Pelvic Floor Physiotherapy Treatment

Pelvic floor physiotherapy treatment is a special type of physical therapy that helps strengthen or relax the muscles at the bottom of your pelvis. These muscles support your bladder, bowel, and reproductive organs. When they get too weak or too tight, you can have problems like urine leaks, pelvic pain, or pressure "down there." A trained pelvic floor physiotherapist uses hands-on techniques, exercises, and education to help you get better   without surgery or drugs.

If you live in or around Markham, Ontario, and you've been dealing with these kinds of symptoms, you're not alone. Research published in Scientific Reports found that roughly 1 in 3 women in the U.S. experience at least one pelvic floor disorder. The numbers in Canada are similar. The good news? Pelvic floor physiotherapy treatment is backed by strong evidence and is considered a first-line option for most pelvic floor problems.

In this article, we'll walk you through everything   from what a pelvic floor physiotherapist actually does, to what your first session looks like, to the exercises that can help. We'll also answer the honest, sometimes awkward questions people search for but rarely ask out loud.

What Is Pelvic Floor Physiotherapy and What Does It Do?

Think of your pelvic floor as a hammock made of 26 muscles. This hammock stretches from your pubic bone in the front to your tailbone in the back. It holds your bladder, uterus (or prostate), and rectum in place. It also helps you control when you go to the bathroom, supports your core, and plays a role in sexual function.

When those muscles stop working the way they should   either because they are too weak or too tight   that's called pelvic floor dysfunction.

What Does a Pelvic Floor Physiotherapist Do?

A pelvic floor physiotherapist is a registered physiotherapist with extra training in pelvic health. They assess the muscles of your pelvic floor through both external and internal exams. Then they build a treatment plan just for you.

At Northville Rehabilitation Centre in Markham, our pelvic floor physiotherapist is Irene Chau, MScPT, BSc.Kin (Hons). Irene graduated from Queen's University with a Master of Science in Physical Therapy and holds a Bachelor of Science in Kinesiology. She has gone above and beyond basic pelvic floor training, with advanced education in childbirth and the pelvic floor, diastasis recti, pregnancy-related pelvic girdle pain, postpartum recovery, and cesarean birth rehabilitation.

Her hands-on, patient-first approach means you'll never feel rushed or judged. Whether you're a new mom in Unionville, a busy professional near Kennedy Road and Highway 7, or a senior in the Markham community   Irene works with you to set personal goals and build a plan that fits your life.

Who Needs Pelvic Floor Therapy?

Pelvic floor therapy isn't just for women who've had babies. It can help a wide range of people, including men. You might benefit from pelvic floor physiotherapy treatment if you experience any of the following:

• Leaking urine when you cough, sneeze, or exercise

• Rushing to the bathroom and not always making it in time

• A heavy or dragging feeling in your pelvis

• Pain during sex

• Chronic constipation or difficulty with bowel movements

• Lower back pain that won't go away

• Pelvic pain before, during, or after pregnancy

• Recovery after prostate surgery (for men)

If any of these sound familiar, it's worth having a conversation with a professional. You can always contact the team at Northville Rehab to ask questions before booking.

Signs of a Weak Pelvic Floor (and When to Worry)

Many people live with pelvic floor symptoms for years without knowing there's a name   and a fix   for what they're going through. Let's look at the signs.

What Are the Symptoms of a Weak Pelvic Floor?

The most common signs include leaking urine (even a few drops count), feeling like your bladder never fully empties, a bulge or heaviness in the vagina, lower belly pressure, pain during intercourse, and trouble controlling gas or stool. Some people also feel a constant dull ache in the pelvis or lower back.

How to Tell if Something Is Wrong With the Pelvic Floor

Here's a simple check. If you can't stop the flow of urine midstream, or if you frequently leak when you laugh, sneeze, or lift something heavy, your pelvic floor may need attention. If you feel pressure in your pelvis when you stand for a long time, or if sex has become painful, those are also signs.

Pain that you can't explain in the pelvic area should not be ignored. It does not mean something terrible is happening, but it does mean your body is asking for help.

What Is the Most Common Pelvic Floor Disorder?

Urinary incontinence is by far the most common. Data from the National Health and Nutritional Examination Survey (NHANES) showed that urinary incontinence had a prevalence of about 17% among U.S. women. Stress urinary incontinence, the kind where you leak during a cough or jump, is the most frequent type.

What Happens if a Weak Pelvic Floor Goes Untreated?

If left alone, a weak pelvic floor can get worse over time. Minor leaks can become more frequent. A small prolapse (where organs drop lower than they should) can progress. Chronic pelvic pain can affect your mood, your sleep, and your relationships. It can even lead to social isolation. People stop going out because they're afraid of accidents.

The earlier you start treatment, the better the outcomes. Pelvic floor physiotherapy treatment is most effective when it begins before symptoms become severe.

