Pregnancy
Any pregnancy related ache or pain can be addressed by a pelvic floor physiotherapist. This may include low back pain, sciatica, pubic symphysis dysfunction, rib pain, etc.
Another important part of pelvic floor physiotherapy in pregnancy is the preventative nature - teaching you about your core and pelvic floor, doing delivery preparation including pushing practice, and discussing what you can and should be doing in the early days postpartum.
Postpartum
It is never too late to see pelvic floor physiotherapy after having a baby. This includes both vaginal and caesarian delivery. Common complaints postpartum include urinary incontinence, pelvic organ prolapse, and painful intercourse. It is also very important to have your pelvic floor assessed postpartum before returning to specific activities such as running, that place a big demand on the pelvic floor.
Diastasis Recti (Abdominal Separation)
Diastasis recti is a natural adaptation to pregnancy, however what we do throughout pregnancy and early postpartum can aid in the recovery of these tissues.
Even if you had a baby years ago and think this might be an issue, an assessment can be done to determine the extent of separation and proper breathing and core exercises can be prescribed to aid in optimal functioning.
Pelvic Organ Prolapse (POP)
POP is when any of your organs starts to descend down the vaginal canal (bladder, uterus, rectum). Common complaints with a prolapse are the feeling of incomplete emptying, or a bulging sensation inside the vagina. Prolapses range in severity as well as symptoms felt. Although not always related to childbirth, prolapses are more common after vaginal delivery.
Painful Intercourse
Many women experience pain or discomfort with penetrative intercourse - this does not make it normal or something we should just accept. There are many factors that play into why some women may experience this, and physiotherapy can address these. Some of these include overactive or tight muscles, vaginal dryness, scar tissue, or an underlying health condition like endometriosis.
Ano-rectal Disorders
Pelvic floor physiotherapy also addresses complaints related to bowel functioning or "back door issues" - constipation, difficult evacuation, unwanted leaking of stool or gas, pain in the rectum or tailbone, etc.
Pre- and post-operatively
Any gynecological or colorectal surgery may affect your pelvic floor. Oftentimes after surgery the pelvic floor gets tight or overactive because it is responding to the pain/healing and tensing as a protection mechanism. Seeing a physiotherapist prior to surgery can teach you all about these muscles and proper recruitment and relaxation. Seeing a physiotherapist after surgery can address any post-operative concerns.
Common surgeries include hysterectomy, endometriosis excision, anal sphincter repair, etc.
Menopause
With menopause comes a change in the hormones responsible for pelvic floor elasticity and lubrication. A physiotherapist can discuss different options for complaints such as vaginal dryness or painful intercourse, as well as address the pelvic floor muscles.
