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Pelvic Health Physiotherapy

Our Pelvic Health Physiotherapists are passionate about helping women resolve their problems, improve their quality of life, and help them return to the life they love. Our service is highly confidential and respects the often-sensitive nature of these problems. We provide physiotherapy services for the whole of Liverpool Women’s, both for inpatients and outpatients. As well as giving treatment and advice to maternity and gynaecology patients. Our chartered physiotherapists work in close liaison with clinical teams to ensure patients receive continuity of care and services that reflect current clinical practice.

  • Our approach & values

    Before any physiotherapy, you will receive a full explanation about the treatment plan. With ample opportunity to ask questions, we aim to ensure all patients understand the aims of the treatment proposed. We are also guided by our professional standards of care and rules of professional conduct to support the delivery of a high quality service. The physiotherapy team, as is the case with all our clinical staff, is trained to assess and treat patients with courtesy, dignity and respect. All information is treated in strictest confidence.

    Our values:

    • We are passionate about Pelvic health and aim to treat the person not just the condition
    • We aim to break the taboos about pelvic health.
    • We strive to empower women and restore confidence
    • We aim to collaborate with other health professionals and provide a holistic approach to  your treatment and care.

  • What do we treat?

    Our specialist Physiotherapists can help you with a range of conditions including:

    • Bladder incontinence and/or urgency
    • Leaking with exercise or coughing and sneezing
    • Bowel incontinence / urgency and/or constipation.
    • Pelvic pain including - vulvodynia/vaginismus/bladder pain syndrome
    • Pelvic organ prolapse
    • Sexual dysfunction or discomfort
    • pregnancy-related pelvic girdle pain
    • Perineal trauma

    Physiotherapy can also address some of the many side effects of menopause, including physical aches and pains, vaginal symptoms, and pelvic floor muscle rehabilitation.

  • How to get a referral

    if you would like to be seen by one of our Physiotherapists you can be referred by your GP or if you’re an antenatal patient you can ask for a referral from your midwife.

  • What to expect during your Physiotherapy appointment

    What happens during a pelvic health physiotherapy appointment?

    A detailed history will be taken about the problems you are experiencing. Some of the questions may be of a personal nature to gain a full insight into the nature of your problems. You will also be given the opportunity to ask any questions you might have.

    You may be offered an internal (vaginal) pelvic floor examination. This is not compulsory but forms a valuable part of the assessment and enables your physiotherapist to give you individualised treatment and ensure you can activate your pelvic floor muscles correctly. Your physiotherapist will discuss the examination in detail with you during your appointment and a chaperone can be arranged if you would like one.

    What does pelvic health physiotherapy treatment involve?

    Pelvic health physiotherapy treatments are based around exercise and advice, which is tailored to you following a detailed assessment. It may also involve some manual therapy, relaxation and breathing techniques. To ensure the best outcome, it is important that you take an active part in your rehabilitation and follow the advice of your specialist physiotherapist.

    Is there anything I need to bring to my initial Pelvic Health physiotherapy appointment?

    An up-to-date list of any medications you take is useful, plus details of any past or ongoing health conditions, investigations, or treatments, especially if they are related to your current symptoms.

    You may also wish to note down any questions you have about the problem to ask your physiotherapist as well as thinking about the main problems you experience and how much they affect your day-to-day life.

    Do I need to do anything at home for my pelvic health physiotherapy appointments?

    You may be asked to complete a frequency volume chart for your bladder at home prior to attending your initial appointment or at some point during your treatment.

    Do you inform my GP about my pelvic health physiotherapy?

    Your GP is not routinely informed about details of your treatment but is informed if there are any concerns about your condition or if you require further investigations or referral to another health professional.

  • Antenatal Physiotherapy

    We provide antenatal outpatient appointments for women experiencing back or pelvic pain. At these appointments, women are taught self-help techniques and are given advice, including an information leaflet, about posture and about back and pelvic care. As well as being taught stability exercises, some pregnant women are fitted with a back support if necessary. Other physiotherapy treatment techniques are provided depending on individual needs. 

  • Physiotherapy for gynaecology inpatients

    All women undergoing a major abdominal procedure are seen routinely by a physiotherapist. Other patients are referred to us for specific treatments. Working alongside the clinical teams, our therapy objectives are preventive and educational to reduce the risk of complications and speed recovery.  Sometimes treatment is required to aid recovery from complications such as reduced air entry, chest infections and poor mobility.


  • Physiotherapy for gynaecology outpatients

    We see a range of patients in the outpatient department. Common outpatient conditions that are treated by our specialist Women’s Health

    Physiotherapists include;

    Urinary incontinence
    Overactive bladder syndrome
    Dyspareunia (pain during sexual intercourse)
    Faecal incontinence
    Obstructed defecation
    Pelvic pain



  • Where to find us

    You will find us on the ground floor of the Crown Street hospital site, within the antenatal clinic area. 

