ISM & Pelvic Health Physiotherapy

“I have tried pelvic floor exercises and practice them regularly. My pelvic health /abdominal muscle concerns feel a bit better but not completely or they keep coming back and recurring.”

Has this been your experience?

Well, it is not always just about the pelvic floor.

The pelvic floor muscles do not work alone. They are part of a team that involves your breathing muscle – the diaphragm, the abdominal muscles as well as your back muscles. Our trunk and pelvis are the links between the upper and lower body. When we move load is transferred through our trunk, back and pelvis. The ways or strategies we use for this load transfer can vary. Sometimes, our strategies may contribute to pain, and pelvic pressure and also affect our continence mechanism.

The pelvic floor may not always be the ‘driver’(cause) of your symptoms/pain. It could be just a ‘reactor’ that is compensating or reacting to the ‘driver’. Finding and treating the source of the problem from the start can help achieve positive results. The Integrated Systems Model (ISM) approach helps in doing just that.

The Integrated Systems Model (ISM)

ISM is a whole-body approach that considers the whole person (body and mind) rather than single injuries or individual body parts. The ISM approach is an evidence-based framework developed by world-renowned physiotherapists and educators Diane Lee and Linda Joy Lee. It guides the treating therapist to find the driving cause of pain and/ or symptoms. ISM-trained therapists do not just assess the body part affected. They use special ways to determine which problem areas are ‘drivers’ and which ones are ‘compensators’.

An ISM assessment starts with listening to your unique story to help identify your main concern (meaningful complaint). Then you and your therapist determine a meaningful task. Specific movements and/or postures related to your meaningful task are then assessed. In the ISM approach, the movement tasks that are chosen to be assessed are not necessarily related to the location of pain and/or symptoms, but they are relevant to your functional goals.

From this assessment, an individualized treatment plan is developed. Your treatment session may involve components of RACM (Release, Align, Connect and control, Move). ISM treatment initially focuses on using techniques, manual therapy, exercises and education to ‘release’ and ‘align’ the ‘driver or drivers’. Following the release, muscles are trained if needed ‘connect and control’. The final step is training to ‘move,’ aiming to build and use new and better ‘brain maps’ for improving function and performance. ISM-trained therapists integrate their unique and individual professional training and skills into this treatment approach.

Your story and the relationship between your symptoms/pain and the rest of your body can be assessed by our ISM-trained pelvic health physiotherapist Eliza Pereira-Karve. To learn more and see if you may benefit from an ISM-based assessment and treatment approach call our office at 519-780-0606.



Diane Lee ISM series (2021)

Diane Lee Lecture: New ISM perspectives for treating women with PGP, UI, POP and DRA

Diane Lee book: The thorax: an integrated approach

Diane Lee book: Diastasis Rectus Abdominis: A clinical guide for those who are split down the middle

Diane Lee Course: Diastasis Rectus Abdominis & the Implications for Low back & Pelvic Health

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