Pelvic health solutions for men and women

Your pelvic floor muscles do a lot: they support the organs above them, control the bladder and bowel, and play a part in healthy sexual function. They also work with your abdominal and back muscles to stabilize and support your spine.

When something goes wrong with your pelvic floor muscles, it can lead to leakage, constant trips to the bathroom, sexual frustration and pain. Pelvic health is a big deal.

Though in the past resources have focused more on women’s pelvic health, awareness is growing about this being an issue for both men and women. With that awareness comes information on all the options available, such as physical therapy, for recovering and maintaining good pelvic health.

What is pelvic health physiotherapy?

Pelvic health physiotherapy (sometimes called pelvic floor physiotherapy or pelvic physiotherapy) is the assessment and treatment of conditions involving the pelvic floor and the symptoms that result from problems in this area.

It usually starts with an external and internal (vaginal and/or rectal) examination of the pelvic floor muscles and soft tissue, identifying imbalances and dysfunction that are causing your symptoms. If you have concerns or reservations about the internal examination talk to your therapist at the initial visit. Together you will decide when and if this exam is appropriate for you. Your concerns matter and will help to shape your treatment approach.

Your physiotherapist will then develop a customized treatment plan using a variety of approaches such as manual therapy, pelvic floor muscle facilitation and exercise programs, soft tissue release and more.

Symptoms of pelvic health dysfunction

There are a range of symptoms you may be experiencing if you have a pelvic health disorder, such as:

• Pelvic pain
• Pain in the lower back, hips, groin, buttock
• Leakage when coughing, sneezing, laughing or exercising
• Repeatedly waking at night to urinate (nocturia)
• Increased frequency of urination during the day, interrupting daily routines
• Pain or discomfort during or after sexual intercourse or other types of sexual stimulation
• Erectile dysfunction
• Pelvic floor spasms
• Heaviness or pressure in the pelvic area
• Chronic constipation
• Pain with bowel movements and/or urination
• Unable to completely empty bladder

Conditions treated with pelvic physiotherapy

Pelvic physiotherapy can treat a range of symptoms and conditions caused by pelvic floor dysfunction. It can address your hypotonicity (weak pelvic floor muscles, commonly associated with stress incontinence) and/or hypertonicity (tight pelvic floor muscles, commonly associated with urge incontinence).

Physiotherapy can also help relieve painful symptoms from conditions like endometriosis (a painful condition that occurs when tissue normally lining the uterus grows on other pelvic organs).

Physio treatment options

Following an assessment, your physiotherapist will develop a treatment plan that may involve a variety of the following techniques:

• Manual therapy: Your pelvic health physiotherapist will use hands-on manipulations like stretching, soft tissue massage and mobilization. They may combine this with various types of release techniques such as myofascial and trigger point release.
• Exercise: Various exercises like stretching, strengthening, proper posture and breathing techniques will be used to target the pelvis, thorax and lower limbs.
• Hypopressive exercise: Using specific postures and breathing techniques, your therapist will have you create a lower pressure system in the abdomen and pelvic area, then activate your pelvic floor muscles. It’s helpful with urinary incontinence and pelvic organ prolapse.
• Electrical muscle stimulation (EMS): Electrical impulses are used to activate the pelvic floor muscle, helping them contract and strengthen. 
• Biofeedback: An electrical or mechanical device is used to give auditory or visual feedback on the use of your pelvic floor muscles, helping you identify how and when to activate muscles more effectively.
• Percutaneous tibial nerve stimulation (PTNS): This neuromodulation stimulates the posterior tibial nerve at the ankle through an acupuncture needle that’s connected to electrical impulse device. It’s used to treat an overactive bladder, as well as symptoms of urinary urgency, urinary frequency and urge incontinence.
• Bladder and bowel tracking: Going over your daily routines with your therapist will help you establish healthy bladder and bowel habits.
• Education: Understanding the fundamentals of pelvic health will help you track symptoms and deal with chronic pain.
• Pain relief: Your therapist may also provide pain relief with hot/cold treatments, trans-electrical nerve stimulation (TENS), breathing techniques and more.

Additional resources

Learn more about how to restore pelvic health through physiotherapy

Learn about the range of causes of urinary incontinence in women