Pelvic Floor Dysfunction
Pelvic floor dysfunction encompasses various conditions affecting the muscles, ligaments, and connective tissues supporting the pelvic organs. Our specialized women’s health physiotherapists provide comprehensive assessment and evidence-based treatment for all types of pelvic floor dysfunction.
Understanding Pelvic Floor Dysfunction
Types of Dysfunction
Underactive Pelvic Floor (Weakness)
- Inability to contract muscles effectively
- Poor endurance and strength
- Delayed muscle activation
- Common after childbirth or with aging
Overactive Pelvic Floor (Tension)
- Muscles unable to relax fully
- Chronic muscle tension and spasm
- Pain with intercourse or examinations
- Associated with chronic pain conditions
Coordination Problems
- Poor timing of muscle activation
- Inability to relax after contraction
- Paradoxical contractions
- Difficulty with voluntary control
Common Presentations
Stress Incontinence
- Leakage with cough, sneeze, or exercise
- Weakness of pelvic floor muscles
- Common after childbirth
- Worsens with high-impact activities
Urge Incontinence
- Sudden, strong need to urinate
- Difficulty making it to bathroom in time
- Overactive bladder symptoms
- May include nighttime urgency
Pelvic Organ Prolapse
- Feeling of heaviness or dragging
- Visible or palpable bulge
- Difficulty emptying bladder or bowel
- Worse with standing or lifting
Sexual Dysfunction
- Pain with intercourse (dyspareunia)
- Difficulty achieving orgasm
- Decreased sensation
- Vaginal tightness or spasm
Comprehensive Assessment
Initial Consultation
- Detailed symptom history
- Obstetric and gynecological history
- Bladder and bowel diary review
- Quality of life assessment
Physical Examination
- External pelvic assessment
- Internal examination (with consent)
- Real-time ultrasound assessment
- Functional movement analysis
Diagnostic Tools
- Biofeedback assessment
- Strength and endurance testing
- Coordination evaluation
- Posture and breathing assessment
Treatment Approaches
Pelvic Floor Muscle Training
- Individualized exercise programs
- Progressive strengthening protocols
- Functional training positions
- Home exercise prescription
Manual Therapy
- Soft tissue release techniques
- Trigger point therapy
- Scar tissue mobilization
- Joint mobilization
Biofeedback Training
- Real-time ultrasound guidance
- EMG biofeedback
- Pressure biofeedback
- Visual and verbal cues
Behavioral Modifications
- Bladder retraining programs
- Bowel management strategies
- Fluid and dietary guidance
- Toileting posture education
Life Stage Considerations
Pre-Pregnancy
- Optimizing pelvic floor function
- Addressing existing dysfunction
- Education and prevention strategies
- Preparing for pregnancy changes
During Pregnancy
- Managing pregnancy-related changes
- Preventing dysfunction
- Birth preparation
- Safe exercise guidance
Postpartum
- Recovery assessment at 6 weeks
- Addressing birth-related trauma
- Return to exercise protocols
- Diastasis recti management
Menopause
- Managing hormonal changes
- Addressing tissue changes
- Pessary fitting if needed
- Long-term management strategies
Treatment Outcomes
With proper treatment, expect:
- 70-80% improvement in incontinence symptoms
- Reduced prolapse symptoms
- Improved sexual function
- Enhanced quality of life
- Better bladder and bowel control
- Increased confidence in daily activities
