RPM Physiotherapy

5 Things You Should Know Before Your First Pelvic Floor Appointment

Ok, you’ve heard about pelvic health. You’ve probably leaned into a conversation where friends were talking about it in hushed voices because you’ve been suspecting it is something you might need but didn’t want to start the discussion.

Is it the new hot trend in healthcare? No. Women in Europe have been practicing pelvic health as standard care for a long time but here in North America it is still relatively new and less common practice.

Is it awkward? Maybe a little. Is it uncomfortable? Potentially. Is it essential? Definitely!

The reality is that pelvic health is an important service for both men and women. In our conservative society, many of us have issues that are under reported and undetected but could be resolved with proper pelvic exam and treatment. Unfortunately most clients who walk through my door still have little idea of why they are coming to see me or what the appointment entails.

To save us all some long, awkward moments of silence, here are the 5 things I think you should know before you walk through the door for your first pelvic appointment.

Pelvic health is not just for urinary incontinence

Although your pelvic floor could be one of many reasons for incontinence, that is not the only condition we treat. Individuals with a dysfunctional pelvic floor may also experience bowel dysfunction, pelvic organ prolapse, pelvic pain, pain during intercourse, low back pain, hip pain or painful periods. Pelvic health can also be helpful for postnatal scaring, endometriosis, sexual dysfunction and conditions of the prostate (yes men can be helped by pelvic floor physiotherapy as well).


It is an internal treatment

Most people understand that our assessment and treatment is going to involve an internal component. What often startles people is when I tell them that we do both a vaginal and rectal internal exam. Yes I said rectal. The reason that both are necessary is that internal palpation is the only accurate way to determine the tone and strength of your pelvic floor. Some of the muscles of the pelvic floor attach to your tailbone or coccyx and can not be reached vaginally. If you are uncomfortable with any of this, not to worry. Your therapist will always ask for your consent and never proceed against your wishes.


We do a lot of talking

A good assessment means getting a very thorough history of all the factors that might be influencing your pelvic floor. We may touch upon some sensitive topics including your lifestyle, sexual activity, your bowel and bladder function, trauma and your mental health. We also discuss other aspects of your health including your nutrition, hydration, sleep and previous medical history. This can take a while and sometimes can be so exhaustive that we may not even do the physical exam at the first appointment. We understand that these may be difficult conversations but your practitioner’s office is a safe space without judgement and the more we know, the more we can help.


You do not need to cancel your appointment if you have your period

We have no issue if you have your are menstruating at the time of your assessment or treatment. All internals are done in a using a clean technique with the client and table properly draped. In some cases you may be more symptomatic while menstruating which may give a more accurate picture of your particular concern.


Be prepared to go home with some homework

Your pelvic floor is a muscle just like any other muscle in the body. Clients are much more successful in their treatment if they bridge the time between appointments by continuing their care with work prescribed by their physiotherapist. Your physiotherapist may suggest strengthening exercises, stretches, relaxation work or some behavioural techniques. We may also ask you to fill out some additional paperwork like a bladder or nutrition diary. As with all other forms of physiotherapy, the clients who are diligent about their homework are typically the most successful.


Do you still have questions about pelvic floor physiotherapy? Feel free to ask one of our therapists before you schedule your first appointment.

Our goal is not only to treat pelvic health conditions but also to make pelvic health more accessible through education and awareness. To find a pelvic health professional near you, we suggest looking through the Pelvic Health Solutions directory.

Melanie is the owner, clinical director and senior physiotherapist at RPM Physiotherapy. She is a graduate of McMaster University and brings 16 years of experience as an orthopaedic physiotherapist to RPM. In 2017 she became certified as a pelvic health physiotherapist  She is passionate about preventing injury and illness through healthy lifestyle. Melanie is a Fellow of the Canadian Academy of Manipulative Therapy and is qualified to perform spinal and peripheral manipulation.  Her treatments include not only manual therapy but also a strong exercise prescription component to prevent further injury. Contact Melanie directly at physiotherapy@rpmstudio.ca.

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