How does pelvic floor physiotherapy work?

The first visit may cover bladder and bowel habits, sexual symptoms, pregnancy or birth history, movement and pain. With consent, the physiotherapist may assess breathing, posture, abdominal movement and pelvic floor contraction or relaxation. Internal assessment is optional and should be explained before it happens.

Treatment can include pelvic floor contractions, relaxation practice, breathing coordination, stretches, scar or soft-tissue work and bladder training. A person with Stress Urinary Incontinence may need graded strengthening, while Vaginismus or Chronic Pelvic Pain may require down-training and gentle desensitisation. Plans can also support Pelvic Organ Prolapse, Pelvic Girdle Pain or Interstitial Cystitis.

Practise the exact technique taught rather than repeatedly squeezing throughout the day. Keep a short symptom or bladder diary if requested, pace activities and report pain or worsening leakage. Improvement depends on matching the exercise to whether muscles are weak, overactive or poorly coordinated.

Arrange medical assessment for new blood in urine or stool, unexplained vaginal bleeding, fever, severe pelvic pain, sudden leg weakness or loss of bladder or bowel control. Contact the physiotherapist if exercises cause persistent pain, numbness or worsening symptoms.

Are my pelvic floor muscles weak, tense or poorly coordinated, and would physiotherapy be appropriate before considering a Mid-Urethral Sling?