What Age Does the Pelvic Floor Weaken?

Pelvic floor muscles can weaken at any age, but the risk goes up after pregnancy, during menopause, and as you get older. Studies show that for every 10-year increase in age, women are about 1.2 times more likely to develop a pelvic floor disorder. That said, even younger people can have pelvic floor issues, especially after childbirth, intense exercise, chronic coughing, or surgery.

What Is Stage 4 Pelvic Floor Dysfunction?

Pelvic organ prolapse is graded in stages from 1 to 4. Stage 4 is the most advanced; it means an organ (like the uterus or bladder) has dropped so far that it comes out through the vaginal opening. This is rare and usually happens after years of untreated prolapse. Even at this stage, physiotherapy can help manage symptoms, though surgery may also be discussed.

What to Expect During Pelvic Floor Physiotherapy Treatment

This is where a lot of people get nervous. Let's break it down step by step so you know exactly what happens, no surprises.

What Should I Expect in My First Session?

Your first visit usually lasts about 60 minutes. It starts with a private, one-on-one conversation. Your physiotherapist will ask about your symptoms, your health history, your goals, and how your symptoms affect your daily life. This is your chance to share your story. No detail is too small or too embarrassing.

After the conversation, the therapist will do a physical assessment. This may include looking at your posture, checking your hips and lower back, and assessing your core and breathing patterns. If you consent, it will also include a pelvic floor muscle assessment.

At Northville Rehab on Kennedy Road in Markham, Irene Chau takes time to explain every step before she does it. You are always in control, and you can pause or stop at any point.

Do Pelvic Floor Physios Do Internal Exams?

Yes, an internal exam is often part of a thorough pelvic floor assessment. But here's what you need to know   it is nothing like a gynecological exam. There is no speculum involved. The therapist uses one gloved, lubricated finger (inserted vaginally or rectally) to feel the pelvic floor muscles. They check for strength, tightness, trigger points, and control.

The internal exam usually takes about five minutes. It gives the therapist valuable information that can't be gathered any other way. Think of it like this: if you had a sore shoulder, the physio would press on the muscles to find the problem. It's the same idea, just in a different spot.

Do You Have to Undress for Pelvic Floor Therapy?

For the internal portion of the exam, you'll undress from the waist down. The therapist will leave the room while you change and drape a sheet over yourself. You'll be covered at all times except during the brief exam. Wearing comfortable clothes, loose pants or shorts work well.

Do They Touch You in Pelvic Floor Therapy?

Yes, but always with your clear consent. Touch in pelvic floor therapy is clinical, professional, and explained before it happens. You'll know what the therapist is doing and why, at every step. If anything feels uncomfortable, you say the word and the therapist adjusts or stops.

How Painful Is Pelvic Floor Therapy?

For most people, pelvic floor therapy is not painful. If your muscles are very tight or if you have active trigger points, you may feel some tenderness during the internal exam   similar to pressing on a sore muscle. But the therapist will go at your pace. If something hurts, they change what they're doing.

Many patients say they feel relief during and after treatment, not pain.

Why Did I Cry During My Pelvic Exam?

If you've ever teared up during a pelvic exam, please know this: you are not alone, and it's completely normal. The pelvic region holds a lot of emotional energy. Stress, anxiety, past trauma, or even just the vulnerability of the situation can bring up strong feelings. Research from Harvard Health notes that pelvic exams can be anxiety-provoking, and for survivors of trauma, they can feel especially overwhelming.

A good pelvic floor physiotherapist is trained to handle these moments with care. At our Markham clinic, we create a safe space where emotions are welcome, not something to apologize for.

Treatment Techniques Used in Pelvic Floor Physiotherapy

Once your therapist completes the assessment, they'll build a plan based on your specific needs. Here's a look at common techniques used in pelvic floor physiotherapy treatment.

Manual Therapy

This includes gentle pressure and massage techniques (both internal and external) to help tight muscles relax. Myofascial release, trigger point therapy, and soft tissue mobilization all fall under this category.

Pelvic Floor Exercises (Including Kegels)

You've probably heard of Kegels. They involve squeezing and lifting the pelvic floor muscles, then relaxing them. But here's the catch: many people do Kegels wrong, and doing them incorrectly can actually make things worse. Mayo Clinic Health System notes that most people initially perform Kegels incorrectly, which leads to poor results. A trained physiotherapist will teach you how to do them right.

Your therapist may prescribe a different combination based on your assessment. Not everyone needs Kegels, some people need to learn to relax their muscles first.

Biofeedback

Biofeedback uses sensors to track your pelvic floor muscle activity on a screen in real time. It helps you see when you're squeezing and when you're letting go. This is especially helpful for people who have trouble feeling their pelvic floor muscles.

Electrical Stimulation

A mild electrical current is used to stimulate pelvic muscles. This can help strengthen very weak muscles or calm down overactive nerves. It sounds intense, but most people say it feels like a gentle tingling.

