PREGNANCY & POSTPARTUM PHYSIOTHERAPY

Perinatal Physiotherapy

If you are pregnant, or have ever been pregnant, and you experience pain or dysfunction related to your pregnancy and/or labor and delivery, our physiotherapists are trained to help. This booking option is for those whose primary issue is not related to the pelvic floor, however our therapists may ask questions related to your pelvic floor to assess if this may be a factor in your symptoms.

Common conditions treated include:

pelvic girdle pain

pubic symphysis dysfunction

lower back pain

tailbone pain

This list is not extensive - please feel free to reach out if you are unsure if this option is right for you.

Vancouver Perinatal Physiotherapy services are offered at both our clinics, at South Granville and at False Creek.

If you feel your pelvic floor is related to your symptoms, see our PELVIC FLOOR PAGE for more information. IF you are unsure which appointment type you need, book either Peri-natal OR Pelvic Floor physiotherapy and your therapist can work with you to determine what's best.

Meet the Pelvic Health Physiotherapy Team

Our five pelvic floor physiotherapists have an approach that is rooted in the knowledge and teachings of pioneer Marcy Dayan, and they each bring their own experience and continuing education to their practice. Dayan Physiotherapy & Pelvic Floor Clinic merged with Envision in 2020 and continues to work as a team supported by our broader services like Clinical Pilates, Kinesiology, Dietitians and other specially focused Physiotherapy.

Please click on each physio’s name below to read their bio and determine who you think might be the best fit to help you.

PELVIC FLOOR PHYSIOTHERAPISTS

Click on Name for Bio

Click on Name for Bio

Click on Name for Bio

Click on Name for Bio

Click on Name for Bio

Click on Name for Bio

Anna Hudon-Kaide

How to Make an Appointment

If you have questions or concerns about booking an appointment for pelvic floor physio, you can call our reception staff at either office:

South Granville 604-737-7309 or False Creek 604-876-2344

If you would like to book online, you can do so by clicking on the Booking Link above and pick which clinic and which physio you would like to see.

Learn More

Please click on any of the links below to learn more about our pelvic floor services and common conditions that we can help with:

Physiotherapy Services

Pelvic Health Education

Pessary Fitting

Core Muscle Activation and Training

Physical Assessment with Internal Exam

EMG Biofeedback

Real-Time Ultrasound

Pelvic Health Related Conditions

Abdominal Separation / DRA

Bladder Control - Incontinence

Bowel Control - Incontinence

Coccydynia / Tailbone Pain

Pelvic Organ Prolapse

Low Back & Pelvic Girdle

Painful Intercourse

Pelvic Dysfunction (SI joint, pubic symphysis)

Pudendal Neuralgia

Prostate Problems

Prostate Cancer / Prostatectomy Health

*Contact us if you have any more questions regarding Pelvic Health Physiotherapy

Prostatitis / Prostadynia

Also know as prostatitis, pelvic pain syndrome, chronic nonbacterial prostatitis, chronic genitourinary pain, pudendal neuralgia, painful bladder syndrome or interstitial cystitis. Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition in men.

Symptoms may include a few or all of the following:

Pain in the testicles, or tip, shaft or base of the penis
Pain at the perineum (the area between the testicles and penis)
Pain on urination
Increased pain in sitting
Pain or discomfort with sexual arousal, or during or after ejaculation
Pain or discomfort above the pubic bone
Urinary frequency
Urinary urgency
Pain before, during or after a bowel movement
Decreased interest in sex
It is often found along with interstitial cystitis, painful bladder syndrome and IBS (irritable
bowel syndrome)

Investigations for bacteria and yeast are negative. Physical examination does not usually show anything unusual, although the prostate may be swollen, soft or firm, warm and tender. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, pain-killers, and medications prescribed in attempt to relax the muscles of the prostate are often not effective. Many men have been told that they must learn to live with the symptoms because a cure is not available.

