The Ultimate Guide to Pelvic Floor Physiotherapy

This article is a complete guide to pelvic floor physiotherapy. If you are experiencing pelvic pain or conditions caused by pelvic floor muscle dysfunction, this guide will help you decide if a pelvic floor physiotherapist is right for you.

What is a pelvic floor physiotherapist?

A pelvic floor physiotherapist is a physical therapist that focuses on pelvic floor issues. The pelvic floor comprises muscles, ligaments, and connective tissue that support the pelvic organs, including the bladder, uterus, and rectum.

Pelvic floor physiotherapy treats various pelvic floor problems, including urinary incontinence, pelvic discomfort, and prolapse. To help their patients attain maximum pelvic health, pelvic floor physiotherapists utilize a mix of manual treatment, education, and exercises.

Pelvic Floor Physiotherapist assisting a client with an exercise.

Manual therapy techniques such as myofascial release and trigger point release help relieve pain and tension in the pelvic floor muscles. Education is an essential component of pelvic floor physiotherapy, as many patients are not aware of the importance of the pelvic floor muscles in overall health. Exercises help strengthen and tone the pelvic floor muscles tailored to each patient’s specific needs.

A pelvic floor physiotherapist is a specialized expert who can help you identify the cause of your symptoms and provide the treatment you need to feel better. If you are dealing with bladder or bowel control problems, painful sex, pelvic organ prolapses, or other pelvic floor disorders, consulting a pelvic floor physical therapist can provide the guidance and treatment necessary to address these issues effectively.

A qualified physiotherapist will assist you in determining the source of your problems and providing you with the therapy you require to get back to feeling great.

What are the muscles of the pelvic floor?

The pelvic floor muscles are essential for both men and women by supporting the organs in the pelvis, including the bladder, bowel, and uterus. They also have a role in sexual performance.

The pelvic floor muscles divide into the levator ani and the coccygeus. The iliococcygeus, pubococcygeus, and coccygeus are the three muscles that make up the levator ani. The coccygeus muscle is located at the very bottom of the pelvis.

A person holding a pelvis with pelvic floor muscles inside

The pelvic floor muscles keep the pelvic organs in place. They also aid in the regulation of urination and defecation. During sexual activity, these muscles tighten, giving both men and women pleasurable sensations.

The pelvic floor muscles are essential for both men and women. The pelvic floor muscles help support the pelvis’ organs, including the bladder, bowel, and uterus.

The pelvic floor muscles support women’s bladder, bowel, and uterus. They also have a role in sexual pleasure, including orgasm.

The pelvic floor muscles support the bladder and bowel in males. They also play a part in male sexual performance, including orgasm.

As a result of aging, pregnancy and childbirth, being overweight or obese, and chronic coughing, the pelvic region’s muscles can weaken. Urinary incontinence, fecal incontinence, and pelvic organ prolapse can all be caused by this. Prostate surgery may affects males’ pelvic floor muscles; females’ pelvic floor muscles can weaken due to vaginal childbirth.

What are the Nerves of the Pelvic Floor?

The pelvic floor nerves are responsible for controlling the pelvic floor muscles. These muscles help support the pelvis’ organs, including the bladder, uterus, and bowel. The nerves of the pelvic floor are also responsible for sexual function.

Several different nerves make up the pelvic floor. The pudendal nerve is one of the most important nerves of the pelvic floor. It runs from the base of the spine to the perineum, which is the area between the anus and the vagina. The pudendal nerve

controls the perineum muscles, including the anal sphincter muscle.

The sacral plexus is another vital nerve of the pelvic floor. It is a group of nerves that arise from the sacral spine, located at the base of the spine. The sacral plexus innervates the pelvic floor muscles, including the levator ani muscle.

The nerves of the pelvic floor are responsible for controlling these essential muscles. If there is a problem with these nerves, it can lead to problems with the muscles. This nerve damage can cause bowel or bladder control problems, sexual dysfunction, or pain.

If you are experiencing any of these symptoms, you must see a doctor or pelvic floor specialist to find out if there is a problem with your nerves. Treatment will vary depending on the cause of the nerve dysfunction. However, some treatments may include exercises to strengthen the pelvic floor muscles, medications, or surgery.

It is important to remember that the pelvic floor nerves control many essential muscles. If there is a problem with these nerves, it can cause various problems. If you are experiencing any of these symptoms, you must see a therapist to find out if there is a problem with your nerves.

