Physiotherapist doing leg therapy to a man using foam roll in clinic

The clinics under review specialize with problems and conditions related to the pelvic floor. This consists of a group of muscles situated in the pelvis. These muscles are interconnected. They comprise the pubic bone, tail bone and the hips. Pelvic floor supports the pelvic organs including the rectum, bladder as well as prostate in men and uterus in women proactive pelvic health

Occasionally, pelvic floor may become dysfunctional due to various causes. This is characterized by one or several of the following symptoms; incontinence, retention (inability to empty the bladder or bowels), urgency or frequency to pass urine or bowel movement, and pelvic pain. 

The main objective of pelvic floor physiotherapy is to improve the function of the pelvic floor through education, lifestyle modification, exercises and hands on treatment to alleviate the suffering. Specialists who provide these services are referred to as pelvic health physiotherapists. 

Pelvic floor plays a major role in core stability, sexual performance, controlling the bladder and bowel movement and the pumping out of lymph fluid in the pelvis. Pelvic floor forms part of a person’s core. Core refers to all the components from the diaphragm down to the pelvic floor. It consists of the diaphragm, abdominal muscles (transversus abdominis), low back muscles (multifidus), and the pelvic floor muscles. 

These muscles coordinate to support and hold the abdominal contents (viscera) in place. All components of your core should always be functioning appropriately. The chief objective of pelvic floor physiotherapy is to create and strengthen good core function through exercises. Therefore, all these parts have to be assessed for the best results. 

Virtually anyone can have dysfunctional pelvic floor and likewise anyone can access and benefit from pelvic floor physiotherapy. 

Symptoms of pelvic floor dysfunction 

  • Pain around low back, tail bone, pelvis and hips. 
  • Incontinence, heaviness/bulging, urgency and frequency of urination and bowel movement. 
  • Painful sexual intercourse (dysperunia). 
  • Feeling incomplete bladder and/or bowel emptying. 
  • Slow or weak stream during urination. 
  • Erectile dysfunction. 

Factors triggering pelvic floor dysfunction 

  • Pregnancy and delivery: During pregnancy, there’s much pressure exerted on the muscles. During delivery, pelvic muscles get overstretched. All these cause discomfort. 
  • Menopause: One of the post-menopausal symptoms is a significant decrease in oestrogen levels. Oestrogen is useful in the maintenance of pelvic floor function. 
  • PID: Pelvic Inflammatory Disease. This requires inclusion of chemotherapy. 
  • Chronic prostatitis: Inflammation of the prostate gland. 
  • Prostatectomy: Removal of the prostate gland. 
  • Pelvic surgery and abdominal surgery. 

Pelvic floor muscles could either be normal and strong, weak or tight. 

Evaluation of pelvic floor dysfunction 

This therapy involves assessing and treating a group of muscles that are involved with urinary, bowel and sexual function. 

Initial session: 

The physiotherapist collects a detailed history of the symptoms via an interview. Therapy goals are also discussed. 

External assessment: 

This includes examining posture, flexibility and strength around low back, hips and pelvis. 

Internal assessment: 

This is aimed at examining pelvic floor musculature. This is done via the vagina for women and/or the rectum for both genders. 

Follow-up session: 

This focuses on treatment for symptoms. It includes; education, advice, exercises, lifestyle modifications, manual therapy, electrotherapy and relaxation techniques. This therapy targets the muscles, ligaments and connective tissues that work together to support pelvic organs, ease sexual intercourse and control bladder and bowel movement. 

Some of the exercises involved include; Pelvic floor strengthening exercises for weak muscles and exercises focused on relaxation and gentle stretches for tight pelvic floor. The goal is to have a strong and healthy pelvic floor. 

Is the approach painful? 

One might experience some slight discomfort during internal exam and while doing exercises but physiotherapy should not be painful. It should also not aggravate your symptoms. You should also not experience any pain after either the exam or the exercises. 

Services offered in pelvic health physiotherapy clinics