What Is Pelvic Floor Physiotherapy?
When most people hear the words pelvic floor, they may think of pregnancy, bladder leaks, or postpartum recovery. But pelvic floor physiotherapy is about so much more than that.
Your pelvic floor plays an important role in your everyday health and movement, and pelvic floor physiotherapy can help people of all ages and stages of life — whether you’re experiencing symptoms or simply want to better understand and care for your body.
WHAT IS THE PELVIC FLOOR?
The pelvic floor is a group of muscles, connective tissues, and other structures that sit at the bottom of your pelvis. Think of it like a supportive hammock that helps support your pelvic organs, including your bladder, bowel, and reproductive organs.
Your pelvic floor muscles have several important jobs. They help you:
Control your bladder and bowel
Support your pelvic organs
Maintain continence when you cough, sneeze, laugh, or exercise
Coordinate with your core and breathing muscles
Support your pelvis and spine during movement
Contribute to sexual function
Relax and lengthen when you need to urinate, have a bowel movement, or give birth
Like any other muscle group in your body, the pelvic floor can become weak, overactive, tight, poorly coordinated, or painful. Sometimes, more than one of these things can be happening at the same time.
WHAT DOES A PELVIC FLOOR PHYSIOTHERAPIST DO?
A pelvic floor physiotherapist is a physiotherapist who has additional training in assessing and treating conditions involving the pelvic floor, pelvis, abdomen, hips, and surrounding areas.
Your assessment is individualized and starts with a conversation about your symptoms, health history, goals, and what you would like help with.
Depending on your concerns, your physiotherapist may assess:
Pelvic floor muscle strength and coordination
Pelvic floor muscle relaxation
Breathing and pressure management
Abdominal and core function
Hip and pelvic movement
Posture and movement patterns
Bladder and bowel habits
Scar tissue and abdominal or pelvic mobility
Pain and sensitivity around the pelvis
An internal pelvic floor assessment may also be offered when appropriate and with your consent. An internal examination is not automatically required and your physiotherapist will discuss what is appropriate for you.
WHAT CAN PELVIC FLOOR PHYSIOTHERAPY HELP WITH?
Pelvic floor physiotherapy can help with a wide variety of concerns.
BLADDER SYMPTOMS
This may include:
Urinary leakage with exercise, coughing, sneezing, or laughing
Urgency or frequent urination
Difficulty emptying your bladder
Getting up frequently during the night to urinate
You don't have to consider bladder leakage "normal" just because you've had a baby, are getting older, or exercise regularly. It is common, but that doesn't mean you have to live with it.
BOWEL SYMPTOMS
Pelvic floor physiotherapy can also help with bowel-related concerns such as:
Constipation
Straining to have a bowel movement
Difficulty fully emptying your bowels
Bowel leakage
Difficulty coordinating your pelvic floor muscles during bowel movements
Sometimes the issue isn't that the pelvic floor is weak — it may actually be that the muscles aren't relaxing when they need to.
PELVIC PAIN
Pelvic floor physiotherapy can be helpful for people experiencing pain in or around the pelvis, including:
Pelvic pain
Pain with intercourse
Pain with tampon insertion
Pain with pelvic examinations
Tailbone pain
Pain associated with endometriosis
Pain following pelvic surgery
Pregnancy-related pelvic pain
Pelvic pain can have many contributing factors, so treatment is individualized rather than simply focusing on "strengthening the pelvic floor."
PREGNANCY AND POSTPARTUM
Pregnancy and childbirth place significant demands on your pelvic floor and surrounding tissues.
Pelvic floor physiotherapy can help during pregnancy with concerns such as:
Pelvic girdle pain
Back or hip pain
Urinary leakage
Constipation
Preparing for birth
Learning pelvic floor relaxation and breathing strategies
After birth, physiotherapy can help with recovery, returning to exercise, pelvic floor symptoms, abdominal function, scar tissue, and getting back to the activities you enjoy.
You don't need to wait until you have symptoms to see a pelvic floor physiotherapist during pregnancy or postpartum.
DO YOU NEED TO HAVE HAD A BABY?
Absolutely not.
Pelvic floor physiotherapy isn't just for pregnancy and postpartum.
People who have never been pregnant can experience pelvic floor dysfunction too. Athletes, people who lift weights, runners, cyclists, and individuals with chronic pain or pelvic symptoms may all benefit from pelvic floor physiotherapy.
Your pelvic floor is part of your musculoskeletal system, so it is involved in how you breathe, move, exercise, and manage pressure through your body.
DO I NEED TO DO KEGELS?
Not necessarily.
One of the biggest misconceptions about pelvic floor physiotherapy is that everyone needs to strengthen their pelvic floor with Kegel exercises.
Your pelvic floor is a muscle, but stronger isn't always better.
Some people have a pelvic floor that is weak and needs strengthening. Others have muscles that are already working too hard and need to learn how to relax. Some people have difficulty coordinating contraction and relaxation.
Your physiotherapist will determine what your pelvic floor needs rather than automatically prescribing the same exercises to everyone.
WHAT HAPPENS DURING YOUR FIRST APPOINTMENT?
Your first appointment will typically begin with a conversation about your concerns and goals.
Your physiotherapist may ask questions about your bladder, bowel habits, menstrual cycle, pregnancy and birth history, sexual health, exercise, pain, or previous surgeries — depending on what is relevant to you.
From there, your physiotherapist may perform an external assessment and, when appropriate, discuss an internal pelvic floor assessment.
Treatment may include:
Pelvic floor strengthening
Pelvic floor relaxation
Breathing exercises
Core and abdominal rehabilitation
Mobility exercises
Strength training
Manual therapy
Scar tissue treatment
Education about bladder and bowel habits
Exercise modifications
Strategies for returning to sport or other activities
Most importantly, your treatment plan should be specific to you.
WHEN SHOULD YOU SEE A PELVIC FLOOR PHYSIOTHERAPIST?
You don't have to wait until your symptoms become severe.
Consider booking an assessment if you're experiencing:
Urinary or bowel leakage
Pelvic pain
Pain with intercourse
Constipation or difficulty emptying your bowels
Pelvic pressure or heaviness
Pain during exercise
Pregnancy-related pelvic or back pain
Symptoms following childbirth
Concerns following pelvic or abdominal surgery
Difficulty returning to exercise after pregnancy or surgery
Changes in bladder or bowel function
A feeling that something "isn't right" in your pelvic health
And if you're simply curious about your pelvic floor and want to learn how to properly coordinate your pelvic floor, core, and breathing muscles, that's a great reason to book an assessment too.
YOUR PELVIC FLOOR IS PART OF YOUR WHOLE BODY
Your pelvic floor doesn't work in isolation.
It works together with your diaphragm, abdominal muscles, back muscles, hips, and other parts of your body to help you breathe, move, exercise, and manage pressure.
That's why pelvic floor physiotherapy isn't simply about doing Kegels. It's about understanding how your entire body is functioning and how your pelvic floor fits into the picture.
If you're experiencing pelvic floor symptoms, you don't have to just put up with them because they're common. Common doesn't mean you have to live with it.
At Sitka Health Collective, our pelvic health physiotherapy services are individualized to your symptoms, goals, and stage of life.
Ready to learn more about your pelvic health? Join our physiotherapy waiting list today.
