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Perineal Pain

Pain localized in the perineum, a feeling of pressure, burning, or discomfort when sitting. These symptoms can be related to the pelvic floor muscles, the nerves in the area, or tensions that are not always easy to identify. The evaluation helps understand which structures truly contribute to the pain and why it persists.

Why perineal pain often returns.

In many cases, pain is addressed only as a local irritation.

For example, pelvic floor tension can be influenced by the hips, lower back, or nerve irritation, such as that of the pudendal nerve.

When these elements are not evaluated together, pain can persist or reappear despite treatments.

Combined analysis of the pelvic floor, hips, and lumbar region.

Work on the involved muscles, tensions, and nerve structures.

Treatment adjustment based on tissue response and symptom evolution.

Key Steps in Physical Therapy

A physical therapist’s goal is to assess movement and physical function issues, and then plan and implement treatments to restore your mobility and completely eliminate pain. This will help you regain the quality of life you once had.

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Comprehensive Physical Therapy Assessment

A comprehensive evaluation lasting about an hour to determine whether the pain is coming from a nerve, a tendon, or a joint.
We also analyze the factors contributing to the problem, such as work, sports, and past injuries.

You’ll leave with a clear understanding of your condition and the next steps.

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Treatment, relief, education

Treatments that combine manual therapy and targeted exercises tailored to your condition
We tailor the treatment to your progress and your specific limitations.

You’ll know what to do between sessions to recover faster.

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Relapse Prevention and Return to Activities

Once the pain has subsided, we’ll help you gradually resume your activities to prevent relapses, with a clear plan to maintain your progress.

You’ll be able to manage your condition on your own in the long term.

Specific conditions addressed in the treatment

Coccygodynia

Precise pain in the tailbone when sitting, worsening when standing up or during bowel movements. Often follows a fall on the tailbone or a difficult childbirth, sometimes with no identified trauma. Internal mobilization of the tailbone and release of muscles attached to this region to relieve pain when sitting.

Pelvic Organ Prolapse

Sensation of heaviness or a 'ball' in the vagina, worsening at the end of the day, after prolonged standing, or during exertion. Results from a weakening of pelvic support structures, common after difficult childbirth or during menopause. Progressive strengthening of the pelvic floor and modification of weight-bearing habits to relieve the descent.

Constipation

Difficulty with bowel movements despite the urge, hard stools requiring straining several times a week. Often linked to pelvic floor dyssynergia: the muscles contract instead of relaxing during evacuation. Pelvic floor relaxation re-education and correction of toilet posture to facilitate bowel movements.

Vulvovaginal Pain

Burning, irritation, or pain at the vaginal opening during intercourse, tampon insertion, or simple pressure. Can result from pelvic floor hypertonicity or local sensitization, often postpartum or menopausal. Progressive desensitization of vulvar tissues and release of contracted levator ani muscles.

Pudendal Neuralgia

A burning pain or a sensation like sitting on a pebble in the anal, vulvar, or perineal area, which is relieved when standing. This is linked to irritation of the pudendal nerve, and it worsens with prolonged sitting on hard surfaces, such as a bicycle seat or an office chair. Treatment includes neural mobilization of the pudendal nerve and releasing the contracted obturator muscles that are compressing the nerve.

Proctalgia Fugax

Intense and sudden, stabbing anal pain, occurring mainly at night and disappearing within a few minutes. Involuntary spasm of the posterior pelvic floor muscles, with no organic cause, common in stressed adults. Techniques for releasing the puborectalis muscles and managing nocturnal triggers.

Overactive bladder syndrome

Urgent and frequent urges to urinate, sometimes several times at night, with or without leakage before reaching the toilet. Often maintained by inappropriate bladder behaviors such as drinking preventatively or going to the toilet too often. Bladder re-education by progressively lengthening voiding intervals and working on urgency with the pelvic floor.

Chronic Pelvic Pain Syndrome

Persistent pain in the lower abdomen, perineum, or lower back for more than 3 to 6 months with no anatomical cause found. Maintained by pelvic floor hypertonicity and central sensitization, aggravated by stress and sitting. Multimodal approach combining pelvic muscle release, pain education, and physiological stress management.

