What Does a Pelvic Floor Physiotherapist Do?
Everything you need to know about pelvic floor physiotherapy; what to expect, when to see one, and why it could be the most important appointment you book for your women’s health.
If you’ve ever wondered whether leaking when you laugh is “normal”, struggled with pelvic pain, or felt unsure about returning to exercise after having a baby… a women’s pelvic floor physiotherapist is the specialist you need to see.
Pelvic floor physiotherapy is a highly specialised area of women’s health physiotherapy. It focuses on assessing and treating the muscles, connective tissues, and nerves of the pelvic floor (together these play a critical role in bladder and bowel control, sexual function, and core stability).
At Hatched House, our pelvic floor physiotherapists work with women at every life stage, from pre-pregnancy and pregnancy care through to postnatal recovery, perimenopause, and beyond.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, and connective tissues that sit at the base of your pelvis. Think of it like a hammock that supports your bladder, bowel, and uterus.
These muscles have four key jobs:
• Support — holding your pelvic organs in the correct position
• Sphincteric — controlling bladder and bowel opening and closing
• Sexual — contributing to sexual sensation and function
• Stability — working as part of your deep core to support your spine and pelvis
When the pelvic floor isn’t functioning well — whether it’s too weak, too tight, or poorly coordinated — the effects can significantly impact your quality of life.
What Does a Pelvic Floor Physiotherapist Treat?
A women’s pelvic floor physiotherapist is trained to assess and treat a wide range of conditions, including:
Bladder & Bowel Conditions
• Urinary incontinence (leaking with coughing, sneezing, laughing, or urgency)
• Overactive bladder and urinary urgency
• Constipation and difficulty with bowel emptying
• Faecal incontinence
Pelvic Pain
• Chronic pelvic pain
• Vulvodynia and vestibulodynia
• Vaginismus and painful intercourse (dyspareunia)
• Endometriosis-related pain
• Coccyx (tailbone) pain
Pregnancy & Postnatal Care
• Pelvic girdle pain and symphysis pubis dysfunction (SPD)
• Preparing the pelvic floor for labour and birth
• Postnatal pelvic floor rehabilitation
• Diastasis recti (abdominal separation) assessment and treatment AKA DRAM
• Return to exercise after birth
• Caesarean scar management
Prolapse
Pelvic organ prolapse occurs when pelvic organs descend into or outside the vaginal canal. Pelvic floor physiotherapy is a first-line treatment for managing prolapse symptoms, reducing severity, and preventing progression.
Menopause & Perimenopause Symptoms
Hormonal changes during perimenopause and menopause can significantly affect pelvic floor function, causing increased urinary urgency, pelvic dryness, and changes to sexual function. Pelvic floor physiotherapy plays an important role in managing these symptoms as part of a holistic women’s health approach.
What Happens in a Pelvic Floor Physiotherapy Appointment?
Many women feel nervous about their first pelvic floor physiotherapy appointment. Understanding what to expect can help put your mind at ease.
Your Initial Assessment
Your first appointment is a comprehensive assessment. Your physiotherapist will:
• Take a detailed history of your symptoms, health, and lifestyle
• Discuss your bladder and bowel habits
• Ask about your pregnancy and birth history (if relevant)
• Discuss your goals — whether that’s running, returning to the gym, pain-free sex, or simply sneezing without leaking
Internal Assessment (Only if appropriate and always with consent)
Depending on your presentation and comfort, your physiotherapist may perform an internal pelvic floor examination. This is done vaginally and allows your physio to directly assess the strength, tone, coordination, and sensitivity of your pelvic floor muscles.
An internal assessment is always optional and will only be performed with your full informed consent. Your physiotherapist will explain everything before proceeding and will stop at any time if you’re uncomfortable.
Your Treatment Plan
Following your assessment, your physiotherapist will explain their findings and develop a personalised treatment plan. This might include:
• Pelvic floor muscle training (strengthening or down-training, depending on your needs)
• Manual therapy — internal or external soft tissue techniques
• Biofeedback to help you connect with and activate your pelvic floor correctly
• Breathwork and load management strategies
• Exercise prescription and return-to-activity guidance
• Education on bladder and bowel habits
When Should You See a Pelvic Floor Physiotherapist?
The short answer? Sooner than you think. Many of the symptoms women put up with for years — or accept as “normal” — are treatable with pelvic floor physiotherapy.
You should consider seeing a pelvic floor physiotherapist if you:
• Leak when you cough, sneeze, laugh, jump, or exercise
• Feel a sudden, urgent need to rush to the toilet
• Experience pelvic, vaginal, or vulval pain
• Have pain during or after sex
• Are pregnant or planning a pregnancy
• Are recovering from birth — whether vaginal or caesarean
• Want to return to exercise after having a baby
• Have been diagnosed with prolapse, or think you might have a prolpase
• Are going through perimenopause or menopause
• Have been told you have a “tight” pelvic floor, or struggle to relax during examinations
Is Leaking After Pregnancy Normal? (And Other Myths, Debunked)
One of the most common things we hear at Hatched House is: “I just assumed this was normal after having kids.”
Urinary incontinence after childbirth is common, but it is not normal — and it is almost always treatable. The same applies to pelvic pain, painful sex, and prolapse symptoms.
Pelvic floor physiotherapy has strong evidence behind it as the first-line treatment for urinary incontinence and pelvic floor dysfunction. In many cases, surgery can be avoided entirely with the right physiotherapy intervention.
Pelvic Floor Physiotherapy at Hatched House, Melbourne
At Hatched House, we offer specialist pelvic floor physiotherapy as part of a truly multidisciplinary women’s health clinic. Our physiotherapists work alongside our clinical Pilates instructors, and the broader Hatched House team, to provide holistic, expert care for women at every life stage.
We specialise in:
• Pregnancy and prenatal physiotherapy
• Postnatal pelvic floor rehabilitation
• Chronic pelvic pain and complex presentations
• Women’s health physiotherapy across all life stages — from fertility to menopause
Our clinic is designed to feel warm, welcoming, and far removed from the clinical environments that can feel intimidating. Because we believe that the best care happens when you feel safe, seen, and supported.
Ready to Book?
If you’re based in Melbourne and looking for a trusted, expert women’s pelvic floor physiotherapist, we’d love to see you at Hatched House. Your pelvic floor health matters — and you deserve more than just “pushing through it.”
By Rosie Purdue, expert women’s Health Physiotherapist
B. Physiotherapy.
Grad Cert Pelvic Floor & Continence.
Grad Cert Sports Medicine.
Book your initial pelvic floor physiotherapy assessment today.