If you’ve been told you might need pelvic floor physiotherapy, one of the first questions that probably popped into your mind was, “Does it hurt?” And that’s a totally valid concern. After all, no one likes the idea of discomfort, especially in such a sensitive area.
Let’s have an honest, no-nonsense conversation about what pelvic floor physiotherapy actually feels like, what you can expect during a session, and how to manage any discomfort. Spoiler alert: it’s not as scary as you might think!
First, What is Pelvic Floor Physiotherapy?
Pelvic floor physiotherapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and tissues that support your pelvic organs (bladder, uterus, prostate, rectum, etc.). These muscles play a huge role in bladder and bowel control, sexual function, and core stability. When they’re too weak, too tight, or not functioning properly, they can cause a variety of issues, including:
- Urinary incontinence (leaking urine when you sneeze, laugh, or exercise)
- Pelvic pain
- Pain during sex
- Constipation
- Prolapse (a feeling of heaviness or pressure in the pelvic region)
A pelvic floor physiotherapist helps assess and treat these issues using a combination of hands-on techniques, exercises, and education. But let’s get to the main question—does it hurt?
The Honest Truth: Does It Hurt?
1. The Initial Assessment – Uncomfortable, But Not Painful
Your first visit will typically involve a detailed discussion about your symptoms, medical history, and lifestyle habits. After that, your therapist may perform a physical assessment, which could include an internal exam to evaluate your pelvic floor muscles. This is where people start to worry.
The idea of an internal exam might sound intimidating, but it’s important to remember:
- It’s not the same as a pap smear or a gynecological exam.
- The therapist will explain everything before they do anything.
- You are always in control—if you feel uncomfortable at any point, you can stop.
Most people describe this part as uncomfortable but not painful. If you already have pelvic pain or tight muscles, you might feel some mild discomfort, but your therapist will work with you to ensure you’re as relaxed as possible.
2. Treatment – What to Expect
Pelvic floor physiotherapy isn’t just about internal exams. Treatment can include a variety of techniques, such as:
- Manual Therapy: Gentle internal or external techniques to release muscle tension.
- Biofeedback: A non-invasive way to measure how well you can contract and relax your pelvic floor muscles.
- Exercises: Strengthening or relaxing exercises depending on your needs.
- Education: Learning how to breathe properly, improve posture, and use relaxation techniques.
If manual therapy is needed, some people experience mild discomfort, especially if their pelvic floor muscles are very tight or sensitive. However, pain should never be a normal part of treatment. If something is painful, let your therapist know so they can adjust their approach.
3. After the Session – Soreness is Possible
Just like any other physiotherapy, you might feel a little sore after a session, especially if you worked on tight muscles or did some deep tissue release. It’s similar to that post-workout soreness—it’s a sign that your body is adapting and healing.
To manage any discomfort:
- Take a warm bath or use a heating pad.
- Stay hydrated.
- Do gentle stretching or relaxation exercises recommended by your therapist.
Most people find that any mild discomfort fades quickly, and with each session, the therapy becomes easier.
How to Minimize Discomfort
If you’re worried about pain during pelvic floor physiotherapy, there are a few things you can do to make it as comfortable as possible:
1. Communicate Openly
- Tell your physiotherapist if you’re feeling anxious or tense.
- Let them know if something feels uncomfortable or painful—they can adjust the technique or try a different approach.
2. Focus on Relaxation
- Deep breathing techniques can help relax the pelvic floor muscles.
- Some people find that listening to calming music or using guided meditation before a session helps.
3. Go at Your Own Pace
- You don’t have to rush into internal work if you’re not ready.
- Your therapist will work with you to gradually progress at a pace that feels safe and comfortable.
When Does Pelvic Floor Physiotherapy Hurt?
While the goal of pelvic floor therapy is to reduce pain, there are some situations where discomfort might be more pronounced:
- If you have pelvic pain conditions (e.g., vaginismus, endometriosis, interstitial cystitis) – These conditions can make the muscles extremely sensitive, so therapy needs to be approached gently and gradually.
- If your muscles are very tight or overactive – Tight muscles are more sensitive, and working on them might initially cause discomfort.
- If you’re feeling anxious or tense – Anxiety can make the pelvic floor muscles involuntarily tighten, which can increase discomfort. Practicing relaxation techniques before and during the session can help.
That said, a good physiotherapist will never force anything that causes sharp or unbearable pain. Your comfort and safety should always come first.
The Long-Term Benefits Outweigh Temporary Discomfort
While you might experience some mild discomfort during or after a session, most people find that pelvic floor physiotherapy is life-changing. Over time, as the muscles become more functional and less tense, discomfort decreases, and relief sets in. Many people report improvements in:
- Bladder control (no more unexpected leaks!)
- Less pelvic pain
- More comfortable intimacy
- Better core strength and posture
- Increased overall confidence in their body
Final Thoughts: Is It Worth It?
If you’re dealing with pelvic floor issues, it’s completely normal to feel a little nervous about starting physiotherapy. But here’s the thing—while it might feel a little awkward at first, and you might experience some mild discomfort, it should never be painful. And the benefits? They are absolutely worth it.
A good pelvic floor physiotherapist will prioritize your comfort, move at a pace that feels right for you, and help you regain control of your body. So, if you’ve been on the fence about trying pelvic floor physiotherapy, take a deep breath, know that you’re not alone, and remember—you’ve got this!
