Pelvic floor dysfunction can affect anyone, and it’s more common than you think. The good news? Pelvic floor physiotherapy offers a range of treatments aimed at improving these muscles and relieving your symptoms. Whether you’re dealing with incontinence, pelvic pain, or post-surgical recovery, understanding how your pelvic floor works and how physiotherapy can help is crucial. Here are five important things to know about pelvic floor physiotherapy from Telma Hembruff, a Pelvic Health Specialist and Physiotherapist.
1. It’s Not All About Kegels
When we think of pelvic floor exercises, kegels are often the first thing that comes to mind. However, not every pelvic floor problem can be solved by strengthening these muscles. In fact, kegels might not be the right solution for everyone.
The goal isn’t just to strengthen the pelvic floor—it’s to strike a balance. A strong but flexible pelvic floor can better support your urinary, bowel, and sexual functions.
Condition | Symptoms | Approach |
Weak Pelvic Floor | Incontinence, prolapse, urinary urgency/frequency | Kegels and strengthening exercises |
Tight Pelvic Floor | Pelvic pain, incomplete bladder/bowel emptying, discomfort in sex | Relaxation exercises, gentle stretches |
Balanced Pelvic Floor | No symptoms, optimal pelvic floor function | Combination of strengthening and relaxation |
2. The Pelvic Floor Is Part of Your Core
Did you know that your pelvic floor is a key part of your core? When people think of their core, they usually think of their abs. But the core actually includes several other muscle groups:
- Abdominal muscles
- Low back muscles
- Diaphragm
- Pelvic floor muscles
All these muscles work together to stabilize your body and support your abdominal organs. If one part of the core, like the pelvic floor, isn’t functioning properly, it can throw everything else off balance. This is why Pelvic Floor Physiotherapy often focuses on improving overall core function, not just the pelvic floor.
Core Muscle Group | Function |
Pelvic Floor Muscles | Supports urinary, bowel, and sexual functions |
Abdominal Muscles | Stabilizes torso and supports posture |
Low Back Muscles | Provides spinal stability and allows flexibility |
Diaphragm | Assists in breathing and supports intra-abdominal pressure during exertion |
3. Pelvic Floor Physiotherapy Isn’t Just for Women
Yes, pelvic floor physiotherapy is commonly associated with pregnancy and postpartum recovery, but anyone can benefit from pelvic floor physiotherapy. Both men and women can experience pelvic floor dysfunction at different stages of life. Here’s how different groups might benefit:
- Prenatal and Postpartum: During pregnancy, women’s bodies undergo significant changes that can affect their pelvic floor. Pelvic floor therapy can help alleviate pain in the lower back, pelvis, and hips, as well as manage symptoms like incontinence or heaviness.
- Post-Menopause: The drop in estrogen during menopause can weaken the pelvic floor, leading to symptoms like incontinence, urgency, and pelvic pain. Pelvic floor physiotherapy can help manage these issues in combination with hormonal treatments.
- Men: Pelvic floor dysfunction isn’t just a women’s issue. Men can suffer from symptoms like pelvic pain, urinary problems, and erectile dysfunction, often due to chronic prostatitis or post-surgical complications (e.g., after prostate surgery).
- Post-Surgery: Abdominal or pelvic surgeries often disrupt the pelvic floor. Physiotherapy can help with pain management, scar mobilization, and restoring pelvic floor function.
Group | Common Pelvic Floor Symptoms | Treatment Focus |
Prenatal/Postpartum | Incontinence, pelvic pain, heaviness, pain with intercourse | Strengthening, pelvic stability exercises |
Post-Menopause | Urgency, incontinence, pelvic pain | Strengthening, lifestyle modifications |
Men | Chronic pelvic pain, prostatitis, post-prostatectomy complications | Pain relief, bladder control exercises |
Post-Surgery (All Genders) | Incontinence, pelvic pain, scar tissue complications | Scar mobilization, manual therapy |
4. What to Expect During a Pelvic Floor Physio Session
For those new to pelvic floor physiotherapy, the idea of treatment might seem intimidating. But rest assured, your physiotherapist will guide you every step of the way. Here’s what a typical session might look like:
Initial Assessment:
- History Review: Your physiotherapist will start by reviewing your medical history and symptoms.
- External Exam: This will involve assessing your posture, flexibility, and muscle strength in the lower back, pelvis, and hips.
- Internal Exam: An internal exam may be recommended to check the condition of your pelvic floor muscles. This is done vaginally or rectally. However, if you’re uncomfortable with this, there are alternative assessments available.
Follow-up Sessions:
- The focus will shift to treatment, which might involve:
- Exercises tailored to your needs
- Lifestyle modifications
- Manual therapy
- Relaxation techniques
The key is that each treatment plan is individualized, ensuring you receive care tailored to your specific symptoms.
5. Will It Be Painful?
It’s normal to feel concerned about discomfort during treatment, but here’s the truth: while some parts of the treatment may cause mild discomfort, the goal is not to cause pain. Your physiotherapist will carefully assess what’s contributing to your symptoms and work within your comfort zone.
- Assessing Movement: Sometimes, your therapist may ask you to perform movements (like bending over) to understand the source of your pain. This might temporarily reproduce symptoms, but it shouldn’t make things worse.
- Hands-on Techniques: Manual therapy might involve some pressure or stretching, but it’s aimed at relieving discomfort, not adding to it.
- Home Exercises: Your physiotherapist will recommend exercises you can do at home. Some mild discomfort is normal, but pain is not. If you feel pain during or after your home exercises, it’s important to communicate that to your therapist.
FAQs
Is pelvic floor physiotherapy safe during pregnancy?
Absolutely. Pelvic floor therapy can be incredibly beneficial during pregnancy and postpartum. It helps manage symptoms like pelvic pain, incontinence, and heaviness.
Do I need an internal exam?
An internal exam is often recommended to assess the pelvic floor muscles, but it’s not mandatory. If you’re uncomfortable or in acute pain, your physiotherapist will offer alternative assessment methods.
How many sessions will I need?
This depends on your individual symptoms and how your body responds to treatment. Some people see improvement after a few sessions, while others may need more ongoing care.
Will it hurt?
Some discomfort is possible during assessments or exercises, but pain should not occur. Your physiotherapist will work to minimize discomfort and prevent any aggravation of symptoms.
Final Thoughts
Pelvic floor physiotherapy is a personalized, effective approach to managing pelvic health concerns, from urinary incontinence to post-surgical recovery. With the right guidance, you can strengthen and relax your pelvic muscles, restore core function, and improve your quality of life. If you’re experiencing any pelvic floor symptoms, it’s worth speaking to a pelvic health specialist.
Interested in learning more? Visit PC Rehab Services to book an appointment with our experienced pelvic floor physiotherapists today!