Pelvic Health - Women & Men 

Many people with pelvic pain have pelvic floor dysfunction, but specifically hypertonic muscles, or muscles that are too tight. The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women).

These muscles must be able to contract to maintain continence and relax to allow for urination, bowel movements, and in women, sexual intercourse.
When these muscles have too much tension (hypertonic) they will often cause pelvic pain or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they will contribute to stress incontinence and organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.

Pelvic floor dysfunction is diagnosed by specially trained doctors and physiotherapists by using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. They will also assess your ability to contract and relax these muscles. Your bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since these joints can stress your pelvic floor muscles.

If an internal examination is too painful, the connective tissue of your abdomen, thighs, groins and low back are often very tight. The connective tissue forms the container of the muscles, and this tissue often needs to be relaxed before any internal work can be done.

When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and strengthening exercises are prescribed, if appropriate (Pelvic Health Solutions, 2014).

Conditions may be caused by either:

(1) HYPOTONICITY (Weak pelvic floor muscles): contributing to stress incontinence, urge incontinence and pelvic organ prolapse. Incontinence is NOT a normal part of aging.

or...

(2) HYPERTONICITY (Tight pelvic floor muscles): contributing to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatitis.

Kegels are NOT always indicated for pelvic floor problems. Sometimes they do more harm than good, and often they are NOT performed correctly.
The Cochrane Collaboration 2010 concluded that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defense, before surgical consultation, for stress, urge and mixed incontinence in women

Pre-Natal Health

Let us follow you through your pregnancy and give you month-to-month tips and health education to ensure the smoothest pregnancy possible. You can come alone or with your partner. We will set up a personalized plan for your pregnancy for each month as well as deal with any upcoming aches and pains you may experience. 

Call into our office and book a visit with Sascha so she can help you make this pregnancy a pleasant one. 

We will discuss normal changes to your body, baby's development, education on baby's development such as tummy time and why it is so important, discussions on sex and pregnancy, stretching your perineum to improve ease of delivery, and any questions you may be having throughout this precious time in your life. 

Post-Natal Health

Most moms feel overwhelmed post delivery - and guess what? - it is normal! I'm here to talk to you regarding your post-natal health. When should I become active again? Is it normal that I feel more emotional or less emotional than usual? When can I resume sexual activity? You have questions...I'll work on building a plan with you that fits your lifestyle and your baby's schedule. Breast soreness? let's look at our options. Learn to self-massage or schedule an appointment for a breast massage with myself to relieve pain and discomfort. 

I like to increase your odds of a successful post-natal recovery. It is often not discussed and we often feel like all the focus has changed to baby - I'm here to discuss everything from your healing scars to your biggest concerns regarding you and baby's health. My goal is to ensure all mom's are followed throughout all their pregnancy - pre-post and preparing for the next one when desired. Have questions on what else I can offer you? Give me a call at 473-7064.

Pessaries

Pressure? Discomfort? Pelvic organ prolapse occurs when a pelvic organ-such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organ in place get weak or stretched from childbirth or surgery.

Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn't usually a big health problem. It doesn't always get worse. And in some women, it can get better with time.

More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the: the bladder, the urethra, the uterus, the vagina, the small bowel, or the rectum.

Symptoms of pelvic organ prolapse include:

  • Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom.
  • Feeling very full in your lower belly.
  • Feeling as if something is falling out of your vagina.
  • Feeling a pull or stretch in your groin area or pain in your lower back.
  • Releasing urine without meaning to (incontinence), or needing to urinate a lot.
  • Having pain in your vagina during sex.
  • Having problems with your bowels, such as constipation.

A vaginal pessary is a removable device placed into the vagina. It is designed to support areas of pelvic organ prolapse.

A variety of pessaries are available, including the ring, the cube, the doughnut...

Sascha will fit your pessary to hold the pelvic organs in position without causing discomfort. Many have had previous negative experiences with pessaries, but when done carefully and with the patient's best interest first a pessary fitting session goes very smoothly and without pain. Pessaries come in different sizes and should be fitted carefully. Our physio will find the perfect fitting pessary for you personally and then discuss this with your doctor. Post-agreement she will fit order your pessary and teach you a daily routine to insert, remove, and care for your pessary. 

(HealthLinkBC2019)

Sexual Education

           

Sex education is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, and other aspects of human sexual behavior. (ScienceDaily 2019)

My goal in sex education is to empower our youth, as well as adults, in understanding What is normal? Why is this happening? Where can I access this information? What should I expect during menopause? Should I worry about this?...no matter the topic we will have you covered and answer your questions in an individual or group format. You can attend one of our sessions as a group of friends or alone or you can schedule a one-on-one with Sascha and discuss such topics relating only to you and in a more private manner. 

Our program is age specific and the amount of detail which is revealed, and topics dealing with human sexuality and behavior (eg. safe sex practices and masturbation, and sexual ethics) is relative to each age.