Pelvic Floor Physiotherapy: Treatment for Women's and Men's Health

Pelvic floor physiotherapy addresses a range of conditions affecting millions of people, yet many suffer in silence due to embarrassment. This specialized treatment offers effective, non-invasive solutions for pelvic health concerns that significantly impact quality of life.

Understanding the Pelvic Floor

The pelvic floor is a hammock of muscles, ligaments, and connective tissues that support your pelvic organs (bladder, uterus/prostate, rectum) and control urinary and bowel function.

Functions

• Supports pelvic organs
• Controls bladder and bowel
• Sexual function
• Core stability
• Breathing assistance

Common Pelvic Floor Disorders

Urinary Incontinence

Stress Incontinence:

• Leakage with coughing, sneezing, jumping
• Most common type
• Weak pelvic floor muscles
• Highly treatable with physiotherapy

Urge Incontinence:

• Sudden, strong need to urinate
• May not make it to bathroom
• Overactive bladder
• Responds to behavioral strategies + exercise

Mixed Incontinence:

• Combination of both types
• Requires comprehensive approach

Pelvic Organ Prolapse

• Descent of pelvic organs
• Feeling of "falling out"
• Pressure or heaviness
• Conservative management often effective

Pelvic Pain

Causes:

• Muscle dysfunction
• Nerve sensitivity
• Endometriosis
• Previous surgery/trauma
• Tension and trigger points

Symptoms:

• Chronic pelvic pain
• Pain with intercourse
• Tailbone pain
• Hip and lower back pain

Postpartum Issues

• Diastasis recti (abdominal separation)
• Perineal pain or scarring
• Incontinence
• Pelvic organ prolapse
• Core weakness

Men's Pelvic Health

• Post-prostate surgery incontinence
• Chronic prostatitis
• Pelvic pain
• Erectile dysfunction
• Bowel issues

Assessment

What to Expect

Comprehensive Evaluation:

• Detailed history
• Symptom questionnaires
• Functional assessment
• Postural analysis
• Breathing assessment

Internal Examination (With Consent):

• Assesses muscle strength
• Identifies trigger points
• Checks for prolapse
• Coordination testing
• Always optional but recommended

Treatment Approaches

Pelvic Floor Exercises

Not Just Kegels:

• Proper technique crucial
• Coordination training
• Strength building
• Endurance training
• Functional integration

Common Mistakes:

• Bearing down instead of lifting
• Holding breath
• Using wrong muscles
• Doing too many
• Never relaxing

Manual Therapy

Techniques:

• Internal pelvic floor release
• External soft tissue work
• Trigger point therapy
• Scar tissue mobilization
• Joint mobilization (hips, sacroiliac)

Biofeedback

Technology-Assisted Training:

• Visual feedback of muscle activity
• Helps learn proper contraction
• Monitors relaxation
• Motivational
• Accelerates learning

Electrical Stimulation

For Weak Muscles:

• Passive muscle stimulation
• Helps identify muscles
• Strengthens tissue
• Reduces urgency

Bladder Retraining

For Urge Incontinence:

• Scheduled voiding
• Gradual interval increases
• Urge suppression techniques
• Fluid management
• Dietary modifications

Lifestyle Modifications

Bladder Irritants:

• Caffeine
• Alcohol
• Carbonated drinks
• Citrus fruits
• Artificial sweeteners

Constipation Management:

• Adequate fiber
• Hydration
• Proper toileting posture
• Avoid straining

Exercises You Can Start

Finding Your Pelvic Floor

For Women:

• Imagine stopping urination midstream
• Or tightening around a tampon
• Lift and squeeze

For Men:

• Imagine stopping urination
• Or lift testicles
• Squeeze around anus

Basic Kegel Exercise

1. Empty bladder
2. Contract pelvic floor (lift and squeeze)
3. Hold 5 seconds
4. Fully relax 10 seconds
5. Repeat 10 times
6. Do 2-3 sets daily

Progress gradually:

• Hold longer (up to 10 seconds)
• More repetitions
• Different positions
• Functional activities

Quick Flicks

• Rapid contractions
• 1 second each
• 10 in a row
• Builds power for coughing/sneezing

Relaxation is Equally Important

Down-Training:

• Consciously relax pelvic floor
• Deep diaphragmatic breathing
• Visualization
• Reverse kegels

Postpartum Recovery

Timeline

First 6 Weeks:

• Focus on healing
• Gentle breathing exercises
• Pelvic floor awareness
• Gradual walking

6 Weeks - 3 Months:

• Begin gentle exercises
• Progress core work
• Increase activity
• Physiotherapy assessment recommended

