Pelvic health
What is pelvic floor therapy? What to expect at your first visit
By Natura Integrative Care Clinic · Updated · 4 min read
If you’ve typed “what is pelvic floor therapy” into a search bar, you may have been living with a symptom for a while: a leak when you laugh, pain with sex, a heavy feeling at the end of the day. Many people put off booking because they don’t know what happens in the room. This guide walks you through it.
Your pelvic floor is a group of muscles, ligaments and connective tissue at the base of your pelvis. It supports the bladder, bowel and reproductive organs, and it plays a part in bladder and bowel control, sexual function, core stability and everyday movement.
What is pelvic floor therapy?
Pelvic floor therapy is the assessment and treatment of the muscles, connective tissues and tendons that make up the pelvic floor. The strength, coordination and relaxation of the pelvic floor muscles are assessed to determine potential causes for symptoms. Therapy is done by a trained clinician using hands-on techniques, exercises, breathing strategies and lifestyle guidance. Pelvic floor therapy is for everyone: both genders and all ages.
Pelvic floor dysfunction symptoms: is it for me?
People book pelvic floor therapy for a wide variety of reasons, including, but not limited to, the list below:
- Urine incontinence when you cough, sneeze, laugh or exercise
- Needing to urinate often
- Difficulty controlling gas or bowels
- Chronic constipation
- Heaviness, pressure or a bulge in the vagina
- Pain in the pelvis, vulva, vagina, penis, rectum and/or tailbone
- Painful intercourse
- Erectile dysfunction
- Diastasis recti and core weakness
- Lower back and hip pain
- Rehabilitation after abdominal or pelvic surgeries
All these symptoms are common, and they are worth discussing with a pelvic floor therapist. See also bladder leaks after pregnancy and diastasis recti.
What to expect at pelvic floor therapy: your first visit
At Natura Integrative Care Clinic in Steinbach, pelvic floor therapy is provided by Taryn Bloodworth, RNBN. Visits are 50 minutes in length, though a shorter visit may be suggested, depending on your needs. We recommend wearing comfortable clothes. A visit usually goes as follows:
- Conversation first. Taryn asks about what you’ve been experiencing: bladder and bowel habits, pain, pregnancies and births, surgeries, sex, exercise and what you want to get back to doing. The questions are personal; share what you’re comfortable with.
- Assessment. Taryn assesses the pelvic floor, which includes both an external and an internal exam, looking for areas of restriction, scarring, muscle tightness or weakness.
- Treatment. Depending on what she finds, the session often includes hands-on work, stretches, exercises, breathing strategies and practical advice for daily life.
- Homework. You’ll usually leave with exercises or stretches to practise between visits.
Is pelvic floor therapy internal?
Yes, pelvic floor therapy often includes an internal examination. The pelvic floor sits inside the pelvis and therefore the most direct way to check its strength, tension and coordination is through a gentle internal exam with a gloved finger in the vagina and/or rectum.
Many people feel nervous about this part, and that’s okay. Nothing happens without your consent. Registered nurses in Manitoba are expected to support a patient’s right to refuse or withdraw consent for care at any time. You are welcome to ask questions, ask to pause or ask to stop. An internal exam isn’t the only way to begin pelvic floor therapy. If you are not ready, talk to Taryn. Please share any difficult or traumatic experiences, as you feel comfortable, so that Taryn can go at your pace.
How many pelvic floor therapy sessions will I need?
It varies widely, as treatment plans are unique to each patient. At Natura, it is common to come every two weeks at the beginning, then move to monthly visits for maintenance. Exercises are practiced at home between visits, and programs commonly run over a few months. Ask Taryn at your first visit what schedule she suggests for you.
How much does pelvic floor therapy cost, and is it covered?
At Natura, both the initial pelvic floor therapy visit and follow-up visits are $115 for 50 minutes. The clinic doesn’t direct bill insurers: you pay at your visit and submit the receipt yourself. See fees and insurance for more.
- Check your extended health plan. Taryn is a registered nurse, not a physiotherapist. Some plans only reimburse pelvic floor treatment billed as “physiotherapy”, so ask your insurer before you book.
- Health care spending accounts can cover these visits.
- Tax time. Registered nurses are on the Canada Revenue Agency’s list of authorized medical practitioners in Manitoba, so uninsured fees may count toward the medical expense tax credit. Keep your receipts.
If you searched for a pelvic floor physio: pelvic floor rehabilitation training happens after graduation, so clinicians from several professions, including physiotherapists and nurses, can take it. Taryn is a registered nurse with focused training in pelvic floor rehabilitation.
Common questions
Does pelvic floor therapy hurt?
It shouldn’t be painful. You may feel brief, mild discomfort if a muscle is tight or tender, especially if pain is the reason you came. Tell your therapist straight away if anything hurts; pressure, position and pace can all be changed, and you can stop at any time.
Can I have pelvic floor therapy while pregnant?
Yes. Pregnancy-related discomfort and preparing for birth are common reasons people book with Taryn. Let her know how far along you are when you book, and mention anything your prenatal care provider has flagged about your pregnancy, so the assessment can be planned around it.
Is pelvic floor therapy only for women?
No. Taryn sees people of both genders and all ages. Men may book before or after prostate surgery, or for pelvic pain, leaking or bowel control concerns. The pelvic floor does similar jobs in every body: supporting organs, controlling the bladder and bowel, and playing a role in sexual function.
Can’t I just do Kegels at home?
Many people start there. It’s easy to squeeze the wrong muscles or hold your breath without realizing, and some people’s pelvic floor muscles are tight rather than weak. An assessment checks how your muscles contract and relax, so you know which exercises to practise and how to do them.
Sources
- Public information on urinary incontinence — Canadian Continence Foundation
- What to expect during pelvic health physical therapy — APTA Pelvic Health
- Practice expectation spotlight: informed decision-making — College of Registered Nurses of Manitoba
- Authorized medical practitioners for the medical expense tax credit — Canada Revenue Agency
- Pelvic floor dysfunction — Cleveland Clinic
This article is general information, not medical advice for your situation. If you're unwell or worried, talk to your doctor or call Health Links – Info Santé, Manitoba’s free 24-hour nurse line, at 1-888-315-9257. In an emergency, call 911.
