Your surgeon referred you to pelvic physiotherapy

author: Marianna Marais

Date: 8 October 2025

If your surgeon has referred you to a pelvic physiotherapist, you might have a few questions — or even some concerns about what to expect. Many people think physiotherapy only relates to sports injuries or post-surgical rehabilitation, but pelvic physiotherapy is a specialised field that focuses on the muscles, joints, and connective tissues of the pelvis — and how they work together for healthy bladder, bowel, and sexual function.

Let’s explore what this means and how it can help you feel more comfortable and confident again.

common reasons for referral

Pelvic health physiotherapy can help with a wide range of conditions, including:

Pelvic Organ Prolapse
When the bladder, uterus, or rectum shifts out of its usual position due to weakness in the pelvic floor or supporting system. You may notice a feeling of heaviness, pressure, or a bulge in the vaginal area.

Incontinence

The involuntary leakage of urine or stool. This can result from weakened or uncoordinated pelvic floor muscles, nerve changes, or post-surgical effects.

Constipation
Difficulty or infrequency in bowel movements often relates to pelvic floor dysfunction — when muscles don’t relax or coordinate properly to allow complete emptying.

Haemorrhoids
Swollen veins around the rectum or anus, often made worse by poor bowel habits, straining, or unbalanced abdominal pressure. Physiotherapy can help improve bowel mechanics and reduce symptoms.

Post-Surgical Recovery
After pelvic or abdominal surgery, physiotherapy supports recovery by improving mobility, reducing scar tissue, rebuilding strength, and retraining bladder and bowel control.

These issues can affect anyone — regardless of age or gender — and can have a big impact on quality of life. The good news is that pelvic physiotherapy offers gentle, effective, and conservative treatment options that make a real difference.

How Pelvic Physiotherapy Helps

Your physiotherapist will help you:

Understand Your Bladder and Bowel Habits
Learn how your body’s natural reflexes and signals work — and how to respond to them in a healthy way. Misinterpreting or ignoring these signals can lead to issues like urgency, frequency, leakage, or constipation.

Improve Your Toileting Posture and Techniques
How you sit and breathe on the toilet can make a big difference! Your therapist will show you positions and breathing strategies that help you empty more easily — without straining.

Manage Abdominal Pressure
Everyday actions like coughing, laughing, lifting, or exercising increase pressure inside your abdomen. Your physiotherapist will teach you how to manage that pressure safely so you can protect your pelvic organs and prevent symptoms like prolapse or haemorrhoids.

Strengthen and Relax the Pelvic Floor
Finding the right muscles in your pelvic floor and contracting them the right way can be a challenge.  Most people have an ineffective contraction and need some guidance to get it right!

But, it’s not all about kegels! Some people need to strengthen weak muscles, while others need to learn to relax overactive ones. Your physiotherapist will assess your unique muscle pattern and design a program that’s right for you.

Release Tight Muscles and Scar Tissue
Gentle hands-on techniques (external or internal, as appropriate) may be used to release restrictions, improve comfort, and enhance movement.

Support Post-Surgical Healing
Therapy may include gentle mobility work, scar management, and progressive strengthening to restore your core and pelvic health.

What to Expect at your Appointment

If you’ve never seen a pelvic health physiotherapist before, it’s completely normal to feel a bit nervous. Here’s what typically happens:

Discussion: Your first session includes a detailed chat about your symptoms, medical history, daily habits, and goals.

Assessment: Your movement, posture, and breathing patterns are observed to see how they affect your pelvic floor function.

Examination: An external and/or internal assessment may be offered to evaluate muscle strength, coordination, and control. This is always done with your full consent and in a private, respectful environment.

Education: Understanding your condition is key. You’ll learn what’s happening in your body and how your daily habits influence your symptoms.

Treatment Plan: Together, you and your therapist will design a treatment plan that may include exercises, manual therapy, and lifestyle advice. You’ll also receive a home program to help reinforce your progress.