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Pelvic Floor Therapy Explained: Q&A with Physiotherapist Marna Snyman
At Pelvic Care we are not only proud of the results that are achieved for clients who have completed sessions with our Pelvic Chair, but also of the people at our branches across South Africa who’s knowledge, care and dedication is a fundamental part of these success stories.
In this blog posting we asked physiotherapist Marna Snyman from Pelvic Care Centurion 10 questions about how she uses the Pelvic Chair as part of her treatments at her practice.
With over 12 years of experience and a BSc Physiotherapy degree, Marna's knowledge and experience in the field provides us with a closer look at:
- How she approaches a treatment plan.
- The benefits of pelvic floor therapy across varies rehabilitation programmes.
- Why the Pelvic Chair is an important component to her work.
Q&A With Marna Snyman
Q1. As a physiotherapist, what clinical indicators tell you a patient would benefit from pelvic floor therapy?
In practice, I look for both obvious and subtle indicators, from both my male and female patients.
Obvious complaints from patients include urinary leakage, pelvic heaviness, prolapse symptoms, painful intercourse, erectile dysfunction or difficulty emptying the bladder or bowels. But often the clinical signs are more complex - patients complain of persistent lower back or hip pain, poor core stability, post-surgical scar tightness, postpartum weakness.
Pelvic floor dysfunction rarely exists in isolation. When I assess a patient, I consider posture, breathing patterns, previous surgeries, muscle strength, and take a good thorough history.
If the pelvic floor is not functioning optimally within this complex system, targeted pelvic floor therapy can make a meaningful difference.
Q2. How does electromagnetic stimulation compare to traditional pelvic floor rehabilitation techniques?
Traditional pelvic floor rehabilitation relies on voluntary contraction and relaxation of the muscles. This includes teaching patients how to correctly activate and co-ordinate their pelvic floor muscles. This remains a great option for pelvic floor rehabilitation.
The technology used in the Pelvic Chair, electromagnetic stimulation, adds another level to help the muscles engage and contract more effectively. It induces deep, involuntary muscle contractions that are difficult for patients to achieve on their own, especially if there is significant weakness or poor neuromuscular awareness. It not only addresses weakness but has a significant increase in circulation to the pelvic region that helps with chronic tight muscles and helps reduce pelvic pain conditions. And the best part, it is non-invasive. 30-minute sessions while fully clothed.
Rather than replacing physiotherapy, I use it as an addition. It accelerates strengthening, improves co-ordinated muscle contraction, and can be particularly helpful for patients who struggle to learn about their pelvic floor during early rehabilitation.
Q3. Can you explain what “supramaximal contractions” mean in a clinical context and why they are effective?
In very simple terms, a supramaximal contraction is a muscle contraction that is stronger than what a person can voluntarily produce.
With the electromagnetic stimulation of the Pelvic Chair, the pelvic floor muscles are being contracted repeatedly at an intensity greater than what most patients can achieve on their own.
From a clinical perspective, this promotes significant strength gains, improves muscle endurance, and increases neuromuscular coordination.
This is great for patients with pelvic muscle weakness, such as postpartum women or those experiencing incontinence, as this deeper level of activation can help restore muscle function more effectively than voluntary exercises alone.
Q4. In postpartum recovery, how does pelvic floor strengthening support long-term musculoskeletal health?
Pregnancy and childbirth place enormous strain on the pelvic floor, abdominal wall, and surrounding connective tissues. If these areas are not properly rehabilitated, it can affect posture, bladder and bowel control, and even hip and lower back mechanics.
Postpartum recovery is not just about “bouncing back” - it’s about restoring your foundational stability that will support women for decades to come.
The pelvic floor plays a key role in rebuilding this strength and coordination. I also work gently with post–C-section scar tissue, helping the abdominal wall move more freely, which supports overall core function and comfort.
