We often hear about pelvic floor rehabilitation for the first time after giving birth. But contrary to a widespread belief, perineal rehabilitation is far from being exclusively for women who have just given birth!
It can be useful throughout a woman's life. We'll tell you more about pelvic floor rehabilitation: its usefulness, when to practice it, and the different methods.
Just like any other muscle in the body, the pelvic floor is a set of muscles that is important to take care of throughout one's life. Pelvic floor rehabilitation is therefore not exclusively reserved for women after childbirth. These muscles play a vital supporting role in the lower abdomen.
Health professionals recommend taking care of your pelvic floor throughout your life. The goal is to prevent a relaxation (weakening) which can lead, in the most severe cases, to a prolapse (descent of organs).
Regardless of age or gender, it is therefore possible to perform pelvic floor rehabilitation sessions (because yes, men also have a pelvic floor and can rehabilitate it!).
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What is the pelvic floor? |
To understand why it is important to maintain a toned pelvic floor and the impact of pelvic floor rehabilitation, here are a few anatomical concepts. The pelvic floor is a set of muscles, ligaments, and tissues located in the lower abdomen, within the pelvis (extending from the pubis in the front to the tailbone in the back). |
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What is it's role? |
Often compared to a hammock because of its shape, it acts as a net. It helps support the pelvic organs. It is crossed by the urethra, the vagina, and the anal canal. In addition to its supportive role, the pelvic floor is also involved in sexual function. It plays a primary role during urination (the act of urinating) and defecation (the expulsion of fecal matter). |
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Pelvic floor and continence |
You have to imagine the bladder and the rectum as reservoirs that continuously fill up (respectively, from the kidneys and the colon). At rest, the urinary and anal sphincters can be compared to taps that are closed. During urination or defecation, the opening and closing of these sphincters are part of the pelvic floor's functions. It is therefore quite easy to understand why the pelvic floor is largely involved in the phenomena of continence and incontinence. |
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Symptoms of a relaxed pelvic floor |
When the pelvic muscles relax, it can have multiple consequences in a woman’s life. Urinary leakage may appear and, in more severe cases, even organ prolapse. A weakened or fragile pelvic floor can also reduce sensation during intimacy. Furthermore, if pain occurs, it can negatively affect the quality of sexual relations. The importance of these muscles and the practice of pelvic floor rehabilitation should not be underestimated, as they have a significant impact throughout a woman’s life. |
In which cases should pelvic floor training be done?
Muscle rehabilitation in the pelvic area may be recommended to address a variety of issues and can be done at any stage of a woman’s life, whether after pregnancy or at the onset of menopause.
It may be necessary in cases of
Rehabilitation can also be carried out as a preventive measure to avoid these conditions. Pelvic muscle therapy can serve both therapeutic and preventive purposes.
Only a doctor or a licensed medical professional can prescribe pelvic muscle rehabilitation sessions. Your gynecologist or primary care physician can provide a prescription, whereas a physiotherapist or midwife is not authorized to do so.
It’s important to note that pelvic muscle therapy is not only for pregnant women. Many factors can affect the strength and tone of these muscles, including sports activity and age. Weakening of the pelvic muscles, as well as the onset of pain or urinary problems, can occur at any stage of life.
