Pelvic Floor Physiotherapy

Keeping these muscles strong is essential for both men and women

Pelvic floor muscles are an important group of muscles that provide cradle like support for the pelvic organs, as well as giving you control when you urinate.  Keeping these muscles strong is essential for both men and women: a great way to learn more is by having pelvic floor physiotherapy sessions.

Pelvic Floor explained for women

Pelvic floor muscles can weaken for a number of reasons, including childbirth and ageing. These weakened muscles can lead to stress incontinence – the leakage of urine when there is extra pressure on the bladder through coughing, laughing or exercising like running and jumping.

Feeling that you always need to urinate is another common problem that can arise. The average number should be around 4-6 times a day. There could be many reasons why, including weak pelvic floor muscles, lifestyle habits or tension within the pelvic floor muscles. Following a detailed assessment, the right treatment will be tailored for you. Following this course of physiotherapy with one of our specialists, we highly recommend the MUTU system programme as a follow-on at home.

Pelvic Floor explained for men

Men may experience incontinence following surgery to the prostate, including a prostatectomy for cancer, which can be greatly helped through pelvic floor muscle exercises.

Prostatitis and chronic pelvic pain syndrome is one of the most common diagnosis for pain located around the pelvis, groin and genitalia. Prostatitis can be very misunderstood. Many men are left feeling anxious and lost without any idea of how to treat their symptoms. Our Specialist Men’s Health Physio team can assess, offer advice and put together a tailored treatment plan.

One particular cause for prostatitis is tension within the pelvic floor muscles. Along with some lifestyle changes, specific exercises and work on the pelvic floor muscles to release this tension it can significantly improve the symptoms.

It is important that you exercise the right muscles in the correct way. Pelvic floor physiotherapy gives you a tailored programme to help, prevent and treat pelvic floor dysfunction – incontinence, organ prolapse or pelvic pain.

Our service is highly confidential and respects the sensitive nature of these problems. For more information on Women’s Health Physiotherapy, Men’s Health Physio and pelvic floor physiotherapy please call us on 020 7036 0286 or drop us an email.

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What are some common symptoms of pelvic floor dysfunction?

  • Urinary incontinence 
  • Bladder urgency 
  • Pelvic floor pain 
  • Pelvic organ prolapse
  • Pain with intercourse 
  • Bowel incontinence 
  • Bowel urgency
  • Constipation

What are the common issues that pelvic floor physiotherapy can help with?

As a woman, pelvic floor muscle physiotherapy can be a benefit for: pre or post natal conditions, chronic pain (vulvodynia, vaginismus, interstitial cystitis, endometriosis), menopausal conditions. 

How can Women's Health Physiotherapy help with pelvic floor dysfunction?

A Women’s Health Physiotherapist uses specialist skills and potentially an internal assessment to assess the strength and tone of your pelvic floor. This helps determine a specialist programme to help strengthen or mobilise your muscles as needed, depending on your symptoms.

What should I expect during a pelvic floor physiotherapy session?

The specialist will first ask you some questions to take your history and understand more about your condition. This is essential to understand what to do during the session. They will assess your abdomen to check your breathing, your abdominal muscles activation, tightness, and specifically for post natal patients your abdominal separation. We will then check your pelvic floor strength and tone via a real time ultrasound and/or internal examination with your consent. After the assessment we will create a customised rehab program for you.

How can Women's Health Physiotherapy help with urinary incontinence?

A Women’s Health Physiotherapist will assess the pelvic floor to determine the strength and the impact it may be having on the symptoms of the bladder. The patient would be advised what their long contraction is, how many seconds the long contraction can be held for and then how many times it can be repeated. These exercises would need to be repeated on a daily basis and the patient to come back for a review. Once the physiotherapist is happy with the progression of pelvic floor strength the exercises should become functional and incorporated into the patients exercise/ routine. 

Can pelvic floor physiotherapy help with faecal incontinence?

The physiotherapist will determine the reason for your incontinence during the initial assessment with the ultrasound and with a rectal internal examination and will decide which exercises you will need to carry on and which manual techniques to use/stretches if there’s a tightness issue. Education will be given regarding diet, fluid intake and toilet habits.

