When Should You See a Pelvic Floor Physiotherapist in Burlington?

Many people experience pelvic floor symptoms but aren't sure when it's time to seek help. At Burlington Pelvic Physiotherapy, we hear it often: "I thought this was normal," or "I didn't know there was treatment for this." Up to 25% of adults experience urinary incontinence, pelvic pain, pelvic pressure, sexual problems, or pelvic organ prolapse, yet many patients are too embarrassed to discuss pelvic floor issues with their healthcare provider and incorrectly assume that their symptoms are normal.

The truth is, pelvic floor dysfunction is very common among men and women, and most symptoms can improve significantly with proper treatment. This guide will help you understand when to see a pelvic floor physiotherapist and why early intervention often leads to better outcomes.

Understanding Pelvic Floor Dysfunction

Your pelvic floor is a group of muscles, ligaments, and nerves that support your bladder, bowel, and reproductive organs. When these structures become weak, strained, or overly tight, pelvic floor dysfunction can develop, which may include pelvic pain, urinary or bowel incontinence, pain with sex, sexual dysfunction, and pelvic organ prolapse.

The good news? Pelvic floor physical therapy has robust evidence-based support and clear benefit as a first-line treatment for most pelvic floor disorders. Referral to a pelvic health physical therapist should be considered the first-level standard of care for all patients with pelvic health concerns.

Key Signs You Should See a Pelvic Floor Physiotherapist

Urinary Dysfunction

Urinary issues are one of the primary indicators that you should see a pelvic floor physical therapist. These symptoms include:

Leaking urine when coughing, sneezing, laughing, or exercising
Frequent bathroom visits (more than 8 times per day)
Urgency—feeling like you need to run to the bathroom
Having to frequently start and stop when trying to urinate
Difficulty emptying your bladder completely
Waking multiple times at night to urinate

Many women are reluctant to tell their healthcare provider about symptoms because they may feel embarrassed, and many women think that problems with bladder control are normal. However, bladder control problems are treatable. As women get older, the muscles, ligaments, and nerves in the pelvis often weaken, but urinary incontinence is not a normal part of aging.

When treating urinary incontinence, particularly stress urinary incontinence, pelvic floor muscle exercise has been recommended as first-line treatment. Evidence suggests that age is no barrier to the benefits of pelvic floor muscle exercises—older people are just as likely to benefit from pelvic floor muscle exercises for incontinence as younger people.

If you're experiencing frequent leaking or urgency, you may find our post on breaking free from "just in case" peeing helpful.

Bowel Dysfunction and Constipation

Constipation and defecation problems are key indicators to see a pelvic floor physical therapist. Watch for:

Straining or pushing to pass a bowel movement
Feeling like you can't completely empty your bowels
Fecal incontinence or difficulty controlling gas
Pain during bowel movements
Chronic constipation that doesn't improve with diet changes

The pelvic floor plays a crucial role in coordinating bowel movements. When these muscles are too tight or not coordinating properly, even increasing fiber may not resolve the issue.

Pelvic Pain

Pain felt as general pain or pressure in the pelvic area, low back, or hips, or pain specific to a location (like the bladder) or during certain activities (like bowel movements or sex) warrants evaluation. Specific pain concerns include:

Chronic pelvic pain lasting three months or longer
Pain during or after intercourse
Painful menstrual periods that interfere with daily activities
Tailbone pain (coccydynia)
Groin or hip pain that won't resolve
Pain when sitting for extended periods

For men, clinicians should consider the diagnosis of chronic prostatitis/chronic pelvic pain syndrome in patients who experience chronic perineal pain, bilateral scrotal content pain, penile pain, suprapubic pain, dysuria, or pain with ejaculation—particularly when men have symptoms of chronic pain or discomfort in the pelvic region for at least three months within the past six months.

Multidisciplinary care is essential for chronic pelvic pain because central nervous system sensitization makes it unlikely pain will resolve through single intervention. Treating identified physical pain generators and psychological comorbidities is essential, and pelvic floor physical therapy can be an important component of this approach.

Our team has written extensively about specific pain conditions, including pudendal neuralgia, tailbone pain, and painful intercourse.

Sexual Dysfunction

Sexual health is an important part of overall wellbeing. Consider seeing a pelvic floor physiotherapist if you experience:

Pain during penetration or intercourse
Difficulty achieving or maintaining arousal
Erectile dysfunction (often related to pelvic floor muscle tension)
Pain with orgasm
Difficulty with vaginal insertion (tampons, medical exams)

Sexual dysfunction often improves with pelvic floor treatment, whether the underlying issue is muscle tension, weakness, or coordination problems.

Pelvic Organ Prolapse

Prolapse is sensed as the pelvic organs dropping or a sensation that organs are falling. You might notice:

A bulge or pressure in the vaginal area
Feeling like something is "falling out"
Heaviness or pressure in the pelvis
Lower back discomfort
Difficulty emptying your bladder or bowels

Pelvic floor disorders become more common as women get older, but they are not a normal or acceptable part of aging, and these disorders often can be reversed with treatment. Learn more about understanding pelvic organ prolapse and how physiotherapy can help.