This condition is now understood as a pain condition and it is highly doubtful that problem lies solely in the prostate. Treatment interventions include pain education and ensuring an understanding of the multiple factors contributing to the condition; ensuring there is no reactive pelvic floor spasm and if so, teaching men skill in relaxing their pelvic floor; bladder management techniques; and cognitive, behavioural and dietary interventions to address bladder and bowel symptoms. Using these interventions, concepts of pacing and grading are included to enable men to return to activities (sitting, cycling, sexual) that have become too painful to enjoy. Our clinic is fully equipped with biofeedback and imaging ultrasound to ensure the best in technology to support excellence in assessment and treatment. Our philosophy is to teach clients what they need to know and do in order to be able to manage their condition and minimize or eliminate pain and other symptoms.

Bladder Control - Incontinence

Bladder incontinence is the involuntary loss of urine. It is not a disease, but a symptom of a physical or neurological problem. It is estimated that up to 25% of adults have urinary incontinence and that women are affected twice as often as men. Although the chance of becoming incontinent increases with age, it happens to people of all ages and is NOT a natural part of aging.

Symptoms can include:

* Leaking urine or stool when you sneeze, run, exercise, laugh, cough… (Stress urinary incontinence)

* Problems getting to the bathroom in time (urgency)

* Constipation

* Frequent need to urinate

The bladder is a hollow muscular organ that collects urine. Urine leaves the bladder through the urethra, a narrow tube-like structure extending from the bladder to the outside of the body. The bladder has two functions. It either stores urine or empties urine. During the storage phase the bladder muscle remains relaxed, while the sphincters and muscles that block off the urethra and bladder stay contracted, thus preventing any urine from escaping. If urine escapes during the storage phase, it is called a leak.

Urine leakage, or incontinence, can have many causes.. Stress and urge are two common types of urinary incontinence. Many people have more than one type of incontinence at the same time.

STRESS INCONTINENCE

Many people leak urine when they cough, sneeze, walk, run or otherwise exert themselves. This is called stress urinary incontinence. These actions increase the pressure within the abdomen. This increased pressure squeezes the bladder. If the pressure squeezing the bladder is greater than the closure pressure of the sphincters sealing the urethra, urine is forced out and a leak occurs. Correctly performed pelvic floor muscle (Kegel) exercises can help stop this leakage. Research shows that based on verbal and written instruction, 75% of women are doing these exercises incorrectly.

URGE INCONTINENCE

A strong, sudden need to empty the bladder is called urgency. When it is associated with leakage it is called urge incontinence. Remember, the bladder is a muscle. The strong urge is caused by an overactive contraction of the bladder muscle. The problem is compounded if the pelvic floor muscles that close the urethra and bladder are weak. Several things can cause your bladder to become overactive. Small bladder capacity, nerve damage, caffeine, and anxiety are a few of the contributors to an overactive bladder. It is not uncommon for someone to have both stress and urge incontinence. The individual can learn to suppress the urges, increase their bladder capacity and the amount of time between emptying their bladder, and strengthen their pelvic floor muscles. There are also medications that can help the bladder to be less active.

Treatment varies depending on the problem. We use both Real-Time Ultrasound and Biofeedback to help you learn how to contract and strengthen your pelvic floor (Kegels). Research shows that up to 75% of women, based on verbal and written instruction alone, are doing Kegels (contracting their pelvic floor) incorrectly. We do not have the research for men, but our clinical experience shows it to be about the same. We also help you learn behavioural changes involving diet and toileting patterns and, prescribe the use of internal assistive devices (pessaries) to help you regain control of your bladder.

Painful Intercourse

Vaginal pain – it’s not in your head! Many women suffer from a common and often misunderstood vaginal pain condition called vulvar vestibulodynia, also know as vulvar vestibulitis syndrome (VVS) or vulvodynia. Pain can be experienced with intercourse or other sexual contact, tampon use, a medical exam, riding a bike, sitting, or wearing tight pants. A study published in the Journal of the American Medical Women’s Association [2003] demonstrated that 16% of the female population experienced vaginal pain at some point in their life. Many women chose not to seek treatment, of those that did, 60% saw 3 or more doctors, many of whom could not diagnose the condition. The study also showed that women who have pain the first time they use a tampon are 7% more likely to have chronic vulvar pain later in life. Considering that vestibulodynia (vestibulitis) is believed to be quite prevalent and is often misdiagnosed, it is important that women are informed about this condition – the causes, treatment and supports – enabling women to make informed decisions regarding their health care.

