We’re a team of highly skilled physiotherapists who specialise in pelvic floor dysfunction.
In this section you’ll find how can you can access the service and also the different locations where the service is available.
What are your Pelvic Floor Muscles?
The pelvic floor muscles are a hammock of muscles that lie beneath your pelvis. Their role is to support the bladder, the bowel, and the uterus. The pelvic floor muscles work to help keep the bladder and bowel openings closed to prevent unwanted leakage (incontinence) and they relax to allow easy bladder and bowel emptying. The pelvic floor muscles also help with sexual intercourse by allowing for increased vaginal sensation for women.
How to Exercise your Pelvic Floor Muscles
To exercise the pelvic floor muscles, lie sit or stand with your knees slightly apart. Tighten up your back passage as though you are trying to stop yourself passing wind. At the same time tighten the muscles that you would use to stop yourself from passing urine. The feeling is one of ‘squeeze and lift’, closing and drawing up the back and front passage (imagine you are trying to stop urine and wind from passing at the same time).
There are two ways to exercise your pelvic floor muscles:
Slow Squeezes
- Tighten your pelvic floor muscles for up to 10 seconds
- Relax fully for 4 seconds
- Now tighten again for the same time
- Relax fully for 4 seconds
- Repeat this until your muscles get tired
Fast Squeezes
- Quickly tighten up your pelvic floor muscles
- Hold for 1 second and relax
- Repeat this until the muscles get tired
Bladder Issues
Bladder dysfunction refers to problems with storing or emptying urine. It can affect both men and women and may have a significant impact on daily life. Physiotherapy can help manage many types of bladder problems using non-surgical methods.
Common types of bladder issues include:
Stress Urinary Incontinence
Stress urinary incontinence (SUI) occurs when urine leaks out during activities that put pressure on the bladder. It can happen when you cough, sneeze, laugh, lift, exercise, rise from a chair, walk upstairs or downstairs, or during sexual intercourse. Physical strain increases the pressure on the abdomen, which in turn puts pressure on the bladder. If the pelvic floor muscles or the muscles controlling the bladder are weak, urine can leak out. While SUI is more common in women, some men can experience it as well.
Urinary Urgency
Urinary urgency is a sudden, strong need to urinate that’s difficult to delay. It can happen even if your bladder isn’t full and may make you feel anxious about finding a bathroom in time.
Urinary Urge Incontinence
Urinary urge incontinence (UUI) happens when you leak urine because of a strong urge to empty your bladder. You may not make it to the toilet in time. It is often caused by bladder muscles that squeeze too often or without warning.
Overactive Bladder
Overactive bladder (OAB) is a condition that includes:
- A strong, sudden need to urinate (urinary urgency)
- Going to the bathroom more than 6 to 8 times during the day (frequency)
- Waking up more than once at night to urinate (nocturia)
- Sometimes leaking urine before reaching the toilet (urinary urge incontinence)
Common Causes of Bladder Issues
- Pregnancy and childbirth
- Ageing
- Menopause
- Obesity
- Pelvic surgery, including prostate surgery
- Overactive bladder muscles
- Certain medications, for example, diuretics (water pills)
- Constipation
- Urinary tract infections, bladder stones, interstitial cystitis
- Caffeine, alcohol, fizzy drinks, spicy or acidic foods
- High fluid intake, anxiety, frequent “just in case” urination
- Stroke, multiple sclerosis (MS), Parkinson’s disease, spinal injury, diabetes
- High impact activities, for example, trampolining
What can you do to improve bladder symptoms?
- Pelvic floor exercises: Strengthen the muscles that support the bladder
- Bladder training: Helps increase the time between trips to the toilet
- Lifestyle advice: Includes guidance on fluid intake, diet, and healthy toileting habits
- Electrical stimulation: A gentle current may be used to activate and strengthen weak pelvic floor muscles
- Biofeedback: Helps you learn how to properly use and contract pelvic floor muscles
Bowel Issues
Good bowel health is very important to feel healthy and when things aren’t working properly it can quickly affect quality of life. It is estimated that bowel problems affect 10% of the general population. Physiotherapy can help you manage these issues and whilst it can be difficult to talk about, our Physiotherapists will make you feel at ease whilst trying to help you with your issues.