What are the Tissues of the Pelvic Floor?

The tissues of the pelvic floor are essential for both men and women. The muscles, ligaments, and fascia make up the pelvic floor. The tissues support the bladder, bowel, and uterus in women and the prostate and rectum in men. The pelvic floor muscles help stop the flow of urine and gas.

Pelvic floor disorders such as urinary incontinence and pelvic organ prolapse can occur when these tissues are weak or damaged. Pelvic floor exercises can help to strengthen these muscles and improve symptoms. For women, pelvic floor exercises may also help to improve sexual function.

Pelvic floor physio showing a client the anatomy of the pelvic floor

Weak or damaged tissues in the pelvic floor can cause several problems. When organs such as the uterus or rectum recede into the vagina, pelvic organ prolapse can also occur. Other issues include fecal incontinence, inability to control your bowel movements, and sexual dysfunction.

Pelvic floor exercises are one way to help strengthen the pelvic floor tissues. These exercises involve tightening and relaxing the muscles in the pelvic floor.

Your pelvic floor physiotherapist will guide you through the appropriate exercises for your needs.

How Does Pelvic Floor Physiotherapy Work?

As we age, our bodies go through many changes. One of the things that can happen is that our pelvic floor muscles can weaken. This weakening can lead to several problems, including not exclusive to incontinence, pain during sex, and even prolapse.

Pelvic floor physiotherapy is a type of physical therapy that helps to strengthen or relax these muscles.

The main goal of pelvic floor physiotherapy is to help you regain control of your pelvic muscles. This control can help improve your quality of life in many ways.

One of the most common reasons people seek pelvic floor physiotherapy is to improve their bladder control. Incontinence can be a very embarrassing problem and can impact your quality of life in several ways.

Pelvic floor therapy can help strengthen the muscles around your bladder, which can help you regain control over your bladder. This control can help you to feel more confident and less embarrassed. It can also help to reduce the number of accidents you have.

Pelvic floor physiotherapy can also help to improve pain during sex. If you are experiencing pain during sex, it can make it difficult to enjoy yourself. Pelvic floor physiotherapy can help relax the muscles around your vagina, which can help alleviate pain during intercourse.

What are the Symptoms of Pelvic Floor

Pain?

Symptoms of pelvic pain include:

  • discomfort or pain in the pelvic region

  • pain during sex

  • pain with urination or bowel movements

  • unexplained pain in the lower back or abdomen

  • urinary incontinence or difficulty controlling urine stream

  • fecal incontinence or difficulty controlling bowel movements.

Person holding their stomach to show pelvic floor pain/dysfunction

A variety of issues may cause pelvic floor pain, including:

  • muscle spasms or cramps in the pelvic floor muscles

  • nerve damage

  • infection

  • inflammation

  • problems with other organs in the pelvis, such as the uterus, bladder, or rectum.

If you are experiencing any of these symptoms, you must see a doctor for diagnosis and treatment. Treatment for pelvic floor pain includes various methods, including medication, physical therapy, and relaxation techniques. Early diagnosis and treatment are essential for the best possible outcome.

What Conditions do Pelvic Floor Physiotherapists treat?

There are many conditions that pelvic floor physiotherapists treat. These conditions include urinary incontinence, fecal incontinence, constipation, prolapse, and pain. Each disorder has its own unique set of symptoms and causes.

Urinary incontinence

Urinary incontinence is the leakage of urine. This leakage can occur randomly or when coughing, sneezing, laughing, or exercising.

Fecal Incontinence

Fecal incontinence is the leakage of feces. This leakage can occur when passing gas, bowel movement, or lifting something heavy.

Constipation

Constipation is the inability to have a bowel movement regularly.

Prolapse

Prolapse is when the pelvic organs descend into the vaginal cavity. There are varying degrees of prolapse severity (grades 1-4). This shifting can cause pain, difficulty having a bowel movement or urinating, and feeling something “fallen” in the vagina.

Pelvic Pain

Pain can occur in the pelvic area for many different reasons. Some causes of pain include childbirth, ovarian cysts, endometriosis, and pelvic floor dysfunction.

Endometriosis

Endometriosis is when the tissue that usually lines the uterus grows outside the uterus. This growth can cause pain, fertility struggles, and heavy periods.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that grow on or inside the ovary. They are often painless but can cause pelvic pain, bloating, and difficulty getting pregnant.

