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Are you going to see a women’s pelvic health physiotherapist?

Written by Jane Appleyard,

Chartered Physiotherapist

Find out what to expect from your appointment and five top tips about how to make the most of it.

Tip One

Be prepared to talk about your symptoms, decide which ones are most ‘bothersome’ and how long they’ve been an issue in your life.

Understanding the types of symptoms you experience and hearing you describe them is a really important part of the assessment process. It helps your physiotherapist begin to piece together a ‘clinical picture’ before your physical examination. Women often find it a huge relief to be able to talk openly about problems they may have been silently coping with for years.

Now some of your symptoms may be absolutely toe curlingly embarrassing to you but it’s good to understand that an experienced pelvic health physio will have heard them all before!

This word cloud gives examples of the kinds of symptoms

women describe.

Tip Two

Be prepared to take some information about your bladder habits.

This is really important if your main issues are with, what we often call, an ‘overactive bladder’. This is when the feeling of needing to wee is constantly on your mind and when urgency stops you reaching the toilet on time.

A diary can also help to identify ‘stress leaks’. These can happen with any activity that puts pressure on a bladder that’s not well supported.

A diary shows how your bladder behaves on a day-to-day basis. Measurements such as how much urine your bladder holds, how often you have to pass urine and the circumstances that cause you to leak all add to your ‘clinical picture’.


F – Fluid intake

Record how much fluid you drink in mls and whether it’s coffee, tea, water, beer etc.

U – Urine passed

It’s really important to record the amount of urine passed in mls. Use a measuring jug if you’re at home. If you’re out and about and it’s impossible to measure, then just tick the box instead.

W – Wet

Record any wet episodes, simply tick the box.

Bowel problems are incredibly common and people find it very difficult to seek help often because they don’t know whom they could approach. It’s tempting to search the Internet for answers but seeking guidance from a professional is safer.

There are a number of ‘red flag’ symptoms that a health care professional would be able to screen for and then often simple strategies can sort out bowel symptoms that have been bothersome for years.

Both bladder and bowel diaries are downloadable from the Internet and are set out in a format that helps you to capture the details easily as well as helping your therapist to easily pull out all the relevant information.

Tip Three

Be prepared for a physical assessment that will include more than just reviewing your pelvic floor area. The examination may begin in a standing position where your postural alignment, spine and pelvic movements can be viewed.

We do know that no-one is symmetrical and that as far as alignment is concerned it’s ‘normal to be abnormal’.

The aim of the assessment is to see if the muscles of your core and pelvic floor are able to work in a co-ordinated way.

So expect your therapist to be looking at the bigger picture of how your body puts movements together and whether it’s able to co-ordinate effective patterns of breathing.

Tip Four

Be prepared for the pelvic floor examination to be ‘interactive’ and take a few minutes to complete. Don’t be embarrassed – Remember your therapist is likely to have examined hundreds of women and will have a wealth of experience in ‘pelvic floors’.

You should be comfortable, relaxed, have been given a clear explanation of what the internal vaginal examination will involve and know that you can opt out at any stage.

The assessment is likely to include:

  • Checking the skin condition of the vulva and vaginal area

  • Assessing for weakness of the front and back vaginal walls (prolapse) on coughing

  • Palpating the resting background tone of the pelvic floor

  • Assessing the co-ordination of the pelvic floor movement with abdominal, diaphragm and other core muscle activity

  • Ability of the pelvic floor muscles to fully release and relax

  • Evaluate the power, speed and endurance of the pelvic floor muscles

  • Check your technique and ability to perform an effective contraction

  • Note areas of sensitivity, tension and tightness

  • A test to see if there a reflex contraction of your pelvic floor when you cough

So the internal examination may take five minutes or more but the information that’s gathered combined with the discussion about your symptoms means that your physiotherapist is likely to be able to give to an accurate diagnosis and put together an effective treatment plan.

Tip Five

Be prepared to be given a rehabilitation plan that may include anything in this word cloud.

Pelvic physiotherapy can lead to a steady improvement in your symptoms but not usually a ‘quick fix’. The general guidance is that it can take around three months to see an improvement but that can very much depend on what your main problem has been.

Some women do notice a faster improvement especially if their main issue has been leaks on coughing. Once they learn to engage their pelvic floor effectively before a cough they stay dry!

Do be patient with yourself. We know even simple lifestyle changes or short exercise programmes can be a challenge to stick to. Changing behaviour is never easy but remember that with a personalised treatment programme you’re on the right path to recovery!

The information on this website is written to give general information and does not in any way replace advice from your G.P. or qualified health care professional. If you have any specific concerns about your health you should seek an individual consultation with your G.P. for diagnosis and advice.


de Smit Medical is a family run distributor of medical products and training that has built a reputation for excellence and outstanding performance. Established in 2002 by Lyn de Smit, the company has grown organically ensuring that Lyn’s core values are maintained. Providing sales and service from our rapidly expanding facility in North Bristol, on the borders of the beautiful Cotswolds, your needs are supported by a national, field-based sales team, a responsive and expert customer service team and an excellent logistical and technical team. Our highly trained staff are further supported by respected clinical advisors, enabling us to respond to your needs appropriately and with expertise... More Info


+44 (0)845 345 4226

Local: +44 (0)1454 329 151 Fax: +44 (0)845 345 4227 Email: Contact Form Head Office: Unit 15 Falcons Gate Bristol, BS37 5NH

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