“You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it.”

— Maya Angelou

Frequently asked questions.

Is pelvic physiotherapy only for women?

 

Pelvic physiotherapy is available to all genders. If you have a concern, we are here to help.

 

Is an internal pelvic exam necessary?

 

Most people would benefit from a pelvic exam if they are experiencing any incontinence, pain with sex, chronic pelvic pain, etc. However, this only occurs after a lengthy discussion about consent. If this is something that makes you uncomfortable, discuss this with your therapist. There are always alternatives that can be explored if a pelvic exam is not wanted.

 

What can I expect during a pelvic health initial exam?

 

A lot of talking. The majority of the first appointment is taken up with a thorough history taking and discussion about your concerns so that the therapist can have a good understanding of your situation. There may also be discussion about constipation, fluid and fibre norms, proper toileting practices, etc. After that, an external physical exam will be conducted and will focus on the thoracic and lumbar spines, abdomen, pelvis, hips and knees. Range of motion, muscle length, muscle balance, joint mobility and functional strength may be examined. Time permitting and with consent, an internal pelvic exam may or may not be completed during the initial assessment. This depends on the clients’ complaints and wishes.

Once the assessment is completed, a treatment will conclude the appointment and some exercise will be prescribed. Questions can be answered throughout the appointment.

If there is something that you absolutely want addressed during the initial assessment, please let the therapist know immediately upon commencing the appointment.

Do you have experience treating survivors of sexual violence?

 

Unfortunately, approximately 1 in 3 women and 1 in 6 men will experience sexual violence at some point in their lifetime. This is something that we hear about from our clients very often. If you require assistance with the recovery from violence or assault, we are here to help. If you suffer from pelvic pain but are uncomfortable with an internal exam please discuss this with your therapist so that alternatives that fit your comfort level can be explored.

Statistics source: https://carleton.ca/sexual-violence-support/what-is-sexual-assault/getting-the-facts/

Need help? https://www.ontario.ca/page/sexual-violence

 

I am a man seeking pelvic physiotherapy. Is this common?

 

YES! Common symptoms that we treat are: testicular pain, penile pain, pain with erections or post ejaculation, urinary urgency, stress incontinence, post void dribble, rectal pain, and feeling like you are sitting on a golf ball. These individuals have often been suffering for years before commencing pelvic physiotherapy and THEY DO GREAT!

 

I am pregnant. What are the benefits of pelvic physiotherapy?

 

Research shows that pelvic physiotherapy can help to reduce the second stage of labour, reduce peri- and postpartum incontinence and assist with recovery postpartum. Pelvic physiotherapy for pain, incontinence, or just prophylactic treatment, can commence anytime after the first trimester and with overseeing obstetrician or midwife’s approval.

What are the risks to a pelvic exam?

 

A pelvic exam involves the insertion of a gloved finger vaginally or rectally (dependent on gender and comfort level) to assess the pelvic floor muscles.

There are four risks to a pelvic exam regardless of gender:

  1. a risk of pain - if a muscle is tight or tissue is irritated this can cause some discomfort with touch. If this occurs, please tell the therapist so that they can adjust their pressure. Some discomfort is to be expected but it should not be painful.

  2. a risk of spotting - this can occur in women who are breastfeeding or women who are post-menopausal. This may also occur if a rectal exam occurs and there is an internal fissure or hemorrhoid that is irritated. Some light spotting is not a major concern but should be monitored. If bleeding lasts for more than 24 hours or becomes heavy, immediate medical attention should be sought. This rarely occurs and is usually associated with the presence of an unknown fissure.

  3. a risk of skin reaction to the lubricant used - though uncommon, some individuals with sensitive skin or certain skin conditions may react to the lubricant causing a burning sensation. If this is noted, the lubricant can be wiped off immediately and a different lubricant can be used.

  4. a risk of being triggered - individuals who have a history of sexual assault/violence may be triggered by a pelvic exam. Therapists are trained to recognized signs of being triggered and will stop the exam immediately if it is requested or an individual begins to show these signs. If you are concerned about being triggered by a pelvic exam, please discuss this with your therapist.

 

What are the contraindicatons of a pelvic exam?

 

A pelvic exam cannot be completed in the following scenarios:

  • consent is not obtained

  • an active local infection (for example, a sexually transmitted disease, a urinary tract infection, a yeast infection, etc)

  • less than 12 weeks post hysterectomy, prolapse repair surgery, or gender reassignment surgery

  • less than 6 weeks postpartum

  • current local cancer

  • brachytherapy or internal radiation therapy

  • unexplained vaginal or rectal bleeding

  • high risk pregnancy where a physician has told the client to abstain from intercourse

 

Can I still have a pelvic exam if I am on my period?

 

Yes. The therapist will be using gloves throughout the exam so it does not influence assessment or treatment. It entirely depends on your comfort level. If this makes you uncomfortable, please discuss this with your therapist and your appointments can be booked around your menses.