Pelvic Floor Physiotherapy is a specialized branch of physiotherapy focused on the assessment and treatment of the pelvic floor muscles. These muscles form a supportive “hammock” at the base of the pelvis and play an essential role in bladder and bowel control, sexual function, core stability, and spinal support.

When the pelvic floor is not functioning optimally, whether due to weakness, tightness, poor coordination, surgery, pregnancy, or stress, it can contribute to a wide range of symptoms that affect daily life and quality of movement.

Pelvic floor physiotherapy can help identify and treat these dysfunctions in a safe, supportive, and individualized way.

Internal Pelvic Floor Physiotherapy

We are excited to now offer Internal Pelvic Floor Physiotherapy as part of our pelvic health services.

Internal pelvic floor physiotherapy involves a detailed assessment of the pelvic floor muscles using a gentle internal approach (vaginal or rectal, depending on the individual and their condition). This allows for a highly accurate evaluation of:

Muscle strength
Muscle tone (tightness or overactivity)
Coordination and control
Sensitivity or pain response

Because these muscles cannot be fully assessed externally, internal assessment can provide valuable information for more targeted treatment.

Learn more about what to expect when you come for pelvic floor physiotherapy.

Your comfort and consent come first

Internal assessment and treatment are always performed with full informed consent. You are in control at every stage, and nothing is ever done without your understanding, agreement, and comfort. You can pause or stop at any time.

What Internal Pelvic Floor Physiotherapy Can Help Identify and Treat:

Depending on findings, treatment may include:

Gentle manual therapy and soft tissue release
Neuromuscular retraining (re-educating muscle coordination)
Breathing and pelvic floor coordination
Pelvic floor relaxation or strengthening strategies
Pain sensitivity and down-training techniques

External Pelvic Floor Physiotherapy

External pelvic floor physiotherapy focuses on the pelvic floor system without internal examination or treatment.

This approach is non-invasive and may be preferred by some individuals, or used as an initial step in care.

External treatment may include:

Assessment of abdominal, hip, and pelvic muscle function
Posture and movement analysis
External soft tissue release techniques
Breathing and diaphragm coordination training
Core and pelvic stability exercises
Education and individualized exercise programming

External pelvic floor physiotherapy targets not only the pelvic floor muscles, but also the surrounding systems that influence pelvic health, including the hips, spine, and diaphragm.

Choosing the Right Approach for You

Not everyone requires internal pelvic floor physiotherapy.

Your physiotherapist will complete a thorough assessment and discussion to determine the most appropriate and comfortable approach for your needs, symptoms, and goals.

We always prioritize education, consent, and collaboration so you feel fully informed in your care plan. If you would like to discuss your case, we would be happy to talk with you during a free, complimentary appointment, to ensure you get the best fit.

Benefits of Pelvic Floor Physiotherapy

Pelvic floor physiotherapy can help improve a wide range of symptoms and conditions by restoring balance, coordination, and strength to the pelvic region.

Common benefits include:

Improved bladder control and reduced leakage
Reduced urgency and frequency of urination
Decreased pelvic pain and muscle tension
Improved sexual comfort and function
Better core stability and posture
Support during postpartum recovery
Improved bowel function and reduced constipation symptoms
Enhanced recovery after pelvic or abdominal surgery
Reduced symptoms of pelvic organ prolapse
Improved confidence with movement, exercise, and daily activities

By addressing both strength and coordination, not just tightness or weakness, pelvic floor physiotherapy helps restore more efficient and comfortable function.

What Pelvic Floor Physiotherapy Can Help With

There are many different symptoms and concerns pelvic floor physiotherapy can help with.

Urinary Incontinence

Includes leakage with coughing, sneezing, running, or exercise (stress incontinence), as well as sudden urgency and difficulty holding urine (urge incontinence). Treatment focuses on improving pelvic floor strength, timing, and bladder control strategies.

Pelvic Pain

Pelvic pain may be related to muscle tension, trauma, surgical history, or conditions such as endometriosis. Physiotherapy helps reduce muscle overactivity, improve mobility, and restore comfort in the pelvic region. Learn more about how Physiotherapy can help with chronic pelvic pain.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when pelvic organs descend due to reduced support. Pelvic floor physiotherapy can improve muscle support, reduce symptoms of pressure or heaviness, and enhance functional control.

Postpartum Recovery

Pregnancy and childbirth can significantly change pelvic floor function. Physiotherapy supports recovery by restoring strength, coordination, and function, while addressing symptoms such as leakage, pain, or heaviness.

Chronic Constipation

The pelvic floor plays a key role in bowel function. Dysfunction can contribute to difficulty passing stool or incomplete emptying. Treatment focuses on coordination, relaxation, and pressure management strategies.

Men’s Pelvic Health

Men can experience pelvic floor dysfunction, particularly after prostate surgery or with age. Pelvic floor physiotherapy may help with urinary incontinence, pelvic pain, and sexual function concerns.

Painful Intercourse (Dyspareunia)

Pelvic floor dysfunction can contribute to pain during intercourse. Treatment may focus on reducing muscle tension, improving coordination, and restoring comfort and confidence. Learn more about Dyspareunia here.

Post-Surgical Recovery

Following pelvic or abdominal surgery (such as hysterectomy, prostate surgery, or C-section), pelvic floor physiotherapy supports recovery by improving tissue mobility, reducing scar sensitivity, and restoring function.

Techniques Used in Pelvic Floor Physiotherapy

Pelvic floor physiotherapy is highly individualized. Treatment may include a combination of internal and external techniques depending on your needs.

