What to Expect During Your First Pelvic Floor Physiotherapy Appointment at Harmony Physiotherapy?

At Harmony Physiotherapy, your initial visit includes a thorough health history review, a physical examination encompassing a postural and movement assessment, a complete musculoskeletal exam, and a gentle abdominal examination. If you are comfortable, an internal evaluation may also be conducted. We recommend wearing or bringing shorts and a loose-fitting top to facilitate an easy and effective assessment. You'll also receive a home exercise program and a personalized treatment plan.

How Long is the Initial Physiotherapy Assessment?

Each initial appointment at Harmony Physiotherapy lasts approximately 60 minutes, ensuring ample time to address your concerns and questions.

What if I have to cancel my appointment?

We understand that schedules can change. However, we request that you provide 1 business day's (Full 24-hour) notice by phone to cancel or reschedule any appointments as our amazing practitioner set aside significant time for your treatment and care. Without prior notice, any missed appointment time cannot be filled by other patients . Missed appointments or late cancellations will incur a full treatment fee, as this time is reserved specifically for you.

Understanding the Internal Examination

At Harmony Physiotherapy, our pelvic physiotherapy assessments are thorough yet gentle, offering a level of detail . We begin with a careful inspection of the external anatomy, looking for any signs of imbalance, irritation, scarring, or dysfunction in the tissues. We also evaluate sensation and reflexes to check for proper neurological function.

The assessment may include a gentle internal evaluation (vaginal and/or ano-rectal) to assess muscle tension, strength, coordination, and to identify any issues. Our physiotherapists are meticulous in guiding patients through each step, explaining movements and procedures to ensure comfort and understanding.

For those who prefer not to have an internal examination, we are fully prepared to tailor a treatment plan using alternative methods that still address your needs effectively. Our goal is to ensure you feel supported and informed throughout the process.

Why Might I Need Another Pelvic Exam Even If I’ve Had One by a Doctor?

Pelvic exams performed by doctors are crucial for determining if medical or surgical interventions are necessary. However, these exams are very different from those conducted by pelvic floor physiotherapists.

At Harmony Physiotherapy, our pelvic floor physiotherapists conduct comprehensive assessments that go beyond basic medical evaluations. We meticulously examine for signs of infection or irritation, assess the alignment and mobility of bones, evaluate muscle tension, strength, and coordination, and check the positioning and mobility of pelvic organs and any scar tissue adhesions. This holistic approach allows us to gain a complete understanding of your pelvic health.

This detailed assessment is crucial as it forms the foundation of your personalized diagnosis and treatment plan. By focusing on these comprehensive evaluations, we ensure that we address all aspects of your pelvic health, providing more than just superficial results and truly supporting your overall well-being.

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a specialized branch of orthopedic physiotherapy requiring advanced training. It addresses a wide range of conditions related to the pelvic region, serving both men and women. This includes managing symptoms such as urinary or fecal urgency and incontinence, issues like pelvic organ prolapse, and various forms of pelvic pain—including discomfort associated with the coccyx, pubic bone, and during sexual activity. Additionally, it's beneficial for those experiencing complications from Cesarean sections, episiotomies, chronic constipation, and non-bacterial prostatitis. Moreover, pelvic floor disorders often correlate with other bodily pains, including those affecting the lower back, sacroiliac joint, hips, limbs, as well as the head, neck, and jaw.

At Harmony Physiotherapy, our approach to treatment is holistic and comprehensive, incorporating educational insights, correct positioning, and exercises aimed at enhancing strength and coordination. Our methods extend beyond the standard Kegel exercises to include a variety of functional movements, stretching, myofascial release, manual therapy, and pelvic alignment techniques, supplemented by biofeedback for visualization. Our experienced pelvic floor physiotherapists employ these techniques in both internal (vaginal and ano-rectal) and external treatments, tailored to address and resolve the unique challenges of each patient.

Can I Attend Pelvic Floor Physiotherapy During My Menstrual Cycle?

