Individual · functional · practical

Pelvic floor physiotherapy

Understand your symptoms, recognise connections and regain confidence in everyday life – for women and men, in person in Mallorca or supported online.

Medical assessment and physiotherapy meaningfully combined

Katja von Boetticher at Palma Clinic
Katja von Boetticher M.Sc. Physiotherapy Specialist field: pelvic floor
Women & men at every stage of life
20+ years of experience in prevention and rehabilitation
In person in Palma personal assessment
Supported online training programme with chat

Quickly find the right information

What would you like to understand better?

Choose a topic for a brief explanation and an overview of how pelvic floor physiotherapy may help.

Choose a topic

One click opens the explanation directly below.

Understanding symptoms

LUTS: lower urinary tract symptoms

LUTS is an umbrella term for symptoms during bladder storage, voiding and immediately afterwards. Causes vary, which is why medical assessment comes first.

  • frequent urgency
  • night-time urination
  • weak stream
  • difficulty starting
  • feeling of incomplete emptying
  • post-void dribbling

Our approach

Turning exercise into meaningful change.

The pelvic floor never works in isolation. We therefore consider breathing, pressure control, posture, movement and everyday life together.

Understand

Discuss symptoms, daily life and goals, and meaningfully include medical findings.

Perceive

Distinguish contraction from relaxation and control both without compensatory movement.

Train

A personal plan for daily life, sport, preparation or rehabilitation.

Integrate

Integrate the new strategy into walking, lifting, coughing, toileting and exercise.

The three pillars of pelvic floor therapy

The foundation for a healthy pelvic floor.

Effective training combines awareness, breathing and posture. Control for everyday life develops through their interaction.

Awareness

Feeling the pelvic floor and activating it deliberately is the most important foundation for consciously controlling contraction and relaxation.

Breathing

The diaphragm and pelvic floor work together. Calm, functional breathing supports relaxation, protects against unnecessary pressure in the abdomen and improves activation.

Posture

An upright, stable posture reduces strain on the pelvic floor and helps it work automatically and effectively in everyday life.

A look at therapy

Personal support. Clear explanations. Purposeful practice.

Each photo represents a different element: awareness and breathing, physiotherapy assessment, personal guidance and follow-up.
Katja von Boetticher demonstrates a seated awareness and breathing exercise
Awareness & breathing Recognise tension, release it intentionally and coordinate movement.
Katja von Boetticher guides a patient through a functional exercise
Guidance & function Exercises are adapted to posture, movement and everyday life.
Katja von Boetticher during a personal consultation
Guidance & progress Review progress and adapt training appropriately.

Knowledge that helps

Understand symptoms – step by step.

Clear, concise articles explain terminology, connections and possible next steps.
6 articles
Personal initial consultation about LUTS and pelvic floor symptoms Feature article · LUTS
full article · with short check

When the pelvic floor will not let go: urgency without incontinence

This in-depth article explains how urgency, voiding difficulties and a persistently tense pelvic floor may be connected – including an interactive personal check.

Targeted functional training with a small exercise ball OAB
bladder

Overactive bladder: when urgency controls daily life

How urgency, frequent urination and preventive toilet visits can form a cycle.

Functional physiotherapy treatment Tension
pelvic floor

A tense pelvic floor: more strength is not always the answer

Why relaxation, breathing and coordination may matter for pain or voiding problems.

Supported biofeedback training with a male patient Prostate surgery
rehabilitation

Continence after prostate surgery: what matters before and after

How awareness, technique and well-dosed training may support rehabilitation.

Pelvic Tool biofeedback on a tablet Biofeedback
training

Biofeedback: making invisible muscle activity visible

Feedback that can help clarify contraction, relaxation and training intensity.

Katja von Boetticher planning digital training Online
support

Supported online: a personal plan with chat

For travel and life outside Spain: exercises, progress and questions remain connected.
Personal initial consultation about LUTS and pelvic floor symptoms

FEATURE ARTICLE · LUTS

When the pelvic floor will not let go: urgency without incontinence

Urgency, frequent toilet visits or a weak urine stream do not automatically mean incontinence. Many women and men experience lower urinary tract symptoms without leaking urine. These symptoms are grouped under the term LUTS – Lower Urinary Tract Symptoms. They may affect bladder storage, bladder emptying or the period immediately afterwards.

When urgency and emptying control daily life

Common signs include sudden urgency, very frequent urination, getting up at night, difficulty starting, a weak or interrupted stream, a feeling of incomplete emptying and post-void dribbling. Some people look for every available toilet, reduce their fluid intake or organise trips around toilet access. Quality of life can be significantly affected even when no visible leakage occurs.

The pelvic floor must also be able to relax

During urination the pelvic floor should relax appropriately. If it remains tense, the bladder, urethra and pelvic floor may not work together efficiently. Stress, habitually drawing in the abdomen, prolonged sitting, pain or fear of leakage may encourage this pattern. The body tries to create control but may achieve the opposite: urgency feels stronger, the stream stops and starts, or the bladder feels incompletely emptied.

Important to knowThe pelvic floor may be weak, poorly coordinated or overly tense. Therefore “more strengthening” is not the right first response for every symptom.

Why strengthening alone may miss the point

A functional pelvic floor can contract, hold and then release completely. Physiotherapy therefore considers awareness, breathing, posture, pressure control and movement together. Within the BeBo® approach, you first learn to perceive the area and distinguish activity from relaxation. Non-intimate biofeedback with the Pelvic Tool can make muscle activity visible and provide immediate feedback. A bladder diary also shows how fluid intake, toilet intervals and symptoms are connected.

