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Pelvic and Perineal Rehabilitation

Some health problems are often overlooked. Yet, they affect the quality of life of many women and men.
Sylvie Leduc, pht
Sylvie Leduc, phtPhysiothérapeute
Sylvie Leduc, pht
Sylvie Leduc, phtPhysiothérapeute
- Titulaire d’un baccalauréat en physiothérapie de l’Université McGill
- Membre de l’Ordre Professionnel de la physiothérapie du Québec (OPPQ)
- Formation en rééducation périnéale et pelvienne

Problems related to the bladder
• Losing urine: a few drops or in large quantities
• Urinate frequently with small amounts of urine
• Urinate with difficulty
• Rush to the toilet to avoid losses

Problems related to the rectum and anus
• Escape gas or stool involuntarily
• Evacuate stools with difficulty
• Feel pain during stool evacuation
• Feel anal pain

Problems related to vulva and vagina
• Feel pain during sex
• Feel pain in the vulva, clitoris and vestibule
• experience difficulty or impossibility of penetration

All these problems reveal pelvic floor dysfunction and can be treated in perineal and pelvic rehabilitation.

Pelvic floor muscles

The pelvic floor muscles form the base of the pelvis. They stretch like a hammock between the pubis and coccyx. In women, they surround the urethra, vagina, and anus as they surround the urethra and anus in men. They react like other muscles in the body and can weaken or develop tension.

The pelvic floor plays an important role in:
• Control of urine, gas and stool
• Support of pelvic organs
• The stabilization of the body
• Sexual function

When pelvic floor muscles are atrophied, weakened, or uncoordinated, the following problems may occur:

• Inability of muscles to contract sufficiently or at the right time to prevent leakage (urinary or gas) during coughing, sneezing, or physical exertion
• Inability to support organs in the pelvis, resulting in descent (prolapse) of the bladder, vagina, uterus, or rectum
• Difficulty holding back in case of urge to urinate or go to the saddle.

When pelvic floor muscles are tight or have spasms, the following problems may occur:

• Difficulty contracting and releasing muscles easily causing difficulty in urinating or evacuating stool
• Appearance of pain or difficulty during sex (vaginismus)
• Presence of an exaggerated sensitivity of the tissues at the entrance of the vagina secondary to a lack of elasticity of the tissues and to the presence of tensions associated with the dysfunction with other structures of the perineal region (vestibulodynia, vulvodynia, eczema, lichen sclerosus, infection)

Are you bothered by any of these problems?

Talk to one of our physiotherapists with perineal and pelvic rehabilitation training. She will answer your questions, evaluate your condition and offer you the appropriate treatment.

Pelvic and Perineal Rehabilitation: A Specialized Approach to Physiotherapy

The physiotherapist specializing in pelvic floor and perineal rehabilitation has the knowledge and skills to assess, make a physiotherapeutic diagnosis, develop a treatment plan and treat pelvic floor muscle dysfunction.

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The goal of perineal and pelvic rehabilitation is to normalize the function of the pelvic floor muscles to optimize the functioning of the urinary system, the viscera support system, and the pelvic and perineal area.

The initial evaluation

The initial assessment in perineal rehabilitation aims to identify the various problems related to the urinary problem, fecal or sexual for which you consult. It will establish a personalized treatment plan adapted to your condition. The evaluation includes:
• The detailed questionnaire on the reason for consultation
• Physical examination of the abdomen, pelvis and lower limbs
• External examination of the perineum
• Internal vaginal examination
• Internal anal examination as needed

Be assured that throughout the evaluation, we will take care to describe and explain the progress of the evaluation and ensure your comfort and your understanding of the actions taken.

Possible interventions

• Education and teaching to the patient: notions of anatomy and physiology, habits of life, risk factors, aggravating activities
• Pelvic floor muscular rehabilitation: recruitment and muscle building
   - Manual techniques of facilitation and proprioception
   - Exercises with and / or without biological feedback (manual, electromyography with probe, abdominal and perineal ultrasound)
   - Neuroelectrostimulation with external or internal electrode
   - Resisted exercises manually or with cones
• Myofascial release, muscle stretching and soft tissue mobilization: manual and / or instrumental techniques to relax or relax muscles and tissues
• Rehabilitation of abdominal, lumbar and pelvic musculature
• Bladder retraining to suppress urgent cravings, to improve the ability to hold oneself and to reduce the frequency of urination
• Functional exercises
• Joint mobilizations

Note regarding the availability of physiotherapy treatments:
• For stress, emergency or mixed urinary incontinence in women: you can now consult any of our physiotherapists
• For pains in the pelvis and lumbar region: right now
• For male and anorectal issues: from April 2013
• For perineal and vaginal pain without incontinence components: from autumn 2013

Book an appointment now

The Chiromedic Center offers more than 20 different specialties

If pain persists and you need help, our multidisciplinary team will be able to get you back on track quickly.