We’re a team of highly skilled physiotherapists who specialise in pelvic floor/health dysfunction. 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.
In this section, you’ll find an overview of the conditions we treat, some useful resources and advice for managing them, how to access our service and the various locations of our clinics.
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/issues 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
- Life stages: Pregnancy, childbirth, ageing, menopause.
- Weight and lifestyle: Obesity, high-impact activities (e.g., trampolining).
- Medical procedures: Pelvic or prostate surgery.
- Bladder and bowel issues: Overactive bladder muscles, constipation, urinary tract infections, interstitial cystitis.
- Medications and diet: Diuretics (water tablets), caffeine, alcohol, fizzy drinks, spicy or acidic foods.
- Bladder habits and fluid intake: High fluid intake, frequent “just in case” urination, anxiety.
- Neurological conditions: Stroke, MS, Parkinson’s disease, spinal injury, diabetes.
What Can Help
- Pelvic Floor Exercises: Strengthen the muscles that support the bladder and improve control.
- Bladder Training: Helps increase the time between toilet visits to reduce urgency and frequency.
- Lifestyle Advice: Guidance on fluid intake, diet, and healthy toileting habits to support bladder health.
- Electrical Stimulation: A gentle current may be used to activate and strengthen weak pelvic floor muscles when they are difficult to contract.
- Biofeedback: Uses sensors to show how the pelvic floor muscles are working, helping you learn how to contract them correctly.
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 Help:
- Stay Hydrated: Aim to drink 1.5–2 litres of water-based fluids each day.
- Diet: Eating more fibre can help keep stools soft and easier to pass.
- Toilet Positioning: Using the right posture on the toilet can make bowel movements easier. Watch this video for tips.
- Helpful Guides: POGP Good Bowel Health and POGP Improving Your Bowel Health.
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 Help:
- Anal Sphincter Exercises: Strengthening the muscles around the back passage can improve control.
- Healthy Diet: Make sure you’re eating enough fibre to keep stools well-formed.
- Toilet Positioning: Using the correct position can help with better bowel emptying. Watch this video for tips.
- Medication: Some people may benefit from medication—speak to your healthcare professional.
- ‘Just Can’t Wait’ Card: This card gives you quicker access to public toilets. You can apply for one online here.
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 Help:
- Fluids: Drink 1.5–2 litres of water-based fluids daily.
- Healthy Diet: Make sure you’re eating enough fibre to keep stools well-formed.
- Stay Active: Aim for 30 minutes of physical activity a day to support bowel movement.
- Belly Breathing: This relaxation technique helps release the pelvic floor. Your physiotherapist can teach you how to do it correctly.
Faecal Urgency
Faecal urgency is a sudden and strong urge to empty your bowels. You may reach the toilet in time, but it can also lead to accidental leakage/faecal incontinence.
What Can Help:
- Healthy Diet: Keep your diet balanced and rich in fibre to regulate bowel movements.
- Holding On Programme: This programme helps train your bowel to delay the urge to go. A healthcare professional can guide you through it.
- Anal Sphincter Exercises: These exercises strengthen the muscles around the back passage to improve control and 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.
What Can Help:
- Pelvic Floor Exercises: Regular pelvic floor exercises can help support the pelvic organs and reduce symptoms over time.
Useful Resources
- Pelvic Organ Prolapse – a Guide for Women, POGP. Provides helpful information and practical advice on managing prolapse.
Pelvic Pain
Pelvic pain can have many different causes. It’s important to get the underlying cause checked by your GP, Advanced Nurse Practitioner, Sexual Health Clinic, or Consultant. Depending on the diagnosis, Pelvic Health Physiotherapy may help you manage and reduce your symptoms.
Bladder Pain Syndrome
Bladder pain syndrome is a condition that causes pelvic pain and difficulty urinating. It can be difficult to diagnose because there isn’t a single test that can confirm it.
Vaginismus
Repeated difficulty allowing vaginal entry of a penis, finger, or other object. It may lead to involuntary tightening of the pelvic floor muscles, along with fear or 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
Pelvic floor muscles may be tense or overactive. This can be linked to conditions such as Endometriosis, Adenomyosis, Irritable Bowel Syndrome (IBS), or Vulvodynia, or may occur alongside other causes mentioned above.
What Can Help:
- Relaxation techniques: Learning to relax your pelvic floor and abdominal muscles can help reduce pelvic pain.
- Relieving Pelvic Floor Muscle Tension: Tips and exercises to release tension in pelvic floor muscles.
Useful Resources
- Your Pelvic Floor – Dyspareunia: Guide to understanding dyspareunia, including treatment options.
- Brook – Painful Sex: Information on causes, symptoms, and ways to manage painful sex.
- Pelvic Pain: Comprehensive guide to understanding pelvic pain and management strategies.
Before and After Gynaecology Surgery
You will be seen by a specialist physiotherapist on the gynaecology ward following your surgery. They will provide guidance on:
- Staying comfortable during your hospital stay
- Getting up and moving safely after surgery
- Advice on improving your recovery and beyond, allowing you to return to your normal activity levels
You may be invited to attend a GERAS Class (Gynaecological Enhanced Recovery After Surgery) at one of the NHS GGC hospitals. This is a one-off session that provides advice on preparing for surgery and supporting your recovery.
If you need physiotherapy after your surgery, speak with your consultant or GP, who can refer you to the GGC Pelvic Health Team.
Useful Resources
- POGP Fit Following Surgery – Advice & Exercise Following Major Gynaecological Surgery.
- POGP Fit Following Surgery – Advice for Trans Men, Trans Masculine and Non-Binary People Following Hysterectomy.
- POGP Promoting Continence with Physiotherapy.
Before and After Prostate Surgery
After 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.
You will be invited to attend a pre-surgery appointment at one of the NHS GGC hospitals. This may be offered individually or as part of a group session. The appointment aims to provide:
- Advice about your surgery
- Information on staying comfortable and moving safely after surgery
- Education on pelvic floor muscle exercises to help manage likely urinary incontinence after surgery
- Guidance to support your recovery and help you return to normal activity levels
Post-Surgery Follow-Up
A follow-up appointment will be arranged from six weeks after surgery to monitor your progress. Any additional appointments will depend on your recovery and symptoms.
Useful Resources
- Prostate UK – Information and support for men with prostate conditions.
- Prostate Scotland – Support and guidance for people affected by prostate issues in Scotland.
- Pelvic Floor Muscle Exercises for Men, POGP – Guidance on exercises to strengthen pelvic floor muscles.
- Pelvic Floor Exercises and Advice – A Guide for Trans Women, Trans Feminine and Non-Binary People (assigned male at birth), POGP – Tailored pelvic floor exercise guidance for trans and non-binary individuals.
- Promoting Continence with Physiotherapy, POGP – Advice on maintaining bladder and bowel control through physiotherapy.
- Squeezy App for Men – App to help you perform and track pelvic floor exercises.
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