What you can observe yourself

Notice whether you strain, hold your breath or strongly tense the abdomen when passing urine. Avoid visiting the toilet at very short intervals purely as a precaution. Do not reduce fluids without medical advice. Calm breathing, sufficient time and a relaxed seated position may support emptying. Individual exercises should, however, be selected after a suitable assessment.

Medical assessment remains important

LUTS has different possible causes. Prostate changes, infection, medication, neurological factors and other conditions need to be considered. Urological assessment provides safety and a basis for targeted physiotherapy. Blood in the urine, fever, severe pain, burning or sudden inability to pass urine require prompt medical attention.

LUTS short check

Select what has applied to you more often during the past four weeks.

When was your last urological check-up?

Warning signs

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If you would like help understanding your symptoms, please contact us. Together we can clarify whether a urological check-up or a physiotherapy assessment is the right next step.
Targeted functional training with a small exercise ball

OAB

When urgency controls daily life

Overactive bladder is characterised by sudden, difficult-to-defer urgency. It is often accompanied by increased daytime frequency, night-time urination and sometimes leakage.

Why preventive toilet visits may not help

Visiting the toilet very frequently out of concern gives the bladder less opportunity to experience normal filling. This may encourage a cycle of attention, tension and increasingly short intervals.

Before trainingInfection and other identifiable causes should be medically excluded. Individual bladder and pelvic floor training may then be appropriate.

Possible components

  • fluid and bladder diary for a realistic overview
  • strategies for managing sudden urgency calmly
  • gradually adapted toilet intervals
  • relaxation, breathing and functional pelvic floor coordination

Training is adjusted so that it remains realistic in everyday life.
Functional physiotherapy treatment

TENSION

More strength is not always the answer

The pelvic floor can be weak, but it can also have excessive resting tension or hold at the wrong moment. Additional strengthening can then aggravate symptoms.

Possible signs

Pelvic or perineal pain, pressure, pain when sitting, difficulty urinating or emptying the bowel, and a sense of never fully releasing may fit this pattern.

Relaxation is an active skillLetting go does not mean doing nothing. It requires awareness, confidence and coordination with breathing and movement.

Therapy may include

  • recognising and understanding tension
  • using breathing and mobility
  • reducing unnecessary tension in the abdomen, buttocks or jaw
  • gradually rebuilding coordination and capacity
Supported biofeedback training with a male patient

PROSTATE SURGERY

What matters before and after surgery

After prostate surgery, control of the urethra may temporarily change. Good preparation and correctly performed training can help you understand the new situation and develop suitable strategies.

Before surgery

If you can already identify, contract and relax the pelvic floor, it is often easier to return to familiar movement patterns after medical clearance.

After surgery

More is not automatically better. Healing, catheter removal, fatigue and individual continence determine when and how training begins.

Quality before quantityShort, focused sessions and the right strategy when standing, coughing or walking may be more useful than constant bracing.
Pelvic Tool biofeedback on a tablet

BIOFEEDBACK

Making invisible muscle activity visible

The pelvic floor lies inside the body, so it may be difficult to judge whether the intended movement is actually occurring. Biofeedback can display muscle activity visually.

Feedback may show

  • whether activation is detected
  • how well tension decreases again
  • whether effort is too strong or too long
  • how coordination changes over time
A tool, not the goalBiofeedback does not replace assessment or body awareness. It is used when additional feedback meaningfully supports learning.
Katja von Boetticher planning digital training

ONLINE

Training with a personal plan and chat

Continuity often matters more than one appointment. The online programme helps you integrate exercise into everyday life while travelling or living outside Spain.

What is included

  • individually selected exercises with clear instructions
  • a structured plan instead of a random exercise collection
  • chat for questions between appointments
  • adjustments based on your feedback and progress
Combine online and in-person careDepending on the symptoms, an initial in-person assessment may be advisable. Follow-up can then continue flexibly online.
Portrait of Katja von Boetticher

Your physiotherapist

Katja von Boetticher

For me, physiotherapy is not about training one muscle group in isolation. What matters is helping your body rediscover the right strategy at the right moment.
  • M.Sc. Physiotherapy
    specialised in functional pelvic floor therapy
  • More than 20 years of experience
    in prevention, sport and rehabilitation
  • Individual support
    for women and men – discreet, clear and practical
Palma Clinic Urology team with Katja von Boetticher
Alexandra · Dr. Stefan Kamp · Alice · Katja von Boetticher

Connected across disciplines

Pelvic floor physiotherapy as part of urological care.

The entire team connects urological assessment, physiotherapy findings, nursing care and the right support for daily life.

Flexible support

Online training programme – while travelling or living outside Spain.

Your personal programme stays accessible. Exercises, progress and questions are supported in a structured way – with direct chat.

Individually selected exercises instead of generic plans

Videos and clear instructions for independent training

Chat for questions and targeted adjustments

Monitor progress – regardless of location or travel plans

Frequently asked questions

In brief.

So you know what to expect before your first appointment.
Do I need a urological examination first?

Medical assessment is important for new, unclear or worsening symptoms. It helps identify possible causes and plan physiotherapy safely and specifically.
Is pelvic floor therapy only strengthening?

No. Depending on the findings, relaxation may be just as important as strength. Therapy also addresses awareness, coordination, breathing, pressure control and transfer into daily life or sport.
Is the therapy suitable for men?

Yes. Common topics include symptoms before or after prostate surgery, incontinence, urgency, voiding difficulties, pelvic pain or an overactive pelvic floor.
Can I train entirely online?

Online support can be especially useful for follow-up, everyday training and questions. Whether an in-person assessment is advisable at the beginning is discussed individually.

Next step

Let us talk about your symptoms.

Together we will clarify which starting point suits your situation – in person in Palma or supported online.
+34971905202