Pelvic floor physiotherapy in practice

Pain is familiar territory for physiotherapists, whether it's back pain, neck pain, or pain caused by a tennis elbow. However, sometimes, discomfort resides in an area that patients prefer not to discuss: the pelvic floor. Due to its vital functions, issues occurring in this particular area can have far-reaching consequences. Fortunately, for these patients, this is where a pelvic floor physiotherapist comes into play—a professional who not only addresses any embarrassment a patient might experience but also plays a vital role on the patient’s road to recovery. We spoke with Laura Calzado, a Spanish pelvic floor physiotherapist, about her motivation and personal practical experiences.

Specialisation in pelvic floor physiotherapy

Nowadays, there are so many physiotherapists and practices around that it’s become essential to stand out. This can be achieved in various ways—whether through multidisciplinarity, through the design of your practice, or, of course, through specialisation. Laura considered this as well:

"There were already so many physiotherapists in Spain that I wanted a different approach to make an impression. By specialising in something unique, I aimed to increase my chances of employment. Since pelvic floor physiotherapy was relatively unknown then, I made the most of an opportunity."

The role of the pelvic floor

The pelvic floor not only provides stability, keeps your internal organs in place and plays a crucial role in controlling gas, bowel movements, and bladder function but also plays a major role in sexual function. A pelvic floor physiotherapist examines how the pelvic floor is involved in and contributes to issues related to the pelvis, back, abdomen, or even sexual functioning. It treats any possible dysfunctions that might occur in that area.

Pelvic issues can affect anyone

Many people think that only women can experience pelvic floor problems, but that's not true. Men and children can also encounter issues with their pelvic floor. And it’s precisely that diversity that motivates Laura:

"Pelvic floor physiotherapy fascinates me because I work with the many aspects of life. Each day, I work with pregnant women or women in the postnatal phase, but also with patients who have overcome cancer or chronic pain."

Pelvic floor physiotherapy 2.0: myofeedback, shockwave, and TECAR therapy

In her multidisciplinary treatment sessions, Laura often chooses to integrate different types of therapy, such as manual therapy, exercise therapy, behavioural treatment, and even physiotherapy techniques. Regarding physiotherapy techniques, Laura considers myofeedback, shockwave, and TECAR therapy to be valuable tools in her treatment arsenal:

"With male patients with prostatitis (non-bacterial prostatitis), I use shockwave to improve vascularisation because this type of peripheral stimulation seems to have a good effect on the central nervous system. I use TECAR therapy to improve tropism and for its inherent sympathetic effect. For female patients who have just given birth, I use myofeedback, in the form of biofeedback for motor learning, but also for electrostimulation. I also use TECAR therapy and shockwave for pain reduction and to promote vascularisation after an episiotomy."

Shockwave and TECAR therapy for pelvic pain

Using shockwave and TECAR therapy is not only interesting because of their pain-relieving effects and their effects on blood vessels (neovascularisation and vasodilation) but also because of neuromodulation, which, according to Laura, is particularly beneficial for chronic pelvic pain. And that's not all. "Using physiotherapy techniques increases the treatment’s effectiveness, which means fewer sessions are required," says Laura.

Myofeedback in pelvic floor physiotherapy

Myofeedback has significant added value when it comes to teaching the correct way to contract and use the pelvic floor muscles: where are the pelvic floor muscles located, how does the patient contract them, and perhaps even more importantly, how does the patient relax them again? After the therapy, the patient no longer considers the pelvic floor muscles as shrouded in mystery but as perceptible and tangible muscles that can be trained just like their biceps or triceps. This approach increases a patient’s engagement and shortens their recovery time. Moreover, it enables the therapist to assess the therapy’s progress more accurately, improving and strengthening the patient's motivation.

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Pelvic floor physiotherapy: the path to an improved quality of life

The pelvic floor has many functions; if it doesn't function properly, it can significantly impact various aspects of a patient’s daily life. Laura explains that men with prostatitis may experience increased urinary frequency, nocturia (night-time urination), and pain when filling and emptying the bladder and sometimes also during ejaculation. This can mean:

• Leaving the house is more difficult because a toilet always needs to be nearby.
• Difficult, sleepless nights, making patients start their day exhausted.
• Difficulty concentrating due to severe pain.
• Reluctance to engage in sexual relations.

Poor sleep, fatigue, less exercise, and a more limited social life—are significant consequences of one single problem. Therefore, it's unsurprising that improving pelvic issues can drastically and positively influence a patient’s overall well-being and quality of life. And that's precisely what Laura loves about her job:

"I find satisfaction in my work because the treatments bring exceptional results and significantly improve the quality of life, especially for patients with chronic pelvic pain."

Pelvic floor physiotherapy in practice

So, a pelvic floor physiotherapist can make a significant difference for anyone with pelvic floor issues. By embracing innovative techniques such as shockwave, TECAR, and myofeedback, new levels of patient care and professional satisfaction are within reach. Laura has set the bar high:

"What I aim to achieve is reducing my patients’ pain, improving their quality of life, and, of course, that my patients are finally and permanently able to recover from their problems after my treatments."

Judging by her experience and enthusiasm, she seems to be doing just fine.

Are you a pelvic floor physiotherapist but haven't had the chance to use much or any of this type of equipment yet, and has this blog piqued your professional curiosity? Explore the possibilities that shockwave, TECAR therapy, and myofeedback can offer you. Gymna is happy to assist.

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