Pelvic floor physio: who it helps and what to expect

What is the pelvic floor?

The pelvic floor is a group of muscles at the base of the pelvis. They support the bladder, bowel and, in women, the uterus, and help control when you pass urine, wind or a bowel motion. They also play a role in sexual function and in supporting your trunk.

Pelvic floor problems can affect anyone, including men, women, pregnant and postnatal people, athletes and older adults.

Who it can help

• Leaking urine with coughing, sneezing, exercise or when you cannot get to the toilet in time
• Needing to go often or urgently
• A feeling of heaviness or bulge in the vagina, which can be a sign of prolapse
• Pelvic or perineal pain, or pain with sex
• Constipation or difficulty emptying your bowels
• Pregnancy preparation and recovery after birth or pelvic surgery
• Men who have had prostate surgery or who have pelvic pain

These problems are common, but they are not something you simply have to accept. Many respond to physio-led treatment.

What an appointment involves

Pelvic health physios have extra training in this area. A first appointment usually starts with a conversation about your symptoms, bladder and bowel habits, medical history and goals. You may be asked to keep a bladder diary.

Depending on your situation, your physio may suggest an assessment of your pelvic floor muscles. This might be done by an internal exam, or by looking at the muscles from outside with real-time ultrasound. Your physio should explain what they recommend and why.

You are in control

• You can ask questions at any point and say no to any part of an examination
• You can stop at any time
• You can bring a support person, and you can ask for a chaperone
• Your physio should explain what they are doing and get your consent before starting
• If you prefer, you can ask whether a female or male physio is available when booking

What treatment looks like

Treatment is built around your assessment. It may include:

• Pelvic floor muscle training, which for some people means learning to relax the muscles as well as strengthen them
• Bladder and bowel habit advice, including fluids, toileting position and constipation strategies
• Exercise and lifestyle changes
• Biofeedback or other tools to help you find and control the right muscles
• A plan to return to exercise or sport
• Referral to a doctor, continence nurse or specialist if you need further care

If you are pregnant or have had a baby, see our guide to physio during pregnancy.

When to see a doctor first

• Blood in your urine or from your bowel
• You cannot pass urine, or you suddenly lose bladder or bowel control with back pain, leg weakness or numbness in the groin. This needs urgent medical help
• Repeated urinary tract infections, fever or pain when passing urine
• Pelvic pain that is severe, new or getting worse
• Heavy bleeding or unusual discharge

The National Continence Helpline (1800 33 00 66) offers free information and support on bladder and bowel problems.

Costs and funding

Pelvic floor appointments are often longer than standard physio sessions, so fees can be higher. Private health extras may pay a rebate. See our cost guide.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.