Education and Lifestyle Changes

A big part of pelvic floor physiotherapy treatment is education. Your therapist may recommend changes to your fluid intake, diet (more fiber, less caffeine), bathroom habits, or exercise routine. Patient education empowers you to take an active role in your own recovery.

How Long Does Pelvic Floor Therapy Take?

Pelvic Floor Physiotherapy Timeline

Most patients attend weekly sessions for about 4 to 12 weeks. Johns Hopkins Medicine notes that you can generally expect to work with a pelvic floor therapist for 8 to 12 weeks, with one or two sessions per week.

The exact timeline depends on your condition, how severe your symptoms are, and how consistent you are with home exercises. Some people feel better after just a few sessions. Others need longer care. Your physiotherapist will monitor your progress and adjust the plan as you go.

How Often Should You Have Pelvic Floor Physiotherapy?

Most therapists recommend once a week to start. As you improve, sessions may become less frequent, maybe every two weeks, then once a month for check-ins. Home exercises between sessions are just as important as the in-clinic work.

Is It Worth Seeing a Pelvic Floor Physio?

In a word, yes. Pelvic floor physiotherapy treatment has strong evidence behind it. A review published in Current Opinion in Obstetrics and Gynecology concluded that pelvic floor physical therapy can improve or even cure symptoms of urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic pain conditions.

For many people, it means the difference between living with daily discomfort and getting your life back. It's a conservative, non-surgical treatment that puts you in the driver's seat.

If you've been told to "just do Kegels" and it hasn't worked, or if you've been living with symptoms for months (or years), a visit to a pelvic floor physiotherapist could change things for you.

Insurance, Cost, and Practical Questions

Why Is Pelvic Floor PT Not Always Covered by Insurance?

In Canada, pelvic floor physiotherapy is often covered under extended health benefits as part of your physiotherapy coverage. The good news for Markham residents is that Northville Rehabilitation Centre accepts the majority of Canadian extended health insurance providers, including Sun Life, Manulife, Canada Life, Green Shield, Desjardins, and many more. Check the full list on our insurance providers page.

Our front staff will even help you submit your claim on the day of your visit so you get reimbursed quickly.

What to Wear to a Pelvic Floor Physio Appointment

Wear comfortable, loose-fitting clothes. You'll be moving around, and for the internal exam portion, you'll change into a drape. There's no need for special athletic gear. Just come as you are.

Red Flags and How to Tell if Your Physical Therapist Is Good

What Is a Red Flag in Physical Therapy?

A red flag in any physical therapy setting is when something doesn't feel right. Watch for a therapist who doesn't explain what they're doing before they do it, rushes through your visit, doesn't ask for consent before touching you, or dismisses your concerns. If a therapist makes you feel uncomfortable or pressured, that's not okay.

How to Tell if Your Physical Therapist Is Good

A good pelvic floor physiotherapist will listen carefully to your story, explain everything clearly, check in with you during the exam, respect your boundaries, and give you a clear treatment plan. They should also have advanced training in pelvic health, not just general physiotherapy. Irene Chau at Northville Rehab holds specialized credentials in pelvic floor and pregnancy-related conditions, giving you confidence that you're in experienced hands.

Why Choose Northville Rehabilitation Centre in Markham?

Northville Rehabilitation Centre has served the Markham community for over 30 years. Located at 9980 Kennedy Road, Unit 5, Markham, ON L6C 0M4, our clinic is easy to reach from Unionville, Cornell, Angus Glen, Cathedraltown, and other neighborhoods across Markham and the York Region.

What sets us apart is our multi-disciplinary team. Under one roof, you have access to chiropractors, physiotherapists, registered massage therapists, an osteopath, a chiropodist, acupuncturists, a naturopath, and a psychotherapist. If your pelvic floor issues are connected to other concerns   like lower back pain, stress, or post-pregnancy body changes   our team works together to give you complete care.

We believe that partnering with our patients helps restore quality of life. Every treatment plan at our Markham clinic is evidence-based, patient-centered, and built around your specific goals. We speak English, Cantonese, Mandarin, and Tamil   because serving the diverse Markham community means meeting people where they are.

Final Thoughts

Pelvic floor physiotherapy treatment is one of the best-kept secrets in healthcare. It's safe, effective, and backed by strong research. Whether you're dealing with bladder leaks, pelvic pain, postpartum recovery, or something you haven't been able to put into words   help is available right here in Markham.

You don't have to wait until things get worse. You don't have to just "live with it." And you certainly don't have to feel embarrassed about asking for help.

If you're ready to take the first step, book an appointment online with our pelvic floor physiotherapist Irene Chau at Northville Rehabilitation Centre. Or call us at 905-534-8666. We're open Monday through Saturday, and we're here to help you feel like yourself again.

Your pelvic floor carried you through a lot. Now let us help you take care of it.