What is Pelvic Floor Physiotherapy?

So what exactly is pelvic health physiotherapy? 

A lot of the time, talking about our pelvic health can be uncomfortable. It can be extremely nerve-wracking trying to explain our washroom routines and the pains we may be experiencing – this is why a lot of the time, pelvic floor dysfunction can go without treatment, and many people end up living with chronic pain. This is why understanding the signs of pelvic floor dysfunction and awareness of pelvic floor physiotherapy is vital!

At All About Physiotherapy Performance Centre, I had an experience with a patient who suffered from severe pelvic pain through most of her adolescence and throughout early adulthood. She was never educated on potential causes of it, with many medical professionals claiming that pelvic pain occurs in many young women and she can take medication to reduce her pain. No one actually informed her that her pain wasn’t in fact normal and didn’t even know that pelvic floor physiotherapy even existed!

“Upon my first assessment with this individual, I provided her education regarding the anatomy of the pelvic floor and its associated dysfunctions that can occur. I distinctly remember her eyes lighting up, telling me that she finally felt like she understood what was going on in her body and was excited that her pelvic pain wasn’t permanent, reiterating again that pelvic floor education and treatment can not only help our physical pain, but our mental and emotional wellbeing!” – All About Physiotherapy Performance Centre Pelvic Floor Physiotherapist.

This is where we get a little nerdy!

Our pelvic floor consists of a set of muscles that serve many important functions required for our everyday life. When working optimally, these muscles are integral to our bowel and bladder function, sexual function, and allows for balance and stability of our core.

The muscles of the pelvic floor provide support to our organs against gravity and intra-abdominal pressure, along with the vaginal and rectal walls. They work together with our sphincters to control the openings of the urethra, vagina and rectum to maintain both urinary and fecal continence. The pelvic floor is associated with our sexual function as well. Oftentimes, individuals who have pain with sexual activity may have excessive muscle tone in their pelvic floor! Moreover, the pelvic floor also acts as a ‘sump-pump’, which essentially helps to promote venous and lymphatic flow within the pelvis. If this becomes impaired, it can produce pelvic congestion and swelling. And last but certainly not least, the pelvic floor muscles provide stability to assist in the movement and control of the low back, pelvic and hip bones.

The pelvic floor, in conjunction with our transversus abdominis (our deep core muscles), multifidus (the deep muscles of our back that attach directly to our spine) and the diaphragm (our breathing muscle), helps to make up our ‘core canister’. You can think of the canister as a team of muscles working together to provide stability during movement. They work together to keep our core and pelvis stable relative to one another, and are an essential component to our breathing mechanics. A lot of the time, people who have imbalances within the canister can have pelvic floor dysfunction and pain!

Pelvic floor physiotherapy can help to retrain tight or weak muscles to work optimally. This can be done through breathing exercises, pelvic repositioning movements, and various core strengthening exercises to ensure that the canister is working cohesively as a team. At All About Physiotherapy Performance Centre, we are also trained to know when our patients would need to be referred to a physiotherapist licensed to provide internal examinations, should external pelvic floor physiotherapy not be sufficient enough to relieve overactive muscles.

What if these muscles are too tight or too weak?

This is where pelvic health physiotherapists come in. At All About Physiotherapy Performance Centre, our pelvic health physios are highly trained physiotherapists that are specialized in treating pelvic floor dysfunction through both external and internal physiotherapy. 

Why is our pelvic floor important?

It’s imperative that you manage your pelvic floor problems NOW. Just like any other muscle in your body.. Use it or lose it!

If you don’t take the time to strengthen your pelvic muscles now, then it could lead to bigger problems like..

• Low back pain
• Bowel and bladder problems
• Pelvic organ prolapse
• Sexual dysfunction

A strong and connected pelvic floor means:

• You’re able to exercise without pain
• You have optimal breathing mechanics
• You have more core awareness during movement or lifting

For more information and a few starter exercises, check out this Youtube video below!

