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.
Pelvic-floor physiotherapy is one way to treat it.
“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.
“I see these issues all day every day,” she says. “They’re far more common than people think.”