Antenatal Education

  • What is Pregnancy related pelvic girdle pain (PGP)

    Pelvic Girdle Pain (PGP) is described as pain in the joints that make up your pelvic girdle, this includes the symphysis pubis (SPJ) at the front and/or the sacroiliac joints (SIJ) at the back. 

    • Pain in the lower back, pelvic area and/or legs
    • Can occur in any trimester - most common is 28-36 weeks.
    • Can be debilitating and differ from one person to the next.
    • It can impact on daily function and quality of life, and contributes to anxiety, depression and disability.
    • Self managing condition with help & guidance from pelvic health Physiotherapists

  • Management of PGP
    • Postural Changes

    • Functional Difficulties

    • Adjustments at work


  • Posture and positioning during pregnancy and following the birth

    View this video in different languages below:

    Portuguese - 

    Spanish -

    Arabic -

    Italian -

  • Perineal massage

    Perineal massage is a way of helping to prepare the perineum for childbirth, making it more flexible so it can stretch more easily during labour. 

    Your perineum spans from the rear of your vagina through your anus and rectum and it includes the back part of the birth canal. 

    View the video below for further advice

    Our top tips!

  • Exercises to help with PGP

    Here is a selection of exercise videos you may find useful when suffering from pregnancy related pelvic girdle pain.

    When purchasing your exercise ball, please make sure you purchase an anti-burst ball and a size that is suitable for your height.

    Here below is the recommended sizes:



    Pelvic tilts

    Side Flexion

    Childs pose

    Thoracic Rotations

    Pelvic Circles


    Seated adduction with ball or towel

    Glute activation

    Leg lifts


    Baby Hugs


  • Pelvic Floor Exercises

    Pelvic floor muscle exercises
    The pelvic floor muscles (PFM) are at the bottom of
    your pelvis, and support the pelvic organs.

    When to start?

    • Now's a great time to start these exercises if you haven't been doing them.
    • Try to get into the habit of doing these exercises every day. To make it easier, try to link them with something you do regularly, such as brushing your teeth or watching TV.
    • If you find them difficult or you need advice, speak to your midwife or watch the video below for verbal cues. 

    Pelvic floor muscle exercises are needed to:

    • Improve muscle strength so that you can control your bladder and bowel
    • Support your pelvic organs
    • Support your growing baby during your pregnancy


Postnatal Education

  • Week 1 after Birth - Bladder care

    All women are at risk of postpartum urinary retention. Should you experience any issues with your bladder or voiding problems please speak to your GP and Midwife. 

    Make sure you are emptying your bladder regularly (5-8x per day), particularly if you have had an epidural.

     If you can’t pass urine, inform your midwife immediately.
    If you are unable to control and pass urine as usual, ask to see the specialist physiotherapist or talk to your midwife.

    Our top bladder tips:

    • Do not ‘stop and start’ the flow of urine.
      • Do not get into the habit of going to the toilet ‘just in case’.
      • Breathing out slowly as you pass urine
      may also help.
      • Drink 1.5-2 litres (3-4 pints) of fluids per day to include water/squash.

    View the video below for further information:

  • Week 1 after Birth - Pain management and wound care

    It can be common to experience pain and discomfort following a vaginal delivery post birth. 

    Should you experience ongoing symptoms of discomfort or pain please speak to your GP or midwife. 

    View the video below for more information and advice:

  • Diastasis Recti

    Diastasis recti is a separation between the left and right side of the rectus abdominis muscle. This muscle covers the front surface of the belly area. All women will experience changes in their tummy muscles during the 3rd trimester period. It is normal for these changes to be present in the early stages post delivery. 


    These changes can be: 

    • Separation of the abdominal wall 
    • Doming 
    • Coning 
    • Elasticity changes to the skin 
    • Belly button changes 
    •  Abdominal hernias 

    Generally most of these changes improve over time. Intervention such has exercise can help to improve the strength and tension within the tummy muscles. Please speak to a postnatal fitness professional or Pelvic Health Physiotherapist for further guidance. 


    View the video below for further information:

  • Constipation

    Our top 5 tips to help with Constipation following birth: 

    • Drink plenty of water 
    • The use of stool softeners  
    • Aim to open your bowels soon as you feel comfortable to do so following birth
    • Some women experience constipation - sitting in the right position on the toilet helps your muscles to relax, and makes it easier to open your bowels. You can use the position in the diagram on the right to help you empty your bowels more easily.
      • When having a bowel movement, you may find some extra support will make you more comfortable. Try holding a wad of toilet paper or a sanitary pad firmly in front of the back passage. If you have had a Caesarean section operation, supporting your wound with a folded towel may also help.