After the rehabilitation journey I do see women feel more confident, move more comfortably, experience less back pain, and enjoy a lower risk of incontinence or prolapse later in life.
Q5. How does pelvic floor dysfunction contribute to stress and urge incontinence from a bio-mechanical perspective?
From a practical point of view, the pelvic floor acts like a supportive hammock underneath the pelvic organs (bladder, uterus and rectum).
In stress incontinence, these muscles are not strong enough to handle a sudden increase in pressure like when you cough, laugh, sneeze, or exercise. Without that support or weakened muscle contraction, you may experience urinary leakage.
With urge incontinence, the problem is more about control and communication between the bladder, brain and pelvic floor muscles. The bladder becomes ‘overactive’ and sends strong signals to empty, even when it isn’t full. If the pelvic floor is not strong or well-coordinated enough to respond quickly, leakage can occur.
When we strengthen and retrain these muscles, we improve both support and control - which is why many patients notice better bladder control, fewer leaks and more confidence.
Q6. What role does pelvic floor strength play in core stability and spinal support?
The pelvic floor is a key part of your deep core system. It works together with your diaphragm, abdominal muscles, and lower back muscles to support your spine during everyday movement.
When the pelvic floor is strong and well-coordinated, it helps create internal support for the lower back. This makes lifting, walking, exercising, and even standing for long periods feel more comfortable and controlled.
If the pelvic floor is weak, the rest of the core must compensate. Over time, this can contribute to lower back discomfort, poor posture, and potentially chronic injuries.
Strengthening the pelvic floor is therefore not only about bladder control, it’s about building a stable foundation for the whole body.
Q7. In cases of pelvic organ prolapse, how does strengthening therapy reduce symptom severity?
Pelvic organ prolapse occurs when the supportive structures of the pelvic floor weaken, allowing organs such as the bladder or uterus to descend.
While strengthening cannot correct advanced structural prolapse, it can significantly reduce your symptoms. Improved muscle tone enhances organ support, decreases the sensation of heaviness or pressure, and improves continence.
In many cases, strengthening of the pelvic floor can delay or prevent the need for surgical intervention.
Q8. How do you integrate the Pelvic Chair into broader rehabilitation programmes?
I see the Pelvic Chair as one component of a comprehensive rehabilitation plan. Patients undergo a full assessment. Treatment may include manual therapy, scar tissue release, postural correction, breathing exercises, pelvic floor and transvers abdominis strengthening and lifestyle education.
The Pelvic Chair accelerates muscle strengthening, while hands-on physiotherapy addresses alignment, mobility, and functional integration. Combining these approaches produces the most sustainable outcomes.
Q9. What improvements do you typically observe in patients experiencing Genitourinary Syndrome of Menopause (GSM)?
Most often I see improvements in their urinary urgency and frequency, decreased incontinence, reduction in pelvic floor weakness, and many report they feel more comfortable and confident during intimacy.
While GSM has hormonal components that require medical management, strengthening the pelvic floor improves blood flow, tissue support, and muscular function all of which can meaningfully improve quality of life.
Q10. From a rehabilitation standpoint, why is early intervention in pelvic floor weakness so important?
Early intervention prevents compensation patterns from becoming entrenched.
When pelvic floor weakness is left untreated, patients may develop poor posture, abdominal bracing strategies, chronic back pain, worsening incontinence, or progressive prolapse.
The earlier we restore strength, coordination, and proper biomechanics, the easier and more effective rehabilitation becomes.
Pelvic health is foundational for men and women of all ages. Addressing it early protects long-term function and dignity. It adds to your quality of life and makes you move with confidence.
Where Can I Get Pelvic Floor Therapy?
Pelvic Care has 22 locations across South Africa and is constantly growing. Each of our branches will be able to provide you with advice on how to best approach your requirements for Pelvic Floor Therapy and provide you with more information on the sessions.
Professionals in the rehabilitation space are also welcome to contact us to find out more about our services and offering and how it can benefit their practice.
