FREQUENTLY ASKED QUESTIONS

Do I need a doctor referral for physiotherapy?

 

No. You do not require a referral to attend physiotherapy, including pelvic health physiotherapy, in Ontario. However, some insurance providers require you to have a doctor’s referral to be eligible for reimbursement. Check with your provider . 

 

** Please note we do not bill through OHIP or WSIB/ workers compensation. **

 

How can I pay for my appointment?

 

We accept e-transfer, credit card and cash payments due at the end of each session. 

Does extended health insurance cover pelvic health physio?

If you have coverage for physiotherapy through extended health benefits, you will be covered for pelvic health physiotherapy. We will provide you with a receipt at the end of your session that you can submit for reimbursement or retain for tax purposes. 

 

What if I need to reschedule or cancel my appointment?

 

If you need to reschedule your session, please provide 24 hours’ notice so another client can book the appointment spot. If you are positive on any of the COVID screening questions, are unable to get childcare, or need to cancel due to transportation or weather conditions, we will switch to a virtual appointment. 

 

If 24 hours’ notice is not provided prior to a cancellation or an appointment is missed, the fee of $40 will be charged. Please note that extended health insurance does not cover missed or late cancellation fees.

What is the pelvic floor?

 

The pelvic floor is a group of muscles and connective tissue that span the underside of the pelvis and attach from your pubic bone to the tail bone and between your sit bones. The purpose of these muscles is to support your internal organs - including supporting a baby when pregnant. These muscles play a part in stabilizing your pelvis, hips and lower back; have a roll in sexual function; and impact your ability to hold and expel urine, gas and faeces. 

 

What is pelvic floor physiotherapy?

 

Pelvic floor physiotherapy is focused on the deep core and pelvic floor musculature, specifically. As I believe that no part of the body is an island, I take on a holistic, full body approach that assesses not only the pelvic floor but your body in its entirety. 

 

Pelvic health physiotherapists have specific post graduate training which includes using internal and external hands-on techniques to evaluate how your pelvic floor muscles are working and coordinating with the rest of your body. 

 

What symptoms and conditions does a pelvic health physiotherapist treat?

 

A pelvic health physio can help prevent and treat many conditions including:

 

  • incontinence or leaking of urine, stool or gas when you cough, laugh or exercise

  • urinary urgency and frequency more than 7 times per day

  • difficulty initiating urination or passing stool

  • internal pelvic pain such as that caused by: endometriosis, vaginismus or pain during intercourse,  interstitial cystitis or painful bladder syndrome, pain or heavy cramping with menstruation

  • pain in clitoris, vagina, rectum or perineum 

  • pelvic organ prolapse

  • heaviness or pressure in the pelvis

  • pain associated with the low back, pelvic girdle, sacroiliac joint (SIJ), public symphysis or tailbone

  • diastasis recti (abdominal separation)

  • pregnancy related pelvic pain. 

 

A pelvic health physio can also provide guidance with exercise during pregnancy, early postpartum return to exercise, and years to decades past the postpartum period and into menopause.

 

What happens during a pelvic floor assessment?

 

During your initial assessment, your physiotherapist will discuss with you your history of symptoms and any relevant health history. 

 

Based on your reported symptoms your physio will perform a thorough external exam of your back, hips, abdominals and pelvis to evaluate movement, structure, mobility, strength and tone. If necessary, an internal vaginal/rectal exam will then be performed to evaluate tension, strength and coordination of the pelvic floor musculature. 

 

Following the assessment, your therapist will discuss the results of your assessment,  provide education and a home exercise management plan. 

 

What is an internal pelvic floor exam and is it necessary?

 

Your physiotherapist will first explain why they believe an internal exam would be helpful along with other pros and cons of internal palpation. They will then guide you through the exam and provide feedback throughout. You must provide consent before any step of the exam and you are able to withdraw consent at any time. 

 

During the internal portion of the pelvic floor exam, your physiotherapist will gently insert one or two gloved fingers into your vagina or one finger into your rectum. This allows the therapist to palpate each muscle group and evaluate its tension and function. There is no speculum nor instruments inserted into the vagina or rectum. 

 

At any point during the exam you may withdraw your consent. 

 

Depending on concerns presented and information that was gathered from your history and external exam, an internal exam may not be necessary. However, an internal exam is usually recommended as it is the gold standard for assessing pelvic floor muscles and associated structures. If you choose not to proceed with an internal exam the physiotherapist will make recommendations for treatment from your subjective history and external exam to work towards your goals. 

 

Can I still come to my appointment if I’m on my period?

 

It’s up to you. 

 

Pelvic floor assessment and treatment can be provided even if you’re on your period. Pelvic organ position and pelvic floor muscle tone can be affected by hormonal changes and it can actually be helpful to assess this during this time. 

 

If you’re not comfortable with an internal assessment or treatment when you’re menstruating, we can complete the session with external techniques or you can reschedule your appointment with at least 24 hours notice. 

 

Can I bring my baby to my appointment?

 

Yes. You’re welcome to bring your baby to your appointment though due to COVID-19 restrictions they need to remain in their car seat and I completely understand if you need to attend to them during your session. We appreciate your understanding that we are unable to extend physiotherapy sessions past their allotted time due to other booked clients. Until precautions are lifted we are unable to have other older children or support persons attend your appointments.  

 

What sparked your interest in pelvic health physio?

 

For years I worked in both orthopaedic and neurological physiotherapy. During this time I developed an appreciation for treating any injury by looking at the whole person holistically and in more than just a physical sense. 

 

Following the birth of my two children I attended pelvic physiotherapy. At the time there was very little support for postpartum women available. It was hard to understand why during pregnancy you’re followed weekly or more, but six weeks after you’ve given birth, you’re discharged. 

 

I realized that a lot of what we’ve been told is a “normal” part of pregnancy, postpartum and aging is not normal at all and there are ways to have success in improving our pelvic health. I began taking post-graduate courses in pelvic health and pilates and my passion ignited. 

 

My mission is to make sure every woman feels heard, seen, hopeful, and show that although something may be common, it doesn’t need to be your new normal.