Pelvic Floor Dysfunction

Pelvic floor dysfunction is when the pelvic floor muscles are weak or tight. This weakness can cause pain, urinary or fecal incontinence/retention, constipation, and prolapse.

Urinary Urgency

Urinary urgency is the feeling that you need to urinate immediately. This urgency results from an infection, pregnancy, menopause, or pelvic floor dysfunction.

Overactive Bladder

Overactive bladder is a condition where the bladder muscles contract too often. This contraction can cause urinary frequency (needing to go often), urgency, and incontinence.

Childbirth

Childbirth can cause damage to the pelvic floor muscles, ligaments, and nerves. This damage can lead to urinary incontinence, fecal incontinence, prolapse, and pelvic pain.

Pregnancy

Pregnancy can cause changes in the pelvis, leading to urinary incontinence, fecal incontinence, and pelvic pain.

Menopause

Menopause can cause changes in the pelvic floor muscles, leading to urinary incontinence, fecal incontinence, and pelvic pain.

Painful Intercourse (Dyspareunia)

Painful intercourse is pain that occurs during or after sexual intercourse. This pain results from several things, such as

endometriosis, ovarian cysts, pelvic floor dysfunction, and scarring from previous surgery.

Painful Bladder Syndrome

Painful bladder syndrome (PBS) is a condition where the bladder is constantly aching. This pain results from an infection, nerve damage, or chemical imbalances.

Interstitial Cystitis

Interstitial cystitis (IC) is a condition where the bladder is inflamed. This inflammation can cause pain, urinary frequency, and urgency.

As you can see, pelvic floor physical therapists treat various conditions. If you are experiencing any of the symptoms listed above, it is vital to seek help from a pelvic floor therapist.

The Risks and Benefits of Pelvic Floor Therapy?

Are there risks associated with pelvic floor therapy?

Yes, there are a few risks associated with pelvic floor therapy. The person may experience some discomfort or pain during or after the treatment.

Another potential risk is that the person may need to urinate or have a bowel movement during or after the treatment.

A trained therapist will work to minimize any pain or discomfort. However, this therapy is low risk.

Despite these slight risks, pelvic floor therapy can be an extremely beneficial treatment for many people. This therapy can help improve incontinence, sexual function, and pelvic pain. It can also help to improve the overall health of the pelvic floor muscles. Physical therapy will reduce pain and discomfort associated with pelvic floor disorders.

If you consider pelvic floor therapy, discussing the risks and benefits with your doctor or therapist is essential. They will help you decide if this therapy is right for you.

The Importance of Pelvic Health

Maintaining optimum pelvic health is essential for many reasons. The pelvic region houses some of the most vital organs in the human body, including the bladder, uterus, and rectum.

Therefore, any problems in this area can lead to serious health complications.

Our pelvic health can deteriorate through age, pregnancy, childbirth, or another cause. Restoring pelvic health can be difficult, but it is essential to seek medical help if you are experiencing any problems in this area.

Pelvic floor physical therapy is one non-invasive option for treating pelvic health problems. A trained therapist can help to strengthen the muscles in the pelvic region, which can improve bladder control, reduce pain, and increase sexual pleasure.

Pelvic Floor Muscle Training

Pelvic floor muscle training (PFMT) is an exercise that helps strengthen the pelvic floor muscles. These muscles support the bladder, bowel, and uterus. PFMT can help to improve bladder and bowel control, as well as reduce or prevent incontinence.

There are several ways that physiotherapists can help facilitate pelvic floor muscle training. One way is by providing education on the anatomy and function of the pelvic floor muscles. This education can help people understand how these muscles work and why PFMT is essential.

Women doing pelvic floor muscle training

Additionally, physiotherapists can demonstrate how to perform PFMT exercises properly. This guidance may involve demonstrating exercises, providing written instructions, or using computer-aided instruction.

Another way that physiotherapists can help is by providing feedback during PFMT exercises. This feedback can help people correctly perform the exercises and achieve the desired results. Additionally, physiotherapists can provide support and motivation throughout completing PFMT exercises.

Pelvic floor muscle training is an integral part of maintaining pelvic floor health. Physiotherapists can play a crucial role in helping people perform these exercises correctly. By providing education, guidance, feedback, and support, physiotherapists can help people achieve the best possible results from pelvic floor muscle training.

