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Consultation & Treatment


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Consultation & Treatment



A pelvic floor physiotherapist is a trained expert in the pelvic floor anatomy, as well as the entire musculoskeletal system. By performing an internal examination and assessment of the internal anatomy, she can help women strengthen the muscles that have been stretched, torn and weakened during pregnancy, childbirth and/or pelvic surgery or use vaginal myofascial triggerpoint release to release and elongate tense and shortened pelvic floor muscles causing pelvic pain. Like with injuries to any other part of the body, physiotherapy can help to ensure that the weak or damaged structures or tight structures return to their optimal function.​



What to Expect During a Consultation & Evaulation



Firstly the physiotherapist will take a thorough history asking personal questions about bladder and bowel habits, menstruation and kind of delivery as well as the duration of the delivery and your sex health. She may also ask you questions about your pain, when you notice it the most, how it affects your daily life and what your goals might be.


The more information you can give, the better the physical therapist can help determine the right course of treatment for you.


Education will be done on:

• Bladder and bowel function in relation to the pelvic floor muscle

• Optimize breathing, core function and muscle condition around the pelvis


After a conversation, there will be an external and internal exam to asses range of motion and strength of different muscle groups.


External Examination:

  1. Soft-tissue structures:
    • Connective tissue evaluation of the abdomen, trunk, bony pelvis, legs
    • Myofascial trigger point evaluation of the pelvic girdle muscles
    • Neural testing
  2. Skeletal structures:
    • Sacroiliac joints
    • Hip joint
    • Lumbar Spine
  3. Biomechanics/Motor Control evaluation


Internal examination and skin inspection


  1. Skin inspection:
    • Vulva skin colouring, atrophic or dermatologic changes, fissures to determine if the patient needs a referral to a vulvovaginal dermatologist or a gynaecologist.
    • Mobility of clitoral hood, size of clitoris. Abnormalities can be indicative of hormonal insufficiencies, dermatological diseases, infection or connective tissue issues.
    • Perineal movement
    • Vestibule inspection and Q-tip test
    • Reflex testing: anal wink, clitoral
  2. Internal pelvic floor muscle examination of the vulvar and peri-urethral connective tissue, palpation of all pudendal nerve branches, the coccygeus, and a more involved investigation of a patient’s motor control, muscle length, and strength and endurance. Healthy muscles do not hurt when they are palpated!


Physiotherapy Treatment Options



Following the history and the physical examination, a short and longterm treatment program will be formulated. Physiotherapeutical treatment consists of 1-2 weekly sessions of 1 hour for 1-3 months.


  1. Manual Therapy Techniques
    • Pelvic girdle alignment
    • Connective tissue manipulation
    • Myofascial release and myofascial trigger point release
    • Neural mobilizations
    • Joint mobilizations
  2. Pain physiology education
  3. Peripheral and central nervous system desensitization strategies
  4. Behavioural and lifestyle modifications
  5. Pelvic floor and girdle neuromuscular re-education
  6. Home exercise program development to supplement in-office treatments
  7. Foam rolling
  8. Pelvic floor muscle relaxation exercises
  9. Diaphragmatic breathing
  10. Appropriate stretching
  11. Strengthening if weak
  12. Dilator exercises




Suite 13, Netcare Pretoria East Hospital
Cnr Garsfontein Road & Netcare Ave
Pretoria East



Antoinette Jansen van Vuuren