The pelvic floor is a group of muscles that attach to the front, back, and sides of the pelvis and sacrum (lowest part of the back). Together, the muscles of the pelvic floor act as a hammock to support internal organs such as the uterus, bladder, and rectum. They also wrap around the urethra, rectum, and vagina.
It is important that the muscles of the pelvic floor can relax and contract. Relaxation of the pelvic floor allows for urination, bowel movements, and sexual penetration. The pelvic floor muscles must be able to contract to maintain continence. Problems can arise when these muscles are too tense such as:
- pelvic pain
- urinary urgency
- urinary frequency
- constipation or straining with bowel movements
- pain during or after intercourse
- hip, back, rectum pain
When the muscles are too relaxed, the following situations can arise:
- stress urinary incontinence (leaking with coughing, sneezing, heavy lifting)
- pelvic organ prolapse
- low back pain
Pelvic floor physiotherapy can help treat a variety of pelvic floor conditions such as urinary incontinence, pelvic organ prolapse, and pelvic pain. Pelvic floor physiotherapy is for women AND men.
An initial pelvic physiotherapy exam involves a thorough discussion between you and your physiotherapist. An initial exam may include an internal exam which may be done vaginally or rectally. The pelvic floor muscles are deep in the pelvis, and an internal exam allows for direct palpation. By directly palpating the pelvic floor, it can be determined if the muscles are too tight or too weak. This information is valuable and will determine which exercises or education is provided to you by your therapist. Strengthening a pelvic floor that is already too tense or stretching a pelvic floor that is already too relaxed may not be beneficial. Internal exams are a gold standard for physiotherapy treatment; however, they are not mandatory and will not be done without your informed consent.