Robyn Rubinger, PT

As a Physiotherapist, Robyn has worked in private clinics, homecare, and hospitals throughout Ontario. With her extensive background in the pelvic floor, Robyn is a huge advocate for pelvic health awareness. One of her goals is to reduce the stigma of pelvic floor dysfunction; and normalize having “awkward” conversations surrounding basic bodily functions.

Robyn’s practice philosophy is to empower her patients, so they feel confident in making impactful lifestyle changes to optimize their health. When treating patients, she fosters an environment of welcome curiosity and effective communication.

When she’s not working as a Physiotherapist, you can find Robyn performing on-camera, or tackling the latest fitness trends, and/or learning way too many languages on Duolingo.

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#### **Pelvic Floor Physiotherapy FAQ**

**1. What is the pelvic floor?**

The pelvic floor muscles are a group of muscles that act like a hammock, attaching to the front, back and sides of the pelvic bone and sacrum. They also wrap around your urethra (where urine comes out), rectum, and vagina.

The Main Functions of the Pelvic Floor Muscles Are:

* Sphincter: To prevent urinary and fecal leakage.

* Support: For our internal organs (bladder, uterus, and rectum).

* Stability: For our back and pelvic girdle.

* Sexual: To increase satisfaction in sexual activity.

* Sump pump: Actions to assist the lymphatic system and veins in bringing blood back to the trunk.

**2. What is pelvic floor physiotherapy?**

Pelvic floor physiotherapy is an evidence-based physiotherapy treatment option for common conditions within the pelvis such as incontinence, constipation, pelvic organ prolapse, and pelvic pain.

Pelvic floor dysfunction is very common amongst people of all ages, yet societal stigmas prevent people from getting the proper care they deserve. As a result, many people suffer alone in silence and shame, without realizing that there are effective and evidence-based treatment options available to them.

**3. What does a pelvic floor physiotherapist do?**

Pelvic Floor Physiotherapists have advanced training in assessing your pelvic floor through internal palpation. Your physiotherapist will be able to identify the state of your pelvic floor and create a treatment plan as necessary. Your pelvic floor physiotherapist will maintain your comfort and dignity at all times. They will thoroughly explain what the assessment and treatment will involve (including proper draping), give you alternative options, and obtain your consent before proceeding and throughout your assessment and treatment.

**4. Do I need to have an internal assessment?**

Assessing the pelvic floor without doing an internal exam is like an orthopaedic surgeon doing a knee exam through a pair of jeans. Treating any other part of the body without touching the affected body part to see which muscles are tight or weak and how the joints move and glide is not a comprehensive way to gather information. It may seem strange or uncomfortable to assess the pelvic floor by completing an internal exam of the vagina or rectum, however internal examination of the pelvic floor is the international gold standard by which assessment and treatment of the pelvic floor is carried out.

When the pelvic floor muscles are assessed this way, the research has shown that the interventions carried out by a physiotherapist for pelvic floor problems are highly successful and should be the first line of treatment for incontinence, pelvic organ prolapse, and pelvic pain.

**5. Why is the initial intake form so long? Do all these questions really matter?**

The comprehensive initial intake form helps your pelvic floor physiotherapist understand how best to help you. The questions factor in a biopsychosocial approach to your care. The ‘bio’ looks at the muscles and tissues and the possible physiological pathology. The ‘psycho’ looks at how thoughts, beliefs, emotions, and behaviours such as fear, distress, avoidance, and coping strategies contribute to symptoms. The ‘social’ looks at factors that might influence the health of a patient such as economic status, culture, environment, and family circumstances.

When physiotherapists use a biopsychosocial approach, there is an acknowledgment that there can be a blend of both tissue dysfunction and psychosocial factors that contribute to symptoms. This thorough assessment will help target the right driver of your symptoms, and will allow your pelvic floor physiotherapist to make recommendations for additional healthcare professionals to include in your care.

**6. What’s the deal with kegels?**

Kegels (pelvic floor strengthening) are not for everyone, and even when indicated, are often not done properly because people lack the awareness of where these muscles are and how to use them. Kegels are NOT always an appropriate treatment for patients with pelvic floor dysfunction and can sometimes aggravate your symptoms.

**7. I’m interested in Pelvic Floor Physiotherapy? What’s the next step I should take?**

Book an initial assessment (60min) appointment with Robyn Rubinger, PT.

Please take the time to fill out the comprehensive initial intake form online, so you can maximize your appointment time with your physiotherapist.

If you are not interested in having an internal assessment, that is completely understandable. You can absolutely still have a pelvic floor physiotherapy assessment, and alternative assessment and treatment options will be provided to you.