PELVIC HEALTH SERVICES

Pelvic Health Physiotherapy Services

Pelvic floor physiotherapists are specially trained to offer the following services as part of an appointment as needed.  Please click on the type of service to learn more.

Pelvic Health Education
Pessary Fitting
Core Muscle Activation & Training
Physical Assessment with Internal Exam
Manual Therapy
EMG Biofeedback
Real-Time Ultrasound

PELVIC FLOOR PHYSIOTHERAPISTS

Meet our team of pelvic health physios available to help you.

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Marcy Dayan
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Dikla Barer
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Anna Hudon-Kaide
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Allison Evers
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Meghan Hunt
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*Contact us if you have any more questions regarding Pelvic Health Physiotherapy

Core Muscle Activation & Training

The timing and coordination of muscles and movement is important for painfree, healthy function. The deep muscles of your pelvis and abdomen (the pelvic floor, transversus abdominus, multifidus and the diaphragm) turn on milliseconds before you move your arms or legs in order to stabilize your trunk, also referred to as your core. This stabilization forms a stable base from which your arms and legs can move.  Poor motor control and the poor timing or sequencing of certain muscles can be the result of injury or can cause injury to our bodies.

 

We provide one on one attention as we carefully assess your movement patterns, coordination and balance, along with your strength, to ensure optimal movement strategies for painfree, healthy function.

Pelvic Health Education

Your physiotherapist will explain all the relevant anatomy around the pelvis and how it relates to the rest of your body to help give you context to understand what you are experiencing.  You will have the opportunity to ask questions in a safe environment with a health professional that has knowledge and experience helping people with sensitive and personal health matters.

EMG Biofeedback

Biofeedback is an important tool for both accurate physiotherapy diagnosis and client learning. It senses how much tension is in a muscle. The technology works the same as a heart monitor. When the heart is monitored, electrodes on the chest detect heart (a muscle) activity and the information is displayed on a graph on the heart monitor screen. The person only feels the electrodes being placed and removed.
 

Pelvic floor biofeedback works much the same way. During pelvic floor biofeedback three electrodes are placed on the skin, two on either side of the anus very close to the opening, while the third electrode is placed on the inner thigh. For women, the electrodes do not go in or touch the area immediately around the vagina. The biofeedback doesn’t provide any electrical output to the patient (It doesn’t zap you!). It simply reads the amount of muscle activity occurring in any given moment. The computer processes this information and a graph is displayed demonstrating the muscle activity.
 
Biofeedback is a helpful tool in learning to control both contracting and relaxing your pelvic floor muscles. Electrodes can also be used that go in the vagina or anus. We rarely use these, as they can be uncomfortable, they change the sensation of contraction and cost the client more.

Marcy Dayan - BSR, MHA

Marcy is a registered physiotherapist and is a designated Clinical Specialist in Women’s Health which includes expertise in the management and treatment of female, male and paediatric bladder and bowel control problems, vaginal/genital/rectal pain, diastasis abdominis and perinatal low back, SIJ and symphysis pubis dysfunction and pain.

 

Since graduating from UBC in 1984, Marcy has completed postgraduate courses in incontinence, pain, sexual health and counseling, pelvic dysfunction and orthopaedics. She has also completed a Master of Health Administration from the University of British Columbia.

 

Active in clinical practice, teaching and research, Marcy works in private practice at Envision Physiotherapy (False Creek) in Vancouver and in public practice at the Vancouver Coastal Health Authority’s Prostate Cancer Supportive Care Program. 

 

Marcy worked at the Multidisciplinary Vulvodynia Program (now the BC Centre for Vulvar Health) from 2008-2019.  She is a clinical faculty member and lecturer on urogenital pathophysiology in the Master of Physiotherapy program at the University of British Columbia. She is also a guest lecturer at UBC’s Midwifery Program and preceptors UBC midwifery and obstetric and gynaecology residents in clinic.

 

When not at work, you can find Marcy spending time with her family, cycling, kayaking or at her torch melting glass into wonky wine goblets and silver and glass jewelry and sculpture.

Meghan Hunt - MScPT

Meghan is a physiotherapist with advanced training in pelvic floor physiotherapy, including bowel, bladder, sexual pain, and pelvic pain-related issues. She also has extensive experience with the pre- and post-natal population through her work at BC Women's Hospital, in addition to post-graduate training in manual therapy.
 
 
She graduated with her Bachelor of Science in Kinesiology with Distinction from the University of Calgary, before continuing to the University of British Columbia to complete her Master of Physical Therapy degree. Meghan started training in pelvic floor physiotherapy while studying at UBC, and has been at Envision Physiotherapy ever since.
 
 
Meghan is passionate about helping clients achieve their goals in a safe space using evidence-based treatment, and works with clients of any sex, and any gender. She will always adjust the assessment to your comfort level - an internal exam is not always necessary, and she can discuss this with you during your first visit.