3-6 Months:

• Progressive strengthening
• Return to higher impact activities
• Address any concerns
• Ongoing exercises

Diastasis Recti

What It Is:

• Separation of abdominal muscles
• Common in pregnancy
• Usually improves postpartum
• May need specific exercises

Treatment:

• Avoid crunches initially
• Focus on deep core
• Proper form crucial
• May close over time

Men's Pelvic Health

Post-Prostate Surgery

Common After Prostate Removal:

• Temporary incontinence
• Improves with exercises
• Start exercises pre-surgery if possible
• Most regain control

Rehabilitation:

• Pelvic floor exercises
• Progressive program
• Patience (can take 6-12 months)
• Support garments temporarily

Chronic Pelvic Pain (Men)

Often Muscle-Related:

• Trigger points
• Tension
• Poor relaxation
• Stress component

Treatment:

• Internal and external manual therapy
• Relaxation training
• Stretching
• Stress management

Pregnancy and Pelvic Health

During Pregnancy

Benefits of Pelvic Floor Training:

• May prevent incontinence
• Prepares for labor
• Faster postpartum recovery
• Reduces risk of prolapse

Safe Exercises:

• Pelvic floor exercises
• Core work (modified)
• Walking
• Swimming
• Prenatal yoga

Labor Preparation

Perineal Massage:

• Week 34+ of pregnancy
• May reduce tearing risk
• With partner or self
• Specific technique

Treatment Success Rates

Stress Incontinence:

• 70-80% cure/significant improvement
• With proper physiotherapy
• Often avoiding surgery

Urge Incontinence:

• 60-70% improvement
• Combination behavioral + exercise
• Better than medication alone

Pelvic Pain:

• Varies by cause
• Significant improvement common
• Multidisciplinary approach best

Prolapse:

• Can prevent worsening
• May improve symptoms
• Delays or avoids surgery
• Pessary fitting option

When to Seek Help

Don't Wait:

• Any urinary leakage
• Pelvic organ bulging
• Pain with intercourse
• Chronic pelvic pain
• Postpartum concerns
• Pre/post prostate surgery

It's Not Normal:

• "Just part of aging" - FALSE
• "Expected after babies" - FALSE
• "Nothing can help" - FALSE
• Treatment is available and effective

Myths and Facts

Myth: Kegels are only for women Fact: Men benefit too, especially post-surgery

Myth: If you leak, you need surgery Fact: 70-80% improve with physiotherapy alone

Myth: Pelvic floor exercises mean just doing Kegels Fact: Comprehensive program includes relaxation, coordination, strength, and functional training

Myth: You can't exercise with prolapse Fact: Proper exercise often helps; modifications needed

Prevention Strategies

Throughout Life

Maintain Pelvic Floor Health:

• Regular pelvic floor exercises
• Healthy body weight
• Avoid smoking
• Treat chronic cough
• Prevent constipation
• Proper lifting technique

Before Pregnancy:

• Strengthen pelvic floor
• Good core strength
• Address any existing issues

During Pregnancy:

• Continue exercises
• Proper form
• Modifications as needed
• Prepare for labor

Postpartum:

• Gradual return to exercise
• Address issues early
• Professional assessment
• Ongoing maintenance

Aging Well

Menopause:

• Hormonal changes affect tissues
• Continued exercises important
• May need additional support
• Regular assessment

Later Years:

• Maintain strength
• Fall prevention
• Manage chronic conditions
• Quality of life focus

Additional Support

Pessaries

For Prolapse:

• Silicone devices
• Support organs
• Many types available
• Fitted by trained provider
• Use with physiotherapy

Bladder Support Products

Temporary:

• Disposable supports
• For exercise/activities
• Not long-term solution
• Use with treatment program

Living Well

Regain Confidence:

• Most conditions very treatable
• Non-invasive options first
• Significant quality of life improvement
• You don't have to suffer

It's Common:

• 1 in 3 women have incontinence
• More common than diabetes
• Men affected too
• Help is available

Take Action:

• Don't wait
• Worsens over time if untreated
• Earlier treatment = better results
• Speak up for your health

Experiencing pelvic floor dysfunction? Our specialized pelvic health physiotherapists at M.O. Therapy provide discreet, professional care for all pelvic floor concerns. Men and women welcome. We understand the sensitive nature of these issues and create a comfortable, supportive environment.

Book your confidential assessment today. You don't have to live with incontinence, pain, or other pelvic health concerns. Effective, non-invasive treatment is available, and we're here to help you regain confidence and quality of life.