physiotherapy and osteopathy

pelvic floor

Although we hear more and more about pelvic floor physiotherapy, this discipline remains largely unknown today.

The Pelviperineal physiotherapy (which comes from the union of the terms “pelvis” and “perineum”) It is the treatment at the level of tissues and muscles found between the pubis and the tailbone. This therapeutic discipline allows us to evaluate and treat dysfunctions, and of the sexual sphere that accompany women in the postpartum and menopause and men after prostate surgery.

Women who have not given birth or are in the perimenopausal period, as well as men who have never undergone surgery for a prostatectomy, may also need preventive or rehabilitative treatment. Also the women who do high impact sports (running, tennis, athletics, weight lifting).

The most common pelvic floor dysfunctions:

Urinary incontinence
Fecal incontinence or gases
Organ descent (prolapse)
Perineal pain
Terminal constipation
During the pregnancy and in the postpartum

Sexual dysfunctions (dyspareunia, vaginismus, erectile dysfunction)

If you want to know more about this topic, read on….

How do we do the assessment of the pelvic floor?

It is performed by a physiotherapist specialized in this field. and it is important to differentiate it from the gynecological assessment carried out by a gynecologist. In this gynecological assessment, it is intended detect organ disorders, sexually transmitted diseases or any type of pathology.

Both evaluations have different purposes and the ideal thing is to be able to have both reviews to have a more complete view of our urogynecological system.

To know if a pelviperineal physiotherapy treatment is indicated, It is necessary to go to a professional to carry out an assessment of the pelvic floor, which will consist of maintaining an interview with the patient and carrying out a physical examination.

Data collected at the interview

In the clinical interview we collect important information in order to fully understand the specific case of each patient and design subsequent treatment. In the interview, data related to:

General health: medical history, if you have underlying diseases, if you take medication, surgical interventions, pathologies neurological, urogynecological, digestive or psychological, eating habits, etc.
Profession and sports activities: type of professional activity that the patient carries out, if he spends many hours standing, if he has to lift or push weights, if it greatly requires diaphragm activity or increases abdominal pressure (singers, teachers, actresses, wind players, dancers, fitness instructors, etc.).
Bladder dynamics: how many times he urinates a day, characteristics of urination (volume, strength of urinary flow, position, sensation of complete emptying, abnormal practices, etc.), how much liquid he ingests, if he wakes up at night to pee, if he leaks, if you feel an urgency to go to the service, if you are aware of when your bladder is full, etc.
Defecation: How many times a day or week do bowel movements occur, the nature of the bowel movements, whether you use particular stimuli to help yourself defecate, whether you take laxatives, whether you feel pain when passing stool or make great efforts to do so, whether an abnormal amount of time passes prolonged in the bathroom, etc.
The gynecological history, in the case of women: If there have been pregnancies, cesarean sections and births, how were these, did suction cups or forceps have to be used, if an episiotomy was performed or a perineal tear occurred, if perineal preparation or postpartum recovery was performed, etc
Sexual relations: if they exist, if they are pleasurable, if they are accompanied by pain, if there is difficulty or impossibility of reaching orgasm, if urinary or fecal symptoms appear during them (such as the urge to pee or leaks), etc.

Physical examination of the pelvic floor

After collecting the information provided by the clinical interview, the functional assessment of the pelvic floor which consists of a physical, external and internal examination of the muscles, as well as the pelvis, abdomen, diaphragm and posture.

The physical examination includes thevisual and palpatory examination, muscle assessment, assessment of pelvi-perineal statics and mobility of the pelvic organs (existence of organ descent or prolapses), the neurological examination and examination of lumbo-abdomino-pelvic statics.

Based on all the data obtained in the different tests, the physiotherapist establishes treatment objectives and selects the most appropriate pelviperineal re-education techniques to achieve these objectives.

pelvic floor

How do we do the assessment of the pelvic floor?

Data collected at the interview

Physical examination of the pelvic floor

Request your first interview at our clinic in L'Elianaa