Comox Physiotherapy Clinic

Pelvic Floor Physio


Pelvic Floor Physiotherapy

At Comox Physiotherapy Clinic we are passionate about Pelvic Floor Health. Shannon Lawrence and Rosemarie Sanche are highly specialized physiotherapists who have an extensive training and experience to help male and female patients with a myriad of pelvic health concerns.  They have chosen this specialty because they find it both challenging and rewarding, and they are committed to helping their patients feel hope, rediscover function, enjoy life, get stronger and more active, and feel less pain.

If you have a question about your pelvic health problem, please feel free to call our clinic and ask Shannon or Rosemarie if pelvic health physiotherapy can help you.


A bit more about our pelvic health physiotherapists...

Shannon Lawrence and Rosemarie Sanche have a combined 10 years of pelvic health specific experience.  They are committed to ongoing learning in order to stay up-to-date with the latest research, educational tools, and evidence-based treatment options for their patients.

Both Shannon and Rosemarie have completed the following courses through Pelvic Health Solutions including:

  • Male and Female Incontinence (Level 1)

  • Male and Female Pelvic Pain (Level 2)

  • Physiotherapy Management of Central Sensitization (Level 3)

  • Ano-rectal Disorders (Level 5)

  • Developing a Toolkit for Persistent Pain and Pelvic Neurodynamics (Level 6)

  • Pessary Fitting for Pelvic Organ Prolapse


In addition they have taken the following pelvic health specific courses:

  • Hypopressives (Shannon Level 1; Rosemarie Level 2)

  • Rost Therapy for Pelvic Girdle Pain 

  • Gynaecological Visceral Manipulation (Shannon)

  • Diastasis Rectus Abdominis (the new course by Diane Lee) (Shannon)

  • Bulletproof your Core for the Female Athlete (Rosemarie)

  • John Barnes Myofascial Release - Women’s Health (Rosemarie)

  • Numerous online research articles, symposia, and lectures by respected experts in the field


The Pelvic Health Physiotherapists at Comox Physiotherapy Clinic have established a very collaborative relationship with other local, provincial and national pelvic health physiotherapists, as well as, midwives, nurse continence advisors, general practitioners, naturopaths, and specialists such as urologists, obstetricians, gynaecologists, general surgeons and gastro-intestinal specialists.  Shannon and Rosemarie are members of a number of national and international pelvic health organizations including:

  • Pelvic Health Solutions

  • Women’s Health Division of the Canadian Physiotherapy Association

  • Women’s Health Special Interest Group of the APTA (American Physical Therapy  Association)

  • ICS (International Continence Society)

  • IUGA (International Urogynecological Association)

  • NVA (National Vulvodynia Association)


What to expect when you attend our clinic for a pelvic health visit?

Your first visit:

  • Please arrive 10 minutes early for your appointment, and bring along the fully completed forms that were mailed or emailed to you by our office team. These forms will provide Shannon and Rosemarie with the information they need to best help you that first day.

  • During the first part of your appointment, Shannon or Rosemarie will take a thorough history of your pelvic floor condition. They may give you additional questionnaires to fill out if they feel it is appropriate. They will explain the process of the assessment and give you a chance to ask questions and to give your approval before proceeding with the physical assessment. They will usually start with some education and an external assessment. A internal pelvic floor assessment (vaginal and/or rectal) is then (or may be) performed to provide invaluable information on the condition of the pelvic floor - including muscle strength, tightness, endurance, symmetry, presence of prolapse, adhesions.

  • Treatment options are discussed and initiated as time allows.

Your second and follow up visits:

  • Shannon and Rosemarie have an extensive toolkit of treatment options that they can provide, and they’ll choose the most appropriate treatment plan for you based on their ongoing assessment and re-evaluation of your pelvic health concerns as your treatment progresses.


Treatment Options that may be included in your session:

  • Education

  • Lifestyle management (diet, sleep, exercise, stress)

  • Self-treatment techniques

  • Pain education

  • Mindfulness practice and meditation

  • Specific exercises

  • Manual therapy, myofascial release, visceral manipulation

  • Muscle re-education - internal palpation and biofeedback

  • Electrical Muscle Stimulation


Other questions you might have

Pregnancy and Pelvic Floor Physiotherapy

A pelvic floor physio can help you prepare for your upcoming delivery and early postpartum recovery. It is safe to have an internal assessment of your pelvic floor as long as there are no contraindications and your pregnancy has not been deemed high risk.  

Postpartum moms are welcome to attend physiotherapy at any time after delivery to address concerns regarding pelvic girdle pain and early recovery. We recommend a thorough pelvic health assessment at 6 - 8 weeks postpartum to ensure your body is recovering well from your vaginal delivery or C-section.  


Menses and appointments?

Both Shannon and Rosemarie are comfortable treating patients who are currently menstruating, so please do not feel that you need to reschedule your appointment. However, if you do not wish to have an internal exam for reasons of your own comfort there are plenty of treatment options such as external manual treatments, more education and review or exercise progressions that can be performed instead.



  • Urinary Incontinence and Bladder Control (stress, urge and mixed)

  • Pelvic Organ Prolapse (prolapse of the bladder, uterus or rectum) as well as pessary fitting

  • Pelvic Pain conditions 

    • Vulvodynia, Vestibulodynia

    • Perineal scar tissue and adhesion management including lichen sclerosis

    • Dyspareunia (Painful Intercourse)

    • Dysmennorhea (painful periods)

    • Endometriosis

  • Coccydynia (tailbone pain)

  • Bladder Pain syndromes including Interstitial Cystitis and frequent Bladder Infections

  • Men’s Health - Post Prostatectomy Incontinence and rehabilitation

    • Erectile Dysfunction (ED)

    • Premature Ejaculation

    • Chronic Pelvic Pain Syndrome

    • Chronic Non-bacterial Prostatitis

  • Pre-natal and Postpartum Care 

    • Preparation for labour and delivery

    • Diastasis Rectus Abdominis (abdominal separation)

    • Pregnancy Related Pelvic Girdle Pain

    • Pubic Symphysis Pain

    • Coccyx Pain 

    • Painful Intercourse 

    • Perineal and C-section Scar tissue Management

    • Guidance for safe return to activities and sports

  • Sexual Dysfunction (LGBTQ informed, Trauma informed care)

    • Painful Intercourse

    • Erectile Dysfunction

    • Premature Ejaculation

    • Perineal Scar tissue mobilization

  • Bowel Dysfunction

    • Constipation management

    • Fecal Incontinence

    • Rectal Prolapse

    • IBS (irritable bowel syndrome)

    • Dyssynergic defecation

    • Ano-rectal Pain

    • Anal fissures

    • ASIS (obstetric anal sphincter injuries)

  • Abdominal Wall concerns

    • Abdominal hernias (men and women)

    • Parastomal hernias

    • Abdominal adhesions 

    • Diastasis Rectus Abdominis