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With which professional should you do your perineal rehabilitation? |
There are several methods of pelvic muscle rehabilitation used by healthcare professionals, each with a slightly different approach. Midwives often focus on manual therapy and visual feedback, while physiotherapists trained in pelvic muscle rehabilitation typically use biofeedback and/or electrical stimulation. During the first session, the healthcare professional always performs an assessment of the pelvic muscles to evaluate your symptoms and their causes. This allows them to tailor the treatment and recommend the rehabilitation method best suited to your needs. |
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Manual pelvic floor rehabilitation |
During a manual pelvic muscle rehabilitation session, with your consent, the practitioner performs a vaginal examination. This allows them to assess the quality of your muscle contractions. The practitioner will indicate to the patient, through gentle pressure, which muscles to contract. Depending on the patient’s needs, various movements can be performed with the fingers to properly stimulate the muscles, such as resistance, stretching, counterpressure, or massage. This method provides highly targeted work, allowing the patient to focus on the muscles that need it most. Direct contact with the body helps the woman become aware of and accurately locate her pelvic muscles. In postpartum rehabilitation, manual therapy can also help identify and work on any painful or scarred areas resulting from childbirth. |
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Pelvic muscle rehabilitation using visualization exercises |
Manual pelvic muscle rehabilitation can be combined with visualization exercises. This helps a woman develop an even finer awareness of her pelvic muscles and serves as a complementary way to work on them. Many midwives use visualization exercises as part of their practice. This method involves a series of exercises that associate the pelvic muscles and their different areas with specific images. Common examples include a cave, an elevator, or a drawbridge. These images help the patient gain a much more precise awareness of her pelvic floor and its various zones. Once these perceptions are well established, the midwife guides the patient in developing reflex movements. These are quick contraction movements that can be applied in daily life to protect the pelvic muscles. These automatic responses help shield the pelvic floor from pressure caused by physical effort, such as lifting heavy objects, coughing, sneezing, or even laughing. |
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Pelvic muscle rehabilitation using electrical stimulation |
Electrical stimulation is a useful method for women who have difficulty contracting their pelvic muscles. It can help them better feel and locate these muscles. Electrical stimulation devices work by activating the pelvic floor muscles through electric currents. These devices usually consist of a vaginal probe connected to a control unit that adjusts the intensity of the electric currents. With this method, the patient is passive in her rehabilitation—she does not contract her pelvic muscles herself. Instead, the electrical currents reflexively stimulate the muscles. It is important to note that electrical stimulation is often not recommended in the postpartum period to nerve injuries that can frequently occur during childbirth. This method is typically used for a short period and as a first-line approach. It helps the woman learn to accurately locate her pelvic muscles. Once this is well understood, it is recommended to perform active exercises over the long term to strengthen the pelvic muscles. |
Unlike electrical stimulation, biofeedback is based on learning to voluntarily contract the pelvic muscles. With this method, the woman actively contracts her pelvic floor herself. Biofeedback allows her to be actively involved in her pelvic muscle rehabilitation.
The goal of this method is to detect pelvic muscle contractions using a vaginal device or surface electrodes. These sensors detect and record the muscle activity and then transmit it to the patient as an auditory or visual signal.
The biofeedback technique is based on “instantaneous feedback.” After an action, such as a pelvic muscle contraction, which cannot be directly observed to assess its effectiveness, a control signal is sent to the patient. The sensors indicate whether the action was performed correctly or not.
In practice, during a biofeedback rehabilitation session, cues for contracting and relaxing will be displayed on a screen. You will need to follow them by adjusting the movements of your pelvic muscles.
Your contractions are also shown in real time on the screen, allowing you to see whether the action you are performing matches the expected movement. Biofeedback helps you become aware of how your pelvic muscles work and, most importantly, teaches you to contract them voluntarily.
With biofeedback devices, the patient is active. She is the one who decides to voluntarily contract her pelvic floor.
Women gain excellent control of their pelvic muscles using this method. It allows them to incorporate automatic and reflexive contractions into daily life to protect the pelvic floor.
In the scientific literature, biofeedback is even described as one of the most effective methods for pelvic muscle rehabilitation.
Pelvic floor training at home
The pelvic muscles are often neglected and forgotten because, anatomically speaking, they are not visible. However, it is very important to train them regularly to prevent weakening.
When you attend pelvic muscle rehabilitation sessions with a healthcare professional, they will always recommend continuing simple contraction exercises at home. The consistency with which patients perform these exercises at home is closely linked to the long-term effectiveness of the results.
In other words, the more regularly you practice these exercises, the more you will maintain a strong pelvic floor over time. You will also help prevent problems associated with weakened pelvic muscles, such as urinary leakage or organ prolapse.
There many other ways to train your pelvic muscles at home. Interestingly, scientific studies highlight that patient engagement in pelvic muscle rehabilitation is enhanced by the use of a mobile application.
Emy is a biofeedback device developed in collaboration with healthcare professionals. It allows women to continue their pelvic muscle rehabilitation effectively at home.
The wireless Emy Trainer connects to a playful mobile app, enabling users to see their efforts in real time directly on their smartphone.
Thanks to more than thirty medical mini-games, each woman is free to perform her rehabilitation exercises at home, in complete privacy, whenever she wishes.
Real time visualisation of pelvic floor contractions 
Progess tracking 
Training remindersReal time visualisation of pelvic floor contractions Progess tracking Training remindersDownload our guides to know more
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