Pelvic Health 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 Mummy Tummy 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, 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.
INITIAL CONSULTATION: $160
FOLLOW UP VISIT: $90
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.
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 $90.
If you have been referred to a class, you can register in person or by calling The WOMB. Private sessions are also available for $90 per session.
- Tuesdays 12:30 - 1:30PM
- Wednesdays 9:45 - 10:45AM
- Wednesays 5:45 - 6:45PM
- Mondays 9:30 - 10:30AM
- Thursdays 7:00 - 8:00PM
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.
MILTON: Tuesdays 7:15 - 8:15PM
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.
Date: Saturday March 3, 8am-4pm
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.
Appointments are available Mondays through Saturdays. Call or Book online.
INITIAL CONSULTATION: $125 (1 hour)
FOLLOW UPS: $90 (30-60 minutes)
Belly wrapping has been used for centuries in many cultures around the world, especially in Asia. Layers of cloth are meticulously wrapped and tied around the new mother in a similar way to a corset only with the ties at the front. It is a beautiful tradition but is a laborious process and doesn’t allow for much movement once it is on. While limiting movement in the early days is beneficial, we ultimately need to move without restriction.
Providing support to the healing connective tissues and muscles, belly wrapping is an age old tradition that inspired us to design a modern day version so moms, like yourself, could reap the benefits without being subjected to the tedious wrapping and inability to move and breathe. We also believe that wrapping alone is not enough. Our 8 week core confidence exercise program coupled with the AB Tank and Wrap is a holistic solution to help you heal and rebuild from the inside out so not only do you have the flat tummy you want but you are also a stronger mummy too!
The 'After Baby' AB Tank and Wrap
The core breath - part of the 8 week core confidence program will help rebuild your core from the inside and the AB tank and Wrap will support it from the outside - offering exceptional light external compression to support the healing connective tissues while encouraging the muscles to return to their ideal alignment. Just like you would wrap the injured tissues and muscles in an ankle strain, so too should you wrap the injured tissues in your abdomen after pregnancy and birth. It is meant to be temporary and done IN CONJUNCTION with the core confidence exercise program.
The AB Tank and Wrap are part of our holistic system that provides you with physical support for your healing tissues while also rebuilding your core from the inside out with our Core Confidence exercise program. By supporting the healing tissues and guiding the muscles back into ideal alignment, the AB Tank and Wrap make your exercise more effective!
The AB tank is designed to fit under the bust to allow for breastfeeding while keeping your belly covered and supported no matter where you are - even when doing your Core Confidence exercises!
We recommend that the AB Tank and Wrap be purchased while you are still pregnant so you have it to put on immediately postpartum in order to take advantage of the most critical healing time for diastasis - the first 8 weeks postpartum.
Purchase your AB Tank in person at THE WOMB or Online!
The idea which led to the development of the EPI-NO originated in Africa where women insert calabashes/gourds of increasing size gently into the vagina to stretch the perineum and pelvic floor muscles to facilitate a natural birth and reduce the risk of perineal injury. From this age old African custom - still in use today - the soft inflatable EPI-NO balloon and birth-exercise program was conceived and developed into a modern-day medical device by Dr. Whilhelm Horkel, together with a team of gynecologists, midwives, urogenital physiotherapists and pregnant women.
The team also recognized the usefulness of the EPI-NO for women who are not pregnant but were experiencing challenges with a weak pelvic floor. EPI-NO provides a non-surgical, drug free alternative that lets women put pelvic floor wellness in the palm of their hand. Building on the Kegel exercise developed by gynecologist Dr. Arnold H. Kegel, the EPI-NO allows this simple, treatment for incontinence to become more effective through the use of biofeedback.
Manufactured by Tecsana - a German company whose name means "Gentle Technology" the EPI-NO is a revolutionary device for proactive pelvic floor wellness as well as a proven and effective tool to regenerate strength and tone to weakened pelvic floor muscles.
Available at Nourished - A WOMB Specialty Shop!