Common types of bowel issues include:
Constipation
Constipation is where there are changes to how you move your bowels, including not opening your bowels as often as normal and finding it hard to get your stool (poo) out. Often the stool is hard and lumpy and difficult to pass. Most people will suffer from an episode of constipation at some point in their lives, but usually this is temporary and not serious. Unfortunately, for some people constipation can become a long term issue.
What can you do to help constipation?
- Read the POGP Good Bowel Health and POGP Improving Your bowel Health
- Fluid advice: Try to drink between 1.5 and 2 litres of water-based fluids every day
- Dietary advice: Ensure you are getting enough fibre in your diet
- Optimal toilet posture/positioning: Adopt the best sitting position on the toilet to improve your bowel movements. Watch this video for guidance on proper posture and technique to make the process smoother and more effective.
Faecal Incontinence
Faecal incontinence is when there is an unwanted leakage of stool or wind from the back passage. It can be an extremely distressing condition that can be made worse by diarrhoea. It can happen without warning or can be associated with an urge to move your bowel but an inability to make it to the toilet on time.
What can you do to help faecal incontinence?
- Anal Sphincter Strengthening Exercises: strengthen the muscles around the back passage to improve control
- Dietary advice: Ensure you are getting enough fibre in your diet
- Optimal toilet posture/positioning: adopt the best sitting position on the toilet to ensure all your stool has come out. Watch this video for guidance on proper posture and technique
- Medication: can be helpful for some people sometimes help – please speak to your healthcare professional
- Order the Just Can’t Wait Card: this card allows you quicker access to toilets when you are out and about.
Obstructive Defecation
Obstructive defecation is a term used to describe having difficulty opening your bowels. It is often associated with frequent visits to the toilet and a feeling of being unable to fully empty the bowel. This can result in excessive straining, which can increase the risk of vaginal or rectal prolapse.
Normally, when you open your bowels, the muscles around the back passage relax to allow stool to pass. In obstructive defecation, these muscles may not relax fully, or they may even tighten, making it harder to have a bowel movement.
What can you do to help Obstructive Defecation?
What can you do to help Obstructive Defecation?
- Fluid advice: Try to drink between 1.5 and 2 litres of water-based fluids every day
- Dietary advice: Improve the consistency of your stool by ensuring you are getting enough fibre in your diet
- Physical exercise: is known to help empty your bowels. Aim for 30 minutes of exercise each day
- Belly breathing: is a technique that can help relax your pelvic floor muscles. Your physiotherapist can guide you through it
Faecal Urgency
Faecal urgency is when you have a sudden, strong urge to empty your bowels. You may make it to the toilet in time or it may be associated with faecal incontinence.
What can you do to help Faecal Urgency?
What can you do to help Faecal Urgency?
- Dietary advice: Ensure you have a healthy, balanced diet and an adequate fibre intake
- Practice the Holding on Programme: which helps you train your bowels to wait a little longer before opening, which can improve control and reduce urgency. Your health professional can give you more advice on this
- Anal Sphincter Strengthening Exercises: strengthen the muscles around the back passage to improve control and increase your confidence in your ability to get to the toilet on time.
Pelvic Organ Prolapse
Pelvic Organ Prolapse (POP) occurs when one or more of the vaginal walls, or the top of the vagina, move downwards, leading to a bulge or a sensation of heaviness at the vaginal entrance. This may cause pressure or discomfort in the vagina, and in some cases, you may feel a bulge inside or outside the vaginal opening. Prolapse can also affect your bladder, bowel, or sexual function.
If you think you are experiencing a prolapse, here are some resources to help:
What can you do to help a Prolapse?
- Read the POGP Prolapse Leaflet
- Strengthen the pelvic floor muscles: by carrying out these strengthening exercises
Pelvic Pain
There can be many different causes for your pelvic pain. It’s important to have the underlying cause investigated by your General Practitioner, Advanced Nurse Practitioner, Sexual Health Clinic, or Consultant. Depending on the diagnosis, Pelvic Health Physiotherapy may be able to help you manage and relieve your pelvic pain symptoms.
