What we treat
People suffering from Pelvic Floor (PF) dysfunctions see on average three medical doctors, including specialists, before they are referred to Pelvic Health (PH) Physiotherapy. PH Physiotherapists treat a large array of pelvic floor dysfunctions, including conditions that directly involve the PF muscles such as vulvodynia, vaginismus, dyspareunia, chronic prostatitis, interstitial cystitis, coccydynia, enuresis and childhood encopresis, stress, urge and mixed incontinence, pelvic organ prolapse and more. Also, they treat conditions that involve other parts of the body but have a pelvic floor muscle component such as piriformis syndrome, unresolved low back pain and/or hip pain when other pathologies have been ruled out.
According to the assessment of the PF muscles we can separate the PF dysfunctions into three major groups:
1. Tide and short PF muscles cause painful symptoms: such as chronic pelvic pain, abdominal pain, dyspareunia, testicular pain, vaginismus and more
2. Weak and loose PF muscles may cause stress urinary incontinence and prolapse
3. Combination of weak but tide PF muscles may cause both: stress incontinence, prolapse and a variety of pelvic pain symptoms
While treating pelvic floor pathologies, the intimate location of the pelvic floor and its impact on the bio-psycho-social wellbeing of the individual should be taken into consideration. Approximately, 1 in 8 people (male and female) hold their stress in the pelvis. When this persists, it can lead to pelvic pain, an overactive bladder, urge urinary incontinence, vulvodynia, clitorodynia, dyspareunia and more.
In Europe, PH Physiotherapy has been practiced for about 7 decades for the treatment of Stress Urinary Incontinence. It wasn’t until the 1990’s that a group of American Urologists and Physiotherapists came up with the concept of treating short, tight and painful PF muscles by manually releasing the trigger points and the muscle fascia.
There is a sufficient evidence (Level 1, Grade A) in support of the treatment of urinary incontinence with PH Physiotherapy. The Cochrane Collaboration 2010 concluded that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to retrain the pelvic floor muscles) should be the first line of defense before surgical consultation, for stress, urge and mixed incontinence in women.
However, to date there is no conclusive evidence about the effectiveness of PH Physiotherapy alone while treating painful pelvic conditions. Our experience has shown that a more holistic, integrated approach is needed in the successful treatment of these patients.
Consultation with PH Physiotherapist should be the golden rule for each woman pre-conception, during pregnancy and post-partum.
At Beyond Physio we treat male, female and pediatric patients. When appropriate, we use an internal exam to assess and treat adults. Although, we have been trained in pediatric PH Physiotherapy, we do not perform internal exams with our pediatric patients. We believe that in some cases this might cause more damage than good. Instead, we successfully use Traditional Chinese Medicine techniques such as moxa on ginger (see picture), auricular medicine and manual therapy to treat pediatric enuresis.
