Understanding The Pelvic Floor: Signs, Symptoms, Causes & Benefits of Physiotherapy

Quick intro to Jess Higton (Specialist Women's Health Physiotherapy)

Founder & Owner of Women's Physiotherapy Reigate

Jess is a Specialist Women’s Health Physiotherapist with 25 years of experience in the field. She juggles a part time NHS role with her own private women’s health physiotherapy clinic in Reigate,

Surrey. Jess treats women with; bladder problems such as

leaks of urine, bowel problems, pelvic organ prolapse, pelvic pain, pelvic floor weakness or

overactivity. Whilst also supporting women post gynae surgery with personalised rehabilitation. Jess's mission is to help women resolve any pelvic floor symptoms and enable them to return to the activities they love. Jess strongly feels pelvic floor issues are not 'just a normal part of life', and you should not have to put up with them!

The pelvic floor plays a crucial role in our everyday health and wellbeing. Located at

the base of the pelvis, the pelvic floor is a group of twenty three muscles that support

the bladder, uterus (in women), bowel and other pelvic organs. It is responsible for

controlling functions like urination, bowel movements and sexual health. When the

pelvic floor muscles are weakened or damaged, it can lead to several health issues.

Let’s explore what pelvic floor problems are, their causes, and how physiotherapy

can help.

What Are Pelvic Floor Problems?

Pelvic floor dysfunction occurs when these muscles become weak, overactive or

overly strained, affecting their ability to function correctly. Common pelvic floor issues

include:

- Bladder problems including bladder leaks, increased frequency of needing to pass

urine, increased urgency and/or leaking on the way to the toilet.

- Bowel problems including leaks of wind or stool, sudden urge to open bowels or

constipation and straining.

- Pelvic organ prolapse; when the pelvic organs, such as the bladder, uterus, or

bowel, descend due to weakened support from the pelvic floor muscles and other

structures. Symptoms include the feeling of dragging, heaviness or a bulge in the

vagina.

- Pelvic pain; there are different types of pelvic pain including painful intercourse

(dyspareunia), vulval pain (vulvodynia), vaginismus (sudden tightening of the vagina

when something is inserted into it), painful bladder syndrome (interstitial cystitis) as

well as pain from conditions such as endometriosis and adenomyosis.

- Gynaecological cancer; the pelvis including the pelvic floor can be affected after

surgery and treatment for gynaecological cancer.

- Gynaecological surgery; rehabilitation of the pelvic floor and abdominal muscles

after gynaecological surgery is vital to ensure return to full function, hobbies and

sports.

Causes of Pelvic Floor Problems

Pelvic floor problems can arise from various factors, including:

1. Childbirth: The physical strain of pregnancy and childbirth can weaken, stretch

or tear the pelvic floor muscles, especially if there was a difficult delivery or

the use of forceps.

2. Aging: As we age, our muscles including the pelvic floor weaken over time

which may lead to incontinence, prolapse or other pelvic floor problems.

3. Chronic straining: Conditions like chronic constipation or heavy lifting can

strain the pelvic floor over time which affects how well it works.

4. Obesity: Excessive weight puts additional pressure on the pelvic floor, leading

to dysfunction.

5. Hormonal changes: During menopause, lower oestrogen levels can contribute

to pelvic floor dysfunction.

How Can Physiotherapy Help?

Pelvic floor physiotherapy is one of the most effective, non-invasive treatments for

pelvic floor problems with a good evidence base for its effectiveness.

Here’s how physiotherapy can help:

⁃ Exercises: the pelvic floor muscles can be weak in which case strengthening

exercises are needed or for others the pelvic floor can be overactive and

needs to relax. Specific physiotherapy targeted at how the muscles present is

needed to improve pelvic floor muscle function.

⁃ Manual therapy: this hands-on approach can help release tight muscles and

improve how the muscles work.

⁃ Education and lifestyle changes: a physiotherapist provides personalized

advice on managing factors like posture, body mechanics and dietary habits

that affect the pelvic floor.

Top 5 Tips to Improve your Pelvic Floor

1. Practice pelvic floor exercises if you feel your pelvic floor is weak,

however as mentioned above it’s important to note that some women have an

overactive pelvic floor. In such cases, focusing on relaxation techniques such as

diaphragmatic breathing exercises and gentle pelvic floor stretches. If you are

unsure how your pelvic floor is working, a women’s health physiotherapist can help

you.

2. Avoid Straining. Whether lifting heavy objects or pushing too hard

during bowel movements, straining can weaken or further stress the pelvic floor over

time. Practice safe lifting techniques (bend at the knees, not the waist) and put your

feet on a stool to enable easier bowel movements.

3. Avoid constipation. Constipation is one of the main causes of pelvic

floor strain. To prevent it, ensure you drink plenty of water and consume a diet rich in

fibre. This keeps bowel movements regular and reduces pressure on the pelvic floor.

4. Good Posture. Maintaining good posture is key to ensuring that your

pelvic muscles work efficiently. Avoid slumping or sitting for extended periods without

proper support. Stand tall and ensure your spine is well-aligned, as this reduces

unnecessary strain on the pelvic region.

5. Seek Professional Advice Early. You don’t have to live with pelvic floor

problems, and while these issues may feel embarrassing, they are more common

than you might think and can be resolved or greatly improved with women’s health

physiotherapy. Early intervention can lead to quicker recovery, so don’t hesitate to

reach out for help.

In summary, pelvic floor problems can be distressing and upsetting and are more

common than many realise but with individualised care and treatment, they can often

be significantly improved or even resolved. Whether you’re experiencing

incontinence, pelvic pain or prolapse, physiotherapy offers a holistic approach to

women’s health, addressing the root cause of the problem and guiding you towards

a stronger, healthier pelvic floor. By incorporating these five tips into your daily

routine and seeking professional guidance from a physiotherapist, you can take

control of your pelvic health and improve your quality of life. It’s never too late to

address pelvic floor problems.

If you are local to the Surrey area, you can get in touch with Jess for a personalised assessment of your pelvic floor health so you can help you reach your goals and get back to the things you enjoy:

click business card & go to Jess's website