What is it?

Urinary incontinence refers to the unintentional leakage of urine. It is typically classified into:

• Stress Incontinence (SI): Leakage when pressure is placed on the bladder (e.g., coughing, sneezing, laughing, jumping).
• Urge Incontinence (UI): A sudden urge to urinate with difficulty holding it before reaching the bathroom.

Assessment:

• Detailed health history and symptom screening
• Pelvic floor examination (internal and external)

Treatment:

• If weak pelvic floor muscles: Strengthening and coordination exercises
• If muscles are overactive or tight: Internal manual therapy, relaxation techniques, and breathing coordination.

What is it?

Common concerns include constipation and rectal prolapse, often linked to pelvic floor dysfunction.

Assessment:

• Health and dietary history
• External and internal assessment (vaginal and/or rectal)

Treatment:

• Internal pelvic floor release techniques
• Relaxation exercises if excessive muscle tone is present

What is it?

Pelvic organ prolapse occurs when the bladder, uterus, or rectum descends into the vaginal canal, often felt as a bulge or heaviness.

Common symptoms:

• Pelvic pressure
• Urinary leakage
• Pain with intercourse

Assessment:

• Internal pelvic exam
• Visualization or palpation of bulge

Treatment:

• Pelvic floor strengthening
• Breathing mechanics
• Core coordination

What is it?

Pain in the front or back of the pelvic area, hips, or lower back, common during or after pregnancy.

Assessment:

• Range of motion (ROM), strength testing
• Internal exam to determine muscle imbalances

Treatment:

• Manual therapy (internal/external)
• Joint mobilizations
• Strengthening and stabilization exercises

Often overlapping with pelvic conditions, these musculoskeletal issues may stem from pelvic floor dysfunction.

Assessment & Treatment:

• As above—addressing both internal pelvic floor components and surrounding joints and muscles

What is it?

Pain during or after sexual activity, most often due to pelvic floor muscle tightness.

Assessment:

• Internal pelvic floor muscle tone evaluation
• Symptom history

Treatment:

• Internal release techniques
• Pelvic floor relaxation exercises
• Breathing retraining

What is it?

Chronic bladder irritation and inflammation causing:

• Urinary urgency and frequency
• Pelvic pain
• Pain with intercourse

Assessment:

• Medical diagnosis via urologist
• Pelvic floor physio to assess muscle tone

Treatment:

• Releasing tight pelvic floor muscles
• Bladder retraining strategies

What is it?

Endometrial-like tissue grows outside the uterus, leading to pelvic pain, bloating, and painful menstruation or intercourse.

Assessment:

• Medical imaging (ultrasound/MRI)
• Internal exam for pelvic floor muscle tension

Treatment:

• Internal manual therapy
• Myofascial release of abdominal and pelvic tissues
• Breathing and relaxation techniques

What is it?

Separation of abdominal muscles, commonly during pregnancy and postpartum.

Assessment:

• Measurement of gap width and depth by a physiotherapist

Treatment:

• Core and pelvic floor strengthening
• Breathing and intra-abdominal pressure control
• Progressive exercise program

What is it?

Difficulty passing stool or involuntary loss of fecal matter.

Assessment:

• Rectal exam
• Pelvic floor strength and coordination testing

Treatment:

• Internal manual release
• Relaxation and retraining exercises
• Education on optimal toileting posture

What is it?

Irritation or entrapment of the pudendal nerve causing pelvic pain or altered pelvic floor function.

Treatment may include:

• Soft tissue release
• Nerve mobilization techniques
• Collaboration with medical professionals

What is it?

Pain at the coccyx, often due to trauma, poor sitting posture, or muscle tension.

Assessment & Treatment:

• Vaginal or rectal exam
• Mobilization and internal soft tissue release

What is it?

Chronic pelvic pain due to overactivity of the levator ani muscles.

Treatment:

• Internal release techniques
• Relaxation strategies

Helps prepare the body for childbirth and reduce discomfort during pregnancy.

Goals:

• Pelvic floor coordination
• Breathing techniques for labour
• Core strengthening to reduce diastasis
• Labour and birthing education

Timeline:

• Begins in early pregnancy and increases in frequency approaching delivery
• No internal exams until the second trimester

Supports recovery and return to activity after childbirth—vaginal or C-section.

Focus Areas:

• Assess core and glute strength
• Measure and treat diastasis recti
• Address pelvic floor dysfunctions
• Support return to fitness and daily activities