Pelvic Floor Osteopath vs Pelvic Floor Physiotherapist: What's the Difference?
If you've been looking for help with pelvic floor concerns, you may have come across both pelvic floor physiotherapists and pelvic floor osteopaths and wondered: What's the difference? And which one should I see?
The answer isn't always straightforward because there is some overlap between the two professions. Both can assess and treat the pelvic floor, and both may work with concerns such as pelvic pain, pelvic organ prolapse, bladder or bowel symptoms, pregnancy-related changes and postnatal recovery.
The main difference is the training and clinical framework each practitioner brings to pelvic health care.
What does a pelvic floor physiotherapist do?
A pelvic health physiotherapist is a physiotherapist who has undertaken additional education and clinical training in pelvic health.
Physiotherapists can assess the function of the pelvic floor muscles and surrounding structures and may use a range of treatments including:
Pelvic floor muscle strengthening
Pelvic floor relaxation and down-training
Bladder and bowel retraining
Exercise prescription and rehabilitation
Management of pelvic organ prolapse
Treatment of pelvic pain
Pregnancy and postnatal rehabilitation
Internal pelvic floor assessment and treatment, where appropriately trained and with consent
Education around pressure management and movement
A large part of pelvic floor physiotherapy involves rehabilitation and exercise, particularly when the goal is to improve pelvic floor strength, coordination, endurance or functional capacity.
What does a pelvic floor osteopath do?
An osteopath approaches the body from a broader musculoskeletal perspective, looking at how different areas of the body move and function together.
A pelvic floor osteopath may assess the pelvic floor alongside the:
Pelvic floor muscle strengthening
Pelvic floor relaxation and down-training
Bladder and bowel retraining
Exercise prescription and rehabilitation
Management of pelvic organ prolapse
Treatment of pelvic pain
Management of leakage, incontinence, birth preparation and a range of pelvic floor concerns
Pelvis and hips
Lower back and spine
Abdomen and abdominal wall
Rib cage and diaphragm
Breathing mechanics
Posture and movement patterns
Scar tissue, including caesarean and perineal scars
Muscles, joints and connective tissues surrounding the pelvis
The pelvic floor doesn't work in isolation. It works as part of a larger system involving the diaphragm, abdominal wall, pelvis, hips and spine.
For example, changes in breathing mechanics, abdominal pressure, pelvic mobility or hip function may influence how someone experiences their pelvic floor. An osteopathic assessment can consider these relationships as part of the overall picture.
Treatment may include hands-on techniques, movement advice, breathing strategies, education and exercises, depending on the individual and their goals.
So, can an osteopath treat the pelvic floor?
Yes. Osteopaths can assess and treat the pelvic floor within their professional scope of practice, provided they have the appropriate training, experience and competence to do so.
Some osteopaths undertake additional postgraduate education in women's health and pelvic health, including training in internal pelvic floor assessment and treatment.
At Tugun Osteopathy, pelvic health appointments can include assessment of both the internal and external pelvic floor, where clinically appropriate and with your informed consent.
We also look beyond the pelvic floor itself to understand how the pelvis, abdomen, breathing, hips and whole body may be contributing to your symptoms.
What about internal pelvic floor treatment?
Both appropriately trained pelvic health physiotherapists and osteopaths may perform internal pelvic floor assessment and treatment.
An internal assessment can provide information about things such as:
Pelvic floor muscle strength
Muscle coordination
Ability to relax the pelvic floor
Areas of increased muscle tension or tenderness
Changes following pregnancy or birth
Pelvic organ support
Scarring or sensitivity
Differences between the right and left sides
An internal assessment is not always necessary, and it should never be something you feel pressured to have.
Your practitioner should explain what they are assessing, why it may be useful and what the assessment involves before proceeding. You should always be able to ask questions, decline an internal assessment or stop at any point.
Which one should I see?
There isn't one profession that is automatically the right choice for everyone.
It depends on your symptoms, goals and the type of care you are looking for.
And sometimes, you don't have to choose one or the other.
Pelvic health is often best managed as a team. Your osteopath and physiotherapist can work alongside your GP, obstetrician, midwife, exercise physiologist or other healthcare professionals when appropriate.
What can a pelvic floor osteopath help with?
Pelvic floor osteopathy may be appropriate for a range of concerns, including:
Pregnancy
Pelvic and lower back pain
Pelvic girdle pain
Preparing for birth
Pelvic floor awareness and relaxation
Breathing and pressure management
Comfortable movement throughout pregnancy
Postnatal recovery
Returning to exercise
Abdominal wall and pelvic floor rehabilitation
Caesarean scar management
Perineal scar management
Pelvic pain
Changes in pelvic floor function
Supporting a gradual return to activity
Bladder and bowel concerns
Urinary urgency
Urinary leakage
Difficulty emptying the bladder
Constipation and straining
Bowel management strategies
Pelvic pain
Pelvic floor muscle tension
Pain with intercourse
Vaginismus
Chronic pelvic pain
Endometriosis-related pain and restriction
Scar-related discomfort
Pelvic organ prolapse
A pelvic floor assessment can help you understand how the pelvic floor is functioning and how factors such as breathing, pressure management, muscle coordination and movement may relate to your symptoms.
The most important thing is finding the right practitioner for you
If you're experiencing pelvic floor symptoms, you don't need to wait until they become severe before seeking help.
Whether you choose a pelvic floor physiotherapist, pelvic floor osteopath, or a combination of both, look for someone who has specific pelvic health training and experience relevant to your concerns.
At Tugun Osteopathy, we take a whole-body approach to pelvic health, combining osteopathic assessment and treatment with specific pelvic floor assessment, education and rehabilitation.
You don't need to know exactly what's wrong before making an appointment. Part of our role is helping you understand what you're experiencing and working out what support may be most appropriate.
If you're unsure whether pelvic floor osteopathy is right for you, you're welcome to get in touch with us at Tugun Osteopathy to discuss your concerns before booking.