When to Seek Help: Timing Matters

Postpartum Symptoms

After six to eight weeks and certainly by 12 weeks postpartum, symptoms should have self-resolved—there should be no ongoing incontinence or leaking or sense of instability. Women who continue to experience these sensations should be encouraged to see a pelvic health physiotherapist.

Pelvic-floor rehabilitation is recommended to treat persistent urinary incontinence at 3 months postpartum and for persistent postpartum anal incontinence. However, you don't have to wait this long if symptoms are concerning you. Pelvic floor therapy has applications for pregnant women and women who have recently given birth, helping with everything from pregnancy discomfort to C-section healing.

If you're preparing for birth or recovering postpartum, check out our posts on preparing for birth, C-section recovery, and diastasis recti.

After Prostate Surgery

Pelvic floor muscle training is recommended by the European Association of Urology (EAU) and the American Urology Association (AUA) as a first-line treatment for urinary incontinence after radical prostatectomy. Male stress urinary incontinence occurs in 1%–60% of patients following radical prostatectomy, and pelvic floor muscle exercise is the most recommended initial conservative treatment.

Men in the U.S. often are not instructed to see a physical therapist until they attempt Kegel exercises on their own for several months after prostate surgery. However, seeking physical therapy sooner can improve pelvic floor function and relieve urinary incontinence and erectile dysfunction more effectively.

Ideally, men should begin pelvic floor physical therapy before prostate surgery to learn proper techniques and strengthen muscles beforehand, but it's never too late to start. Most physicians recommend beginning post-surgical therapy once initial healing has occurred, typically around 2–4 weeks post-op.

Read more about life after prostate surgery on our blog.

For Athletes

If you're a runner, CrossFit enthusiast, or active individual experiencing leaking during exercise, don't assume this is just "part of being active." Many strong athletes experience pelvic floor issues, but this doesn't mean you have to stop your activities. Early intervention can help you return to the activities you love without symptoms.

Learn more about why strong athletes still have pelvic floor issues.

When "Just Do Kegels" Isn't Enough

You might have been told to "just do Kegels" to address your symptoms. While pelvic floor muscle exercises can be beneficial, Kegel exercises at home may be one element of a larger treatment plan or may not be recommended for your condition. When a person does them incorrectly or without other treatments, their symptoms won't improve or could even worsen.

It's best to be evaluated by a pelvic floor therapist for specific recommendations first because doing the wrong type of exercises or doing certain ones too often could actually make symptoms worse instead of better. In some cases, the pelvic floor muscles are too tight rather than too weak, and Kegels could exacerbate the problem.

We explore this topic in depth in our post: Why "Just Do Kegels" Might Be the Worst Advice You've Heard.

What to Expect at Your First Appointment

If you're wondering what happens during a pelvic floor physiotherapy assessment, here's what you can expect:

You can expect a private, one-on-one setting in which the therapist reviews your medical history, symptoms, and goals and performs a physical exam that may include assessments of hips, spine, bony pelvis, and pelvic floor muscles. Comfort and privacy are always a priority.

A pelvic floor therapist may perform an internal and external examination to assess a patient and create a treatment plan, which may include lifestyle changes, pelvic floor exercises, and other nonsurgical techniques. Everything is explained beforehand, and you're always in control of what happens during your session.

Generally, you can expect to be working with a pelvic floor therapist for eight to twelve weeks, with one or two sessions a week, though the number and frequency of sessions varies and may be adjusted based on progress.

Breaking the Stigma: It's Time to Talk About It

It's important to normalize this conversation and not suffer in silence. Your pelvic floor is vital to daily function, and men and women should feel encouraged to discuss their concerns with their health care teams.

Issues like incontinence, constipation, and painful intercourse might not be fun to talk about, but there is no reason to suffer in silence. If you're experiencing persistent pelvic pain, incontinence, or discomfort, talk with your health care provider or pelvic floor specialist to find out more information on treatment options.

At Burlington Pelvic Physiotherapy, we create a safe, judgment-free environment where you can discuss your symptoms openly and receive evidence-based care tailored to your needs.

The Bottom Line

You don't have to wait until symptoms become unbearable to seek help. Early intervention with pelvic floor physiotherapy often leads to faster improvement and better outcomes. Whether you're dealing with postpartum recovery, post-surgical rehabilitation, chronic pain, or any of the symptoms discussed above, treatment is available and effective.

If you're experiencing any of the symptoms mentioned in this article, consider scheduling an assessment. Pelvic floor physical therapy can improve or cure symptoms of urinary incontinence, pelvic organ prolapse, fecal incontinence, peripartum and postpartum pelvic floor dysfunction, and hypertonic pelvic floor disorders.

Educational Disclaimer: This content is for educational purposes and does not replace professional medical advice. If you're experiencing concerning symptoms, please consult with a healthcare provider for proper evaluation and diagnosis.

Ready to Take the Next Step?

At Burlington Pelvic Physiotherapy, we're here to help you understand your symptoms and develop a personalized treatment plan. Located at 960 Cumberland Ave in Burlington, Ontario, our clinic provides compassionate, evidence-based care for all types of pelvic floor dysfunction.

Don't let embarrassment or uncertainty keep you from getting the care you deserve. Book an appointment today and take the first step toward feeling better.

Reviewed by: Juhi Israni, Pelvic Health Physiotherapist