Pelvic Floor Physiotherapy &
Pelvic Health Rehabilitation (AFAB)

Are you feeling anxious when you cough, or laugh, or sneeze? Avoid certain impact activities that include jumping or running for fear of leakage? Do you go to the washroom before leaving the house even if you don't have to go, just in case? Are you avoiding sexual intimacy because intercourse is painful? Do you feel a heaviness when your standing, or walking, like a downward pressure in your pelvis?

These are just a few of the uncomfortable situations that can occur when our pelvic floor muscles are not functioning optimally. There is good news, pelvic floor physiotherapy can help. 

Pelvic floor physiotherapy is a specialized area of physiotherapy that focuses on the muscles, ligaments, connective tissues, and nerves that support the bladder, bowel, and reproductive organs. The pelvic floor is a group of muscles located at the base of your pelvis. These muscles play an important role in bladder and bowel control, sexual function, core stability, and supporting the pelvic organs. When the pelvic floor muscles are not working properly—whether they are too weak, too tight, uncoordinated, or painful—it can contribute to a variety of symptoms that affect daily life.

Pelvic floor physiotherapy helps identify the underlying cause of your symptoms and provides individualized treatment to improve function, reduce pain, and help you return to the activities that matter most to you. Our goal is to help you feel informed, comfortable, and confident throughout your care.

benefits of treatment

YOUR appointment

Your initial assessment begins with a detailed history including:

• Your current symptoms and goals

• Medical and surgical history

• Bladder and bowel health

• Sexual Health

• Exercise and activity levels

• Pregnancy and birth history (if applicable)

• Any other factors that may be contributing to your symptoms

Education and Understanding

A key part of pelvic floor physiotherapy is helping you understand your body.

We will review the anatomy and function of the pelvic floor using diagrams and models, discuss how it relates to your symptoms, and explain the assessment process so you know exactly what to expect.

Pelvic Floor Assessment

Depending on your symptoms and comfort level, the assessment may include:

• Posture and movement assessment

• Breathing patterns

• Core muscle function

• Biofeedback

• Real-Time Ultrasound (when appropriate)

• Hip, back, and pelvic mobility

• External examination of the pelvic region

• Internal pelvic floor assessment (when appropriate)

An internal assessment can provide valuable information about pelvic floor muscle strength, coordination, tension, and function. However, it is always optional and only performed with your informed consent.

Consent and Your Comfort

Your comfort and autonomy are our priority. Before any assessment or treatment, we will explain what is involved, why it may be helpful, and answer any questions you have. You may choose to consent to, decline, or stop any part of the assessment or treatment at any time. You are never required to participate in any procedure that makes you uncomfortable.

You are welcome to bring a spouse, family member, friend, support person, or chaperone to your appointment if that helps you feel more comfortable.

Treatment

Following the assessment, we will discuss our findings and develop a personalized treatment plan together. Treatment may include:

• Breathing and pressure management strategies

• Exercise and movement retraining

• Pelvic floor muscle training

• Relaxation and down-training techniques

• Manual therapy

• Lifestyle and behavioural strategies

• Bladder and bowel health education

• Return-to-sport or activity guidance
  

Potential Risks and Side Effects

As with any physiotherapy treatment, some people may experience temporary soreness or symptom changes following assessment or treatment. These effects are typically mild and short-lived.

Precautions and Contraindications

Certain medical conditions or situations may require modifications to assessment or treatment, including:

• Active pelvic or urinary tract infections

• Unexplained vaginal bleeding

• Immediate post-surgical restrictions

• Certain pregnancy-related complications

• Acute medical concerns requiring physician assessment

If any precautions apply, your physiotherapist will discuss appropriate options and ensure your treatment remains safe and individualized.

POST-GRADUATE TRAINING AND CERTIFICATIONS
IN PELVIC FLOOR PHYSIOTHERAPY

• Successful completion of components of the Certificate of Advanced Practice in Physical Therapy in Pelvic Health competency-based program through the American Physical Therapy Association’s Academy of Pelvic Health.

  • Pelvic Health Physical Therapy Level 1 Webinar and Lab (focused on urinary incontinence and pelvic organ prolapse)

  • Pelvic Health Physical Therapy Level 2 Bowel Dysfunction Webinar and Lab

  • Pelvic Health Physical Therapy Level 2 Pelvic Pain Webinar and Lab

  • Pelvic Health Physical Therapy Level 3 Hybrid Webinar (focused on neurological conditions, pediatric health and male health (AMAB))

• Herman and Wallace’s Sexual Medicine in Pelvic Rehab

• Marcy Dayan’s Evidence-Based Approach to Treating Dyspareunia and Vulvar Vestibulodynia

• Oncology and the Pelvic Floor through Pelvic Helath Solutions

• Physical Therapy in Gender-Affirming Care: Transgender Health throught the APTA Academy of Pelvic Health

• Mentorship with Laura Werner, Pelvic Floor Physiotherapist