Pelvic Health & Orthopaedic Physiotherapy
Even though pelvic floor challenges are common, they are treatable and you should not have to live with them. Pelvic Health Physiotherapy can help you regain control, maximize function and recovery, and improve your well being.
Pelvic health physiotherapy can assist at any age, any stage….
Reproductive endocrinologists (aka fertility specialists) now recognize the additional benefits of physiotherapists who have advanced training in gynecological conditions on improving fertility. Many conditions that cause pelvic pain, such as endometriosis, interstitial cystitis and pelvic congestion syndrome have also been connected to infertility and the synchronized intervention by physicians and physiotherapists is becoming increasingly more necessary for successful outcomes. Our team of pelvic health physiotherapists uses a combination of evidence-based manual therapies, neuro-modulation techniques and exercise prescription to optimizing the health of the pelvic region for enhanced receptivity for conception.
Pelvic girdle pain is very common during pregnancy and is characterized by pain in the pelvic region that is worse when changing position such as rolling over in bed. In addition to treating this problem through application of advanced international training in obstetrical care, our team assists women during pregnancy to maximize physical function and best prepare women for optimal birth and function post-birth. Research studies confirm that women who learn how to properly train their pelvic floors during pregnancy have shorter less painful labors, less soft tissue damage and faster recoveries.
Learn about The Bump Method, Pre & Postnatal Workout Series, developed by our own Dr Sinead Dufour & Nikki Bergen of The Belle Method:
To purchase the The Bump Method exercise videos for the 1st, 2nd & 3rd Trimesters and Beyond: http://thebellemethod.com/video-courses/
In France, every woman is assessed and treated if necessary by a pelvic floor physiotherapist after giving birth. Our pelvic floor muscles are just like any other skeletal muscle in our body and they need to be restored after the feat of childbirth.
Through specialization in pelvic floor rehabilitation, our team of pelvic health physiotherapists ensure that the lingering causes of pelvic or back pain, bladder issues (“leaking with laughing”), connective tissue separation of their abdomen (“mummy tummy”) are all corrected for optimal physical function.
Here is an article written by Nikki Bergen, of The Belle Method, along with Dr. Sinead, regarding the repair of Diastisis Recti. 'How to Banish Mummy Tummy'
Join our Physiotherapists and Core Specialist for a Bring Back Your Core Workshop!
When women reach the ripe stage of menopause the body, including the pelvis changes due to fluctuations in hormones, namely a reduction in estrogen. Women’s bodies love estrogen so accommodating to lower levels of this hormone can result in some unpleasant symptoms. Bone and bladder health are two areas of key consideration during this time. Applying their expertise in urogynecology, our team of pelvic health physiotherapists can assist women to restore their bladder function and optimize overall mobility through strategies to prevent functional decline.
What is Pelvic Organ Prolapse? Dr. Sinead shares her expertise with you HERE
Pessaries are made of medical grade silicone and are inserted into the vagina to help to support the vaginal walls, which can be stretched or damaged through childbirth and/or prolonged loading through the pelvis (ie heavy lifting, chronic cough, etc). This damage can lead to pelvic organ prolapse which is a falling down of the bladder, uterus or rectum which leads to feelings of pressure or falling out at the vagina. A prolapse can contribute to stress urinary incontinence (leaking with cough, laugh, sneeze, activity). If you feel you might benefit from a pessary or if you have been referred for a pessary fitting by another health care provider (family doctor, urologist, gynecologist or other pelvic health physiotherapist), please contact The WOMB via phone or email to set up this specialized appointment. If you're not sure if a pessary would be suitable, set up a Pelvic Health Physiotherapy Initial Assessment with JennyTelfer Crum, in Milton or Gerda Hayden in Burlington where you can decide together if using a pessary is right for you. Further appointments can be set up from there as needed.
An internal examination is required to treat all pelvic floor dysfunctions.
Appointments are available Mondays through Saturdays. Call or Book online.
INITIAL CONSULTATION: $135 - $145 (1 hour)
FOLLOW UPS: $90 - $125 (30-60 minutes)
Paediatric pelvic floor dysfunction is very common and yet, extremely under-serviced. 20% of all pediatric primary care visits are for incontinence (enuresis) and over 30% of pediatric GI consults are for functional constipation. Pediatric pelvic floor dysfunction refers to a wide range of issues that occur when the pelvic floor muscles are weak, in spasm or too tight. The two most common pelvic floor dysfunctions amongst children are constipation (dysfunctional elimination) and bedwetting (nocturnal enuresis). Our team of pelvic health physiotherapists treat children who are experiencing day or nighttime incontinence (enuresis), as well as any bowel issues ranging from constipation to fecal incontinence (encopresis). Most of these issues are ultimately related to underlying constipation. As such, our physiotherapists use a holistic approach that include education and consoling related to needed lifestyle or behaviour changes, specific maul therapy techniques and exercise/movement prescription. In addition our physiotherapists work closely with other members of The WOMB team and extends to colleagues in the department of peadiatrics at McMaster Uniberisy to address all of the related factors that underlie the pelvic floor dysfunction. Our physiotherapists offer a workshop that gives an overview of these issues as well as reviews the optimal toilet learning to prevent these issues three times a year.
Traditional orthopaedic physiotherapy involves the assessment, diagnosis, and management of injuries and impairments involving the musculoskeletal system. This includes structures such as ligaments, tendons, muscles, nerves, bones, and fascia. Orthopaedic physiotherapy is often considered the foundation of physiotherapy practice. Many other sub-disciplines of physiotherapy such as pelvic health, vestibular, concussion, and paediatrics branch from orthopaedic physiotherapy. Priya’s interest in working in orthopaedics stems from her experience in working with high level athletes at the McMaster University Sports Medicine Clinic.
