Pelvic floor physiotherapy is a comprehensive treatment aimed at patients suffering from soft tissue impairments of the pelvic floor and the pelvic organs. These impairments can cause disturbances in the proper functioning of the pelvic floor in both women and men. They can occur at any age and have medical, functional, emotional, social, and economic implications. Physiotherapy, along with proper guidance, improves the strength and function of the pelvic floor and the sphincters, alleviates functional disorder symptoms, and is effective both as preventive treatment and for short-term and long-term symptomatic relief.
What is the pelvic floor?
The pelvic floor is composed of a system of muscles, soft tissues, blood vessels, and nerves located in the lower part of the pelvis. These tissues form a kind of hammock that starts from the front of the pelvis and extends to the tailbone, supporting the pelvic organs—such as the bladder, uterus, prostate (in men), and rectum—and through them pass the urethra, the bladder neck (in women), and the anus.
Proper muscle tension in the pelvic floor muscles is necessary for supporting and maintaining the proper function of the pelvic organs. Impaired function of the pelvic floor muscles, such as excessive tightness or weakness, can lead to various problems, including urgency and frequency of urination, difficulty emptying the bladder, urinary leakage during activities (such as coughing, sneezing, dancing, etc.), gas or fecal incontinence, a feeling of pressure, heaviness, and pain in the pelvic area, pain during sexual intercourse, prolapse of the uterus or other pelvic organs, pre and postpartum issues, and issues before and after abdominal and pelvic surgeries. These symptoms can significantly affect the quality of life and functional ability.
Pelvic Floor Rehabilitation
A comprehensive assessment includes a thorough interview and in-depth exploration of the patient's complaints, a general physical examination of posture, abdominal and back muscles, and a local assessment of the tissues and pelvic floor muscles both at rest and during activity. This includes providing an anatomical and physiological explanation of the pelvic organs, the pelvic floor muscles, and the sphincters.
Guidance for adjusting the load during daily activities, changing habits and patterns, such as changing voiding habits, guidance for appropriate postnatal physical activity, and after abdominal and pelvic surgeries, exercises that help improve the stability that affects the function of the pelvic floor muscles, identification of the muscles, strengthening and building endurance in the pelvic floor muscles and improving the timing of the pelvic floor muscles in coordination with the stabilizing and respiratory muscles.
Instructions for performing relaxation exercises, guided imagery, and diaphragmatic breathing that alleviate physical and emotional symptoms of tension, anxiety, and pain associated with pelvic floor issues.
Exercises will be combined with biofeedback equipment, allowing the patient to see in real-time the function of the pelvic floor muscles and sphincters in conjunction with the abdominal and respiratory muscles.
Based on the findings, the physiotherapist will create a tailored rehabilitation plan for the patient's specific problem.
There is great importance in cooperation, motivation, and daily self-practice. The success of treatment is related to the ability to change behavior patterns and habits to establish control over the pelvic floor muscles and sphincters in proper timing and coordination with the stabilizing and respiratory muscles. Successful treatment improves physical, emotional, and behavioral quality of life.
The treatment consists of a series of 4-8 sessions, depending on the examination findings, with intervals of one to three weeks.