Expert Pelvic Health Physiotherapy for Women Living with Pelvic Pain

Living with pelvic pain can be exhausting, frustrating, and at times incredibly isolating. Many women live with pain for months or even years before seeking help, often believing it is “normal” after pregnancy, something they simply have to put up with, or that nothing can be done.

The reality is that persistent pelvic pain is never something you should have to simply accept.

At Alpine Physiotherapy, our Women’s Health Physiotherapists provide comprehensive assessment and evidence-based treatment for a wide range of pelvic pain conditions. We work closely with your GP, specialist and other healthcare providers to help identify contributing factors, reduce pain, restore function and help you return to living life confidently.

What is Pelvic Pain?

Pelvic pain refers to discomfort experienced anywhere within the pelvis, lower abdomen, hips, buttocks or genital region. Pain may be constant or intermittent and can range from a dull ache through to sharp, burning or stabbing pain.

Pregnancy-Related Pelvic Pain

Pregnancy places significant demands on your body. As hormones soften ligaments and your baby grows, increased stress is placed on the pelvis, hips and lower back.

Common pregnancy-related conditions include:

• Pelvic Girdle Pain (PGP)
• Symphysis Pubis Dysfunction (SPD)
• Sacroiliac joint pain
• Low back pain
• Round ligament pain

Symptoms often include:

• Pain turning in bed
• Difficulty walking
• Pain climbing stairs
• Pain standing on one leg
• Pain getting out of the car
• Groin or pubic bone pain

Early physiotherapy can make a significant difference by improving movement strategies, strengthening key muscle groups and reducing unnecessary strain throughout pregnancy.

Pain During Sexual Intercourse (Dyspareunia)

Pain during sex is far more common than many women realise, but it is not normal.

Pain may occur:

• At the entrance of the vagina
• Deep within the pelvis
• During penetration
• After intercourse

Many women develop protective tightening of their pelvic floor muscles after experiencing pain, creating a cycle where the muscles remain tense and increasingly sensitive.

Treatment may include:

• Pelvic floor muscle assessment
• Muscle relaxation techniques
• Breathing retraining
• Desensitisation
• Education
• Graduated return to comfortable intimacy

Our aim is to help women return to pain-free, enjoyable intimacy without fear or anxiety.

Endometriosis and Persistent Pelvic Pain

Endometriosis affects approximately one in ten women and can cause significant pelvic pain, painful periods and pain during intercourse.

While physiotherapy cannot remove endometriosis, it can play an important role in managing symptoms.

Treatment may focus on:

• Pelvic floor muscle relaxation
• Scar tissue management
• Breathing strategies
• Movement therapy
• Pain education
• Graded exercise
• Improving function during pain flares

Physiotherapy works alongside medical management to improve quality of life.

Painful Bladder Syndrome & Interstitial Cystitis

Persistent bladder pain is often mistaken for recurrent urinary tract infections.

Women may experience:

• Bladder pain
• Frequent urination
• Urgency
• Pain as the bladder fills
• Pelvic discomfort

Many women with bladder pain also develop overactive pelvic floor muscles that contribute to ongoing symptoms.

Physiotherapy can help improve muscle function, reduce sensitivity and improve bladder control strategies.

Vulvodynia & Vaginismus

Vulvodynia

Vulvodynia refers to persistent pain around the vulva without an obvious infection or skin condition.

Women often describe:

• Burning
• Stinging
• Irritation
• Pain with sitting
• Pain wearing tight clothing
• Pain during intercourse

Vaginismus

Vaginismus occurs when the pelvic floor muscles tighten involuntarily, making vaginal penetration difficult or impossible.

This may affect:

• Sexual intercourse
• Internal examinations
• Tampon use

Treatment is gentle, individualised and always progresses at your comfort level.

Pudendal Nerve Pain & Neuralgias

The pudendal nerve supplies sensation to much of the pelvic region.

When irritated, symptoms may include:

• Burning pain
• Sharp nerve pain
• Numbness
• Pain while sitting
• Genital pain
• Increased sensitivity

Treatment aims to reduce irritation of the nerve while addressing contributing muscle tension, posture and movement patterns.

Ano-Rectal Pain Disorders

Pain around the anus or rectum can have several causes and is often associated with pelvic floor muscle dysfunction.

Conditions may include:

• Levator ani syndrome
• Proctalgia fugax
• Pain after bowel motions
• Pelvic floor muscle spasm

Assessment helps determine whether muscles, nerves or surrounding tissues are contributing to symptoms.

Sacral, Coccyx & Thoraco-Lumbar Pain

Pain around the tailbone (coccyx), sacrum and lower back commonly occurs following:

• Falls
• Childbirth
• Pregnancy
• Prolonged sitting

Pelvic health physiotherapy assesses how the spine, pelvis and pelvic floor work together to reduce pain and improve movement.

Abdominal & Pelvic Pain

Abdominal pain is not always related to digestive conditions.

Muscles, connective tissue, previous surgery and pelvic floor dysfunction may all contribute to ongoing symptoms.

Following a detailed assessment, treatment may include:

• Manual therapy
• Soft tissue techniques
• Scar mobilisation
• Core rehabilitation
• Movement retraining

Painful Scarring

Following caesarean section, abdominal surgery, pelvic surgery or birth injuries, scar tissue can become painful or restrict movement.

Physiotherapy can assist with:

• Scar mobilisation
• Desensitisation
• Improving tissue mobility
• Restoring confidence with movement