Bladder Pain Syndrome
Bladder pain syndrome is a condition that causes pelvic pain and difficulty peeing. It can be difficult to diagnose because there isn’t a single test that can confirm it.
Vaginismus
Ongoing or repeated difficulty with allowing vaginal entry of a penis, finger, or other object. This may lead to involuntary tightening of the pelvic floor muscles, along with anticipated fear and pain.
Dyspareunia
Dyspareunia is painful sex. This can be pain or discomfort at the opening to the vagina or felt deeper into the pelvis.
Tight or Overactive Pelvic Floor Muscles
This may be linked to the causes mentioned above, or to other conditions such as Endometriosis, Adenomyosis, Irritable Bowel Syndrome, Vulvodynia.
At your appointment, a Specialist Physiotherapist will take a detailed history and, if appropriate, may carry out an examination. Some of the questions may be personal in nature, and your Physiotherapist will explain this at the beginning of your consultation.
What can I do to help my pelvic pain?
Learning how to relax your pelvic floor and abdominal muscles can help relieve your pelvic pain.
Before and After Gynaecology Surgery
You will be seen by the specialist physiotherapist on the gynaecology ward following your surgery. The physiotherapist will give you information and advice on keeping comfortable during your hospital stay; getting up and moving after surgery; advice to improve your recovery and beyond, allowing you to return to your normal activity levels. You may be invited to attend an appointment before surgery at one of the NHS GGC Hospitals. This will be a one-off class, and is called the GERAS Class – Gynaecological Enhanced Recovery After Surgery.
If you need physiotherapy follow up after your surgery, please discuss this with your consultant or GP, who can refer you to the GGC Pelvic Health Team.
Before and After Prostate Surgery
Following your prostate cancer diagnosis, and the decision to have Robotic Assisted Removal of Prostate (RARP) surgery, your Urology consultant or clinical nurse specialist will inform the GGC Pelvic Health Team. They will contact you to invite you to attend an appointment before surgery at one of the NHS GGC Hospitals. This appointment may be offered on an individual basis, or as part of a group session. The aim of this is to give you:
- advice about your surgery
- information to keep you comfortable and moving post-surgery
- education on pelvic floor muscle exercises and training to help manage likely urinary incontinence after surgery
- advice to maximise your recovery and return you to normal activity levels
- A follow up appointment will be organised for you from six weeks after your surgery to monitor your progress. Any further appointments that you need will depend on your recovery and symptoms after surgery.
Useful Resources Before and After Surgery
How to Access the Service
Our Pelvic Floor Physiotherapy service requires a referral letter from either your GP or from a hospital consultant.
Contact Details
Inverclyde Royal Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Level C
Inverclyde Royal Hospital
Larkfield Road
Greenock PA16 0XN
Call: 01475 504 373
New Stobhill Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Ground Floor
The New Stobhill Hospital
Balornock Road
Glasgow G21 3UW
Call: 0141 355 1642
New Victoria Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Ground Floor
New Victoria Hospital
Grange Road
Glasgow G42 9LF
Call: 0141 347 8685
Princess Royal Maternity Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Level 2
Princess Royal Maternity Hospital
16 Alexandra Parade
Glasgow G31 2ER
Call: 0141 201 3432
At present we can only accept referrals from up to 12 weeks post-natal patients who have had their deliveries at this hospital.
Queen Elizabeth University Maternity Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Room 3, 1st Floor Admin Corridor
Maternity Unit
1345 Govan Road
Glasgow G51 4TF
Call: 0141 201 2324
Royal Alexandra Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Ground Floor
Maternity Unit
Royal Alexandra Hospital
Corsebar Road
Paisley PA2 9PN
Call: 0141 314 6765
Vale of Leven Hospital – Pelvic Floor Physiotherapy
Physiotherapy Department
Vale of Leven Hospital
Main Street
Alexandria G83 0UA
Call: 01389 817 531