What is pelvic organ prolapse and how is it treated?

The pelvic organs include the uterus, bowel and bladder. A prolapse is when the pelvic floor muscles and tissues become weaker and they can no longer hold your organs in place. 

The physiotherapist will assess the degree and kind of prolapse to then decide the right program from you. Depending on the degree the physiotherapy will choose exercises, will prescribe pessaries (support for the organs) or will send you to a uro/gynaecologist to eventually get surgery. 

What exercises and techniques are typically used during pelvic floor physiotherapy?

The physiotherapist will ask you to perform a pelvic floor contraction and relaxation and then will test your muscles endurance asking for a long contraction (holding) as well. 

“ Imagine that you are trying to stop yourself from passing wind at the same time as trying to stop passing urine. You should feel a squeeze and lift inside your vagina. Do not hold your breath”

How often should I schedule pelvic floor physiotherapy sessions?

The physiotherapy after the initial consultation will decide how often they need to see you. This can vary from once a week to every other week at the beginning and then spread if progress is good and if you are diligent with your home exercise program.

What exercises can help strengthen the pelvic floor?

A specific pelvic floor activation and contraction would be the best way to activate and strengthen the pelvic floor. 

Other exercises that help strengthen the pelvic floor are: 

  • Squat 
  • Bridge
  • Bird Dog 
  • Lunge 
  • Single leg balance 

How often should one perform pelvic floor exercises?

You should aim to complete your Pelvic floor exercises three times a day. There should be a mixture of both long and quick contractions. You need to determine yourself how long you can hold your contraction for and then how many times you can repeat this. This is different for everyone. 

Can pelvic floor physiotherapy help with painful intercourse?

Yes. After the initial assessment to determine the reason for the pain, the physiotherapist can help with breathing, stretches and exercises that can help with the pain brought on by intercourse. Advice and education are also given on different devices or equipment to help return to intercourse gradually.

Can pelvic floor physiotherapy help with vaginismus?

Yes. After the initial assessment to determine the level of tightness and pain,, the physiotherapist can help with internal massage, breathing, stretches and exercises to help loosen up the involuntary tensing of your muscles. Advice and education can also be given on different devices or equipment to help improving your symptoms.

How long does a typical pelvic floor physiotherapy session last?

The initial appointment is 1 hour. The follow up can be half an hour or 1 hour depending on what you have to do with the physiotherapist (just exercise, just manual, or both).

How much does pelvic floor physiotherapy typically cost?

The initial consultation of 1 hour is £155

A 1 hour follow up is £214

A 30min follow up is £107

Will my insurance cover the cost of pelvic floor physiotherapy?

You will need to clarify that with your insurance.

What should I look for in a qualified pelvic floor physiotherapist?

You should look for clarity, making sure they explain everything that is going to happen in the sessions and they explain the diagnosis to you. You should look for professionality and knowledge.

Can pelvic floor physiotherapy help with pregnancy and postpartum recovery?

Yes. The pelvic floor has a major role in pregnancy, it supports your organs, prevents incontinence and helps turn the baby’s head in the correct position. Postpartum many things can happen to your pelvic floor both after a vaginal delivery and a c section one and pelvic floor exercises will help improve your symptoms.

What can I do at home to complement my pelvic floor physiotherapy sessions?

If your physiotherapy decided to give you pelvic floor exercises to perform at home, these needs to be done daily and multiple times a day (4-5 times) in order to see an improvement, if you feel the need you can even use some biofeedback to help you understanding the correct movement and the physiotherapy will explain how to use it in the sessions.

Moreover you need to follow the advice of the physiotherapist regarding your habits, like for example how to avoid constipation, diet, fluid intake…

How can I find a pelvic floor physiotherapist near me?

You can ask Google, ask your GP, or ask your gynaecologist.

Is pelvic floor physiotherapy painful or uncomfortable?

Pelvic floor physiotherapy is normally not painful. It can be painful/uncomfortable during the internal examination (vaginal/rectal) when you suffer from acute pain syndromes or you are really tight but your physiotherapist will do everything possible to make you comfortable and will stop the internal examination at any point if you want to.

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