All interactions between a therapist and client is bound by confidentiality. Informed consent is required for the initial assessment. Verbal and signed consent is required before any information is shared with the family doctor, specialist or other health professional.

Many clients wait months to a year to see a gynaecologist, urologist or gastroenterologist before being referred to a pelvic health therapist (PHT). You can have direct access to physiotherapy for your pelvic issues. We do NOT require a referral, however many insurance companies require a doctor's referral to provide reimbursement.

Pelvic health issues may bring with them frustration, stress, feelings of anxiety and depression. We take a biopsychosocial/spiritual approach to understand you as a whole person in addressing your pelvic health.

A good understanding of the current problem and any other health issues is important. You will receive a questionnaire before the initial assessment to gain an understanding about your pelvic history and challenges. Our intake questionnaire may seem lengthy but each part is essential to understanding you. Your issues and goals are explored while the physiotherapist reviews the completed forms during the initial assessment.

Most pelvic health specialists have orthopedic training. We incorporate this training into sessions to benefit our clients. A good postural screen, spinal movement analysis, gait analysis, pelvic girdle and lower extremity motion and strength testing is part of the assessment.

Analyzing your breathing pattern and breath awareness is important because the diaphragm, core and pelvic floor work together. Breathing restrictions or holding your breath is common, which profoundly affects the function of the pelvic floor.

We'll examine the abdominal wall and all the muscles externally around the pelvis for excessive tension. Any dysfunction of these muscles can affect the function of the pelvic floor and vice-versa.

The skin and external musculature of the perineum are examined to look for skin irritation and any other issues. The perineum is examined for any prolapse, vaginally or rectally.

This is the most difficult part of the exam for most people to understand. It's not like a pap smear, ladies. There are no stirrups or speculums used. Gentlemen, it isn't like a prostate exam. You lie comfortably on your back and are discreetly covered with a sheet. We need consent to perform every internal exam and you are always in control.

Pelvic health treatment is best with an internal examination, but it can be done with external examination only. The purpose of the internal palpation is to determine if there is low or high tone of the muscles. The internal connective tissue and skin are examined to ensure health and proper movement. The internal should be comfortable and not painful.

The strength is determined by contraction of the pelvic floor during the internal exam. Coordination, endurance and fatigue-ability of the muscles will also be tested.

At the end of the assessment, the findings, issues and goals are summarized and explained. You will leave the appointment with specific education, exercises and strategies to help you manage your individual challenges and pelvic health.