What many patients discover after a few sessions

Pain doesn't always originate from the place where it's felt
Waiting can slow down recovery
Knowing what to do and why often makes a bigger difference than the treatment alone

Customer satisfaction is our top priority

At Physioactif, excellence defines our approach. Don’t just take our word for it—check out the reviews from our patients.

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Our Quality and Satisfaction Guarantees

We offer a three-pronged quality assurance approach: optimized treatment time, a second opinion from a physical therapist, and ongoing expertise to ensure effective care tailored to your needs.

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Over 30 insurance plans accepted for physical therapy services

We handle the claim directly so you can focus your energy on your recovery, not on paperwork.

Discover our physical therapy services for treatment

We offer a full range of healthcare services tailored to your individual needs. Whether you’re seeking treatment for a specific condition or looking to maintain your overall well-being, we’re here to help.

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Comprehensive evaluation and second opinion

When symptoms persist or the results obtained are inconsistent, a thorough evaluation can help clarify the situation. The goal is to pinpoint the exact cause of the problem and avoid guesswork

Common reasons for seeking medical advice
Prenatal and postpartum care

Pregnancy and postpartum bring significant body changes, particularly in the abdominal and pelvic areas. These transformations can cause pain, loss of control, or discomfort that requires tailored care.

Areas of expertise in physical therapy
Perineal and Pelvic Rehabilitation

Urinary leakage, feelings of heaviness, or pelvic discomfort are often related to a lack of coordination or control of the pelvic floor muscles. These symptoms appear when the muscles do not contract or relax effectively.

Areas of expertise in physical therapy
Persistent (chronic) pain

Pain that has persisted for several weeks or months often indicates that the problem is no longer limited to simple physical irritation. Over time, the nervous system becomes more sensitive and perpetuates the pain even after the initial cause has changed

Common reasons for seeking medical advice
Stiffness, rigidity, or loss of mobility

A feeling of stiffness, tightness, or loss of mobility is never something to ignore. Behind this limitation often lies a specific structural issue that prevents normal movement.

Common reasons for seeking medical advice
Nerve pain and numbness

Numbness, tingling, burning sensations, or pain that radiates down an arm or leg is often caused by irritation or compression of the nervous system. These symptoms occur when a nerve is no longer functioning normally or becomes sensitive to movement.

Common reasons for seeking medical advice
IVAC Program (Criminal Offenses)

Injuries related to a criminal event can lead to persistent pain, tension, or physical limitations. Tailored care allows for gradual recovery in a safe and supported environment.

Access to healthcare and reimbursement

Teaching about the condition

Knowledge is the key to a successful recovery. Our educational approach helps you better understand your pain and gives you the tools you need to actively participate in your recovery and prevent future episodes.

Strength and Endurance Exercises

A personalized exercise program is the key to achieving your strength and endurance goals. Our expertise in designing tailored programs allows you to progress safely while taking your abilities and lifestyle into account.

Exercises for stabilizing muscles

Weak stabilizing muscles can cause pain during prolonged periods of standing or sitting, or even during simple movements. Core exercises are often taught incorrectly, which can hinder your progress. Our specialized approach activates these essential deep muscles, creating a solid foundation for all your movements and daily activities.

Mulligan Approach

The globally recognized Mulligan approach combines active movement and mobilization to deliver immediate results. This unique technique restores joint function without pain, even in cases where other approaches have failed.

FCAMPT

Complex musculoskeletal conditions require in-depth expertise for accurate diagnosis and treatment. FCAMPT certification represents the highest level of training in manual therapy in Canada, ensuring specialized care based on the latest evidence.

Joint mobilization and manipulation

Joint pain and stiffness can significantly limit your daily activities. Our physical therapists use specialized joint mobilization and manipulation techniques to restore your joints’ natural range of motion and reduce your pain.

Movement Rehabilitation

Always moving in the same way can lead to injuries because repetitive movements eventually overburden the same parts of your body. Our approach analyzes and precisely corrects your movement patterns to restore biomechanics that won’t cause microtrauma.

