Let’s get real: sneezing when you pee and painful intercourse are not usually topics that women are in a rush to discuss. But the reality is, pelvic floor dysfunction affects one in three Canadian women; a change commonly brought on by childbearing and menopause.
But if you thought looking after your pelvic floor meant doing a few Kegels while you stand in line at the grocery store – think again. Not only are Kegels not appropriate for everyone, if you do them incorrectly, but you can also harm the muscles and tissues you’re trying to help.
It’s also crucial to get a proper diagnosis of what’s going on ‘down there’ if you are having issues; otherwise, if you treat it by yourself, you might do more harm than good.
So, what can women do to make sure that they are properly taking care of their pelvic floor health?
Pelvic floor dysfunction (PFD), refers to any disorder found within the pelvic floor.
This includes bladder and bowel dysfunction, sexual dysfunction, pelvic pain, pelvic organ prolapse (descent of the organs) and pelvic floor muscle dysfunction.
A pelvic floor disorder may begin after surgery, pregnancy, childbirth, trauma, bladder infections, if you play a lot of sports, hormonal changes or aging.
So if PFD is pretty common, and can be caused for multiple reasons, what can we do to help treat it?
Pelvic floor physiotherapy is the most non-invasive approach to treating pelvic health issues, including incontinence, and patients can often see results after only a few visits. Just like the name suggests, pelvic floor physiotherapy strengthens the important muscles lining the pelvic floor. These are the muscles we use to control the urge to urinate or defecate, and they support the uterus, bladder, and rectum. Both men and women have them, and these muscles also help during childbirth.
Just as you wouldn’t go see a dentist to fix your eyes, it is just as important to see an expert who specializes in pelvic health if you have PFD issues. Tamara Nerreter, a Vancouver physiotherapist who specializes in pelvic health, says that seeing an expert is very important if you want to achieve successful results. “If a woman is having issues, she needs to see a pelvic floor physio or someone who has done extra training in pelvic floor health, someone who can do a proper vaginal exam and assessments, because even gynecologists don’t assess the pelvic floor in the same way that we do.”
Nerreter says that a good physio will do a full head-to-toe assessment. You should also expect a physio to use equipment like an ultrasound, to show you your pelvic floor. Nerreter said, “I ask my patients to do a Kegel, and they can see that on the ultrasound image in front of them, and perhaps they can see that their pelvic floor might not even be responding.
An ultrasound is a really good way for women to get to know their bodies and reidentify with their pelvic floor and vaginal area.”
If you go to see a pelvic floor specialist, you can also expect to do a vaginal examination, although this is only done as long as the patient is comfortable with the idea.
Nerreter said that getting help, and talking about PFD is something women should feel empowered doing. “I think one of the biggest issues is just breaking down the myth and getting women to understand that you’re not at a loss if these changes are happening. That you can get back to running, or the things that you want to do and that you don’t have to give these things up just because you’ve had kids.”
While seeing a pelvic floor physiotherapist is not necessarily common practice in Canada, and is only covered by extended medical care, in many other parts of the world, a woman’s pelvic floor health is considered imperative. In France, pelvic health is viewed as so important, that at four-six weeks’ postpartum, every single woman who has delivered a baby, (either by C-section or vaginally) gets up to 12 paid-for visits with their doctor and a pelvic floor physiotherapist, at the same time. Together as a group, the patient, doctor, and physiotherapist come up with a treatment plan.
Marcy Dayan a registered physiotherapist and clinical specialist in women’s health, who has a practice in Vancouver said, “It’s important to go and see a pelvic floor physiotherapist postpartum because the pelvic floor has been carrying a heavy load for several months and it’s had a baby go through it, and there are most likely nerve muscle and fascial changes. What we know is that you can get stress incontinence not just from delivery, but it can happen during pregnancy, and even if it resolves by itself, there is a higher risk that it will return.”
She also says, “If you don’t address it, it can also get worse as you get older, as more things change in your body.”
Both Nerreter and Dayan agree although seeking help postpartum recovery is a good idea, if you are a pregnant woman, getting advice in the prenatal period is even better.
Nerreter says, “I treat all age ranges of women. I see young girls who are athletes, I see kids with continence issues, I see new moms and then I have patients who are all the way up past menopause. It’s very important no matter where you are in life to find solutions that work for your pelvic floor. Because the alternative is surgery and it has a very high failure rate.” Nerreter also said that it’s important to receive guidance from a specialist because treatment plans are not one-size-fits-all; since we all have a unique set of problems concerning our pelvic floor health. “We go into pregnancy with a story, and with that in mind, every woman is going to have a different experience of pregnancy.”
If going to see a pelvic floor specialist is something you think you could benefit from, check out the physios below to get you started or go to the BC Physiotherapy Association of BC for more info. Most physio offices are also happy to take your calls and answer any questions and concerns that you make have.
Bump Physio & Co
Port Moody | Langley
Port Moody: 604-562-2867 / Langley: 604-649-2867
bumpphysioco.ca
Physiotherapy for your BUMP and beyond!
Bump Physio & Co is a community of health care providers dedicated to changing the way
pelvic health and obstetrical services are delivered. Our team has advanced training in Pelvic
Health, Orthopedics, Obstetrics, Clinical Pilates, Needling, and C-section Rehabilitation.
COVID-19 Safety Protocols:
Face masks are required for everyone within the clinic. Our staff are continuing to adopt
healthy hand hygiene practices, including handwashing, and covering coughs and sneezes.
Online sessions are also available from the comfort and convenience of your home for those
who are unable to attend in person.
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