    If unsure speak your GP or Midwife for support. 


    View the video below for further information:

  • Returning back to exercise following pregnancy

    Returning to exercise after delivery is recommended but it should be gradual and should not involve high impact exercise too quickly. It is advised to wait until at least 6weeks after your delivery to ensure healing and vaginal discharge and bleeding have stopped.

    For C-section deliveries it is recommended women wait until 12 weeks postnatal before commencing any exercise. 

    If you are unsure please speak to a medical professional or your Pelvic Health Physiotherapist

    View the video below for more information:

  • Pelvic Floor Exercises

    Pelvic floor muscle exercises
    The pelvic floor muscles (PFM) are at the bottom of
    your pelvis, and support the pelvic organs.

    When to start?
    • If you have a urinary catheter, wait until it is removed and you are passing urine normally before starting these exercises.

    Pelvic floor muscle exercises are needed to:
    • improve muscle strength so that you can control your bladder and bowel
    • support your pelvic organs, helping to prevent prolapse

    Remember to:
    • Start the pelvic floor muscle exercises as soon as possible, after any catheter has been removed.
    • Do the exercises in varying positions, but if you are sore in the early days, lying on your side might be most comfortable.
    • Do gentle, rhythmic tightening and relaxing of the muscles, which will help ease discomfort, pain and swelling, and will aid healing if you have stitches following an episiotomy or tear, on your perineum.


    View the video below for further information:

  • C-section Advice & Education

    Advice and exercise following a Caesarean section:

    A Caesarean section is a major operation, which involves an incision (cut) through the tummy muscles and womb. It may take up to 6-12 weeks to recover, for some women this may be longer, and it is important to allow yourself time to rest and recover.

    It is common to experience pain/discomfort for the first few weeks when moving, getting in/out of bed or carrying out activities that cause strain on your tummy. Having anaesthetic can also cause you to feel more tired than usual and may cause sickness. However, it is important to start moving as soon as possible as it will help with your circulation, breathing and prevent your muscles and joints from getting too sore and stiff. You should be given pain relief after your caesarean to help you do this.

    Please view our link with further information: Caesarean section 

    How to exercise the pelvic floor muscles:

    Pelvic floor exercises should include long squeezes as well as short, quick squeezes, making sure you let go/relax the muscle between each squeeze. Aim to complete both long and short squeezes 3 times a day. Start by sitting in a comfortable position, feet flat on the floor or lying on your back or side with your knees bent. Imagine that you are trying to stop yourself passing wind. You want to feel the muscle around your back passage tightening and drawing upwards and forwards towards your tummy button. At the same time, if you can, think about trying to stop yourself passing urine ‘wee’. Try not to clench/squeeze the buttock muscles or hold your breath. Don’t try to stop and start the flow of urine whilst on the toilet – this can interfere with normal bladder function.

    • Long Squeezes: To begin, aim to hold the squeeze for 5 seconds. Let go. Relax for a few seconds. Repeat 5 times. As the muscle gets stronger, aim to hold for up to 10 seconds and up to 10 repetitions.
    • Short, quick squeezes: Quickly squeeze the pelvic floor and then let go immediately. To begin with, aim to repeat 5 short squeezes. Make sure you relax the pelvic floor between each squeeze. As the muscle gets stronger, aim for 10 short squeezes.

    Going home and returning to exercise:

    You will need to rest at home, but it is important that you carry on with pelvic floor exercises, increasing the repetitions as you get stronger. Whilst your abdominal scar  will heal quickly, it is important that you exercise at a steady rate to allow your deeper muscles to recover. Please see the leaflet ‘Improving your pelvic health and fitness after pregnancy’ for more exercises.

    Walking for a short distance every day will help to improve your strength and fitness, and you should try to increase the pace and distance achieved as you feel able. For more information on returning to exercise visit: and their information booklet ‘Fit for the Future’.

    Try to avoid any heavy lifting until you are 6 weeks post-natal. Avoid any activities that causes strain for the first few weeks e.g. vacuuming, prolonged standing, carrying toddlers etc.

    When to return back to exercise:

    Generally, you can start easing back into exercise six to eight weeks after having a c-section. It’s important to note that you may not have the same c-section recovery experiences and timelines as other people you know who have had caesarean deliveries, so it’s key to listen to your own body and your healthcare provider's recommendations.

    There are some very light exercises and movements you can do prior to your six-week postnatal check including light pelvic floor exercises (see above), gently tightening your abdominal muscles in a sitting or lying position to activate them. 

    Please view our early rehab exercises