Pelvic Floor Physiotherapy

The pelvic floor is the group of muscles that holds up the bladder, bowel and other pelvic organs. When those muscles are weak, too tense or poorly coordinated, the result can be leaking when you cough, sneeze, run or jump, sudden urges and frequent trips to the bathroom, heaviness or a bulge in the pelvis, pelvic pain, or pain with sex. Pelvic floor physiotherapy assesses those muscles and the body around them, then treats what it finds.

Both women and men have pelvic floors, and both can have pelvic floor dysfunction. For women the common triggers are pregnancy, birth and menopause; men most often come to us after prostate surgery, or with pelvic pain. We also see people before and after pelvic or abdominal surgery, including after cancer treatment.

Assessment

Your physiotherapist asks about your symptoms, how they affect daily life, exercise and sex, and about pregnancy, birth, surgery and your general health. You share as much or as little as you like. They then check your breathing, posture, back, hips and abdominal muscles, and how they work with the pelvic floor when you lift, run or jump.

An external examination, and with your consent an internal examination, helps determine the physical factors behind the condition. An internal examination is never required: your physiotherapist explains what it involves and you decide, and treatment can go ahead without it. Pelvic health physiotherapists have additional training to perform it.

Treatment

Treatment is built from the assessment and often includes:

• pelvic floor muscle training and education
• biofeedback
• muscle stimulation
• relaxation and breathing techniques
• bladder training
• core stabilization
• manual therapy
• exercise prescription

The pelvic health page follows this from the first visit to a return to running, skiing and lifting.