Pelvic Floor Dysfunction Treatment in Guelph & Wellington County

Pelvic floor physiotherapy is increasingly established in the research as a first line of defence against incontinence and pelvic pain. The Cochrane Collaboration (2010) concluded that physiotherapists with specialized training in pelvic floor physiotherapy and rehabilitation should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence in women.

The pelvic floor muscles attach to the front, back and sides of the pelvic bone and sacrum. Like a hammock or a sling, they support the bladder, uterus, prostate and rectum — and they must be able to contract to maintain continence and relax to allow for urination, bowel movements and, in women, sexual intercourse.

When these muscles have too much tension (hypertonic) they will often cause pelvic pain or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they contribute to stress incontinence and organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.

Common causes of pelvic floor dysfunction

Pelvic floor dysfunction usually comes down to how the muscles are working — too weak, too tight, or poorly coordinated:

• Weak (hypotonic) pelvic floor muscles — contributing to stress incontinence, urge incontinence and pelvic organ prolapse; incontinence is NOT a normal part of aging
• Tight (hypertonic) pelvic floor muscles — contributing to urinary and fecal urgency, urge incontinence, chronic pelvic pain, dyspareunia, vaginismus, vulvodynia, pudendal neuralgia, interstitial cystitis and chronic prostatitis
• Tight connective tissue in the abdomen, thighs, groins and low back — the container of the muscles, which often needs to be relaxed before internal work can be done
• Stress and anxiety — the pelvis is an area where we often hold stress, and thoughts, attitudes and beliefs can perpetuate pelvic pain

Pelvic health conditions we treat

Pelvic floor dysfunction shows up differently at every age and life stage. Each of these has its own dedicated page:

• Pelvic pain — most individuals who experience pelvic pain have pelvic floor dysfunction, specifically muscles that are too tight
• Female incontinence — the involuntary loss of bladder control, from stress, urge or mixed causes
• Male incontinence — involuntary loss of bladder control in men, often following prostate treatment
• Prolapse — pelvic organ prolapse, which can cause heaviness, pressure or bulging symptoms
• Pregnancy & beyond — education and treatment through pregnancy, birth preparation and postpartum recovery
• Youth pelvic health — pediatric pelvic health concerns including bedwetting and daytime accidents
• Menopause — pelvic health symptoms through perimenopause and menopause

How we treat pelvic floor dysfunction

Pelvic floor dysfunction is assessed by specially trained physiotherapists using internal and external hands-on techniques to evaluate the function of the pelvic floor muscles — always at your pace, and always with your informed consent. Treatment may include:

• Assessment of your ability to contract and relax the pelvic floor, along with the bones and muscles of your lower back, hips and sacroiliac joints, which can stress the pelvic floor
• Treating tension before weakness — once the muscles reach a normal resting tone and can relax fully, strength is reassessed and strengthening exercises are prescribed if appropriate
• Connective tissue release for the abdomen, thighs, groins and low back when an internal examination isn’t yet comfortable
• Self-care strategies — avoiding pushing or straining when urinating, reverse Kegels to lengthen and relax the muscles, warm baths, posture and stretching such as yoga
• Persistent-pain education — understanding how our pain system works has been shown to be an effective way of reducing the threat of ongoing pelvic floor dysfunction

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