Pelvic Physiotherapy

What is the pelvic floor?

The pelvic floor is a group of muscles that support the organs in our abdominal cavity. In men, these organs are the bladder and intestines, and in women, the bladder, intestines and uterus.

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

The muscles around these orifices bind tightly to keep these passages closed, with the help of an extra muscle around the urethra and anus – the urethral sphincter and the anal sphincter.

What is the function of these muscles?

The pelvic floor muscles provide support for the abdominal organs, while the sphincters allow us to have conscious control over the bladder and bowel, making it possible to control 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 through.

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 help with labor.

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

These muscles also work in partnership with the abdominal and back muscles to stabilize and support the spine.

Main pathologies that benefit from pelvic floor physiotherapy:

• Urinary incontinence (stress, urge, mixed)
• Urinary retention
• Fecal incontinence.
• Descent/Pelvic organ prolapse.
• Sexual dysfunctions mainly involving pain. In women, the most common cases are vaginismus, vulvodynia, anorgasmia, deep pain, and in men erectile dysfunction, premature ejaculation and pain after ejaculating.
• Compression of the pudendal nerve;
• Chronic pelvic pain
• Endometriosis
• Menstrual pain
• Prostatectomy

How can physiotherapy help?

Physiotherapy is necessary when the muscles are too contracted and cannot relax or when they are too relaxed and cannot contract.

With physiotherapy, we will understand the reason for these changes and develop a treatment plan:

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

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

As well as technical quality, we value comprehensive care and a good relationship with patients and staff. Follow-ups are carried out between sessions in order to achieve faster and longer-lasting results.

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

Some of the triggers of pelvic floor dysfunction may be:

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

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

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

Health Insurance

• Future Healthcare: 15% off the list price
• ADSE Free Regime: Under this regime, ADSE beneficiaries are free to choose healthcare providers outside the scope of the ADSE Network. This scheme works by initially bearing all the costs and then requesting reimbursement from ADSE, which will be allocated in accordance with the Price List and Rules of the Free Scheme in force. For more information on how to request reimbursement, see the ADSE website.

At the moment, we don’t work with other health insurances, but we do provide invoices and the necessary reports so that they can be reimbursed by the insurance company.

Degree in Physiotherapy from the School of Health Technology in Coimbra.

Highly qualified. Believes in continuous training. Has various complementary training courses.

Always, to guarantee excellent results for your patients.