Nerve treatment

We are pioneers in Quebec in the field of nerve treatment. We know that symptoms of nerve compression—such as tingling, numbness, or burning pain—can disrupt your sleep and affect your quality of life. Our specialized nerve treatment techniques precisely target these sensitive structures to reduce irritation and restore their proper function.

Our clinics

We have locations in several areas to better serve you.

Frequently Asked Questions About Physical Therapy

What are your rates for a consultation?

At Physioactif, our rates are $150 for the initial consultation, or $166 for a senior physical therapist. The initial consultation lasts about 60 minutes and allows the physical therapist to conduct a thorough assessment and establish a clear diagnosis. Follow-up consultations cost $110 or $119 for a senior physiotherapist. They are then tailored to your personalized treatment plan: exercises, manual therapy, advice, and education. We accept various payment methods and can provide you with the necessary receipts for your private insurance.

Physical Therapy Treatment: Find Out How It Works

It’s important to know that physical therapy treatments are tailored to each individual and their specific injury. First, the physical therapist will ask you about any changes you’ve noticed since your last appointment. The physical therapist will also check how you’ve been doing with your exercises. If necessary, the exercises will be modified, corrected, or progressed to ensure the best possible improvement in your condition. Next, the physical therapist will perform a few tests to reassess your condition. If your condition requires manual therapy, the physical therapist will treat your joints, muscles, or nerves. Finally, the physical therapist will check if you have any questions or concerns regarding your condition. Read this blog post for more details on how a treatment session unfolds.

Physical Therapy Assessment: Learn About the Physioactif Process

Before your evaluation begins, you will be asked to fill out a questionnaire about your overall health, including any medical conditions, past injuries, surgeries, and a list of medications you are taking. This will give the physical therapist a comprehensive understanding of your health and enable them to better assist you. During the evaluation, you will discuss your condition with the physical therapist. This will be followed by a physical assessment, which will lead to a diagnosis by the physical therapist. Afterward, a treatment plan will be developed in collaboration with the physical therapist. You will leave with your treatment plan sheet, which will also include the exercises you need to do at home. Read this blog post for more details on how the assessment works.

How can I tell if I'm receiving the right physical therapy?

As with any profession, the quality of physical therapy can vary greatly from one clinic to another. Here are a few key indicators to help you determine whether you are receiving high-quality physical therapy care:a. The physical therapist spends the entire duration of your appointment with you.b. You have a home exercise program tailored to your condition that you fully understand.c. You have received a diagnosis and can briefly explain the cause of your problem.d. You know what to do when you’re in pain to relieve it because your physical therapist has given you advice.e. During your appointments, you are not hooked up to electrotherapy devices.f. You have received a clearly defined treatment plan that has been personalized by the physical therapist.g. Other factors that may hinder recovery (stress, sleep, anxiety, worries, etc.) have been assessed and discussed with you.h. Your treatment is not exclusively passive; in other words, you are not just receiving manual therapy without a plan of exercises, advice, and education about your condition. Read this blog post for more details on what constitutes effective physical therapy care.

Physical therapy hasn't helped me in the past—is there still hope?

Yes, there is hope! Whether you’ve seen other physical therapists, osteopaths, chiropractors, acupuncturists, massage therapists, or other practitioners, you’ll find solutions with our physical therapists at Physioactif. We’re used to treating complex issues and helping people who haven’t seen results with other professionals. Thanks to this reputation, every week we see patients who come to us even after having consulted 3–4 other professionals who couldn’t resolve their problem. You’ll see from the very first meeting that care at Physioactif is different from what you’ve experienced elsewhere. From diagnosis to exercises and treatments, you’ll notice a difference with Physioactif compared to other professionals who have treated you in the past. We encourage you to come to us full of hope, because we can’t wait to help you!

Do you provide insurance coverage, and do you handle workplace and traffic accident claims?

Yes, your physical therapy treatments may be covered by your insurance. Most insurance plans cover part of the cost of physical therapy. To find out if this applies to you, contact your insurer or review the details of your insurance plan. During your appointment at the clinic, we will work with you to verify your coverage. If your pain is the result of a work-related accident, then the CNESST covers your physical therapy. To do so, you must first see a doctor and obtain a prescription for physical therapy from the doctor. If your pain is the result of a traffic accident, then the SAAQ covers your physical therapy. To do so, you must first see a doctor and obtain a prescription for physical therapy from the doctor.