Orthopaedic physiotherapists can address musculoskeletal injuries including:
• Muscle strains
• Chronic pain
• Rehabilitation after surgery
• Sports related injuries
During your physiotherapy session, your therapist will do a thorough assessment of your range of motion, strength, balance, posture, movement patterns, and exercise tolerance to identify physical limitations. We know that your overall health is influenced by more than just your physical impairments. This is why your therapist will use a biopsychosocial approach to understand your how your unique lifestyle factors play a role in your overall health. Our therapists use a collaborative approach to encourage you to be a leader of your own health. Your treatment will include a combination of individualized exercises, manual therapy, and counselling to empower you and help you reach your most optimal level of functioning.
Pfilates: The WOMB offers Pelvic Floor Pilates (pfilates) to women who have been referred by our pelvic health physiotherapists for additional exercise therapy to restore the pelvic floor and/or diastasis recti. These classes are covered by physiotherapy benefits and are 3 classes for the price of one physiotherapy session. 3 sessions for $120.
If you have been referred to a class, you can register in person or by calling The WOMB. Private sessions are also available for $120 per session.
Yin Yoga for Modulating the Nervous System: This rehab class is an extension of Pelvic Health Physiotherapy treatment for clients who need support modulating their nervous system. Clients will be guided through breath work and yin yoga poses that are aimed to help them activate their parasympathetic nervous system, so their body and mind can start unwinding and be ready to rest and digest versus fight or flight.
Yin Yoga is practiced sitting or lying on the floor. There are no planks, no warriors, no core work. No dynamic sun salutations. No standing poses. This class allows you to experience the benefits of meditation while holding poses for a long duration within your comfort level. At a physical level this practice will help you stretch out fascia and connective tissue. On a mental and emotional level, Yin Yoga practice allows the body to move into the parasympathetic nervous system which helps to promote muscle relaxation patterns and combat our cortisol-driven stress response throughout the body and therefore becomes deeply healing and nourishing. You will leave the class feeling grounded, calm and revitalized. These classes are covered by physiotherapy benefits and are 3 classes for the price of one physiotherapy session. 3 sessions for $90.
If you have been referred to a class, you can register in person or by calling The WOMB.
Physiotherapy Barre Class
The WOMB offers Pelvic Floor Barre classes to women who have been referred by our pelvic health physiotherapists for additional exercise therapy to tone and strengthen the pelvic floor. This workout is set to music with movements that incorporate coordination, timing and conditioning with elements of Yoga, Pilates and ballet to sweat, sculpt and have fun in the process.
These classes are covered by physiotherapy benefits and are 3 classes for the price of one physiotherapy session - 3 sessions for $120.
If you have been referred to a class, you can register in person or by calling The WOMB at 905-842-2434.
Advanced Topics and in Perinatal Care: Application of Rehabilitation Principals
This 1-day course is for pelvic health physiotherapists, primary health care providers and fitness professionals interested in women's health. The course provides practical, evidence-based knowledge related to considerations and associated interventions with the pregnant and postpartum client. Didactic instruction includes:
- a very brief overview pelvic anatomy and physiologic changes in pregnancy
- an overview of pregnancy related pelvic floor dysfunctions
- urinary incontinence
- pelvic organ prolapse
- pelvic girdle pain
- diastasis rectus abdomninis
- an overview of current pain science (inclusive of new insights related to the microbiome!) and neurophysiologic education as it relates to pregnancy and birth
- an overview of rehabilitation and fitness informed strategies across the perinatal care (pre-natal, intrapartum and post-partum).
- an overview of preventative strategies for pelvic floor injury dysfunction through labour and delivery.
- advanced clinical decision making with these populations will be discussed.
The didactic aspect of this course will be broken up with practice of a few key exercise interventions.
NO internal pelvic floor techniques are taught at this course.
Unlike other women’s health courses, this course will integrate findings from four recent and ongoing studies led Dr. Sinéad Dufour.
Dufour S, Vandyken B, Forget MJ, and Vandyken C (2017). Association between Lumbopelvic Pain and Pelvic Floor Dysfunction in Women: A Cross Sectional Study. Musculoskeletal Science and Practice (IP)
Dufour S, Bernard S, Murray-Davis B, Graham N (2017). Establishing best practice principles for pregnancy-related diastasis rectus abdominis: A consensus study. The Journal of Women’s Health Physical Therapy (IP).
Clark-Smith M, Dufour S, Cryan J, O’Mahony S (2017). Stress reduction therapy improves symptoms of pregnancy-related pelvic girdle pain and reduces salivary cortisol. University College Cork Ireland/McMaster Univeristy Canada Collaboration.
Daniel S, Alaniz G, DeGroote Y, Dufour S (2017). Towards understanding pregnancy-related pelvic girdle pain. Physiotherapy Canada (IP).
Dr. Sinéad Dufour is Assistant Clinical Professor in the Faculty of Health Science at McMaster University. Faculty of Health Science. She teaches and conducts research in both the School of Rehabilitation Science and the School of Medicine. Her current research interests include: conservative and lifestyle approaches to manage pelvic pain, concordant approaches to prevent pelvic floor dysfunctions, technologies to support pelvic floor rehabilitation, and interprofessional collaborative practice models of service provision. Sinéad stays currently clinically through her work as the Director of Pelvic Health Services at The World of my Baby (the WOMB) in Milton, Ontario. She has worked as a physiotherapist for over a decade with an emphasis on treating lumbo-pelvic concerns and a more recent focus in obstetrics and urogynaecology. Sinéad is an associate of Pelvic Health Solutions and a member of the Urogynaecology Committee of the Society of Obstetricians and Gynaecologists of Canada.