Pregnancy, birth and parenting is different for all of us.
Contrary to popular belief, you don’t need to live with incontinence, pelvic pain and low back pain as a side effect of motherhood. If you’re experiencing bladder control issues or pelvic floor pain when you sneeze, cough, or in the middle of your fitness routine, Oona in Toronto and Newmarket can help.
Pelvic floor physiotherapy treatments address the pain and discomfort associated with weak or imbalanced pelvic floor muscles. Even if you’ve been doing your Kegel exercises on a regular basis, you might still have trouble with lower back pain or abdominal pain or discomfort during sex. That’s where we come in.
Pelvic Floor Physio for Pregnancy and Postpartum
Pelvic Floor Physiotherapy During Pregnancy
Until we tell them, many of our patients are unaware that pelvic floor physiotherapy is useful during pregnancy.
While you may not have any incontinence, you may find that your entire pelvic area (inside and out) just feels different than it used to. Perhaps sex doesn’t feel the same as it did before you got pregnant. Maybe you are getting up to pee a few too many times every night. (FYI more than 3x/night while pregnant is too many times!)
In addition, many of our patients don’t realize that prepping the pelvic floor for delivery is just as important as taking a childbirth education class, learning effective breathing techniques for labour and making a good birth plan.
Birth is complex - Pelvic Floor Physio can help make it easier
In a vaginal birth, your baby’s head descends through the pelvis to the pelvic floor and then rotates on the pelvic floor to get out of the mother’s body.
Beyond helping you with uncomfortable pregnancy symptoms, pelvic floor physiotherapy can help you have a balanced pelvic floor for a smoother and easier delivery.
During your prenatal treatments your pelvic floor physiotherapist can teach you optimal pushing practices, the basics of perineal massage, and teach you birthing techniques for a better and more efficient birth.
We recommend that every pregnant person visit the pelvic floor physio, before their baby is born – ideally between weeks 28-32 to start, but it’s never too late to get started. If you are experiencing symptoms like incontinence, come in as soon as you can – no need to wait.
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Postnatal Pelvic Floor Physiotherapy
Pelvic Floor Physiotherapy is essential after your baby is born
Pregnancy and birth – whether vaginal or surgical – causes trauma to the pelvic muscles, and much like if you had any other kind of muscle trauma, you need some rehab for your pelvic floor.
Peeing even a single drop while you sneeze/cough/laugh/jump, pain during sex, a feeling of “fullness” in the pelvis, chronic low back pain; these are all signs that you need a pelvic floor physiotherapist in Newmarket and Toronto.
Pelvic Floor Physiotherapy is appropriate for all postpartum patients – no matter how long ago you had your baby. Whether it’s been 6 weeks or 20 years since you had your first child, Pelvic Floor Physiotherapy is for you.
Even with a caesarean delivery, Pelvic Floor Physiotherapy is essential
The weight of your baby, fluid, placenta and uterus, all put strain on your pelvic floor. Even if you feel great after having a baby, we always recommend that you book a Pelvic Floor Physiotherapy appointment so you have a baseline as you age, and it’s absolutely essential before you plan to have another baby. A pelvic floor specialist can help.
Before returning to any kind of exercise or activity after birth, visit a Pelvic Floor Physiotherapist to assess your core function to ensure that your activities are appropriate for you.
Pelvic Floor Physiotherapy Treatments
Pelvic Floor Physiotherapy treatments in Newmarket and Toronto can prevent and/or treat:
- Incontinence and bladder control issues
- Low back pain
- Pelvic pain and discomfort
- Hip Pain
- Pain turning over in bed
- Abdominal pain
- Caesarean section (c-section) scarring
- Episiotomy and tearing complaints
- Pain during or after postpartum sexual intercourse
- Diastasis Rectus Abdominus
Start your journey with Oona
Book your pelvic floor physiotherapy appointment now
Your First Pelvic Floor Physiotherapy Visit
First and foremost, we take a very thorough history to get a clear idea of what your pelvic history (prior to pregnancy) was like.
For example: have you ever leaked while doing crossfit? Do you have a history of chronic pelvic pain? Has sex ever been painful? Has everything always felt perfect? These are all useful questions.
Moving on, we get to your current symptoms are, if you have any. For example: are you getting up to pee more than 3 times per night? Do you have a feeling of fullness in your pelvis? Do you leak a little when you aren’t on the toilet trying to pee? Do you feel like you maybe can’t quite make it to the bathroom on time?
We go through a very thorough explanation of and assessment of the pelvic floor.
For those that are unfamiliar, your pelvic floor consists of the muscles inside your pelvis.
After explaining what is about to happen, your Pelvic Floor Physiotherapist will move on to an assessment. Your first visit may or may not include an internal exam of your pelvic floor muscles. Don’t worry, if an internal exam isn’t for you, we can always start externally and see what we can do that way first.
It’s nothing at all like a pap smear; there’s no stirrups, no speculum, no one staring at your lady bits. Our experienced physios are experts at making you feel comfortable through the entire process.
