Pelvic health

Pelvic Floor Physiotherapy in Indirapuram

The pelvic floor gets talked about as if it only has one problem, weakness, and one fix, Kegels. In practice it can be weak, tight or badly timed, and each needs a different approach. Working out which one you have is the point of seeing a physiotherapist.

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What the pelvic floor does

The pelvic floor is a sling of muscles across the base of the pelvis, from the pubic bone at the front to the tailbone at the back. It keeps the bladder and bowel closed until you choose to open them, supports the pelvic organs, plays a part in sexual function, and works with the diaphragm and deep abdominal muscles to manage pressure inside the trunk.

That last job explains a lot. When you breathe in, the diaphragm drops and the pelvic floor lowers slightly with it. When you cough, lift or jump, it should tighten a fraction of a second before the pressure arrives. When that timing is off, leaking happens even if the muscle is strong.

Weak, tight or poorly timed

Underactive

The muscles don't generate enough strength or endurance. Typical signs: leaking with coughing, sneezing or exercise, heaviness, difficulty holding wind.

Overactive

The muscles are holding too much tension and can't fully let go. Typical signs: pelvic pain, pain with sex or tampons, urgency, constipation, a sense of incomplete emptying.

Poorly coordinated

The strength is there but the timing isn't: the muscle doesn't switch on before a cough, or doesn't relax to let you empty your bladder or bowel.

Mixed

Common after childbirth, when some parts of the muscle are weak and others are guarding.

Why Kegels aren't always the answer

For an underactive pelvic floor, well-taught pelvic floor training is the first-line treatment, and the evidence behind it is strong. For an overactive one, more squeezing can make pain and urgency worse. And studies have found that a large share of women told to "do Kegels" from written or verbal instructions alone are actually bearing down instead of lifting. A few minutes of checking technique changes the outcome of months of effort.

Who we see

Pelvic floor physiotherapy covers a wide range of problems, including stress and urge incontinence, prolapse symptoms, bowel control problems, recovery after vaginal delivery or caesarean birth, chronic pelvic pain, changes around menopause, and leaking during sport, which we cover under female sports physiotherapy.

What the assessment involves

We start by talking: bladder and bowel habits, pain, births, surgery, exercise and what you want to get back to. You may be asked to keep a simple three-day bladder diary beforehand. Then we look at breathing, posture, the abdominal wall and hip movement, and assess the pelvic floor externally.

An internal examination gives the most accurate picture of strength, tension and coordination, but it's always optional. It's only done with your consent, it can wait until a later visit, and you can stop at any time. You can ask for a female physiotherapist, and you're welcome to bring someone with you.

How treatment works

Strength and endurance: Long holds, quick contractions and "the knack": tightening just before you cough, sneeze or lift.
Relaxation: Down-training with breathing, positions such as child's pose and deep squats, and hands-on release of tight muscles around the pelvis and hips.
Coordination: Timing the pelvic floor with breathing, lifting and impact, so it works automatically rather than only when you think about it.
Bladder and bowel habits: Bladder retraining for urgency, fluid advice, and toilet posture: a footstool under the feet on a western toilet mimics the squat position that makes emptying easier.

How long it takes

Muscle takes time to change. Most women notice the first improvements at four to six weeks, and a full program runs at least twelve weeks, with appointments every one to two weeks and short daily practice at home. Our clinical team explains more in what pelvic floor physiotherapy is and who needs it.

Frequently asked questions

Are Kegel exercises enough on their own?

For some women, yes, as long as the technique is right. If you have pain, urgency or a tight pelvic floor, Kegels alone can make things worse, which is why assessment comes first.

Do I need an internal examination?

No. It gives useful information, but it is always optional and only done with your consent. Treatment can start without it.

Can young women without children have pelvic floor problems?

Yes. Athletes, women with chronic constipation or pelvic pain, and those with a tight pelvic floor often have symptoms without ever having been pregnant.

Can pelvic floor physiotherapy help with pain during sex?

Often, yes. When muscle tension is part of the problem, relaxation training and hands-on treatment can make a real difference, alongside medical care from your gynaecologist.

How often should I practise at home?

Usually a few minutes, two to three times a day. Your physiotherapist will set the exact routine, because it depends on whether you need strength, relaxation or both.

Blood in the urine, heavy or unexpected bleeding, or bleeding after menopause needs medical assessment. Pelvic floor physiotherapy works alongside your gynaecologist or urologist.