Pelvic Health Physiotherapy treatments in Mississauga

Pelvic Urinary Incontinence

3.3 million Canadian have urinary incontinence

1 in 4 are women

1 in 9 are men

According to the Canadian Continence Foundation, 1.5 million Canadian are incontinent without discussing with their problems with the health care providers. Various conditions can be treated by pelvic health physiotherapy which was a cause of distress in their life. Only 1 in 12 people tell a health care worker.

WHY?

– Embarrassed

– They think it is a Private Issue

– Some think it is an NORMAL part of aging….IT IS NOT!

This issue has a lot of Social Consequences like decreased self esteem. It also causes impaired emotional status, depression and isolation. It impedes social and physical activity. It has a heavy economic burden on patients, families and society (Hunskaar, 1991, Temml, 2000).

A Randomized Clinical Trial (strongest type of study) was presented at the International Pelvic Pain Society conference (Chicago 2010), and has just been published in the Journal of Urology (2012) by Fitzgerald et al. which demonstrated that internal pelvic floor myofascial treatment in chronic bladder pain patients was effective in 59% of patients compared to generalized massage therapy.

We now have Level I evidence to support the use of internal pelvic floor physiotherapy for painful bladder conditions. Third, the American Urological Association (2010) has issued its first set of Interstitial Cystitis Treatment Guidelines recommending diet modification and physiotherapy as the first line of defence when a patient presents with painful bladder syndrome.

Canadian urinary Bladder survey (CUBS 2003)

21.8% OF CANADIAN OVER 18 YEARS HAVE BLADDER PROBLEM

Costing Canadian 1.5 billion per year

PFM Retraining: Stress urinary Incontinence SUI

Is the first line treatment in women (Level 1, Grade A evidence) (Wilson 2005) (2009 ICS Conference) ( Cochrane collaboration 2014)

British Guidelines as presented at the ICS conference 2010 in Toronto:

• In Britain, pelvic floor muscle training should be the first line of defense against SUI
• Should be completed before surgical intervention is considered

Post-prostatectomy-incontinence

Up to 75 percent of men experience a short period of mild incontinence. This is particularly after removal of the catheter that was placed during surgery. Most patients regain total urinary control after radical prostatectomy. However, this can take up to a year to achieve. Although, a small percentage (2% to 4%) experience permanent incontinence. They usually have Stress incontinence or Urge incontinence.

Pelvic Floor Dysfunction can be caused by:

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

• 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 defence, before surgical consultation, for stress, urge and mixed incontinence in women.

Common misconceptions about Pelvic Health

It is normal to have urinary leakage after childbirth DYSFUNCTION

It is normal to have urinary leakage as YOU age DYSFUNCTION

To think there is nothing you can do about urinary DYSFUNCTION

PFMT versus no treatment, placebo or control for urinary incontinence in women

Men Conditions treated in pelvic health physiotherapy @ Curezone Physiotherapy in Mississauga

• Post-Prostatectomy Incontinence

• Pelvic Pain

• Pelvic Floor Dysfunction

• Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) in men

• Pain during stimulation, ejaculation problems

• Pain during urination Women conditions treated in pelvic health physiotherapy @ Curezone Physiotherapy in Mississauga

• Vaginal Pain Syndrome

• Pelvic Floor Dysfunction

• Bowel issues including constipation, straining or pain

• Unexplained pain in the low back, the pelvic region, the genital area or the rectum

• Pain during or following intercourse, orgasm or stimulation, ejaculation problems

• Prolapse Symptoms

According to the Canadian Continence Foundation, 1.5 million Canadian are incontinent without discussing with their problems with the health care providers. Various conditions can be treated by pelvic health physiotherapy which was a cause of distress in their life. Only 1 in 12 people tell a health care worker

• Dysmenorrhea

Physiotherapist assess the muscles and connective tissues of your abdomen, pelvic girdle and pelvic floor. Your physiotherapist can teach you how to relax these muscles, use deep breathing and other relaxation strategies, and help you with stress management.

• Rectus Diastasis

• Vaginismus

• Dyspareunia

• Chronic Prostatitis

• Vulvodynia

• Pudendal Nerve Irritation

• Interstitial Cystitis

• Constipation

How is the assessment done?

After a detailed questionnaire and physical examination of your pelvic area (External/Internal), your therapist will discuss the findings with you and plan a treatment program to best suite your needs. This may include internal and external examinations to identify the affected tissues that may be contributing to your urinary, bowel or pelvic pain symptoms.

How can Physiotherapist Help?

Pelvic Health Physiotherapists are registered physiotherapists who have specialized in the treatment of the pelvic health concerns. Like physiotherapists in other settings, our goal is to assist our patients in resuming their daily or nightly activities as quickly as possible. Exercises for the pelvic floor ,prescribed by a physiotherapist with the training in this area, have numerous benefits including maintaining continence, helping the bladder to hold on after getting the urge to urinate, and increased satisfaction in sexual relationships.

A physiotherapist will design an exercise program for the individuals’ specific problem, involving muscle re education, bladder retraining and strengthening of the pelvic floor muscles. If the muscles are very weak, a physiotherapist may use electrical stimulation of the pelvic floor muscles. The can teach strengthening of the pelvic floor muscles, which can help to reverse the process.

Physiotherapist may also make recommendations for lifestyle changes that will help the bladder be less irritable, such as:

• Bracing the pelvic floor muscles before you cough, laugh or sneeze;

• Avoiding common bladder irritants, such as caffeine, alcohol and cigarettes;

• Lifting and moving correctly

• Dietary management

Pelvic Health Physiotherapy Treatments

• Correcting postural dysfunction

• Manual therapy

• Connective tissue release

• Pelvic floor muscle facilitation with breathing techniques

• Exercises for other core muscles

• Training for healthy bladder and bowel habits

• Education such as behavioural therapy/stress management

Unsure if Pelvic Health rehabilitation is right for you?

Take advantage of our 10 min complimentary phone consultation at 907-997-4333