I've been in pain for a long time—is it too late?

No, it’s never too late. No matter how long you’ve been dealing with your injury or pain, it’s always possible to improve your condition. In fact, studies show that the duration of your pain doesn’t prevent you from getting better. The majority of the clients we see are people who have been in pain for at least several months. So we’re very comfortable helping people who’ve been in pain for 6 months, 1 year, 5 years, and even 20 years! The most important thing is to start at the beginning—that means getting a physical therapy evaluation to get an accurate diagnosis. After that, you’ll work with your physical therapist to create a treatment plan to start getting better.

Can physical therapy help me?

Physical therapy treats injuries, pain, and discomfort related to bones, muscles, joints, vertebrae, tendons, ligaments, menisci, and nerves—in short, all the structures in the body that allow us to move. If you have pain or discomfort that bothers you or limits your activities, work, or leisure time, then physical therapy is the solution for you. Here are some examples of conditions that physical therapy can treat: back, neck, knee, and shoulder pain; headaches and migraines; jaw pain, concussions, dizziness and lightheadedness, urinary incontinence/prolapsed bladder/pain during sex, sprains, strains, tendonitis, stiff neck, whiplash, fractures, tears, sciatica, herniated discs, contusions, plantar fasciitis, osteoarthritis, arthritis, car accidents, workplace accidents, sports injuries.

What is the difference between an osteopath, a chiropractor, a physical therapist, a massage therapist, an acupuncturist, and a kinesiologist?

Osteopaths receive non-university training and make a diagnosis using their hands to palpate various parts of the body (organs, bones, muscles, etc.). Their approach is based on the belief that the body has the ability to heal itself and that manipulating organs, bones, and muscles can restore function to affected tissues. Physical therapists have a university education and make a diagnosis based on the history of the injury, the nature of the pain, and a physical examination. They then develop a treatment plan that includes specific exercises, advice on managing activities, postures, and sports, and apply manual therapy treatments as needed.Chiropractors have a university education and often make a diagnosis using X-rays of the spine or a joint, as well as their hands. The fundamental principle has been to use “chiropractic adjustments” to restore the electrical current in nerves that is blocked by joint misalignment. This approach is no longer as prevalent as it once was, since the scientific basis for this practice has been invalidated. The massage therapist has non-university training and uses various massage techniques to work on the muscles in order to reduce pain or stiffness. The acupuncturist has college-level training based on traditional Chinese medicine. Acupuncturists use techniques to stimulate an energy called “Qi,” often with needles, to restore energy flow and alleviate pain or treat illnesses.Kinesiologists have a university education and are health professionals specializing in training and physical activity. They use physical activity as a tool to improve physical abilities, prevent risk factors associated with a sedentary lifestyle, and optimize athletic or physical performance. For more details on the differences between these professionals, read this blog post

Do I need a prescription?

No. Anyone can see a physical therapist directly. All you need to do is call the clinic to make an appointment. You do not need to be evaluated by a doctor before starting physical therapy. Physical therapists are experts in assessing pain and do not need a doctor’s referral.However, some insurance companies that cover physical therapy expenses require a doctor’s prescription before reimbursing costs. If this applies to your insurance company, then you’ll need an appointment with a doctor and a prescription if you want to be reimbursed by your insurer. Check with your insurer to see if this applies to you.

How does physical therapy work?

Physical therapy is a medical discipline that helps improve your quality of life and enables you to return to your desired activities when you are in pain. This is achieved through exercises, guidance, lifestyle changes, and hands-on therapy. During the first appointment, the physical therapist conducts a comprehensive assessment of your condition, including a physical examination with tests and certain manipulations. Then, the physical therapist makes a diagnosis and works with you to develop a treatment plan to help you achieve your goals. The physical therapist will monitor your progress over a set period to optimize your recovery until your goals are met. During follow-up, exercises are often necessary to improve your condition, and these can be done at home. At the clinic, the physical therapist performs the necessary treatments and adjusts the treatment plan as needed to ensure proper healing of the injury.

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