How Long Does a Typical Course of Treatment Last?

The number of treatments for pelvic floor therapy depends on the person’s condition. However, a typical course of treatment usually lasts between six and eight sessions.

Reversing pelvic floor dysfunctions and chronic pelvic pain could result in as little as two or three sessions. However, a full six to eight sessions are generally recommended if you seek to improve pelvic floor function for health reasons.

It is essential to continue with your pelvic floor exercises even after therapy. Continuing with your prescribed activities will help maintain your progress and prevent relapses.

Prenatal Therapy Can Prevent Post-Natal Problems

Prenatal pelvic floor physical therapy can help to prevent many post-natal problems. A recent study showed that women who received prenatal pelvic floor physical therapy were two-thirds less likely to need surgery for prolapse or incontinence after giving birth.

Pelvic floor muscles play an essential role in both pregnancy and childbirth. They help support the uterus and baby and aid in the baby’s delivery. However, these muscles can be damaged during pregnancy and childbirth. This damage can lead to incontinence, prolapse, and sexual dysfunction.

Pregnant women doing pelvic floor exercise

Prenatal pelvic floor physical therapy can help to strengthen and tone the pelvic floor muscles. Strengthening and toning can prevent or reduce the severity of post-natal problems. Pelvic floor physical therapy can also help improve the pelvis’s alignment and reduce pain in the lower back and pelvis.

If you are pregnant or planning to become pregnant, talk to your doctor about prenatal pelvic floor physical therapy. It may be able to help you avoid post-natal problems.

Conclusion

There is no doubt that pelvic floor physiotherapy offers many benefits for restoring pelvic health. By addressing the underlying causes of pelvic floor dysfunction, physiotherapists can help women and men overcome incontinence, prolapse, and pain.

Pelvic floor physiotherapy is a safe, effective, and affordable treatment that can make a real difference in the lives of those who suffer from pelvic floor dysfunction. For anyone who is considering pelvic floor physiotherapy, here are some of the key benefits to keep in mind:

  1. Pelvic floor physiotherapy can help to improve incontinence.

Incontinence is a common problem that can significantly impact the quality of life. Pelvic floor physiotherapy can be an effective treatment for incontinence, helping to improve bladder control and reduce the number of accidents.

  • Pelvic floor physiotherapy can help to prevent or treat prolapse.

Prolapse is a condition in which the pelvic organs fall out of place. Prolapse can be a severe condition and can also lead to incontinence. Pelvic floor physiotherapy can help treat prolapse by strengthening the muscles and tissues supporting pelvic organs.

  • Pelvic floor physiotherapy can help to relieve pain.

Pelvic floor dysfunction can often lead to pain in the pelvis, lower back, and legs. Pelvic floor physiotherapy can help to relieve this pain by releasing tight muscles and improving circulation.

  • Pelvic floor physiotherapy can improve sexual function.

Pelvic floor dysfunction can often lead to sexual problems such as pain during intercourse, erectile dysfunction, and orgasm difficulties. Pelvic floor physiotherapy can help to improve sexual function by relieving pain and tension in the pelvic area.

  • Pelvic floor physiotherapy is a safe and affordable treatment.

Pelvic floor physiotherapy is a safe and affordable treatment tailored to meet the needs of each individual. It is a treatment that can be used alone or combined with other therapies, such as medications or surgery.

Pelvic floor physiotherapy offers a wide range of benefits for restoring pelvic health. If you suffer from pelvic floor dysfunction, consider meeting with a physiotherapist to see if this treatment could help you.

Additional Resources

Web MD on pelvic floor dysfunction.

Healthline has a personal account story of a woman who went to a pelvic floor physiotherapist.

About the Author

Katja Bergin PT is a certified physiotherapist and one of the owners of Bergin Motion. Bergin Motion is a family-run Barrie Physiotherapy Clinic located in Barrie’s Southend. Katja specializes in pelvic floor physiotherapy. Katja works with women and men to strengthen their pelvic floor muscles. Katja is part of a team at Bergin Motion in Barrie, Ontario that works with all kinds of conditions.

Bergin Motion

Is a family owned physiotherapy company built by the Bergin family. Our family has served as physiotherapists in the Barrie area for over 30 years, spanning two generations. We are passionate about this community and helping people achieve their highest potential. Book with us now!

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