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Pelvic Floor Rehabilitation

This Is Samia Farooqi, a Registered Pakistani Physiotherapist. I would be sharing some chunks of useful information through my writing.

The Pelvic Floor

The female pelvic floor is formed by the muscles, tendons, and ligaments which extend from the pubic bone to the coccyx (tailbone). The pelvic floor functions like a bowl that supports and contains the pelvic organs that are the vagina, the bladder, and the rectum. The bladder lies between the vagina and the rectum. Weakness of the muscles of the pelvic floor resulting in the dysfunction of the pelvic floor. Dysfunction of the pelvic floor may cause leakage of urine (incontinence), vaginal prolapse, and even uterine prolapse.


Risk Factors for Pelvic Floor Dysfunction

There are some risk factors that can lead to Pelvic Floor Dysfunction:

  • Obesity
  • Trauma to the pelvic region
  • Menopause
  • Nerve damage
  • Hysterectomy
  • Abdominal muscle weakness

Symptoms of Pelvic Floor Dysfunction

How would you know that you might be having a pelvic floor dysfunction? Well, there are some signs and symptoms which indicate that you should visit a Gynecologist

  • Low back pain or pelvic girdle pain
  • Urine leakage during coughing or sneezing
  • Constipation
  • Frequent urination
  • Feeling an urgency to urinate
  • Pain during Sex

Men can also benefit from pelvic physiotherapy to treat pelvic pain and muscle strengthening after prostatitis or prostatectomy

Pelvic Floor Rehabilitation

Pelvic Floor muscles can become weak or overactive. Weak pelvic floor muscles cause urinary incontinence and pelvic organ prolapse. Overactive pelvic muscles can cause urgency, frequent urination, or a feeling of incomplete emptying of the bowels. A tight or overactive pelvic floor may also cause pelvic pain and pain during sex (dyspareunia).

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When you visit your pelvic physiotherapist, she will assess you for your problem. The assessment includes both internal and external examination. The rectum and vagina are assessed for determining the strength of your muscle contractions. The lower back, pelvic region, and core muscles are also assessed to determine the possible causes of the condition. On the basis of detailed examination and assessment, a specific treatment plan is designed.

Manual therapy techniques, diaphragmatic breathing, relaxation exercises, biofeedback, electrotherapy, muscle re-training or re-education, and patient education are the treatment strategies for pelvic floor disorders.

Manual Therapy: Usually applied to lengthen and relax the muscles to reduce pain. The techniques are used according to the diagnosed problem. Manual techniques may be applied internally to treat the vagina and rectum. Externally, manual therapy techniques are applied to muscles, tendons, ligaments, and fascia. Soft tissue mobilization, connective tissue mobilization, muscle energy technique, myofascial release, deep tissue massage, and joint mobilizations are some of the manual therapy techniques a therapist use to treat your condition.

Muscle re-training or re-education: Muscle re-education is about restoring the strength and flexibility of the pelvic floor muscles and training them to work in coordination with the core muscles. The therapist assesses the muscles of the pelvic floor and prescribes specifically-tailored exercises.

Muscle re-education is giving awareness and mindfulness while exercising the pelvic floor muscles:

  • Activating the right muscles
  • Relax the tight and overactive muscles
  • Coordinating the pelvic floor muscles with the diaphragm, abdominals and other core muscles
  • Doing the right exercise at the right time

Electrotherapy: Weak muscles can be strengthened and re-activated by applying electrical stimulators. TENS( Transcutaneous Electrical Nerve Stimulation) and ultrasound can be applied for pelvic and lower back pain management.

Home Exercise Programme: Patients are given a home exercise program including progressive exercises and self-care advice. A home exercise program encourages the patients to actively participate in their rehabilitation. It is given solely for a better outcome.

Patient education: The therapist briefs you about your condition, advises you to do some modifications in your lifestyle according to your condition. In some cases dietary or fluid modifications are also advised by the therapist.


This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2022 Samia Farooqi

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