Pelvic Health Physiotherapy is the therapeutic treatment of disorders affecting the pelvis and pelvic floor. Many people will experience some kind of pelvic health problem during their lifetime, but often don’t know that help is available. There is growing evidence that physiotherapy can alleviate and, in many cases, cure these symptoms.

The pelvic floor is made up of a group of muscles that sit within the base of the pelvis in all of us and extend like a hammock from the coccyx at the back, to the pubic bone at the front. They help to provide stability to the pelvis, support our internal organs, control functions of the bladder and bowel and assist in sexual function.

Common symptoms that may indicate a pelvic floor problem include:

• accidentally leaking urine when you exercise, laugh, cough or sneeze
• needing to get to the toilet in a hurry or not making it there in time
• frequently needing to go to the toilet
• finding it difficult to empty your bladder or bowel
• accidentally losing control of your bladder or bowel
• accidentally passing wind
• constipation
• a prolapse – this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping in the pelvis or abdomen
• pain in your abdomen or pelvic area
• pain during sex
• sexual dysfunction

Pelvic floor problems can occur when the pelvic floor muscles are stretched, weakened or too tight.

Some people have weak pelvic floor muscles from an early age, whilst others notice problems after certain life stages such as pregnancy, childbirth, or menopause.

Some people have pelvic floor muscles that are too tight and cannot relax. This can be made worse by doing squeezing exercises (kegels) and overworking the muscles without learning how to relax.

Your ability to effectively contract or relax your pelvic floor can be affected by many things. These include:

• Not keeping your pelvic floor muscles active or over working them
• Being pregnant and having babies
• A long history of back pain
• Ongoing constipation and straining to empty the bowels
• Being overweight
• Repeated heavy lifting (e.g. at work or the gym)
• Chronic coughing or sneezing, including those linked to Asthma, smoking or Hayfever
• Previous injury to the pelvic region (e.g. giving birth, surgery or pelvic radiotherapy)
• Menopause
• Growing older.
• Trauma, stress or anxiety

Annoying and embarrassing bladder or bowel problems can have a huge impact on your life. You might find yourself avoiding enjoyable activities, arranging your daily routine around where the nearest toilets are or waking up exhausted because your bladder has interrupted your sleep.

Pelvic pain can occur as a result of certain conditions such as endometriosis or bladder pain syndrome, following childbirth or after surgery.

In men, pelvic floor issues can present as erectile dysfunction, pelvic pain, urinary leakage or difficulty emptying the bladder. Problems may also arise from issues related to the prostate.

Many people of all ages may experience pelvic health issues and whilst this is common, it is not normal. You don’t have to live with it or suffer in silence. In most cases, these problems can be cured or more successfully managed with pelvic health physiotherapy. 

What to expect on your first visit

Your assessment and treatment will be tailored specifically to you and your presenting complaints. We will start with a detailed history which will be taken in privacy – we are very sensitive to the fact that these conditions may be difficult to discuss.

Your physical assessment will most likely begin with examination of your abdominal muscles, pelvis and lumbar spine – this is to establish whether one or more of these areas is contributing to your problem. If appropriate you may then be offered an internal examination. This is an important part of your assessment as it is necessary to establish how well your pelvic floor muscles are functioning. Using finger palpation, the pelvic floor muscles and connective tissue will be assessed for signs of pelvic organ prolapse, muscle tone, sensation and for pain. Following this the pelvic floor muscle will be tested for strength and endurance. It is important to determine if the pelvic floor muscles are activating and working together, and if they are not, we would establish the reasons for this.

The information you have given us, together with the examination findings, will enable us devise a specific and individualised treatment and exercise programme that is suited to your individual needs. Of course, all the findings and solutions will be discussed with you so you fully understand exactly what is going on and how you can be best helped.

Please be assured that every effort will be made to maintain privacy and dignity at all times and everything you discuss with us will be completely confidential.