Pelvic Floor Manual Therapy is a clinical approach utilizing skilled, specific hands-on mobilizing techniques to diagnose and treat soft tissues.  This is for the purpose of:

Modulating pain
Increasing range of motion
Reducing or eliminating soft tissue inflammation
Inducing relaxation
Improving tissue repair
Improving tissue extensibility
Improving stability
Facilitating movement
Improving function

Closeup of abdomen massage
The pelvic floor is susceptible to negative tension and holding patterns for many reasons. Posture, poor seating, holding patterns, emotional holding due to stress, childbirth damage, history of constipation or any bowel disorders or history of urinary tract infections. There may be no history of any of the above but just a genetically tight pelvic floor. These can all lead to a tension build up in the pelvic floor.

Strengthening an already tense or tight pelvic floor can be counterproductive and can increase rather than relieve symptoms or can mean that regular pelvic floor exercises just don’t work.


Pelvic floor manual therapy is a series of internal and external soft tissue release techniques to address unwanted tension in the pelvic floor muscles and fascia. There should be a sense of relief having had the pelvic floor mobilised that results either immediately or over time in an increased range of movement in the muscles. This in turn should result in an increased ability to either contract or release muscles improving timing in the muscles and pelvic organ position.

Pelvic floor manual therapy is used for stress incontinence, pelvic organ prolapse, urinary urgency, urge incontinence, bowel disorders, chronic pelvic pain and sexual disorders. There may be some discomfort at the time of mobilization in the same way that one would feel it with back or neck mobilisation but there should not be any post treatment soreness.

Myofascial trigger point therapy to the pelvic floor
Dry needling to the pelvic floor
Myofascial trigger point therapy to the pelvis, trunk and abdomen
Dry needling to the pelvis,  trunk and abdomen
Connective tissue manipulation to the external perineal tissue, abdomen and pelvis.
Trigger Points
Pelvic Floor Manual Therapy techniques for the pelvic floor include stretching and trigger point treatment where a muscle is tense.
A short or tense muscle is identified by internal examination and then stretched centrally along the bulk of the muscle or at the attachment to bone which is often more uncomfortable.

A trigger point will often refer pain elsewhere in the pelvic floor or to the hips or rectum or may just be painful on the spot. Once held for a few seconds the pain eases and the therapist moves on to the next point.

There are also nerves in the pelvic floor and they can be mobilised along their pathways.

There is often external tension in the pelvis and abdomen linked to internal restriction, this is known as a connective tissue restriction. This can be successfully released through pelvic floor manual therapy externally on the identified areas.

Trigger Point Complex
Pelvic Floor Manual therapy should not be so painful that the patient reacts by tensing up. The pelvic floor muscles should not be sore after manual therapy.
Trigger point palpation pincer
Trigger point palpation
The contractility of the pelvic floor can be seen to change on realtime ultrasound following a session of manual therapy.