Incontinence
Pelvic Pain
(Kegel Exercises for the Pelvic Floor)

Treatments usually scheduled for half hour appointments usually last between 30 to 60 minutes depending on your injury. Treatments should be covered under most private health plans with the normal deductions and percentages.

Physiotherapy is a professional health care discipline directed primarily towards the prevention or alleviation of movement dysfunction in people.

Physiotherapists are qualified to:

• establish physical diagnosis and determine a client's movement potential;
• plan and implement physiotherapy treatment programs, using specialized knowledge and skills in exercise prescription and hands on techniques for the prevention and treatment of movement dysfunction;
• undertake related professional activities such as research, teaching, administration, and consultation.

Physiotherapists use:

• skilled "hands on" treatments such as soft tissue mobilization, and manipulation;
• lasers, ultrasound, magnetic fields, electrical currents, acupuncture, heat and ice to relieve pain and assist recovery form injury;
• individually prescribed exercise programs, relaxation techniques, sophisticated diagnostic and treatment equipment, hydrotherapy and biofeedback;
• suitable assistive devices such as walking aids, splints, orthotics, prosthetics and other therapeutic appliances and train clients in their correct use.

The goal of the rehabilitation process includes the following seven areas:

1. Support the Tissue Healing Process

Reaction Phase (<4 Days)
Minimize the normal inflammatory phrase (vasodilation, exudation of tissue fluids, extravasation of blood, secondary reactive edema, stimulation of pain fibres, chemo taxis of cells, activation of the immune response, initiation of cell production):

• ice
• elevation
• application of cooling modalities
• appropriate splinting
• protected activity (range of motion within the pain free range, without resistance)

Regeneration Phase (variable- from 0 -6 weeks)
Optimize the normal regenerative phase (elimination of debris, revascularization, fibroblast proliferation):

• minimize swelling
• protect neurovascularization
• limit duration of inflammatory response
• stimulate protein production

Remodeling Phase (1-3+ months)
Influence the remodeling phase (contraction of scar tissue, maturation of collagen, increase in tensile strength) through influence on the strength and quality of the connective tissue:

• minimize immobilization
• balance increasing functional stresses with increasing tissue strength
• re-establish range of motion
• enhance proprioception

2. Restore Range of Motion and Joint Mobility

Methods may include, but are not limited to:

• Teach range of motion exercises - beginning with active assisted and active exercise.
• Use manual therapy techniques such as joint glides and myofascial release to mobilize areas of stiffness
• Use soft tissue techniques to reduce soft tissue resistance, decrease pain and restore mobility

3. Decrease Muscle Spasm

Once the source of the spasm has been identified, the underlying cause can be treated. Methods may include, but are not limited to:

• Soft tissue and manual therapy techniques to restore pain free ROM
• Electrotherapy modalities
• Biofeedback

4. Manage Pain and Reduce Reliance on Medication

Methods may include, but are not limited to:

• Provide reassurance and education regarding the nature of pain and the rehabilitation and recovery process
• Teach relaxation strategies
• Electrotherapy modalities such as TENS, interferential current
• Acupuncture

5. Restore Ability to Manage Activities of Daily Living

Methods may include, but are not limited to:

• Educate the patient regarding hurt vs.. harm
• Teach proper body mechanics
• Teach how to pace activities and taking breaks
• provide functional, dynamic strengthening exercises

6. Restore Ability to Manage the Demands of Work

• Provide education regarding work style
• Assess job demands and recommend suitable activities
• Provide exercises to promote good postural alignment, trunk stability and postural endurance
• If indicated, design and implement a graduated return to work program

7. Prevent Chronicity/ Re-Aggravation

Methods may include, but are not limited to:

• Exploration of the patient's coping strategies
• Support and reassurance
• Encourage active participation in the recovery and decision-making process
• Identification of community resources
• Communication with other members of the treatment team (Physician, Specialist, other Treating Professionals)

Footnote:  Written by Tanja Yardley, PT Rehabilitation in Motion Inc.