What to Expect With Pelvic Floor Physical Therapy
What is pelvic floor physiotherapy?
The pelvic floor:
- Supports the pelvic organs, including the uterus, bladder, and rectum.
- Regulates bladder and bowel function.
- Helps with core stability by working with the abdominal wall, back, and diaphragm muscles.
Pelvic floor physical therapy, also called pelvic health physical therapy, includes a range of treatments.
Who might benefit?
This type of physical therapy can help with a range of conditions, including:
- Urinary incontinence (leaking urine).
- Fecal incontinence (difficulty controlling bowel movements).
- Pelvic pain.
- Pelvic organ prolapse. This occurs when the pelvic organs drop from their normal position, causing a bulging sensation in the pelvic area.
- Recovery after a pelvic surgery.
- Pelvic girdle pain during pregnancy
- Recovery after having a baby
What happens at your first visit?
At your first appointment, your pelvic health physical therapist will ask about your symptoms, medical history, and bladder and bowel habits. They will also talk with you about your goals for treatment.
As part of your assessment, an internal pelvic exam is usually done, but not always. It will only be done with your consent. This exam is done with 1 or 2 gloved fingers gently placed in the vagina or rectum. The purpose of the exam is to assess the tissues that support the bladder, bowel, and uterus.
What kinds of treatment are used?
Your therapist will build a plan based on the treatment goals you talked about during your assessment. The plan may include:
Pelvic floor muscle training
- Pelvic floor muscle training (PFMT, also known as Kegels) is often an important part of pelvic health physical therapy. Depending on your assessment, your treatment plan may focus on strengthening weak muscles, improving muscle coordination, or helping the muscles relax.
- For weak muscles, training often involves gently squeezing and holding the pelvic floor muscles before fully relaxing them. Your pelvic health physical therapist may also teach you exercises for your abdominal wall, low back, and hips to support overall pelvic function.
- For muscles that are overactive, treatment may focus on relaxation and lengthening techniques, sometimes called down training. These techniques can help reduce tension and improve how the muscles work.
Biofeedback
Biofeedback uses sensors connected to a device that shows your muscle activity. This helps you to learn how to contract (squeeze) or relax your pelvic floor muscles. It can help with both strength and relaxation goals.
Electrical stimulation
Electrical stimulation sends a mild current through electrode pads or a small probe in the vagina. This treatment also helps you learn how to contract or relax your pelvic floor muscles. It can help with both strength and relaxation goals.
Tibial nerve stimulation
Tibial nerve stimulation uses a thin needle (percutaneous) or an electrode pad (transcutaneous) placed near the ankle. The needle or pad sends mild electrical pulses along the tibial nerve. This nerve connects to nerves that control the bladder and pelvic floor. It's used most often for overactive bladder and the sudden, strong urge to urinate.
Manual therapy
Manual therapy involves hands-on techniques to release tight muscles and connective tissue. A therapist may work on the abdominal wall, hips, lower back, and inner thighs. They may also use gentle internal techniques to release the pelvic floor muscles.
How long does treatment take?
The evidence suggests you'll need 12 to 16 weeks of pelvic floor training, but this depends on your condition and how your body responds. Most people see their therapist once a week or every other week. Some people see improvement in the first few visits.
Adaptation Date: 10/01/2026
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
