Pelvic Floor
It does more than you think, and it deserves more attention than it usually gets.
What is the pelvic floor?
Your pelvic floor is a group of muscles, ligaments and connective tissue at the base of your pelvis. It runs from your pubic bone at the front to your tailbone at the back, and between your two sitting bones.
It sits under your bladder, uterus and bowel, and it's working all day without you thinking about it.
There are two main layers:
The superficial layer: surrounds the openings to the urethra, vagina and anus
The deep layer: extends between your legs from pubic bone to tailbone, providing the majority of your support and control
Pregnancy, birth, hormones and everyday life all affect both layers.
What does your pelvic floor do?
Your pelvic floor has five main jobs. When one of them isn't working well, you'll usually notice.
Support: holds your pelvic organs in their correct position against gravity and increases in pressure
Continence: keeps your bladder and bowel closed when you don't want to go, and opens them when you do
Sexual function: contributes to arousal, sensation and orgasm. Changes in pelvic floor function after birth or at menopause can affect sexual comfort and satisfaction
Pressure management: responds to increases in intra-abdominal pressure such as coughing, sneezing, lifting, exercising, to protect your bladder and bowel
Urgency inhibition: helps suppress the sudden urge to go until you're ready
Being able to relax your pelvic floor matters as much as being able to tighten it. Muscles that can't let go cause as many problems as weak ones, and we check for both.
Signs your pelvic floor needs attention
You don't need to have had a baby to see a pelvic floor physio. We see women from pregnancy through to menopause and beyond.
You might want an assessment if you have:
Leaking with coughing, sneezing, laughing or exercise
A sudden strong urge to go that's difficult to control
Going to the toilet more than 6–8 times per day
Getting up more than once overnight to void
A feeling of heaviness, pressure or bulging in the vaginal area
Difficulty fully emptying your bladder or bowel
Pain during or after sex
Pelvic, hip or lower back pain
Leaking wind or difficulty controlling your bowel
Even with no symptoms, a pelvic floor check in pregnancy or after birth is a good way to look after your long-term health.
What causes pelvic floor problems?
Pelvic floor problems are common, and there's rarely one cause. Things that contribute include:
Pregnancy: the weight and hormonal changes of pregnancy affect the pelvic floor throughout all three trimesters
Vaginal birth: particularly first birth, instrumental delivery, prolonged pushing or large babies
Caesarean birth: often overlooked, but the pelvic floor is still affected by pregnancy itself
Repetitive heavy lifting or high impact exercise without adequate support
Chronic cough or constipation: both increase downward pressure on the pelvic floor
Hormonal changes: menopause significantly affects the strength and elasticity of pelvic floor tissues
Pelvic floor overactivity: where muscles are too tight rather than too weak
How we assess and treat
Your assessment happens in a private room, and we explain each step before we start. Nothing happens without your consent, and you can stop at any time.
Your assessment will include:
A detailed health and symptom history
An explanation of what the assessment involves before we begin, nothing happens without your understanding and consent
Internal pelvic floor assessment, evaluating muscle strength, coordination, relaxation capacity and pelvic floor anatomy
Abdominal and core assessment where relevant
Treatment is tailored to your individual findings and may include:
Pelvic floor muscle training: both strengthening and relaxation
Bladder and bowel retraining
Manual therapy: hands-on treatment of tight or restricted muscles
Real-time ultrasound: to provide visual biofeedback during assessment and treatment
Pressure management and movement strategies
A personalised home exercise program
Referral to our clinical psychologist if your pelvic health is affecting how you feel
It's never too early or too late to look after your pelvic floor.
Ready to book?
Whether you're pregnant, postpartum or somewhere else in life, we're happy to help.