Pelvic Floor Manual Therapy

Pelvic Floor Manual Therapy2018-07-25T20:14:30+00:00


It is a clinical approach utilizing skilled, specific hands-on mobilizing techniques to diagnose and treat soft tissues.

This is for the purpose of:

  • Modulating pain
  • Increasing range of motion
  • Reducing or eliminating soft tissue inflammation
  • Improving stability
  • Facilitating movement
  • Improving function
  • Inducing relaxation
  • Improving tissue repair
  • Improving tissue extensibility
Why do we feel tension in our pelvic floor?

The pelvic floor is susceptible to negative tension and holding patterns for many reasons.
Posture, poor seating, holding patterns, emotional holding due to stress, childbirth damage, history of constipation or any bowel disorders or history of urinary tract infections. There may be no history of any of the above but just a genetically tight pelvic floor.

Strengthening an already tense or tight pelvic floor can be counterproductive and can increase rather than relieve symptoms or can mean that regular pelvic floor exercises just don’t work.


  • stress incontinence

  • pelvic organ prolapse

  • urinary urgency

  • urge incontinence

  • bowel disorders

  • chronic pelvic pain

  • sexual disorders


Pelvic floor manual therapy is a series of internal and external soft tissue release techniques to address unwanted tension in the pelvic floor muscles and fascia.

There should be a sense of relief having had the pelvic floor mobilised that results either immediately or over time in an increased range of movement in the muscles and fascia. This in turn should result in an increased ability to either contract or release muscles improving timing in the muscles and pelvic organ position.

There may be some initial discomfort at the time of mobilisation in the same way that one would feel it with back or neck mobilisation but this improves quickly at the time of treatment with the specific techniques. There should not be any post treatment soreness.

The contractility of the pelvic floor can be seen to change on realtime ultrasound following a session of manual therapy.


Pelvic Floor Manual Therapy techniques for the pelvic floor include stretching and trigger point treatment where a muscle is tense.
Pelvic floor manual therapy techniques should not be so painful that a patient reacts by tensing up and there should be no treatment soreness afterwards. There are many different types of techniques that we can use.

Myofascial trigger point therapy

Pelvis, trunk and abdomen

Dry needling

Pelvis, trunk and abdomen

Connective tissue manipulation

External perineal tissue, abdomen and pelvis

Trigger Points

A short or tense muscle is identified by internal examination and then released centrally along the bulk of the muscle or at the attachment to bone which is often more uncomfortable.

A trigger point will often refer pain elsewhere in the pelvic floor or to the hips or rectum or may just be painful on the spot. Once held for a few seconds the pain eases and the therapist moves on to the next point.

There are also nerves in the pelvic floor and they can be mobilised along their pathways.

Connective tissue restriction

There is often external tension in the pelvis and abdomen linked to internal restriction, this is known as a connective tissue restriction. This can be successfully released through pelvic floor manual therapy externally on the identified areas.