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Do you need pelvic health physiotherapy? Don’t hesitate – it’s awkward but enlightening

Remember my problems ‘down there’?

You may recall from a previous article that I had some disturbing bladder problems.

I wet my pants quite badly one day while trying to show off my 50 something year old fitness prowess with a skipping workout.

A more pervasive problem was my frequent, sudden and powerful urges to wee – occasionally leaking in the rush to get to the toilet.

Both these issues messed with my head and I started going to the toilet when I didn’t need to – you know, just in case.

I didn’t want to get caught out and thought keeping my bladder empty was a good idea.

Just in case weeing is not a good idea, as I have come to learn.

I came to realise this was not normal

Like many women, I had accepted my predicament as something I had to put up with and normalised it in my mind.

I know lots of women who are always going to the toilet.

This is common, so I thought it must be normal.

It was only through my professional development that I recognised I had a problem.

Content from the EVEolution™ course – the one devoted to exercise considerations for women – showed me that I did not have to simply accept what I was going through, and I needed professional help.

Pelvic health physiotherapy

I needed a pelvic health physiotherapist (PHP) – also known as a women’s health physio or pelvic floor physio – a highly trained professional who can diagnose and treat incontinence and pelvic floor dysfunction.

The diagnosis part is vital because these issues have various causes that require different treatment approaches.

It is not always a case of just needing to do pelvic floor exercises.

I describe my experience of consulting a PHP as awkward but enlightening.

How it’s awkward – talking about really personal stuff

The first part of the process involved talking about what brought me to see the PHP.

And they need to ask specific questions to gather all the information needed to diagnose the problem.

Despite knowing that the PHP is a professional and used to hearing personal stories, telling someone you’ve just met about wetting your pants and bizarre toileting habits can feel awkward.

People can also seek out a PHP with other symptoms such as painful sex, dragging sensations in the vagina or even something bulging out of the vagina.

Not the easiest things to talk about openly, but the PHP is just the person you need to tell about everything you’re experiencing down there.

Then there’s the physical examination…

This involved the PHP checking my pelvic floor muscles by inserting two fingers in my vagina.

It was different to other vaginal examinations I’ve had.

I had to perform various muscle contractions while the PHP used their fingers to assess my pelvic floor function.

All this while answering questions too.

However, this is a routine part of the process for the PHP and I felt very much at ease and even awestruck by their profound knowledge, skill and professionalism.

How it’s enlightening

It turned out that my two problems – wetting my pants when I skipped and extreme urgency to wee – are not related.

Most enlightening was learning that my urgency problem was due to an overactive bladder and there were heaps of things I could implement immediately to help.

Learning that caffeine can play a role and cutting down my obsessive-compulsive tea drinking, for example.

I also learned ways to calm my bladder when I have those intense urges.

What a relief it is to know these things – in more ways than one!

My middle-aged lady toilet training is ongoing, but I’ve made huge progress out of my just in case weeing habit.

Real time ultrasound examination

I am a nerd, so the real time ultrasound examination of my pelvic floor function on my second visit really appealed to me.

The PHP moved the probe over my lower abdomen/pelvic area with the aid of some lubricating gel.

It was amazing to see an image of my bladder right there on a screen.

The PHP also pointed out images of various muscles and I could see them change with my movements.

While I was nailing my pelvic floor contractions, my ability to switch it on during movement was poor.

I could not feel this until I saw it clearly on the ultrasound screen. What a revelation!

Now I’m empowered with knowledge to guide me with both pelvic floor exercises on their own AND how to use my pelvic floor appropriately during exercise and everyday activities.

Don’t let embarrassment be a barrier to getting help

I know that some women have a barrier to seeking out a PHP because it is ‘up close and personal’ – as one of my clients described it.

All I can do is reassure you that this is the PHP’s profession and there is no need to be embarrassed about your problem or the process of diagnosis.

My PHP made me feel at ease immediately and I had no issues disclosing all my stories and having the examinations.

I hope sharing my experience with PHP sheds some light on what to expect and lessen the awkwardness for you.


Another barrier to getting help from a PHP is the belief that we must accept pelvic floor dysfunction and incontinence as a normal part of life for women.

Just because a problem is common does not make it normal.

Don’t suffer in silence.

Start talking to the women in your life about these issues and see you are not alone.

Seek out a PHP to get help and live the life you deserve.

Cost can be a barrier

PHPs are highly educated and skilled health professionals and consultations are necessarily lengthy and complex.

This means that it can be expensive to see a PHP.

I only needed three visits to diagnose and learn the strategies to treat my problems.

However, more visits may be needed for other issues.

A portion of the fee may be covered if you have private health insurance.

It may be possible to get a care plan for PHP through your GP.

More enlightening than awkward

The awkwardness of my PHP physio experience was short lived.

Overwhelmingly, the experience was enlightening.

Who would have thought there was still stuff to learn about one’s body at the age of 55!

I’m so grateful for the knowledge and skill of my PHP and the experience has changed my life for the better.

No more wet pants or just in case weeing for me.

Learn more about exercising safely through all stages of your female life

I realised that I needed to see a PHP through doing a course called EVEolution™.

This is not just a course for fitness professionals – anybody can do it!

Learn more about EVEolution™

What is EVEolutionTM?

EVEolution™ is an online course that educates and empowers you to exercise safely through all stages of your female life.

It’s information that’s missing from your fitness trainer’s education that every trainer and woman needs to know about.

It provides the learning directly to you, so you know what to ask your trainer.

It’s a gateway to awkward but necessary conversations – we need to talk about this stuff!

Learn more and buy your own EVEolutionTM course

As an EVEolutionTM partner, I can make this brilliant course available to you.

Simply follow the link to the EVEolution page on my website to learn more and buy your own EVEolutionTM course.

Keep in touch

Please reach out to me if anything in this article resonates with you.

You can email me at or connect via social media.

I’m on FacebookInstagram and LinkedIn.

You can have a read of my previous blogs here 🙂

This blog was written by

Kate Rowen's avatar

Kate Rowen

A photo of Kate Rowen

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I wish to acknowledge and pay my respects to the traditional custodians of the land where I live, work and exercise, the Whadjuk people of the Noongar Nation.