Do my extended health benefits cover Pelvic Health Physiotherapy?
Yes. Pelvic Health Physiotherapy is covered under regular physiotherapy benefits. So if you have coverage for physiotherapy, this includes pelvic health as well.
Do I need a doctor's referral to see a Pelvic Health Physiotherapist?
No. You do not require a referral to be seen by a Pelvic Health Physiotherapist. If you plan to use your extended health benefits to cover the cost of your visit, it is possible your insurance provider may require a doctor's referral.
Is Pelvic Health Physiotherapy just "Kegels"?
No! This is one of the biggest misconceptions about Pelvic Health Physiotherapy. "Kegels" refer to the voluntary muscle contraction of the PFM and can be very helpful (when done correctly*) for some people. However, in many cases kegels do more harm than good! It is imperative that you have a trained Pelvic Health Physiotherapist assess your PFM and make recommendations based on YOUR pelvic floor.
*Research has shown us that about half of men and women who try kegels are doing them incorrectly. If you think you would benefit from PFM strengthening, it is highly recommended that you have the exercises taught to you by a trained Pelvic Health Physiotherapist.
What makes "Pelvic Health" Physiotherapists different?
Pelvic Health Physiotherapists are still physiotherapists. They have graduated from an accredited physiotherapy university program and are licensed to work in their province or territory. The difference is that "Pelvic Health" Physiotherapists have undergone additional post-graduate training in order to perform internal pelvic exams of the pelvic floor. The pelvic floor muscles are not visible or reachable from the outside, so vaginal or rectal palpation is used to assess and treat pelvic floor conditions. Pelvic exams are restricted to physiotherapists who have received special training. Pelvic Health Physiotherapists use their knowledge of the musculoskeletal system to direct your treatments appropriately, including prescribing individualized exercises, performing soft tissue techniques and joint mobilizations and providing education around physical health.
Is an internal exam absolutely necessary?
You are always in control of your own health care decisions and your physiotherapist will never insist that you undergo an internal exam. However, it is highly recommended due to the limitations of external assessment and treatment. Without assessing the PFM directly (via internal palpation), it is impossible to know whether your PFM are activating correctly, or whether there is scar tissue or trigger points that are preventing healthy PFM function. Declining an internal exam would be comparable to requesting assessment of a shoulder injury while wearing a winter coat; your physiotherapist will do her best but will not be able to gain a full understanding of your dysfunction. That said, your physiotherapist will always be respectful of your comfort level and will give you every opportunity to make your own informed decisions about your care.
How many treatments will I need?
Every body is different and there is no "cookie-cutter" formula for treating pelvic health conditions. Your physiotherapy treatment plan will depend entirely on your symptoms and your health history. For some people, only two or three treatments are required to see a significant improvement in their symptoms. For others with more complex needs, three or four months of treatment at more regular intervals may be needed for more hands-on therapies. You will always be given exercises you can do at home between visits to maximize your recovery.
How long should I wait postpartum to come to physiotherapy?
A postpartum pelvic health check-up is a great way to start your recovery off on the right foot. It is recommended that you wait until incisions or tears are healed before have an internal assessment done - usually about 6-8 weeks after your baby is born. We know it is challenging to go anywhere by yourself during that first year, so we always welcome you to bring your new babe along with you!
Is Pelvic Health Physiotherapy just for women?
Absolutely not. Men have pelvic floors too, and suffer from PFM dysfunction as well. The most common PFM problems among men include persistent pelvic pain (sometimes this is diagnosed as chronic non-bacterial prostatitis) and post-surgical bowel/bladder dysfunction. If you have undergone a prostatectomy (removal of the prostate), or have plans to undergo a prostatectomy, pelvic health physiotherapy is highly recommended to optimize PFM function and prevent or treat incontinence/other post-surgical complications.