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Image by Katarzyna Grabowska



The pelvic floor is a sling of muscles that sits like a hammock across the bottom of the bony pelvis, supporting the bladder, uterus and bowels. Just like any other muscle in the body, we want the pelvic floor muscles to be strong, flexible and coordinated in order to function at their best. These muscles can become weak and uncoordinated, due to pregnancy/childbirth and aging, and can also become tight, just like any other muscle in our body. When you cough, sneeze, jump or carry something heavy, there is a downward pressure on your organs. The pelvic floor muscles need to have the strength, flexibility and coordination to withstand this pressure to prevent any leakage, heaviness or pelvic pain. But it's not just about the pelvic floor! Maybe the old ankle injury or lingering hip pain is part of the equation too, let's assess and find out! My background and education in orthopaedic and pelvic floor physiotherapy, as well as my experiences as a mom of 2, allows me to help you get stronger, and get back to feeling like you again.


You probably haven’t put much thought into your pelvic floor muscles unless they aren’t working properly. Pelvic health physiotherapy can help with a variety of issues, including:

  • Urinary incontinence (leakage) 

  • Urinary urgency, frequency or hesitancy

  • Bowel issues such as constipation or faecal incontinence

  • Prolapsed bladder, uterus or rectum

  • Pelvic pain

  • Diastasis recti or other core and abdominal wall dysfunction

  • Pelvic inflammatory disease

  • Endometriosis

  • Pain with sex (dyspareunia)

  • Pubic symphysis dysfunction

  • Pelvic girdle pain, sciatica, or SI joint pain during or after pregnancy

  • Pre/Postnatal exercise 

  • Childbirth preparation and pre-natal education

  • Painful intercourse

  • Painful bladder syndrome (interstitial cystitis)

  • Persistent low back, hip, groin, or abdominal pain

  • Scar tissue restricting the abdomen, pelvic floor or vulvar region

  • Post surgery for hysterectomies or any other pelvic surgery


  • It is not normal to leak when you laugh, cough, or sneeze.

  • It is not normal to feel pressure or heaviness in your pelvic region.

  • It is not normal to have pain with intercourse. 

  • It is not normal to feel pain in the pelvic region.


In 2010, the Cochrane Collaboration published a review, Pelvic Floor Muscle Training vs. No Treatment, or Inactive Control Treatments, for Urinary Incontinence in Women, which analyzed the effectiveness of pelvic floor strengthening in stress and urge incontinence. The Cochrane Collaboration concluded that there is Level I/Grade A evidence (the strongest level of evidence available) for pelvic floor strengthening for urge and stress incontinence. The Cochrane Collaboration recommended that pelvic floor strengthening should be taught by a physiotherapist using internal assessment and treatment techniques, and this treatment should be the first line of defense for urge and stress incontinence. This means that the research says pelvic floor physiotherapy should happen with all patients who leak before surgery is considered.

Find the study HERE


A pelvic floor physiotherapist has specialized training in the assessment and treatment of pelvic floor dysfunction. After a thorough history and external assessment of the lumbo-pelvic region, an internal vaginal exam may be performed if appropriate. This is the best way to access these muscles to assess tone, strength, coordination and pain. Following your assessment, we will discuss your condition and set goals to develop a treatment plan, which may include pelvic floor exercises, hip and core stability, muscle release techniques, lifestyle/dietary changes, and more. 

Questions? Send me a message or book an appointment online, and I would love to help you.

Claire McDonald, Registered Physiotherapist


LivWell Integrated Health, Squamish BC

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