Pelvic Floor Physiotherapy and Complex Gynaecological & Urological Pain Syndromes

Evidence-based physiotherapy for pelvic dysfunction and persistent pelvic pain in Frankfurt
At Physiotherapie Vitality Frankfurt, physiotherapy for pelvic dysfunction and complex gynaecological and urological pain syndromes covers two key areas:

1. Classical pelvic floor therapy based on the Physio Pelvica concept – for example for incontinence, pelvic organ prolapse, or after surgery.
2. Evidence-based physiotherapy for perinatal, perioperative and chronic gynaecological and urological pain syndromes and functional disorders.

Our approach is evidence-based, patient-centred and aligned with current clinical guidance, aiming to reduce pain, improve function and enhance long-term quality of life.

When is pelvic floor physiotherapy useful?

Pelvic dysfunction and pain affecting the pelvis and pelvic organs can significantly impact daily life and may have different causes. Pelvic floor physiotherapy can be appropriate for a wide range of symptoms and conditions.

Common symptoms and conditions

• Incontinence (urinary, faecal or flatus incontinence)
• Bladder or bowel emptying disorders
• Pain in the pelvic floor and pelvic ring (pubic symphysis, SI joint, coccyx)
• Sexual dysfunction (e.g. pain during intercourse, orgasmic/erectile disorders)
• Pelvic organ prolapse symptoms (uterine, bladder or bowel prolapse), including after surgery
• Haemorrhoids (within a functional context)
• Postpartum complaints (during/after pregnancy and childbirth, including rectus diastasis)

Women, men and children can be affected—often for example after surgery (bladder, rectum, prostate, uterus), during or after pregnancy and childbirth, with connective tissue weakness, overweight, strength deficits, increased or decreased muscle tone, and/or reduced pelvic floor awareness.

Classical Pelvic Floor Therapy

In classical pelvic floor therapy we work in a structured, functional and everyday-oriented way—focusing on control, load tolerance and integration into daily life and sport.

Typical components include:

• Education on anatomy, function and key relationships (bladder, bowel, pelvic organs, breathing, intra-abdominal pressure)
• Pelvic floor awareness training (a central part of therapy)
• Active physiotherapy: individually adapted exercises (strength, endurance, coordination, relaxation)
• Functional training for daily life and load situations (e.g. lifting/carrying, coughing/sneezing, sport)
• Return to Running / Return to Sport after pregnancy and childbirth
• If indicated: biofeedback and additional techniques to support tone regulation
  
  

Physiotherapy for Complex Gynaecological and Urological Pain Syndromes

Another major focus at Vitality is physiotherapy for complex gynaecological and urological pain syndromes. This approach is relevant for women and men, and recognises that lower abdominal and pelvic pain is not always directly linked to the pelvic floor.

Relevant indications (Pain-focused)

• Acute peripartum pain after childbirth (vaginal delivery / caesarean section)
• Pain after gynaecological and urological surgery
• Post-traumatic complaints
• Endometriosis-related pain and functional lower abdominal pain
• Scar-related problems (C-section, laparoscopy, endometriosis surgery)
• Low back, pelvic and hip pain in a gynaecological and urological context
• Chronic sports-related groin pain
• Pelvic ring pain during pregnancy
• Chronic prostatitis in men
• Pain and functional limitations associated with conditions, injuries or surgery of the female breast

Therapeutic Focus (Evidence-based and guideline-oriented)

• Individualised pain-specific assessment
• Structured patient education and active goal setting
• Nocebo-aware, resource-oriented communication
• Non-pharmacological strategies to relieve pain, such as:

          •  Breathing therapy and relaxation techniques
          •  Positioning and unloading strategies
          •  Biofeedback
          •  Myofascial techniques and trigger point therapy
          •  Manual therapy combined with exercise-based treatment (self-management programmes)
          •  Scar therapy
          •  TENS and other physical modalities

We consistently work within a biopsychosocial model, considering beliefs, expectations and emotional responses to pain. The goal is a gradual increase in activity and load tolerance, for example through:

• Graded Exposure (step-by-step load progression)
• Body perception training / Graded Motor Imagery
• Motivation for active exercise programmes
• Improving individual health literacy
  
  

Organisation, collaboration with physicians and coverage

Treatment is individualised, patient-centred and guideline-based, and—if desired—coordinated closely with your treating physicians.
A dedicated reference therapist throughout the entire treatment period ensures continuity and quality.

👉 At Vitality, pelvic floor physiotherapy and pain physiotherapy are now also available for patients with statutory health insurance, as well as for private patients and self-paying clients.