Pelvic Physiotherapy

What is the pelvic floor?

The pelvic floor is a collection of muscles that support the organs that exist in our abdominal cavity. These organs in the case of men are the bladder and intestines and in women, the bladder, intestines and uterus.

This set of muscles is not totally continuous, having small holes that allow the passage of channels that correspond to the urethra, the anus, and in women, also to the vagina.

The muscles around these orifices are tightly connected to keep these passages closed, with the help of extra muscle around the urethra and anus, which are the urethral sfi and the anal sfi.

What is the function of these muscles?

The pelvic floor muscles provide support for the abdominal organs, while the sphincters allow us conscious control over the bladder and bowel, enabling control over the excretion of urine, feces, and flatulence (gas).

Thus, when we contract the pelvic floor muscles the internal organs are lifted and the sphincters tighten the openings of the vagina, anus, and urethra. When we relax these muscles we allow urine and feces to pass.

The pelvic floor muscles also play a very important role in the sexual function of both sexes.

In women, voluntary contractions (compression) of the pelvic floor play an important role in sexual sensation and arousal, and also support the fetus during pregnancy and aid in labor.

In men, they are important in erectile function and ejaculation.

These muscles also partner with the abdominal and back muscles in stabilizing and supporting the spine. 

Main pathologies that benefit from pelvic floor physiotherapy:

• Urinary Incontinence (stress, urge, mixed)
• Urinary Retention
• Fecal incontinence.
• Descent/ Prolapses of the pelvic organs.
• Sexual dysfunctions mainly with pain. In women the most common cases are vaginismus, vulvodynia, anorgasmia, deep pain, and in men erectile dysfunction, premature ejaculation, and pain after ejaculation.
• Pudendal nerve compression;
• Chronic pelvic pain
• Endometriosis
• Menstrual Pain
• Prostatectomy

How can physical therapy help?

Physical therapy is needed when muscles are too contracted and cannot relax, or when they are too relaxed and cannot contract. 

With physical therapy, we will understand the reason for these changes and develop a treatment plan that may include:

• Manual therapy techniques
• Joint mobilization
• Stretching
• Myofascial Therapy
• Neuromuscular re-education
• Internal and external treatment of trigger points (points with pain)
• Electrostimulation
• Biofeedback exercises
• Teaching new habits and self-knowledge of these muscles.

At Michelle Bond Clinic all physiotherapy sessions focus on individualized and personalized treatment. Each session lasts about 1 hour.

In our service, besides the technical quality, we value the integrality of the care and the quality of the relationship with the patients and the team. Follow-up is done between sessions in order to obtain faster and more lasting results.

As with any physical therapy session, it is important to emphasize that the homework is just as important, if not more important, than the time in the office, and so you should follow all the therapist's recommendations.

Some factors that trigger Pelvic Floor Dysfunction may be:

• Pregnancy and vaginal or cesarean delivery
• Abdominal and pelvic surgery - hysterectomy, vasectomy, bowel surgery, endometriosis surgery, removal of abscesses from the pelvic region, etc.
• Chronic cough
• Lifting heavy weights
• High-impact exercises
• Obesity
• Hormonal changes
• Recurrent infections of the urogynecological tract

There are also some psychological factors associated with sexual dysfunctions that can interfere with the muscular action of this region.

• 1 Session of Physiotherapy: 80€.
• Package with 4 sessions: 300€.

Health Insurance

• Future Healthcare: 15% discount on list price
• ADSE Free Regime: In this regime, ADSE beneficiaries are free to choose healthcare providers, outside the scope of the ADSE Network. This regime works by initially bearing all the charges, and then requesting reimbursement from ADSE, which will be attributed in accordance with the Price Table and Rules of the Free Regime in force. For more information on how to request reimbursement, please visit the ADSE website.

At the moment, we do not work with other health insurances, however, we provide invoice and reports necessary to be reimbursed by the insurance company.

Degree in Physiotherapy from Escola Superior de Tecnologia da Saúde in Coimbra.

Highly qualified. Believes in continuous training. Has different complementary training.

Always, to guarantee excellent results for your patients.