Finally, your Pelvic Floor Physio will treat your pelvic floor and surrounding musculature
Treatment is similar to just about any other physiotherapy treatment in Newmarket and Toronto. We perform muscle testing to determine the strength of your pelvic contraction, then assess for areas of tension and tightness in your pelvic floor. We also look for muscle knots and trigger points that might cause dysfunction and pain. If your pain is a bit more complex than that or if there are other factors at play other than purely mechanical factors that are causing your pain, those will also be addressed.
If you are preparing for birth, your physio will very likely give you tips on proper pushing technique and instruct you on perineal massage, if that is of interest to you.
Like all other physiotherapy treatments, you will be sent home with an individualized home exercise program to work on goals for your treatment. This may include pelvic contractions, chiropractic stretches, abdominal work, and relaxation techniques.
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Commonly Asked Questions About Pelvic Floor Physio
The physiotherapist will start by getting a detailed health history. This will include discussions around your bowel and bladder function, if you experience discomfort or pain with intercourse, your pregnancy, labour, and delivery history, what activities/exercises you enjoy, your sleep, diet, and water intake as well as your overall goals for treatment.
We will then provide education on pelvic floor physiotherapy, what and how we assess, what we look for and how we build a treatment plan from what we find.
Next we’ll assess your general movement patterns for your low back, hips, and pelvis. As well as check for core function.
Then, as long as you’ve provided informed consent, we’ll do the internal pelvic floor assessment. This may involve internal palpation of both the vagina and rectum, again, only with your consent.
Once we’re all done, we’ll discuss the findings and send you home with some exercises to get you moving forward towards reaching your goals!
Absolutely, yes! Truly every birthing person could benefit from pelvic floor physiotherapy. Think of it like getting a massage — you may not have a current “issue” going into treatment, but in our experience, everyone has something that can be worked on to make them stronger and more balanced. That said, the most common indications that you need a pelvic floor physio are incontinence (urinary or fecal), pain with intercourse, pelvic pressure and heaviness, and/or prolapse. It is advised that all pregnant mothers visit a pelvic floor physio during pregnancy before birth for labour preparation. We then recommend a first appointment roughly 6 weeks after delivery for an assessment and rehabilitation.
We do an internal treatment for both, however, we spend more time on the scar tissue and releasing connective tissue over the abdominal cavity with Caesarean sections. It’s major surgery and needs to be viewed as such. During the surgery, both the abdominal musculature and connective tissue are cut, which can cause extreme weakness and tension in both structures. This can create a lot of mechanical issues over time, such as lower back pain, pelvic dysfunction, hip pain, and more. The c-section scar itself may create tension and tightness, so we perform gentle scar tissue release and teach patients how to continue doing this at home. We also do core retraining to strengthen the integrity of the abdominal muscles after the surgery.
Absolutely not. Whether you had a baby a year ago, 20 years ago, or are just starting to try to get pregnant, it’s never too late to get started with pelvic floor physiotherapy.
No, you don’t have to. As pelvic health physiotherapists, this does not phase us nor does it affect our ability to carry out our treatment plan, we can still do internal treatment if needed. If you aren’t comfortable with the internal work while you have your period, that’s ok too. You should still come in. There are other ways we can still work on moving forward with your treatment plan.
This depends on what we find during our initial assessment and how your body responds to the treatment. Re-assessing the muscles to make sure we’re on the right track is an important part of the process.
If we don’t have your consent to proceed with the internal assessment, we won’t do it. We will educate you on the benefits of performing the internal assessment, risks of not performing the internal assessment, as well as the alternative options.
Depending on the sensitivity of your tissues, it’s possible that you may experience some discomfort – however we are trained on gentle treatment strategies to help make things as comfortable as possible. As always, we keep in constant communication to ensure your comfort.
The number of pelvic physiotherapy treatments will depend on the mama. Each treatment plan is individualized — similar to other physiotherapy treatments. Sometimes it’s just once a month, while in other cases it may be weekly, depending on the initial assessment and symptoms .
If you have any symptoms at all, we recommend you come in as soon as possible. Symptoms include pain with sex, getting up to pee more than 3 times per night, concern over your diastasis, or leaking at all when you’re not on the toilet.
If you have no symptoms, we recommend your first prenatal visit should be sometime between weeks 28-32, so that you can establish a baseline for where your pelvic floor is at, get treatment if there is something happening that you weren’t aware of until the assessment (this is very, very common), and get started with labour prep.
Generally, we recommend waiting about 6 weeks after your birth – no matter how you birthed your baby – to come in for your postnatal assessment. Don’t worry if it’s been longer than that though. We are happy to see you at any time, even if your children are grown and out of the house. It’s never too late to start.
Yes. The appointment is devoted to manual therapy and treatment, so we always send people home with some guidelines to follow or exercises that are specific to their situation, which may take just a few minutes per day to complete.
Believe it or not, kegels are not for everyone. A lot of people are doing kegels unnecessarily or improperly and they may be causing more harm than good. This is why it is so important to have a proper assessment by a pelvic floor therapist.
Not at all! We may ask you to make reasonable accommodations depending on your own situation, but we know that exercise and your favourite activities are important for yourphysical and mental health. Instead of writing off your favourite activities, we may work towards a modified goal while we get you to where you want to be.
Direct insurance billing
Oona works with insurance companies to do online billing for treatments, whenever possible. Simply ask if your insurance company is compliant when you book your appointment.