Assessment Techniques

Internal pelvic floor assessment (when appropriate and consented)
External musculoskeletal assessment
Breathing pattern and diaphragm evaluation
Movement and posture analysis

Treatment Techniques

Internal and external soft tissue release
Myofascial and trigger point therapy
Pelvic floor muscle retraining (strengthening or relaxation)
Breathing coordination with pelvic floor activation
Core stability and functional movement training
Education on bladder, bowel, and lifestyle factors
Progressive exercise programming tailored to goals

Whole-Body Approach

Because the pelvic floor is part of a larger pressure system, treatment often includes coordination between:

Diaphragm (breathing)
Abdominals (core control)
Pelvic floor muscles
Spine and hips

This integrated approach helps restore efficient movement and reduce symptom recurrence. Learn how your breathing and pelvic floor are closely linked.

Frequently Asked Questions About Pelvic Floor Physiotherapy

What is internal pelvic floor physiotherapy?

Internal pelvic floor physiotherapy is a hands-on assessment and treatment approach that involves gently assessing the pelvic floor muscles through a vaginal or rectal examination (depending on the individual and their condition).

This allows your physiotherapist to directly assess muscle strength, tone, coordination, and sensitivity, information that cannot always be fully obtained externally.

Internal assessment is always performed with full consent, clear communication, and at your comfort level. You are in control at all times.

What is external pelvic floor physiotherapy?

External pelvic floor physiotherapy focuses on assessing and treating the pelvic floor system without internal examination.

This may include assessment of the hips, abdomen, spine, breathing patterns, and movement strategies that influence pelvic floor function.

Treatment may involve exercise therapy, soft tissue release, posture and movement retraining, and diaphragm coordination work.

External treatment is often used as a starting point or when internal assessment is not required or preferred.

👉 Here’s even more information on what to expect when you are working with us.

Is internal pelvic floor physio painful?

Internal pelvic floor physiotherapy should not be painful. Some people may experience mild discomfort if there is existing muscle tightness, sensitivity, or pain in the area, but your physiotherapist will always work within your comfort level.

Treatment is slow, gentle, and guided by your feedback throughout the session. You can stop at any time. The goal is to reduce pain and tension over time, not increase it.

Do I need an internal assessment for pelvic floor issues?

Not everyone needs internal pelvic floor assessment.

Your physiotherapist will complete a thorough assessment of your symptoms, history, and goals to determine the most appropriate approach for you.

Some conditions can be effectively treated externally, while others benefit from internal assessment for more detailed information.

Care is always individualized based on comfort and clinical need.

👉 Here’s even more information on what to expect when you are working with us.

What conditions does pelvic floor physiotherapy treat?

Pelvic floor physiotherapy can help with a wide range of conditions, including:

Urinary incontinence (leakage or urgency)
Pelvic pain
Pelvic organ prolapse
Postpartum recovery
Constipation and bowel dysfunction
Pain with intercourse
Men’s pelvic health concerns
Post-surgical recovery

Is pelvic floor physiotherapy covered by insurance?

Yes, pelvic floor physiotherapy is typically covered under most extended health insurance plans that include physiotherapy services.

Coverage varies depending on your provider and plan, so we recommend checking directly with your insurance company for details about your specific benefits.

Pelvic floor physiotherapy for postpartum recovery

Pelvic floor physiotherapy is highly beneficial after pregnancy and childbirth. It can help restore strength, coordination, and function to the pelvic floor and core system.

It may also help address:

Bladder leakage
Pelvic heaviness or pressure
Abdominal separation (diastasis recti)
Pain or discomfort
Return to exercise safely

Signs of pelvic floor dysfunction

Common signs of pelvic floor dysfunction include:

Leaking urine when coughing, sneezing, or exercising
Frequent or urgent need to urinate
Pelvic pressure or heaviness
Pain in the pelvic region
Pain during intercourse
Difficulty emptying bladder or bowels

If you are experiencing any of these symptoms, pelvic floor physiotherapy may be helpful.

Pelvic floor tightness vs weakness

Pelvic floor dysfunction is not always about weakness—sometimes the muscles are actually too tight or overactive.

A tight pelvic floor may cause pain, urgency, or difficulty relaxing. A weak pelvic floor may lead to leakage or reduced support.

In many cases, symptoms are caused by a combination of both strength and coordination issues, which is why a detailed assessment is important.

Can breathing affect pelvic floor function?

Yes. The diaphragm and pelvic floor work together as part of a pressure system in the core.

When breathing is efficient, the diaphragm and pelvic floor coordinate smoothly. When breathing becomes shallow or dysfunctional, it can contribute to pelvic floor tension, poor coordination, or reduced support.

Why do I leak when I run?

Leaking during running is commonly associated with stress urinary incontinence, which occurs when the pelvic floor muscles cannot adequately support increased pressure during impact activities.

This does not necessarily mean your pelvic floor is weak, it may also reflect timing, coordination, or breathing pattern issues.

Pelvic floor physiotherapy can help retrain the system so it can better manage impact and pressure during running and exercise.

Can pelvic floor physio help men?

Yes. Although pelvic floor therapy is often associated with women’s health, men can also experience pelvic floor dysfunction. Tightness, weakness, stress, breathing patterns, surgery, injuries, and chronic tension can all contribute to pelvic floor symptoms.

At Move Authentically Physiotherapy, we use external pelvic floor techniques to help with men’s health. Read about what external pelvic floor therapy is and what to expect at your visits.

Pelvic floor physiotherapy for men focuses on assessing and treating the muscles, nerves, and connective tissues of the pelvic region. Treatment can help improve bladder control, bowel function, pelvic pain, sexual health concerns, and core function.

👉 Learn more about pelvic floor physiotherapy for men, here.

Book an appointment!

Pelvic Floor Health