Pelvic Floor Physiotherapy

What Is the Pelvic Floor—and Why Does It Matter?

Your pelvic floor is a group of muscles that lines the base of your pelvis, running from the tailbone at the back to the pubic bone at the front. These muscles support your pelvic organs, including the bladder, rectum, and uterus (in female-assigned individuals) or prostate and testicles (in male-assigned individuals).

The pelvic floor helps regulate bowel and bladder control, supports sexual function, and contributes to core and hip stability. It's often overlooked in cases of persistent low back, hip, or pelvic pain.

What Happens When the Pelvic Floor Isn’t Functioning Well?

Pelvic floor dysfunction can result from habitual strain, injury, or trauma such as childbirth or surgery. Common symptoms include:

• Pain in the pelvis, low back, tailbone, or hips

• Leaking during exertion (e.g., coughing, laughing, sneezing, running)

• Urinary or fecal urgency and frequency

• A sense of heaviness or pressure in the pelvis

• Painful intercourse

• Erectile dysfunction

How Can a Pelvic Floor Physiotherapist Help?

Your pelvic health physiotherapist will assess the pelvic floor muscles to determine whether there’s excess tension, weakness, or a lack of connection contributing to your symptoms. Treatment recommendations may include:

• Self-release or relaxation strategies

• Strengthening exercises

• Breathing and postural retraining

• Lifestyle or habit adjustments

What Does a Pelvic Floor Assessment Involve?

After submitting your intake questionnaires, your appointment will take place in a private treatment room. Your physiotherapist will take time to discuss your symptoms, your goals, and your personal history.

Using a biopsychosocial approach, your physiotherapist will assess your posture, movement patterns, breathing mechanics, and muscle activation around the pelvis. If you’re comfortable, they may also perform an internal vaginal and/or rectal exam—the gold standard for evaluating pelvic floor function. These internal exams are always optional and fully guided by your comfort and consent. You are in control at every step.

What Does Treatment Include?

Treatment is one-on-one and fully personalized. Your physiotherapist will summarize their findings and work with you to create a plan based on your goals. This may include:

• Education and behaviour modification

• Manual therapy

• Internal or external pelvic floor treatment

• Nervous system regulation and stress management

We take a whole-person approach, exploring all areas of life that may be contributing to your pelvic floor health.

When Is an Internal Exam Not Recommended?

An internal pelvic floor exam may not be appropriate in certain cases, including:

• When the patient does not consent

• Active urinary tract infection

• Pain with light touch or poor skin integrity

• Pregnancy with pelvic floor rest prescribed (e.g., due to incompetent cervix)

• If the individual has never had penetrative vaginal intercourse

Do I Need to Cancel If I’m Menstruating?

There is no need to cancel your appointment if you are menstruating. Not all pelvic floor treatments require internal exams. If it’s your first assessment and you’re experiencing a particularly heavy flow, you may choose to rebook, but it is not required.

How Many Treatments Will I Need?

After your initial assessment, your physiotherapist will recommend a treatment plan tailored to your needs. Frequency can vary, but it’s common to begin with 1–3 sessions per month, gradually decreasing as your symptoms improve.