment? For internal exams, any internal menstrual products should be removed. It is up to the client as to whether personal comfort preferences dictate rescheduling, but from a therapist point of view, any time in a menstrual cycle is just fine for pelvic floor physio.
Is all pelvic floor physio internal? No. A good deal of pelvic floor physio, can be assessed and treated externally. A lot of what is happening in the pelvic floor is the result of changes elsewhere along the chain: abs, ribcage and hip joints. I start every pelvic floor physio assessment with a thorough observation of these factors before proceeding to a discussion on whether an internal exam is warranted AND something the client is willing to undergo. If even one of those conditions isn’t met, then we stick with what we can treat externally, which quite often is a lot.
Can I change my mind midway through a pelvic floor internal exam? You bet. The client is in the driver’s seat at all times.