Pelvic Floor Physiotherapy in Calgary: What It Is and How to Find the Right Fit

If you are experiencing pelvic pain, incontinence, or are recovering after childbirth, you might be looking for ways to improve your symptoms. Pelvic floor physiotherapy is a specialized type of physiotherapy that focuses on the muscles, ligaments, and connective tissues in your pelvic area. It can help address a range of conditions affecting both men and women.

This guide will explain what pelvic floor physiotherapy involves, what the evidence says, and how to find a qualified professional in Calgary.

What Pelvic Floor Physiotherapy Addresses

Pelvic floor physiotherapy helps with conditions related to the pelvic floor muscles. These muscles support your bladder, bowel, and uterus (in women). They play a role in bladder and bowel control, sexual function, and core stability. When these muscles are too weak, too tight, or not working correctly, various issues can arise.

Common reasons people seek pelvic floor physiotherapy include:

• Urinary Incontinence: This involves involuntary leakage of urine. It can happen when you cough, sneeze, laugh, or exercise (stress incontinence), or when you have a sudden, strong urge to urinate (urgency incontinence).
• Fecal Incontinence: This is the involuntary leakage of stool or gas.
• Pelvic Pain: This can be chronic pain in the pelvic area, which might include pain during intercourse, bladder pain, or pain in the tailbone.
• Postpartum Recovery: After childbirth, many women experience changes in their pelvic floor strength and function. Physiotherapy can help with recovery, addressing issues like incontinence, pelvic organ prolapse, and pain.
• Pregnancy Support: Physiotherapy can help prepare the pelvic floor for childbirth and manage discomfort during pregnancy.
• Prostate Surgery Recovery: For men, pelvic floor physiotherapy can be important for recovery after prostate surgery, especially for managing urinary incontinence.

How Pelvic Floor Muscle Training Can Help

Pelvic floor muscle training (PFMT) is a key part of pelvic floor physiotherapy. Research shows that PFMT can be an effective treatment for certain types of incontinence.

For women with urinary incontinence, PFMT has shown meaningful benefits in trials. (A wording note: "cure" in these studies is the trials' own outcome category — women reporting their leakage had resolved during the study — not a promise about any individual's result.) * Women with stress urinary incontinence (SUI) who underwent PFMT were eight times more likely to report their symptoms had resolved compared to those with no treatment or inactive control treatments (56% versus 6%) [1]. * For women with any type of urinary incontinence, PFMT groups were five times more likely to report resolution (35% versus 6%) [1]. * The likelihood of reporting resolution or improvement was also higher. Women with SUI in PFMT groups were six times more likely to report it (74% versus 11%) [1]. For any type of urinary incontinence, PFMT groups were two times more likely to report resolution or improvement (67% versus 29%) [1]. * PFMT also led to a reduction in leakage episodes, by about one episode less in 24 hours for women with SUI and for those with all types of urinary incontinence [1]. * Women undergoing PFMT were more likely to report significant improvement in urinary incontinence symptoms and quality of life [1].

For women who are pregnant or have recently given birth, PFMT can also be beneficial: * Continent pregnant women who performed antenatal PFMT probably had a lower risk of reporting urinary incontinence in late pregnancy (62% less) and slightly decreased the risk in the mid-postnatal period (more than three to six months postpartum, 29% less) compared to usual care [2]. * In a mixed group of women (with or without urinary incontinence), antenatal PFMT probably decreased the risk of urinary incontinence in late pregnancy (22% less) and may slightly reduce the risk in the mid-postnatal period [2]. * One study reported that two out of 43 pregnant women performing PFMT for prevention of incontinence experienced pelvic floor pain, but no other trials reported adverse effects [2].

It is important to note that the effectiveness of PFMT can vary depending on the specific condition and individual circumstances. For instance, there was no evidence that antenatal PFMT in incontinent women decreased incontinence in late pregnancy or the mid- or late postnatal periods [2]. Similarly, for postnatal women with persistent urinary incontinence, it was uncertain if PFMT made a difference at more than six to 12 months postpartum [2].

What to Expect at Your First Visit

Your first appointment with a pelvic floor physiotherapist in Calgary will typically involve a thorough assessment. This helps the physiotherapist understand your specific concerns and create a personalized treatment plan.