4 Physiotherapy-Based Strategies to Connect with Your Pelvic Floor

1. Diaphragmatic Breathing

   • Do you usually breathe into your shoulders or rib cage? Let’s see…
     • Put one hand on your chest, then put the other hand on your stomach
     • Inhale through your nose and exhale through your mouth.
   • Where did you breathe – chest or stomach?
   • The breathing strategy that is going to benefit you is to breathe into your stomach (or lower rib cage to be exact), as we always want to ensure we are using our inspiratory muscle, i.e. the diaphragm. So let’s practice breathing:
     • Take a deep breath in through your nose, imagining you are filling your lungs and expanding your belly. If you were to put one hand on your chest and the other on your stomach, you ideally want your belly to be moving outwards and your chest to stay still. For optimal breathing mechanics, it is important to be sitting up or standing rather than lying down, as our diaphragm works best in a relaxed position – which happens to be when we are sitting or standing.

2. Pelvic Posture

   • How do you naturally stand? More weight on one side than the other? One leg straight and the other with a knee bent?
   • Let’s consider your pelvic position and rib cage position. Can you stack your rib cage directly over your pelvic while standing on both legs evenly.
   • Try to grow 2 inches taller.
   • Another cue that we can try is tilting our pelvis forward and backward to then find our middle. With hands on our hips, tip your hip bones forward so you are curving your low back, then proceed to tilt in the opposite direction, pushing our tail bone forward. Finally, move your hips in a neutral position, in the middle of the previous 2 movements – this is an optimal position for your pelvis to be in!

3. Transverse Abdominus Activation

   • As we previously mentioned, our transversus abdominis is our deep core muscle that helps to make up our canister. It is an essential part of creating stability through our pelvis, core and low back. Oftentimes, this muscle is not activated in many individuals with pelvic or low back pain and requires specific training to teach it how to activate with movement.
   • One cue that pelvic floor physiotherapists utilize to teach individuals to turn on the transversus abdominis is telling them to flatten their low back into the ground surface, ensuring their hips and ribcage are coming closer together. We want to make sure that this contraction isn’t forced and that it is coming from within. While doing this exercise, individuals can place their fingers along the lower abdomen, right above the groin (as pictured below).

4. Pelvic Floor Muscle Retraining:

   • Our pelvic floor works synergistically with our diaphragm to allow us to brace our core and optimize our breathing mechanics. When we breathe in, our diaphragm and pelvic floor muscles push down, increasing our intra-abdominal pressure. When we exhale out, they move back up and open up our abdominal cavity. We can use this relationship to help improve the biomechanics of our canister, thus allowing us to maximize our core and pelvic stability with movement.
   • One way we can work on this relationship is through an exercise called cat cow, but with a twist. Start off by positioning yourself on all fours. Then as you begin arching your back, take a deep breath in. As you start to round your back upwards, slowly let that breath out. Repeat this and as you do so, try to focus on lengthening the time it takes to inhale and exhale.

So…how important is your pelvic floor?

Before reading this blog, were you aware of the relationship between your pelvic floor and incidences of core instability and low back pain? Most people are not aware of this and that is what we as expert physiotherapists are here to educate individuals on this. If we think back to the patient we talked about who was suffering from years of pelvic pain, it is undeniable the positive impact that pelvic floor physiotherapy can have on our physical and emotional wellbeing. No one should have to experience pain and discomfort for that long and not understand what is happening inside their own body.

Contact All About Physiotherapy Performance Centre to learn more about our Pelvic Floor Physiotherapy services! 

Feel free to stop in to All About Physiotherapy Performance Centre at 

Unit 1-577 Burnhamthorpe Rd, Etobicoke, ON, M9C 2Y3

Or give us a call at 647-598-2201

Or fill out our inquiry form on our website for further information. 

Feel free to stop in at our other location All About Kids Rehabilitation Centre at 

1-3413 Wolfedale Rd, Mississauga, ON, L5C 1V8

Or give us a call at 647-598-5725

Or fill out our inquiry form on our website or further information. 

We would be happy to help you get back to feeling great!