Physiotherapy and Pelvic Health

What is Pelvic health physiotherapy?

Pelvic health physiotherapy involves a full body approach.  The assessment includes a detailed verbal history, looking at your overall movement-both upper and lower extremity, strength, function and an internal pelvic floor examination. Assessment of the internal structures of the pelvic floor muscles is the gold standard to determine the function of the muscles. Research has concluded that Physiotherapists with specialized training in pelvic floor rehabilitation, using internal examination to teach the exercises, should be the first line of defence, before surgical consultation, for all types of bladder leakage in women.

Pelvic health physiotherapists also provide specialized care for the following:

All your prenataland postnatal concerns, leaking urine or stool, chronic pelvic pain, pelvic girdle pain, back/hip pain, pelvic organ prolapse, painful sex (dysparenia), back pain/hip pain, Rectus Diastasisabdominus, general core restoration, female athletes, pediatric bladder and bowel concerns, pre/post caesarean section/any type of abdominal surgery,interstitial cystitis, endometriosis, overactive bladder and chronic constipation and all general orthopedic problems- hips, back, knees, ankle, foot, shoulder, neck, wrist and hand!

Treatment plans are customized for each patient focusing on retraining the pelvic floor muscles as well as working on the rest of your improving movement patterns.   Treatment includes education, breathing techniques (Hypopressives), birth prep, postpartum care, postural retraining, manual therapy, stretching/strengthening, behavioral training and acupuncture. 

Frequently Asked Questions

Should I come for Pelvic Floor Physical Therapy during my pregnancy?

Yes, I recommend 3 visits prior to birth.   The Preparation Program schedule will be at 28, 32 and 36 weeks gestation.

The assessment will focus on overall mobility and function, bladder/bowel habits and assessing your pelvic floor/core connection.  An internal pelvic check can be done at this time depending on your ultrasound results - placental position and pregnancy history.

Subsequent visits will focus on practicing birth positions, breathing/pushing, perineal preparation, exercises for pelvic/core recovery and discussing early post natal care for mama.

Many pregnant women are undertreated in pregnancy and left to struggle with dysfunction (bladder, bowel, painful sex, pelvic pain)  I welcome mamas to come in any point during their pregnancy for their pregnancy related concerns!!

When should I come to physiotherapy after my baby is born?

I recommend all moms have a pelvic health assessment following the birth of their baby at 6 weeks post partum.   Women can access care earlier if they have specific concerns they want to address. At this time, overall mobility/function will be assessed along with your pelvic floor/core function, bladder/bowel/sexual health and recommendations for safe return to activity and sport.

Early postnatal intervention is shown to decrease the development of pelvic floor dysfunction and for bladder/bowel problems in the future. Prevention is key!

How many visits will I need?

Consistency to a program is what will produce long term results!  Maintenance of good pelvic health (bladder, bowel, menstrual, sexual) and how it relates to overall body function is a lifelong journey!

Client Testimonials - What Ladies Are Saying

Vanessa is the best! She helped me so much! 16 months of recovery after my first son. She brought me back to normal! - Tara B.

Vanessa at Shifra is wonderful - Katrina O.

Vanessa at Shifra has been amazing for me. I sought out care because of a prolapse issue. Physiotherapy can do wonders, but you have to do the work! I was SUPER motivated and did all my exercises diligently at the beginning... within 5 months I was jumping on the trampoline with my niece for an hour without any pee-ing issues or anything. I was amazed because I'd been told by lots of moms that I would never jump on a trampoline again after kids. When I get lazy with the exercises, (my youngest is 3 years old)  I notice a difference.  Stick with it momma and don't be afraid to ask for second opinions if you come across a doctor who brushes off your concerns.  It's your body and can defend it!!! -  Suzi M.

Vanessa at Shifra was awesome! Shes straightforward and excellent at explaining whats happening and how to work through it! Like anything, you have to be willing to do the work, but it is so worth it! I always feared that after having kids I would be doomed to running to the bathroom in a panic or never be able to laugh or sneeze without leaking- now, I do all these things with freedom!!! - Naomi R.

I had heard of Pelvic health physiotherapy, but never bothered to go for an assessment.   After an information night I learned about how important pelvic physiotherapy can be. After having two kids I can definitely say it is important to take care of our bodies and a lot starts with your pelvic health. Vanessa is amazing at what she does and has taught me a lot.  Some subjects are hard to talk about like bladder control when you sneeze or jump. I learned that Iwasn't using my pelvic floor muscles properly and she taught me how to find them. If you have and questions, she can help you. It is so worth it!!!

I had the priviledge of being a patient of Vanessas in 2018 after the delivery of my daughter.  As someone who greatly values daily physical activity it was important for me to stay active during pregnancy and to make a slow and safe return to the activities that I love postpartum.  During this process I made an appointment with Vanessa for a pelvic floor assessment to see how my recovery from delivery was going.  Working with Vanessa was a comfortable and incredibly enlightening experience.  Her friendly and welcoming personality, paired with her knowledge and ability to translate it during an appointment were appreciated.  As a certified exercise physiologist I have taken many courses and workshops on functional movement but Vanessa elevated that and taught me so much more.  From breathing to rotation, core connection and posture to core control and stability, all of it was informative and practical.  I am now almost two years postpartum and am thankful for the treatment I received from Vanessa and continue to reap the benefits as I remain active with my family. I would strongly encourage all women see Vanessa during their pregnancy and postpartum journey. - Ashley F.

Vanessa’s skill and care were instrumental in helping me through a difficult postpartum experience with pelvic floor prolapse and diastasis recti. Starting with her thoughtful and respectful approach working with postpartum moms (and welcoming babies into the clinic with open arms), she is completely invested in, and attentive to your every concern. With Vanessa’s guidance in re-programming my core and pelvic floor through my breath, mind, and muscle, I’ve progressed from just gentle 15 minute walks to hiking up mountains, hard strength training, and deep yoga practice. Vanessa has empowered me with skills that allow me to reclaim ownership and awareness of how my body moves. I simply can’t say enough about the life-changing impact of our work together.   J.D.

Exciting news!!!

I am now a Röst Trained therapist.  During pregnancy many women struggle with pelvic girdle pain.  It can be either pain at the sacroiliac joint (SI joint) or symphysis pubis.  Pelvic girdle pain whether you are pregnant or not CAN respond well to this therapy! 

Treatment includes; hands on treatment to improve pelvic girdle symmetry and muscle function, followed by a home exercise program to balance joints and muscle patterns.  It is an active approach where women learn how their posture and movements can manage their symptoms and function.  Röst therapy is effective, with quick and lasting results.