Pelvic Floor Physiotherapy Malvern East

By Hayley Runting, Senior Physiotherapist, Malvern Physiotherapy Clinic

Common signs of a weak pelvic floor include bladder or bowel leakage, a feeling of heaviness or pressure, and ongoing core or lower-back pain. They can affect people at any stage of life, not only after having a baby. A pelvic floor physiotherapist can assess the muscles and create a tailored program that may help improve control and support.

Pelvic floor problems are far more common than most people realise, and far less talked about. Continence Health Australia reports that 7.2 million Australians over the age of 15 experience incontinence, which is more than one in three people, and that 70 per cent of them are under 65.

A common myth keeps people from getting help: that pelvic floor problems only happen after childbirth. That is not the case.

What is the pelvic floor?

The pelvic floor is a group of muscles that sits like a hammock between the tailbone and the pubic bone. The Better Health Channel describes their role as supporting the bladder and bowel, and in women the uterus and vagina.

They do three jobs at once. They hold your pelvic organs in place, they help control the bladder and bowel, and they work with your breathing, deep abdominal and back muscles as part of your trunk support system. That last point is why pelvic floor issues and stubborn core or lower-back weakness so often show up together.

What are the signs of a weak pelvic floor?

The signs are often small and easy to normalise. Common ones include:

Leaking urine when you cough, sneeze, laugh, lift or exercise
Needing to rush to the toilet, or not making it in time
Passing wind you cannot control
A feeling of heaviness, dragging or pressure in the pelvis, often worse by the end of the day
A weak or slow urine stream, or drips after finishing
A core that has never felt the same since a pregnancy, surgery or injury
Ongoing lower-back or pelvic pain that has not responded to usual treatment
Reduced sensation or satisfaction with sexual activity

Can a pelvic floor be too tight rather than too weak?

Yes, and this is important. Not every pelvic floor problem is a weakness problem.

An overactive or over-tight pelvic floor can produce its own set of symptoms, including pain with urination or sexual activity, difficulty emptying, urgency and pelvic pain. In that situation, doing more squeezes can make things worse rather than better.

This is one of the clearest reasons to be assessed rather than to start a generic pelvic floor program from an app. The right approach depends entirely on what your muscles are actually doing, and a thorough assessment is important to determine the most appropriate treatment approach.

Can men have pelvic floor problems?

Yes. Men have a pelvic floor too, and it can become weak, overactive or poorly coordinated.

The most common reason men seek pelvic floor physiotherapy is bladder leakage after prostate surgery. Continence Health Australia notes that strong pelvic floor muscles play a key role in recovery after prostate surgery, and the RACGP includes pelvic floor muscle training in its guidance for men having this surgery.

Is pelvic floor physio only for after having a baby?

No. Pregnancy and birth are common reasons people come in, and we support many patients through that season at our Malvern East clinic, including with pregnancy and post-natal physiotherapy and exercising safely during pregnancy.

But pelvic floor function can also be affected by:

Menopause and hormonal change
Prostate surgery and other pelvic surgery
Chronic constipation and repeated straining
Chronic cough
Heavy lifting at work or in the gym
High-impact sport
Ageing, as with any muscle group
Never having learned to use the muscles well in the first place

What does a pelvic floor physiotherapy assessment involve?

We understand that this can feel like a daunting appointment to book, so it helps to know what to expect.

Your physiotherapist will start with a conversation. That covers your symptoms, your bladder and bowel habits, your health history, your activity and any goals you have. Much of the useful information comes from this discussion alone.

From there, assessment may include looking at how you breathe and how your trunk muscles coordinate, assessing posture and movement, and reviewing how you are currently attempting to activate the pelvic floor. Many people are surprised to learn they have been doing their exercises in a way that is not fully achieving what they intended.

Where appropriate and with your consent, real-time ultrasound can be used as a non-invasive way to see the muscles working, which is often very helpful for learning the correct pattern.

Similarly, an internal examination is another assessment option. This is always discussed first and your full consent is gained beforehand. The examination should be pain-free, and allows for a thorough assessment of both your pelvic floor muscles and your technique contracting these muscles. It also allows for determining if the muscles are overactive or not, whether your symptoms are related to any other causes such as prolapse or tissue sensitivity, or where your pain might be coming from. This assessment can be paused at any point, meaning you stay in control throughout, however many patients find the process not as scary or uncomfortable as they feared.

