Pelvic physiotherapy

Pelvic physiotherapy is dedicated to examining and treating individuals experiencing discomfort in the abdominal, pelvic, and lower back regions, applicable to women, men, children, and the elderly. The interplay between the pelvis, ligaments, pelvic floor, and pelvic organs is significant, as issues in one area can swiftly affect another. Pelvic physiotherapists guide patients in identifying and strengthening the pertinent muscles surrounding the pelvis, occasionally utilizing specialized equipment. They are also qualified to conduct internal examinations when required.

Pelvic floor

The pelvic floor is a layer of muscles at the base of the pelvis that supports the abdominal organs. It opens and closes the pelvic outlet, contributing to pelvic stability. These muscles coordinate with the abdominal and back muscles, playing a crucial role in daily movement and preventing back and pelvic pain. Dysfunctional pelvic floor muscles can lead to various issues, such as unintentional loss of urine or stool, uncontrollable urges to urinate or defecate, frequent bathroom visits, pain in the lower abdomen, pelvic floor, tailbone, or pubic bone, and organ prolapse. Additionally, sexual dysfunction and dermatological issues may be linked to pelvic floor muscle disorders. These problems can develop from improper urination or defecation habits, post-bladder infections, abdominal or prostate surgeries, or as a result of pregnancy and childbirth.

Pelvic complaints

Pelvic physiotherapy is physiotherapy for pelvic complaints such as:

  • Accidental loss of urine or stools; 
  • uncontrollable urge to urinate or defecate; 
  • difficulty in passing stools; prolapses of the bladder, uterus, or intestines; 
  • pain in the lower abdomen, prostate, around the anus or genitals; 
  • pain during intercourse related to the pelvic floor; 
  • erection problems; 
  • guidance during lower abdominal surgeries;
  • pelvic pain during and after pregnancy and childbirth; 
  • guidance during pregnancy and childbirth; 
  • post-prostate surgery guidance; 
  • skin conditions like lichen sclerosis, 
  • among others.

Sexology

If you experience sexual problems, whether or not in combination with the pelvic floor, we can help you. You can think of, for example, a vaginistic reaction, dyspareunia, erection problems, ejaculating too early or difficulty ejaculating. 
Also skin problems such as Lichen sclerosis can also cause pain during sex. During the treatment, attention is paid to physical sexual functioning, sexual behavior, sexual experience and the meaning this has for you.

Pregnancy and after childbirth

Several problems can arise during pregnancy, such as pelvic pain, loss of urine, constipation, etc. You can contact a pelvic physiotherapist for this. But problems can also arise after childbirth. You can have a check-up from the pelvic physiotherapist six weeks after the birth. An extensive history will be taken together with you and, if necessary, an internal examination will be performed to determine whether the pelvic floor is functioning properly and whether there are no prolapses.

coccyx pain (NIMOC)

Coccyx pain arises from a misalignment of the tailbone, leading to difficulties with sitting and other issues. Misalignment may result in back pain, pelvic pain, groin pain, anal cramps, urinary or fecal incontinence, sexual discomfort, and difficulty getting rid of urine or stool.

NIMOC, or Non-Invasive Mobilization of the Os Coccyx, is an external tailbone treatment that corrects its abnormal position through gentle, external movements. Typically performed while seated, this mobilization is seldom painful or stressful for the patient. 

Causes of tailbone misalignment include falls onto the buttocks or complications during childbirth, which may have occurred recently or in the distant past, with symptoms gradually worsening. Incorrect tailbone positioning can prevent patients with back issues from standing or sitting for extended periods and cause pain when rising from a seated position or dismounting a bicycle. 
Often, this treatment is paired with trigger point therapy, where painful muscle knots are alleviated by applied pressure or dry needling.

Triggerpoints

A trigger point is a hard-to-the-touch spot ('knot') in a muscle, which, in addition to local pressure pain, can also often cause pain in other places in the body. 

Complaints can be expressed by:
  • Local pain in a muscle with or without eradiation,
  • Limitation of movement and/or stiffness, 
  • Decreased strength when contracting the muscle, 
  • Pain and pain avoidance behavior. 
  • Sometimes also reactions such as sweating, dizziness, light-headedness, blurred vision, shivering or cold hands. 
How do these muscle hardening occur? 
  • Due to a wrong movement or an accident
  • Due to prolonged incorrect posture or overload
  • Prolonged overload with the common problem of neck and arm complaints (RSI, CANS)
  • Overload in athletes
  • Tissue damage such as a meniscus injury or a hernia
  • Prolonged absence of movement, e.g. due to plaster casts
  • Psychological factors such as stress, depression , restlessness and fatigue. 
  • Foot deformities or differences in leg length (e.g. after a bone fracture) 
  • Chronic infections and allergies 
  • Sleep deprivation 
Trigger points can be tackled manually, but also with Dry Needling.

Dry Needling

Dry needling is commonly used for issues pertaining to the pelvic region. It targets the treatment of muscle complaints, typically pre-existing, within and surrounding the pelvic area. This technique involves relaxing muscle knots, known as 'trigger points,' by inserting a fine acupuncture needle into them. When necessary, the skin and periosteum may also be addressed using specialized dry needling methods to enhance outcomes. 
The therapy is particularly aimed at conditions where prolonged muscle tension leads to pain, such as pelvic pain, coccyx pain, lower back pain, painful sensations in the groin and/or genitals, abdominal pain, and the sensation of a golf ball in the rectum, among others.

Sylo-Pen

For patients who are afraid of needles, such as in dry needling, we can also use the Sylo pen. The Sylo pen is a tool that helps make muscle and connective tissue structures in the body more supple and less painful directly.

The Sylo pen can assist the physiotherapist in treating muscle and connective tissue issues, such as myofascial trigger points, scar tissue, and fascia. It accelerates muscle pain recovery. The Sylo pen is applied on the skin and does not pierce the skin.

Even without referral

The majority of patients come to us after referral by a general practitioner or specialist, but you can also go to a pelvic physiotherapist on your own initiative. 

The health insurer reimburses the pelvic physiotherapeutic treatment if you have taken out supplementary insurance for physiotherapy. If you do not have additional insurance, you can still contact us, but you will pay for the treatments yourself. 

The treatment of urine loss is reimbursed under the basic insurance. Some health insurers require a referral from a doctor or specialist to a pelvic physiotherapist. Consult your policy conditions for this. Reimbursements from the basic insurance are entitled to your deductible. For more information and explanation about pelvic physiotherapy, please visit the NVFB website.