Pelvic floor physio: Treating pain during sex and other common women's health issues
Anniken Chadwick is a physiotherapist who focuses on the muscles and ligaments in the pelvic region. (Maryse Zeidler/CBC)
Pain during intercourse. Incontinence. A prolapsed uterus.
Pelvic floor physiotherapist Anniken Chadwick helps her clients with problems rarely discussed at the dinner table, but that are common nonetheless.
"Mostly my job is oriented around women's health, and we just don't do that well with women's health in our medical system," Chadwick said, sitting on a chair in her small, quiet office on West Broadway in Vancouver.
Chadwick, 33, specializes in healing and strengthening the muscles, ligaments and connective tissues in the pelvic area. Her job can be quite intimate, with her often working internally in those areas.
Her most typical clients are pre- and post-natal women, although she also works with men for similar issues like sexual disfunction, incontinence and pelvic pain.
Physiotherapy centred on the pelvic floor is a mainstay in countries like France, where women routinely see practitioners like Chadwick after they've given birth.
Here in Canada, physiotherapy is often recommended after surgery or trauma on other parts of the body. But Chadwick says the taboo of pelvic issues makes her field of work less normalized — and that's something she's hoping to change.
Chadwick says up to one in four women will experience pain during intercourse in their lifetime.
Her female clients sometimes come to her after years of pain and discomfort. Their doctors just tell them to relax and have a glass of wine, she said.
"I would love for pelvic floor physio to be a routine part of obstetrics care," she said. "I would also love for particularly sexual pain and dysfunction to be understood as a physical thing and not just a mental thing."
Chadwick grew up in Nottingham, England, where she trained to become a physiotherapist.
She briefly practised in the public health system there, then she moved to Canada. A few years into her private practice in Vancouver, she began to notice a pattern — young and middle-aged women who said they were "never the same" after having children.
"I just wanted to learn more about why that was," Chadwick said.
The more she started learning about pelvic floor issues, the more she realized how much more she — and the people around her — needed to know.
"And so I started down that track, and now it's all I do," she said.
"As soon as I started helping women regain continence or be able to have sex with their partner again without pain … it was just hard to get passionate about an ankle sprain after that."
Chadwick's training for pelvic floor problems included specialty post-graduate courses and independent learning.
She likes to take a holistic approach to her work. In her specialty area, injuries often have an emotional or psychological component to them. For women who experience pain after sexual assault, for example, she ensures they're also seeking help from a counsellor or psychologist.
Because of the intimate nature of her treatment, Chadwick is mindful about creating a calm, quiet environment for her clients to feel comfortable in.
But the one aspect of her job that Chadwick really wants people to know about is that pelvic floor issues are relevant to everybody. And although those problems can be scary, getting treatment for them doesn't have to be.
"I get so much satisfaction when people get better. It really gives me a lot of energy," she said.