Beyond Kegels — Local Help for Pelvic Floor Problems

How many times have you heard the suggestion (or the admonition) to “make sure you’re doing your Kegels!” As awareness grows about pelvic floor health, I think women are getting some mixed messages about how to fix and prevent pelvic floor problems. The “just do your Kegels” message is probably the most common one I personally hear, and yet I know from having done pelvic floor physiotherapy myself, it’s not the only or complete answer.

Today I’m really glad to bring you this guest post from pelvic floor physiotherapist Denisha Thompson, B.M.R., PT. Denisha reached out to me with information about pelvic floor physio (she practices at Centric Health Sports Therapy and Wellness Centre), and I thought the info was so useful that I wanted to share all of it! You can also find more local pelvic floor physiotherapists here. So without further ado, here’s Denisha.

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I would like to take this opportunity to introduce you to the Pelvic Health Program that we have started at Centric Health Sports Therapy & Wellness Centre.

Specialized Physiotherapy is becoming more established in the literature as a first-line of defence against Incontinence and Pelvic Pain. Pelvic Floor Dysfunction can be caused by:

  • HYPOTONICITY (weak muscles): contributing to stress incontinence and pelvic organ prolapse
  • HYPERTONICITY (tight muscles): contributing to urgency, urge incontinence, chronic pelvic pain, dyspareunia, vaginismus, vulvodynia, pudendal neuralgia, interstitial cystitis and chronic prostatitis

Kegels are NOT always indicated for pelvic floor problems. Sometimes they do more harm than good, and often they are NOT performed correctly.

The Cochrane Collaboration 2014 concluded that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defence, before surgical consultation, for stress, urge and mixed incontinence in women. Pelvic floor physiotherapy should be considered for:

  • Painful bladder conditions (interstitial cystitis)
  • Stress urinary incontinence (before surgery is considered)
  • Urge incontinence (before anti-cholinergics are considered)
  • Fecal incontinence
  • Pelvic organ prolapse
  • Constipation
  • Dyspareunia and other painful vaginal conditions
  • Posterior pelvic pain in pregnancy
  • Male pelvic pain, including chronic prostatitis and testicular/penile pain
  • Post-partum scar tissue and dysfunction

There is quite a bit of overlap in symptoms and conditions of the pelvic floor that can be applied to variants of the above specified conditions. After a thorough assessment of an individual’s pelvic floor, related connective tissue integrity, and relevant (possible) lifestyle contributors, among other assessment strategies, often great results are achieved when treatment is applied.

If you have any questions, or would like more information about our services, please do not hesitate to contact me at 204-478-6480.

About the author: Denisha Thompson obtained her Bachelor of Medical Rehabilitation degree in 2007 from the University of Manitoba. Her first position as a physiotherapist, was assisting in a return to work rehabilitation program in a private clinic. Following this, she had the privilege of working at Health Sciences Center, specifically in the out-patient orthopedics department. Through this position she also had the opportunity of working on an in-patient ward– including positions in the emergency and burns unit, as well as providing physiotherapy in Churchill, Manitoba. Additionally, she has completed a variety of post graduate courses organized through that facility, and otherwise has successfully completed level I and II in the Orthopedic Division.

Always seeking new challenges and experiences, Denisha decided to embark on a new adventure by moving to Ontario from Winnipeg, Manitoba in 2010. Here, she continued her quest for continued education and expansion as a physiotherapist, by obtaining her certificate in Medical Acupuncture, and taking a variety of additional post-graduate orthopedic courses for assessment and treatment of spinal, shoulder, and muscle imbalance conditions. Denisha is passionate about health, wellness and fitness, and as such obtained her personal training certificate to supplement her interest of implementing exercise based classes and training as one of her hobbies.

Although she continues to practice and enjoy orthopedic physiotherapy, Denisha’s primary focus at this time is in Pelvic Health physiotherapy, as she has seen and become more aware of the positive impact it can provide. Denisha has completed levels one, two and three in Pelvic Health training, as well as completion of Röst Therapy: Relieving Sacro-iliac and Pubic Pain During and After Pregnancy. She is committed to continuing her advancement and training in this sector.

Denisha genuinely looks forward to meeting and working with individuals to achieve their functional goals!