Physiotherapy and strengthening of the pelvic floor muscles can help with many ailments. It plays a key role in the treatment of infertility. Overly tense pelvic floor muscles are the result of stress, an overactive bladder, poor posture and also intense training. Weakened pelvic floor muscles can lead to chronic incontinence, lower genitalia and faecal and gas incontinence. Therefore, systematic exercise and relaxation of the pelvic floor muscles is very important.

Importantly, this problem does not only affect women. Excessive pelvic floor muscle tension in men is also a possibility. The cause of this condition can be chronic stress and anxiety, orthopaedic trauma, surgery or bowel problems.

How to exercise the pelvic floor muscles and what to avoid?

Wondering how to exercise your pelvic floor muscles? Physiotherapy is a must have! You can additionally do some exercises yourself. Make sure, however, that you focus all your attention on your kegel muscles - this will help you perform them very accurately. Also try to relax and breathe slowly. Get rid of distractions, like your smartphone or the TV. Let this be a time for you.

How do I strengthen my pelvic floor muscles? A popular exercise for the pelvic floor muscles is the so-called 'bridge'. Lie on your back and bend your legs into a 90 degree angle. Then rest your feet on the floor and place your arms along your body. Take a deep breath in while simultaneously pushing your hips upwards. The entire exercise should last for two seconds. Do ten repetitions.

Another exercise is to, sitting in a chair, bring your buttocks together with all your strength. Then count to five and relax. Repeat fifteen times.

Karolina Kryczka, a physiotherapist from the InviMed infertility treatment clinic in Gdynia, answers questions about what the kegel muscles are responsible for and what symptoms should be considered alarming.

You don't hear about pelvic floor muscles very often....

Karolina Kryczka: Yes, you hear Kegel muscles more often, and these are the pelvic floor muscles. Their most important tasks are to hold the organs of the lower pelvis in place: the uterus, bladder and rectum, and to prevent them from falling downwards when intra-abdominal pressure increases. They enable us to hold urine, stool and gas. They are also what make natural childbirth possible. When they are in good shape, they influence the sexual satisfaction of both partners.

Who should benefit from pelvic floor physiotherapy?

Everyone should take care of their pelvic floor muscles. However, it is well known that not everyone does. Therefore, instead of prevention, we are often faced with firefighting. Fortunately, public awareness of intimate health is growing and fewer and fewer people are accepting a humble life with bothersome ailments. Physiotherapy of the pelvic floor muscles helps in cases such as urinary or faecal incontinence, overactive bladder, lowering or even prolapse of the organs, dyspareunia (painful intercourse), vaginismus, vulvodynia, painful menstruation, ovulation, perineal pain and even, after excluding other causes, constipation or diarrhoea.

Does pelvic floor muscle relaxation support trying for a baby?

Pelvic floor physiotherapy is also helpful when a woman's infertility is caused by pelvic organ adhesions or problems with the patency of the fallopian tubes. Reports from patients who have undergone pelvic floor physiotherapy for other reasons show that a 'side effect' of the treatments is sometimes the regulation of cycles. Physiotherapy can therefore be an additional method, one of the many 'leads' that a couple takes in consultation with their doctor.

What can pelvic floor muscle problems result from?

Pelvic floor muscle dysfunction can be related to pregnancy and childbirth, trauma in the perineal area, inappropriate physical activity, poor posture, a sedentary lifestyle and stress. Pelvic floor dysfunction can be related to a disruption of nerve conduction, a decrease in muscle strength and endurance, reduced or excessive muscle tone, as well as a lack of coordination or the ability to consciously activate the muscles.

What symptoms should draw our attention?

The most common symptoms of pelvic floor dysfunction are reduced sensation of the intimate area, pain during intercourse or even an inability to have intercourse, a feeling of "slackness" or heaviness in the vagina, difficulty in achieving orgasm, incontinence during intercourse and discomfort and burning sensations in the perineal area, while there is no infection.

Can pelvic floor muscle physiotherapy affect the quality of sexual life?

Yes, it can significantly improve them and sometimes even restore them, as many of the symptoms I have mentioned lead to a lack of desire to engage in sexual intercourse or even to abandon full intercourse altogether.

How many people might need pelvic floor physiotherapy?

Statistically, at least one in three women should attend pelvic floor physiotherapy. According to studies, just one in three women in the world suffers from some form of incontinence, and one in two women over 50 is affected by organ decline. A growing group of patients are young women (including teenagers) and men.

How can a physiotherapist help them?

A suitably trained physiotherapist will initially carry out a history and functional diagnosis. This involves assessing the structure and function of the pelvic floor muscles. Other parts of the musculoskeletal system, posture and breathing patterns are also important. Comprehensive treatment consists of manual and visceral therapy techniques, targeted pelvic floor muscle training and patient education. Strengthening weakened or overly tense muscles, increasing their elasticity and volume, better blood supply and nutrition, improved sensation, control and awareness of the body are some of the benefits of this therapy.

What is visceral therapy?

Not everyone is aware that an illness or dysfunction in one of the internal organs can lead to problems with, for example, the lumbar spine or precisely the pelvic floor muscles. Tensions arise which affect the functioning of the whole organism. Visceral therapy leads to the relaxation of these tensions and, in medical terms, to the relaxation of the fascial restrictions of the abdomen, chest and pelvis. Its purpose is to stimulate the internal organs to function normally.

Does visceral therapy help you get pregnant?

I use a variety of methods in my work - these are always tailored to the specific needs of the couple and the doctor's recommendations. Sometimes I use visceral therapy techniques, which have also been developed to help women and men during fertility treatment.

Can pelvic floor muscle training be done alone?

Yes, it is possible and even recommended, as long as you do the right exercises in the right way and with the recommended number of repetitions. Therefore, it is very important to consult a physiotherapist who will not only define the problem and arrange a set of exercises, but will also show you how to perform them correctly.

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Karolina Kryczka - MSc in physiotherapy, physiotherapist at the infertility clinic InviMed in Gdynia, a teacher of massage technician. In the treatments she offers, she combines physiotherapy with biomassage, as well as Eastern and Western therapeutic techniques. She is an advocate of holistic therapy, encompassing the treatment of the body but not bypassing the mind. Her interests include Chinese medicine, herbal medicine and cosmetology.