For many women who’ve had a baby, “leaking” is simply
accepted as a fact following childbirth. Incontinence may be a side effect of
labour and delivery in the short term, but it shouldn’t be a condition that
lasts long-term.
“In Europe, pelvic-floor physiotherapy is offered as a routine part of public
health for women to recover after you give birth,” says Anniken Chadwick, a
pelvic-floor therapist at Vancouver’s Treloar Physiotherapy Clinic, in a phone
interview. “Because these issues are so common, women think it’s normal to
leak. They might laugh about it among themselves in their fitness group and not
know that something can be done. Lots of women reduce their physical and social
activities due to incontinence because they’re embarrassed.
“For best care and to prevent problems down the road,” she
says, “every woman that gives birth should get their pelvic floor checked six
weeks afterward to know if there’s scar tissue, if they’re building their
strength back, if what they’re experiencing is normal, or if there are other
issues that need to be dealt with.”
As its name implies, pelvic-floor physiotherapy targets the
sling-shaped muscles that run from the pubic bone to the base of the spine and
that hold in place the pelvic organs—the uterus, vagina, and bowel. Treatment
involves assessment of the strength of the pelvic muscles and of a person’s
posture and breathing patterns, education about the structure and function of
the pelvic organs, progressive strengthening exercises, and various
physical-therapy techniques to improve tissue mobility.
“It’s just like regular physiotherapy but for the internal
muscles, the vaginal and rectal muscles,” Chadwick says. “We treat pain, we
treat weakness, we treat tightness, we treat any kind of dysfunction.”
That includes sexual dysfunction in both men and women.
Physio for the pelvic floor can be used to help women
overcome pain during sex or reduced sexual sensation; for men, it can treat
testicular pain or pain following ejaculation. It can also help with erectile
difficulties.
“If there’s weakness in the pelvic floor, we can strengthen
it; if there’s tightness, we can teach them [clients] how to relax,” Chadwick
says. “If there’s tightness in the muscles or fascia so they’re not getting good
circulation to the area, we can work on that.
“The pelvic floor is a really cool muscle,” she adds. “It
controls your organs and your bones. It’s related to sexual function, so it’s
also linked to your emotions.”
Other conditions that pelvic-floor physiotherapy can address
include organ prolapse, constipation, diastasis rectus abdominus (separated
stomach muscles), and painful tailbone, known as coccydynia.
All too often, people avoid seeking treatment for problems
related to the pelvic floor because they are too uncomfortable speaking about
them.
“People are embarrassed about peeing their pants, they’re
embarrassed about having any sexual issues,” Chadwick notes. “There’s still so
much shame around that area and around having problems there. Quite often, people
don’t go and tell their doctor or go and talk to anyone about it.
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