Although pain can be present with or without physical contact, it is often made worse by contact and can vary in intensity and frequency, from very occasional to constant and unrelenting. The type of discomfort can also vary, ranging from mild burning to knife-like pain. Many women experience increased pain at a specific point in their menstrual cycle. Approximately 40% of women also experience simultaneous bladder and bowel conditions and other pain conditions. The onset of pain varies. Some women have had vaginal pain since their first experience of vaginal contact when trying a tampon or intercourse for the first time. Others develop vestibulodynia after many years of painfree vaginal contact.

Often misdiagnosed as a yeast infection or psychological issue, the cause of this condition is unknown. Medical examinations and laboratory test results are negative for bacterial and fungal infections and skin conditions. The medical community believes that vestibulodynia, or vestibulitis, may be caused by injury or irritation of the local pain nerves in response to trauma, infection, or sensitivity to environmental factors. Most women with vestibulodynia have increased tension or spasm (vaginismus) of the pelvic floor (the muscles that support the pelvic organs and surround the vaginal opening).

Several different treatment options are available. Physical therapy, medications, dietary modifications, stress and pain management, counselling and exercise are common treatment approaches. In some situations, surgery may be an option. Physical therapy treatment has many aspects, ranging from learning how to control both the contraction and relaxation of the muscles surrounding the vagina, desensitizing the painful areas to touch, the use of vaginal inserts and information regarding dietary modifications.

At Dayan Physiotherapy, we use biofeedback to help women learn how to relax these muscles (the pelvic floor), and if there is pain, what to do to minimize or eliminate the discomfort. In this way, anxiety can be eliminated as women take back control of their vaginas! Information regarding nonpainful sexual activity and the physiology of pain and of the male and female sexual response are also important treatment components. As several different treatment options can be helpful, we can help direct you to other healthcare professionals knowledgeable about this condition. If you already have other supports, we commit to working as part of your team.

Educate yourself. Women often find a holistic, multi-faceted approach to management of vulvar pain works best. Information, support and treatment options are available; the path is individual. At Dayan Physiotherapy, we help you learn about your options and make informed choices. Remember, the problem is in your vagina – not in your head!

Vulvodynia / Vulvar Pain

Some women suffer from a pain condition called vulvodynia. Pain is not only isolated to the opening of the vagina, as in vestibuldynia, but can be felt anywhere in the vulva, perineum and vagina. Pain is usually constant, but can be intermittent and triggered or worsened by contact such as intercourse or other sexual touch, tampon use, a medical exam, riding a bike, sitting, or wearing tight clothing. Considering that vulvodynia is often misdiagnosed, it is important that women are informed about this condition – the causes, treatment and supports – enabling women to make informed decisions regarding their health care.

Although pain can be present with or without physical contact, it is often exacerbated by contact and can vary in intensity and frequency, from very occasional to constant and unrelenting. The type of discomfort can also vary, ranging from mild burning to knife-like pain. Many women experience increased pain at a specific point in their menstrual cycle. Approximately 40% of women also experience simultaneous bladder and bowel conditions and other pain conditions.

Often misdiagnosed as a yeast infection or psychological issue, the cause of this condition is unknown. Medical examinations and laboratory test results are negative for bacterial and fungal infections and skin conditions. The medical community believes that vulvodynia may be caused by injury or irritation of the pain nerves in response to trauma, infection, or sensitivity to environmental factors. Most women with vulvodynia have increased tension or spasm of the pelvic floor (the muscles that support the pelvic organs and surround the vaginal opening).

Several different treatment options are available. Physical therapy, medications, dietary modifications, stress and pain management, counselling and exercise are common treatment approaches.