Here's what you can generally expect:

1. Detailed History: The physiotherapist will ask you many questions about your medical history, symptoms, lifestyle, and goals. This might include questions about your bladder and bowel habits, pain, sexual health, and any previous pregnancies or surgeries.
2. Physical Assessment: This usually includes an external examination to look at your posture, breathing patterns, and how your core muscles are working. The physiotherapist may also assess your hip and lower back mobility, as these areas can influence pelvic floor function.
3. Internal Pelvic Examination (Optional and Consent-Based): For many pelvic floor conditions, an internal examination is the most effective way for the physiotherapist to assess the strength, tension, and coordination of your pelvic floor muscles. This is always done with your explicit consent.
   • You are in control: You have the right to ask questions at any point during the examination. You can decline any part of the assessment or stop it at any time if you feel uncomfortable.
   • What it involves: If you consent, the physiotherapist will typically use a gloved finger to gently assess the muscles through the vagina (for women) or rectum (for men and women). They will check for muscle strength, tenderness, and how well you can contract and relax the muscles.
   • No speculum is used: Unlike a gynecological exam, a speculum is not used in a pelvic floor physiotherapy internal exam.
4. Education and Treatment Plan: After the assessment, the physiotherapist will explain their findings in clear, easy-to-understand language. They will then discuss a proposed treatment plan, which might include:
   • Specific exercises for your pelvic floor muscles (like Kegels, but often more targeted).
   • Breathing techniques.
   • Posture corrections.
   • Manual therapy (hands-on techniques to release tight muscles).
   • Education on bladder and bowel habits, diet, and lifestyle changes.
   • Home exercise program.

The goal is to empower you with knowledge and tools to manage your condition and improve your quality of life.

Finding a Pelvic Floor Physiotherapist in Calgary

Pelvic health is a specialized area of practice within physiotherapy. It is not a separate license or designation. All physiotherapists in Alberta are regulated by the College of Physiotherapists of Alberta (CPTA) [3]. This means they must meet specific education and practice standards.

When looking for a pelvic floor physiotherapist in Calgary, consider these points:

• Verify Registration: You can confirm that a physiotherapist is registered and in good standing by checking with the College of Physiotherapists of Alberta [3].
• Ask About Post-Graduate Training: Since pelvic health is a specialty, it's important to find a physiotherapist who has completed specific post-graduate training in this area. Don't hesitate to ask clinics or practitioners about their advanced education and experience in pelvic health.
• Inquire About Equipment: Some clinics may use specialized equipment, such as biofeedback devices or electrical stimulation, to help patients learn to activate or relax their pelvic floor muscles. Ask if these are part of their approach if you are interested.
• Comfort and Communication: It's important to feel comfortable with your physiotherapist, especially given the sensitive nature of pelvic health. Look for someone who communicates clearly, listens to your concerns, and respects your boundaries.

You can start your search by exploring physiotherapy clinics in Calgary that offer pelvic health services. For more general advice on choosing a physiotherapist, you can read our guide on how to choose a physiotherapist. To find clinics in Calgary, visit our Calgary physiotherapy hub.

Pelvic Floor Physiotherapy for Men

While often associated with women's health, pelvic floor physiotherapy is also valuable for men. Men have pelvic floor muscles that can become dysfunctional, leading to various symptoms.

Common reasons men seek pelvic floor physiotherapy include:

• Pelvic Pain: Chronic pelvic pain in men can manifest as pain in the perineum, groin, testicles, or during urination or ejaculation. This can often be related to muscle tension or dysfunction in the pelvic floor.
• Post-Prostatectomy Care: After prostate surgery (prostatectomy), many men experience urinary incontinence. Pelvic floor physiotherapy can help strengthen the muscles to improve bladder control and support recovery.
• Erectile Dysfunction: In some cases, pelvic floor muscle dysfunction can contribute to erectile difficulties.
• Bowel Dysfunction: Similar to women, men can experience issues like constipation or fecal incontinence related to pelvic floor muscles.

The assessment and treatment principles for men are similar to those for women, focusing on education, exercises, and manual therapy tailored to the individual's needs.

Benefits and How to Access Care

The best-evidenced outcome of pelvic floor physiotherapy is improved bladder control, as the research above shows [1][2]. Beyond that, treatment aims patients commonly discuss with their physiotherapist include:

• Better bowel control.
• Reduced pelvic pain.
• Sexual function concerns.
• Core stability.
• Recovery after childbirth or surgery.

Whether these goals fit your situation — and what progress is realistic — is exactly what the assessment is for.

In Alberta, you can typically access physiotherapy services directly without a doctor's referral. However, some extended health insurance plans may require a referral from a physician for coverage. It's always a good idea to check with your insurance provider about your specific plan details. If you have a complex medical history or other health concerns, speaking with your doctor before starting physiotherapy can also be helpful. A licensed physiotherapist can assess whether this type of treatment is suitable for your situation.

The Bottom Line

Pelvic floor physiotherapy offers a targeted approach to managing a range of conditions that can significantly impact your daily life. From addressing incontinence and pelvic pain to supporting recovery after childbirth or surgery, this specialized care focuses on the crucial muscles of your pelvic floor. By understanding what to expect and how to find a qualified professional in Calgary, you can take a proactive step towards improving your pelvic health and overall well-being.

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