Pelvic Floor Physiotherapy: Problems and Dysfunction.
in Vélez-Málaga
How can pelvic floor problems be treated with physiotherapy?
Pelvic floor physiotherapy focuses on the prevention, assessment and rehabilitation of conditions affecting this important area of the body.
But, how well do you really know your pelvic floor?
The pelvic floor is made up of a group of muscles and ligaments located at the base of the pelvis. These structures play an essential role in several urinary, bowel, sexual and reproductive functions.
Pelvic floor dysfunction is more common than many people realise. However, there is still a great deal of uncertainty and lack of awareness surrounding these conditions, mainly because they are not always openly discussed.
Both women and men may experience pelvic floor problems and often feel uncomfortable talking about their symptoms. At VITEN, our aim is to provide a professional, confidential and supportive environment where these issues can be properly assessed and treated.
How can you tell if your pelvic floor is not functioning properly?
They also contribute to core stability and posture. However, many people are barely aware of these muscles until symptoms begin to appear.
But how do we know whether the pelvic floor is working properly?
During an assessment, a physiotherapist specialised in pelvic health carries out a detailed evaluation of the perineum and the muscles involved, taking into account factors such as muscle strength, mobility, control, coordination and function.
Other related areas are also considered, including breathing patterns, spinal and abdominal muscles, joints and hip function. Sensory responses and reflexes may also be assessed when necessary.
This comprehensive approach allows us to identify the possible causes of your symptoms and create an individual treatment programme tailored to your needs.
At VITEN, our pelvic health physiotherapists work to help patients return to their normal daily activities, exercise, work and personal life as safely and comfortably as possible.
Personalised pelvic floor physiotherapy
Every patient is different, which is why pelvic floor treatment should always be adapted to each individual case.
Our objective is not simply to treat the symptoms, but also to identify the factors contributing to the problem and help reduce its impact on your everyday life.
Who is most commonly affected?
Pelvic floor dysfunction is particularly common among women of all ages.
Pregnancy and childbirth can place significant demands on the pelvic floor. Young female athletes may also experience problems such as urinary leakage during exercise, while hormonal changes before, during and after the menopause can affect pelvic floor function.
All of these situations may benefit from specialist pelvic floor physiotherapy.
However, pelvic floor problems do not only affect women.
Men have a pelvic floor too, and they may experience symptoms including rectal or pelvic pain, constipation, urinary or anal incontinence, persistent symptoms associated with prostatitis, erectile difficulties or problems with ejaculation.
Specialist assessment can help identify the factors involved and determine the most appropriate treatment approach.
Physiotherapy Before and After Pregnancy
During pregnancy, a woman’s body undergoes significant musculoskeletal and hormonal changes.
Appropriate physical activity can help relieve some of the discomfort associated with these changes, maintain mobility and strength, and prepare the body for childbirth and the postpartum period.
Before joining one of our pregnancy Pilates programmes, we recommend a pelvic floor assessment. This allows us to adapt the exercises to your individual needs and physical condition.
Physiotherapy During Pregnancy
- Treatment and support may include: Physical preparation for childbirth.
- Pilates for pregnant women.
- Prevention of pelvic floor dysfunction.
- Treatment and management of urinary incontinence.
- Manual therapy.
- Perineal massage.
- Manual lymphatic drainage.
Perineal massage is generally introduced from around week 34 of pregnancy when appropriate.
Postpartum Recovery
Treatment may include:
- Postpartum assessment: usually carried out approximately 3–4 weeks after giving birth, depending on each individual case.
- Assessment of abdominal diastasis.
- Treatment of caesarean section scars.
- Treatment of episiotomy scars.
- Treatment following perineal tears.
- Postpartum Pilates.
- Pelvic floor strengthening and rehabilitation.
- Progressive return to exercise.
Pregnancy involves approximately nine months of physical changes and adaptations, and recovery also takes time. The postpartum period should therefore be approached gradually, respecting the body’s natural healing process.
Pelvic Floor Dysfunction
Pelvic floor physiotherapy can help with a wide range of conditions affecting bladder, bowel, pelvic and sexual function.
Colorectal and Proctological Conditions
- Anal incontinence.
- Constipation.
- Rectal prolapse.
- Haemorrhoid-related pelvic floor dysfunction.
- Painful bowel movements.
Urogynaecological Conditions
- Stress urinary incontinence.
- Urinary urgency.
- Pain during urination.
- Pelvic organ prolapse.
- Recurrent urinary tract problems.
- Pelvic floor weakness.
Sexual Dysfunction
Pain or discomfort during sexual intercourse should not simply be accepted as normal.
Pelvic floor physiotherapy may help patients experiencing:
- Dyspareunia: pain during sexual intercourse.
- Vaginismus.
- Vaginal dryness and lubrication-related problems.
- Erectile dysfunction.
- Ejaculatory dysfunction.
- Anorgasmia.
- Pelvic pain associated with sexual intercourse.
Chronic Pelvic Pain
Chronic pelvic pain can have many different causes and may significantly affect a person’s quality of life.
Specialist pelvic floor physiotherapy can form part of the multidisciplinary management of conditions such as:
- Endometriosis.
- Dysmenorrhoea or painful periods.
- Vulvodynia.
- Painful bladder syndrome.
- Pudendal nerve syndrome.
- Coccydynia or coccyx pain.
Pelvic Floor Rehabilitation in Oncology
However, treatments such as radiotherapy, chemotherapy, surgery and hormonal therapy can have short- and long-term effects on the pelvic floor and surrounding tissues.
Pelvic floor physiotherapy can therefore form part of the recovery process for some patients following cancer treatment.
Types of Cancer Associated with Pelvic Floor Dysfunction
- Breast cancer.
- Uterine cancer.
- Cervical cancer.
- Ovarian cancer.
- Bladder cancer.
- Colorectal cancer.
- Prostate cancer.
Associated Signs and Symptoms
Patients may experience:
- External or internal genital tissue changes or atrophy.
- Pain during sexual intercourse.
- Vaginal discomfort, itching or burning.
- Recurrent cystitis or urinary symptoms.
- Pelvic floor weakness.
- Pelvic organ prolapse.
- Urinary or anal incontinence.
Treatment is always adapted to each patient’s medical history, symptoms and individual needs.
Male Pelvic Floor Physiotherapy
Yes, men have a pelvic floor too!
Pelvic floor dysfunction can also affect men and may appear at different stages of life.
Specialist pelvic floor physiotherapy may be beneficial for men experiencing symptoms associated with:
- Prostate cancer and its treatment.
- Testicular cancer and its treatment.
- Urinary dysfunction: urinary incontinence, urinary urgency or pain during urination.
- Colorectal dysfunction: anal incontinence, constipation or haemorrhoid-related pelvic floor problems.
- Sexual dysfunction: pain during or after sexual intercourse, anorgasmia, erectile dysfunction or premature ejaculation.
- Chronic pelvic pain.
- Pelvic floor weakness.
- Post-operative recovery following prostate surgery.
Treatment begins with an individual assessment to understand your symptoms and determine the most appropriate rehabilitation plan.
Pelvic Floor Specialist Team
Juana Martínez
Pelvic Floor Physiotherapist
Dra. Carmen Granados
Gynaecologist
María Quintana
Nurse