What is Pelvic Floor Physiotherapy & How to Connect with Your Pelvic Floor
“Pelvic Floor Physiotherapy changed my life. After having my second child I felt like I would never get my body back. I felt weak, discouraged and broken. Learning to connect with my inner core & pelvic floor muscles through pelvic floor physiotherapy allowed me to exercise again (safely!) and gain control of my life.”
I was out running the other day with a group of ladies when one woman approached me. The ladies know me as “The Pelvic Physio” of the neighbourhood. She confessed that she peed herself when running so she’d been wearing panty liners ever since giving birth 5 yrs ago. While embarrassed she knew there must be a solution. And, of course, I reassured her that Pelvic Floor Physiotherapy is all about solutions!
Urinary leakage is common, but NOT NORMAL and there are SOLUTIONS!
For example DO YOU:
- Wear black clothes to hide potential accidents?
- Avoid jumping activities in fear of leakage?
- Go to the bathroom before you leave the house…”just in case?”
- Have pain with intercourse?
- Feel heavy or uncomfortable in the pelvic region?
- Think your abs are separated?
- Have low back, tailbone or pubic area pain?
If you checked any of the boxes above then this post is FOR YOU!
First, I’m going to explain the pelvic floor anatomy. Second, I’ll touch on its importance. Then I’ll finish by providing STRATEGIES to help you gain control of your pelvic floor and urinary leakage!
What is Pelvic Health Physiotherapy?
So what is PELVIC HEALTH PHYSIOTHERAPY? This is where I get a little nerdy!
Let’s start with the basics, shall we?
The pelvic floor is a group of muscles that run from your tailbone at the back to your pubic bone at the front. You can think of them like the bottom of a basket that supports your internal pelvic organs like your bladder, uterus/prostate and rectum.
But what if these muscles are Too Tight? Too Weak?
This is where Pelvic Health Physiotherapists come in. We are highly trained physiotherapists that are specialized in treating pelvic floor dysfunction. In fact, our practice includes both external physiotherapy and internal physiotherapy. Why internal you ask? It’s recommended to determine the state of the pelvic floor muscles, which are, after all, inside you. However, if you’re not comfortable or ready for an internal exam that’s ok, we are also trained in TONS of external techniques that can help you!
So when my friends always ask me. “What do you do?” The short answer is:
I help YOU connect with their pelvic floor and core muscles so YOU can be
STRONG, CONFIDENT, PAIN FREE, ACTIVE &
LIVE YOUR BEST LIFE
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Why is our Pelvic Floor Important?
The Cochrane Collaboration 2010 concluded that:
“Physiotherapists should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence in women”.
It’s imperative that you manage your pelvic floor issues NOW! Just like any other muscle in your body…use it or lose it! So, if you don’t take the time to strengthen (if weak) or lengthen (if tight) your muscles now then it can lead to bigger problems later like…
- Back pain
- Pelvic organ prolapse
- Surgical intervention(s)
- Decreased quality of life
A strong and connected pelvic floor means:
- You’re able to exercise without pain / leakage etc.
- Have less chance of injury
- More POWER, STRENGTH, EFFICIENCY
Connect with YOUR Pelvic Floor: Top 3 Physiotherapy Based Strategies:
1. Diaphragmatic Breathing:
Do you breathe into your shoulders or rib cage? Let’s see…
- Put one hand on your chest and the other hand on your stomach.
- Take a big inhale through your nose and exhale through your mouth.
Where did you breathe? Chest or stomach?
The breathing strategy that is going to help you is to breathe into the stomach (or lower rib cage, to be exact). So, let’s practice breathing:
Put your hands onto your lower rib cage. Take a deep breath in through your nose and send your breath into your hands (lower rib cage). Exhale out of your mouth.
TIP: you should feel your lower rib cage expanding like the wings of a bird flying when you inhale and relax back to a resting position when you exhale. If you don’t then apply a little pressure to your rib cage so you tell your brain where to breathe into (this is called neurosensory feedback 
).
It takes a bit of practice. Try doing this a few times a day for a few days…you’ll get the hang of it!
2. Pelvic Posture:
How do you stand? More weight on one side than the other? One leg straight and the other with a bent knee? This isn’t a great posture; but it is common (pic 1). Or do you stand with your but out (pic 2) or completely slumped forward (pic 3)
Let’s consider your pelvic position and rib cage position. Can you stack your rib cage directly over your pelvis while standing on both legs evenly?
Cue: “try to row 2 inches taller”
TIP: Imagine your pelvis is a bowl of soup and you want the soup to sit on the bottom of your bowl (not spilling out the front – if your bum is sticking out or out the back if your slumped with your abs tucking your pelvis under at the front)
3. Pelvic Floor Imagery:
Let’s layer things…together…
While you’re standing (or laying down if you find that easier) I want you to imagine your rib cage is an:
- An umbrella that is opening (on inhale) and closing (on exhale) OR
- A Jelly fish swimming in the water OR
- A flower that is blooming (on inhale) and closing (on exhale)
Looking for more? Wondering if you should be adding strength work (for weak muscles) or lengthening work (for tight muscles)? Book an assessment with one of our physiotherapists where we can address YOUR specific issues and work towards YOUR goals. Check out our pelvic health page!
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FAQ
Should I Kegal or Not?
If you have tight muscles then kegals are NOT the thing for you…there is no need to contract muscles that are already short or tight. BUT if you have weak muscles than kegals (when done properly) can be helpful. Drop me a line if you’d like a copy of my handout on “To Kegal or not to Kegal; that is the Questions”
Can Pelvic Floor Physiotherapy Help with Painful Intercourse?
Sure can! Painful intercourse can stem from a number of issues. Generally speaking pelvic floor muscles are tight with painful intercourse. This can be from stress, your posture, previous birth(s) etc. It’s best to have a full assessment with a pelvic floor physiotherapist to explore your specific situation. Email me if you’d like more information on Dyspareunia (painful intercourse)
Does Pelvic Floor Physiotherapy Always Include an Internal Exam?
The short answer is No, you don’t. And there are tones of techniques we can use to help you externally. Long answer: having an internal exam from a trained pelvic floor physiotherapist will provide the most information about your specific pelvic issue allowing a more complete understanding to move forward with a custom treatment plan.
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