If you are having issues with incontinence or pelvic pain, you are not alone!!

Urinary incontinence is a significant issue which is not discussed nearly enough. With an estimated 1 in 3 women experiencing some form of bladder dysfunction in their lifetime, it is time for us to start talking about it.  Incontinence and pelvic floor dysfunction is NOT a normal process of aging and the good news is that there is treatment available to help you. 

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An estimated 32 million adults have issues with incontinence. Up to 32% of women will experience some sort of incontinence issue in their lifetime.
— Harvard Health Publishing

What is the pelvic floor?

The pelvic floor is part of your core ...

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Your pelvic floor muscles are a group of muscles which make up the bottom portion of your core muscle system. Your core muscle system is like a cube which consists of your deep abdominal muscles on the front, your deep low back muscles on the back, your diaphragm at the top and your pelvic floor muscles on the bottom. When all of these muscles are working well together, they will protect your low back, stabilize your pelvis, and ensure normal bowel and bladder function.


The pelvic floor is like a trampoline...

Think of the pelvic floor muscles like a trampoline. The pelvic floor is made up of a number of muscles which run from your pubic bone on the front to your coccyx (tail-bone) at the back. Piercing through the middle of this trampoline are very important end organs including your urethra, vagina and rectum. Above this trampoline are your bladder, bowel and uterus. 

The job of the pelvic floor is to support and hold these organs in the correct place. When you cough, sneeze, jump, or run, there is a downward force on your bladder, bowel and uterus which pushes down on the pelvic floor similar to when a person jumps on a trampoline. Much like a trampoline, the pelvic floor reduces the downward force and helps organs return to their intended location. The pelvic floor has an added function of helping to close your urethra and bowel, ensuring that you have no unwanted leakage and, on the flip side, relaxing when it needs to to ensure you can go to the bathroom unhindered. The pelvic floor also helps strengthen your vaginal wall which is
linked with sexual satisfaction.

Who is at risk for pelvic floor dysfunction?

Although incontinence is most common in women who have had babies, it can happen to women or men of any age. Risk factors commonly associated with pelvic floor dysfunction include:

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  • pregnancy (both pre-natal and post-natal women)

  • menopause

  • obesity

  • urinary tract infections

  • constipation

  • surgery such as hysterectomy (removal of all or part of the uterus and/or ovaries)

  • reduced mobility preventing you from getting to or using the toilet

  • neurological and musculoskeletal conditions such as multiple sclerosis and arthritis

  • health conditions such as diabetes, stroke, heart conditions, respiratory conditions, and prostate problems, and

  • some medications

What happens when the pelvic floor is not functioning properly?

Pelvic floor dysfunction can lead to a variety of disorders including:

  • Stress Incontinence

    • Stress incontinence is the most common urinary incontinence issue. Coughing, sneezing, laughing, walking, running, or most extremely jumping on a trampoline, all create a downward force on your bladder, uterus and bowel. If your pelvic muscles are weak, they are unable to prevent this downward motion and they do not hold your urethra or bowel closed sufficiently, resulting in leakage.

  • Urge Incontinence

    • Do you ever abruptly feel that you must pee so badly that you might pee your pants, even though you don’t think your bladder should be full yet? If so, you may have urge incontinence, also referred to as overactive bladder. Normally, your bladder remains relaxed until it is full and, when you are comfortably sitting on a toilet, your bladder then contracts to push urine out so you can go to the bathroom. With urge incontinence, your bladder contracts too early, kind of like a muscle would spasm, and this contraction pushes urine outward, requiring a very strong contraction of your pelvic floor muscles to stop any leakage.

  • Pelvic Pain

    • Pelvic pain is a complicated problem which can significantly impact sexual satisfaction and quality of life. Overuse and chronic tension in your pelvic floor muscles or adhesion in the muscles or connective tissue in your pelvic region can result in pelvic pain.

  •  Prolapse

    • Your bladder, uterus or bowel are held up by ligaments, fascia and your pelvic floor muscles. If the tissue becomes stretched and your pelvic floor muscles are weakened, your pelvic organs may bulge or sag into your vagina. If you have prolapse you may feel a heaviness or sense that something is bulging into or protruding out of your vagina.  

  • Rectus Diastasis

    • Rectus Diastasis is a separation in the rectus abdominis, or your ‘six-pack’ muscles, which occurs when belly expansion increases intra-abdominal pressure. This separation weakens the abdominal wall and reduces the effectiveness of your pelvic floor contraction. This can lead to incontinence, prolapse and low back pain.

How can our Physiotherapists help?

Our Pelvic Health Physiotherapists have specialized, post-graduate training in the assessment and treatment of pelvic floor disorders. 

Using external and internal techniques, our Physiotherapists will assess:

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  • lifestyle, dietary, and toileting habits which may impact continence

  • tension, strength and endurance of your pelvic floor muscles

  • adhesion or trigger points in pelvic floor musculature

  • for any signs of uterine, bladder, or rectal prolapse

  • rectus diastasis assessment

  • evaluate low back and sacroiliac function, joint mobility, and myofascial tone/adhesion

  • strength of core including transversus abdominus, multifidus and diaphragm muscles

Pelvic Floor treatment from our Physiotherapists may include:

  • education and re-training of pelvic floor muscles

  • pre and post-natal pelvic floor, postural and core strengthening education

  • rectus diastasis rehabilitation

  • education regarding usage of the Elvie, an affordable home biofeedback unit that promotes independence in your strengthening program

  • pelvic floor myofascial release techniques

  • self-myofascial release techniques

  • postural re-education with the goal of maximizing pelvic floor function

  • strengthening of all core musculature

  • treatment of any identified low back or sacroiliac dysfunction

  • education regarding dietary, lifestyle and toileting habits which will minimize risk and maximize function of your pelvic floor

  • collaboration with extended healthcare team including urologists, gynecologists and family physicians

For more information or to book an appointment, please call Resolution Physiotherapy at 705-252-5200.

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