Physical Assessment with Internal Exam

A pelvic floor physiotherapist will first talk through your story with you to determine what type of assessment is most appropriate to help you.  She will look at your global posture and movement patterns and try to determine what role your pelvic anatomy may be playing in your issues.  An internal exam can help the therapist assess the integrity of the pelvic floor muscles in supporting your organs and the structure of your pelvis.  Internal exams can be vaginal or rectal and can help assess if muscles are over or under-active which can then help guide the course of treatment and exercises going forward.  

Dikla (Dee) Barer - MScPT, BHK (ExSc), IMS

Dikla’s treatment philosophy of client empowerment through education, body awareness, and
customized rehabilitation exercise has led her to her interest in pelvic health. Drawing on over a decade of experience in an orthopaedic clinical setting, she brings a client centred, whole-body, hands-on therapy approach. This approach draws from her depth of knowledge in anatomy and physiology and her breadth and depth of experience in private practice.

 

Dikla has been a practicing physiotherapist in Vancouver for over 10 years. She holds a Masters degree in Physical Therapy from Queen’s University (2008), a Bachelor of Human Kinetics (Exercise Science) from UBC (2005), and is a Certified Gunn Intramuscular Stimulation practitioner (CGIMS). She has additional training in male and female pelvic floor dysfunction including incontinence, pelvic organ prolapse, painful intercourse, perinatal low back and pelvic pain, and abdominal separation, as well as certifications in advanced orthopaedic manual therapy and manipulation therapy.

 

Dikla lives in Vancouver with her husband and two daughters. Outside of work, you can find them on various adventures throughout the lower mainland.

Pessary Fitting

A pessary is an internal assistive device that is worn in the vagina to stop incontinence or support pelvic organ prolapse.   It can be easily inserted and removed by the wearer and should not be felt when using it. It can be used just for activities when the prolapse is bothersome, such as running or jumping, or kept in all day long if needed. It helps the user to become symptom free and return to the activities they want to do without leaking urine or experiencing the symptoms of prolapse. 

 

Envision Physiotherapy's pelvic floor physios can assess, prescribe and fit pessaries.

Real Time (imaging) Ultrasound

Real-time ultrasound images your pelvic floor, transversus abdominus (lower abdominals) and multifidus (deep lower back muscles). Research shows that if you have low back or pelvic girdle pain or dysfunction (incontinence, vaginal, perineal or anal pain) or have been pregnant, these muscles stop working effectively. These muscles are very important for stabilizing your back, maintaining bladder and bowel control, and supporting you pelvic organs (bladder, uterus and rectum). As these muscles work effectively at a low amount of contraction, it can be difficult for people to learn the correct technique. The ultrasound gives you a picture of the muscle at rest and contracting, so you can actually see when you are contracting correctly.

Anna Hudon-Kaide - BSc, MPT

Anna Hudon-Kaide is a registered physiotherapist with a passion for helping people with pelvic floor dysfunction. She assesses and treats pelvic health conditions such as bladder and bowel control problems, pelvic organ prolapse, painful intercourse, and other genital pain conditions. She is equally passionate about treating perinatal pelvic pain such as pubic symphysis, SI joint and back pain and coccydynia (tailbone pain). 

 

Anna obtained a Master of Health Sciences in Physiotherapy from the University of Ottawa in 2018, and has completed post-graduate training in pelvic floor rehabilitation. Prior to this, she attended the University of Alberta, where she earned a Bachelor of Sciences degree.

 

As an orthopedic practitioner, Anna came to realize how many patients have common concerns related to pelvic health. She also noticed that patients were often too embarrassed to seek advice, or simply unaware that treatment is available. Anna has since joined Dayan Physiotherapy and Pelvic Floor Clinic. She feels an important part of her work is to help shed the stigma of pelvic health concerns and assist people in optimizing the health and function of their pelvic floor, enabling them to fully engage in all aspects of their lives with comfort and joy.

 

Anna is also fluent in French and Japanese!

 

In her personal time Anna enjoys running and camping. She’s new to Vancouver and excited to learn how to sail.

Allison Evers - MScPT, BSc

Allison completed her education at the University of British Columbia’s Vancouver campus, where she obtained a Bachelor of Science (BSc) in Biology and Master in Physical Therapy (MPT). Allison holds her Level 1 Orthopedic Manual Therapy certification and has advanced training in the assessment and treatment of pelvic floor dysfunction, including urinary and bowel control, and pelvic organ prolapse.

Allison recognizes that clients may feel self-conscious discussing the nature of their visit. She brings a sensitivity to her practice, where she promotes a respectful environment that is responsive to her clients’ individual preferences, needs, and values.

One of Allison’s goals as a physiotherapist is to empower clients by giving them the education and tools needed to manage their condition independently overtime with confidence and success!

A proud Vancouverite, when Allison isn’t at work, she enjoys running, camping, and team sports. She also enjoys time spent with her family and friends. 

Manual Therapy

Manual Therapy involves hands on physiotherapy that uses a variety of techniques with the aim to restore normal movement to the various tissues of the body, including joints, muscles, fascia and nerves.  All Envision physiotherapists use this in conjunction with postural education, exercise, and movement re-training.