Perineal rehabilitation and the pelvic floor

04/04/2024 Par Stéphanie Guinois-Côté, perineal rehabilitation physiotherapist

Despite its growing popularity, perineal rehabilitation and the pelvic floor remain largely unknown to the general public. Most people know where their legs, arms, abdominal muscles and so on are located, but they don’t know where the pelvic floor is or what it’s used for! Everyone would benefit from learning more about this taboo area.

As we all have to start somewhere, this blog briefly summarizes what perineal rehabilitation and the pelvic floor are all about. With this information, you’ll be better equipped to discover and understand other blogs on the subject. Happy reading!

Perineal Rehabilitation

Perineal rehabilitation is a physiotherapy service addressing pelvic floor dysfunctions. The service can be accessed by individuals of any age. It is often useful for the following conditions:

Urinary and fecal incontinence
Prolapse/Descension of pelvic organs
Pelvic pain (back, pelvis, sacrum, coccyx)
Sexual dysfunctions
- Pain, difficulty reaching orgasm, muscle tension
Hyper- or hypotonicity of pelvic floor muscles
Pre- and post-childbirth
Diastasis reeducation
Radical prostatectomy
And many other conditions

A perineal rehabilitation assessment usually consists of a physical examination (posture, abdominal capacity, lumbar mobility, respiratory pattern, etc.), an external gynecological examination (observation of the area, contraction capacity, painful points, etc.), and an internal gynecological examination (assessment of pelvic floor muscle strength, endurance, and speed, presence of prolapse, etc.). Consent is, of course, required for each step.

Depending on the data collected during the assessment, exercises and advice are given to put into practice at home. A treatment plan will be determined according to your situation.

The Pelvic Floor

The pelvic floor is a group of muscles forming a “bowl” at the bottom of the pelvis. These muscles play several roles:

Enabling urinary and fecal continence
Providing important support for the pelvic organs
Sexual functions
Providing additional stabilization for the lumbar/abdominal girdle

It can be difficult to know how to properly contract the pelvic floor. When contracting, there should be a tightening sensation around the vagina and/or anus, and you should feel it rise. Here are a few tricks you can try to achieve a proper contraction:

Imagine that you have the urge to urinate and have to hold back your urge
Imagine that you want to squeeze and pull the vagina upwards (for men, imagine that you want to pull the testicles inwards)
What you would do as a contraction to prevent a gas from escaping

During contraction, the pelvic floor should be the only muscle contracting. If you feel yourself contracting your glutes/abdominals/inner thighs and/or holding your breath, you are compensating for the pelvic floor contraction. Try again without using these compensation techniques.

The best way to make sure you’re using your pelvic floor properly is to make an appointment for perineal rehabilitation. Even without any problems in the area, perineal reeducation is suggested to ensure that everything is working as it should and to prevent dysfunction. It’s even more advisable to book an appointment if you have one or more of the conditions listed above.

Perineal rehabilitation and the pelvic floor

Perineal Rehabilitation

The Pelvic Floor

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