Yes, you can receive pelvic floor treatment during your menstrual cycle at Harmony Physiotherapy. Hygienic protocols are strictly followed, ensuring comfort and safety.

Is Pelvic Floor Physiotherapy Safe During Pregnancy?

Pelvic floor physiotherapy is highly beneficial during pregnancy, effectively alleviating common discomforts such as pelvic girdle pain, pain in the pubic bone, groin, coccyx, and lower back. Additionally, it helps in preparing the pelvic floor for labor by enhancing flexibility, which can reduce the likelihood of tearing or the need for an episiotomy during delivery.

For those with a healthy and normal pregnancy, undergoing an internal pelvic assessment or treatment poses no risks to either the mother or the baby. However, if you have a high-risk pregnancy and are under specific medical orders such as avoiding intercourse or requiring bed rest, it is advised to forego internal assessments and opt for general external physiotherapy treatments instead.

Postpartum Pelvic Floor Physiotherapy: When to Start?

It is generally best to begin pelvic floor physiotherapy as soon as you feel able after delivery, though the exact timing can depend on your specific circumstances and the nature of your delivery. For those who have had a Cesarean section, it's advisable to wait until the surgical incision has healed—typically around 4 to 6 weeks—to begin treatments involving the abdomen or scars. Similarly, if you've had an episiotomy, allowing a few weeks for the incision to heal before starting internal pelvic treatments is recommended. However, if you are experiencing significant pain, it's important to seek treatment promptly as many strategies can be employed that do not aggravate healing areas, effectively easing pain and aiding in faster recovery.

How Can Pelvic Floor Physiotherapy Enhance Fertility?

While physiotherapy does not address hormonal imbalances, reproductive cell issues, or certain medical conditions directly, it is highly effective in managing structural and mechanical problems that may affect fertility. Conditions like abnormal inflammatory responses, adhesions, scar tissue, as well as misalignments and poor circulation in the cervical and uterine areas, can all be effectively treated through manual therapy.

The connective tissues, or fascia, that support and surround the reproductive organs play a crucial role in reproductive health. By applying targeted manual techniques to these tissues, pelvic floor physiotherapists can enhance organ function and potentially improve outcomes related to conception and pregnancy maintenance.

Do I Need a Referral for Pelvic Floor Physiotherapy?

No referral is needed to see a pelvic floor physiotherapist at Harmony Physiotherapy. However, check with your insurance provider as some require a physician's referral for reimbursement.

Does Insurance cover Pelvic Floor Physiotherapy?

At Harmony Physiotherapy Pelvic floor physiotherapy is typically covered under private insurance plans but is not covered by OHIP. Please verify with your insurance provider for specific coverage details.

How Many Treatments Will I Need?

Treatment frequency and duration vary based on individual conditions and response to therapy. Generally, follow-up appointments are scheduled every 1-2  weeks with a treatment range of 6 to 12 sessions. This will be discussed with you on your first visit following the assessment.

I am making a Motor Vehicle or workplace injury (WSIB) claim. What do I need to do?

If you are involved in a motor vehicle accident, it's crucial to seek physiotherapy assessment as quickly as possible, even if you initially feel fine. Symptoms often surface days or weeks after an accident, and early physiotherapy intervention can significantly improve your recovery and reduce the likelihood of long-term complications.

Here’s what you need to do:

1. Report the Accident: First, ensure that you report the accident to your insurance company.

2. Book Your Assessment: Call Harmony Physiotherapy to schedule your assessment. Please inform our reception team that your visit concerns a motor vehicle accident claim. This will help us prepare for your visit and advise you on any specific documentation required from your insurance provider.

3. Payment Information: Please note that Harmony Physiotherapy does not bill insurance companies directly for motor vehicle accident claims. You will need to manage payments at each visit and seek reimbursement from your insurer.

This proactive approach helps us address any issues early, supporting a smoother and more effective recovery process.

For WSIB claims, please report the incident to your insurer and contact us to book your assessment. Note that payments are processed per visit.

Disclaimer:

This information is for educational purposes only and not intended as medical advice. For specific concerns, please consult a qualified healthcare professional.