• Sarah Symmes

How do virtual physiotherapy visits work? Part II: Pelvic Health Physiotherapy


"The most exciting thing that I see evolving in my virtual visits is that it is forcing me to step back from using my hands to try to “fix” a problem and instead it’s empowering clients to have the tools to be at the centre of their own health and recovery and to me that’s what it’s all about!"

The next area of my virtual physiotherapy practice I’d love to highlight is pelvic health physiotherapy.


What do we treat in pelvic health?:

Some of the issues we address in pelvic health physiotherapy include, pelvic pain, incontinence, pelvic organ prolapse, pregnancy related pelvic girdle pain, post-natal recovery, constipation, dyspareunia and vaginismus just to name a few.

This is one area I’m particularly excited to take online. I’ve been wanting to offer virtual follow-ups for pelvic health for a long time. But with a busy in-home practice I hadn’t had time to figure out all the ins and outs of virtual care. And now with a little extra time between building forts and making snacks for my kiddos it has been fun to explore how to offer this service and it has truly ignited a new excitement for how we can serve clients even beyond this time of physical distancing.

Why are virtual visits valuable?

I envision a future where I can help serve clients that live out of my home-visit area, or those that don’t have access to a pelvic health physiotherapist in their neighbourhood. I also see it as a way to help busy clients who need a quick check-in to trouble shoot or progress exercises and review some strategies. Lastly, I love that with virtual care you can see a client, do an exercise in their home, or demonstrate some of the common postures and activities they do during a day. For example, sitting at their home office, cooking in their kitchen or nursing and caring for their new baby. This gives such lovely insight into how we can help make a treatment plan meaningful and sustainable.

The virtual assessment and treatment rundown:

So how does a virtual assessment work? I gave a full rundown a virtual assessment and treatment in my last blog so I’ll invite you to check that out here: https://www.centredphysiotherapy.com/post/how-do-virtual-physiotherapy-visits-work-part-1-orthopaedic-physiotherapy

Some of you may be wondering how we can do a pelvic health exam without the critical component of the internal examination. And it is true the internal exam gives vital information about the health and function of the pelvic floor. So in the absence of this valuable tool we use things like a thorough history, a detailed intake questionnaire and self-report measures, as well as an external physical exam to help us formulate our clinical opinion. From there we can use tools such as visualization exercises and feedback that you provide to help modify the treatment plan to help you achieve your goals!

Virtual pelvic health treatment:

Education and lifestyle modifications are a pillar of pelvic health physiotherapy. Interestingly, during my in-person assessments I most often start with the external assessment and offer loads of education even before we get to an internal exam.

Some of the things we might help clients with are reviewing tools like a bladder or fibre diary for clients with symptoms of incontinence or constipation. We provide prescriptive exercises for areas like posture, core, hips and the pelvic floor. We might also explore lifestyle factors, habits and activity modifications. Lastly, we can teach self-management techniques for soft tissue release and biofeedback. The list of strategies and tools truly is endless which is one of the reasons I love this area of practice.

Considering the whole person:

Guidance from my mentors and my passion for yoga have also led me on the path to a biopsychosocial model of care. In this framework we address not only what is happening at the tissues but we also consider social factors and psychological factors. This might look like helping refer clients to other allied health practitioners for things like psychological support or nutritional counselling. Or, through offering strategies to down regulate a sensitized nervous system. This could look like education on pain science, exercise, sleep, yoga, mindfulness practices and my ultimate favourite… breathing!

Stepping back to move forward:

The most exciting thing that I see evolving in my virtual visits is that it is forcing me to step back from using my hands to try to “fix” a problem and instead it’s empowering clients to have the tools to be at the centre of their own health and recovery and to me that’s what it’s all about!


If you have any other questions about how virtual PT could work for your pelvic health concern send me an email to sarah@centredphysiotherapy.com. Can’t wait to help you with your goals!

~Sarah

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