Physical therapy treatment has many aspects, ranging from learning how to control both the contraction and relaxation of the muscles surrounding the vagina, desensitizing the painful areas to touch, the use of vaginal inserts and information regarding dietary modifications.

At Dayan Physiotherapy, we use biofeedback to help women learn how to relax these muscles (the pelvic floor), and if there is pain, what to do to minimize or eliminate the discomfort. In this way, anxiety can be eliminated as women take back control of their vaginas! Information regarding nonpainful sexual activity and the physiology of pain and of the male and female sexual response are also important treatment components. As several different treatment options can be helpful, we can help direct you to other healthcare professionals knowledgeable about this condition. If you already have other supports, we commit to working as part of your team.

Educate yourself. Women often find a holistic, multi-faceted approach to management of vulvar pain works best. Information, support and treatment options are available; the path is individual. At Dayan Physiotherapy, we help you learn about your options and make informed choices. Remember, the problem is in your vagina – not in your head!

Vaginal Pain / Vestibulitis / Vestibulodynia

Vaginal pain – it’s not in your head! Many women suffer from a common and often misunderstood vaginal pain condition called vulvar vestibulodynia, also know as vulvar vestibulitis syndrome (VVS). Pain can be experienced on penetration with intercourse or other sexual contact, tampon use, a medical exam, riding a bike, sitting, or wearing tight pants. A study published in the Journal of the American Medical Women’s Association [2003] demonstrated that 16% of the female population experienced vaginal pain at some point in their life. Many women chose not to seek treatment. Of those that did, 60% saw 3 or more doctors, many of whom could not diagnose the condition. The study also showed that women who have pain the first time they use a tampon are 7% more likely to have chronic vulvar pain later in life. Considering that vestibulodynia (vestibulitis) is believed to be quite prevalent and is often misdiagnosed, it is important that women are informed about this condition – the causes, treatment and supports – enabling women to make informed decisions regarding their health care.

Although pain can be present with or without physical contact, it is often exacerbated by contact and can vary in intensity and frequency, from very occasional to constant and unrelenting. The type of discomfort can also vary, ranging from mild burning to knife-like pain. Many women experience increased pain at a specific point in their menstrual cycle. Approximately 40% of women also experience simultaneous bladder and bowel conditions and other pain conditions. The onset of pain varies. Some women have had vaginal pain since their first experience of vaginal contact when trying a tampon or intercourse for the first time. Others develop vestibulodynia after many years of painfree vaginal contact.

Often misdiagnosed as a yeast infection or psychological issue, the cause of this condition is unknown. Medical examinations and laboratory test results are negative for bacterial and fungal infections and skin conditions. The medical community believes that vestibulodynia, or vestibulitis, may be caused by injury or irritation of the local pain nerves in response to trauma, infection, or sensitivity to environmental factors. Most women with vestibulodynia have increased tension or spasm of the pelvic floor (the muscles that support the pelvic organs and surround the vaginal opening).

Several different treatment options are available. Physical therapy, medications, dietary modifications, stress and pain management, counselling and exercise are common treatment approaches. In some situations, surgery may be an option. Physical therapy treatment has many aspects, ranging from learning how to control both the contraction and relaxation of the muscles surrounding the vagina, desensitizing the painful areas to touch, the use of vaginal inserts and information regarding dietary modifications.

At Dayan Physiotherapy, we use biofeedback to help women learn how to relax these muscles (the pelvic floor), and if there is pain, what to do to minimize or eliminate the discomfort. In this way, anxiety can be eliminated as women take back control of their vaginas! Information regarding nonpainful sexual activity and the physiology of pain and of the male and female sexual response are also important treatment components. As several different treatment options can be helpful, we can help direct you to other healthcare professionals knowledgeable about this condition. If you already have other supports, we commit to working as part of your team.

Educate yourself. Women often find a holistic, multi-faceted approach to management of vulvar pain works best. Information, support and treatment options are available; the path is individual. At Dayan Physiotherapy, we help you learn about your options and make informed choices. Remember, the problem is in your vagina – not in your head!