Underactive Pelvic Floor

Pelvic Floor Exercises

Article by Nadine Stewart

Underactive Pelvic Floor

What is an Underactive Pelvic Floor?

The pelvic floor muscles span from the pubic bone at the front of the pelvis to the tail bone at the back of the pelvis. This group of muscles assists with stabilising the pelvis during movement supports the pelvic organs (rectum, bladder and uterus) and opens and closes the anus, vagina and urethra to assist with emptying the bowel and bladder as well as sexual function.

If the pelvic floor is underactive, this usually means that there is difficulty activating the pelvic floor musculature or weakness of the pelvic floor musculature.

What Causes an Underactive Pelvic Floor?

There are many factors that can lead to an underactive pelvic floor, including:

  • Pregnancy
  • Childbirth esp. Involving prolonged labour or the use of forceps
  • History of chronic respiratory conditions
  • History of chronic constipation or straining when making a bowel movement
  • Regular heavy lifting
  • Elite / high-level athletes involving high impact and high load sports. E.g. running, gymnastics and weight lifting.
  • Obesity
  • Age
  • Hormonal changes. E.g. menopause
  • Pelvic Surgery

What are the Symptoms of an Underactive Pelvic Floor?

The symptoms of the underactive pelvic floor may include:

  • Leakage of urine during coughing, sneezing, lifting, running or other forms of physical activity
  • Losing control of the bowel or bladder before making it to a toilet
  • Inability to control ‘wind.’
  • Low back pain
  • Dislodging of tampons
  • Pelvic and vaginal discomfort
  • Prolapse – slipping of the pelvic organs
  • Neural damage

How is an Underactive Pelvic Floor Diagnosed?

Usually, a clinical diagnosis can be made using the information you have given and a physical examination. During this examination, your physiotherapist may need to perform an internal exam to assess the ability of the pelvic floor muscles to activate, as well as testing the coordination and strength of the pelvic floor musculature. If further information is required, we can perform other tests and investigations, including ultrasound, EMG biofeedback or manometry devices, bladder testing, and/or urine testing. However, these tests will only be required based on your presentation.

What Treatments are available for an Underactive Pelvic Floor?

Often, physiotherapy is considered the first line of treatment for the underactive pelvic floor and can include:

  • Education
  • Lifestyle Recommendations
  • A pelvic floor exercise program
  • Ultrasound to assist with pelvic floor activation
  • Electrical Stimulation to help with pelvic floor activation
  • Adjustment of usual toileting habits
  • Advice to modify or manage lifting and exercise habits
  • Controlled coughing

What Results Can You Expect?

A large proportion of people with an underactive pelvic floor will have their symptoms improved or resolved with physiotherapy treatment. However, if left untreated, often the problem continues to worsen gradually.

Will You Need Surgery?

A percentage of people may not experience enough improvement with physiotherapy alone and may need to go on to have surgery to resolve their symptoms.

For more information please consult your physiotherapist with a special interest in pelvic floor conditions.

Article by Nadine Stewart

Women's Health Physiotherapy Conditions

Addressing a diverse range of women-specific concerns, Women’s Health Physiotherapy focuses on assessing and treating various conditions. These encompass issues like constipation, faecal incontinence, mastitis, pelvic floor exercises, pregnancy-related back pain, and massages, along with concerns such as prolapse, abdominal separation, stress incontinence, and underactive pelvic floor. Moreover, the discipline encompasses managing urge faecal incontinence, urgency/overactive bladder (OAB), and urge incontinence, while also offering pre and post-pregnancy exercise prescription and rehabilitation.

More Information


Women's Health Physiotherapy Appointment FAQs

Women's Health Conditions

Women’s Health Physiotherapy incorporates the assessment and treatment of a large number of women-specific conditions including:

Q: What Should You Bring To Your Women's Health Appointment?

A: Please bring any information about your condition from your GP, medical specialists, or other healthcare providers to your appointment. Arrive 10 minutes early to complete paperwork. Alternatively, we can email you information before your appointment.

Q: What's the Appropriate Attire for Your Appointment?

A: Wear comfortable clothing for ease of movement.

Q: Will Your Appointment Information Be Kept Confidential?

A: Yes, your appointment details remain confidential. Your physiotherapist will only share with other healthcare providers if you consent. Appointments are held in private rooms for confidentiality. An exception is rectus diastasis, which may be treated in a separate area if requested.

Q: How Long Does the Appointment Last?

A: The appointment duration varies based on your condition. Initial women's health appointments usually take an hour. Mastitis and rectus diastasis appointments are typically 30 to 40 minutes. Contact our receptionist for specific details.

Q: What's the Cost of Women's Health Physiotherapy Appointment?

A: Session costs vary depending on your condition. Contact our reception for more information.

Q: Can You Claim Women's Health Physiotherapy Under Private Health Insurance?

A: Yes, bring your private health insurance card for on-the-spot claim processing.

Q: Is Your Appointment Covered by EPC/Medicare Referral?

A: Yes, we accept GP referrals under EPC guidelines. A gap payment is required after applying the Medicare rebate due to extended consultation time with your women's health physiotherapist. Contact our reception for details.