Do pelvic floor exercises actually work?

For many people, yes, when they are the right exercises done correctly and consistently.

Continence Health Australia notes that everyone has a pelvic floor, and that just a few minutes of exercise a day can help with bladder and bowel control. The catch is that “do your pelvic floor exercises” is generic advice, and generic advice does not work well, particularly as you can’t see if you’re using the muscles correctly.

Getting the technique right matters. So does knowing whether your issue is one of weakness, overactivity, coordination or timing, because the program is different in each case. And, as with any muscle training, consistency over a period of weeks matters more than intensity in any one session.

Following an assessment, your physiotherapist can build a program suited to your specific situation and review it as you progress. For some people, Clinical Pilates is a useful way to integrate that work with broader strength and control, in a supervised setting.

When should I see a pelvic floor physiotherapist?

It is worth booking an assessment if:

You leak, even a small amount, even occasionally
You get sudden strong urges, have to rush to the toilet frequently, or know certain activities give you the urge to empty your bladder or bowel
You feel heaviness, pressure or bulging feeling in the pelvis
You are planning a pregnancy, are pregnant, or have given birth at any point
You are preparing for or recovering from prostate or pelvic surgery
You have ongoing pelvic, groin or lower-back pain that has not responded to other treatment
You have been doing pelvic floor exercises and are not sure they are working
Symptoms are changing what you do, such as avoiding running, trampolining with the kids or lifting

You do not need a referral to see a physiotherapist in Australia, and you do not need to wait until symptoms are severe. Earlier is generally easier.

Some symptoms need medical review rather than physiotherapy first, including blood in the urine, pain with fever, or a sudden change in bladder or bowel control. Please see your doctor promptly if any of those apply.

Frequently asked questions

What are the signs of a weak pelvic floor?

Bladder or bowel leakage, urgency, a feeling of heaviness, bulging or pressure in the pelvis, and persistent core or lower-back weakness are the most common signs. Any of these is worth having assessed.

Can men have pelvic floor problems?

Yes. Men can experience leakage or urgency, particularly after prostate surgery. Assessment and treatment are always tailored to the individual and their goals.

When should I see a pelvic floor physiotherapist?

Any time symptoms are present, including mild ones. Also worth considering when planning a pregnancy, after birth at any stage, and before or after prostate or pelvic surgery.

Do pelvic floor exercises actually work?

They can help many people when the technique is correct and the program suits the underlying problem. Because some pelvic floors are overactive rather than weak, generic squeezing advice does not suit everyone, which is why assessment first is worthwhile.

Is pelvic floor physio only for after having a baby?

No. Menopause, surgery, chronic constipation or cough, heavy lifting, high-impact sport and ageing can all affect pelvic floor function in people who have never been pregnant, including men.

Will I need an internal examination?

Not necessarily. It is one option among several, it is always discussed and consented to beforehand, and you can decline or defer it. A great deal can be assessed and treated without it.

Book a pelvic floor assessment in Malvern East

If something in this article sounded familiar, an assessment is a straightforward, private and practical next step. These are common problems, we discuss them every day, and there is usually more that can be done than people expect.

Book online at malvernphysio.janeapp.com or call our team on 03 9078 8434. We are at 299 Wattletree Road, Malvern East VIC, close to Malvern, Armadale, Toorak, Glen Iris and across Stonnington. No referral is needed.

About the author

Hayley Runting is a Senior Physiotherapist at Malvern Physiotherapy Clinic with a special interest in women’s health. She graduated from the University of Melbourne more than a decade ago and has over 15 years of pelvic health experience across maternity ward and private practice settings. Hayley completed postgraduate qualifications in Continence and Pelvic Floor Physiotherapy in 2017, alongside further study in neck and back pain management and sports injury treatment. Her clinical interests include pre- and post-natal conditions, pelvic girdle pain, pelvic floor dysfunction and pelvic pain. She has taught Clinical Pilates for over 15 years and runs the clinic’s pre- and post-natal Clinical Pilates classes in Malvern East.

This article is general information only and is not a substitute for individual assessment or advice. Please book an appointment so we can tailor recommendations to you. All practitioners at Malvern Physiotherapy Clinic are registered with the Australian Health Practitioner Regulation Agency (AHPRA).

Published October 6, 2026