The Pelvic Floor: Your Body's Hidden Foundation

The pelvic floor is a group of muscles and connective tissues forming the base of the pelvis. It supports the pelvic organs (bladder, uterus, rectum), maintains continence, plays a role in sexual function, and works with the core to stabilise the spine. Pelvic floor dysfunction is extremely common — affecting up to 1 in 3 women and many men — yet remains underdiagnosed and undertreated due to embarrassment and lack of awareness.

Conditions Treated with Pelvic Floor Physiotherapy

Urinary Stress Incontinence: Leaking urine on coughing, sneezing, laughing, or exercise. Most common pelvic floor problem. Urge Incontinence: Sudden, compelling need to urinate with leaking before reaching the toilet. Pelvic Organ Prolapse: Descent of the bladder (cystocele), uterus, or rectum into the vaginal canal. Pelvic Pain: Chronic pelvic pain, dyspareunia (pain during intercourse), vaginismus. Overactive Pelvic Floor: Muscles that are too tight rather than too weak — causes pain, urgency, and incomplete emptying. Male Pelvic Floor Dysfunction: Post-prostatectomy incontinence, pelvic pain.

Treatment Approach

Pelvic Floor Assessment

A comprehensive assessment identifies whether the pelvic floor is weak, overactive, or uncoordinated — as different problems require different treatments. The common mistake of prescribing Kegel exercises for all pelvic floor problems can worsen symptoms if the pelvic floor is overactive rather than weak.

Pelvic Floor Muscle Training (PFMT)

For weakness: progressive pelvic floor strengthening with correct technique, appropriate resistance and repetitions, functional integration into daily activities.

Down-Training

For overactive pelvic floor: breathing techniques, relaxation exercises, and manual therapy to reduce muscle overactivity.

Bladder Training

For urge incontinence: progressively increasing the time between urge and voiding, urgency suppression techniques, fluid management advice.