Pelvic Floor Muscle Function and Strength

Original Editor - Kirsten Ryan

Top Contributors - Laura Ritchie, Kirsten Ryan, Nicole Hills, Scott Buxton and Claire Knott  


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Visual observation, digital palpation, electromyography, ultrasound, and magnetic resonance imaging measure different aspects of pelvic floor muscle (PFM) function.  Pelvic floor muscle strength training is believed to stop or significantly reduce leakage by improving the structural support, timing and strength of automatic contractions.  Several studies have shown that greater than 30% of do not correctly perform a pelvic floor muscle contraction when asked to, even after individual instruction.

External Observation

External visual observation of the perineum may be utilized to visualize what the patient does when asked to contract the pelvic floor and is usually the initial step is assessing pelvic floor muscle function.  Caution against using observation as the only assessment as the inward movement of the skin may be created by contraction of the superficial perineal muscles and have no influence on urethral closure mechanism.  In women who are obese, a correct lift can be difficult to observe externally.


Digital Palpation

Digital palpation of the vagina PFM is the standard when assessing the ability to contract the PFM by most physical therapists.  The quality of contraction and upward movement can be assessed digitally.[2]

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Pelvic Physiotherapy - to Kegel or Not?

This presentation was created by Carolyn Vandyken, a physiotherapist who specializes in the treatment of male and female pelvic dysfunction. She also provides education and mentorship to physiotherapists who are similarly interested in treating these dysfunctions. In the presentation, Carolyn reviews pelvic anatomy, the history of Kegel exercises and what the evidence tells us about when Kegels are and aren't appropriate for our patients.

View the presentation


  1. Tom Ockler, PT. Trigger point assessment and treatment for Pelvic Floor triggers M 3 Seminar. Available from: [last accessed 30/04/14]
  2. Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther 2005;85:269-282.