PELVIC HEALTH

Pelvic Health Physiotherapy: Conditions and Symptoms

Pre/Postnatal Pelvic Health Goals/Conditions

• Loss of bladder control (urinary leakage)
• Urinary retention
• Constipation/fecal incontinence
• Pelvic pain, hip pain, low back pain, symphysis pubis dysfunction
• Painful intercourse
• C-section/scar tissue rehab
• Diastasis Recti
• Labour and Delivery education/preparation (labour and delivery positions, how to push etc) 

Bladder Conditions:

Stress/Urge Urinary Incontinence: Involuntary leakage of urine. This could happen when sneezing, coughing, laughing, walking, and exercise. It can also occur when not being able to make it to the bathroom.

Urinary retention: not being able to pass urine easily 

Incomplete emptying: not being able to empty bladder completely

Overactive bladder/frequent urination: needing to use the bathroom more than 5-7x/day, and nighttime wakings

Urinary urgency: inability to hold bladder for long/chronic need to rush to the bathroom

Bowel Conditions

Constipation: forcing to defecate, pellet like stool, sensation of incomplete emptying, sensation of blockage,  less than 3 defecations a week, or having to use manual maneuvers to pass stool 

Fecal Incontinence: uncontrollable passage of fecal matter. 

Pelvic Organ Prolapse

The descent of pelvic organ into the vaginal cavity, commonly the bladder, uterus, rectum.

Symptom:

• Heaviness, pressure, or fullness in the pelvic region
• A sensation of ‘something being there’ in the pelvic region
• Changes in bladder or bowel function
• Using manual techniques to help evacuate stool
• Discomfort/Pain with intercourse
• Back/pelvic pain
• Inability to keep a tampon in 

Diastasis Recti Abdominis

A horizontal separation of 2 muscle bellies of the rectus abdominis (the 6 pack muscles in the abdomen). This occurs when the linea alba, which is the white connective tissue that runs down the center of the abdomen and connects the rectus abdominis, expands against pressure, creating space between the muscles.  

Painful Intercourse/Vaginismus

Pain during intercourse, or the inability to achieve pain free intercourse due to spasms of the vaginal muscles.

Endometriosis/Adenomyosis

Endometriosis: the presence of endometrial tissue outside of the uterus. These endometrial lesions can implant on various structures in the lower abdomen including but not limited to: the reproductive system, the urinary system and digestive system.

 Adenomyosis: the presence of endometrial tissue in the muscular wall of the uterus. 

Interstitial Cystitis/Bladder Pain Syndrome

An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes.

Low back pain/Hip pain

Chronic low back pain/pelvic and/or hip pain often has a pelvic floor involvement. Often the pelvic floor muscles are found to be tight and/or weak, which leads to pain and decreased core strength. 

Chronic Nonbacterial Prostatitis/ Chronic Pelvic Pain Syndrome

Pain in and around the prostate, without being a bacterial infection.

Symptoms include:

• Pain in the pelvic region, low back, abdomen
• Pain before/during/after urination
• Urinary frequency/urgency
• Pain related to intercourse

Pediatric Pelvic Health Conditions

• Daytime Urinary incontinence (during coughing, sneezing, exercise,  laughing
• Nighttime bedwetting (Enuresis)
• Urinary frequency or urgency
• Under-active bladder or urinary retention
• Chronic Constipation or stool retention
• Fecal incontinence
• Pain while voiding bladder or bowels
• Pain in perineal or rectal region